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Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
Intl. J. of Basic & Clinical Pharmacology     Open Access   (Followers: 3)
Intl. J. of Clinical Trials     Open Access   (Followers: 2)
Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 5)
Intl. J. of Contemporary Pediatrics     Open Access   (Followers: 4)
Intl. J. of Otorhinolaryngology and Head and Neck Surgery     Open Access  
Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 11)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 5)
Intl. J. of Research in Orthopaedics     Open Access  
Intl. J. of Scientific Reports     Open Access   (Followers: 2)
Intl. Surgery J.     Open Access   (Followers: 1)
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International Journal of Research in Medical Sciences
Number of Followers: 5  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-6071 - ISSN (Online) 2320-6012
Published by Medip Academy Homepage  [12 journals]
  • Materno-fetal outcomes in pre eclampsia in a rural hospital of
           Antananarivo Madagascar

    • Authors: Romuald Randriamahavonjy, Rosa L. Tsifiregna, Zafitsara Z. Andrianirina, Hery R. Andrianampanalinarivo
      Pages: 1064 - 1067
      Abstract: Background: Pre-eclampsia is a human-pregnancy-specific disease defined as the occurrence of hypertension and significant proteinuria in a previously healthy woman on or after the 20th week of gestation. It is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. The aim of this study is to determine the prevalence of pre-eclampsia and to evaluate its maternal and fetal outcomes in a rural area.Methods: This is a cross-sectional study carried out at the Bejofo Mahitsy hospital. It is a District Hospital Referral Center, which is located on the outskirts of the capital, 32 km from Antananarivo, Madagascar. This work was carried out during 24 months, from January 2014 to December 2016. We have included all hospitalized pregnant patients with SBP ≥140 or DBP ≥90mmHg, significant proteinuria> 300mg/24H with or without edema.Results: During this period, we recorded 97 cases of pre-eclampsia, frequency of 1.68%. The mean age of the parturient was 28 years old and 46.39% of the patients were primiparous. At the admission to the hospital, 37 (38,14%) did not show any particular signs. Concerning the severe high blood pressure, 47 pregnant patients (48,46%) had SBP greater than 160 mm Hg and 26 womens (26,80%) had DBP greater than 110 mm Hg. Caesarean section was the method of delivery widely adopted in 74.22 %. Maternal morbidity was represented by eclampsia in 21.65%, Retroplacentary Hematoma in 3% and HELLP syndrome in 4.12%. Fetal morbidity was important with 35% of premature newborns, 25.77% was small for gestational age and 12.37% was with neonatal asphyxia. Intra uterine fetal mortality was found in 11.34% and the perinatal mortality rate was 8.73%.Conclusions: There is a high frequency of pre-eclampsia in our setting and the consequences of pre-eclampsia for neonatal mortality and morbidity outcome are alarmingly high pre-eclampsia. Prevention necessarily involves quality prenatal follow-up such as screening, early and appropriate care of hypertension during pregnancy.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Use of transverse penile fasciocutaneous flap in management of long
           segment anterior urethral stricture at the Jos university teaching
           hospital, Jos Nigeria

    • Authors: Chimaobi G. Ofoha, Samaila I. Shu’aibu, Victor E. Onowa, Zingkur Z. Galam, Nuhu K. Dakum
      Pages: 1068 - 1072
      Abstract: Background: Urethral stricture may be defined as a narrowing of the lumen of the urethra due to scar tissue formation. It results from fibrosis and loss of compliance of the urethra leading to bladder outlet obstruction. Treatment of long segment urethral stricture is a huge challenge to the reconstructive Urologist. This study is to determine the aetiology of long segment urethral stricture, location of the stricture, use of distal transverse penile fasciocutaneous flap and the complications associated with the use of the flap.Methods: Twenty two patients with long segment anterior urethral stricture from 2014 to 2017 at the Jos University teaching hospital were included in the study. Patient assessment included complete history including past interventions for the urethral stricture disease, physical examination and radiological examination. Patient’s age, aetiology of stricture, stricture length, location of stricture, surgical management and complications were recorded.Results: Twenty two consecutive patients were involved in the study. The mean age was 48.8years with a range of 35 to 70 years. Post infection accounted for 64% of the strictures while catheter induced inflammatory stricture accounted for 36%. The mean length of the stricture was 9.4cm, with a range of 5cm to 15cm. Penile fasciocutaneous flap was used in all the repairs. Overall complication was 27.3%.Conclusions: Transverse penile fasciocutaneous flap is a well-vascularized pedicle and skin island. It is mobile and can be adapted to repair long segment anterior urethral strictures. Surgical complications include ring stenosis, penile skin necrosis and urethrocutaneous fistula.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • The association between blood glucose level and cognitive dysfunction
           among acute traumatic brain injury in Manado, Indonesia

    • Authors: Sekplin A. S. Sekeon, Mieke A. H. N. Kembuan
      Pages: 1073 - 1077
      Abstract: Background: Traumatic brain injury (TBI) is a public health challenge. TBI contributes to chronic physical impairment and also disrupt mental and personality aspects. Cognitive dysfunction is influenced by multiple factors, including blood glucose level. The objective of the study was to analyze the association between blood glucose level and cognitive dysfunction among TBI patients.Methods: A hospital-based observational study was conducted with cross-sectional design for six months period. Population of research were all of TBI patients treated at the emergency unit. Eligible sample were obtained with total sampling technique. Dyslgycemia was defined as random blood glucose level outside the range of 80-200mg/dl; cognitive dysfunction was defined as MMSE score <26. Statistical analysis with SPSS version 17.0 was employed. Chi square test and odd ratio were executed, p value <0,05 were regarded as significant level.Results: Majority of the 124 patients was male (75.8%), in 21-30 age group (20.7%), mostly due to RTA, specifically from motorcycle-related accident. Most of the motorcyclist (56,5%) were not using helmet. Unconsciousness was in 65.8% sample. Seizure was found in 3.9% of total patients; almost half of patients had history of headache (40.8%). Vomit was found in 30.3% of patients. Vertigo or dizziness post-trauma was in 3.9% patients; almost one third of patients had history of alcohol consumption (30.3%). Majority (65.8%) were in GCS 13-15. Proportion of dysglycemia and cognitive dysfunction were 4.8% and 14.5% consecutively. Odd ratio analysis revealed that dysglycemic group have 3 times higher risk to develop cognitive dysfunction, but the association was statistically not significant.Conclusions: The association between random blood glucose level and cognitive dysfunction among acute traumatic brain injury was statistically not significant.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Evaluation of the effects of Corchorus olitorius L. and Carapa procera in
           the treatment of obesity

    • Authors: Arsène M. Adon, Bognan A. A. J. Ackah, Guillaume Y. Yayé, Constantin O. Okou, Raoul K. K. Brahima, Joseph A. Djaman
      Pages: 1078 - 1081
      Abstract: Background: The obesity remains a pathology today which expands. It leads in its wake much pathology with very serious consequences. It is therefore necessary to take steps to curb this nutritional pathology. Thus, two plant species including Carapa procera and Corchorus olitorius have been tested to assess their effect on this pathology.Methods: Aqueous extracts of Carapa procera bark and Corchorus olitorius roots were tested on rats and biochemical parameters were evaluated. Besides, a chemical characterization was led.Results: These plant extracts contain bioactive molecules that have a regressive activity on the plasma levels of cholesterol, triglyceride and LDL-cholesterol. These bioactive molecules increase the level of HDL-cholesterol. These 2 species are non-toxic on renal, hepatic and pancreatic functions in view of the values of urea, creatinine and blood glucose.Conclusions: Of these 2 extracts, the aqueous extract of Corchorus olitorius is more active. 
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Investigation the effect of propranolol, metoprolol and carvedilol on
           spermatogenesis in rat testis

    • Authors: Huseyin Eren, Abdullah Sivrikaya, Umit Cobanoglu, Nuri Ihsan Kalyoncu, Ersagun Karaguzel, Murat Topbaş, Ilke Onur Kazaz, Mustafa Ozan Horsanali, Omer Kutlu
      Pages: 1082 - 1087
      Abstract: Background: Coronary arterial diseases are one of the increasing disease around the worldwide. Because of common using of the beta blockers, we aimed to investigate the effect of different beta-adrenergic receptor blockers on spermatogenesis in male rats.Methods: Adult male Sprague Dawley rats were obtained. Totally 32 rats homogenized according to their weight and divided into four groups that each one includes eight rats. Three of groups were determined as drug groups and remained groups were determined as a control group. Propranolol 40mg/kg, Metoprolol succinate 60mg/kg, Carvedilol 30mg/kg dosage was given by oral gavage within the saline solution, and the only saline solution was given to control group for 21 days, respectively. After 21 days rats were sacrificed, and testis were extracted. Then, histopathologic evaluation was performed.Results: There was statistical significance both right and left testis volume of experimental between control and carvedilol groups (p<0.05). There was statistical histopathological significance between control and carvedilol (p<0.05), control and propranolol (p<0.05), metoprolol succinate and propranolol (p<0.05), metoprolol succinate and carvedilol groups (p<0.05), respectively.Conclusions: Beta-adrenergic receptor blockers have adverse effects on spermatogenesis. Especially propranolol and carvedilol that were non-selective, effects spermatogenesis worse than selective beta blockers such as metoprolol succinate. Extensive use of these drugs may affect spermatogenesis in male, so male patients who have a complaint of infertility should be questioned regarding the use of beta blockers.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Assessing the irradiance levels of phototherapy devices in Jos, north
           central, Nigeria

    • Authors: Akinyemi O. D. Ofakunrin, Udochukwu M. Diala, Bose O. Toma, David D. Shwe, Sanusi Gidado, Tolulope O. Afolaranmi, Fidelia Bode-Thomas
      Pages: 1088 - 1093
      Abstract: Background: Neonatal jaundice (NNJ) remains a major cause of neonatal morbidity and mortality in Nigeria with significant contribution to the global figures. Effective phototherapy can reduce the complications associated with NNJ. The effectiveness of a phototherapy device (PD) depends mainly on the emitted irradiance of the device. We, therefore, assessed the irradiance of the PDs in Jos, North Central Nigeria in order to determine the effectiveness of the devices and to highlight the need for routine assessment of irradiance levels of PDs in low-middle income settings.Methods: This was a cross- sectional study involving 14 hospitals with a total of 38 functional PDs comprising of 25 (65.8%) locally fabricated, eight (21.0%) light- emitting diode (LED) and five (13.2%) conventional patented devices. The irradiance was measured using the BiliBlanket® light meter II.Results: The irradiance of the PDs ranged from 2 to 102μW/cm2/nm with a median value of 10.6 (IQR 6-18μW/cm2/nm).   Sixteen devices (42.1%) had a suboptimal irradiance (<10μW/cm2/nm); while only five (13.2%) provided irradiance at the intensive level (≥30μW/cm2/nm). The mean distance between the babies and phototherapy lights was 35.1±12.7cm (range 15-70cm).Conclusions: A significant proportion of the PDs in Jos delivered suboptimal irradiance which could reduce the effectiveness of the phototherapy. The irradiance of PDs needs to be assessed regularly and measures should be instituted to improve the irradiance to the optimum level in order to reduce the burden of kernicterus.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • The role of stress management and interpersonal communication in
           preventing violence against family physicians

    • Authors: Cuneyt Ardic, Guzin Zeren Ozturk
      Pages: 1094 - 1100
      Abstract: Background: Family physicians are the first line of contact with patients seeking primary care services. Therefore, they are vulnerable to violence from patients and family members. Therefore, aim of this study was to determine of stress management and interpersonal communication of the family physicians and examine the role of stress management and interpersonal communication to prevent violence.Methods: 736 family physicians were participated from 37 different provinces of Turkey. The scores of stress management and interpersonal communication were compared according to violence situations.Results: A 20.65% (n = 152) of the physicians participating in the study were subjected to physical violence; their interpersonal communication scores were significantly lower than those of physicians who had not been subjected to physical violence (p = 0.022). Among the participants, 90.77% (n = 668) were subjected to verbal violence; their interpersonal communication scores were significantly lower than those of participants who had not been subjected to verbal violence (p = 0.012). Although the interpersonal communication scores were low and statistically related at the participants who had been subjected to violence.Conclusions: This study revealed that the interpersonal communication and stress management scores were low at the participants who had been subjected to violence; only interpersonal communication was statically related. Therefore, stress management and interpersonal communication is very important to protect from violence, we suggested that this should be part of the curriculum of medical schools and postgraduate education.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Effect of exercise on heart rate recovery index in normotensive offspring
           with family history of hypertension

    • Authors: Amrendra Jha, Prajwal Karki, Ritika Agrahari, Neha Kumari
      Pages: 1101 - 1105
      Abstract: Background: The relationship between autonomic system and cardiovascular mortality is significant and this study can be used to study the hereditary risk that an individual carries to develop any autonomic dysfunction and its effect on cardiovascular status. In this study, we aimed to investigate the heart rate recovery index and prevalence of cardiovascular risks in subjects with hypertensive parents.Methods: A total of 30 subjects and 30 healthy controls were recruited in the study. Their anthropometrical and cardiovascular parameters were recorded. Heart rate, blood pressure, weight and height of subjects were measured and BMI calculated. After 3 min step test heart rate will be measured in 1, 2, 3 and 5 minute and heart rate recovery index calculated by subtracting maximum heart rate achieved during exercise by heart rate measured in 1,2,3 and 5 minute. The heart rate recovery index (HRRI) is calculated by extracting the maximum heart rate during treadmill stress testing from the heart rate.Results: The 1st minute HRRI was not significantly different in the groups (43.87±11.54 and 43.00±18.77 respectively, p=0.88). Likewise, the 2nd minute HRRI (50.07±10.38and49.07±16.32 respectively, p=0.843), 3rd minute HRRI (53.33±12.72 and 53.60±17.56 respectively, p=0.962), 4th minute HRRI (55.07±13.25 and 54.60±14.73 respectively, p= 0.928) and 5th minute HRRI (56.33±14.58 and 54.87±14.93 respectively, p=0.788) were also not significantly different.Conclusions: Findings of this study suggest that in the absence high arterial pressure and other comorbidities, a family history of hypertension is not accompanied by dysfunction of autonomic system.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Prevalence of hypertension and associated factors in a rural community in
           Bayelsa State

    • Authors: Oghenekaro G. Egbi, Dimie Ogoina, Abisoye Oyeyemi
      Pages: 1106 - 1113
      Abstract: Background: Hypertension is considered among the most common non-communicable diseases globally with significant morbidity and mortality. Closely related to it is pre-hypertension, a category between hypertension and normotension which is believed to be a forerunner to hypertension and cardiovascular disease. Hypertension has been on the increase in recent times, even in rural communities which were previously less affected. The study was carried during the world health day as a screening exercise to determine the prevalence of hypertension and its associated factors in a rural community.Methods: This cross-sectional study was conducted in Ogboloma village, a small rural community in Bayelsa State, Ngeria Consecutive sampling of all eligible participants who presented for the screening exercise was done. Socio-demographic data, clinical history, anthropometry and blood pressure were taken. Data was stored and analyzed using SPSS version 20.0.Results: One hundred and thirty-one participants completed the study. There were 49(37.4%) males. The prevalence of hypertension was 50.4% while pre-hypertension was found in another 41.2%. Factors associated with hypertension on univariate analysis were age (p <0.001) body mass index (p=0.038) waist hip ratio (p=0.008) hyperglycemia (p=0.030) and smoking (p=0.009) However, only age (p=0.004) and smoking (p=0.037) remained significant on multivariate analysis.Conclusions: Hypertension and Pre-hypertension were highly prevalent in this rural community. Age and smoking were significant predictors of hypertension. Hypertension screening and control programmes should therefore target rural communities and smokers.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Association of chronic viral hepatitis with ABO blood groups and rhesus
           (Rh) factor

