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Intl. J. of Advances in Medicine     Open Access   (Followers: 5)
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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]
  • Prevalence of metabolic syndrome and associated factors among human
           immunodeficiency virus patients on highly active antiretroviral therapy in
           North central Nigeria

    • Authors: Rifkatu S. Reng, Gerald A. Onwuegbuzie, Muaz Salisu, Felicia Anumah
      Pages: 2892 - 2897
      Abstract: Background: Metabolic syndrome (MS) is a complex disorder defined by cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus. The Use of Highly active antiretroviral therapy in HIV patients is associated with metabolic syndrome which increases the risk of cardiovascular disease (CVD). The aim of the study was to determine the prevalence of MS among HAART treated HIV patients and HAART naïve patients.Methods: This was a cross-sectional study that evaluated 581 (396 females, 184 males) consenting HIV patents in the hospital. Clinical characteristics, anthropometry, blood pressure, lipid profile, fasting blood glucose, fasting plasma insulin, CD4 cell counts and viral load were determined using appropriate standard techniques. MS was defined using International Diabetes Federation (IDF) cut-off values.Results: The overall prevalence of MS was 10.7%, with more females 52 (13.1%) than males 10 (5.4%), p=0.005. MS in patients on HAART was 58 (15.1%) and HAART naive 4 (2.0%). Overall, waist circumference, BMI, systolic blood pressure (BP), diastolic blood pressure (BP), triglycerides and fasting blood glucose were 82.7±11.5, 22.7±, 120.6±17.6, 77.5±10.6, 1.1±0.7 and 5.1±1.9 respectively. Patients with MS had significantly higher (p<0.05) waist circumference (94.1 vs 81.3 cm), BMI (24.8 vs 22.5 kg/m2), systolic BP (135.4 vs 118.8 mmHg), diastolic BP (86.2 vs 76.5 mmHg), triglycerides (1.3 vs 1.0 mmol/l) and fasting blood glucose (6.3 vs 4.9 mmol/l).  Insulin resistance (IR) was higher in patients with MS 11.8(7.9) compared with patients without MS 5.5 (6.8) p=0.02.Conclusions: Prevalence of metabolic syndrome in this study was lower than that reported in previous works, the prevalence is much higher in the HAART treated patients. The risk of MS were high triglycerides, hypertension and abnormal fasting blood glucose. There was significant association with the traditional risk factors, age, female gender and HIV duration. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Effects of interactive education with conversation map on foot
           care behaviors in elderly diabetic patients with high-risk diabetic foot

    • Authors: Zhang Yingli
      Pages: 2898 - 2901
      Abstract: Background: Diabetic foot is one of the main reasons that seriously affect the quality of life and disability. Good foot care can prevent 85% amputation of diabetic foot patients. The purpose of this study is to explore the effects of interactive education with conversation map on foot care behaviors among elderly diabetic patients with high-risk diabetic foot.Methods: 96 elderly diabetic patients in Endocrinology Department of the Second Affiliated Hospital of Shandong First Medical University from January to December in 2020 were selected as the research objects. According to the parity of the last two digits of the hospitalization number, the odd number was divided into the control group and the even number was divided into the experimental group. The control group was given traditional health education and interactive education with conversation map for diabetic foot launched by the international diabetes federation was added to the experimental group. After 3 months of intervention, fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin and foot care behaviors of the two groups were observed.Results: The fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin and foot care behaviors of the experimental group were significantly better than those of the control group and the difference was statistically significant (p<0.05).Conclusions: The interactive education with conversation map can effectively improve the foot care behaviors of elderly diabetic patients with high-risk diabetic foot, and then prevent the occurrence of diabetic foot.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Mini craniotomy for chronic subdural haematoma: surgical outcome from a
           single institution experience and predictors of success

    • Authors: Mohammad Nazrul Hossain, Mohammad Humayun Rashid, Israt Zerin Eva, M. Sharif Bhuiyan, Abdullah Al Mamun
      Pages: 2902 - 2907
      Abstract: Background: Chronic subdural hematoma (CSDH) is an increasingly common neurological disease in daily neurosurgical practice. Despite the wide prevalence of CSDH, there remains a lack of consensus regarding numerous aspects of its surgical management. The diagnosis and treatment are well established but there are different surgical procedures and outcome related to these procedures are not completely understood.Methods: The study conducted was conducted in department of neurosurgery at Ibrahim cardiac hospital and research institute, Dhaka, Bangladesh between January 2019 to July 2020, 105 patients were treated for chronic subdural haematoma This study evaluated the clinical features, radiological findings and surgical outcome by mini craniotomy assessed by modified Rankin scale (mRS) score and Glasgow outcome scale (GOS) score in a large series of patients treated at single institution.Results: At 6 months follow up, only one patient died (0.95%) because of co-morbidities and not directly related to the chronic subdural haematoma, 15 patients (14.3%) improved to mRS 0, 33.33% showed only mild symptoms without any significant disability-mRS 1, slight disability was observed in 28.5% patients, moderate disability was observed in 17.14% patients-mRS 3, moderately severe disability was observed in 5.7%-mRS 4.Conclusions: GOS score at 6 months follow up which shows majority of the patient improved to GOS score 4 (45.71%) and 5 (38.09%). Based on these results, among various method of surgical management, mini craniotomy provides better outcome.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Dysfunctional endometres in Libreville: 20 years retrospective study

    • Authors: Mabika Barthélemy, Mbadinga N. Ghislain, Nguizi O. Sidonie Solange, Mendome Grégoire
      Pages: 2908 - 2913
      Abstract: Background: The objectives of this work were to inventory the different morphological entities, to alert the medical class to the need for multidisciplinary care; to sensitize the health authorities on this pathology having a considerable influence on the fertility of the woman and a possible evolution towards cancerous disease.Methods: A retrospective study was carried out over 20 years from January 1983 to December 2002 at the laboratory of anatomy pathology of the faculty of health sciences in Libreville. The revealing clinical signs were the couple's bleeding and infertility. Curettage, endometrial biopsy, and subtotal or total hysterectomy were fixed with 10% buffered formalin or Bouin's fluid. After staining, histological study was carried out by the pathologist.Results: The histological images of the endometrial polyps were the most representative (73 cases or 17.68%), followed by prolonged proliferative endometers (70 cases, or 16.95%), glandulo-cystic hyperplasia (66 cases, or 15.98%) and persistent proliferative endometers (58 cases, or 14.04%). More than half of the numbers concerned women under 35 (225/413 cases); in those over 45 years of age, the predominantly endometrial carcinoma was found. The most affected province was Woleu-Ntem (24%), followed by Haut-Ogooué (18%).Conclusions: The different dysfunctional endometers are also described in the different regions of the continent. The management of these aims to be multidisciplinary and urgently requires a frank collaboration between clinician and morphologist, especially for country where a birth policy is clearly expressed by governing bodies. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Correlation between serum uric acid levels and outcomes of pre-eclampsia
           in Abakaliki, South-east, Nigeria

