Publisher: Medip Academy   (Total: 12 journals)   [Sort by number of followers]

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International Journal of Research in Medical Sciences
Number of Followers: 7  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-6071 - ISSN (Online) 2320-6012
Published by Medip Academy Homepage  [12 journals]
  • Incidence and management of inguinodynia after inguinal plasty

    • Authors: Juan J. Granados-Romero, Jesus C. Ceballos-Villalva, Israel García-Olivo, Cruz Escobar Jonathan E., María J. Corona-Torres, Alba M. Mondragón-Cordero, Quintero Arías Lourdes A., Ayala García Henry, Vázquez González Juan C., Ericka H. Contreras-Flores
      Pages: 3432 - 3438
      Abstract: Background: Hernia is defined as a defect of fascial and muscle-aponeurotic structures, allowing the protrusion of elements. The most frequent is inguinal region, prevailing in men 3:1 vs female. The most frequent complications are persistent chronic pain.Methods: A descriptive, prospective and cross-sectional study was performed in postoperative inguinal plasty patients, using a laparoscopic approach and open approach, the presence or absence of inguinodynia was studied using the visual analogue pain scale (VAS) and the Semmes-Weinstein monofilament, in addition to a systematic investigation in the following PubMed, Medline, Clinical Key and Index Medicus databases, with articles from July 2019 to April 2020.Results: Inguinodynia was present in laparoscopic surgery and open approach, 58 patients had inguinodynia at two weeks associated with the inflammatory response of the tissues and the presence of a foreign body (mesh), 77% of the patients with persistence of pain at 3 months reported mild pain (VAS 1-4), 21% moderate pain that did not limit their daily activities (VAS 5-8) and 2% of the patients reported severe pain which limited physical activity and effort   (VAS 9-10).Conclusions: Inguinodynia has an impact on hospital costs and quality life, we consider it is essential to domain the anatomical variants of the region. We propose an extensive follow-up of this group of patients, to make a comparison of diagnostic methods, as well as conservative management vs. modern techniques for pain control.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204211
      Issue No: Vol. 8, No. 10 (2020)
  • A study of lipid profile and glycemic status in patients with chronic
           kidney disease of unknown etiology in Sri Lanka

    • Authors: Duminda B. Basnayake, W. G. H. Sandamali, Ayesha Nayanamali, Abdul W. M. Wazil, R. M. P. A. Siriwardena, T. M. C. I. Thennakoon, Thilak Dharmasiri, Nishantha Nanayakkara
      Pages: 3439 - 3444
      Abstract: Background: Dyslipidemia and impaired glucose tolerance are common complications of chronic kidney disease (CKD) and are responsible for increased cardiovascular risk. Studies on lipid profile and glycemic status in CKD of unknown origin (CKDu) are scarce. The objective of this study was to evaluate the lipid profile and glycemic status of the patients with CKDu and to aid in preventing morbidity and mortality.Methods: The descriptive, cross sectional study was conducted in a rural CKDu endemic area, Girandurukotte.  Data was collected from February 2018 to June 2019. For the diagnosis of CKDu, history and clinical features with supportive biochemical, renal biopsy and radiological evidence were taken as criteria. Blood samples were taken for serum creatinine, lipid profile and HbA1C. Already diagnosed patients with diabetes mellitus and dyslipidemia were excluded.Results: A total of 168 patients within the age range of 32-66 years (mean 50.3±7.7) were participated. There were 106 males (63%) 46.4% were farmers. Majority of the patients (65.5%) had normal body mass index (BMI) (mean 22.9 kg/m2, normal range 18.5-23.5%) followed by overweight (23.5-30 kg/m2) in 55 (32.7%) patients. The prevalence of dyslipidemia in CKDu was found to be 55.9%.  Majority of the abnormality was seen in the HDL group with 68 (40.5%) patients having low HDL cholesterol (mean 44.7 mg/dl, SD=12.3).  There was a significant rise in the serum triglyceride concentration (>150 mg/dl) in 53 (31.5%) (mean 152.4 mg/dl, SD=73.5) and total cholesterol (>200 mg/dl) in 30 (18%) patients (mean 182 mg/dl, SD=36.9). LDL cholesterol abnormality (>130 mg/dl) was seen in only 9 patients (mean 88.7 7658mg/dl, SD=25.4). From the total, 144 (85.7%) patients had abnormal HbA1C levels; 27 (16.1%) patients had HbA1C levels between 5.7% and 6.4% (pre-diabetes), and 117 (69.6%) patients had HbA1C level more than 6.5% (diabetes mellitus). There was no statistically significant association between HbA1C levels and BMI (p=0.29) or HbA1C and lipid abnormalities (p=0.32)Conclusions: The high prevalence of dyslipidemia, pre-diabetes and diabetes mellitus in patients with CKDu may accelerate the progression of chronic kidney disease and increase the risk of cardiovascular disease. Early detection, initiation of appropriate medication and early referral to the expertise will ameliorate morbidity and mortality. 
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204212
      Issue No: Vol. 8, No. 10 (2020)
  • Antiulcerogenic effect of Capparis cartillaginea decne on indomethacin
           induced gastric ulcer in wistar rats

    • Authors: Nancy W. Mugo, Christine Wangia, Gideon Kikuvi, Samuel Ngugi
      Pages: 3445 - 3448
      Abstract: Background: Peptic ulcer disease is a non-malignant, mucosal lesion of the stomach or duodenum. The mucosal defect reaches the muscularis mucosa and sometimes, beyond causing life threatening complications, including haemorrhage, perforations, gastrointestinal obstruction and malignancy.Methods: The animals were pre-treated with omeprazole 20 mg/kg and 300 mg/kg of Capparis cartillaginea decne orally for 14 days. On the 15th day, ulcers were induced using indomethacin 30 mg/kg and 4 hours post ulcer induction, they were sacrificed. Ulcer index, pH, total acidity and volume were determined.Results: Extensive lesions were seen in indomethacin ulcerated rats with mean ulcer score of (1.260±0.18). In comparison, there were minimal areas of erosion on animals pre-treated with omeprazole (0.14±0.025) and plant extracts (0.280±0.097). Indomethacin-induced ulcer treated animals showed the highest volume of gastric juice output (3.14±0.21 ml), whereas the animals pre-treated with omeprazole had lower gastric juice output (2.20±0.2 9ml). This was comparable to animals pre-treated with the plant extract (1.80±0.13 ml). The pH was high in animals pre-treated with omeprazole (5.02±0.53). This was also seen in animals pre-treated with the extract (4.82±0.31). This was in comparison to the low pH seen in indomethacin ulcerated animals (2.20±0.16). Indomethacin-induced ulcer treated animals showed high levels of total acidity (88.64±1.71 mEq/L). Whereas the animals pre-treated with omeprazole had lower total acidity (55.26±3.77 mEq/L), which was also mirrored in animals pre-treated with the plant extracts (61.44±2.42 mEq/L).Conclusions: The extracts of Capparis cartillaginea decne showed anti-ulcer effect on indomethacin induced ulcers in Wistar rats.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204213
      Issue No: Vol. 8, No. 10 (2020)
  • Oral versus intravenous maternal hydration in isolated third trimester

    • Authors: Humaira Zafar, Mubashra Naz, Umber Fatima, Uzma Shahzad, Anees Fatima, Attiya Yasmeen
      Pages: 3449 - 3452
      Abstract: Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria.  Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al.  In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204214
      Issue No: Vol. 8, No. 10 (2020)
  • Impact of diabetes mellitus on nerves

    • Authors: Muhammad Dilawaer Khan, Hamza Yousaf, Muhammad Umar, Muhammad Shah Zaib, Shaheryar Qazi, Khurram Irshad, Zeeshan Chaughtai, Usman Ali Akbar, Rehan Awais
      Pages: 3453 - 3456
      Abstract: Background: Involvement of the peripheral and autonomic nervous systems is probably the most common complication of diabetes. The main symptoms of diabetic polyneuropathy include negative symptoms (those related to nerve fiber loss or dysfunction) such as numbness and weakness, and positive symptoms (those related to abnormal function of surviving nerve fibers) such as tingling and pain.Methods: This was a cross-sectional study held in diabetic clinic of Nishter hospital, Multan, Pakistan. The study included any diabetic patients showing symptoms of neuropathy.Results: There were total of 140 in this study. This study included 85% of male and 15% of female. Most common symptoms of diabetic neuropathy were pain (70%) and tingling (70%) followed by numbness in 65% of patients. There were 28 patients in 5 years duration of diabetes, 35 people in 6-10 years duration, 21 patients in 11-15 years duration, and 14 patients in 20+ years duration.Conclusions: Neuropathy due to diabetes is crippling especially when pain is the prominent symptoms. Autonomic symptoms like constipation and lightheadedness are discomforting for the patients. The most commonly used screening test is vibrating tuning fork test which is east to perform is clinical setting and is not time consuming. Diabetic patients need to take special care of.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204215
      Issue No: Vol. 8, No. 10 (2020)
  • Effect of antenatal education on knowledge and utilization of
           facility-based delivery services among pregnant women in two health
           institutions in Alimosho, Lagos state

    • Authors: Orji Urenna Okafor, Ademuyiwa Iyabo Yewande
      Pages: 3457 - 3462
      Abstract: Background: Facility-based delivery care is an essential component of maternity care. Overtime, its under-utilization despite improvement in antenatal attendance has become a public health concern in Nigeria. To assess the effect of antenatal education on the knowledge and utilization of facility-based delivery services among pregnant women in primary health facilities in Alimosho, Lagos.Methods: Quasi-experimental design of 2 groups pre- and post-intervention was adopted and through multi-staged sampling techniques, 128 participants were selected but 117 completed the study. Self-developed structured questionnaire with reliability index of 0.76 was used for data collection. The intervention package was antenatal education package on benefits and components of delivery services. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23 statistical package.Results: The mean age of participants in control and experimental groups was 32.3±9.60 and 34.7±8.21 years respectively. Findings revealed moderate knowledge mean score (control- 54.97±10.52; experimental-52.14±11.09) and low pre-intervention utilization mean score (control 13.33±3.41; experimental-13.17±4.21). Findings also showed significant improvement on post-intervention mean knowledge score of 52.14±11.09 versus 104.75±5.56 and a significant difference in post-intervention utilization (p=0.000) and follow-up (p=0.013) on the experimental group.Conclusions: The study concluded that the antenatal education programme had positive effect on the pregnant women’s knowledge and utilization of health facility delivery services, therefore, there is need to strengthen and intensify antenatal education at all levels of healthcare using appropriate teaching techniques.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204216
      Issue No: Vol. 8, No. 10 (2020)
  • Effect of cardiopulmonary resuscitation training towards cardiac arrest
           emergency knowledge upon students at Student Health Association of
           Universitas Gadjah Mada, Indonesia

    • Authors: Bayu Fandhi Achmad
      Pages: 3463 - 3466
      Abstract: Background: The cardiovascular disease, especially the sudden cardiac arrest, was the main cause of death and disability throughout the world. The cardiopulmonary resuscitation (CPR) that should be taken by the first responder or witness was an important part in the chain of survival out of the hospital that could improve the prognosis and avoid the rest of the symptoms. Hence, it is important for students to know and possess the skill, especially the cardiopulmonary resuscitation, to handle the emergency situation. University became the appropriate place to organize the CPR training because the students were more conditioned in emotional, social and cultural terms.Methods: This research utilized the quasi-experiment method. The total number of research subject was 56 Universitas Gadjah Mada students at Student Health Association. The implementation of intervention of this research was conducted on 07 July, 2018. The topic in this research intervention were formed based on American Heart Association (AHA) Guideline 2015. Pretest and posttest instrument were 10 multiple choices with five choices of answer.Results: This research proved that the CPR training gave effect on the improvement of the knowledge about emergency situation, particularly the cardiac arrest through cardiopulmonary resuscitation. The pre-test and post-test results showed that there was a knowledge improvement after the training (p=0,000).Conclusions: CPR training could be recommended to have an impact on increasing student knowledge in emergency management, especially cardiac arrest.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204217
      Issue No: Vol. 8, No. 10 (2020)
  • In vivo experimental infection of sarcosporidiosis and toxoplasmosis of
           rabbits in Duhok Province, Kurdistan region, Iraq