    • Authors: Hassan Abdullah Shakeel, Hamza Maqsood, Basit Ali, Ali Raza Khan
      Pages: 1114 - 1118
      Abstract: Background: Chronic viral hepatitis includes hepatitis B and hepatitis C and is responsible for causing the deaths of millions of people all across the world each year. Although there are small studies in literature about association between ABO blood groups and chronic viral hepatitis, only few studies found relation between them. The objective of this case control study is to establish a relation between the host factors and these viral infections.Methods: This is a case control study on patients diagnosed with CVHB and CVHC. The study was conducted on 508 patients reported to Nishtar Hospital, Multan and Sheikh Zayd Hospital, Rahim Yar Khan, Pakistan.709 healthy blood donors were selected as a control group from Nishtar Hospital blood bank during December 2016 and December 2017.The results were subjected to SPSS v.20 for analysis using the chi square test. The patients and blood donors were also asked about certain demographic factors like age, sex and blood transfusions.Results: Among CVHB patients,173(100%), the distribution of blood groups was following: Group A, 38 (21.96%), B, 57 (32.94%), AB, 11 (6.35%), O, 67 (38.72%). 158 (91.32%) were Rh positive and 15 (8.67%) Rh negative. In CVHC patients, 335 (100%), the distribution was following: Group A, 69 (20.59%), B, 123 (36.71%), AB, 24 (7.16%), O, 119 (35.52%). 303 (90.44%) were Rh positive while 32 (9.55%) were Rh negative. In healthy blood donors, 167 (23.55%) were group A, 225 (31.73%) group B, 41(5.78%) group AB, 276 (38.92%) group O.632 (89.13%) were Rh positive and 77 (10.86%) Rh negative.Conclusions: There was no significant difference between blood groups(p>0.5) and Rh(p>0.5) with chronic viral hepatitis. However, it was also observed that the infections of HCV increase among (26-45) years old patients while the HBV infections increase with progression of age. Association of chronic viral hepatitis infection with blood group types needs more studies to get more knowledge about this aspect.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Asymptomatic UTI in pregnancy attending at tertiary care of Nepal

    • Authors: Laxmi Kumari Yadav, Ram Lochan Yadav
      Pages: 1119 - 1128
      Abstract: Background: Urinary tract infections (UTI) during pregnancy issued by improper laboratory investigations situate women at risk of several detrimental complications. Untreated asymptomatic UTI (AUTI) may lead to pyelonephritis preterm birth, low birth weight, etc. Urine culture is used to confirm the diagnosis of UTI. Aim of this research was to carry out to find the prevalence of asymptomatic UTI and to establish antimicrobial drug susceptibility of the pathogens resulting asymptomatic UTI in pregnant women attending at tertiary care, Nepal.Methods: The urine samples were collected by mid-stream clean catch method from 600 pregnant women of age 15-45 years (mean age – 28.84 years) visiting for antenatal check up in the Department of Gynaecology and Obstetrics, Chitwan Medical College (CMC), a tertiary care of Nepal. All the urine samples were subjected to bio-physical, biochemical, microscopic, and microbiological analysis. The prevalence of UTI in three trimesters and in different age groups was obtained together with antimicrobial drug susceptibility tests.Results: On overall l51.83% of urine samples revealed with significant bacteriuria considered as the AUTI. On One- way ANOVA test, there was significant (P< 0.045) prevalence of AUTI when compared among different trimesters, though higher prevalence being in the first (40%) and second (45.33%) trimesters. The prevalence of AUTI was significant (P<0.004) among different age groups of the pregnancy. However, the most affectecd age groups were between 21-29 years. Escherichia coli were the most implicated organism (67.8%) followed by Klebsiella pneumonia (21.6%). The gram-negative bacteria (E. coli, K. pneumonia, and K. oxytoca) were more sensitive against Amikacin, Gentamycin, Meropenem, and Nitrofurantointhan. Other drugs whereas; gram positive bacteria (E. feacalis) had high susceptibility with Vancomycin.Conclusions: There was high incidence of AUTI among the pregnant ladies in the study region; therefore, microbial screening of urine of all pregnant women are must and should be included in the routine antenatal checkups to detect the AUTI to cut down and prevent the maternal and obstetric detrimental complications in them.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Determination of the dose and time dependent toxicological effects of
           hydroalcoholic extract of Terminalia catappa kernel on the renal functions
           parameters of wister rats

    • Authors: Nimisoere P. Batubo
      Pages: 1129 - 1133
      Abstract: Background: The use of herbal medications has been implicated to cause renal toxicity and failure. Terminalia catappa has been used in ancient tradition in the treatment several diseases. This study aimed to determine the dose and time related effects of the hydroalcoholic extract of Terminalia catappa on the renal functions of Wister rats following long time period of administration.Methods: Forty female Wister rats were used as experimental animals and equally divided into 5 groups. The hydroalcoholic extract of Terminalia catappa were administered on the experimental animals for 42 days. Three groups were treated orally with three different doses of Terminalia catappa hydroalcoholic extract; 0.5g/kg, 1.0g/kg and 3.0g/kg respectively while another two groups as control. Signs of toxicity in the experimental rats were determined by the number of death, nutritional behaviour and physiological characteristics of the animal by observation while blood sample was collected for the determination of renal functions parameters.Results: No death was recorded in all test groups during the period of the study. The nutritional behaviour of the rats was not affected and no abnormalities in the physiological characteristic of the rats were detected. The renal functions parameters (Na+, K+, Cl-, HCO3-, Urea, Uric acid and Creatinine) were not significantly (p>0.05) altered.Conclusions: Based on the results, it can be concluded that there were no nephrotoxic effects of hydroalcoholic extract of Terminalia catappa on Wister rats and therefore it can be said to have a wide margin of safety for use and consumption.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Contemporary management of genitourinary injuries in a tertiary trauma
           centre in Nigeria

    • Authors: Chimaobi G. Ofoha, Samaila I. Shu'aibu, Victor E. Onowa, Zingkur Z. Galam
      Pages: 1134 - 1138
      Abstract: Background: The genitourinary system has been shown to be involved in 10% of patients presenting after trauma and is therefore a significant factor in trauma induced morbidity and mortality. It affects all age groups and both sexes. The aim of this study is to determine the aetiology, mechanism of injury and management of genitourinary injuries in a tertiary trauma centre.Methods: This is a prospective study carried out at the Jos University Teaching Hospital between 2012 and 2017. All patients who presented at the A and E with genitourinary trauma were recruited into the study. Initial assessment involved taking an AMPLE history and resuscitation, using the Advanced Trauma Life Support (ATLS) protocol of the American College of Surgeons. Physical examination and investigation were carried out to localize and determine extent of injury. Investigations carried out were complete blood count, blood grouping, serum electrolyte, urea and creatinine and radiography where applicable. Surgical intervention was carried out where indicated.Results: A total of 104 patients were involved in this study. The mean age was 32.14±15.5 years with a range of 3 to 75yrs. Median age was 28yrs. Eighty-nine (85.6%) were males while fifteen (14.4%) were females. The genitalia were the most affected in 34% (n=35) of the patients. Gunshot was the commonest mechanism of injury (37.5%, n=39). Operative and non-operative management were employed depending on mechanism and extent of injury.Conclusions: Gunshot was the commonest cause of genitourinary trauma. These injuries require specialized attention for proper assessment and management. 
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Prognostic role of robinson cytological grading system in breast cancer in
           correlation with the histological grading of modified bloom richardson in

    • Authors: Noora M. Kareem, Nihad Salih Rahmatullah
      Pages: 1139 - 1143
      Abstract: Background: The breast cancer is increasing in developing countries and the management options are widened, therefore providing the surgeon with accurate prognostic information on which the mode of therapy will be chosen became so important. Robinson grading system was found to be useful in grading breast carcinoma in fine needle aspirates. The objectives of the study were to estimate the benefits of using Robinson grading system in fine needle aspiration for breast cancer and to estimate the correlation of Robinson grading system in fine needle aspiration with histological grading.Methods: There were Seventy cases of invasive ductal carcinoma was graded on FNA aspirates by Robinson grading system using six cytological parameters (cell dissociation, cell size, cell uniformity, nucleolus, nuclear margin, and nuclear chromatin).Results: The concordance rate between grade I tumors on cytology and histology was 100%, while for grade II tumors it was 62.5% and for grade III tumors it was 100%. The absolute concordance rate was 87.5%, the Spearman rank correlation coefficient (r) was 0.762, p value was (0.00), the sensitivity of Robinson’s cytological grading system in cytological grade I tumors was 73.33% and specificity was 100%. In cytological grade II tumors the sensitivity was 100% and specificity was 76% and in cytological grade III tumors the sensitivity is 100% and specificity was 100%.Conclusions: Robinson’s cytological grading of breast carcinoma correlates well with Bloom-Richardson’s histological grading system and could be a helpful parameter in selecting a neoadjuvant treatment for the breast cancer patients on fine needle aspiration cytology alone.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Impact of tranexamic acid on coagulation parameters in patients undergoing

    • Authors: Ajit Kumar Singh, Gagan Kumar Narula, Bala Chandran Nambiar, Parvinder Singh Bedi, Deeparani S., Moloy Rajkhowa
      Pages: 1144 - 1150
      Abstract: Background: A growing body of evidence has shown Tranexamic Acid (TXA) is effective in decreasing perioperative blood loss and transfusion requirements in both primary and revision joint arthroplasty. TXA is a synthetic drug which limits blood loss through inhibition of fibrinolysis and clot degradation. It helps reduce requirement of colloids and crystalloids and hence provides better haemodynamic stability. The aim of this study was to detect the effect of tranexamic acid on coagulation parameters and effect on bleeding in knee replacement surgeries performed under tourniquet.Methods: Patients undergone surgeries of Total Knee Replacement (TKR) performed under tourniquet were included in the study. A single dosage of 20 mg/kg per body weight of tranexamic acid was administered after application of a tourniquet. Three times blood sample was collected, and coagulation parameters were recorded and compared. The first sample was collected at the time of TXA injection and application of a tourniquet, second after 4 hours and third after 24 hours post TXA injection. Coagulation parameters noted were analyzed using Statistical analysis by SPSS software. All parameters were compared in relation to baseline i.e. at the time of TXA injection.Results: On comparison of demographic profile, morbidity, sofa score and hemodynamic parameters there was the insignificant difference (P > 0.05). Repeated measures of ANOVA at 95% Confidential Interval P value was 0.000 which is less than the significant level that is 0.05 so that value of Platelet Function (PF), Activated Coagulation Time (ACT) and Clot Rate (CR) at 0 hrs, 04 hrs and 24 hrs was statistically significant. Correlation between blood loss and difference of the value of ACT at 0 hrs and 04 hrs is a small negative correlation but statistically nonsignificant (P value is 0.359).Conclusions: After TXA administration there is a change in coagulation parameters like an Activated Coagulation Time (ACT), Platelet Function (PF), and Clot Rate (CR) measured at three intervals, hence it can be a guide to detect early derangement in the coagulation profile in a patient undergoing knee replace surgery. TXA correlation between blood loss with changes in parameters of coagulation i.e. ACT, PF and CR were noted but not significant.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Study of glycemic gap in hyperglycemic emergencies of type 2 diabetes

    • Authors: Periyasamy Sivakumar, Thiyagarajan Manjuladevi Moonishaa, Neethu George
      Pages: 1151 - 1155
      Abstract: Background: Type 2 diabetes mellitus (T2DM) is associated with two serious hyperglycemic emergencies namely Diabetic ketoacidosis (DKA) and Hyperosmolar hyperglycemic state (HHS). The aim of the study was to determine the usefulness of glycemic gap in T2DM patients with DKA and HHS.Methods: T2DM cases above 20 years of age were included in this study. The study population was divided into three broad groups as T2DM without hyperglycemic emergencies, T2DM with DKA, T2DM with HHS, with 50 subjects in each group. Glycemic gap was calculated in the study population and compared between the three groups. The relationship between glycemic gap and the conventional indicators of severity in hyperglycemic emergencies of T2DM were determined.Results: Of the three study groups, T2DM cases with HHS presented with substantial alterations in the baseline biochemical parameters. The glycemic gap was also highly elevated in the HHS cases than the others. Glycemic gap showed significant correlation only with plasma osmolality of the HHS cases.Conclusions: Elevated glycemic gap indicating stress induced hyperglycemia (SIH) occur in hyperglycemic emergencies of T2DM, especially HHS. 
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Study the body mass index (BMI) of HIV patients at tertiary centre, Madhya
           Pradesh, India

    • Authors: Dinesh Kumar Malviya
      Pages: 1156 - 1160
      Abstract: Background: Individuals at all stages of HIV disease are at risk of nutritional deficiency, and nutritional status is a strong predictor of disease progression, survival, and functional status during the course of the disease.Methods: It was an observational study including 269 HIV positive patients who were willing to be a part of the study. HIV individuals not willing to undergo above study were excluded from the study. The aim of our study was to assess the of body mass index in HIV patients at tertiary centre, Madhya Pradesh. Nutritional status was evaluated by using internationally accepted BMI guidelines given by World Health Organisation.Results: In this study, mean age of male HIV patients was 37.21±10.59 and mean age of female HIV patients was 34.27±8.46. Out of the 269 HIV patients, majority of 138 (51.30%) HIV patients have BMI 18.50-24.99 and 122 (45.35%) HIV patients having BMI less than 18.50. Prevalence of undernutrition in male HIV patients was 50 (36.76%) out of 136 male HIV patients and female HIV patients was 72 (54.14%) out of 133 female HIV patients. Out of 261 HIV patients, 225 (86.2%) patients have CD4 count more than 200. Patients having CD4 count less than 200, majority of patients had undernutrition that is 20 (55.56%) out of 36 HIV patients.Conclusions: The regular measurement of Body Mass Index (BMI) in centre with limited resource may therefore be useful to clinicians in monitoring patient’s response to antiretroviral therapy and predicting the stage of the disease.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Incidence of types of hypospadias in and around Tumkur district,
           Karnataka, India: an anatomical classification

    • Authors: Suresh N. M., Subramanya Kattepura, N. Yathindra, Khizer Hussain Afroze
      Pages: 1161 - 1164
      Abstract: Background: Hypospadias is the second most common congenital anomaly in children. It is characterized by the abnormal ventral opening of the urethral meatus. Abnormal urethral opening may be located on the penile shaft, scrotum or perineum respectively. This article mainly deals with the embryology, etiology, anatomy and incidence of different types of hypospadias in Tumakuru rural district.Methods: This study was interdepartmental and prospective, consisting of 80 cases conducted at department of pediatric surgery and Anatomy and the period of study was from April 2013 to March 2017. The hypospadias have been classified into 1) Proximal hypospadias 2) Midshaft hypospadias, 3) Distal Hypospadias according to the location of external urethral opening.Results: Out of the 80 cases, distal hypospadias is the most common incidence followed by midshaft and proximal hypospadias.Conclusions: The condition is repairable in the vast majority of cases, leaving a functional and normal looking penis. Early diagnosis and surgical intervention, hypospadias and chordee repair procedures are highly successful and can avoid the emotional distress.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Visual evoked potentials in children with type 1 diabetes mellitus