    • Authors: Nnabugwu A. Adiele, Odidika U. J. Umeora, Robinson C. Onoh, Ikechukwu B. O. Dimejesi, Arinze C. Ikeotuonye, Nkemjika M. Adiele, Ayodele A. Olaleye, Amuchechukwu V. Nwafor
      Pages: 2914 - 2922
      Abstract: Background: Pre-eclampsia is a leading cause of fetomaternal and perinatal morbidity and mortality. The role of serum uric acid (SUA) in determining the complications of preeclampsia has been controversial. This study compared mean SUA levels between severe pre-eclamptics and normotensive women at term and ascertained its correlation with outcomes of preeclampsia; as well as determined if there is a threshold value of SUA level beyond which fetomaternal complications occur.Methods: A case-controlled study where 80 severe pre-eclamptics at term and 80 normotensive women matched for gestational age were recruited. Blood samples were collected from them for assay of SUA levels and they were followed till delivery. The fetomaternal outcomes and the corresponding SUA levels at diagnosis were documented and variables statistically analyzed. A receiver operating characteristic curve was used to determine the cut-off value of SUA beyond which adverse fetomateral complications are likely to occur in pre-eclampsia.Results: The mean SUA level in severe pre-eclamptics (0.283±0.09 mmol/l) was not significantly higher than that of normotensive women (0.263±0.09 mmol/l, p=0.13). There was a weak positive correlation between the SUA levels and fetomaternal outcomes [maternal (r=0.102, p=0.236) and fetal (r=0.096, p=0.226)]. The study was unable to identify the threshold SUA level at which adverse fetomaternal outcomes occur as the values of SUA were closely related.Conclusions: SUA levels of pre-eclamptics and normotensive women did not show significant difference and correlated weakly with fetomaternal outcomes and are therefore poor predictor of fetomaternal outcomes in pre-eclampsia.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Hypertensive disorders in pregnancy at the Federal Medical Centre,
           Yenagoa, South-South Nigeria: a 5-year review

    • Authors: Peter Chibuzor Oriji, Dennis Oju Allagoa, Akaninyene Eseme Ubom, Amos Kattey Kattey, Datonye Christopher Briggs, Maduabuchi Nduaguba Chika, Ugoeze Nneka Iloeje, Inere Daniel Akanatei, Gordon Atemie
      Pages: 2923 - 2929
      Abstract: Background: Hypertensive disorders complicate 5.2%-8.2% of pregnancies, and contribute significantly to perinatal and maternal morbidity and mortality worldwide. The objective of this study is to determine the incidence, clinical characteristics, maternal and perinatal outcomes of hypertensive disorders in pregnancy at the Federal Medical Centre, Yenagoa, Bayelsa State, South-South Nigeria.Methods: This retrospective study was conducted between 1 January, 2016 and 31 December, 2020. Relevant data was retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0.Results: Out of the 4,571 obstetric patients that were managed in our Centre in the period under review, 335 of them had HDP, giving an incidence rate of 7.32%. The most common HDP were pre-eclampsia (189, 56.4%) and eclampsia (82, 24.5%), while the least common was chronic hypertension (3, 0.9%). A little more than one-half (171, 51.0%) of the women delivered preterm, with a mean gestational age at delivery of 35.5 weeks. The most common route of delivery was emergency Caesarean section (205, 61.2%). There were three maternal deaths, giving a case fatality rate of 0.9%. Two of the maternal deaths were due to eclampsia, and one, from pre-eclampsia.Conclusions: Women should be adequately counseled to embrace preconception care, early booking and regular antenatal care visits, with proper monitoring of blood pressure and urine protein. Prompt diagnosis and management are key in preventing the maternal and perinatal morbidity and mortality that are associated with these disorders.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Study of incidence of allergic conjunctivitis in patients with allergic

    • Authors: Sucheta Gupta, Vinod Gupta
      Pages: 2930 - 2932
      Abstract: Background: Allergic conjunctivitis (AC) accounts for 15% of eye related consultations in primary care centers. AC is commonly manifesting as itchy or watering or red eye, comprising the symptoms of the total ocular symptom scores (TOSS). Recognition of AC is unreported even in patients with recognized AR (allergic rhinitis). Therefore, the objective of the present study was to identify the incidence of AC in patients with AR.Methods: This randomized observational study was conducted on 110 patients for a 6 month period from February to July 2019, having diagnosed AR and attending the outpatient clinic in CHC Chenani, district Udhampur, Jammu and Kashmir. The patients were directly questioned if they had AC, clarified by using standard screening questions of red, itchy and watery eyes and quantified by TOSS and were asked about indirect symptoms that may be attributable to AC.Results: Among the 110 patients, 50.9% of patients identified AC on direct questioning; additional symptoms were squint at 47.3% and blinking at 51.2%. Olopatadine, significantly reduced TOSS scores within 5 minutes of treatment and 80.9% showed improvement, which identified 39% silent sufferers of AC. A total of 90% AC subjects were identified through TOSS symptoms and totally 95.5%, detecting additional symptoms. The other co-morbidity that was associated with allergic conjunctivitis was allergic dermatitis.Conclusions: The screening questions could identify only about 56% of the patients with AC. Additional specific questioning and a therapeutic challenge in suspected patients can help identify patients who may benefit from treatment of AC. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Efficacy and safety of intravenous and/or oral levonadifloxacin in the
           management of secondary bacterial pulmonary infections in COVID-19
           patients: findings of a retrospective, real-world, multi-center study

    • Authors: Sanjith Saseedharan, Pankaj Aneja, Aditya Chowti, Khokan Debnath, Kapil Dev Mehta, Pramit Sonone
      Pages: 2933 - 2939
      Abstract: Background: Owing to dysregulated immune response, secondary bacterial pulmonary infections involving both gram-positive and gram-negative pathogens are common in COVID-19 patients and are often associated with higher mortality. This is a first ever report on the safety and efficacy of levonadifloxacin in the treatment of secondary bacterial pulmonary infections in patients with COVID-19 pneumonia.Methods: This multi-center, retrospective, post-marketing and real-world study assessed the safety and efficacy of IV and/or oral levonadifloxacin in the treatment of bacterial infections encountered in COVID-19 patients. Data for 154 male/female patients above 18 years of age who received levonadifloxacin (injectable and/or oral) was collected from 44 participating sites. Study outcomes were the clinical and microbial success at the end of therapy. Safety was assessed based on clinical and laboratory adverse events.Results: Among the 154 patients assessed, 121 (78.6%) were males and 142 (92.2%) were hospitalized. Majority of the patients (119) received all-IV therapy while 11 patients were prescribed with IV followed by oral regimen. All-oral therapy was received by 24 patients. The most common co-morbid conditions were diabetes (19.6%) and hypertension (19.2%). Post-treatment with levonadifloxacin, clinical and microbial success rates were 96.8% and 97.0% respectively.Conclusions: Levonadifloxacin showed promising safety and efficacy when used as IV and/or oral therapy for the treatment of secondary bacterial pulmonary infections in COVID-19 patients. Clinically relevant features of levonadifloxacin such as availability of both IV and oral options, broad spectrum coverage and reassuring safety in patients with significant co-morbidities could help simplify the management.Trial registration no. CTRI/2020/09/028152 [Registered on: 30/09/2020].
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Analysis of prognostic factors and complications following decompressive
           craniectomy for traumatic brain injury