    • Authors: Shivan N. Hussein, Mohammed S. Shukur
      Pages: 3467 - 3474
      Abstract: Background: Sarcocystis species and Toxoplasma gondii are both zoonotic obligatory intracellular protozoan organisms and cyst-forming coccidian parasites that occur in domestic animals and human throughout the world.Methods: Forty local breed rabbits were divided into four groups, each group ten. Group one were infected with Sarcocystis, group two with Toxoplasma and group three with both parasites and last group was non-infected control group. The LAT serological test was used for detection of anti-toxoplasma antibody in serum of Toxoplasma infected rabbits. The direct impression smears stained with Giemsa was prepared from different body organs including; liver, lung, heart, brain and skeletal muscle for detection of tissue cysts (Bradyzoites) of T. gondii and microcysts of Sarcocystis.Results: In group one, 70% of infected rabbits were positive for toxoplasmosis by serological test; both are and by impression smear method 80% of the rabbits were positive for T. gondii with tissue cysts. Fifty percent of rabbits were positive for microcysts of Sarcocystis by direct impression smear method in group two. In group three, the impression smear and latex agglutination method were positive in 40% and 60% of rabbits, respectively. Statistically, there was no significant difference in detection of toxoplasmosis and sarcocystosis by LAT and impression smear method in group one and three.Conclusions: Rabbits could be source of toxoplasmosis and sarcocystosis and have public health implications and hazard as source of food. They might be source of infection for cats and shed environmentally resistant oocysts.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204218
      Issue No: Vol. 8, No. 10 (2020)
  • The effect of anaesthesia and antenatal care on feto-maternal outcome
           after caesarean section in a developing country

    • Authors: Fidelis A. Onyekwulu, Friday G. Okonna, Tochukwu C. Okeke, Israel O. Okwor
      Pages: 3475 - 3480
      Abstract: Background: The feto-maternal outcome after delivery is precarious in developing country. The anaesthetic technique and antenatal care as it affect this outcome is assessed.Methods: This is a 5-year retrospective study carried out at the University of Nigeria Teaching Hospital Enugu. Obstetric theatre records of patients who had caesarean section between January 1st 2011 and December 31st 2015 were reviewed. Data extracted from the records using a proformer included socio-dermographic characteristics, indications for surgery, maternal and neonatal outcome, and anaesthetic technique. The data were analyzed using SPSS Version 17 [SPSS Inc., Chicago, IL, USA].Results: A total of 1574 patients had caesarean section within the study period and 1158 (73.6%) of the patients were booked, while 416 (26.4%) were unbooked. The total number of deliveries during this period was 6235 giving a caesarean section rate of 39.6%. More deaths on the operating table were recorded in the unbooked patients as compared to booked parturient (x2=20.013, p<0.001). More babies of the unbooked patients died perioperatively (17.3%) when compared to booked paturient (3.4%) p<0.001.Conclusions: The commonest anaesthesia administered was subarachnoid block. Maternal and neonatal mortality was significantly higher in paturient who did not attend antenatal care compared to those who attended.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204219
      Issue No: Vol. 8, No. 10 (2020)
  • Prevalence and components of metabolic syndrome in HIV-infected patients
           at the Tiko Central Clinic and Cottage Hospital in Cameroon

    • Authors: Vigny N. Njongang, Assob J. C. Nguedia, Ojong E. Walter
      Pages: 3481 - 3487
      Abstract: Background: HAART and HIV related metabolic syndrome (MS) is associated with increased cardiovascular risk in aging HIV patients. This study was aimed at comparing the prevalence of MS between HIV-infected patients on HAART and apparently healthy HIV-uninfected individuals and identifying key MS components in these groups of subjects.Methods: This was a hospital-based case-control study. The cases were HIV sero-positive individuals on HAART for at least 6 months and controls were HIV sero-negative individuals.Results: 74/135 (54.8%) participants were females amongst which 53/75 (70.7%) and 21/60 (35%) were in the test and control groups respectively. The prevalence of MS was insignificantly higher in HIV-infected patients on HAART than in control subjects according to the IDF (22.7% versus 20%, p=0.834) and NCEP ATP III criteria (18.7% versus 18.3%, p=1.000) respectively. The most prevalent components of MS in HIV-infected patients on HAART were low HDL-c (100%), abdominal obesity (IDF: 68%, ATP III: 32%), and hypertension (28%). Multivariate analysis of MS components in HIV-infected patients on HAART revealed that hypertension (OR: 15.996, 95% CI: 3.385-75.585; p≤0.001) and high blood glucose (OR: 10.760, 95% CI: 1.642-70.505; p=0.013) were associated with MS. Significantly more HIV-infected females were seen with abdominal obesity than HIV-infected males (86.8% versus 4.5%, p≤0.001).Conclusions: Abdominal obesity is a driving component of MS in HIV-infected patients particularly among females and hypertension is a prevalent and predictor component of MS among HIV patients.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204220
      Issue No: Vol. 8, No. 10 (2020)
  • Effect of coffee consumption on liver enzymes (alanine transaminase,
           aspartate transaminase and alkaline phosphatase), total and conjugated
           bilirubin levels among students in Nnewi

    • Authors: Ubou K. Amah, Adamma R. Analike, Somadina S. Uzodinma, Chukwuemeka E. Ogbodo, Chinonso J. Nnamdi, Chidiadi M. Njoku, Chibuike C. Agudi, Akuma K. Amah, Chikaodili N. Obi-Ezeani
      Pages: 3488 - 3492
      Abstract: Background: Coffee has a number of bioactive compounds that have beneficial effects on human health in general and more importantly is the fact that coffee consumption has positive impact on the liver function. The present study investigated the effect of coffee consumption on liver enzymes: alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP), total bilirubin (TB) and conjugated bilirubin (CB) levels among student in Nnewi.Methods: A total of twenty-five (25) apparently healthy participants aged between 18 and 30 years which were randomly recruited from College of Health Sciences’ students to serve as both test and control group. Each participant was advised to abstain from coffee and similar beverages for a period of three weeks prior to the commencement of the study. Subsequently, in addition to their normal diet, each of the subjects was given 2 gm of coffee dissolved in 150 ml of hot water in which 50 mg of non-dairy creamer was added before breakfast daily for 28 consecutive days. 6 ml each of baseline and test samples (after an overnight fast) were collected at day 0 and 29 respectively from each participant. Liver enzymes such as ALT, AST, and ALP activity as well as TB and CB levels was determined using standard laboratory methods.Results: This showed significant reductions in the mean serum AST and ALT activity, TB and unconjugated bilirubin (UB) levels with no significant alterations in the mean ALP activity and CB level in participants studied after short-term coffee consumption.Conclusions: This study revealed the hepatoprotective effect of coffee intake at short term basis.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204221
      Issue No: Vol. 8, No. 10 (2020)
  • Changing indications for intravitreal anti-vascular endothelial growth
           factor injections at the university college hospital, Ibadan, Sub-Saharan

    • Authors: Adeyemi Timothy Adewole, Tunji Sunday Oluleye, Yewande Olubunmi Babalola, Oluwole Majekodunmi, Modupe Ijaduola
      Pages: 3493 - 3496
      Abstract: Background: To review the current indications for intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, in order to make recommendations for planning of services.Methods: The medical records of 172 patients who had intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections from January 2016 to December 2019 were retrieved. Socio-demographic and clinical data were extracted, analysed, and compared with data from the previously published audit report covering 2010 to 2012.Results: Three hundred and thirty injections were given to 182 eyes in this cohort of patients. The mean age was 61.1±16.3 years (range <1-90 years), with a male to female ratio of 1.1:1. Retinal vein occlusion, 64 (35%) remained the most common indication for anti-VEGF injections in the eyes treated. This was followed by choroidal neovascular membrane/wet age-related macular degeneration which accounted for 42 (23%) as reported previously. However, cases of proliferative diabetic retinopathy/ diabetic maculopathy needing anti-VEGF were noticed to have almost doubled from about 8 (10%) in the previous study to 15 (27%) in the present study. In addition, idiopathic polypoidal choroidal vasculopathy, 18 (10%) ranked above proliferative sickle cell retinopathy in the present study. Retinopathy of prematurity (ROP), neovascular glaucoma, retinal artery macro-aneurysm and myopic choroidal neovascular membrane were the new emerging indications.Conclusion: There is an expanding indication for anti-VEGF in the management of retinal vascular diseases in the health facility and adequate measures should be put in place for early diagnosis and management. Patients should be counselled on the availability of this treatment option.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204222
      Issue No: Vol. 8, No. 10 (2020)
  • Knowledge and attitude towards mental illness among health and non-health
           university students in Riyadh

    • Authors: Samira M. Mahboub, Rahaf A. Aleyadhi, Reema I. Aldrees, Shahad S. Almuhanna
      Pages: 3497 - 3502
      Abstract: Background: Mental illness can affect anyone regardless of age, gender, and residence. Studying the attitude and knowledge about mental illnesses among university students is important, because they are the future decision makers dealing with such problems. The aim of this study was to assess level of knowledge and attitude towards mental illnesses among health and non-health university students in Riyadh.Methods: This study was a cross-sectional study on students of the governmental universities in Riyadh with both health and non-health speciality. The total sample size was 587 students. The questionnaire was designed electronically, and the link was distributed through social media. It included socio-demographic questions, 17 questions to assess knowledge and 22 questions to assess the attitudes. The statistical tests used were chi square, independent sample t-test, spearman’s correlation and multiple linear regression tests.Results: More than half of the participants had a positive attitude toward mental illness (52%). Only 13.46% of university students had good knowledge about mental illness. Significant higher level of good knowledge and positive attitude were reported among health college students compared to non-health (24.7% versus 7.9% for good knowledge and 60.8% versus 48.3 for positive attitude respectively). Attitude towards mental illness can be successfully predicted by using the knowledge score about mental illness and the type of college.Conclusion: Low percentage of university students had good knowledge about mental illness and their attitude towards mental illness was generally positive. Health college students had better attitude and knowledge about mental illness than non-health.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204223
      Issue No: Vol. 8, No. 10 (2020)
  • Comparison of mortality rate between bipolar hemiarthroplasty and proximal
           femoral nail anti-rotation for intertrochanteric fractures in Sanglah
           hospital, Bali

    • Authors: I. Wayan Suryanto Dusak, I. Gusti Ngurah Wien Aryana, Cokorda Gde Oka Dharmayuda, I. Wayan Subawa, Hans Kristian Nugraha, I. Made Arya Susila
      Pages: 3503 - 3507
      Abstract: Introduction: Intertrochanteric fractures occur in about 50% of all hip fracture events, with a mortality rate within 1 year after fracture reaching 15 to 20%. The most common treatment nowadays is either the bipolar hemiarthroplasty procedure or proximal femoral nail anti-rotation (PFNA), although there is still no consensus regarding which is better from the two, especially on patient mortality.Method: This study was an observational study using a retrospective cohort design. A total of 102 study subjects who met the inclusion requirements were grouped into 2 groups, one with bipolar hemiarthroplasty fixation treatment and another with PFNA fixation treatment. Mortality rate was recorded by survey 2 years after surgery.Result: Chi-square test showed that 2-year mortality rate after intertrochanteric fracture treated with bipolar hemiarthroplasty (21.4%) was significantly higher than the PFNA group (10.3%)
      (p=0.028). Bipolar hemiarthroplasty group also had longer length of stay (LoS) (50%) than the PFNA group (32.4%), albeit statistically insignificant (p=0.13). There was no significant difference between the 2-year mortality rate and LoS (p=0.976).Conclusion: Patients with intertrochanteric fractures who underwent bipolar hemiarthroplasty have significantly higher 2-year mortality rate than similar patients underwent fixation with PFNA, while they did not experience higher LoS than the PFNA group. Future prospective, multi-center study with larger sample size will be likely to validate similar fixation choice needed to decrease the mortality rate in intertrochanteric fractures.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204224
      Issue No: Vol. 8, No. 10 (2020)
  • The effect of Toxoplasma gondii infection in women on some biochemical and
           hormonal parameters in Duhok province, Iraq

    • Authors: Farhad B. Mikaeel
      Pages: 3508 - 3512
      Abstract: Background: Toxoplasma gondii is protozoal parasite that cause Toxoplasmosis, which is an important protozoal disease that infect more around billion people globally. Toxoplasmosis transmitted by two way in human; the horizontal transmission by accidental and ingestion of oocysts of Toxoplasma gondii through contaminated water or food, and the second rout is vertical transmission by placenta from mother to the baby. The aim of the current study was to detect the effect of toxoplasmosis on kidney function, liver function enzymes and gonadotropin hormones like follicle-stimulating hormone (FSH) and Luteinizing hormone (LH).Methods: A total of 101 (71 samples and 30 controls) of blood samples were collected from women, which were tested for seropositivity against anti-toxoplasma antibodies like immunoglobulin G (IgG), immunoglobulin M (IgM) by ELISA. After that the biochemical test (alanine aminotransferase-ALT, Aspartate transaminase-AST, Alkaline phosphatase-ALP, Urea and Creatinine) and hormonal assay (LH and FSH) and achieved for all samples.Results: Results revealed a slight increase in the level of both urea and creatinine in infected women compared with the control group. A Pearson’s Coefficient Correlation test was used to examine the positive correlations between ALT and Anaplastic lymphoma kinase (ALK), LH and FSH at p value (<0.001 for both). Preliminary studies indicate that the level of LH and FSH in infected women is lower compared to control healthy group. Finally, current study indicated that toxoplasmosis is effect on the levels of studied biochemical and hormonal parameters.Conclusions: Current study shows a significant increase in the levels of biochemical and hormonal parameters in women infected with toxoplasmosis.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20203995
      Issue No: Vol. 8, No. 10 (2020)
  • Efficacy in treatment of moderate to severe degree organophosphorus
           poisoning with fresh frozen plasma, atropine and 2-pyridine aldoxime
           methyl chloride as compared to treatment with atropine and 2-pyridine
           aldoxime methyl chloride in Western Odisha