    • Authors: Meenal Batta, Rajeev Sharma, Naveenta Gupta, Sonia Garg, Gurmeet Kaur, Shashi Kant Dhir, Amarpreet Kaur
      Pages: 1165 - 1168
      Abstract: Background: Insulin-dependent (type 1) diabetes mellitus is associated with different degrees of neuropathies affecting peripheral as well as central neural pathways. The subclinical neurological involvement in diabetic children can be assessed by changes appearing in the electrophysiological parameters like Visual Evoked Potentials (VEPs). The objective of the study was to assess the effect of type I diabetes melitus on the visual evoked potentials in children.Methods: This cross-sectional case-control study was done on 30 children with type 1 diabetes mellitus of minimum two years duration as cases and 30 age and gender matched euglycemic children with normal HbA1c taken as controls. Visual Evoked Potentials (VEPs) were done on both the groups of children and the latencies (ms) of waves -N75, P100, N145 and amplitude (μV) of wave P100 were recorded. The data was compiled in the pre-designed proforma and statistically analysed using student t-test.Results: The increase in the mean latencies of waveforms of VEPs N75, P100 and amplitude P100 were found to be highly significant statistically (p<0.001) in both the eyes among the children with type 1 diabetes mellitus. The mean latency of waveform N145 was found to be statistically insignificant in the two groups (p>0.05).Conclusions: The type 1 diabetes does affect the visual pathways in children. Visual Evoked Potentials are helpful in the detection of early changes in the conduction across the neural pathways in the sub-clinical diseases.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • The incidence of AmpC β-lactamases producing Klebsiella pneumoniae
           subspecies pneumoniae

    • Authors: Priyanka Singh
      Pages: 1169 - 1173
      Abstract: Background: AmpC β- lactamases in the clinical isolates reduces the therapeutic value of β- lactam- β-lactam inhibitor combinations. if not detected can be disseminated in the hospital environment and pose a serious therapeutic challenge. Hence present study is undertaken to detect the incidence of AmpC β -lactamases producing Klebsiella pneumoniae subspecies pneumoniae out of total 300 Klebsiella pneumoniae subspecies pneumoniae isolated from different clinical samples of the patient attending Jawaharlal Nehru Medical College and its hospital in Dept of Microbiology.Methods: Isolates are screened for presumptive AmpC production by testing their susceptibility to Cefoxitin using Kirby-Bauer disk diffusion method. Phenotypic confirmatory tests for detection of AmpC β- lactamases by Modified three dimentional test, Amp C disc test, Amp C disc test with Inhibitor (Boronic Acid) based disc potentiation test.Results: In our present study 75 (25%) Klebsiella pneumoniae strains were positive for AmpC β lactamases production either alone or in combinations with other β- lactamases. 75 strains were positive for AmpC β-lactamase (25%). These 75 strains were further confirmed by E Test.Conclusions: Overproduction of AmpC β- lactamases by mutation is responsible for resistance. if not detected can be pose a serious therapeutic challenge. So, its detection improves the therapeutic outcome in patient care.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • The relation of serum GGT level in patients with non valvular atrial
           fibrillation and normal sinus rhythm

    • Authors: C. L. Nawal, Radhey Shyam Chejara, Ankush Panwar, M. K. Agrawal, Aradhana Singh, P. D. Meena
      Pages: 1174 - 1178
      Abstract: Background: The primary objective of the study was to assess and compare the relation of serum GGT level in patients with non valvular atrial fibrillation and normal sinus rhythm. The fundamental mechanisms underlying AF remains poorly understood. Oxidative stress is hypothesized to induce and maintain nonvalvular atrial fibrillation particularly in elderly patients. GGT levels are increased in patients with chronic inflammation. Increased serum levels of GGT are found in chronic nonvalvular atrial fibrillation (AF) patients as compared with patients in sinus rhythm.Methods: We included 75 patients of nonvalvular atrial fibrillation and 75 patients of sinus rhythm after applying exclusion criteria. Serum level of gamma glutamyl transrerase (GGT) of both the groups was compared.Results: Presence of coronary artery disease, hypertension, gender, hyperlipidemia, diabetes mellitus and smoking status were comparable between the 2 groups (P > 0.05 for all). Serum gamma glutamyl transferase activity in 75 cases was 71.45±26.21 with maximum being 147 IU/L more than the normal range for age, whereas in controls it was 19.68±5.53 i.e. much within the normal range for age.Conclusions: At the end of the study we concluded that serum GGT levels were significantly higher in patients with chronic nonvalvular atrial fibrillation (AF) patients as compared with patients in sinus rhythm.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Latent coronary artery disease among smokers and smokeless tobacco users:
           a cross-sectional study

    • Authors: Dheerendra Kumar Mishra, Nimisha Mishra, Pradeep Kumar, Gyanendra Raghuvanshi
      Pages: 1179 - 1182
      Abstract: Background: Tobacco related mortality and morbidity and increase in developing country like India. WHO projected till 2020 India will accounts 15% of tobacco related mortality especially preventable causes of death e.g. cardiovascular disease. Active tobacco smoking is undoubtedly major risk factor for cardiovascular disease, but subjects use smokeless tobacco in dependence pattern is not extensively evaluated for cardiovascular risk factor. In India smokeless tobacco especially Khaini is major form of tobacco consumption. Scarcity of data on effects of smokeless tobacco in cardiovascular disease especially coronary artery disease major limiting factor for undermine the detailed evaluation of cardiovascular effects in smokeless tobacco dependence subjects. The aim of the study was to study the risk of coronary artery disease among smokeless tobacco dependence in comparison to tobacco dependence smokers.Methods: Cross-sectional assessments were done on 36 adults (>18 years), treatment-seeking patients with a ICD 10 diagnosis of Mental and behavioral disorders due to use of tobacco. Data was collected on socio-demographic characteristics, and after detailed clinical evaluation treadmill exercise test was done.Results: Mean age of tobacco dependence smokers 51.5±9.6 years vs 53.6±7.5 years. There were male predominant in study subjects and 38% subjects was treadmill test positive. Smokeless tobacco users had 35% positive treadmill test, and among Smokers 42% subjects was positive for treadmill test.Conclusions: Risk for latent coronary artery disease was similarly higher in smokers and smokeless tobacco dependence subjects.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Obsessive compulsive symptoms in patients with primary generalized and
           partial onset epilepsy

    • Authors: Sagar Lavania, Mohd. Aleem Siddiqui, Shantanu Bharti, Abhishek Kumar
      Pages: 1183 - 1186
      Abstract: Background: To find out and compare the obsessive-compulsive symptoms / disorder among patients of primary generalized and partial onset epilepsy.Methods: Patients with epilepsy diagnosed clinically at psychiatric out patient’s department were selected for the study and categorized as primary generalized onset tonic clonic seizure type and partial onset seizure. Yale-Brown obsessive-compulsive symptoms check list and scale was applied to find out the obsessive-compulsive symptoms.Results: A total of 110 patients were categorized as primary generalized (GE) 49 and partial onset epilepsy (PE) 61 patients. Obsessive-Compulsive Symptoms (OCS) were found to be 19.9%, and OCD among 3.63%. Mean Y-BOCS scores for obsession were found to be 3.77±1.93 and 4.93±2.03, (t = -3.034, df= 108, p= .003). Whereas the mean Y-BOCS compulsions score was 2.93±1.96 and 4.62±1.87 was (t = -4.590, df= 108, p= .000) for GE and PE group respectively.Conclusions: OCD and OCS among the epilepsy patients were found to be 3.63%, and 19.9% respectively, and significantly higher mean obsessive and compulsive score were found for the group of partial onset epilepsy.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Clinical profile of patients with pancytopenia in a tertiary care centre

    • Authors: Jyotsana ., Khan Afreen, Vishakha Sharma, Prem Kapur, Smita Manjavkar, Vineet Jain, Sunil Kohli, Anwar Habib
      Pages: 1187 - 1190
      Abstract: Background: Pancytopenia is a condition in which all three cell lines i.e. erythroid, myeloid and megakaryocytic are affected resulting in anaemia, leukopenia and thrombocytopenia. It can be a manifestation of a wide variety of disorders which primarily or secondarily affect the bone marrow. Early diagnosis of these conditions will help in implementing the appropriate treatment. The objective of the study was to know the clinical presentation and etiology of patients presenting with pancytopenia.Methods: A one year study from April 2016 to March 2017 was conducted in the department of medicine at a tertiary care centre. Total 32 patients with pancytopenia were studied to determine their clinical features and etiology through relevant investigations.Results: Our study revealed megaloblastic anaemia (46.87%) as the most common cause of pancytopenia, followed by malaria (12.5%). Other causes included hypothyroidism (6.2%), hypersplenism (6.2%), drugs (12.5%) and miscellaneous (9.43%).Conclusions: Megaloblastic anaemia was found to be the major cause of pancytopenia in patients. Other causes of pancytopenia were malaria, drugs, hypersplenism and hypothyroidism. These should be kept in mind while evaluating patients with pancytopenia.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Brain MRI: a useful tool for screening of hypertensive patients for silent
           cerebro-vascular damage

    • Authors: Meena K. Rana, Manish K. Thakur, Dhruv Gupta
      Pages: 1191 - 1196
      Abstract: Background: Worldwide hypertension is an important public-health challenge because of its high frequency and concomitant risks of cardiovascular, renal, cerebrovascular disease and death. Current guidelines for the management of hypertension mainly recommend the search for preclinical damage to the heart and kidneys. However, extending this search to other organs, for instance the brain, might improve risk stratification, might optimize antihypertensive therapy and might, in the end help to further reduce the burden of disease attributable to hypertension.Methods: 84 consecutive hypertensive patients with no target organ damage were enrolled in study to find out silent brain damage over a period of one year.Results: Mean body mass index (BMI) of the study population was 28.4±2.5 kg/m2 (range 23.2 to 35.3kg/m2). 33 (39.3%) subjects had white matter lesions. 13 (15.47%) study subjects were found to have vascular changes which included micro angiopathic changes, infarcts and reduced/slow blood flow. 33 (39.3%) subjects were found to have normal brain MRI in the study. Early brain MRI was found to be beneficial in patients who had uncontrolled blood pressure either due to lack of treatment or irregular use of anti-hypertensive treatment. This was true for every age group in general and particularly in subjects above the age of 50 years.Conclusions: The screening of hypertensive patients for silent cerebrovascular damage with brain MRI may be useful in stratifying the risk of future cerebrovascular disease.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • A comparative study of parasympathetic function tests during different
           phases of menstrual cycle in young healthy females

    • Authors: Shaily Verma, Prashant Khuraiya, Rajni Soni
      Pages: 1197 - 1202
      Abstract: Background: The hormonal fluctuations that occur during normal menstrual cycle has profound influence on autonomic functions. This influence on autonomic nervous system may affect cardiovagal control. The aim of the study is to find out the variation of Parasympathetic function tests during different phases of menstrual cycle in young healthy females.Methods: The present study was carried out on 50 healthy female subjects with normal menstrual cycles between the ages of 18 to 25 years. Various non-invasive parasympathetic function tests during different phases of menstrual cycle were performed that include Resting heart rate (RHR), Heart rate variation during deep breathing (E:I Ratio), Heart rate response to standing (30:15 Ratio), Heart rate response to Valsalva maneuver (Valsalva Ratio). The results were analysed using ANOVA and student’s paired-t tests.Results: During the menstrual cycle, we found varied heart rate response with higher values towards the luteal phase, when compared to the follicular phase and the menstrual phase. There was a statistically significant difference in the heart rate parameters like resting heart rate, 30:15 ratio, valsalva ratio and E:I ratio during the three phases of menstrual cycle.Conclusions: The study concludes that there was statistically significant heart rate variability during three phases of the menstrual cycle, as observed by the increased sympathetic discharge in the luteal phase compared to the increased parasympathetic discharge in the follicular phase. The results of our study have emphasized the complexity of the relationship between ovarian steroids and various hemodynamic regulatory systems.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Effectiveness of deep breathing and walking exercise in reducing
           menopausal symptoms among women at Karadivavi, India

    • Authors: Sreerenjini B., Muthulakshmi .
      Pages: 1203 - 1206
      Abstract: Background: Menopause has been defined as the point in time of the last menstrual bleeding in a women’s life. Menopausal symptoms affect about 70% of women. The objectives of the study were assessment of the women for menopausal symptoms, assessment of the effectiveness of exercises in reducing menopausal symptoms and associate the demographic variables with menopausal symptoms.Methods: One group pre test and post test design was adopted for the study. Allowable error method was adopted to select the desired sample. The sample size was 30. Demographic profile and menopausal symptoms information were collected. Menopausal symptoms were assessed by Menopausal rating scale. The data collected were analyzed by using both descriptive and inferential statistics method. Paired ‘t’ test was used to compare the pretest and posttest level of menopausal symptoms.Results: Majority of the women (80%) had moderate menopausal symptoms before practice of deep breathing and walking exercise. After practicing exercises only four women had mild menopausal symptoms and 70% of the women relieved from joint pain. Association was found between age at first conception, number of conception, medical problems with pretest menopausal symptoms score.Conclusions: This study review shows that Deep breathing and walking exercise was helpful in reduction of menopausal symptoms among menopausal women. This result can be potentially employed as one of the complementary therapy in the reduction of menopausal symptoms.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Effect of a plant versus animal based diet on lipid profile of yoga
           practicing medical students: a pilot study

    • Authors: Sanasam Meetali, Shashikiran H. C., Prashanth Shetty, Ganesh Prasad, Chandrakanth K. K.
      Pages: 1207 - 1210
      Abstract: Background: Foods play an important role in human health. An excess accumulation of cholesterol in the body is one of the main causes of cardio vascular disease, hypertension, type 2 diabetes mellitus, dyslipidemia and mortality. In the interests of food safety and public health, plants and their compounds are now re-emerging as an alternative approach to treat gastrointestinal diseases. The present study was designed to discuss changes in blood cholesterol levels after the consumption of animal based (non vegetarian) and plant based (vegetarian) food on yoga practising medical students.Methods: Of 81 subjects, a total of 60 subjects within the age group 18 to 22 years were selected for the study and were divided into two groups, non-vegetarian diet group (group A; n=30) and vegetarian diet group (group B; n=30). Subjects in the group A were given a non vegetarian diet and group B a vegetarian diet for a period of 10 days. Assessments were done at baseline and after 10 days.Results: There were no statistically significant changes seen in the lipid profiles of group B and group A after the application of a paired t test. In this study the mean value of total cholesterol, serum triglyceride, serum LDL and serum VLDL were found to be slightly higher in vegetarian group than the non-vegetarian group. Mean value of serum HDL was found to be higher in non-vegetarian group than the vegetarian.Conclusions: The present study concludes that there are more changes in the pre and post lipid profile assessments of the vegetarian group in comparison to the non-vegetarian group.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Profile of arrythmogenic right ventricular cardiomyopathy/dysplasia
           (ARCV/D) patients presenting with sustained ventricular tachycardia in a
           tertiary care center

