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Current Medicine Research and Practice
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ISSN (Print) 2352-0817
Published by Elsevier

[3201 journals]

Boiled egg on surgical menu-First report of laparoscopic removal of
preoperatively diagnosed peritoneal mouse and review of literature
- Abstract: Publication date: Available online 2 July 2018Source: Current Medicine Research and PracticeAuthor(s): Brij B. Agarwal, Neeraj Dhamija, Murali Krishna B, Kiran B. Muley, Nayan Agarwal, Anil Arora AimClinical hunt for the cause of primary or unreferred abdominal pain is guided by either by its visceral or somatic root.MethodsA structured clinical examination and conventional imaging leads to localization of the cause of abdominal pain. The pathology is mostly localized to an abdominal visceral content or neighboring reteroperitoneal structure, which are fixed in their location on imaging. Abdominal & peritoneal spaces are free of any freely mobile structures outside the luminal viscera. Even the image picked pathologies, usually urinary tract stones or foreign bodies in gastrointestinal tracts, shift their image positions at a speed dictated by the physiological function of the viscera.ResultsAny finding of an image that shifts faster than the physiological movement and is extraluminal is a free or loose peritoneal body. These bodies have been found either on autopsies or as incidental findings on exploratory laparotomy for other causes.ConclusionThese have a boiled egg appearance and are known as peritoneal mouse. A preoperative diagnosis of these bodies in abdominal pain has not been reported so far.
Haploidentical peripheral blood stem cell transplantation using T cell
replete grafts with post-transplant high dose cyclophosphamide: report of
two cases
- Abstract: Publication date: Available online 2 July 2018Source: Current Medicine Research and PracticeAuthor(s): Nitin Gupta, Jasmita Das, Vivek Ranjan, Monika Jain, Jyoti Kotwal, Ajay Sharma
Posterior component separation by transversus abdominis release-current
paradigm in management of large complex hernias: Our initial experience
- Abstract: Publication date: Available online 22 June 2018Source: Current Medicine Research and PracticeAuthor(s): Ashish Dey, Vinod K. Malik, Arun Kumar, Vasu Vashishta, Bipul Agarwal BackgroundRepair of large complex ventral hernia repair presents many difficulties to the hernia surgeon owing to large wide defects that are difficult to appose in the midline. PCS- TAR is one novel reconstructive technique that addresses the goals of hernia repair without tension and placement of extraperitoneal large mesh without tension.MethodThe retrorectus plane is entered by incising the posterior rectus sheath as in the modified Rives-Stoppa technique, the transversus abdominis muscle is released at its attachment medial to the linea semilunaris. This plane is dissected laterally to the psoas muscle in the retro-peritoneum preserving the neurovascular bundles supplying the recti. A large polypropylene mesh is placed with a large overlap. The posterior sheath and the linea alba is reconstructed in the midline creating a functionally physiological abdominal wall.ResultsOur patient was a 62 year old lady with a BMI of 29 with a large incisional hernia following multiple surgeries and loss of domain. The size of the defect was 7 × 8 cm in the midline with another defect laterally. PCS- TAR was performed under General anaesthesia and took slightly more than 4 h. There were no intraoperative complications. Follow-up at 5 weeks showed no wound infection, seroma or recurrence.ConclusionTAR is a novel but effective technique in dealing with large complex hernias with loss of abdominal domain and gives good postoperative outcomes.