    • Authors: Purna C. Karua, Surya K. Parida
      Pages: 3513 - 3517
      Abstract: Background: Organophosphorus (OP) compounds are one of the most common agents used for suicidal poisoning. People in the middle socioeconomic status are mainly affected. The most important determinant of death in OP poisoning is the severity. The ideal treatment of OP poisoning, this study was undertaken to compare the efficacy of fresh frozen plasma (FFP) along with the standard regimen of atropine and oximes.Methods: 80 patients were taken in this study (40 cases and 40 controls) with history and biochemical pictures suggestive of acute OP poisoning. Normality assumption and equality of variance were satisfied for most of quantitative variables. As a comparison of the baseline data of the study groups did not reveal any significant difference (p>0.05), the result at a given point of time between two groups were also compared with the same methods of assess the comparative changes.Results: Total 80 patients >15 years of age were taken for the study. Out of the total 63.7% are female and 36.3% are males. OP compounds are commonly used as suicidal agent. Salivation is the most common presenting symptoms in both cases and controls. The mean value of serum cholinesterase on day -1 in cases and controls are nearly same but the subsequent mean values as the days progresses are higher in cases than that controls.Conclusions: FFP showed its positive effect in reducing the development of intermediate syndrome/ fatality/ ventilatory support. 
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20203979
      Issue No: Vol. 8, No. 10 (2020)
  • The beneficial role of N-acetylcysteine as an adjunctive drug in treatment
           of COVID-19 patients in a tertiary care hospital in India: an
           observational study

    • Authors: Raja Bhattacharya, Maitry Mondal, Subhendu Bikash Naiya, Lamsaka Lyngdoh, Rishav Mukherjee, Prabhat K. Singh
      Pages: 3518 - 3522
      Abstract: Background: N-acetyl cysteine, a mucolytic agent, demonstrates free radical scavenging and anti-inflammatory properties, and prevents endothelial dysfunction by inhibition of NF-KB and formation of no adducts. This has a potential role to tackle cytokine storms, endothelial dysfunction and prothrombotic state observed in COVID-19 manifestations like ARDS and Multi organ dysfunction.Methods: Institution based descriptive cross sectional study, 164 patients from laboratory confirmed RT PCR positive COVID-19 patients, in the study period from 27th May 2020 to 10th August 2020, were assessed, in medical college Kolkata, a dedicated COVID-19 care facility.Results: It was observed that moderate-severe patients who received N-acetyl cysteine along with standard therapy had average hospital stay duration of 12 days, higher rate of discharge, average duration of oxygen therapy of 8 days, less number of deaths and reduced transfer to critical care facilities.Conclusions: N-acetyl cysteine can be considered as an adjunctive therapy with standard protocol driven care, due to its beneficial anti-inflammatory and free radical scavenging properties.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204010
      Issue No: Vol. 8, No. 10 (2020)
  • Comparison of platelet count by manual and automated method

    • Authors: Dileep Kumar Jain
      Pages: 3523 - 3527
      Abstract: Background: Since the emergence of dengue fever in the past few years, platelet count has become a routine test in every pathology lab. Common methods are by peripheral blood smears made from blood collected in ethylenediaminetetraacetic acid (EDTA) tubes, by neubaeur chamber, automated method by hematology cell counter.Methods: Blood samples of 460 adult patients and 72 children (<15 years), including indoor and outdoor, between May to August 2019, attending Hind institute of medical sciences, were collected in EDTA tubes. Samples were properly mixed on blood shaker and immediately peripheral blood smears were made and stained with Leishman stain. Platelet count of every sample was done by peripheral blood smear and by Mindray (BC5150) automated cell counter, simultaneously.Results:  Results by manual slide method are slightly higher than automated method but significantly not different from automated method.Conclusions: Traditional slide method can also be used if done carefully comparable to automated method especially useful in small labs which can’t afford automated cell counter.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204011
      Issue No: Vol. 8, No. 10 (2020)
  • Long term prognostic significance of thrombolysis in myocardial infarction
           risk score after revascularization in non-ST elevation acute coronary

    • Authors: Pawan Sarda, Gaurav Kumar, Rohit Mathur, Anil Baroopal, Sanjeev Sanghvi
      Pages: 3528 - 3533
      Abstract: Background: Non-ST elevation acute coronary syndrome (NSTE-ACS) patients are complex and varied population. Primarily thrombolysis in myocardial infarction (TIMI) risk score was developed to guide therapy and assess the short term (14 days) prognosis of these patients. However, few studies have evaluated the long term prognostic significance of TIMI risk score after revascularization. This study aims at assessing the long term prognostic significance of TIMI risk score, 36 months after revascularization in NSTE-ACS.Methods: This was a retrospective observational cohort study of consecutive NSTE-ACS patients (n=150) treated by percutaneous coronary intervention between January 2017 to June 2017 in a tertiary care center. TIMI risk score was calculated for each patient at admission. The primary endpoint was a composite of MACE (death, repeat target-vessel revascularization, and non-fatal recurrent MI) at the end of 36 months of follow up. Clinical secondary endpoints included the individual components of the primary endpoint, death, nonfatal recurrent MI, and repeat target vessel revascularization.Results: Baseline characteristics for 150 participants were as follows, age 56±9.5 years, 78.7% male, 25% diabetics, 82% hypertensives, and 36% had hypercholesterolemia. The event rates of the primary endpoint and its components after 36 months were 26.6%. Event rates increased significantly as the TIMI risk score increased as determined by regression analysis (p=0.004). The relative risk increased by 66% as the TIMI risk score increased from low risk category (TIMI score 0-2) to high risk (TIMI score 5-6).Conclusions: TIMI risk score can be used for long term prognostication of NSTE-ACS patients after revascularization, and thus can be used by clinicians for therapeutic decision making.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204023
      Issue No: Vol. 8, No. 10 (2020)
  • Evaluation of coronary microcirculation by myocardial contrast
           echocardiography in patients of ST elevation myocardial infarction

    • Authors: Avijit Singh, Vishwa Deepak Tripathi, Pushpraj Patel
      Pages: 3534 - 3538
      Abstract: Background: No reflow phenomenon observed during catheter intervention has been associated with poor cardiovascular outcomes. Assessment of filling defect by myocardial contrast echocardiography (MCE) correlates with no reflow. Limited studies are available for the same. This study was designed to look for impact of type of therapy for revascularization (whether percutaneous coronary intervention or thrombolysis) and its evaluation by MCE and follow up echocardiography parameters.Methods: Total 50 consecutive patients of ST-elevation myocardial infarction (STEMI) were taken study including recent STEMI (within 7 days). After all routine investigations patient underwent coronary angiography and percutaneous coronary intervention (PCI) procedure. Following completion of procedure, thrombolysis in myocardial infarction (TIMI) flow, TIMI frame count, and myocardial blush grade were calculated and noted. Post revascularization contrast echocardiography was done after patient stabilization. Findings were correlated with cath-lab parameters applying appropriate statistical tests. Follow up was planned after 30 days.Results: 50 consecutive patients admitted with acute myocardial infarction (MI) or recent MI (0-7 day) who underwent primary PCI - 82% (n=41) or thrombolysed with various thrombolytic agents - 18% (n=9). Mean age of the study group was 55.02±12.65 years. There was significant association in between TIMI 3 flow and absence of filling defect in MCE (p=0.03), but no significant association found in between revascularization therapy (Either PCI or Thrombolysis) and filling defect in MCE (p=0.08).Conclusions: Our study found good correlation between myocardial contrast score with angiographically measured TIMI flow and improved echocardiographic findings on follow up.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204019
      Issue No: Vol. 8, No. 10 (2020)
  • Intravenous ferric carboxymaltose for anaemia in pregnancy

    • Authors: Nikita Gandotra, Shazia Zargar, Neha Mahajan
      Pages: 3539 - 3542
      Abstract: Background: Anaemia in pregnancy is associated with unfavourable consequences both for the mother and the fetus and is a major cause of maternal and perinatal mortality and morbidity.Methods: The study was conducted over a period of one year in which 100 pregnant females who met the inclusion criteria were administered ferric carboxymaltose (FCM) preparation.Results: There was significant rise in mean haemoglobin and serum ferritin after transfusion of ferric maltose in the patients with very less adverse effects.Conclusions: FCM, because of its high efficacy and safety can revolutionize the management of iron deficiency anaemia (IDA) in pregnancy.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204225
      Issue No: Vol. 8, No. 10 (2020)
  • Clinicopathological study of premalignant and malignant lesions of cervix
           along with apoptotic index and Ki-67 expression

    • Authors: Bhagyalakshmi Atla, Uma Prasad, Saraswathi Samantra, Venkata Satya Kartheek Botta, Naresh Dasari, Glen Christopher Changala
      Pages: 3543 - 3549
      Abstract: Background: Cervical cancer is known to have a good response to radiotherapy. The response and prognosis are dependent on the level of apoptosis. Pap smear and histopathology are cost-effective methods in diagnosing premalignant and malignant lesions of cervix but not accurate in classifying and estimating the progression of the disease, especially in premalignant lesions. Therefore this study was undertaken to know the role of Ki-67 expression and apoptotic index in classifying accurately the premalignant lesions for better management.Methods: The study included 540 cases diagnosed histologically as cervical intraepithelial neoplasia or carcinoma. The apoptotic index is calculated for all the 540 cases using light microscopy on Haematoxylin and Eosin stained sections. Ki-67 immunohistochemical staining was done for 100 cervical biopsies. Ki-67 expression was graded and the Ki-67 labelling index was calculated. Statistical evaluation was done using the unpaired t-test.Results: The Apoptotic index increased with increasing grade of dysplasia. There is a significant difference in the mean apoptotic index between premalignant and malignant lesions of the cervix. The ki-67 index increased with increasing grade of dysplasia. There is a significant difference in the mean Ki-67 index between premalignant and malignant lesions of the cervix.Conclusions: Apoptotic index and proliferative indices have been found useful in distinguishing between premalignant and malignant lesions of the cervix and gives an idea about the proliferative activity of the tumour for better management of the patient and to determine prognosis.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204226
      Issue No: Vol. 8, No. 10 (2020)
  • A case control study of serum vitamin D levels in alopecia areata

    • Authors: Bobbili Tarun Kesava Naidu, Kavya Baddireddy
      Pages: 3550 - 3553
      Abstract: Background: Alopecia areata is an autoimmune disorder of anagen hair follicle leading to distressing and relapsing non-scarring hair loss. Vitamin D is an immunomodulator and plays a role in regulating normal hair cycle. Recent evidence suggests inconsistent association between vitamin D deficiency and alopecia areata.Methods: This case control study included 70 newly diagnosed cases of alopecia areata and 70 healthy controls. Competitive chemiluminescence immunoassay was used to determine and compare the serum vitamin D (25‑hydroxyvitamin D) levels between these groups. Also, the serum vitamin D levels correlation with severity of the disease was studied. ANOVA test and student t test were used for the statistical analysis.Results: Serum Vitamin D levels were significantly decreased in alopecia areata patients than in controls (p<0.05). There was no stastically significant relationship between serum 25-OH Vitamin D levels and severity of the disease (p=0.06).Conclusions: Prevalence of serum 25 (OH) deficiency was significantly higher in alopecia areata group. However no significant relation was found with disease severity.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204227
      Issue No: Vol. 8, No. 10 (2020)
  • Pregnancy emerged thrombocytopenia: maternal and fetal outcome

    • Authors: Fasiha Tasneem, Vinutha M. Sharma
      Pages: 3554 - 3559
      Abstract: Background: A low platelet count is often an incidental finding in pregnancy. It can be an indicator of a severe systemic disorder requiring emergent maternal and fetal care or can just be unique to pregnancy with no harm to mother or fetus. Physiological decrease in platelet count is seen in pregnancy due to hemodilution and hypercoagulating state, though the exact pathophysiology is still unclear.Methods: It is a prospective observational study done in a tertiary care centre.Results: In about 11,258 cases screened 46 patients had thrombocytopenia (0.4%). The commonest etiology is found to be gestational thrombocytopenia (n=21, 45.6%) followed by preeclampsia/ eclampsia/ HELLP (haemolysis, elevated liver enzymes, low platelet count) syndrome (n=19, 41.3%). Only one patient had immune thrombocytopenic purpura (ITP) and 7 (15.3%) were associated with amplified fragment length polymorphism (AFLP). Maximum of them (n=19, 41.3%) underwent spontaneous vaginal delivery. 4 patients (8.6%) had postpartum haemorrhage, 6 (13.04%) had ceserean section wound infection, 4 (8.6%) had disseminated intravascular coagulation (DIC) and 4 (8.6%) had multiorgan failure. 13 patients (28.3%) had platelet count between 40 to 60 thousand per cumm, 11 (23.9%) had between 60 to 80 thousand per cumm, 10 (21.7%) had between 80,000 to 1 lakh and none had their platelet count less than 20,000 per cumm.Conclusions: Gestational thrombocytopenia is not a preventable condition. It is an incidental finding in pregnancy. With strict vigilance during intrapartum and postpartum period, even without any treatment proper for the same, the maternal and fetal outcome is found to be good.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204228
      Issue No: Vol. 8, No. 10 (2020)
  • Cyto-histological correlation in diagnosis of gastrointestinal lesions- a
           prospective study in a tertiary care institute