    • Authors: Rahul Sudan, Irfan Yaqoob, Khursheed Aslam, Mehroz Ahmad
      Pages: 1211 - 1216
      Abstract: Background: Arrhythmogenic right ventricular cardiomyopathy /dysplasia (ARVC/D) is a genetic form of cardiomyopathy and is one among the most common causes of sudden cardiac death (SCD). The aim of our study was to analyze the clinical profile of (ARVC/D) patients presenting with sustained Ventricular Tachycardia (VT).Methods: This single center cohort study evaluated 107 patients who presented with sustained ventricular tachycardia (VT) in our hospital. After aetiological evaluation of all these patients, 15 patients were found to have ARVC/D as the cause of sustained ventricular tachycardia (VT) as per the Modified Task Force Criteria. The clinical profile of these patients was observed in detail to enhance our knowledge about this entity in our part of the world.Results: Mean age at presentation was 30 years and 12 patients were males. Nine patients were haemodynamically stable at the time of sustained VT and the rest of patients were haemodynamically unstable. Left Bundle Branch Block (LBBB) was the most common ECG morphology present in 11 patients. Antiarrhythmic drugs terminated VT in 7 patients. All the 6 patients presenting in a state of haemodynamic instability received DC cardioversion. Mortality occurred in 2 patients during the hospital stay.Conclusions: ARVC/D presenting with sustained VT is an important manifestation of the disease. Males are more commonly affected than females. Haemodynamic instability at the time of presentation carries a poor prognosis.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Histopathological study of nasal lesions: 2 years study

    • Authors: Nisha Jayantilal Parmar, Deepa P. Jethwani, Gauravi A. Dhruva
      Pages: 1217 - 1223
      Abstract: ackground: Majority of the nasal lesions are polypoid. It is difficult to comment upon the nature of the nasal lesion- whether neoplastic or non-neoplastic. Hence histopathological examination is essential for both ENT surgeons as well as pathologists. Aim to study the incidence of different nasal lesion. Also, to find out frequency of inflammatory, benign and malignant conditions of nasal lesions and to compare various histopathological lesions of nasal mass in relation to age, sex and site distribution.Methods: The present study was undertaken in histopathology laboratory of Department of Pathology, P.D.U. medical college and hospital, Rajkot for period of 2 years from October 2013 to September 2015. A histopathological study of total 100 cases of nasal lesions was done. Tissue were processed and studied.Results: Out of 100 cases, 59 were males and 41 were females. Male to Female ratio was 1.44:1. Maximum numbers of nasal lesions were detected in age group of 11-20 years with 24 (24.00%) cases. Out of these 100 cases, 80 (80.00%) were non neoplastic and 20 (20.00%) were of neoplastic origin. In neoplastic lesions, 12(12.00%) were benign, 1 (1.00%) was borderline and 7 (7.00%) were malignant nasal lesions. Non neoplastic lesions were composed of the majority of cases followed by benign neoplastic lesions.Conclusions: Most of malignant neoplastic lesions were occurs after 40 years of age. Incidence of malignant neoplastic lesions was increase with advanced age.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Studies on the hepatic and renal status of patients with sickle cell
           disease from western zone of Maharashtra, India

    • Authors: Deepa Garg, Neha Satam, Nimisha N., T. Marar, V. W. Patil
      Pages: 1224 - 1227
      Abstract: Background: Sickle cell disease (SCD) is the most common inherited monogenic genetic disorder in Indian tribal and non-tribal population. This condition is caused by mutations in the hemoglobin gene and inherited in an autosomal recessive pattern. Pathogenesis in SCD varies widely from patient to patient. Most of the infections affect SCD pathogenesis, so early diagnosis of the same is important.Methods: The present study was designed to evaluate the biochemical parameters to assess the hepatic and renal status in SCD subjects from west zone of Maharashtra, India. Patients with sickle cell disease (n=50) from primary health centres of Palghar were included in this study and age and sex matched healthy persons (n=50) were controls. Informed written consent was obtained from all the study subjects.Results: Our findings showed that Aspartate trasaminase (AST), Alanine transaminase (ALT), bilirubin and creatinine increased significantly above normal level in SCD subjects. Albumin and urea levels in SCD were found to have decreased in the SCD subjects. There is a slight increase in uric acid and creatinine levels; this indicates an adverse effect on hepatic function and moderate effect on renal function in sickle cell anemia patients. Most common events of SCD pathogenesis, can be categorized into hemolytic events and vaso-occlusive crisis-based events. Adverse effect on hepatic function can lead to further hemolytic events.Conclusions: Although specific biomarkers related to these different events needs to understand for assessment of pathogenesis, the ones we have studied can be useful to assess the status of hepatic and renal function to follow the effectiveness of therapeutic interventions. 
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Prevalence and antibiogram of nonfermenting gram negative bacilli isolates
           obtained from various clinical samples in a tertiary care hospital,
           Bathinda, Punjab, India

    • Authors: Amandeep Kaur, Amarjit Kaur Gill, Satnam Singh
      Pages: 1228 - 1234
      Abstract: Background: Non-fermenting gram-negative bacilli (NFGNB) have emerged as important healthcare associated pathogens in recent years. Infections caused by these bacteria are almost always secondary to some predisposing factors in patients such as burns, prolonged antimicrobial therapy, immunosuppression etc. The Objectives of the study was to be carried out with an objective to identify NFGNB upto genus and species level and study their antimicrobial sensitivity/ resistance pattern so that empiric therapy could be selected accordingly.Methods: A total of 2261 clinical samples were collected from patients admitted in ICU and different wards of the hospital. All samples were processed according to standard microbiological procedures. Identification of NFGNB upto genus and species level was done by various biochemical tests. Antimicrobial susceptibility testing was done by Kirby Bauer disc diffusion method results were interpreted in accordance with clinical laboratory standards institute guidelines.Results: In this study, 365 NFGNB were obtained accounting for their prevalence of 16.1%. P. aeruginosa was the commonest NFGNB isolated in this study accounting for 52.6%, A. baumannii was the second common NFGNB isolated (31.7%). Other NFGNB isolates were obtained with a lesser frequency. P. aeruginosa isolates were highly sensitive to polymyxin B and colistin followed by imipenem. Most of the A. baumannii isolates were multidrug resistant.Conclusions: This study gives an alarming sign towards high prevalence of multi drug resistant NFGNB in our hospital. Therefore, improved antibiotic stewardship and strict protocols for hand washing need to be implemented to prevent emergence and spread of multidrug resistant NFGNB in health care settings.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Variations in the anatomical and branching pattern of the left coronary
           artery: a cadaveric study

    • Authors: Lakshmiprabha S., Khizer Hussain Afroze, Ramesh P., Asha K. R., Shivaleela C., Anupama D.
      Pages: 1235 - 1240
      Abstract: Background: Coronary arteries are the branch of ascending aorta and it is the main arterial supply of the myocardium of the heart. Left coronary artery (LCA) usually arises from left posterior aortic sinus. The site of manifestation of myocardial infarction depends on the occlusion of an artery or its branches involved in atherosclerosis. To know the site of lesion and occlusion of the particular artery, detailed anatomy of its course, branches and variations to be studied in detail.Methods: Study was conducted on 55 heart specimens in Department of Anatomy at Sri Siddhartha Medical College (SSMC), Sri Siddhartha Academy of Higher Education (SSAHE). The left coronary artery was dissected carefully, and it was traced from its origin. Any variation in the course and branching pattern was recorded and photographed.Results: No variation was found in the origin of LCA. In the present study, the most frequent division pattern of the left coronary artery was observed as the bifurcation in 30 specimens (54.54%) followed by trifurcation in 23 specimens (41.82%). Tetrafurcation and pentafurcation of LCA were observed in one specimen each (1.82%).Conclusions: Our study tries to focus on branching pattern of LCA for the better knowledge of accurate diagnosis and therapeutic intervention in the management of coronary artery diseases.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Prescription audit in outpatient department of a teaching hospital of
           North East India

    • Authors: Arjun Saha, Himadri Bhattacharjya, Bitan Sengupta, Rajkishore Debbarma
      Pages: 1241 - 1247
      Abstract: Background: Quality of the prescriptions generated from OPD of Agartala Government Medical College and Govinda Ballabh Pant Hospital is never assessed. The study objectives were to find out the quality in terms of legibility, completeness and adherence to WHO core prescribing indicators of the prescriptions generated from OPD of this hospital.Methods: This hospital based cross-sectional study was conducted during 11th to 16th December 2017 among 442 prescriptions picked up from 12 OPDs by multi stage sampling technique and examined using a checklist designed to assess adherence to WHO core prescribing indicators, legibility and completeness. Data entry and analysis were performed with computer using SPSS 15.0. Descriptive statistics and Chi-square test were used to present data.Results: Total 1169 items were prescribed in 442 prescriptions. Only 50.90% prescriptions were legible. Average number of drugs prescribed per encounter was 2.64, 223 (19.07%) were generic drugs, 14 (1.19%) were injections, 176 (15.05%) were antibiotics and 618 (52.86%) items were from the national essential drug list. History was written in 62.70%, findings were written in 52.70%, diagnosis was written in 40.00%, 87.80% prescriptions contained no review instructions, 84.60% contained complete directions to the pharmacist, 87.10% did not contain complete direction to the patients and signature section was incomplete in 99.80% of the prescriptions. Significantly higher proportions of the high ranked prescribers wrote generic items, review instructions and complete directions to the patients in their prescriptions (p < 0.05).Conclusions: Most of the prescriptions generated from OPD of Agartala Government Medical College and Govinda Ballabh Pant Hospital were found to be incomplete, about half of them were illegible and sizeable proportions did not adhere to the WHO core prescribing indicators.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Prevalence of diabetes mellitus in rural population of Mullana, district
           Ambala, Haryana, India

    • Authors: Nitesh Pradhan, Abhishek Sachdeva, Tushar Goel, Sahil Arora, Shekhar Barua
      Pages: 1248 - 1251
      Abstract: Background: Diabetes mellitus (DM) is a major cause of avoidable blindness in developing and developed countries. The International Diabetes Federation (IDF)’s Diabetes Atlas reports that India has the highest number of people with diabetes (nearly 25%) in the world, and hence considered to be the “Diabetes Capital of the World”.Methods: This is a hospital record based study was planned to estimate the prevalence of Diabetes Mellitus in various age groups in rural population of Mullana, District Ambala(Haryana).Results: Out of 1050 patients screened 50 were found to be having Diabetes mellitus (DM) 1000 were non-diabetic i.e. prevalence of Diabetes mellitus (DM) was found to be 4.76%. Out of 362 males screened 22 were suffering from Diabetes mellitus (DM) i.e. prevalence of 6.07%. Whereas out of 688 females screened 28 were suffering from Diabetes mellitus (DM) i.e. prevalence of 4.06%. Prevalence of Diabetes mellitus (DM) in males was found to be maximum in age group of more than 70 years i.e. 6.97% as compare to female i.e.5.29%.Conclusions: Thus, the current study recorded high prevalence of Diabetes mellitus (DM) among rural population which should be a cause of concern for health care providers. 
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Profile of organophosphate poising cases, clinical outcome and factors
           associated with outcome among them in a tertiary care teaching hospital

    • Authors: Dhulipalla Harika, Bunga Bhaskara Rao, Aparna Gorijala
      Pages: 1252 - 1257
      Abstract: Background: Poisoning by Organophosphorus poisoning is still one of the most common cause of poisoning and is associated with significant morbidity and mortality. With addition of new compounds and changing patient profile, periodic studies exploring the factors affecting treatment outcomes are vital in providing effective management.Methods: The current study was conducted with an objective of assessing the profile of organophosphate poisoning and factors affecting the outcome in a tertiary care hospital. The current study was a prospective observational study, conducted in the emergency department of medical inpatient ward and ICU of NRI medical college and Hospital, Andhra Pradesh between June 2015 to July 2016. Patients >18 years admitted to emergency department organophosphorus or carbamate poisoning were included in the study.Results: One hundred patients presented to the hospital between June 2015 to July 2016 of which 71% were males. About 59% of the patients belonged to 21-30-year group and 67% of them reached our hospital in <6 hours. Grade 1 poisoning was observed in 45% of patients, a dose of <500 units of pseudo cholinesterase was given to 40% of them. A Glasgow Coma Score >10 was found in 75% of the patients and the overall mortality of OP poisoning was 17%.Conclusions: OP poisoning is more common among younger population, below 30 years with male preponderance. Favourable outcome determinants were younger age, female gender, being admitted to the hospital before 6 hours of OP consumption.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Clinical evaluation of adding solitary dose of magnesium to fentanyl on
           post-operative analgesia during combined spinal epidural technique for hip
           replacement procedures

    • Authors: Deepak Sharma, Daljit Kaur, Bilal Ahmad, Abhishek Kumar, Divya Agarwal
      Pages: 1258 - 1263
      Abstract: Background: Numerous receptors such as NMDA have evolved in the management of post-operative pain which can be antagonized effectively before the initiation of painful stimuli. The analgesic property of Magnesium is primarily related to the regulation of calcium influx and antagonism of N-methyl-D-aspartate (NMDA) receptors distributed throughout the central nervous system. This study was designed to evaluate if addition of magnesium to epidural fentanyl as pre-emptive solitary dose could prolong post-operative analgesia during combined spinal epidural anesthesia in elective hip replacement surgeries.Methods: A total of 63 adult consented ASA grade I and II patients aged between 40 and 70 years of either sex, who met the inclusion criteria for hip replacement surgery, were randomized to receive either epidural fentanyl (Group I) or combined epidural magnesium sulphate and fentanyl (Group II). Both the groups subsequently received subarachnoid block with 0.5 % heavy bupivacaine. Intraoperative hemodynamic, subarachnoid block characteristics and 24 hours post-operative analgesia was evaluated.Results: There was significant delay in two dermatome regression for the combined fentanyl magnesium group (149.07±6.48 min) compared to fentanyl alone group (121.23±2.92 min). The post-operative VAS score was statistically lower for the combined fentanyl magnesium group (lowest:0.7±0.4 at 4th hr, highest: 2.9±0.3 at 20th hr) compared to fentanyl alone group (lowest:1.86±1.7 at 5th hr, highest: 3.37±0.9 at 4th hr). There was highly significant difference in average time to first epidural top up and 24hrs epidural top up consumption between fentanyl alone group (264.83±34.08min, 2.8±0.5) and combined fentanyl magnesium group (398±69.55min, 1.43±0.5). Total epidural top ups were 84 in fentanyl alone group and 43 in combined fentanyl magnesium group. Hemodynamic parameters were stable in both groups.Conclusions: Pre-emptive co-administration of magnesium sulphate as a solitary dose to epidural fentanyl in CSE technique prolongs the duration of post-operative analgesia, reduce the requirement of epidural top up and provide stable hemodynamic perioperatively compared to epidural fentanyl alone. 
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Preoperative pain associated with peribulbar injection for cataract

    • Authors: Isha Gupta, Abhishek Sachdeva, Tushar Goel, Nitesh Pradhan, Komal Singh
      Pages: 1264 - 1268
      Abstract: Background: Patients admitted for cataract surgery have a fear of worst pain due to peribulbar injection for anaesthesia rather than surgery itself. The aim of this study is to find out the threshold of pain associated with the anaesthetic peribulbar injection for cataract surgery.Methods: This prospective randomised study was carried out at Ophthalmology department of Maharishi Markandeshwar University from 10 January 2017 to 22 March 2017. 100 patients undergoing elective cataract surgery were administered a peribulbar block. Before injection all patients were briefed about the procedure and counselled regarding the degree of pain that they may experience. Patients were asked to grade the pain of peribulbar anaesthetic injection, using a Visual Analogue Scale (VAS).Results: Focus of the study was on the degree of pain associated with anaesthetic peribulbar injection for cataract surgery. 100 patients (60 males and 40 females) were included in the study. 90 (90%) patients were having their first surgery, they were more apprehensive especially about the injection associated pain. 10 (10%) patients with history of previous cataract surgery were calm, confident and claimed that they felt no pain at all. 92 (92%) patients had just needle prick lead to heaviness or mild pain. Only small percentage of patients i.e. 8 (8%) had injection associated moderate to severe pain.Conclusions: The study revealed that the peribulbar anaesthesia for cataract surgery is safe and highly effective. The degree of pain associated with peribulbar injection is much less than what the patients actually have in their mind and fear of. The study also shows ‘pain threshold’ and anxiety level as major factors for pain perception.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Derangement in lipid profile in nephrotic syndrome in children