    • Authors: Ranjith Chittikappil Gopalan, Shaji Urambath Abu, Ljo John Kollannur, Rony Louis
      Pages: 2940 - 2945
      Abstract: Background: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality. Decompressive craniectomy (DC) is a common surgery done for patients with TBI. An analysis of factors that determine the outcome and complications will go a long way in improving the prognosis of such patients.Methods: This is a single‑center, retrospective study of TBI patients who underwent DC from March 2016 to February 2020 at a tertiary care hospital in South India. Demographic profile, clinical data, radiological findings, intraoperative observations, postoperative complications, and Glasgow Outcome Score (GOS) at discharge were noted.Results: 164 patients underwent DC. Road Traffic Accident was the most common cause (116 patients) 71%. The mortality rate among patients with a motor score of M1 was 73.8%, 77.8% in the M2 group, 54.4%, 34.6%, and 10.6% in M3, M4, and M5 groups respectively. The survival rate among patients with bilaterally dilated pupils was 18.1%. 48.3% and 62.1% in those with unequal and equal reactive pupils respectively. The most common pathology was subdural hemorrhage in 108 (65.9%). External cerebral herniation was seen in 62 cases (37.8%). The mortality rate was 39% (64 patients). Persistent vegetative state was noted in 6.1% (10 patients) and severe disability in 24.4% (40 patients). Poor outcome was seen in 69.5% (114 patients). Primary DC was done in 113 patients (68.9%) with a mortality rate of 39.8% (45 patients) and secondary DC in 51 patients (31.1%) with a mortality rate of 37.2% (19 patients).Conclusions: Preoperative low motor score and dilated pupils were associated with higher mortality rate. The most common pathologies were subdural hemorrhage (SDH) and contusion and external cerebral herniation was the most common complication. Primary DC had a higher mortality rate than secondary DC.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Trans-anastomotic tube in esophageal atresia with trachea-esophageal
           fistula repair: how beneficial are they'

    • Authors: Pradeep Gupta, Vikram Singh Mujalde
      Pages: 2946 - 2948
      Abstract: Background: Congenital esophageal atresia with tracheo-esophageal fistula is a common congenital anomaly facing at our centre. There is various proposed anastomotic technique to avoid post-operative complications. In our center, feeding has been conventionally initiated after a contrast esophagogram done at the seventh day post repair. The current study tried to assess the benefits and risks of initiation of early feeding in these patients by placement of a Tran’s anastomotic feeding tube during the repair.Methods: Twenty-five patients had a trans anastomotic feeding tube inserted during trachea esophageal fistula repair and were followed up for different outcomes.Results: Twenty-five patients were operated out of which were sixteen males and nine were females. Early complications of esophageal atresia surgery such as anastomotic leak, surgical site infection, pneumonia and sepsis occur in eight patients. All the complications were managed successfully conservatively, however, one patient died due to anastomotic leak and subsequent septicemia.Conclusions: We conclude that early tube feeding is safe and does not increase risks of anastomotic leaks. It also reduces the need of total parenteral nutrition bringing down the costs of procedure in developing nations.   
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Correlative study of diabetic retinopathy in type 2 diabetes mellitus with
           haemoglobin A1c, duration of diabetes and modifiable risk factors:
           smoking, alcohol and BMI in adult population attending a tertiary care

    • Authors: Nutan Bedi, Archana O. Gulati, Gauri V. Devasthali
      Pages: 2949 - 2953
      Abstract: Background: Diabetes is a disease, which if not controlled, affects every cell of the body from head to toe. No wonder it is often referred to as the “SILENT KILLER”. So through our study, we aim to study the correlation between (haemoglobin A1c) HbA1c levels, duration of diabetes and modifiable risk factors with diabetic retinopathy (DR) in patients of type 2 diabetes mellitus.Methods: This study was conducted in 100 patients (200 eyes) who were diagnosed cases of type 2 diabetes mellitus. A detailed history of the duration of diabetes, alcohol intake and smoking and HbA1c levels was taken. Complete ocular examination was done. BMI was also calculated.Results: 2/3rd of the eyes with grade 3 DR were of>10 years duration while 2/3rd of the eyes with grade 2 DR were of 5-10 years duration. Of the eyes with grade 3 DR, all the patients had HbA1c of more than 8. Significant p value shows strong correlation between DR and obesity. No significant correlation of DR was found with alcohol and smoking.Conclusions: The findings in our study endorse the view that duration and HbA1c are important risk factors for occurrence and severity of DR and therefore a regular follow up and good glycemic control is highly essential for the prevention of occurrence and progression of DR. Strong correlation between BMI and DR suggest that lifestyle changes play a pivotal role.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Morphometric study of nutrient foramen of tibia in Jharkhand population

    • Authors: Rajesh K. Kushwaha, Rajiv Ranjan, Makardhawaj Prasad
      Pages: 2954 - 2958
      Abstract: Background: Nutrient foramen gives passage to the nutrient vessels which supply major portion of the bone even bone marrow. Many vascular foramina are present in all bones for the passage of blood vessels. In long bones many small vascular foramina are present at the ends through which epiphyseal and metaphyseal blood vessels passes. In the shaft of long bones one or two larger foramina are present through which nutrient vessels passes. Nutrient artery provides 70% to 80% blood supply of long bones in children and if blood supply is decreased, it may lead to ischemia of bone resulting into less vascularisation of metaphysis and growth plate. Thus precise topographical knowledge of nutrient foramen is necessary for the surgeons to save the nutrient vessels during surgical procedures i.e. fracture fixation, bone grafting etc. Damage to the nutrient artery causes avascular necrosis of bone.Methods: Total 70 dry bones of tibia were taken in the study, without knowledge of sex of the bone. Position, number and direction of the nutrient foramen were noted.Results: single nutrient foramina present in 91.43% of cases and double in 6% of cases. 97.14 % nutrient foramina are directed downward and 2.86% directed upward. 90% nutrient foramina present on posterior surface, 1.42% on lateral surface and 8.57% on lateral border. 75% of nutrient foramina present in upper 1/3 and 25% in middle 1/3. Primary nutrient foramina (>24 G) present in 89.47% and secondary nutrient foramina (<24 G) present in 10.53% of cases.Conclusions: A sound knowledge of nutrient foramen topography, prevent the injuries of vasculature of bone during surgeries.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Biofilm formation by bacteria isolated from intensive care units of a
           tertiary care hospital, with special relevance to its risk factors

    • Authors: Mayuri Gogoi, Ajanta Sharma
      Pages: 2959 - 2965
      Abstract: Background: The purpose of this study was to detect biofilm formation by bacterial isolates from patients with device associated infection admitted in intensive care units (ICUs), to compare the three methods used for detection of bioiflm, to compare the antimicrobial susceptibility pattern of the biofilm producers with the non-producers and to study the risk factors associated with biofilm formation.Methods: A total of 115 bacterial isolates from patients with device associated infection admitted in different ICU for a period of one year was included in the study. These clinical isolates were detected for biofilm formation by tissue culture plate method, tube method and Congo red agar method. Kirby-Bauer disc diffusion method of antibiotic susceptibility was performed on all isolates.Results: Out of the 115 bacterial isolates, 71 were biofilm producers. Tissue culture plate method detected the maximum number of biofilm producers (61.7%). The maximum number of biofilm producers were isolated from tracheal aspirate and endotracheal tubes (52.1%) followed by blood (17%) and urine (12.6%) respectively. The predominant biofilm producing isolates were Klebsiella pneumoniae (39.4%), Staphylococcus aureus (19.7%) and Pseudomonas aeruginosa (16.9%). Multi drug resistance among the biofilm producers was significantly higher than the non-biofilm producers (p value=0.0125). The risk of biofilm formation was seen to increase with the increase in duration of hospital stay (p value=0.0092, statistically very significant).Conclusions: From this study it was found that a high degree of biofilm producers were isolated from patients on indwelling devices. Tissue culture plate was found to be the most accurate method. The degree of multidrug resistance among the bioiflm producers was significantly higher than the non-producers.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Evaluation of in vivo anti-inflammatory activity of Ariflex tablet in
           comparison with diclofenac and aceclofenac tablet in carrageenan induced
           rat paw edema model