    • Authors: Swati Aggarwal, Kavita Mardi, Shivani Sood, Vijay Kaushal, Brij Sharma, Pranav Sood
      Pages: 3560 - 3564
      Abstract: Background: Gastrointestinal tract is involved by a large number of inflammatory, infectious and neoplastic diseases. There is a worldwide rising incidence of GIT lesions especially neoplasms.Methods: This study was planned to correlate endoscopic and colonoscopic brush cytology with histopathology of gastrointestinal lesions and to determine the spectrum of gastrointestinal lesions in patients subjected to endoscopic brushings and biopsy.Results: Sensitivity of upper GI brush cytology was 95.15% and specificity 90.41%. Sensitivity of colonoscopic brush cytology was 100% and specificity 86.79%. The accuracy of brush cytology came out to be 92.45% in upper GIT and 92.22% in lower GIT.Conclusions: Brush cytology is a non-invasive and cost-effective method to retrieve epithelial cells from a much larger surface area of the mucosa, thus allowing thorough sampling and increasing the diagnostic yield.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204229
      Issue No: Vol. 8, No. 10 (2020)
  • Comparison of two ophthalmic solutions of olopatadine hydrochloride (0.1%)
           and epinastine hydrochloride (0.05%) on clinical signs of vernal
           keratoconjunctivitis and side effects of the two drugs

    • Authors: Tahir Husain Ansari, Yusuf Rizvi
      Pages: 3565 - 3570
      Abstract: Background: Vernal keratoconjunctivitis (VKC) is a recurrent, bilateral, external, ocular inflammation primarily affecting young adults living in warm dry climates. The objectives of the research was to compare the two ophthalmic solutions of olopatadine hydrochloride (0.1%) and epinastine hydrochloride (0.05%) on clinical signs of vernal keratoconjuntivitis and to determine side effects of both the drugs.Methods: The study was carried out in 40 patients who attended the out-patient department (OPD) Ophthalmology, Darbhanga Medical College and Hospital, Laheriasarai from July 2007 to December 2008.  Forty patients with symptoms of VKC (ocular itching, ropy discharge, papillary hypertrophy, gelatinous thickening and horner-trantas spots were selected and included in our study.Results: Mean score of palpebral hyperemia at 0, 14, 28 and 42 days in olopatadine treated eye were 2.1, 1.4, 0.8 and 0.4 respectively having p value <0.01, and <0.01 and <0.05 respectively, while mean score at same stages in placebo eye were 2.1, 2, 1.9, and 1.5 having value >0.05. Epinastine treated group mean score of palpebral hyperemia were <0.01 and <0.01 respectively in epinastine treated eye whereas in placebo treated eye, mean score were 2.1, 2.0, 1.8 and 1.6 respectively having p value >0.05 in all stages. Statistically insignificant reduction at day 14 while very significant reduction at day 28 and 42 was observed in epinastine treated eye as compared to placebo.Conclusions: The present study had shown that both olopatadine and epinastine were effective in treating clinical signs of VKC as compared to placebo.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204230
      Issue No: Vol. 8, No. 10 (2020)
  • Staphylococcus aureus still the commonest culprit

    • Authors: Saurabh Kumar, Yousuf Faisal, Rajib Ratan Chaudhary, Mukund Shyam Sarda
      Pages: 3571 - 3574
      Abstract: Background: Sepsis is still one of the most leading cause of death in world. 19 million sepsis (formerly severe sepsis) cases and 5 million sepsis-related deaths are estimated to occur annually. Sepsis is also one of the most common cause of patients getting critically ill and getting admission in intensive care unit. The main focus of this study is to identify the culture isolate from the critically ill patients and to check for the antibiotic sensitivity and resistance and identify if the report has changed the course of treatment and outcome of the patients. Critical illness is a life-threatening multisystem process that can result in significant morbidity or mortality. Critically ill patients are those who have dysfunction or failure of one or more organs/system and depend on survival from advanced instruments of monitoring and therapy. The aim of the study was to identify the causative organism causing sepsis in critically ill patients.Methods: It will be multi central retrospective study which included patients of critical illness of Rohilkhand Medical college, Bareilly, Uttar Pradesh and Varun Arjun Medical college, Shahjanpur, A total of 468 patients were taken for the analysis during period of from August 2018 to November 2019 among of which 324 samples came positive. Samples were taken on day one of the patient’s presentation to the hospital and were analysed in BD BACTEC culture medium. Patient’s data were taken from records available at both the hospitals. Sensitivity was performed using disk diffusion method and the results were compared with the records of patients.Results: Among of samples taken that is 324; 194 were male and 130 were female. Maximum patients which were tested positive for Staphylococcus aureus (n=198). Others included Streptococcus pneumococcus (n=25), Escherichia coli (n=50), Klebsiella oxytoca (n=13), Klebsiella pneumoniae (n=15), Pseudomonas aeruginosa (n=20), and Acinetobacter (n=3). In retrospective analysis of the patients of all 324 cases treatment in approximately 148 patients was changed due to change in the sensitivity of antibiotics.Conclusions: Staphylococcus still dominates the sepsis. It is advisable to add an antibiotic with gram negative if patients count does not improve in first 24 hour. 
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204231
      Issue No: Vol. 8, No. 10 (2020)
  • Role of diffusion: weighted magnetic resonance imaging in evaluation of
           renal masses

    • Authors: Jitendra K. Meena, Anil Taneja
      Pages: 3575 - 3584
      Abstract: Background: Diffusion-weighted magnetic resonance imaging (DWI) is a valuable tool to narrow down the differential diagnosis of renal masses. Studies have shown that benign renal masses have higher Apparent diffusion coefficient (ADC) value than malignant renal masses. Aim of study was to evaluate the role of diffusion-weighted magnetic resonance imaging in the characterization of renal masses.Methods: The study was conducted in department of Radio diagnosis at ABVIMS and Dr. RML Hospital, New Delhi between June 2017 to March 2019. This was a cross-sectional observational study comprising of 28 patients. Patients found to have renal mass on ultrasound and computed tomography (CT) were evaluated further on 3T siemens Magnetic resonance imaging (MRI) scanner. In addition to routine sequences, DWI using b value of 0,500,1000 s/mm2 sequence was used to study to differentiate benign and malignant renal masses.Results: Of a total of 28 cases, the most common malignant mass was renal cell carcinoma (RCC). Angiomyolipoma (AML) was the most common benign masses. DWI showed low ADC values in most of the malignant masses and high ADC values in most of the benign masses. The cut-off level of ADC value for differentiation among benign and malignant renal masses was 1.08×10-3 mm2/s. DWI-MR findings were correlated with histopathological diagnosis.Conclusion: DWI with ADC measurements are a non-invasive, problem solving tool for characterization of renal masses helping to differentiate malignant from benign masses. 
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204232
      Issue No: Vol. 8, No. 10 (2020)
  • A cross-sectional study on self-medication practice and attitude towards
           self-medication among medical students of GMERS Medical College, Valsad

    • Authors: Hinaben R. Patel, Ravikant R. Patel
      Pages: 3585 - 3590
      Abstract: Background: Self-medication is becoming a most prevalent practice among educated people across the world. In today’s era, internet and media is one of the most important sources for promoting self-medication practice. Medical students are highly influenced with this practice as their future medical preference and the fact that medical students find themselves having more knowledge about drugs this may lead to irrational usage of drugs. Aim and Objectives of the study were conducted to know the 1. Self-medication practices among medical students 2. Common, indications and reasons for self-medication practice. 3.Attitude of medical students towards self-medication practice.Methods: A cross-sectional, questionnaire-based study was conducted among undergraduate medical students of GMERS Medical College Valsad. The study was carried out in the months of October to December 2017. Medical students of first and final year MBBS participated voluntarily in this study after being briefed in detail about the goals & method of the study.Results: In this study, 91.50% of medical students were practiced self-medication. The common indication for self-medication was fever (76.50%) and cough (75.96%). Acquaintances (67.76%) are main source of information for self-medication. Common reasons they know the medicine (78.14%) and previous exposure (64.48%). 12.5% student perceived self-medication is harmless and 21.0% of medical students advise other to take self-medication.Conclusions: It was concluded that more than half of strength of students practice self-medication for various illnesses; the reason might be the awareness of drugs due to easy accessibility of information through books, internet as well as availability of medicine without prescription from pharmacist. So, essential measure should be taken to reduce the practice of self-medication among students to avoid development of drug dependence, resistance and drug interactions.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204233
      Issue No: Vol. 8, No. 10 (2020)
  • Soft tissue neoplasms: a clinicopathological study

    • Authors: Athulya Krishna Kumar K. T., Ariya S.
      Pages: 3591 - 3595
      Abstract: Background: The current WHO classification has categorized soft tissue tumours into benign, malignant and so-called intermediate neoplasms. Soft tissue sarcoma comprises <1% of adult cancers. The aim of the study was to clinically correlate soft tissue neoplasms and study the histomorphological features of various malignant soft tissue tumors.Methods: This was a retrospective study conducted in a tertiary care hospital in Mangalore, India from January 2019 to June 2020. Clinical details of all cases of soft tissue neoplasms retrieved from the medical records of our institution. Data collected included age, gender, presenting symptoms, site and size of soft tissue neoplasms and clinical diagnosis. Pathological diagnosis of these tumours was made and details recorded.Results: A total of 113 cases of soft tissue neoplasms were collected. 94.4% benign and 18.6 %. malignant tumours were present. 77% cases presented with swelling whereas 23% presented with pain. Majority of benign soft tissue tumours were located in the trunk (36.9%) and the most common type was lipomas (66.38%). Malignant soft tissue tumours showed male to female ratio of 1.33:1. Most predilection was noted for the extremities (42.8%) and leiomyosarcomas were the most common type (38%).Conclusions: The incidence of malignant soft tissue tumours is rare. Majority of the cases were noted in the extremities. Leiomyosarcoma was the most common type, in our study. Lipomas were the most common benign soft tissue tumours, and majority of the benign tumours were located in the trunk. 
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204234
      Issue No: Vol. 8, No. 10 (2020)
  • A study on scrape smear cytology in oral leukoplakia in a tertiary health
           care centre of southern Assam

    • Authors: Sania S. Ullah, Manoj K. Deka, Nitumani Khakhlari
      Pages: 3596 - 3599
      Abstract: Background: Oral cavity is susceptible to countless changes with advancing, environmental, and lifestyle related habits and factors. Oral mucosal lesions especially related to chewing and smoking of tobacco have led to the increased incidence and prevalence of potentially malignant and malignant disorders worldwide. Oral leukoplakia has been a very frequent finding in patients coming to our department and with an increasing rise of oral squamous cell carcinoma in the region, the study was conducted.Methods: Patients referred to our section from various department with white oral lesion. Scrapping smears were prepared. Stained with MGG and PAP stain. Study period: January 2019 to May 2020.Results: Total number of patients with white oral lesion were 83. Out of these 65 were male and 18 were female. Most of the patients had addiction to betel nut and leaf with tobacco and few had history of intake of bidi for several years.Conclusions: The study reveals that most of the oral leukoplakia cases is attributed to smoking, betel nut and lime intake. Exfoliative cytology of oral mucosa serves to be an easy, convenient and reproducible technique for early diagnosis of premalignant condition. Biopsy can be used as an adjunct in cases showing atypia and mixed type of keratosis.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204235
      Issue No: Vol. 8, No. 10 (2020)
  • Impact of coronavirus on pregnant females in India: an observational study

    • Authors: Megha Garg, Madhu Jain, Shuchi Jain
      Pages: 3600 - 3604
      Abstract: Background: Coronavirus (COVID-19) has emerged as a rampant pandemic and the entire world is struggling against it. The entire nations are trying to device measure like national lockdowns, diverting resources towards fighting coronavirus, extensive media coverage, closing of elective services in hospitals. All this has influences the masses to a deep level. Coronavirus not only is morbid for the sick, but also the healthy pregnant females seeking health care and impacted them more mentally than physically.Methods: In this study 103 pregnant females from the entire nation of India were made to answer a well thought and made questionnaire which aimed at assessing the mental state and impact of coronavirus on the pregnant females.Results: Majority of the females answered that they felt anxious and were undergoing stress due to the coronavirus. They fear impending doom for the child and also are struggling a lot to seek apt healthcare for themselves and their children because of the ongoing pandemic.Conclusions: Coronavirus has not only affected people who are directly affected with the virus, but also who are still not affected but are mentally stressed because of it. National lockdown and alteration in the healthcare services are also stress- inducing for the pregnant females.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204236
      Issue No: Vol. 8, No. 10 (2020)
  • Estimation of interleukin-17 levels in gingival crevicular fluid from
           healthy individuals, chronic gingivitis and chronic periodontitis patients
           using enzyme linked immunosorbent assay