Impact of in Effect of Instructional booklet on the knowledge, attitude,
problems faced and coping strategies adopted by colostomy patients in
selected hospitals of Delhi
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s): Gaddam Rachel Andrews, Asha Sharma AimThe main aim of the study was to evaluate effectiveness of the instructional booklet (IB) on colostomy patients.Material and methodsQuasi experimental approach was used on 200 patients drawn from two tertiary care hospitals of Delhi.Intervention: instructional booklet on colostomy care(IB) for colostomy care was developed that included: knowledge of disease related to colorectal cancer, Colostomy care, Care of appliance, Diet, Self-care, Problems arising from stoma.ResultsDemo graphic characteristics and clinical profile of patients were similar in control and experimental groups except gender, age, Education, monthly income and type of colostomy. Information booklet significantly enhanced knowledge, attitude, and coping and reduced physical and psychosocial problems. The acceptability and utility of informational booklet by patients was very high.ConclusionInformation booklet was found to be effective in enhancing knowledge, developing positive attitude, decreasing physical and psychosocial problems and adopting better coping.ImplicationsAll the colostomy patients and their care givers need to be trained on colostomy care prior to their discharge after surgery so that they can independently take care of themselves.
Retroperitoneal angiomatoid fibrous histiocytoma; an extremely rare entity
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s): Saleh S. Elbalka, Islam H. Metwally, Mohamed A. Elbadrawy, Khaled Abdelwahab, Gehad A. Saleh, Abdelhadi M. Shebl Angiomatoid fibrous histiocytoma (AFH) is a rare, soft tissue tumour with malignant potential that occurs most commonly in children and young adults. Only a few case reports had described this disease, which typically occurs in the extremities, trunk, head and neck or rarely in the bones. We represent an extremely rare case of a young male with retroperitoneal AFH. We emphasize that AFH may occur in the retroperitoneum so; in any patient with a retroperitoneal tumour the possibility of having AFH should be considered. Also, we highlight that surgery remains the mainstay management that can effectively control local symptoms, although complete excision is usually difficult.
Primary pleuropulmonary echinococcosis – Varied manifestations
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s): Sunny Kalra, Pratibha Gogia, Niketa Rakheja Echinococcosis commonly known as “hydatid disease” is seen worldwide and is caused by eccinococcus larvae. It mainly affects liver (70%) followed by lung involvement (20%) in adults. In the thoracic cavity, it mostly affects lung parenchyma but pleural involvement is well documented. We present three cases of hydatid disease affecting pleuro-pulmonary system as primary site of involvement without hepatic involvement.
Clinical significance of reproductive hormones
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s): Anjali Manocha, Mamta Kankra, Parul Singla, Anisha Sharma, Ashok K. Ahirwar, Seema Bhargava Though a topic of speculation since the early ages, the true nature, mechanisms and functions of the reproductive hormones have been understood only fairly recently. The earliest known description was in the Sushruta in 1400 BCE, but it was not till the 17th century that the physiological processes involved started becoming lucid. Another few decades passed before experiments revealed the mechanism of action of these hormones. The reproductive hormones are secreted by the anterior pituitary gland as well as the gonads, and include both steroid and peptide hormones. It was elucidated that these reproductive hormones act through receptors whereby they alter transcriptional activation of target genes. Prolactin and the gonadotropin hormones i.e. Follicle Stimulating Hormone and Luteinizing Hormone are released from the anterior lobe of the pituitary gland. The major gonadal hormones include Estrogen, Progesterone and Testerosterone and the placental hormone, Human Chorionic Gonadotropin. Recently, the Anti-Mullerian Hormone has been included as a unique marker of gonadal function. Testing of these hormones provides significant insight into the underlying pathology and can thus be highly useful in aiding clinical decisions; however, interpreting the results can be challenging. In view of the intricate mechanisms and complex interactions of the reproductive hormones, this review aims to highlight briefly, the physiology, metabolism and the most important clinical aspects of these hormones, to facilitate their optimal utilization in clinical practice.