    • Authors: Sanjay Nipanikar, Sohan S. Chitlange
      Pages: 2966 - 2970
      Abstract: Background: Osteoarthritis is a major cause of pain and locomotor disability worldwide. Though various pharmacological, mechanical and surgical interventions are used, there is no known cure for OA. The present study was conducted to evaluate anti-inflammatory activity of Ariflex tablet (conceptualized and developed by Ari Healthcare Pvt. Ltd.) in comparison with diclofenac and aceclofenac tablet in carrageenan induced rat paw edema model.Methods: Wistar rats of either sex weighing 150-180 g were taken and divided into 4 groups with 6 animals in each group i.e. group 1 (control group), group 2 (diclofenac tablet), group 3 (aceclofenac tablet) and group 4 (ariflex tablet). The study drugs were orally administered with feeding needle, 30 minutes prior to carrageenan injection. After 30 min 1% w/v of 0.05 ml carrageenan was injected subcutaneously in the rat paw. The paw was marked with ink at the level of lateral malleolus and immersed in mercury up to lateral malleolus mark. The paw volume was measured plethysmographically after injection at 30 minutes, 1 hour, 2 hour, 3 hour, 4 hour and eventually at 5 hour.Results: All the test formulations possess statistically significant (p<0.05) anti-inflammatory activity as compared to control group. The maximum percentage inhibition for Ariflex tablet was 96.97% at the end of 5 hours. When compared to control group, statistically significant reduction of paw edema was observed. The anti-inflammatory activity of Ariflex tablet from 2 hours onwards is comparable to that of diclofenac tablet and aceclofenac tablet.Conclusions: Ariflex tablet possesses significant anti-inflammatory activity.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Clinical profile of post flood fever in a tertiary care hospital in Kerala

    • Authors: Bhagyanath T., Anoop Joseph, Jacob K. Jacob, Suma Samuel, Rakhi R. Kurup, Reshnu Ravindran
      Pages: 2971 - 2975
      Abstract: Background: Floods are an important source of infection epidemic worldwide. Analysis of different infections presenting during floods can lead us to have a unified approach during such periods.Methods: This study describes the clinical features of fever patients presented to a tertiary care hospital in Kerala after the 2018 flood. Clinical findings of the confirmed leptospirosis cases were also compared with non-leptospirosis cases.Results: A total of 48 patients with fever and myalgia were studied and majority of them were males (77%). 40 patients had contact with contaminated water. But only 10 of them had taken prophylactic doxycycline. Complications were seen less among those who took prophylactic doxycycline. The mean time from the first symptom to first medical care was 4.4 days. Leptospirosis was seen among 15 patients and 2 patients had dengue fever. Hepatic involvement and renal involvement were seen significantly higher among leptospirosis patients.Conclusions: This study emphasized the importance of prophylactic doxycycline and early initiation of antibiotics during flood outbreaks. Awareness among treating doctors and patients is required for the control of outbreaks and prevention of mortality during floods. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Immunophenotyping of non-Hodgkin’s lymphoma by flowcytometry on fine
           needle aspiration

    • Authors: Sanjay Kumar, Meena Verma, Pinki Devi, Sant P. Kataria, Rajeev Sen
      Pages: 2976 - 2980
      Abstract: Background: Lymphoma represents one of the major health problems all over the world. Flow cytometry (FCM) can be used on fine-needle aspiration cytology (FNAC) from lymph node as an ancillary technique. Aim of the study was to assess the utility of flowcytometry (FCM) in diagnosis and differentiation of reactive hyperplasia and non-Hodgkin’s lymphoma (NHL) on FNAC.Methods: The study was carried out on 50 cases, 25 each of reactive hyperplasia and suspicious or confirmed NHL on FNAC. FCI was performed with a complete panel of antibodies on FACS Canto II FCM.Results: All 25 cases of reactive hyperplasia on FNAC were polyclonal on FCM. FCM could be performed in 22 cases (88%) out of 25 suspicious NHL and in three cases the material was inadequate on aspirate. Out of 22 cases of NHL on FNAC 17 cases (77.30%) were diagnosed as B-NHL on FCM. Light chain restriction was demonstrated in 15/17 cases. With the help of FCI, 6 cases were diagnosed as small cell lymphocytic lymphoma, one case as mantle cell lymphoma, one case as follicular lymphoma, and 9 cases as B-NHL-NOS. Histopathology diagnosis was available in nine cases and were in concordance to FCM. Sensitivity of combined FNAC and FCM in sub-classification was 77.30% (17/22). Four cases showed discordance between FNAC and FCM.Conclusion: We concluded that FCM enhances the diagnostic ability of FNAC, playing a crucial role in a rapid and accurate differential diagnosis between reactive hyperplasia, B-NHL and T-NHL.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Effect of clinical rotation on attitude of medical students towards
           psychiatry and mental patients: a cross-sectional study from Western

    • Authors: Aditi Agrawal, Sanjay Gehlot, Ashok Singhal, Amandeep .
      Pages: 2981 - 2987
      Abstract: Background: People with mental illnesses experience extreme stigmatization and discrimination despite their ubiquitous presentation. Studies have reported that these negative stereotypes are shared by health care professionals too. Attitude of undergraduate medical students towards psychiatry is vital as it reflects their willingness to deal with psychiatric and behavioral disorders in general practice.Methods: A descriptive cross-sectional study was conducted in a government medical college in Rajasthan to explore the impact of sociodemographic variables and undergraduate psychiatry training on the attitude of medical students towards mental illness and psychiatry. 105 first year MBBS students and 75 interns participated in the study. Attitude towards mental illness (AMI) scale and attitude towards psychiatry-30 (ATP-30) scale were used to document AMI and ATP respectively. Data collected were analyzed using SPSS statistical software and appropriate tests were used to compare mean scores of both groups.Results: There was no statistically significant difference on AMI and ATP scores between the undergraduate medical students and interns. Females, students belonging to urban setting and more educated families had a favorable attitude towards psychiatric patients. A notable shift in scores on ATP scale towards positive side was reflected between male MBBS students and interns and among students coming from rural background with exposure to medical curriculum.Conclusions: No attitude change was observed in majority of participants indicating need for greater emphasis on mental health and psychiatry. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Ultrasound guided erector Spinae plane block versus modified pectoral
           plane block in modified radical mastectomy: a prospective, randomized,
           single blinded study

    • Authors: Upasana Majumdar, Arun Deka, Jili Basing, Rajib Paul
      Pages: 2988 - 2993
      Abstract: Background: Modified radical mastectomy (MRM) is the most common surgery for cancer breast that is associated with marked postoperative pain. Effective control of this pain suppresses the surgical stress response and decreases the need for opioids and general anesthetics. This study was aimed to compare ultrasound guided erector spinae block (US-ESP) with modified pectoralis nerve block (US-PECS) in terms of post-operative pain scores as the primary objective, in patients undergoing MRM. The secondary objectives of our study were to compare the time of first rescue analgesic, total analgesic consumption and side-effects between the two groups.Methods: Group E comprised of patients receiving 20 mL of 0.2% ropivacaine plus 0.5 µ/kg dexmedetomidine and it was injected in‑between erector spinae muscle and transverse process. Group P comprised of patients receiving 30 mL of 0.2% ropivacaine plus 0.5 µg/kg dexmedetomidine divided into 10 mL that was injected between the two pectoralis muscles in the inter-fascial plane and the remaining 20 mL was injected between the serratus anterior and the pectoralis minor muscle.Results: Demographic profile was comparable between both groups. Both groups offered good analgesia, but PECS group took an upper hand up to the 6th post-operative hour (p<0.05). Beyond the 6th post-operative hour, analgesic efficacy of both groups was comparableConclusions: Modified pectoralis nerve block offered better analgesia over the erector spinae block technique up to 6th post-operative hour and it is more effective in terms of total rescue analgesic consumption and the time for request of first rescue analgesic, in patients posted for MRM.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Thyroid dysfunction in patients of depression and anxiety and response to