    • Authors: Neha Nainee, Sheetal Sanikop, Abhilasha Jha
      Pages: 3605 - 3610
      Abstract: Background: Chronic Periodontitis (CP) is an infectious disease resulting in inflammation of supporting tissues of the teeth. A number of pro-inflammatory cytokines are formed against periodontopathogenic microorganisms. Interleukin-17 (IL-17) is a pro-inflammatory cytokine, implicated in numerous inflammatory and autoimmune conditions.Methods: A total of 25 periodontally healthy subjects (Group 1), 25 patients with gingivitis (Group 2) and 25 patients with CP (Group 3) were included for the study based on clinical examination. Gingival index, probing pocket depth and clinical attachment loss were recorded in all subjects.Results: The levels of IL-17 increased from healthy to gingivitis to periodontitis patients. A positive correlation was found with the IL-17 and the clinical parameters like gingival index, probing pocket depth and clinical attachment loss.Conclusions: There is a strong association between the levels of IL-17 with periodontal disease as well as with its severity and its possible use as a biomarker for inflammatory periodontal disease.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204237
      Issue No: Vol. 8, No. 10 (2020)
  • Evaluating substance use in an urbanizing town of mid hills of Northern

    • Authors: Ajay K Singh, Kushel Verma, Amit Guleria, Shalini Puri, Ankit Sharma, Vaishali Sharma
      Pages: 3611 - 3617
      Abstract: Background: Substance use is emerging as a major cause of morbidity and mortality across the world. Solan, a fast urbanizing town of India has witnessed mushrooming of industries and educational institutes. A surge in the persons booked under the Narcotic Drug and Psychoactive Substance Act 1985 led us to look into the determinants of the substance use in this region.Methods: We undertook a cross sectional study of one year secondary data analysis of 750 substance users screened at the de-addiction centre of Solan Hospital. The data mining was done by the cluster analysis technique. SPSS 16 and STATA 13 software were employed.Results: Mean age of users was 31 years with dominance of males (89.20 %), two third of total users were married, 75% were unemployed, 42% had upper school level education. About 60 and 38% were using cannabis and chitta (a synthetic opioid) respectively. Only 2% were consuming tobacco and alcohol. 62% of substance users had the fear of legal action and 44% had no family history of substance use. 39% had only single parent, 54% had started substance use under peer pressure and duration of use varied between 6 to 24 months.  Alcohol and cannabis were used more in urban and rural areas respectively. 63 and 70% had family history and experience of peer pressure respectively.Conclusions: Cluster analysis has generated substance specific socio-demographic determinants of substance use which would help in planning appropriate substance use alleviation strategies. 
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204238
      Issue No: Vol. 8, No. 10 (2020)
  • Relationship of serum vitamin D with hepatic fibrosis in patients with
           chronic hepatitis C

    • Authors: Manas Kumar Behera, Surendra Nath Swain, V. B. Abhilash, Sunit Kumar Shukla, Vinod Kumar Dixit
      Pages: 3618 - 3623
      Abstract: Background: Serum vitamin D concentration is proposed to have an important role on outcome in patients with chronic hepatitis C virus (HCV) infection. A few studies have shown an inverse association of vitamin D level with stage of fibrosis. The aim of the present study was to verify whether serum vitamin D level is an independent predictor of significant hepatic fibrosis.Methods: Seventy-two treatment naive chronic HCV subjects and 40 healthy age and sex matched controls were included in the study. A serum vitamin D level was assessed in both HCV subjects and controls, and liver biopsy was performed in all HCV subjects to assess for stage of fibrosis.Results: Serum vitamin D levels were significantly lower HCV patients in comparison to age and sex matched controls (18.04±6.92 versus 21.53±8.2, p<0.01). Most common genotype in HCV patients was genotype 3 (62.5%) and blood transfusion was the most common mode of transmission (28%) followed by intravenous drug user (IVDU) (17%). The HCV patients with vitamin D level <20 ng/ml had higher metavir score as compared to vitamin D≥20 ng/ml (1.67±0.66 versus 2.5±0.67, p<0.001). Both univariate and multivariate analysis performed using logistic regression revealed that vitamin D<20 ng/dl is a significant negative predictor of liver fibrosis (p<0.05).Conclusions: Chronic HCV patients had significantly lower vitamin D levels as compared to healthy controls. Serum vitamin D was a negative predictor of stage of fibrosis in patients with chronic hepatitis C.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204239
      Issue No: Vol. 8, No. 10 (2020)
  • Association of ocular biometric parameters with diabetic retinopathy

    • Authors: Shubhneek Kaur Dhillon Utaal, Rupali Chopra, Nitin Batra
      Pages: 3624 - 3628
      Abstract: Background: To study the association of ocular biometric parameters {Spherical equivalent (SE), Axial length (AL), Anterior chamber depth (ACD) and Corneal curvature (CC)} with diabetic retinopathy (DR) in subjects with Type 2 diabetes mellitus (DM).Methods: This prospective observational study was conducted in the Outpatient Department of Ophthalmology of a tertiary care teaching hospital in North India. The study included 100 subjects having various grades of DR as cases and 100 diabetics without DR as controls. The SE was assessed using objective autorefraction, while AL, CC and ACD were measured using the NIDEK AL SCAN.  International Clinical Diabetic Retinopathy Disease Severity Scale was used for grading of DR.Results: A total of 181 eyes in the study group and 200 eyes in the control group were analysed.  Progressive decrease in the mean AL was observed with the increasing severity of DR (p=0.017). Deeper ACD had a negative correlation with severity of DR (p=0.037). No statistically significant difference was observed for AL and ACD with the incidence of DR (p=0.147 and p=0.091 respectively). Likewise, there was no significant relation of DR with SE or CC.Conclusions: Longer AL and deep ACD were protective against progression to the severe forms of DR. However, there was no correlation of AL and ACD with the incidence of DR. The SE and CC were not found to be significant determinants for either development or severity of DR.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204240
      Issue No: Vol. 8, No. 10 (2020)
  • Evaluation of maternal and perinatal morbidity and mortality in eclampsia
           by early termination of pregnancy

    • Authors: Suresh C. Mondal, Sandip Lahiri
      Pages: 3629 - 3632
      Abstract:  Background: Eclampsia is one of the leading causes of maternal mortality in India.Methods: A prospective observational study was done on 200 pregnant women admitted with antepartum eclampsia in Malda Medical College from 1 April 2017 to 30 October 2019. Group A included patients who delivered through vaginal route within 10 to 12 hrs of eclampsia by stabilisation of patients while Group B included subjects who underwent early caesarean section for uncontrolled convulsions or poor Bishop score. Maternal and perinatal outcomes were compared between the groups. Data was recorded in a pretested performa and was analyzed using appropriate statistical methods with SPSS.Results: Caesarean section (group B) was done in 130 cases (65%) while vaginal delivery (group A) was done in 65 cases (37.5%). Group A had higher maternal mortality (10.7%) in comparison to group B (4.6%) which was statistically not significant (p=0.1075). There were 32 neonatal deaths (24.6%) and 11 still births (8.46%) in group A while there were 12 neonatal deaths (18.46%) and 3 still births (4.61%) in group B. There was a statistically significant difference (p<0.0001) between the groups with respect to total perinatal deaths.Conclusions: Antenatal and intranatal eclampsia should be managed by early termination of pregnancy preferably with Caesarean section. Early presentation and timely decision to terminate pregnancy will improve the maternal and perinatal outcome.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204241
      Issue No: Vol. 8, No. 10 (2020)
  • Clinical and socio-demographic profile of substance abusing persons
           seeking treatment at a teaching hospital in Garhwal hills of Uttarakhand

    • Authors: Prem Singh, Harsh Rathi
      Pages: 3633 - 3636
      Abstract: Background: The substance abuse is gradually becoming one of the major public health issues of present day India. Many factors influence the pattern of substance abuse, including age, sex, educational level, social support, cultural factors, availability of drugs and the presence of cognitive or psychiatric problems. This study was planned to find out the clinical and socio-demographic profile of substance abusing persons.Methods: The study was conducted in the Out-patient facility of the Department of Psychiatry, Veer Chandra Singh Garhwali Government Institute Of Medical Science and Research, Srinagar (Uttarakhand), starting from 23 September 2015. One hundred consecutive treatment seeking subjects fulfilling International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), criteria for Mental and behavioural disorders due to psychoactive substance use were included in the study. All the participants were required to sign an informed consent approved by the institutional ethical committee before being enrolled in the study. All the subjects included in the study were administered a self-structured proforma to elicit the clinical and socio-demographic variables.Results: One hundred patients consisting of 95 men (95%) and 05 women (05%) were included. The average age of the sample was 39.68 years (SD=11.97). As for the socio-demographic variables other than age, 87% of the patients were married, 62% patients were living in nuclear families and 66% belonged to the rural areas. 79% patients were educated up to high school and above and only 06% were illiterate. Alcohol was the most frequently abused substance seen in 78% patients followed by tobacco smoking in 58% of the study subjects. Peer Pressure was cited as the most common reason for the initiation of substance abuse by 75 (75%) patients.Conclusions: Alcohol was the most commonly abused substance. Substance abuse was higher in married, educated males from rural areas living in nuclear families.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204242
      Issue No: Vol. 8, No. 10 (2020)
  • A study of percutaneous injuries amongst health care workers in a tertiary
           care hospital

    • Authors: Aswin Geo Jacob, Divya Deodhar, Mary John
      Pages: 3637 - 3642
      Abstract: Background: Percutaneous injuries (PCI) pose a significant risk of occupational transmission of blood borne pathogens to health care workers (HCWs). Their incidence is considerably higher than current estimates, and hence a low injury rate should not be interpreted as a non-existent problem.Methods: This prospective observational study was conducted over a period of 1 year at a tertiary care teaching hospital in northern India. As soon as the HCW sustains a PCI, they were instructed to report to the emergency department where note was made of all the details in the post exposure reporting form.Results: The incidence of PCI in this study was found to be 4.3%. PCIs were reported maximum among nursing staff (63.41%) compared to doctors (36.58%). Majority of PCIs were reported within 1 hour of sustaining the injury (57.1%). Needle stick injury was the commonest injury sustained by HCWs (84.5%). 91.46% of HCWs were fully immunized against hepatitis B.Conclusions: Preventing PCI is an essential part of infection control program in a hospital. Stress must be laid for mandatory reporting of all PCI irrespective of the source.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204243
      Issue No: Vol. 8, No. 10 (2020)
  • Correlation between peak expiratory flow rate and pectoralis muscle length

    • Authors: Visalakshi H. Subramanian, Aruna Chennakeshawaran, Vijay Krishna Kumar
      Pages: 3643 - 3646
      Abstract: Background: Peak expiratory flow rate (PEFR) is a measure of the maximum speed of exhalation after a deep inspiration. The peak expiratory flow is measured by a device named peak flow meter. This study concentrates on the correlation of the PEFR with the pectoral muscle length.Methods: It is a cross sectional study of 30 convenient samples based on gender distribution where the PEFR and pectoralis muscle length were measured in the subjects.Results: Statistical analysis shows that there is a significant correlation between right pectoralis major general muscle length and PEFR (p=0.030), left pectoralis major general muscle length and PEFR (p=0.014), right pectoralis major clavicular end muscle length with PEFR (p=0.010).Conclusions: There is a significant correlation between peak expiratory flow and pectoralis muscle length. 
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204244
      Issue No: Vol. 8, No. 10 (2020)
  • Study the role of hepcidin in diagnosis of iron deficiency anemia in young
           females of northern India