    • Authors: Arnab Biswas, Rajarshi Basu
      Pages: 1269 - 1272
      Abstract: Background: Hyperlipidemia, an important characteristic of idiopathic nephrotic syndrome in children (NS),thereby makes them prone to develop premature atherosclerosis and related complications.Methods: We have investigated the changes in different fractions of lipids and apolipoproteins level in thirtychildren of 1-12 years of age with idiopathic nephrotic syndrome. Twenty-six age and sex matched hospitalizedchildren, suffering from non-renal diseases, were enrolled as controls.Results: The results revealed that ApoB along with cholesterol, triglyceride and LDL-cholesterol, were significantly increased (p<0.001), whereas apoA1 and HDL-cholesterol were unaltered in the patients compared to the controls. Further, the ratios cholesterol: HDL-cholesterol, triglyceride: HDL-cholesterol and LDL cholesterol: HDL-cholesterol were also increased (p<0.001) and apoA1: apoB were lowered (p<0.001) in patients of nephrotic syndrome.Conclusions: Therefore, there is a need to evaluate the lipid and lipoprotein levels early and so that appropriate therapy can be offered to selective candidates.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • A camp based screening of BMD in medical students: early detection of an
           iceberg phenomenon

    • Authors: Santosh Kumar Mishra, Anshuli Trivedi, Namita Neelkanth, Anubhooti Trivedi
      Pages: 1273 - 1276
      Abstract: Background: Low Bone mineral density (BMD)/Osteopenia is an iceberg phenomenon. It is ignored by younger population and perceived as geriatric illness. As the study of medicine is very taxing its need of hour to detect low BMD amongst medical students to avoid musculo-skeletal disease due to low BMD in future.Methods: A DXA based technique was used to detect BMD amongst 72 under 25 years female medical students using nonrandom, opportunistic sampling technique. The data was collected in pre-designed pretested proforma and complied and analyzed using MS-Excel 2010 and Epi info-7.0. The data was expressed in percentages and proportions. Those with osteopenia were given appropriate medical advice.Results: In total 20.93% students had osteopenia and 55.56% participants had musculoskeletal complaints and most common being low back pain esp. in osteopenic participants. A statistically significant low level of BMD was observed amongst sunscreen users and physically inactive participants. No association was seen between BMD and BMI, regular, milk intake, type of diet or fasting.Conclusions: A significant number of female medical students were osteopenic and suffered from musculoskeletal disorders. A regular BMD assessment with calcium/vit D supplementation and regular physical exercise can restore/ conserve BMD. The currently available techniques can detect BMD in females but not in young males.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Influence of cataract and small incision cataract surgery on the macular
           thickness measurements: an optical coherence tomography-based study

    • Authors: Anu F. Anand, C. V. Anthrayose Kakkanatt, Monsy T. Mathai, Minu Sasikumar
      Pages: 1277 - 1282
      Abstract: Background: Optical Coherence Tomography (OCT) is a noninvasive imaging technique for analysing retinal architecture. It is a common investigation for various optic disc and macular diseases like glaucoma and diabetic macular oedema nowadays. OCT image quality is affected by many factors especially media opacity due to cataract. This study was done to compare macular thickness measurements by OCT in the presence of cataract and after removal of the cataract by Small Incision Cataract Surgery (SICS).Methods: A prospective observational study was designed which included 99 eyes of 99 patients with no optic disc and retinal pathology who underwent uncomplicated small incision cataract surgery. Routine ophthalmological evaluation including scans using macular analysis protocols of Cirrus HD OCT were done on the first visit to outpatient department and repeated on the day of surgery, one week and three weeks after surgery. The difference between the visits were analysed by Student’s t-test for paired samples.Results: The best corrected visual acuity and signal strength of OCT scans improved significantly after surgery. Among the macular parameters the temporal inner, nasal inner and nasal outer area thicknesses showed significant improvement from preoperative to postoperative values. The foveal thickness, nasal inner and nasal outer thicknesses changed significantly between two postoperative visits.Conclusions: The presence of cataract and small incision cataract surgery affects the macular measurements performed with Cirrus HD OCT. This should be taken into consideration while managing macular diseases like diabetic macular oedema.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Carotid intima-media thickness as a marker for assessing the severity of
           coronary artery disease on coronary angiography

    • Authors: Asif S. Wani, Zafirah ., Samia Rashid, Hanief M. Tantray
      Pages: 1283 - 1287
      Abstract: Background: Coronary artery disease (CAD), the leading cause of death worldwide, has a huge area of primary prevention where patients at risk can be identified for more intensive, evidence-based medical interventions to reduce cardiovascular events. Whereas coronary angiography has stood the test of time to assess atherosclerotic burden, it is still unavailable to a huge population at risk of CAD. This study was devised in search of a cheap and simple tool to assess atherosclerotic burden. We aimed to investigate the relationship between Carotid Intima Media Thickness (CIMT) and Coronary Artery Disease (CAD) in patients evaluated by coronary angiography for suspected CAD and whether CIMT could predict the extension of CAD.Methods: This study was a cross-sectional study conducted from March 2013 to September 2015 in Department of Medicine, SMHS Hospital, J and K, India. A total of 100 patients admitted to for undergoing coronary angiography indicated for suspected coronary artery disease were enrolled. the risk factors evaluated in this study included age, body mass index, sex, dyslipidemia, hypertension, diabetes mellitus and smoking. CAD was assessed and classified by coronary angiography and CIMT was assessed by carotid doppler.Results: There was a positive relationship between CIMT and CAD. Risk factors like Age, smoking, BMI, cholesterol, hypertension, and diabetes had significant positive effect on CIMT; whereas gender, VLDL, triglycerides, HDL and LDL were statistically insignificant in affecting CIMT.Conclusions: CIMT is a cheap and simple tool to predict the extent of CAD.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Recent trends in the antimicrobial susceptibility patterns of urinary
           pathogens in type II diabetes mellitus

    • Authors: Dinesh Gurjar, Akash Mathur, Ramkrishna Sai, Arvind Lakesar, Puneet Saxena
      Pages: 1288 - 1291
      Abstract: Background: Diabetes mellitus is one of the most frequently encountered diseases in clinical practice and since the diabetic patients are at an increased risk of infections specially those of the urinary tract it is imperative for a physician to be aware of the prevalence and antibiotic susceptibility patterns of urinary pathogens. Thus, in this study we assess the recent trends in antimicrobial susceptibility patterns of urinary pathogens in type II diabetes mellitus.Methods: Ninety-three eligible type II diabetes mellitus cases without genitourinary symptoms or abnormalities along with 93 non-diabetic healthy controls were recruited. Mid-stream urine was collected after taking informed consent and each sample tested using the dipstick, microscopy and culture techniques. Isolates were identified using standard biochemical tests.Results: Prevalence of asymptomatic bacteriuria (ASB) in our study was found to be 34.4% among cases of type II diabetes mellitus while it was 6.45% among non-diabetic healthy controls. E. coli was the most common urinary pathogen isolated. E. coli susceptibility towards amikacin was 85.71%, towards ceftriaxone and nitrofurantoin was 71.73% and for meropenem and doxycycline 66.67% susceptibility was observed. In the one case where pseudomonas was cultured, it was susceptible to meropenem, gentamycin, cefoperazone-sulbactum and cefuroxime. In an isolated case where Proteus species was grown, it showed susceptibility to meropenem, norfloxacin, levofloxacin and co-trimoxazole. Enterobacter species which was grown, showed susceptibility to meropenem, vancomycin, amikacin, nitrofurantoin, norfloxacin, levofloxacin and co-trimoxazole. Gram positive bacteria mainly showed susceptibility to ceftriaxone, teicoplanin, vancomycin and doxycycline.Conclusions: The prevalence of bacteriuria is significantly higher in diabetics as compared to non-diabetics and with the recent trends suggestive of emerging resistance among urinary pathogens to some of the commonly used anti-microbials it is of utmost importance to carry out regular surveillance of bacterial profile and their anti-microbial susceptibilities to formulate updated guidelines for effectively treating urinary infections in diabetic patients.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Primary renal leiomyosarcoma: a rare entity

    • Authors: Ambreen Beigh, Junaid Sheikh, Bilal Sheikh, Shaheena Parveen Mujo, Farooq Summyia
      Pages: 1292 - 1296
      Abstract: Background: Primary leiomyosarcoma of the kidney is an exceptionally rare tumor with an aggressive behavior. However, reported literature is very limited. Since the prognosis for a renal sarcoma is extremely poor, differentiation from sarcomatoid renal cell carcinoma (RCC) is necessary. Histopathology and immunohistochemistry are the only modes of diagnosing these sarcomas as they have no specific diagnostic features clinically and radiologically. Objectives was to evaluate the clinicopathological pattern of leiomyosarcomas arising from kidney.Methods: This study was conducted in the Department of Pathology, Government Medical College, Srinagar. It was a retrospective study done over a period of 3 years, July 2014 to June 2017. A total of 4 patients, who underwent surgery and were diagnosed with primary LMS of the kidney, were included in the present study.Results: The study was done to evaluate the clinicopathological pattern of 4 cases of primary renal LMS diagnosed at a tertiary care hospital. Age of the patients ranged from 35-64 years with a mean age of 53.5 years. Sex ratio of 1:1 was observed. Major presenting symptom was flank pain (75%) followed by mass abdomen (50%). Also, one of the patients presented with spontaneous rupture of kidney. Radical nephrectomy was done in all patients. On gross examination tumor had originated from renal pelvis (50%) in 2 patients, renal vein (25%) in one patient whereas, renal capsule (25%) appeared to be the site of origin in other patient. Histopathological examination and immunohistochemistry proved the lesion as primary leiomyosarcoma of kidney.Conclusions: Being a rare tumour, renal leiomyosarcoma needs to be considered in the differential diagnosis of renal masses even in patients younger than 40 years.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • A comparative study of intravenous dexmedetomidine and midazolam on
           prolongation of spinal anesthesia

    • Authors: Malarvizhi T., Vidhya A., Lavanya R.
      Pages: 1297 - 1303
      Abstract: Background: The present study was conducted to compare the efficacy and safety of intravenous dexmedetomidine and midazolam on prolongation of spinal anesthesia.Methods: The study population included people who were undergoing for spinal anesthesia for various surgeries. A total of 90 subject were randomized equally to Dexmedetomidine, Midazolam and saline groups using a computer generated random number sequence. Three study groups were compared with respect to all the baseline variables. The key outcome parameters and hemodynamic parameters were compared among the three study groups.Results: No statistically significant differences were observed in baseline paramters across study groups. The median values of patient satisfaction score and anesthesiologist satisfaction score were almost equal among three study groups, but the association was statistically not significant. The median VAS and the median HSL were slightly lower in dexmedetomidine group than other two groups (VAS-1,2,3 respectively and HSL -4,6,6 respectively) with statistically significant association (P<0.001). The proportion of Bradycardia and hypertension was slightly higher(13.3%) in dexmedetomidine group than other two groups whereas patients with excessive sedation 16.7% in midazolam group. The proportion of patients requiring analgesic for the first 24 hours was 36.7% in saline group, 33.33% in midazolam group. The association between symptoms and study groups was statistically not significant (P value>0.05) except with number of patients requiring analgesic for the first 24 hours (P value<0.05).Conclusions: Measurement of patient and anesthesiologist satisfaction scores are more or less similar in midazolam and dexmedetomidine groups compare to saline group.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Retinal nerve fiber layer thickness analysis in normal, ocular
           hypertensive, and primary open angle glaucoma: an optical coherence
           tomography study

    • Authors: Dipak Patel, Poonam Rana, Siddharth Dua, Roshni Patel
      Pages: 1304 - 1307
      Abstract: Background: To correlate the findings of optical coherence tomography (OCT) evaluation of retinal nerve fiber layer (RNFL) thickness in primary open angle glaucoma, ocular hypertensive and normal eyes.Methods: A 34 consecutive normal, 26 consecutive ocular hypertensives and 40 consecutive glaucomatous eyes underwent a complete ophthalmic examination, including applanation tonometry, disc evaluation, gonioscopy and perimetry. Thickness of the RNFL around the optic disc was determined with 3.4 mm diameter-wide 3D 2000 TOPCON OCT. Average and segmental RNFL thickness values were compared among all groups.Results: Of the 100 eyes enrolled, the mean RNFL thickness was significantly less in glaucomatous eyes (83.165±15.938) than in normal’s (102.42±15.2) and ocular hypertensive’s (100.45±7.38). RNFL, average thicknesses in all four quadrants in POAG patients were significantly decreased compared with the OHT and the control groups.Conclusions: RNFL measurement with SD-OCT could provide important information for detection of early stages of glaucoma. (pre-perimetric glaucoma) as well as help in evaluating progression of glaucoma.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Prevalence of extended spectrum β-lactamase, AmpC β-lactamase and
           metallo β-lactamase mediated resistance in Escherichia coli from
           diagnostic and tertiary healthcare centers in south Bangalore, India

    • Authors: Rituparna Tewari, Susweta D. Mitra, Feroze Ganaie, Nimita Venugopal, Sangita Das, Rajeswari Shome, Habibur Rehman, Bibek R. Shome
      Pages: 1308 - 1313
      Abstract: Background: The increasing reports on multidrug resistant Escherichia coli has become a potential threat to global health. Here, we present a cross-sectional study to characterize extended spectrum β-lactamase, AmpC β-lactamase and metallo β-lactamase producing E. coli isolated from different human clinical samples.Methods: A total of 300 clinical Gram negative bacterial isolates were collected and re-characterized for the identification of E. coli following standard microbiological techniques. The antimicrobial susceptibility of E. coli isolates was initially screened by Kirby-Bauer disk diffusion and MIC methods. The resistant isolates were confirmed to be ESBL, AmpC and MBL producers by their respective phenotypic confirmatory tests of combined disc method.Results: We identified 203 (68%) E. coli and 97 (32%) Non-E. coli isolates. The highest recovery of E. coli was from urine samples 72 (35%). Combined disc method using ceftazidime/ceftazidime+clavulanic acid and cefotaxime/cefotaxime+clavulanic acid confirmed 156 (79%) and 144 (73%) E. coli as ESBL producers, respectively. Thirty-four (34%) and 16 (27%) resistant E. coli isolates were confirmed to be AmpC and MBL producers, likewise.Conclusions: Increased prevalence of ESBL, AmpC and MBL producing E. coli were observed. Beta-lactamase mediated resistance appears to be prime mechanism in the multidrug resistant E. coli. Thus, early detection of beta lactamase producing E. coli is necessary to avoid treatment failure and prevent the spread of MDR.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Epidemiology of pseudoexfoliation syndrome: a hospital based comparative