    • Authors: Harsha ., Amandeep ., Jitendra Jeenger, R. S. Ahlawat, Manju Subberwal
      Pages: 2994 - 2999
      Abstract: Background: Depression and anxiety are the most common psychiatric presentation in thyroid dysfunction. Aim of the study was to determine the thyroid profile in patients with depressive and anxiety symptoms and to determine the change in symptoms with correction of thyroid profile.Methods: This longitudinal observational study was conducted in patients presented with depressive or anxiety symptoms who visited the psychiatry out patient department (OPD) first time. Two groups were made based on the serum thyroid profile. First group, (n=27) was patients with depression and anxiety with hypothyroidism (experimental group) and second was (n=123) without hypothyroidism (control group). Experimental group, (n=27) was then exposed to thyroxine, 15 patients came for first follow up and 11 patients came for second follow up.Results: The 63% of patients in the experimental group and 62.6% of patients in the control group were of female gender, 66.7% and 33.3% of patients in the experimental group had depressive disorder and anxiety disorder respectively. TSH level of 11 patients of experimental group had significantly less value in first follow up compared to entry point (p=0.002). Generalized anxiety disorder (GAD) 7 scores were significantly lower in first and second follow up than that of the entry point in 11 patients of experimental group (p=0.008, 0.016 respectively).Conclusions: Many patients of the clinical diagnosis of depression (17.6%) and clinical diagnosis of anxiety (18.75%) had hypothyroidism during the first visit to the psychiatry OPD. There was significant reduction in the hypothyroid patients of the serum thyroid stimulating hormone (TSH) value and anxiety scores during the follow up after treatment with levothyroxine.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Clinico-pathological study of oesophageal cancer: a 3 years retrospective
           and 1½ year’s prospective analysis

    • Authors: Shrikant S. Suryawanshi, Saia Chenkula, John Zohmingthanga, Zothansanga Ralte
      Pages: 3000 - 3005
      Abstract: Background: In India, oesophageal cancer is second most common cancer among males and fourth most common among females and is associated with certain diets and lifestyle. In India, the age-adjusted incidence rates for oesophageal cancer are the highest in men (25.5) and women (5.5) in Mizoram. Aim of the study was to find the clinical and histopathological findings of oesophageal cancer patients at Civil Hospital, Aizawl.Methods: A descriptive study (3 years retrospective and 1½ years prospective) was conducted at Civil Hospital, Aizawl, Mizoram from July 2013 to December 2014 (1½ years) amongst 104 patients reporting to Civil Hospital, Aizawl for oesophageal cancer.Results: History of progressive dysphagia to solids was most common symptom and observed in 91.3% patients. Histopathological examination of resected esophageal specimen showed 95.7% patients were detected with squamous cell carcinoma, 4.3% patients were detected with no proper malignancy/residual tumor.Conclusion: Squamous-cell carcinoma was the most common type of esophageal cancer occurring in the middle third of the oesophagus with as observed on upper gastrointestinal (GI) endoscopy. More men were affected than female. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Clinico-radiological and functional outcome of surgical management of
           displaced two part, three part and four part proximal humeral fractures in
           adults treated by PHILOS plate in a tertiary care hospital in North India:
           a prospective study of 30 patients

    • Authors: Pankaj Spolia, Abdul Ghani, Sakib Arfee
      Pages: 3006 - 3011
      Abstract: Background: Treatment of proximal humeral fractures is challenging. In the past, the fractures were treated conservatively which compromised the functional results. PHILOS plate provides a good functional outcome with context to the early joint mobilization and rigid fixation of the fracture.Methods: This was the prospective study of 30 patients aged 20 to 60 years (mean age 48.4 years) with proximal humeral fractures including two part, three part and four part fractures based on Neer’s classification, treated by open reduction internal fixation with PHILOS plating. Functional outcome was assessed using Constant-Murley Score.Results: The final outcome was observed at 6 months follow up. The results were comparable with the existing literature. The Mean Constant Score at 6 month follow up was 79.4, range (38 to 92). Out of 30, (n = 12, 40%) had excellent outcome, (n = 9, 30%) had good functional outcome, 6 (20%) had moderate outcome, 3 (10 %) had poor outcome. Out of 30 patients, one patient with four part fracture had a lowest CS of 38. Complications were observed in 5, (16.7%) patients. Varus malunion in one patient, avascular necrosis in one patient, stiffness in one patient.Conclusions: PHILOS plate gives stable fixation, enables early range of motion and minimizes complications with good functional outcome if done with expert hands.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Retrospective analysis of donor deferral for plateletpheresis at a
           regional transfusion center, in North-West India

    • Authors: Ashok Pal, Sunita Bundas, Anjali Handa, Udai Singh Meena
      Pages: 3012 - 3016
      Abstract:  Background: Single donor platelet (SDP) is one of the valuable component for thrombocytopenic patients for obtaining good post transfusion count increment, good yield of product is required. Proper donor selection has a crucial role in in safety and quality of product therefore proper screening of donor is mandatory. The aim was to find out reasons and frequency of plateletpheresis donor deferral and to encourage safety of donor for recruitment of new SDP donors.Methods: A retrospective analysis of data was done over a period of 1 year from June 2018 to May 2019 from the data centre of the institute.Results: Out of 1365 donors, 1200 were selected for plateletpheresis procedure and remaining 165 donors were deferred for various reasons. The predominant age of donors ranges from 25-35 years. Among the deferred donors temporary donors accounted for 93.33% and permanently deferred donors were 6.61. Most common cause for deferral were poor venous access 52 (31.51%). Low platelet counts 32 (19.39), low Hb 26 (15.75%), underweight 24 (14.54%), under medication 9 (5.45%), alcohol intake within 24 hours 6 (3.63%) and others like tattoos, infections/inflammations at phlebotomy sites 5 (3.03%) and most common reason for permanent deferral were sero-positivity for HbsAg 6 (3.63%), chronic diseases 4 (2.42%) (cardiovascular diseases bronchial asthma), others 1 (0.6%).Conclusions: For obtaining good yield of product, proper donor screening is required. Temporary deferred donors should be counselled properly and encouraged for further donation when comes under selection criteria. Donor selection criteria for apheresis may be revised.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Sleep quality, mental health and body mass index among undergraduate
           medical students: a cross-sectional study