    • Authors: Shaveta ., Sanjiv Kumar Bansal, Seema Patel
      Pages: 3647 - 3651
      Abstract: Background: Iron deficiency is one of the most common nutritional disorder. Maintenance of body iron status is an integral part of healthcare in young female of reproductive age group. Thereby early detection could lead to early intervention and reduce its comorbidity.  Indeed, an ideal screening test should be capable of identifying iron deficiency long before developing anemia. Henceforth, the present study was aimed to determine utility of serum hepcidin in iron deficiency and to access the baseline value of hepcidin in young female.Methods: This sectional study was conducted in the Department of biochemistry SGT Medical College Hospital and Research Institute, Budhera, Gurugram. It included non-pregnant female students of age 18-25 years with normal RBC indices and hemoglobin >12 gm%. Estimation of serum hepcidin-25 was by ELISA.Results: The reference range of hepcidin established in this study was 12.14-139.89 ng/ml for females with the mean being 42.4±29.13 ng/ml. It showed higher discriminating power in evaluating iron status in young healthy women (AUC 0.984) with best combination of diagnostic sensitivity (95.7%) and specificity (93.2%) at a cut off of >15.7 ng/ml. Serum hepcidin identified 17% of young healthy females with normal hemoglobin to have functional or storage iron deficiency.Conclusions: The prevention of iron deficiency anemia remains insufficient worldwide especially among underprivileged women and children Therefore, estimation of serum hepcidin may be considered as a valuable tool in assessing iron status in young healthy female population who are the prime target group for iron supplements to reduce comorbidity associated with iron deficiency and anemia.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204245
      Issue No: Vol. 8, No. 10 (2020)
  • Knowledge, attitude and practices towards COVID-19 pandemic in the
           community: a cross-sectional web-based survey in India

    • Authors: Shruti Shukla, Prerana Deotale
      Pages: 3652 - 3656
      Abstract: Background: Coronavirus disease is a current new virulent disease rising its transmission and fatality with each passing day globally. People’s observance of the prevention measures is essential for controlling the spread of COVID-19, which is affected by their knowledge, attitude, and practices (KAP) towards COVID-19. The aim of this study was to assess knowledge, attitude, and practices towards COVID-19 in the community in India.Methods: Present descriptive cross-sectional study was a web-based survey carried out between 15th July and 19th July 2020 among 570 participants in Maharashtra, India. A 30-item questionnaire distributed among the public using Google forms through social media networks.Results: 97.4% participants knew contact with the infected person as a mode of transmission for COVID-19. Common symptoms of COVID-19 reported were difficulty in breathing (96.3%), fever (90.7%), cough (88.9%), sore throat (82.8%), etc. The majority of participants (>90%) had correct knowledge about preventive measures to stop the spread of COVID-19. Around 80% had a positive attitude that India will win the battle against the disease. More than 90% were practicing appropriate preventive measures while going out.Conclusions: Majority of the Indian population demonstrated good knowledge, positive attitude, and good practices regarding the COVID-19 pandemic.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204246
      Issue No: Vol. 8, No. 10 (2020)
  • Imaging spectrum of renal masses on multi-slice computed tomography

    • Authors: Dipak R. Thakor, Yashpal R. Rana, Megha M. Sheth
      Pages: 3657 - 3664
      Abstract: Background: Multi-slice computed tomography (MSCT) is the mainstay for preoperative assessment of many complex renal masses in current clinical practice. Benign renal processes may simulate malignant renal tumors and could be defined correctly by CT. MSCT has also an important role in tumor staging. The purpose of this article is to understand the imaging spectrum of renal masses on MSCT and assess the usefulness of CT in surgical planning and management.Methods: Studied 500 patients with suspected renal lesions who underwent MSCT during the period July 2017 to July 2020 at state-of-art imaging center. CT imaging was done in those patients in whom clinical examination and ultrasonography (USG) revealed possibility of diagnosis of renal masses for further detailed evaluation and deciding management.Results: Out of 500 total subjects, the common age group in this study is 51 to 60 years (25%). Male preponderance (59%) was noted. The most common presentation was pain (84%) followed by lump (29.4%) and haematuria (17.8%). Malignant masses (51%) were more common followed by benign (39%) and inflammatory masses (10%) respectively. Renal cell carcinoma has more incidence (30%) followed by simple cyst (20%). Calcification (19.6%), perinephric extension (78%) and vascular invasion (21.5%) are more common in malignant masses. Conclusion: MSCT is the modality of choice for the diagnosis of renal masses and deciding management approach in current practice. Detection of tumoral spread, invasion of surrounding organs and vascular structure are better with CT. MSCT also has a role in postoperative follow-up of renal masses.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204247
      Issue No: Vol. 8, No. 10 (2020)
  • Tamoxifen treatment and its outcome in breast cancer patients at a
           hospital-based cancer registry in Kerala

    • Authors: Reema A. Thomas, Catherin Nisha
      Pages: 3665 - 3669
      Abstract: Background: Endocrine therapy for breast cancer is directed at reducing oestrogen synthesis or alternatively blocking oestrogen receptors (ER) in tumour-sensitive tumors. Despite side effects, the use of systemic adjuvant therapy after local management of breast cancer substantially improves survival and reduces the risk of relapse. The study objective was to assess the recurrence of breast cancer and the complications seen in breast cancer patients on tamoxifen therapy at a hospital-based cancer registry, Thrissur, Kerala.Methods: After obtaining institutional ethical clearance, included 75 patients of histologically diagnosed breast carcinoma currently on tamoxifen, diagnosed in the year of 2016. Data was obtained from the patient files and by personal intimation.Results: Of the 75 patients on tamoxifen, four (5.33%) patients had history of recurrence. 22.6% of patients on tamoxifen were noted to have increased endometrial thickness. Other side effects noted were weight gain, TIA, bone pain and vaginal discharge.Conclusions: It was found that the recurrence rate at three years for the study population was 5.33%. More studies from developing countries, with larger sample size and clinical trials will give us more accurate information regarding the efficacy of the drug.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204248
      Issue No: Vol. 8, No. 10 (2020)
  • The Bethesda system for reporting thyroid cytology: a prospective study in
           a tertiary care institute along with review of literature

    • Authors: Avni Bhatnagar, Kavita Mardi, Shivani Sood, Vijay Kaushal, Kanishk Gupta
      Pages: 3670 - 3677
      Abstract: Background: The Bethesda system for reporting thyroid cytology (TSBRTC) was devised by the National Cancer Institute (NCI) to obtain uniformity, reproducibility and a defined management protocol while dealing with thyroid lesions. This study was undertaken with the aim to see the benefits of adopting TBSRTC in the diagnosis of thyroid FNAC, and identify the malignancy risk of each category.Methods: This cross-sectional study was conducted in Indira Gandhi Medical College, Shimla, Himachal Pradesh from June 2016 to July 2017 on 181 thyroid FNACs which were reported according to the Bethesda system for reporting thyroid cytopathology (TBSRTC) under six categories: (I) non-diagnostic/unsatisfactory (II) benign (III) atypia of undetermined significance/follicular lesion of undetermined significance (IV) follicular neoplasm/suspicious for follicular neoplasm (specify if Hurthle cell (oncocytic) type (V) suspicious for malignancy (VI) malignant. Histopathological diagnosis was available for 65 cases where thyroidectomy was performed. Malignancy risk was calculated for each category. Sensitivity, specificity, positive and negative predictive values for TBSRCT were also calculated. All the data was analyzed in SPSS software version 22.0 (IBM, USA).Results: Benign lesions constituted the major bulk. After the use of TBSRTC, there was increased ability to look for follicular neoplasms, improvement in making definitive diagnosis of the cases, an improvement in diagnostic accuracy, and we were in line with the implied risk outlined by TBSRTC in most of the cases.Conclusions: Application of TBSRTC results in uniformity in reporting among pathologists and better interdisciplinary communication and patient management.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204249
      Issue No: Vol. 8, No. 10 (2020)
  • Effect of ethanolic extract of Centella asiatica on maximal electroshock
           seizure in albino mice

    • Authors: Ahmed A. Kannoor, Ramani P. T.
      Pages: 3678 - 3681
      Abstract: Background: Animal models had always served as integral part in introducing newer drugs for epilepsy. India has long tradition of using herbal medicines. Centella asiatica is an ingredient of various ayurvedic preparations to treat brain related disorders like insanity, memory loss and epilepsy. This research is done to find out the usefulness of Centella asiatica in epilepsy.  Methods: Ethanolic extract of the plant is prepared using Soxhlet apparatus. Experimental seizure is induced in albino mice by maximal electroshock method. Resulting seizure goes through different phases. Duration of the phase of hind limb extension was the measured data. Clinically used anti epileptic drugs can abolish hind limb extension. Effect is compared to that of standard drug phenytoin. Four different doses of the plant extract; 100mg, 200mg, 500mg and 1000mg per kilogram bodyweight was given orally. Statistical analysis of data was done by one way ANOVA and Dunnett test.Results: Ethanolic extract of Centella asiatica exhibited statistically significant protection from maximal electroshock seizures. All given doses of the extract had p<0.05 when compared to control.Conclusions: Centella asiatica is potential source of anti-epileptic drug. Detailed phytochemical studies and animal experiments are recommended.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204250
      Issue No: Vol. 8, No. 10 (2020)
  • Metabolic syndrome in south Indian population with skin tags: a
           hospital-based case control study

    • Authors: Bobbili Tarun Kesava Naidu, Kavya Baddireddy
      Pages: 3682 - 3686
      Abstract: Background: Metabolic syndrome is a constellation of several clinical and laboratory cardiovascular risk factors that have been linked with numerous medical and dermatologic conditions. Recent evidence suggests a strong association between skin tags and insulin resistance and obesity, yet there is a paucity of data on relation of skin tags with metabolic syndrome as a whole. Aim of the study was to evaluate the strength of association between skin tags and metabolic syndrome.Methods: 70 patients with skin tags and an equal number of age and gender matched controls were enrolled in a hospital-based case control study. Anthropometric measures, blood pressure, fasting glucose, high density lipoprotein cholesterol and triglycerides were measured. Metabolic syndrome was diagnosed by the presence of 3 or more of the south Asian modified national cholesterol education program’s adult panel III criteria. Statistical analysis was performed using chi square test, and odds ratio was calculated. P≤0.05 were considered significant.Results: Metabolic syndrome was significantly more common in patients with skin tags than in controls (70% vs. 26%, p<0.001). Triglycerides and waist circumference values were significantly increased in cases as compared to controls (p<0.05).  There was no statistically significant difference in the high-density lipoprotein levels, fasting blood glucose levels and presence of hypertension among cases and controls.Conclusion: Skin tags when present in multiple could be an early warning sign for Metabolic syndrome. They serve a cutaneous marker to initiate early detection and intervention of at-risk patients for cardiovascular disorders.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204251
      Issue No: Vol. 8, No. 10 (2020)
  • Barriers encountered during online classes among undergraduate nursing
           students during COVID-19 pandemic in India

    • Authors: Rakhi Gaur, Shiv Kumar Mudgal, Isha Thakur Dharni, Ravikant Sharma, Neha Suyal
      Pages: 3687 - 3693
      Abstract: Background: The advents of new technologies are providing a variety of effective learning environment. However, many adult students still prefer traditional, academic settings and do not want to take online or hybrid classes.Methods: Present study included cross sectional descriptive survey design which was carried out on 394 undergraduate nursing students. Convenient sampling technique was chosen for selection of samples. A five-point Likert self-structured scale was used for data collection. Descriptive and inferential statistics were used to analyze the data in SPSS.Results: Study findings showed that there were 209 (53%) female participants. Significant difference (p=0.05) was found among participants’ gender and year of study, area of residence, father education, family income and whether they had ever attended online classes. Lack of control over the group was top perceived barrier with highest score (261 marks). Majority of participants (61%) perceived barriers encountered during online classes. Mann Whitney U test showed the significant differences of participants’ perceived barriers among male and female participants by their age, year of study, fathers’ education and family income (p<0.05).Conclusions: As more students are growing up familiar with internet-based learning, many students were still opposing to go with online classes. Barriers explored in the study can limit the acceptance of online classes among undergraduate nursing students. Higher authorities must find the ways for making online education user friendly.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204252
      Issue No: Vol. 8, No. 10 (2020)
  • Hysteroscopy in evaluation of intrauterine causes of abnormal uterine

    • Authors: Nikita Gandotra, Isha Sunil, Shazia Zargar
      Pages: 3694 - 3697
      Abstract: Background: Various endometrial pathologies contribute to a large proportion of cases of abnormal uterine bleeding (AUB) during the reproductive years as well as after menopause.Methods: This is a retrospective observational study conducted in department of Obstetrics and Gynaecology at SMGS Hospital, Jammu. 200 patients between 20-70 years age presenting to gynaecology OPD with abnormal uterine bleeding between January 2019 to December 2019 were studied. All patients were subjected to thorough clinical evaluation followed by hysteroscopy. Data collected from medical records, analysed and various intrauterine causes of AUB were studied. Hysteroscopy directed biopsies were taken in the same sitting and sent for histopathology and culture. Results: Mean age of patients in our study was 45 years with majority of patients in 40-50-year age group (69%). Most common symptom reported was menorrhagia (48%) followed by menometrorrhagia (18%) and polymenorrhea (10%). Hysteroscopy detected intrauterine abnormality in 59% cases. Most common being hyperplastic endometrium in 52 patients (26%) followed by polyp (20%). 14 (7%) had sub mucous fibroid, 8 (4%) had atrophic endometrium and 2 (1%) had intrauterine adhesions.Conclusion: Hysteroscopy provides a simple & easy method for visualization of the cervical canal & uterine cavity for the evaluation of AUB. Hysteroscopic pattern recognition is a useful concept to triage women who require sampling for histopathological diagnosis.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204253
      Issue No: Vol. 8, No. 10 (2020)
  • Correlation of serum magnesium levels with renal parameters in patients
           with acute kidney injury