Quality of life (QOL) of people living with substance users in urban and
rural community of Delhi
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s): Sumity Arora, Raminder Kalra Background and objectivesA substance dependent person in the family affects almost all aspects of family life. This leads to problems, difficulties or adverse events which impact the lives of family members and affects the quality of life (QOL) of whole family. The present study was aimed to evaluate QOL of people living with substance users in urban and rural regions of Delhi as well as to determine some factors associated with it.MethodA cross sectional study was conducted on 500 people staying in urban and rural areas of Delhi state of India. Samples were selected by using simple random method. WHOQOL-Bref instrument was used to assess the QOL.Analysis and resultsAnalysis was done by using descriptive and inferential statistics. The level of significance was set at p
Hormonal therapy in erectile dysfunction
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s):
Prevalence of erectile dysfunction in diabetic patients
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s): Manuj Sondhi, Atul Kakar, Atul Gogia, Manu Gupta IntroductionErectile dysfunction (ED) is one of the most common yet neglected medical problems which warrants screening at regular interval so that appropriate treatment can be delivered. The aim of this study was to determine the prevalence of erectile dysfunction in Type 2 diabetic men.Material and methodsThe study was conducted in Department of Medicine at Sir Ganga Ram hospital, New Delhi. All males diagnosed with type 2 Diabetes Mellitus between age group of 18–65, were included in the study. Non Diabetic males of same age group were also taken as control group. SHIM questionnaire was administered to all patients and controls. Association of ED with duration of diabetes (10 yrs.) were compared.ResultsPrevalence of ED determined by SHIM score was 78.7% which is more than in the control group (46%). ED was significantly more in diabetic population than in non-diabetics. In present study, 21.4% of the diabetic males had No ED, 12.3% had mild ED, 30.9% had mild to moderate ED, 19.1% had moderate ED and 16.4% had severe ED. Longer duration of diabetes consistently increased the risk of ED. Duration of diabetes had a significant correlation with ED.ConclusionPrevalence of ED in was significantly more in diabetic population than in non-diabetics.
Justice for sexual assault survivors – Role of healthcare
professionals
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s): M. Sreenivas
Snippets
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s):
Genital tract abnormalities
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s):
HIV/AIDS: Test and Treat, Atul Kakar, Samiran Nundy (Eds.), Jaypee
Brothers (2018). p. 230
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s): Richa Dewan
Is enhanced prophylaxis over standard prophylaxis helpful for advanced HIV
infection along with antiretroviral therapy'
- Abstract: Publication date: May–June 2018Source: Current Medicine Research and Practice, Volume 8, Issue 3Author(s):
Pathophysiological basis of Hemorrhoidal Treatment
- Abstract: Publication date: Available online 3 April 2018Source: Current Medicine Research and PracticeAuthor(s): Vijay Arora, Sushrut Agarwal, Vasu Vashishtha, Hashmatullah Stanickzai, Srikrishna Das, Pramoj Jindal, C.S. Ramachandran ObjectiveTo study the underlying pathophysiology of hemorrhoidal disease and its application to the treatment modalities particularly the operation of Stapled Anopexy with Lateral Internal Sphinctertomy.Methods253 patients of hemorrhoids with or without fissure were evaluated using the techniques of anal manometry. The establishment of control studies and the measurement of pressures in various grades of hemorrhoids were the first phase and we continued the use of the measurements for all cases defining the changes which occurred not only with the grade of hemorrhoids but also in various stages of treatment and disease.ResultsThe anal pressures increase with the increase in the grade of hemorrhoids and particularly high when associated with fissure. The primary treatment of hemorrhoids by stapled anopexy gave a very satisfactory postoperative result. In the presence of high pressures both resting as well as squeeze particularly in presence of fissure were indications for adding the operation of LIS.ConclusionThe technique of stapled anopexy with LIS when applicable is the methodology of choice for our patients of hemorrhoids of all grades. Use of the principle of STARR helps in the application of the technique to Grade IV hemorrhoids also.