    • Authors: Piyush Kharche, Rupali A. Patle
      Pages: 3017 - 3021
      Abstract: Background: Association of sleep disorders is found cardiovascular mortality, stroke, diabetes, impaired glucose tolerance, immune dysfunction, endocrine impairments, and psychiatric morbidities including depression. Sleep quality affects college students physical and psychological health. Thus, poor sleep quality is a serious problem in college students. This study was done to assess the quality of sleep among undergraduate medical college students, to explore relationship between quality of sleep and body mass index, to study relationship between quality of sleep and anxiety, to study relationship between quality of sleep and depression.Methods: Total 300 medical students were selected by systematic random sampling method i.e. 25 students from each year studying in 3 government medical college were selected. A descriptive questionnaire for all socio-demographic parameters along with validated instrument i.e. for sleep quality, Pittsburgh sleep quality index (PSQI), for anxiety Hamilton anxiety rating scale and for depression, Becks depression inventory were used for the data collection instruments.Results: Amongst the 300 subjects 189 (63.00%) were found to be poor sleepers. The sleep quality was poor among the subjects who are in final academic year though the difference was not statistically significant (c²=2.78, df=3, p=0.4267). It was found that sleep quality was decreased among overweight and obese persons, but the difference was not statistically significant. (c²=4.657, df=2, p=0.0974). Prevalence of anxiety was found to be more in poor sleepers. Depression was also more common among the poor sleepers and the difference was statistically significant.Conclusions: Poor sleep quality was associated with depression and anxiety in students.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Effect of storage duration and analyte concentration on measurement of
           neutral pH clinical chemistry urine analytes

    • Authors: Chapal Debnath, Niral Savaliya
      Pages: 3022 - 3027
      Abstract: Background: The aim of the study was focused very keenly in measuring the changes in concentration of sodium, potassium and creatinine in urine, stored for 60 days effect of urinary storage duration of clinical chemistry analytes. This study determined whether patient urine samples can be used for day to day urine quality control.Methods: Spot urine samples were collected from left over samples from the admitted patients in various hospital wards. The samples are kept which its pH was unaltered or unspiked and was aliquoted and deep fridged immediately. These aliquots were melted at an incubator temperature of 86 ºC and was analyzed in the analyzer for 60 days and data were collected for checking variations.Results: With the strenous and continious monitoring from the side of the researchers, the researchers had throughly analysed and found that in both the sets almost all of those analysed urine test of pH 5 and analytes remained very much stable for a period of 60 days which could be used for running daily internal quality controls.Conclusions: Patient urine can be used as internal quality control sample for at least 60 days for sodium, potassium and creatinine. During the 60 days period, there is no appreciable degradation of any of the two sets of samples for sodium, potassium and creatinine measurements.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • A cross sectional study to assess the prevalence and risk factors of
           post-partum depression in urban area of Indore district

    • Authors: Priyanka Bhaskar, Veena Yesikar, S. B. Bansal, Bhagwan Waskel
      Pages: 3028 - 3032
      Abstract: Background: Pregnancy and childbirth are important events in the life of a woman. Life with the new born can be very rewarding but it can be very tough for some women. This phase of life brings about many hormonals, physical and emotional changes in the women during childbirth. Aims and objectives were to find out the prevalence and risk factors of post-partum depression (PPD) in urban area of Indore district and to assess the socio demographic profile of study populationMethods: The study was a cross sectional community-based study, conducted on women who had delivered within a period of 6 weeks to 3 months. 100 women from urban area were selected from Indore district through simple random sampling. Informed consent in written was taken from the mothers. The study tool was pre designed semi structured questionnaire and Edinburgh post-natal depression scale (EPDS) scale, data were entered in excel sheet and analyzed using SPSS software, appropriate statistical test were applied wherever necessary.Results: In our study it was found that prevalence of PPD in urban Indore was 23%. We found that age at the time of marriage below 18 years, mode of delivery (LSCS), initiation of breast feeding (after 1 hour) and birth weight of baby less than 2.5 kg had a strong association with PPD. In our study 58% had normal vaginal delivery and 42% had LSCS in urban area. In urban areas 36% gave a history of birth weight of babies <2.5 kg.Conclusions: Symptoms of PPD were significantly high in urban Indore mothers and they were strongly associated with risk factors.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Correlation between cholesterol levels and the severity of Parkinson

    • Authors: Sandy Kumala, Rizal Tumewah, Sekplin A. S. Sekeon
      Pages: 3033 - 3038
      Abstract: Background: Parkinson disease is the second most common neurodegenerative disease after dementia Alzheimer. In neurodegenerative disease such as PD, there is a disturbance of cholesterol metabolism in the brain that could affect plasma cholesterol level. Laboratory test of cholesterol level could be used as an alternative parameter in assessing the severity degree of PD. Our objectives in this study are to analyze the correlation between cholesterol level and the severity of PD. Methods: This study is a cross sectional study. The sample is collected from patients with PD that came too neurology clinic in Prof Dr. R. D. Kandou Manado Hospital. Patients will then be assessed whether they meet the inclusion criteria which is examined using unified Parkinson disease rating scale (UPDRS) questionnaire and Hoehn and Yahr (H and Y). If the inclusion criteria are met, subject will be tested for total cholesterol, high density lipoprotein (HDL), and low density lipoprotein (LDL) levels in plasma.Results: There are 60 subjects of PD patients with mean age 64.37±8.26 years old. Male subjects were more dominant (53.3%) than female. Total cholesterol level and LDL have moderate negative correlation with UPDRS I, UPDRS II, UPDRS III, and UPDRS total score. Total cholesterol and LDL level also has moderate negative correlation with H and Y severity.Conclusions: There is a moderate negative correlation between total cholesterol level and LDL with PD severity degree based on H&Y degree and UPDRS I, II, III, and UPDRS total score. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Anatomical study on variable disposition of structures in the renal hilum

    • Authors: Pooja Dawani, Vandana Mehta, Amandeep Kaur
      Pages: 3039 - 3042
      Abstract: Background: The hilum is a deep vertical fissure present anteromedially in the kidney, and contains renal vessels and pelvis. Due to advancements in imaging techniques; nephron sparing surgeries like laparoscopic partial nephrectomy have become more common. In these procedures, only specific branch of renal artery, and tributary of renal vein are ligated in the renal hilum. This requires adequate skill of the surgeon as the structures are crowded in the renal hilum. The knowledge of arrangement of renal hilar structures is also important for radiologists to correctly interpret renal angiograms and other radiological scans.Methods: The present study was conducted in the department of anatomy, Vardhman Mahavir medical college, New Delhi on 64 kidneys derived from embalmed human cadavers. The renal hilum was dissected and the sequence of structures from anterior to posterior direction was noted.Results: The kidneys were classified in 6 patterns, with the classical pattern (renal vein, artery and pelvis from anterior to posterior) observed in 37.5% cases only. Remaining 62.5% cases exhibited variations, of which the pattern 2 (V-A1-P-A2) was seen in maximum cases (26.5%).Conclusions: The classical pattern described in anatomical textbooks is not the only pattern of arrangement of renal hilar structures. Instead, variant patterns are commonly encountered. The present study attempts to elucidate the variant anatomy of the renal hilar region to help radiologists and surgeons in proper diagnosis and treatment.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Histogenesis of developing human fetal stomach