    • Authors: Raveendra K. R., Avinash H. R., Nitish Ashok Gurav
      Pages: 3698 - 3702
      Abstract: Background: Acute kidney injury is a common problem with various causes and consequences like electrolyte disturbances in the form of hypocalcaemia, hypokalemia, hyperkalemia depending on the phase. Hypomagnesaemia is one of the most common electrolyte disturbance found in hospitalized patients especially in the critically ill patients. Prevalence of hypomagnesemia varies from 11 to 65% in different studies. Hence, we decided to conduct a study to evaluate correlation of serum magnesium levels in AKI.Methods: A cross-sectional, hospital based time bound study was conducted between November 2016 and August 2018 with a sample of 100 patients aged 18-65 years and who had AKI were included and patients with diabetes mellitus, multi-organ dysfunction, obstructive uropathy and drug induced AKI were excluded from study. The decrease in magnesium <1.7 mg/L was defined as hypomagnesaemia. AKI was defined as per AKIN criteria. Day 1, day 3 and day 6 magnesium levels were measured.Results: Prevalence of hypomagnesaemia was 53%, 30% and 36% on day 1, day 3 and day 6 respectively. It was observed that there was a positive correlation between serum magnesium, and serum creatinine. Normomagnsemia and hypermagnesemia on day 1, 3 and 6 were significantly associated with recovery of AKI (p<0.001).Conclusions: The prevalence of hypomagnesemia was significantly higher in AKI patients and normal magnesium and hypermagnesium on day 1, 3 and day 6 was associated with recovery than non-recovery. Hypomagnesemia was associated more with non-recovery then recovery.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204254
      Issue No: Vol. 8, No. 10 (2020)
  • Glaucoma in diabetic patients and the need for further research

    • Authors: Omyma Abbas Banaga Salih, Zaid Al Hamadani, Bayan Alemrayat, AlAnoud AlFehaidi, Ehab Hamed
      Pages: 3703 - 3705
      Abstract: Glaucoma is considered the leading cause of irreversible blindness worldwide. Patients with diabetes are at risk of different eye complications, mainly retinopathy. Patients with diabetes are also at risk of developing cataract, uveitis and glaucoma. Three systematic reviews examined the associations between diabetes and glaucoma. Pooled analysis from those studies reported different OR 1.37, (95% CI=0.72-2.02), OR=1.36, (95% CI=1.25-1.50) and OR=1.48, (95% CI=1.29-1.71). Although the results seem close and suggest an increased risk in the diabetic population, the systematic reviews report significant heterogenicity and come short in explaining causality. Indeed, in one systematic review where 3 out of 7 studies suggested a non-significant association, the results were skewed to the positive side with a one-record based study that had a population size exceeding 2 million patients, while the rest of the studies had collectively 100 thousand patients. In our view, a case control study design that combines the patient surveys and electronic medical records ensure accurate data and more valid study results to validate or refute the association. This short communication article discusses the condition associations, theories for increased risk in the diabetic population and implications for future research.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204255
      Issue No: Vol. 8, No. 10 (2020)
  • Meigs syndrome: literature review of a case report

    • Authors: Camilo Levi Acuña Pinzón, Diego Hinojosa Ugarte, Aldo Edyair Jimenez Herevia, Miguel Angel Guerrero
      Pages: 3706 - 3709
      Abstract: Ovarian cancer is the presence of one or multiple tumors, which appears in one or both ovaries. These tumors are usually classified as epithelial and non-epithelial. Sex cord-stromal tumors are a group of benign and malignant neoplasms that develop from the sexual cord. Many are functional and therefore have hormonal secretions. Meigs syndrome is defined by the presence of pleural effusion and ascites in association with an ovarian tumor. We present a case of a 55 years old patient who was admitted due to a pelvic tumor, exudative pleural effusion that was difficult to manage, and ascites. A benign ovarian stromal tumor associated with elevated Ca 125 was diagnosed. After the management of the effusions, a 20x20x10 cm ovarian tumor resection was performed by laparotomy, and a transoperative report of a thecoma/fibroma type stromal tumor was received. Meigs syndrome occurs in 1% of ovarian tumors, being very rare before the third decade of life, the pathogenesis of ascites and pleural effusion could be related to the imbalance of hydrostatic forces between arterial flow and lymphovenous drainage culminating in a stromal transudate. Treatment of this syndrome should be focused on tumor debulking surgery and symptomatic treatments such as chest tubes and pleurodesis.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204256
      Issue No: Vol. 8, No. 10 (2020)
  • Hemichorea-hemiballismus in a patient with hyperglycaemic hyperosmolar

    • Authors: Rifkatu S. Reng, Odumodu Kenechukwu, Shuaibu Ramatu, Oyakhire Shyngle, Omonua Special, Osi-ogbu Ogugua, Felicia Anumah
      Pages: 3710 - 3712
      Abstract: Hemichorea-hemiballismus (HCHB) is a rare manifestation of hyperglycaemic hyperosmolar state caused by contralateral lesion in basal ganglia. A 74-year-old, known diabetic and hypertensive woman presented with one-week history of high-grade fever and loss of consciousness associated with involuntary movement of the right upper and lower limbs for 10 hours prior to presentation. Physical examination revealed pyrexia, tachycardia and altered sensorium. Blood glucose was 53.8 mmol/l, hemoglobin A1c (Hb A1c) 9.9% and brain computed tomography (CT) scan showed cerebral atrophy with bilateral basal ganglia hyperdensities. Escherichia coli was cultured from the urine. She did well on treatment with soluble insulin, rehydration and intravenous ceftriaxone. HCHB is a rare complication seen in patients with poorly controlled diabetes mellitus. This report highlights the reversibility of the disease with prompt diagnosis and appropriate insulin treatment. HCHB should be distinguished from other intracranial pathologies.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204257
      Issue No: Vol. 8, No. 10 (2020)
  • Mediastinitis as a complication of Epstein-Barr virus infection: a rare

    • Authors: Shifa Younus, Hamza Maqsood, Amna Younas
      Pages: 3713 - 3714
      Abstract: Epstein-Barr virus (EBV) is a member of the herpes virus family that can infect humans. Common manifestations of Epstein-Barr virus infection include fever, lymphadenopathy and pharyngitis with some rare complications including mediastinitis, myocarditis, pancreatitis, acute kidney failure and neurological disorders. Clinical findings along with serological evidences are needed to diagnose the infection. Early investigation for EBV in febrile patients can expedite both diagnosis and treatment.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204258
      Issue No: Vol. 8, No. 10 (2020)
  • Pathological fracture of subtrochanter femur, soft tissue infection along
           the fracture site, shaft femur bone cortex thickening and blastic lession
           on contralateral shaft femur due to renal osteodystrophy on the end stage
           renal disease patient: a case report

    • Authors: Gde Dedy Andika, Gede Ketut Alit Satria Nugraha, I. Made Sunaria, Putu Astawa, I Gede Eka Wiratnaya, Made Agus Maharjana
      Pages: 3715 - 3719
      Abstract: Renal osteodystrophy (ROD) is a skeletal complication resulting from pathologic alterations in calcium, phosphate, and bone metabolism. The potential link between bone turnover and bone quality is an important question meriting study because of the relatively high incidence of fractures reported. In this case presents a pathological fracture on a routinely hemodialyzed woman. She complained pain on her left subtrochanteric area after low energy trauma accident. A thickening of the shaft femoral bone cortex was also found, reflecting the osteosclerosis event due to imbalance of proliferation and differentiation of osteoblast with increase bone formation. She also had a blastic lesion on her contralateral shaft femoral during the bone survey, but this finding remains asymptomatic. Decreased osteoclastic activity may contribute to cortical thickening, resulting in overall bone mass increase, which may lead to decreased elasticity of the bone or impaired repair capabilities, therefore increasing the risk of fracture. The blastic lesion that occurred on contralateral side may indicated effect of ROD or primary bone lesion. Careful assessment and holistic management of patients with kidney disease is necessary to achieve optimal outcome. The prevention of falls is also an important strategy to prevent pathological fractures. End stage renal disease (ESRD) have reduced bone mineral density, a risk factor for fracture incidence. Careful anamnesis and clinical examination are needed for diagnosis and management.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204259
      Issue No: Vol. 8, No. 10 (2020)
  • Periorbital necrotizing fasciitis in a case of lid and conjunctival

    • Authors: Anamika D. Das, Aalok S. Gore, Indravadan G. Vasava, Anurag S. Yadav
      Pages: 3720 - 3723
      Abstract: Necrotizing fasciitis is a severe, progressive, rapidly spreading infection of the subcutaneous soft tissue and underlying fascia. Periorbital necrotizing fasciitis is rare owing to the excellent blood supply of the area. Ocular amyloidosis is relatively uncommon- that of the eyelid is typically associated with systemic associations whereas amyloidosis of the conjunctiva is often localised with no other associations.
      Authors report a case of a 40-year-old female with a 4-year history of eyelid and conjunctival amyloidosis who presented with necrotic ulcers and eschars in the upper and lower lid with purulent discharge, conjunctival mass and a dry looking cornea in the left eye. She was a known case of rheumatoid arthritis (RA) on treatment in the last 2 years. The presentation, investigations and management are described. 
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204020
      Issue No: Vol. 8, No. 10 (2020)
  • Speech language characteristics and intervention approaches in lockedin
           syndrome post snake envenomation

    • Authors: Shantanu Arya, Dakshta Vaid, Nima Zangmo, L. N. Garg, Sachin Praveen Kumar
      Pages: 3724 - 3726
      Abstract: The present case study illustrates hypoxic-ischemic encephalopathy as a result of neuroparalytic snake envenomation in an 11 year old male patient. Detailed speech assessment was done which revealed diverged oral structures and language loss. The study aims to document speech and language characteristics as well as rehabilitation in terms of speech therapy. The study enlightens the role of speech language pathologist in assessment and intervention of locked in syndrome. Study shows the swapped roles of traditional therapy approaches and the importance of augmentative and alternative communication as compassion and a beneficial technique in an intricate incident like hypoxic-ischemic encephalopathy as a result of neuroparalytic snake envenomation.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204260
      Issue No: Vol. 8, No. 10 (2020)
  • Screening beyond conventional serological markers for hepatitis B and C
           viruses in cirrhosis: an entity overlooked

    • Authors: Manjri ., Virender Katyal, Deepak Yadav, Sandeep Goyal
      Pages: 3727 - 3731
      Abstract: We aimed to emphasise the role of screening beyond conventional serological markers (HBsAg and Anti HCV antibodies for chronic viral hepatitis B and C respectively) in patients with cirrhosis. Patients with cirrhosis of liver are often labelled as having cryptogenic cirrhosis (CC), if no etiology is found. In chronic viral hepatitis B and C (CHB and CHC) induced cirrhosis, HBsAg and Anti HCV antibodies respectively are usually done to rule out the viral infections however their absence have been documented in subset of patients having these infections. In this regard, we hereby present a case labelled as CC and developed HCC; later on, further evaluation turned out to be having both CHB and CHC. A 51-year-old male with diabetes presented with index episode of hemetemesis. On further evaluation he was diagnosed to have cirrhosis of liver. No etiology was found and he was labeled as cirrhosis secondary to Non-alcoholic steatohepatitis (NASH)/cryptogenic cirrhosis. Later on, he developed hepatocellular carcinoma (HCC). We evaluated the patient with HBV DNA and HCV RNA levels keeping possibility of occult hepatitis B (OBI)/ seronegative hepatitis C infection despite HBsAg and Anti HCV antibodies being negative. Both levels were found to be raised and we attributed cirrhosis to dual hit by CHB and CHC. Patient was managed with antiviral drugs successfully with no recurrence of HCC and control of blood sugar levels.  We hereby stress that screening beyond the HBsAg and Anti HCV antibodies should be done in all cases of liver cirrhosis in which etiology is not found on initial screening.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204261
      Issue No: Vol. 8, No. 10 (2020)
  • Subarachnoid haemorrhage mimicking unstable angina: a case report

    • Authors: Subhash Chand, Subhash Chander, Gaveshna Gargi, Tarun Sharma, Rittin Sharma
      Pages: 3732 - 3734
      Abstract: Subarachnoid haemorrhage (SAH) is medical emergency caused by bleeding into the subarachnoid space. It is caused by rupture of an aneurysm or arteriovenous malformations (AVM). Symptoms of SAH are severe headache, nausea, vomiting, impaired consciousness and seizures. Neck stiffness and neck pain are relatively uncommon. Risk factors are high blood pressure, smoking, family history, alcoholism and even cocaine use. Diagnosis is mainly made by CT scan of head which should be done within six hours of the onset of symptoms and occasionally lumber puncture can also be done. An electrocardiogram (ECG) of all patients with subarachnoid should be done because patient with SAH can have myocardial ischemia due to increased level of circulating catecholamines or due to autonomic stimulation of the brain. ECG changes associated with SAH primarily reflect repolarisation abnormalities involving ST segment, T wave, U wave and QTc interval. Myocardial ischemia or infarction is often suspected in patients with SAH. Even troponin levels may be raised in these patients. However, suspicion of SAH is a contraindication for thrombolytic and anticoagulant therapy. This is a case of SAH which was initially treated for acute coronary syndrome (ACS) on the basis of symptoms and gradually changing ECG findings but on CT Head, patient was having SAH.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204262
      Issue No: Vol. 8, No. 10 (2020)
  • Alveolar soft part sarcoma of extremity