Parathyromatosis- Rare cause of recurrent hyperparathyroidism
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): Ankita Grover, Seema Rao Parathyromatosis is a rare cause of recurrent or persistent hyperparathyroidism. It poses great diagnostic and therapeutic challenge for the pathologist as well as the treating clinician. Parathyroid carcinoma remains a close clinical and histological diagnostic pitfall. We present a case of 44 year old woman who presented with persistent hypercalcemia and underwent multiple neck surgeries over a period of six years when she was finally diagnosed as parathyromatosis. There was also an incidental occurrence of papillary carcinoma of thyroid which is only rarely reported in literature.
Naturally occurring anti-M with high thermal amplitude complicating ABO
blood grouping
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): Vivek Ranjan, Kamini Khillan Anti-M is fairly common naturally occurring antibody that is usually active at a temperature below 37 °C, with an optimum temperature of 4 °C rarely causing haemolytic transfusion reaction or haemolytic disease of new born and can generally be ignored in transfusion practice. We report a case of 28 year old unmarried female blood donor who had an unexpected reaction in blood grouping due to anti-M that posed a problem for us in the interpretation of her blood group. We also reviewed literature to find out the significance of anti-M antibody.
Electronic health records: A general overview
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): Ruby Sahney, Mukesh Sharma Electronic Health Records (EHR) is a digital collection of patient health information in an electronic format. It is the need of the hour because it improves the quality and cost of health care, thus adopted by many developing countries. Despite of the positive effects of the EHR system in medical practices, the adoption rate in India is very slow, the main hurdle is clinicians. For successful adoption many steps have been initiated, and several new steps has to be taken. It requires a coordinated effort from all the stakeholders. Information technologies can be hazards so its security should be always concern. The purpose of this article is to increase awareness and valuable uses of EHR in health system.
Human tuberculosis in India: Some neglected issues
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): T.D. Chugh Tuberculosis (TB) has a high global burden with high mortality including India. The actual data may not be accurate due to lack of proper identification and reporting. The source of bovine tuberculosis and its management is also still undetermined. India has the largest burden of human tuberculosis in the world, the annual reported cases being 2.2 million. However, 80% of our healthcare is in private sector which does not report its cases. There is thus a gross underestimate of the disease due to poor surveillance. However, using actual consumption of anti tubercular (ATT) drugs in India as a marker, there is a much larger burden of the disease (2–3 times higher). Also, the prevalence of tuberculosis in animals (especially cattle and even domesticated wild animals) with a risk of zoonosis and reverse zoonosis in India is not known. Mycobacterium bovis causing pulmonary and extra pulmonary disease in humans, its clinical impact on the course of disease and mortality especially due to inherent resistance of M.bovis to the first-line antitubercular drug (pyrazinamide) needs investigation.
A study on the effectiveness of teaching the principles and methods of
clinical audit to medical postgraduates
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): T Saravanan, S Shanmugapriya BackgroundClinical audit is based on the concept of quality assurance in health care. It is important for all health care providers especially specialists and consultants to be aware of the principles governing clinical audit in addition to the methods in conducting such an audit.Objectives•To assess the knowledge and attitude of medical postgraduate students on clinical audit.•To evaluate the effectiveness of an interventional program conducted to educate the principles and methods of conducting clinical audit to medical postgraduates.MethodsThe study was done in 92 postgraduate medical students in our institute using a pre-test and post-test questionnaire, evaluating their knowledge on different perspectives of medical audit and also assessing the change in their attitude towards audit after an educative interventional program. The questionnaire consisted of 13 knowledge questions and 3 attitude questions. Each question was scored and the overall maximum score was 35.ResultsThe mean post-test score (24.45 ± 3.21) was significantly higher than the mean pre-test score (16.18 ± 3.41) using paired t-test (p 
Minilaparoscopic treatment of a Grynfeltt lumbar hernia
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): Gustavo L. Carvalho, Diego Laurentino Lima, Raimundo Hugo Matias Furtado, Gustavo Henrique Belarmino de Góes, Prashant Rao AimThis study reports a successful minilaparoscopic treatment of a 62 years old male patient with a Grynfeltt hernia, and outlines a new minimally invasive way to do the procedure. A patient presented with a left lumbar herniation of two years duration with no other symptoms. Physical examination showed a 5 cm soft mass on the left lumbar region, which was confirmed as a hernia by an ultrasound.MethodA minilaparoscopic approach to surgery was chosen, using a 10 mm trocar inserted in the umbilical region for pneumoperitoneum and the optics, a 3 mm minilaparoscopy trocar inserted in the preperitoneal region in the left iliac region and another 3 mm trocar inserted more dorsally in the lumbar region.ResultsThe polypropylene mesh was placed in the preperitoneal space without need for any mesh fixation. The total time of surgery was 41 min and the patient was discharged on the next day.ConclusionThe proposed novel approach is not only feasible, but offers advantages as it appears to be safer, less invasive, cost-effective and above all eminently reproducible.