    • Authors: Hina Kounsar, Nusrat Shaheen, Suhail R. Rather
      Pages: 1314 - 1321
      Abstract: Background: Pseudoexfoliation syndrome (PEX), is an age-related condition with generalized disorder of the extracellular matrix (ECM) characterized by a pathological accumulation of polymorphic fibrillar extracellular material in ocular tissue and various visceral organs. The search for the etiology of pseudoexfoliation syndrome has been directed towards both genetic and environmental factors. It is associated with many ocular and systemic complications.Methods: The study was a hospital based comparative clinical study with 100 consecutive patients with pseudoexfoliation and age and sex matched 100 patients as control without pseudoexfoliation. The patients were registered on a Pre-structured Proforma which included patients’ demographic detail, history and examination. Examination protocol including visual acuity with snellen’s chart for literate patients and E-Chart for illiterate patients, intraocular pressure (by Goldmann applanation tonometry), slit lamp examination and fundus examination.Results: The mean age of cases was 65.93± 7.82 years ranging from 49 to 85 years. The mean age of controls was 63.98± 7.06 years ranging from 50 to 80 years (p=0.139). 72% of cases were more than 60 years old. Male female ratio was 1.63:1. Most of the cases were from Budgam, Bandipora and Ganderbal areas. Spring water was proportionately more frequently used as water source in cases (χ2 =18.5, p=0.000), and tube well water in controls. The mean duration of smoking was 26.63±24.74 pack years for cases and 14.88±17.10 pack years for controls (p=0.000). Average duration of daytime exposure for cases was 6.68±2.13 hours and for controls it was 4.52±2.53 hours. Among cases 12 patients (12%) were on treatment for glaucoma whereas among controls, 1 patient (1%) was on treatment for glaucoma. With respect to dietary habits, there was no difference between cases and controls. Farmers comprised of 49% of cases, followed by House wives and government employees.Conclusions: The study concludes that PEX is very common in our region, increasing with age and more in men. Smoking, occupations involved with sunlight exposure, spring water as water source are possible risk factors for PEX. Glaucoma and cataract are common ocular complications of the syndrome.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Prevalence of non-alcoholic fatty liver disease in type-2 diabetes
           mellitus patients

    • Authors: Hardik Patel, Yadav Narain Verma
      Pages: 1322 - 1326
      Abstract: Background: Non-alcoholic fatty liver disease (NAFLD) is a common chronic condition of which diabetic fatty liver accounts for a large proportion, with 50 to 75% of the subjects demonstrating fat in the liver on ultrasound. As a result of epidemic increase in diabetes mellitus, hypertension, obesity and hyperlipidemia, the prevalence of NAFLD is increasing worldwide.Methods: A study was conducted on a total 100 type-2 diabetes mellitus patients attending Geetanjali Medical College and Hospital, Udaipur, Rajasthan. Patients with known chronic liver disease and history of alcohol intake were excluded. These patients were evaluated by abdominal ultrasonography to determine the presence of fatty liver. They were divided into fatty liver group and non-fatty liver group; and were further evaluated by measurement of body mass index, Central obesity, HbA1c and lipid profile. The data obtained was analyzed using SPSS version 20.0.Results: Of the 100 diabetic patients enrolled in this study, 64 (64%) presented with NAFLD. The highest prevalence of NAFLD was recorded in the age group of 50-59 years at 37.5%. The prevalence rate among males (65.62%) was higher than for females (34.38%). A comprised NAFLD patients (64%) and Non-NAFLD patients (34%).Conclusions: This study revealed that the NAFLD is a vital part of cluster of abnormalities such as dysglycemia, dyslipidemia, hypertension and obesity. Age and duration of diabetes are also important contributing factors in occurrence of NAFLD.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Status of serum anti-mullerian hormone and lipid profile in polycystic
           ovarian syndrome: a cross-sectional study at tertiary care centre of
           central India

    • Authors: Sangita Paneri, Shakti Suslade, Angurbala Bafna, Jayshee Shreedhar, P. Dey Sarkar, Meena Verma
      Pages: 1327 - 1330
      Abstract: Background: Polycystic ovarian syndrome (PCOS) is the most common cause of chronic anovulation in young women and affects 5 to 10 % of the female population. Anti-Mullerian Hormone (AMH) level indicate the quantity of the ovarian follicle pool and may be a useful marker of ovarian reserves. In order to establish the pattern of change in serum AMH level and its contribution in alteration of lipid metabolism and PCOS related complications the present study was planned.Methods: Study was carried out in M.G.M. medical college, Govt Holker College and K. R. G’s Blessed mom centre from June -2016 to December -2017. The study population consisted total 50 women subjects among them 25 women suffering from PCOS aged between 18 to 35-year taken as case group and 25 age matched healthy women taken as control group. Fasting blood sample was collected from each subject and analyzed for AMH level and Lipid profile level.Results: Results revealed that significantly increased serum AMH, cholesterol, triglycerides, LDL, VLDL levels and significantly decreased HDL levels were observed in PCOS cases when compare to control subjects.Conclusions: Study concluded elevated AMH level leads to increase risk of polycystic ovarian syndrome and PCOS associated hyperlipidemia and other complications.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Correlation of histologic grade of breast carcinoma with hormone receptor
           status in a tertiary care hospital

    • Authors: Greeshma Ann George, Archana Sachin Bembde, Neha Borde, Chandrashekhar Bhale
      Pages: 1331 - 1336
      Abstract: Background: Breast cancer is one of the most common malignancies affecting the female population worldwide. Prognosis and management of breast cancer are influenced by variables such as stage, grade, hormone receptor status of oestrogen(ER), progesterone(PR) and Human epidermal growth factor receptor2 (HER2/neu) overexpression. Aim to correlate grade of tumour with ER, PR and HER2/neu receptor status of breast carcinoma.Methods: A prospective study was done in Pathology department, MGM Medical College and Hospital, Aurangabad, Maharashtra for one year. Out of 65 cases studied, 28 cases were biopsy and 37 cases were modified radical mastectomy specimens. All samples were subjected for routine histological examination and immunohistochemical analysis.Results: Age of patients ranged from 30 to 82 years; 60% of tumours were right sided; 46% were involving upper outer quadrant; 58% were radiologically BI-RADS 4; 46% tumours were histopathologically grade 2 and 90% were invasive breast carcinoma, not otherwise specified. By immunohistochemistry, 60% were ER/PRpositive, 9% HER2/neu positive, 26% triple negative and 5% HER2/neu equivocal. In our study, out of 13 grade 1 tumours, 100% were ER/PRpositive and HER2/neu negative; thus an inverse relationship was found between HER2/neu and ER/PR receptors. Also 70% of triple negative tumours were grade 3 which have an aggressive behaviour compared to other subtypes and were common in premenopausal women.Conclusions: Assessment of hormone receptors for clinical management of breast cancer patients is strongly advocated to provide prognostic information and best therapeutic options. A significant correlation was observed between hormonal receptor status and the grade of tumour.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Pattern of blood component cross-matching and their utilization in a
           tertiary care hospital of Jammu region

    • Authors: Irm Yasmeen, Ibrar Ahmed, Meena Sidhu
      Pages: 1337 - 1341
      Abstract: Background: Transfusion of donated blood remains the mainstay of treatment for a wide range of medical and surgical conditions. Although it can save life, but transfusion of blood is not without risk. Clinicians should cautiously assess the appropriateness of indications before requesting various blood components thereby preventing misuse of blood and unnecessary exposure of patient to various transfusion transmitted infections and antibodies production. This study was conducted to determine the pattern of whole blood (WB) and blood component cross-matching and their utilization and to minimize the inappropriate use of blood and its components.Methods: This cross-sectional prospective study was performed at SMGS Hospital Blood Bank, Jammu from April 2016 to September 2016. The requisition forms were analysed at the reception counter and inside the pre-transfusion testing laboratory for any error. The department wise utilization of blood and its components, Crossmatching to transfusion (C/T) ratio, transfusion probability (T%) and transfusion index (TI) were calculated.Results: A total of 14376 requests for cross-matching of blood and its components were received. All the units were cross-matched. Out of these, 12766(88.8%) units of blood and its components were issued to various departments. The most common indication for using packed red cells and whole blood was anemia and bleeding (APH/PPH/Trauma). The total C/T Ratio, transfusion probability (T%) and Transfusion index(TI)  of various blood components were 1.12:1, 88.8% and 0.88 respectively.Conclusions: Our study indicates efficient usage of blood and its component. However, awareness is still needed amongst the clinicians and residents to ensure the appropriate use of blood and its components in the future as well. Hospital transfusion committee has to develop transfusion guidelines and subsequent implementation of such guidelines to assure effective blood utilization. MSBOS (maximum surgical blood ordering schedule) should be formulated for elective procedures with regular auditing, feedback, and modifications to improve blood ordering and utilization.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Anatomical variations in the extra hepatic biliary system: a cross
           sectional study

    • Authors: P. G. Anandhi, V. N. Alagavenkatesan
      Pages: 1342 - 1347
      Abstract: Background: The anatomy of the biliary system has been the subject of extended research for many years. Largely because of their surgical importance in cholecystectomies and the ease with which they may be studied. Though, interest has been focused on the extrahepatic bile ducts very few studies have been carried out in the Indian subcontinent. Objectives was to study the anatomical variations in extrahepatic biliary system in sample of Indian cadaveric specimens.Methods: The study material consisted of 20 adult dissection room cadavers and 30 enbloc post-mortem specimens. Cadaver specimens were studied from dissection room. Post-mortem enbloc specimens were collected from the Department of Forensic Medicine, Madurai Medical College, Madurai. They were studied by conventional dissection method.Results: The key abnormalities found in all bladder were Hartman's pouch shape and neck in 2 (4%) subjects each. Gallstones were present in 2 (4%) subject. The length of the common Bile duct was ranging from as short as 6.5 cm in 24% of the subjects to 9cm in 4% of the subjects. High level of the cystic duct union with the common hepatic duct was noted in16% of specimens and in remaining 2% it was low union. Abnormal arrangement of structures in hepatoduodenal duct was normal in 98% but was abnormal in 2% of subjects. A total of 14% of the specimens had accessory ducts. Double and accessory cystic artery was found in 2% of the subjects each.  In 8% of the subjects, cystic artery had abnormal course and division. The right hepatic artery was had shown abnormal course and division in 4% of the subjects. Abnormal boundaries of Calot’s triangle was found in 2% of the subjects. Abnormal contents of Calot’s triangle include Accessory hepatic ducts in 10% of subjects.Conclusions: Anatomical variations of the extrahepatic biliary system are very common and a through an understanding of them is essential for surgeons to avoid damage to vital structures during surgical procedures and better surgical outcomes.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Clinical and histopathological correlation of breast lesions

    • Authors: Kavita Sharma, S. P. Vyas, Subhash Dhayal
      Pages: 1348 - 1355
      Abstract: Background: To study the histopathological features of neoplastic and non neoplastic lesions of breast.  To correlate the pathological findings with clinical parameters.Methods: We have studied total 170 cases of breast lesions over a period of two years in our institute. The specimens were received in histopathology section of our department. Detailed gross examination of specimens was done followed by fixation, thorough sampling, and tissue processing. The different lesions were studied by histopathological examination and analysed. Neoplastic lesions were classified according to the WHO classification.Results: Out of the 170 cases, 128 cases had neoplastic lesions and 41 cases had non-neoplastic lesions, and one case had coexistent neoplastic and nonneoplastic lesions. Out of the total 129 cases with neoplastic lesions, 76 cases had benign breast tumors, 51 cases had malignant breast tumors, and 2 cases had precursor lesions. Fibroadenoma was the most common benign tumour with 62 cases. Invasive carcinoma no special type was the most common malignant tumour with 43 cases. Special subtypes of invasive carcinoma found in our study were mucinous carcinoma (2 case). The most common nonneoplastic lesion was mastitis with 12 cases, followed by duct ectasia and fibrocystic change. There were 6 cases of gynaecomastia. All the tumors involved upper outer quadrant most frequently. The benign tumors were most frequent in second, third and fourth decades, malignant tumours were seen beyond 4th decade. The nonneoplastic lesions were common in 4th decade.Conclusions: Histopathological study is important in the management of breast lesions.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Teneligliptin add on to monotherapy treatment in patients with type 2

    • Authors: Amitesh Kumar Chatterjee
      Pages: 1356 - 1361
      Abstract: Background: In patient with type 2 diabetes (T2D) inadequately controlled on monotherapy, teneligliptin is efficacious and safe as add-on to treatment with oral antidiabetic drugs (OADs) or insulin. Data on efficacy of teneligliptin in Indian patients is relatively sparse. Aim of the study was to assess the efficacy of teneligliptin used as add-on treatment in patients inadequately controlled on monotherapy with OADs or insulin.Methods: We retrospectively evaluated the electronic database at our endocrinology clinic from East India. Patients who were treated with teneligliptin (20 mg/day) as add-on to monotherapy with OADs or insulin were identified, and data analysed. Primary assessment parameters were change in glycosylated haemoglobin (HbA1c %), fasting plasma glucose (FPG, mg/dL) and post-prandial plasma glucose (PPG, mg/dL) over 12-week from the addition of teneligliptin. Paired t test and McNemar test applied to derive statistical significance of paired continuous and categorical variables respectively.Results: In 88 patients, teneligliptin was used as add-on treatment in 77.3% and 22.7% patients receiving OAD and insulin as monotherapy respectively. Mean age of population was 48.3±15.1 years and 67% were males. From baseline to 12-weeks, there was significant change in HbA1c (9.6±2.1 to 8.4±1.2%, P<0.001), FPG (181.4±54.5 to 140.9±27.1 mg/dL, P<0.001) and PPG (273.7±75.6 to 201.1±47.7 mg/dL, P<0.001). Reduction in these glycemic parameters was significant in patients with teneligliptin as add-on to either OADs or insulin. Overall, 12.5% patients reached the target HbA1c of <7% after 12-week treatment (P=0.004).Conclusions: In patients who are uncontrolled on monotherapy with either OADs or insulin, addition of teneligliptin resulted in significant reduction of HbA1c, FPG and PPG after 12-week treatment. This establishes usefulness of teneligliptin in Indian patients with T2D. A larger, randomized, comparative study with other gliptins is warranted.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • A study on assessment of awareness on generic drugs among doctors in a
           tertiary care teaching hospital in north India

    • Authors: Rohini Gupta, Apoorva Malhotra, Pavan Malhotra
      Pages: 1362 - 1367
      Abstract: Background: The assessment of doctors’ perceptions and understanding about generic medicines may help in recognizing the key areas which may act as hurdle to mass scale use of generics. The primary objective of this study was to explore the knowledge, attitude, and practice (KAP) of doctors toward generic medicines.Methods: A cross-sectional study was carried out using a pretested questionnaire in a tertiary care teaching hospital of Jammu (J and K). The questionnaire was designed to assess the KAP about generic medicines. The doctors working in this institute during the study period were included. Data was compiled and analysed using online website, P-values of < 0.05 were considered to indicate statistical significance.Results: A 62.9% doctors agreed to the fact that generic medicines were intended to be interchangeable with a branded drug (p=0.0139). Among the doctors, 77.5% were aware that generic drug manufacturers need to conduct studies to show bioequivalence between the generic medicine and their branded counterparts (p =0.0001). 88.8% of the doctors agreed that importance of generic medicines should be taught in early part of internship. 80.9% doctors did not think that switching a patient from a brand-name to generic drug may change the outcome of the therapy (p <0.0001).Conclusion: The present study showed that a good percentage of doctors were well aware of generic medicines’ usage. However due to concerns expressed by a certain fraction of participants, further work is needed on how interventions for medical professionals and for the public can lead to increase in the awareness and acceptability of generic medicines.