    • Authors: Shilpa Kaushal, Muninder K. Negi
      Pages: 3735 - 3737
      Abstract: Alveolar soft-part sarcoma (ASPS) is an extremely rare connective tissue tumor, predominantly seen in adolescents and young adults, with a female preponderance. Alveolar soft-part sarcoma (ASPS) is a slow growing tumor, but with high likelihood of metastasis, leading to high mortality. A classical histopathological feature of an alveolar pattern from the biopsy of the lesion favors the diagnosis. We report a case of 14 years old male patient who presented with a history of single painless swelling over thigh for which surgical excision was done. Histopathology was suggestive of Alveolar soft-part sarcoma (ASPS). There was no evidence of distant metastases. He was treated with external beam radiotherapy in view of vascular invasion.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204263
      Issue No: Vol. 8, No. 10 (2020)
  • Myeloma coexisting with jejunal light chain amyloidosis

    • Authors: Aishwarya K. Marimuthu, Purnima Ramkumar, Mohammed S. Abdulsalam, Prabu Pandurangan, Jainudeen Khalander Abdul Jameel, Maya Menon
      Pages: 3738 - 3741
      Abstract: Amyloid Light chain (AL) amyloidosis is a rare disease, which is seen in approximately one-tenth of patients with multiple myeloma. We report a 52 years old male, who presented with complaints of anorexia and weight loss. He was diagnosed to have multiple myeloma-international staging score (ISS) Stage 3 and was started on VTD (Bortezomib, Thalidomide, and Dexamethasone) chemotherapy. Within 2 weeks of therapy, he had abdominal symptoms like abdominal pain, loose stools, vomiting and hematochezia. Imaging showed dilated proximal bowel loops with fluid filled contents and prominent vessels in rectum. Emergency surgical exploration revealed thickened proximal jejunum with blood clots in the lumen. Resection of proximal jejunum was done. Histopathological examination of resected specimen was suggestive of AL amyloidosis. Post-surgical resection of jejunum, patient had initial improvement followed by deterioration. He was discharged against medical advice as per relative’s request. Hence an index of clinical suspicion of amyloidosis must been present in all Multiple myeloma patients.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204264
      Issue No: Vol. 8, No. 10 (2020)
  • A case report: remdesivir effective in the treatment of severe category

    • Authors: Hetal Pandya, Archit Jain, Pradeep Reddy, Aarsh Shah
      Pages: 3742 - 3745
      Abstract: Since the first cases were reported in December 2019, infection with the severe acute respiratory corona virus 2 (SARS-CoV-2) has become a worldwide pandemic. COVID-19 the illness caused by SARS-CoV-2 is overwhelming health care systems globally. In the absence of a proven effective therapy, current management consists of supportive care, including invasive and noninvasive oxygen support and off-label or compassionate-use therapies, including   anti-retrovirals, anti-parasitic agents, anti-inflammatory compounds, and convalescent plasma. Amongst these experimental therapies, remdesivir a broad-spectrum antiviral drug has shown some promising results. We present a successfully treated patient of severe acute respiratory illness by SARS-CoV-2 with remdesivir along with standard management protocol. Reporting a case with aim to add favoring evidence for remdesivir in the treatment of         SARS-CoV-2.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204265
      Issue No: Vol. 8, No. 10 (2020)
  • Polycythemia: a mystery solved by history

    • Authors: Chetan Kalal, Atif Patel, Adinath Wagh, Harshad Joshi, Samit Jain, Ravindra Surude, Shobna Bhatia, Chetan Bhatt
      Pages: 3746 - 3748
      Abstract: Testosterone is responsible for increased muscle mass. Leaner body mass helps control weight and increases energy. High levels of testosterone help build muscles and also stimulate growth in strength. Androgenic-anabolic steroids (AAS) are drugs that are structurally related to the cyclic steroid rings system and have similar effects to testosterone in the body. Athletes who abuse steroids do so for muscle growth and quick recovery. Testosterone - whether it's injected, applied via a patch or cream, or taken orally - allows athletes to rapidly increase muscle mass beyond their usual capacity, and also reduces their recovery time which allows them to train continuously with little need to rest their bodies in between workouts. Physiologically, erythrocytosis is defined by an erythrocyte mass that exceeds 125% of that predicted for sex and body mass. Much of the concern with the use of testosterone involves increase in blood viscosity, resulting from increased red blood cell mass causing a potential increased risk for venous thromboembolism (VTE), myocardial infarction (MI), and cerebrovascular accidents (CVA). We report a case of secondary polycythemia related to testosterone therapy.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204266
      Issue No: Vol. 8, No. 10 (2020)
  • The anti-synthetase syndrome in a type 1 diabetes

    • Authors: Kshithija Sajjan, Anuj Pahuja, Yadav Ponvijaya, Manoj Prakash Jeyaseelan
      Pages: 3749 - 3752
      Abstract: Anti-synthetase syndrome is an autoimmune disease associated with interstitial lung disease (ILD), dermatomyositis and polymyositis. It has been recognized as an important cause of autoimmune inflammatory myopathy in a subset of patients with dermatomyositis. 37-year-old male, known case of type 1 diabetes mellitus, came with complaints of: generalized anasarca, pain in both knees, ankles, wrist and small joints of fingers. He also had dyspnoea on exertion, chronic non-productive cough, and fever off and on, all for 1 month. Initially all involvement was attributed to diabetes. For joint pain an antinuclear antibodies (ANA) was sent. He turned out to be anti-Jo1, antibody positive. Rash on hands was diagnosed by dermatologist as, mechanic’s hand, hence diagnosed as an inflammatory myopathy with dermatomyositis anti-synthetase syndrome. Patient was successfully treated with immunosuppressants and supportive treatment and responded to tablet Prednisolone and Mycophenolate mofetil. The patient had one major and 2 minor criteria-ILD, arthritis and Mechanic’s hand and anti-Jo 1 antibody positive. Thus, diagnosed as anti-synthetase syndrome with type 1 diabetes mellitus.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204267
      Issue No: Vol. 8, No. 10 (2020)
  • Sarcoidosis presenting as Lofgran’s syndrome

    • Authors: Atiullah Imran Malik, Kshithija Sajjan, Parati Rupesh Shivkumar, Vijayashree S. Gokhale
      Pages: 3753 - 3756
      Abstract: A 40 year old male, first presented with erythema nodosum, fever, weight loss and joint pains and did not respond to anti-tubercular treatment. One year later he came back with joint pains, erythema nodosum, fever and dry cough. He also had weakness in distal right lower limb more than left limb. He had raised ESR, hypocalcaemia, raised ACE levels and lymphnode involvement on HRCT, with skin biopsy suggestive of sarcoidosis. This time patient responded to treatment and is on regular follow up.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204268
      Issue No: Vol. 8, No. 10 (2020)
  • Rhabdomyolysis with acute kidney injury after single episode of
           generalized seizure in a known case of epilepsy: a case report

    • Authors: Sudhakar Pandey, Nomal C. Borah, Manjari Dwivedi, Rup J. Das
      Pages: 3757 - 3760
      Abstract: Rhabdomyolysis is defined as breakdown of skeletal muscle fibers with subsequent release of its cellular components into the circulation. It is associated with variety of causes and status epilepticus is one of it. The excessive muscular activity associated with seizure is possible explanation for it. It is clinically evident by the new onset severe generalized bodyache, weakness and myalgia associated with dark coloured urine. Acute kidney injury is one of the most serious complications associted with rhabdomyolysis. Single episode of generalized seizure is not a frequent cause for rhabdomyolysis. Acute kidney injury due to rhabdomyolysis, following a single episode of seizure is a rare entity. Here we report a case of rhabdomyolysis with acute kidney injury following a single episode of generalized seizure. High index of suspicion is required to timely diagnose and treat such patients. Timely intervention with hemodialysis along with other supportive care can completely revert this potentially serious complication to normal.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204269
      Issue No: Vol. 8, No. 10 (2020)
  • Management of X-linked hypophosphatemic rickets: a review

    • Authors: Mohammed Azar
      Pages: 3761 - 3764
      Abstract: There are two types of management in X-linked hypophosphatemic rickets (XLH), out of which the main stay of treatment is conventional treatment which includes combination of oral phosphate supplements and active vitamin D (calcitriol or alfacalcidol) after the diagnosis is established. Although, conventional treatment with phosphate supplementation and active vitamin D might improve the rickets and control the renal phosphate excretion but it has significant risk of high calcium excretion in the urine and thereby increases the risk of nephrocalcinosis. The other emerging treatment is burosumab therapy which is human monoclonal IgG1 antibody against fibroblast growth factor 23 (FGF 23) for the treatment of XLH in children ≥1 year of age and in adolescents and is found to be effective in improving rickets without major adverse events. In this review, modalities for XLH treatment over the past and the near future will be discussed along with clinical manifestations and investigations. 
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204270
      Issue No: Vol. 8, No. 10 (2020)
  • Prevalence of work-related musculoskeletal disorders among IT
           professionals in India-a literature review

    • Authors: Ritika M. Singh, Pradeep Borkar
      Pages: 3765 - 3771
      Abstract: Musculoskeletal disorders are typically characterised by discomfort (often persistent) and restrictions in mobility, dexterity and functional ability, reducing people’s capability to work and participate in social roles with associated influences on psychological welfare, and at a wider level influence on the prosperity of communities Information technology- has played a vital role in transforming India from a slow administrative economy into a land of innovational entrepreneurs. The aim of this review is to, critically analyze the literature and report on the prevalence of work-related musculoskeletal disorders in information technology professionals. The review focused on computers users and software professionals. An extensive literature search was undertaken using google scholar and PubMed databases for last 10 years from 2011 to 2020. Further Following a thorough search of the databases, a total of 25 articles were evaluated. A number of articles reported a high prevalence of MSD, generally various studies have been done on information technology professionals and related to the work of IT professionals and studies on various risk factors also have been done in different states of India. 17 articles had selected for the study purpose in which prevalence study had selected for the review. The prevalence among the IT professionals is not uniform; however, Software engineers and computer operators appear to be more prone to neck, shoulder and back pain.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204271
      Issue No: Vol. 8, No. 10 (2020)
  • Insight on the usage of mask with respect to COVID-19: a review

    • Authors: Adeel A. Bajjad, Navneet Kour, Anil Sharma, Minha M. Kak
      Pages: 3772 - 3777
      Abstract: Face-masks are currently turning into a fundamental piece of our clothing standard, without a doubt. While the West wasn't entirely ok with face-masks in the pre-COVID-19 period, East Asians were all the more inviting of them. Controlling a respiratory contamination at source by a mask is an entrenched procedure. The utilization of masks followed by certain precautionary measure is a piece of a thorough bundle of the avoidance and control gauges that can restrain the spread of any respiratory viral maladies, including COVID-19. Subsequently the fundamental point of the examination is to illuminate the mask, their utilization and guidelines to be followed during this pandemic period. Numerous nations have suggested the utilization of fabric mask/face covers for the overall population. Right now, the boundless utilization of mask by healthy individuals in the network setting isn't yet upheld by high calibre or direct logical proof and there are likely advantages and damages to consider. Any mask worn for everyday assurance against COVID-19 will be flawed, at any rate for the current pandemic time.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204272
      Issue No: Vol. 8, No. 10 (2020)
  • Metformin and nitrosamine impurities

    • Authors: Ajith Kumar P. V., Deepa M.
      Pages: 3778 - 3784
      Abstract: Metformin is considered as gold standard anti-diabetic drug and is the preferred initial pharmacologic agent for most of the patients with type 2 diabetes mellitus. Metformin is cheap, widely available and safe, backed by pharmaco-epidemiological evidence of more than 60 years regular use in clinical practice. Due to its durable efficacy, once initiated, metformin will be continued as long as it is tolerated and not contraindicated.  It has got additional benefits on cholesterol, liver, cardio vascular system and cancer. Recent evidence and recall of metformin extended release formulation due to detection of excess amount of cancer-causing nitrosamine impurities has created concern among health care providers and patients. Adherence to regulatory guidelines and use of approved technologies in manufacturing and quality control may help in solving the issue.
      PubDate: 2020-09-24
      DOI: 10.18203/2320-6012.ijrms20204273
      Issue No: Vol. 8, No. 10 (2020)
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