    • Authors: Rafika Munawara, Kanchan Kapoor, Mahesh K. Sharma, Poonam Goel, Poonam Chaudhary
      Pages: 3043 - 3050
      Abstract: Background: Human stomach is a highly specialised organ with distinct types of glands and microscopic features for its physiological activity. This study aimed to assess the chronological order in the development of different layers and the cyto-differentiation of various glandular cells in 50 fetuses from 12 weeks of gestation till term.Methods: Tissue was taken from cardiac, body and pylorus to investigate with light and confocal microscopy.Results: The gastric gland formation began as an indentation of the surface epithelium, gastric pit and simultaneous development of glandular buds in the mucosa. The pyloric glands preceded the development of cardiac and gastric glands showing retro cranial sequence of development. In contrast, the muscularis externa showed the classical craniocaudal model of development with oblique layer in the cardiac region by 14 weeks and body region by 16 weeks of gestation. The parietal cells were well developed by 12 weeks and the chief cells by 16 weeks with prominent secretory granules. In addition, the pyloric sphincter was a clearly defined anatomical sphincter developed by whorling of the inner circular layer at the pyloric end of the stomach evident from 12 weeks of gestation.Conclusions: The results showed that the significant cellular morphogenesis occurred between 12-20 weeks of gestation. This aggregated data will serve as a catalyst in the understanding intricacy of embryogenesis, pathogenesis tracing of congenital anomalies and invention of new drugs.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Efficacy and safety of paclitaxel drug-eluting balloons in femoropopliteal
           artery disease: a prospective observational study

    • Authors: Mohammed Hidayathulla, Nagesh .
      Pages: 3051 - 3056
      Abstract: Background: The femoropopliteal artery is most frequently involved artery in peripheral artery disease. To treat femoropopliteal artery disease (FPAD), various revascularization approaches have been available such as simple balloon angioplasty, debulking techniques, stent implantation, and recently the drug-eluting balloon (DEBs). Nowadays, the paclitaxel DEBs have been emerged to treat FPAD with promising outcomes. We therefore evaluate the efficacy and safety of paclitaxel DEBs in patients with lower limb FPAD.Methods: In total, 25 patients with FPAD were enrolled in the study. All patients underwent peripheral angioplasty using paclitaxel DEBs via antegrade femoral approach or contralateral femoral artery using crossover sheath. Demographics, risk factors, clinical characteristics, and pre- and post-procedure VascuQol-6 score were noted.Results: Out of 25 patients, the majority of patients (52%) were in the 6th decades of life. The incidence of FPAD was most common in patients with an O +ve blood group. The common risk factors of FPAD, include smoking (88%), diabetes (68%), dyslipidemia (68%), and hypertension (64%). Rest pain (64%) and ulcer (32%) were the most frequent clinical symptoms of FPAD. The percent stenosis was 100% in 17 patients, and 70-99% in 32 patients. A statistically significant difference was found in VascuQol-6 score between pre and post peripheral angioplasty (p<0.001).Conclusions: We have concluded that the paclitaxel DEBs are safe and efficacious in treating FPAD.
      Authors recommend that clinician should educate FPAD patients pertaining to modification of controllable risk factors such as cessation of smoking, unhealthy diet, sedentary lifestyle, high blood pressure, and high blood sugar. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Correlation between atherogenic index of plasma and national institutes of
           health stroke scale score in acute ischemic stroke patients at Haji Adam
           Malik general hospital, Medan

    • Authors: Muhammad Zulfikri, Cut A. Arina, Chairil A. Batubara
      Pages: 3057 - 3061
      Abstract: Background: Stroke is the leading cause of morbidity and mortality in Indonesia. Dyslipidemia is one of the main risk factors of ischemic stroke. Atherogenic index of plasma (AIP) is the logarithm of the triglyceride’s plasma ratio concentration to high density lipoprotein cholesterol (HDL-C) plasma concentration. Previous studies showed that the high AIP at hospital admission was associated with deterioration of neurological deficits in patients with acute ischemic stroke.Methods: This is a cross sectional study with 82 sample of acute ischemic stroke subjects that consecutively collected from the medical records of Haji Adam Malik general hospital Medan from January to December 2019, AIP assessment performed at the 1st day of hospitalization and then at the 7th -onset the national institutes of health stroke scale (NIHSS) score assessment was count. Data analysis is conducted with Spearman test.Results: Demographic characteristics showed that most subjects were female (51.2%), at age range between 60 -68 years (30.5%), had high school education level (48.8%), self-employed (35.4%) and Bataknese (68.3%). The mean of AIP was 0.15±0.26 and the mean NIHSS score was 6.70±3.6. There was a positive significant and mild power of correlation between AIP and the NIHSS score (p=0.017; r=0.262).Conclusions: There is a significant relationship between AIP and the NIHSS score. The higher the AIP of acute ischemic stroke patients was associated with the increase in the NIHHS scores. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Effect of physiotherapy on single breath count and breath holding time in
           COVID-19 patients

    • Authors: Sushama A. Bhandare, Sayali S. Rasal, Anil M. Sathe, Vaishnavi R. Nagpure, Urvi B. Parmar, Saraswati K. Iyer
      Pages: 3062 - 3067
      Abstract: Background: The novel Coronavirus is known to primarily affect the respiratory system and physiotherapy treatment is integral to combat this infection. However, the assessment of pulmonary function poses a difficult challenge considering the risk of spread of infection and sanitisation of the devices used. Single breath count (SBC) and breath holding time (BHT) can be thus adopted as bedside assessment tests for pulmonary function following physiotherapy treatment.Method: In this a retrospective observational study of 51 COVID-19 patients, mean age 51.7±14.56 years, on room air, admitted in the step-down units of a tertiary care hospital. Patients received standard physiotherapy treatment, within safe hemodynamic limits. Pre and post treatment session SBC was recorded in 32 patients and BHT in 19 patients. Three reading were noted and the best of three readings were used for analysis.Results: The paired t test was used to analyse SBC and BHT. Mean pre and post SBC was 18.25±8.96 and 23.31±9.96 respectively with a mean difference of 5.06 and p<0.0001. Mean pre and post BHT were 19.37 and 23.05 seconds respectively with a mean difference of 3.68 and p<0.0001.  Statistically significant difference in the pre and post treatment session SBC and BHT was observed, indicating a positive effect of physiotherapy treatment on pulmonary function.Conclusion: Physiotherapy treatment shows significant improvement in the pulmonary function in COVID-19 patients. SBC and BHT tests can be used as assessment and prognostic tools for pulmonary function in COVID-19 patients.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Gender based variation of lipid abnormalities in type-2 diabetes mellitus

    • Authors: Arpita Jaidev, Hitesh Shah, Liggy Andrews, Bhavisha N. Vagheda
      Pages: 3068 - 3073
      Abstract: Background: Dyslipidemia has a varying pattern among the male and female patients of type 2 diabetes mellitus (DM).Methods: This study was conducted in the out-patient department (OPD) of department of medicine at GMERS, Patan, Gujarat from July 2020 to December 2020 for a period of six months. Fasting blood sugar, hemoglobin A1c (FBS, HbA1c) lipid profile triacylglycerol-triglyceride, total cholesterol, low density lipoprotein cholesterol and high-density lipoprotein cholesterol (TG, TC, LDL-C, and HDLC) were measured. Statistical analyses were performed with the SPSS software program.Results: A total number of 200 type 2 DM patients (100 males and 100 females) attending to GMERS OPD were recruited in this study. Blood sugar was higher than normal in both male and female (FBS=142.44±36.21, 146.40±41.49 respectively). TG level was also higher in two groups of study subjects with female level slightly more than male (164.99±67.1and 138.21±70 respectively) with no significant difference between the groups (p>0.05).Total cholesterol and LDL-C level was within normal physiological level in both groups, where-as these levels were higher in female in comparison to male (TC=198.07±40.82 and 169.5±36.13 respectively, LDLC=118±34 and 99±27, respectively), showing significant difference between the groups (p=0.014). HDL-C was not below normal in both male (41±5.4) and female (43.99±4.31); however, HDL-C was slightly higher in female than male and the difference was significant (p=0.0129).Conclusions: Dyslipidemia was noticed in a greater proportion of female diabetic patients than male diabetic patients.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Laboratory biomarkers of COVID-19 outcome: findings from a high dependency
           unit of South Bengal