      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Cardiovascular changes in patients presenting with vertigo

    • Authors: David D. M. Rosario, Anitha Sequeira
      Pages: 1368 - 1372
      Abstract: Background: The term dizziness often used to refer to a host of complaints which present in a similar manner. Of these vertigo is the most common. A thorough knowledge of cardiovascular changes that occur in subjects presenting with peripheral vertigo will help the treating medical practioner to promptly identify the cause of symptoms and prevent any confusion that may alter the course of treatment. The aim of this study to identify the changes in cardiovascular parameters that occur in patients with vertigo.Methods: Study was conducted at a tertiary care hospital during a period of two years during which 100 subjects where studied. Of these 50 where healthy adults which was taken as control group. Remaining 50 subjects where those who were admitted to hospital with a diagnosis of peripheral vertigo and termed as case group. Cardiovascular parameters where accessed in terms of pulse rate, rhythm, blood pressure and ECG Recordings among both the groups taken in static position and with 30 degree head tilt backwards and 45 degree angulation on either sides as is done during Dix-Hallpike’s maneuver immediately, after 3 minutes and 10 minutes of positioning the patient.Results: The study showed that there is no significant change in cardiovascular parameters in patients with vertigo when compared with healthy individuals in static position. Immediately following change in position of head there is sudden fall in pulse as well as blood pressure which then gradually comes back to baseline levels in healthy individuals. When there is a labyrinthine dysfunction in those who have hyper active labyrinth the pulse rate and Blood pressure increases sharply immediately after change in position then gradually comes back to baseline level. In hypo active labyrinth the pulse rate and blood pressure falls marginally compared to normal individuals and in dead labyrinths there is a significant fall in pulse rate and blood pressure immediately following change in position which then gradually reverts back to normal.Conclusions: From our study it is quite clear that there are considerable changes in cardiac parameters in patients presenting vertigo which should be kept in mind while evaluating the patients to prevent misdiagnosis. The study also proves a close coordination between vestibular system and central cardiovascular regulatory mechanisms during positional changes to maintain hemodynamic stability. 
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Descriptive study of gastrointestinal manifestations in HIV/AIDS

    • Authors: Varghese Koshy, George Koshy, Vandana Gangadharan
      Pages: 1373 - 1376
      Abstract: Background: Acquired Immunodeficiency Syndrome (AIDS) was first recognized in 1981 as a clinical syndrome consisting of opportunistic infections and /or neoplasia associated with uneplained immunodeficiency. The gastrointestinal tract is one of the most common sites of clinical affection of AIDS and all levels from the oral cavity to the anus are frequently involved.Methods: A cohort of 70 HIV positive patients, admitted in a tertiary level referral hospital, were studied for symptoms of gastrointestinal disease and patients with clinical or investigative findings of gastrointestinal disease were clinically examined and then subjected to further relevant investigations.Results: The prevalence of GI menifestations in this cohort was 71.4%. The mean age of the study population was 36 years. Amongst frequency of GI manifestations, diarrhoea was found in 26 patients (52%), of whom 77% (20 out of 26) had diarrhoea lasting longer than one month and amongst the patients with oral ulcers, oral candidiasis was the most common oral manifestation, present in 87% of them. Cryptosporidium was the most common organism isolated from the stool samples.Conclusions: The most common presenting complaints were oral ulcers and chronic diarrhoea amongst the cohort examined in this study.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Frequency of peripheral neuropathy in pre diabetics in sub Himalayan
           region: a cross sectional observational study

    • Authors: Roshan Lal, Madan Kaushik, Sudhir Sharma, Rajiv Raina, Sanjay Mahajan, Satish Chaudhary, Ritin Sharma, Neeraj Kanwar, Manish Kumar Thakur
      Pages: 1377 - 1381
      Abstract: Background: Peripheral neuropathy in pre diabetics has been studied in various studies till now. Many are in support and many against. No data was available in any study using all three criteria i.e. impaired fasting glucose, impaired glucose tolerance and HbA1C. Aim was to study the frequency of peripheral neuropathy in pre diabetics in a tertiary health care centre in sub Himalayan region.Methods: A 50 patients of prediabetes were enrolled for this study; preformed proforma was used to collect the information, data on examination and investigations. Then these patients were subjected to nerve conduction studies.Results: Out of total 50 pre diabetic patients 9(18%) were diagnosed having peripheral neuropathy. Maximum number of pre diabetic patients were (26) in the age group 46-55 years with mean age of 44.49 years ±7.01 (S.D.). 28 (56%) were males with a female to male ratio of 1:1.27. 20% patients had complaint of polyuria, 12% presented with polydipsia, 14% of total pre diabetic patients had paresthesia on history. 6% patients had impaired vibration and position sense on clinical examination. Out of total 9 patients having evidence of Peripheral Neuropathy 6 (66.66%) were meeting all three criteria for Prediabetes while 8 (88.88%) had IFG, 7 patients had IGT. 42% of the patients were fulfilling the criteria of metabolic syndrome. 28 had raised TGs and out of them 5 (17.8%) had peripheral neuropathy. Out of 24 obese patients, 4 (16.6%) had peripheral neuropathy. Out of 9 patients with peripheral neuropathy 66.66% patients were considered to be suffering with peripheral neuropathy on the basis of sensory symptoms and 33.33% were considered on the basis of impaired vibration and position sense on examination, one patient diagnosed on the basis of nerve conduction studies. 38% were in high risk group of developing T2DM in future as per Indian diabetes risk score. Mean compound motor action potential (CMAP) and nerve conduction velocity (NCV) were less in patients with peripheral neuropathy in comparison to patients without peripheral neuropathy.Conclusions: Peripheral neuropathy can occur in prediabetes though it is difficult to confirm it. Most common is small fiber neuropathy which can be diagnosed on the basis of history and examination. But by diagnosing it early in the course of prediabetes, morbidity and mortality secondary to neuropathy can be prevented.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • A study of nutritional assessment of newly diagnosed tuberculosis patients
           in a tertiary care hospital of Tripura, India

    • Authors: Somnath Das, Sukanta Sen, Ankita Debnath, Sumitra Basuthakur, Prabir Kumar Saha, Chinmoy Biswas
      Pages: 1382 - 1387
      Abstract: Background: Tuberculosis kills more than any infection in India. TB is a serious public health problem in India. Tuberculosis causes immense morbidity. The mortality rate of this disease is also very high. Tuberculosis causes a great distress to the patients. To control this infection is a challenge to the health care facility of India. A lot of steps are being taken at various levels to end this disease. Still a huge number of patients are dying everyday from these deadly diseases. Out of so many recognised risk factors, malnutrition is considered to be as one of the most important among them. The immunity of a malnourished patient is suppressed. When the patient’s immunity is ineffective, the conversion of latent tuberculosis to diseases happens. Malnutrition invites tuberculosis and tuberculosis again causes morbidity, so there is a complex relation between this two. Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world.Methods: In this cross sectional hospital based study involving 400 newly diagnosed Tuberculosis cases were taken. Their nutritional status was measured by BMI.Results: It was found that 66% of the study population is having malnutrition (BMI <18.5kg/m2). Malnutrition was more in females (71%). Mean BMI is 17.9Kg/m2. Mean height of the population is 1.53 meters.Conclusions: Nutritional supplementation may represent a novel approach for fast recovery in tuberculosis patients. In addition, raising nutritional status of population may prove to be an effective measure to control tuberculosis in underdeveloped areas of world. This study has demonstrated that half of newly diagnosed adult TB patients were malnourished at the time of starting treatment, with more than a quarter having moderate to severe malnutrition.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Role of combined wash-in and wash-out threshold criteria on dynamic
           multislice CECT for solitary pulmonary nodule characterisation: data from
           Indian tertiary care hospital

    • Authors: Rohini Gupta Ghasi, Pragya Singh, B. B. Thukral
      Pages: 1388 - 1397
      Abstract: Background: To prospectively assess the accuracy of combined wash-in and washout characteristics at dynamic contrast material–enhanced multi– detector row computed tomography (CT in distinguishing benign from malignant solitary pulmonary nodule (SPN).Methods: Institutional review board approval and informed consent were obtained. The study included 30 patients (16 men, 14 women; mean age, 52 years; range, 25-80 years) with SPN. After unenhanced CT (1.25mm collimation) scan, dynamic CT was performed (series of images obtained throughout the nodule, with 0.6mm collimation, at 30, 60, 90, and 120 seconds and 4, 5, 9, 12, and 15 minutes) after intravenous injection of contrast medium (120 mL). The HU value of nodule was noted at each of the scans. Data was analyzed for dynamic enhancement characteristics. FNAC from the nodule was done in all patients. The data were correlated with the cytopathological and follow –up results. The significance of various dynamic enhancement features and different threshold criteria for wash-in and wash-out of contrast medium for differentiation between benign and malignant nodules were derived.Results: There were 16 malignant and 14 benign nodules. When diagnostic criteria for malignancy of both wash-in of 25 HU or greater and washout of 5-34 HU were applied, sensitivity, specificity, and accuracy for malignancy were 100%, 92.8% and 96.7% respectively.Conclusions: Evaluation of solitary pulmonary nodules by analyzing combined wash-in and washout characteristics at dynamic contrast-enhanced multi– detector row CT showed 96.7% accuracy (p<0.001) for distinguishing benign nodules from malignant nodules.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Spectrum of fungal infections at a tertiary care hospital in Haryana,

    • Authors: Alfia Alim, Nidhi Goel, Uma Chaudhary
      Pages: 1398 - 1401
      Abstract: Background: In recent years, fungi have been emerging as a common infection in hospitalised patients of tertiary care centres. The climate of our country is well suited for a wide variety of fungal infections. Within the limited data available, an increased incidence of invasive candidiasis, aspergillosis and other dematiaceous fungi are reported at our tertiary care centre. This study was undertaken to know the prevalence of common fungal infections at a tertiary care hospital in a period of five years.Methods: The various clinical samples received from the patients presenting with clinically suspected fungal infections were subjected to direct microscopy with potassium hydroxide (KOH) and Gram staining. All samples were inoculated in duplicate SDA with or without antibiotics.Results: A total of 8450 suspected fungal etiology samples were received during the five years (2011-2015) included in the study. The most common sample was sputum 2502 (29.6%) followed by skin swabs 2175 (25.7%), urine 1302 (15.4%), blood 875 (10.35%) and BAL 810 (9.5%). Male to female ratio was 5:3. Candida albicans was the predominant isolate followed by non-albicans candida, Aspergillus flavus, Aspergillus fumigatus and dematiaceous fungi.Conclusions: The fungal isolates, which used to be discarded as laboratory contaminants are playing a significant role in pathogenicity of many infections. These organisms are now capable of affecting immunocompromised as well as immunocompetent individuals.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • A descriptive study on correlates of stress and coping in relation to
           demographic variables in retirees of Kashmir valley

    • Authors: Ifshana Iliyas, Shabir Ahmad Dar, Tabasum Dilawar, Temheeda Rahman
      Pages: 1402 - 1406
      Abstract: Background: As age develops in employees, they have to get retirement from job permanently or they have to reach their retirement period. Studies on adjustment at retirement report that one-thirds of adults report significant difficulty during this process. This study was carried out to correlate stress and coping among old age retirees in relation to sociodemographic variables.Methods: A descriptive, cross-sectional study was conducted among 100 retirees of district Srinagar between June 2015 and June 2016, using a semi-structured questionnaire. Levels of Stress among elderly retirees and their coping were assessed. Correlates of stress and coping were assessed with respect to different sociodemographic variables.Results: Nearly 40% of cases had moderate level, 03% had severe level, 04% had extremely severe level, and around 35% had no stress. Majority of retired employees 85% either used average level, or used good level of coping with a minority 10% using low level of coping. There was a significant positive correlation between the stress and gender, stress and education and stress and years of experience. However there was statistically no significance between coping and demographic variables.Conclusions: There is a need for organized family and social support to improve the physical and psychological health of elderly.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Comparison of analgesic efficacy between TAP block and local site
           infiltration post operatively in caesarean section

    • Authors: Nabanita Das, Usha Shukla, Dheer Singh, Urvashi Yadav
      Pages: 1407 - 1413
      Abstract: Background: Patients undergoing caesarean section need to be alert, comfortable and mobile in order to take care of their babies, for which they must be pain free in post operative period. The aim of present study is to compare the analgesic efficacy of TAP block with local anaesthetic infiltration specifically in LSCS patients in reducing patient pain postoperatively, as well as to decrease the analgesic requirements.Methods: The study population consisted of 60 patients posted for elective and emergency caesarean section. They were blindly divided into two groups of 30 patients each. Group T received 40ml 0.25% Ropivacaine in Transverses abdominis plane (TAP) block for postoperative analgesia and group I received 40ml 0.25% ropivacaine as infiltration at incision site for postoperative analgesia. Patients were observed for numeric pain score NPS, analgesic requirements, total analgesic consumption and adverse effects if any.Results: There was highly significant difference in numeric pain scores at 2nd, 6th, 12th and 24th hours (p<0.0001). Both the time for first rescue analgesic and total amount of analgesic consumed are statistically significant (p<0.0001).Conclusions: TAP block is an effective postoperative analgesic procedure for post caesarean section patients.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • A histopathological analysis of prevalence of various heart diseases: an
           autopsy study

    • Authors: Shilpa Garg, Sonia Hasija, Puja Sharma, Shivani Kalhan, Neerav Saini, Anam Khan
      Pages: 1414 - 1418
      Abstract: Background: Objective was to study the histopathological spectrum of heart diseases in autopsy specimens, that play a major role as cause of death.Methods: During the period from October 2015 to October 2017. Total 170 medicolegal autopsies were received during this period. Out of 170, specimens of heart were 150. Nine specimens were autolyzed. So, 141 specimen of heart were included in the study. Gross and microscopic findings on H and E stained sections were studied.Results: out of 141 cases, 78 cases showed atherosclerosis, 20 cases showed features of myocardial infarction, myocardial hypertrophy was found in 10 cases, 5 cases revealed myocarditis, pericarditis in 4 cases and one case each of infective endocarditis and aortic stenosis. In 22 cases, there was no identifiable cause of death even after complete gross and microscopic autopsy was performed.Conclusions: Myocardial infarction due to atherosclerosis is probably the commonest finding in death cases subjected to medicolegal autopsies.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Application of the translated version of Buss and Perry questionnaire and
           to see its reliability and validity in aggression estimation in North
           Indian population

    • Authors: Balreet Kaur
      Pages: 1419 - 1421
      Abstract: Background: The present study was done to translate the Buss and Perry questionnaire in Hindi and to check its validity and reliability. The questionnaire was translated as there was no translated version of the questionnaire available. The study was done to see the level of aggression in males and females with the translated version of questionnaire.Methods: The study was done on 500 subjects for the estimation of aggression. The Buss and Perry questionnaire has four factors 1) Physical aggression 2) Verbal aggression 3) Anger aggression 4) Hostility aggression. The questionnaire was translated by a bilingual person and was applied on both male and female subjects of North Indian population. The questionnaire was also got filled in the English version as well and no difference was found in the results of both the versions.Results: Out of 288 female subjects 77%, 15% and 8% subjects had low, medium and high level of aggression respectively while 67%, 17% and 16% male subjects were found to have low, medium and high level of aggression. The physical aggression was found more in males while the verbal aggression was found more in females.Conclusions: In the present study the results found were similar to the results with the English version. So it was found that the translated version of aggression questionnaire is valid and reliable for the estimation of aggression in males and females and free from gender bias.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • A clinical study of comparison of effect with 0.15% ropivacaine and
           fentanyl 2mcg/ml versus 0.125% bupivacaine and fentanyl 2mcg/ml epidurally
           for labour analgesia