Prevalence of obesity and awareness about diabetes among adolescents of
schools of Delhi
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): Rita Sapra, Mahesh Gupta, Ramesh Lal Sapra BackgroundDiabetes is an epidemic of the present century and its growing prevalence among adolescents is a genuine concern. Therefore, awareness about the disease prior to its occurrence is the need of the hour. The present study addresses this issue at length based on a data pertaining to diabetes awareness, type of schooling and mothers’ literacy etc. collected from a large number of adolescents of various schools of Delhi.ObjectivesTo assess i) the status of obesity, and awareness of diabetes ii) the effectiveness of ‘structured teaching program on management of diabetes mellitus’ in generating awareness.MethodsWe conducted the study on 1785 students – 950 from twelve government schools and 835 from ten private schools. The level of awareness of students was measured through a validated questionnaire. Data was analyzed using primarily nonparametric statistical methodsResultsWilcoxon signed rank test indicated a significant rise in awareness following the structured teaching program. Private schools performed significantly better than those of government ones (p = 0.005) in pre-teaching. Chi Square showed significant association of BMI with type of schooling (p 
Management and control of methicillin—Resistant Staphylococcus aureus
infections in children and adults in India
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): TD Chugh
Snipppets
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s):
Does peri-operative antiplatelet therapy increase bleeding risk in
non-cardiac surgery'
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s):
Medical Biostatistics Fourth Edition (Chapman & Hall/CRC Biostatistics
Series), A. Indrayan, R.K. Malhotra. CRC Press, Taylor & Francis Group.
(2018), 720, ISBN-13:978-1-4987-9953-9(Hardback)
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): R.L. Sapra
Tertiary Hyperparathyroidism: A diagnostic and management dilemma
- Abstract: Publication date: March–April 2018Source: Current Medicine Research and Practice, Volume 8, Issue 2Author(s): Aakriti Soni, Ashish Dey, Tarun Mittal, Manish Malik, Vinod K. Malik IntroductionTertiary Hyperparathyroidism (HPTH) can persist even after the cause of secondary HPTH like chronic kidney disease (CKD) is corrected. Surgical intervention is recommended in tertiary HPTH and gives good outcomes.Material and methodsWe report the case of a 59 year old male, with CKD Stage 5 on Continuous ambulatory peritoneal dialysis (CAPD) with tertiary hyperparathyroidism. He had undergone a right inferior parathyroidectomy for a parathyroid adenoma in the past. He was found to be having left inferior parathyroid adenoma and underwent left lower parathyroid adenoma excision and Hemithyroidectomy with upper retrosternal exploration for the same.ResultsParathyroid hormone (PTH) levels of the patient fell by 50% in intraoperative assay and decreased by another 50% in two days time. His current S Calcium and Vitamin D 3 levels are 9.62 mg/dl and 35.1 ng/ml respectively. He is currently on reduced medications with symptomatic relief.ConclusionTertiary hyperparathyroidism is a common finding in patients with prior secondary HPTH as seen in this patient, and needs to be treated surgically to manage all the symptoms and to prevent further complications.