    • Authors: Pravin Kumar, Vijay Kanna, Kirubahar ., Azagappan .
      Pages: 1422 - 1428
      Abstract: Background: Adequate pain control is vital during labor as it can have negative impacts on maternal and fetal physiology. Epidural Bupivacaine with opioid has been in use for many years. Ropivacaine is almost similar to bupivacaine in terms of onset, duration, and quality of sensory blockade, but it is less toxic and produces less motor blockade.Methods:
      Authors did a prospective randomized controlled study on 50 prim gravidas of ASA I category with singleton pregnancy in full-term labor, undergoing normal vaginal delivery, admitted to the antenatal ward requesting labor analgesia. They were randomly divided into two groups of 25 each receiving 8 ml Epidural bolus of either 0.125% Bupivacaine with 2ug/ml Fentanyl or 0.15% Ropivacaine with 2ug/ml Fentanyl by the epidural catheter.Results: Analgesia in Ropivacaine group lasted 7.84 minutes longer than Bupivacaine group (p<0.001). Only 28% in the Ropivacaine group needed 3 analgesia top-ups or more compared to 76% in Bupivacaine group. No one out of 25 subjects in Ropivacaine group developed motor block, whereas 21 subjects (84%) in Bupivacaine group developed partial motor (grade 2) block. There was no significant difference in maternal or neonatal outcome between the groups.Conclusions: Subjects in Ropivacaine group on comparison with Bupivacaine group experienced excellent labor analgesia, with greater duration of action, and reduced fentanyl, a local anesthetic requirement with similar VAS scores, maternal and neonatal outcomes besides the major advantage of reduced incidence of motor block. 
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Comparison of hemodynamic responses of intravenous dexmedetomidine and
           esmolol infusion during laparoscopic cholecystectomy

    • Authors: Azka Zuberi, Vaibhav Tiwary, Bhawana Rastogi, Kumkum Gupta, Abhishake Kumar, Raza Farooqui
      Pages: 1429 - 1434
      Abstract: Background: Laparoscopic cholecystectomy is one of the commonest surgery performed under general anesthesia in this set up but maintaining the hemodynamic stability is challenging in these patients. The present study was conducted to comparatively analyse the hemodynamic variations using intravenous dexmedetomidine and intravenous esmolol during laparoscopic cholecystectomy.Methods: Study was conducted on 90 adult patients aged 18-60 years, of ASA grade I or II of both gender, scheduled for laparoscopic cholecystectomy under general anesthesia. Patients were randomized into three groups of 30 patients each. Patients of Group A received esmolol infusion (loading: 1mg/kg and maintenance: 5-15µg/kg/min), patients of Group B received dexmedetomedine infusion (loading: 0.7µg/kg and maintenance: 0.4µg/kg/hr) and Group C (control group) received normal saline infusion. Patients were monitored for changes in heart rate, ECG, systemic blood pressure and EtCO2, at baseline, at 5 min and 10 min after giving study drug bolus, after induction, intubation, skin incision and CO2 insufflation. Thereafter, these changes were recorded at 15 min intervals till the end of surgery.Results: It was observed that perioperative use of dexmedetomidine and esmolol infusions maintained better hemodynamic stability as compared to the normal saline in control group. Though the patients in esmolol group showed less fluctuations in BP and HR (as compared to control group), but, stability was better in the patients of dexmedetomidine group at all-time intervals.Conclusions: Dexmedetomidine infusion was a better option for maintaining hemodynamic stability in comparison to emolol infusion during laparoscopic surgeries.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Genotyping pattern of hepatitis C virus among patients on maintenance
           haemodialysis at tertiary care hospitals of Pune, Maharashtra, India

    • Authors: Anubha Patel, Ramanesh Murthy, Ashish Baghel, Partha Roy, Kavita S. Lole
      Pages: 1435 - 1439
      Abstract: Background: Increased incidence of HCV infection is noted universally throughout the world in patients undergoing haemodialysis. Genotyping and gene sequencing of Hepatitis C virus in individuals with positive HCV-RNA helps in determining the optimal type, duration and response to therapy. Aim of the study was to determine gene sequencing which is considered as gold standard for determination of genotypes.Methods: A cross sectional study design was conducted among 250 patients from five dialysis centres in Pune city in a period of one year. Qualitative HCV RNA detection was carried out by nested RT-PCR. Genotyping and sequencing was carried out using the Big-Dye Terminator cycle sequencing ready reaction kit. SPSS 21.0 version software was used to analyze the data.Results: Out of total 250 patients 47(18.8%) were anti HCV antibody positive and 37 (14.8%) were HCV RNA positive. Out of 47 patients who tested positive for anti-HCV antibody 36 showed presence of HCV RNA (76.6% positive correlation). Out of 203 ELISA negative patients only 1 was found to be positive. Out of total 37 patients predominant genotype was found to be 1a (54.1%) followed by 1b (43.2%) and 3a (2.7%).Conclusions: Genotyping and gene sequencing in patients with HCV RNA positivity revealed predominant genotype 1a and 1b. Detailed phylogenetic tree analysis revealed clustering of same genotypes in centre likely suggesting common source of infection prevalent in dialysis units and nosocomial transmission of virus.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Comparing the functional analysis of I-gel with Baska mask in laparascopic
           surgeries: an observational study

    • Authors: G. Shanmugavelu, T. Kanagarajan
      Pages: 1440 - 1443
      Abstract: Background: More than 40% of general anaesthetics are managed with supraglottic airway devices. First generation SADs act as airway conduits whereas second generation devices have safety designs like integrated bite block, gastric drainage channel and act as airway conduit for endotracheal intubation. Supraglottic airway devices are getting accepted by many anaesthetists during laparascopic surgeries.Methods:
      Authors did a study, comparing the functional analysis of I- gel with Baska mask during laparascopic surgeries with controlled ventilation. The study was conducted on sixty patients of either sex scheduled for short duration laparascopic surgeries (<2 hs). The study conducted on ASA I and II patients with a BMI of <30kg/m2. Patients with restricted mouth opening(<2.5cm), difficult airway, known GERD patients, obese patients (>30kg/m2), and ASA physical status III and IV patients were excluded from the study. patients were induced with fentanyl 2µg/ kg, propofol 2-2.5mg/kg and neuromuscular paralysis facilitated with atracurium 0.5mg/kg. Anaesthesia was maintained with oxygen, air (fio2 40%) with isoflurane1.5-2%. Ease of insertion was evaluated using 4-points scale. Score 1 means easy insertion to score 4 denotes impossible to insert. Oropharyngeal seal pressure was measured after five minutes of placement. FGF 5L/min was used after closing the APL valve at 70cm h2o, recording the pressure at which pressue is plateaued. Presence of sore throat, dysphagia and dysphonia were examined 2hrs and 24hrs post operatively.Results: The insertion time was shorter for I-gel (12.3±3.8secs) than Baska mask (20.1±8.1secs). Oropharyngeal leak pressure was significantly higher for Baska mask (24-32cmh20). Oropharyngeal airway morbidity was not significantly different between two groups. So, it has been decided that both airways are suitable for laparascopic surgeries, but I-gel was quicker to insert, but Baska mask gave good airway seal.Conclusions: In this study, authors have noticed that Baska mask will give good airway seal when compared with I-gel. But I-gel was quicker to insert than Baskamask. The main problem of the study was that it was not blinded.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Effect of a hydrotherapy based alternate compress on osteoarthritis of the
           knee joint: a randomized controlled trial

    • Authors: Archanah T., Shashikiran H. C., Prashanth Shetty, Chandrakanth K. K.
      Pages: 1444 - 1449
      Abstract: Background: Osteoarthritis (OA) of the knees causes pain; swelling and decreases its range of motion in the knee joint. An alternate hot and cold compress gives a circulatory effect without thermic reaction. This treatment induces only a revulsive, non-excitant, and analgesic effect, till date there have been no investigations on the usage of an alternate hot and cold compress as an intervention in individuals with OA of knees.Methods: The control group (n=30) received only routine naturopathy based treatments, whereas the study group received naturopathy based treatments along with an alternate hot and cold compress as an additional intervention for 10 days. Subjects were assessed with Numerical Rating Scale (NRS) and Knee injury and Osteoarthritis Outcome Score (KOOS) as standard questionnaires at baseline and at the end of 10 days.Results: To perform statistical analysis of the collected data we use Kolmogorov-Smirnov goodness of fit test to validate the assumption of normality. We applied Paired sample t – test to test the effectiveness before the treatment and after the treatment in Control group as well in Intervention group. We use independent two sample t-test to test effectiveness of treatment. Results of NRS and KOOS questionnaire are expressed as mean and standard deviation and P value (< 0.05). There was a significant reduction in pain in experimental group compared to control group P value (< 0.05).Conclusions: This study concluded that an alternate hydryatic compress was effective in the management of pain in knee OA.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • A study of patients with acute poison: a single center experience

    • Authors: Ashvin Chaudhari, Dalchand C. Kumawat
      Pages: 1450 - 1453
      Abstract: Background: Periodic experimental and epidemiological studies are essential to understand the pattern of poisoning in society. These studies are useful for planning of providing better and fast health care facilities to decrease poisoning connected mortality. This study was intended to assess the pattern & consequence of acute poisoning cases.Methods: This study was conducted with 100 patients admitted at a Geetanjali Medical college and hospital from June 2015 to December 2017 were studied. We retrospectively analyzed the gender, age, causes of poisoning, types of poisons, poisoning route, emergency diagnoses, outcomes, and prognoses of these patients.Results: Most of the patients were from the age group of 21 - 30 years (49 %) followed by 31-40 years (33%). Males (59%) prevailed females (41%). Out of all subjects, 53% belonged to middle socioeconomic class, whereas only 19% were from high socioeconomic class. Out of all patients, 62% were from illiterate class and 38% were literate. Suicide (77%) was the most communal nature of poisoning. Phenyl (19%) was the most commonly used poison. Mortality was found to be 4% and was mainly related to organophosphate compounds.Conclusions: Poisoning is further common in young males so they should be emotionally maintained in stressful conditions. Mortality was found significantly to organophosphate poisoning. Easy availability of this compound should be checked. Early care in tertiary care center may assistance to reduce mortality in India.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Craniorachischisis: first case reported in Madagascar

    • Authors: Hary F. Rabarikoto, Patrick S. Rakotozanany, Rosa L. Tsifiregna, Willy Ratovondrainy, Domoina M. A. Randriambololona
      Pages: 1454 - 1456
      Abstract: Craniorachischisis is the most severe type of neural tube defect in which almost the entire brain and spinal cord remain open. We report a case in a female fetus born at gestational week 38, with both anencephaly and open spina bifida. It was the second pregnancy of a 26-year-old woman. The first pregnancy had to be interrupted by a medical termination at 18th gestational week because of an anencephaly. We aim to report the first case documented in Madagascar.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Laparoscopic retrieval of misplaced copper T

    • Authors: Nishi Gupta, Sukriti Chandra
      Pages: 1457 - 1458
      Abstract: Intrauterine contraceptive device is important part of family planning services in India. These can be inserted post menstrually, post abortal, post-delivery or in post puerperal period. Associated complications include bleeding, pain, infection, expulsion and most serious complication as perforation of uterine wall and migration to adjacent organs. We present a case of successful laparoscopic retrieval of a misplaced cuT. A 30-year-old female para 2 live 1 presented in SDMH outpatient department with right sided lower abdominal pain since one year. NCCT scan of pelvis showed IUCD in pelvic cavity anteriorly just above urinary bladder. Laparoscopic removal of cuT was done along with tubal recanalization.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Intramuscular spindle cell lipoma/pleomorphic lipoma unusual site fore arm

    • Authors: Anu Anna Jacob, Geethanjali N., Usha Poothiode
      Pages: 1459 - 1461
      Abstract: Pleomorphic lipoma/ spindle cell lipoma accounts for 15 % of lipoma within extremities, confining to the superficial plain comprising lower dermis and subcutaneous tissue. Intramuscular presentation in extrimities is a rare presentation. Here is a case of deep seated pleomorphic lipoma, of forearm, both on fine needle aspiration, biopsy and IHC confirmation. 100% of benign cases of lipoma are positive for CD 34, as stated in many studies and was also positive in our case.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Comparison of effectiveness of Swamiji Vethathiri Maharishi’s
           acupressure 14 points exercise with TCM acupressure therapy in the
           treatment of depression, thyroid problems and heart ailments

    • Authors: C. Vijayalakshmi, M. Jothilakshmi, V. Devarajan
      Pages: 1462 - 1470
      Abstract: In this research article, the research scholar has made a maiden attempt in presenting three original case reports pertaining to the treatment of depression, thyroid problems and heart ailments faced by three different patients and a gradual recovery from these problems through a regular and unintermittent practice of Acupressure 14 points exercise designed by Swamiji Vethathiri Maharishi (1911-2006) a South Indian born Saint and Savant. According to him a continuous practice of this acupressure 14 points exercise ensures free flow of bio-magnetic energy or vital life force energy throughout the body without any short-circuit by removing air bubbles in the nerves and helps in the free flow of blood circulation and restores the body to the normal condition free from pain and diseases. In a similar manner, the concept of Traditional Chinese Medicine acupressure therapy involves Qi energy or vital life force energy which circulates through natural pathway in the body called meridians such as Yin-Yang channels. Blockage or an imbalance or disharmony in the flow of Qi energy or vital life force energy in Yin and Yang channels can cause illness and pain. Thus, concept of TCM acupressure therapy as well as Swamij Vethathiri Maharishi’s Acupressure 14 points exercise help the patients to correct the functional imbalance and restore the free flow of bio-magnetic energy or Qi energy and thereby returning the body to a more natural state of well-being. Thus, Swamiji Vethathiri Maharishi's acupressure14 point’s exercises and TCM acupressure therapy can be regarded as a priceless treasure to the society in general and to the patients suffering from various illnesses in particular. Swamiji Vethathiri Maharishi's Acupressure 14 points exercises as well as TCM acupressure therapy using fingertips is a non-pharmacological and self-care treatment, very safe, involves no side-effect and an inexpensive method which doesn’t require any equipment.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
  • Adult chordoid meningioma: a case report

    • Authors: Lakshmipriya U., Umasankar P., Asiq Sideeque, Aparna Govindan
      Pages: 1471 - 1473
      Abstract: Chordoid meningioma is a rare tumour accounting for less than 0.5% of all meningiomas. It is a WHO grade II tumour with an aggressive behavior. It is a rare variant characterized by cords or trabeculae of eosinophilic or vacuolated cells set in an abundant mucoid matrix. It can be associated with systemic or hematologic manifestations like Castleman disease. The tumor has a propensity for aggressive behavior and increased likelihood of recurrence We report a case of an adult patient with chordoid meningioma who presented with headache and seizures and did not have any hematological/ systemic manifestations. She underwent total excision of the lesion and is doing well.
      PubDate: 2018-03-28
      Issue No: Vol. 6, No. 4 (2018)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
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