    • Authors: Rabilochan Maji, Arindam Bhattacharjee, Akshaya Elango, Sayan Ghosh, Kripasindhu Gantait
      Pages: 3074 - 3078
      Abstract: Background: Coronavirus disease-19 (COVID-19) has become a world wellbeing compromise. The danger factors for unfavorable occasions of coronavirus disease-19 (COVID-19) have not been very much depicted. This study aimed to explore clinical characteristics, laboratory results, and CT imaging characteristics of COVID-19 patients in Midnapore medical college and hospital and provide evidence for the prevention and treatment of COVID-19.Methods: In this retrospective, single-center study, data of all confirmed patients with COVID-19 admitted at SARI HDU of Midnapore medical college and hospital from 1st July to 21July 2021 were collected and analyzed. Data including clinical presentations, basic laboratory investigations, and CT severity scores were analyzed and compared between survival and death patients.Results: In this study total of 81 patients of COVID-19 admitted at SARI HDU were included (male=50, female=31). The patients were divided into 2 groups according to the outcome: survival group (n=38) and death group (n=43). Information on the overall clinical characteristics of the patients was collected, including age, sexual orientation, past medical history, clinical symptoms, and so on. Compared with the patients in the Survival group, the patients in the death group, the proportion of patients presented with Dyspnoea and suffering from Diabetes and hypertension were higher (p<0.05). In patients of the death group, TLC, CRP, D-dimer, urea, and creatinine had higher values, while the levels of albumin were significantly reduced, and the differences were statistically significant (p<0.05). Between the Survival group and death group, there was no significant difference in other indexes such as NLR, platelet count, and liver enzymes (SGOT, SGPT) (p>0.05). Conclusions: The risk factors of comorbidities, like diabetes, hypertension and others like leucocytosis, high CRP, high d-dimer, altered renal function, low serum albumin, and higher CT severity score could help clinicians identify patients with potential adverse events.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Histomorphology of germ cell tumors at various anatomic sites: a 5 years
           study at a tertiary care centre

    • Authors: Manal A. Lateef, M. I. Lone
      Pages: 3079 - 3085
      Abstract: Background: Germ cell tumors (GCTs) are a heterogeneous group of neoplasms, which occur in the gonads, and at extra gonadal sites of the body. The aim of the study was to observe the different histopathological patterns of various GCTs in the body at all possible sites and to know their IHC staining patterns.Methods: The study was conducted for a period of 5 years from 2015 to 2019 and was an observational study. The recorded data was compiled and entered in a spreadsheet and then exported to data editor of SPSS Version 20.0. Continuous variables were expressed as mean SD and categorical variables were summarized as frequencies and percentages. Graphically the data was presented by bar and pie diagrams Chi-square test or Fisher’s exact test was applied for comparing categorical values. P<0.05 was considered statistically significant. All p values were 2 tailed.Results: A total of 93 cases were analyzed and the mean age of the patients was 27.8 years. Mature cystic teratoma was the most common histopathological variant and was mostly seen in the ovaries. There was a difference in age predilection of benign and malignant tumors. Most of the malignant GCTs were gonadal while EGCTs were likely to be benign. MGCTs (mixed GCTs) were mostly testicular in origin with only one MGCT being extragonadal.Conclusions: Mature cystic teratomas were the most frequent GCTs with frequent site being in ovaries. Out 0f 18 EGCTs only 2 were malignant, rest all were mature cystic teratomas. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • A questionnaire-based study to assess the knowledge, attitude and
           behaviour about leprosy among paramedical staff in a tertiary care
           hospital in Chennai

    • Authors: D. Manoharan, Ojas Dipak Kulkarni, Geo Danny C., K. Manoharan
      Pages: 3086 - 3090
      Abstract: Background: The paramedical staff has an important part in the management of leprosy patients. They have a role in counselling, wound management, performing investigations etc. This study aimed at assessing the knowledge, attitude and behaviour of paramedical workers in a tertiary care hospital in Chennai.Methods: This cross-sectional study comprised of 100 paramedical workers of which 41 were males and 59 were females. Following classes of workers were included: nursing staff, auxiliary nursing midwives, ASHA workers, laboratory technicians, pharmacists and allied medical workers. Of these, the nursing staff comprised of the highest proportion (44%). The paramedical workers were given a questionnaire consisting of their demographic profile and further 32 questions to assess knowledge, attitude and behaviour towards leprosy. The data hence obtained over a period of 1 month was later systematically analysed.Results: The knowledge of paramedical workers was considered sufficient in the nursing staff, ANM and ASHA workers. It was consistently found that those workers who had some experience in the field of leprosy (39%) showed good level of knowledge, while others had a scope for improvement. The paramedical workers’ attitudes and behaviour were deemed to be overall appropriate, while there is a clear need to improve outreach initiatives in order to properly train them.Conclusions: The training of paramedical workers in leprosy should be prioritised. They are the initial point of contact for patients. There should be a greater emphasis on raising awareness and providing accurate information about the disease.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Nationwide surveillance for Telmisartan alone or with combination at real
           world therapy in Indian patients with hypertension (START)

    • Authors: Manoj B. Chopda, Sunil G. Gadkar, Yashwanth A. Lakshmaiah, Ravi K. Lambata, Dhammadeep C. Dabhade, Sanket R. Newale
      Pages: 3091 - 3094
      Abstract: Background: Angiotensin receptor blockers (ARBs) are amongst the most preferred class of antihypertensive as reported at various evidences or guidelines. However, choice amongst ARBs differs between practicing physicians in real-life scenario. This survey aimed to understand the usage preferences of telmisartan therapy alone and in combination for treating hypertension (HT) among practitioners at various clinical settings in real-life scenario in India.Methods: A cross‑sectional survey was conducted with a pre-validated survey questionnaire consisting of 15 questions pertaining to the telmisartan and its combination usage in HT management. Total 498 registered medical practitioners (mostly physicians and cardiologists) had participated in survey. They were approached for seeking their perception, opinions, and prescribing behaviour. Categorical data was summarized by number (n) and percentage (%) in each category. Data were summarised in frequency tables.Results: Key findings from the data analysed were as follows: Around 20-40% of patients been reported to have co-morbid hypertension and diabetes as reported by majority of the physicians. Preferred class of drug in patients with hypertension with diabetes reported to be ARB. Around 90.36% of doctors reported that telmisartan was the most preferred ARB in patients with hypertension associated with high cardiovascular risk. Around 90.76% of doctors reported for their preference for telmisartan in patients with hypertension for 24-hr BP control. Around 82.93% of doctors preferred telmisartan in patients with hypertension and stroke/post-MI status.Conclusions: Indian healthcare practitioners prefer telmisartan as the most preferred ARB either alone or in a combination in patients with hypertension, including those with comorbidities.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Prospective study on usefulness of sural-nerve biopsy

    • Authors: Nipun Saproo, Roma Singh
      Pages: 3095 - 3098
      Abstract: Background: Peripheral neuropathies are a heterogeneous group of disorders, but common among patients attending neurology clinics. A systematic approach, like sural nerve biopsy, is the need of the hour, for a cost effective diagnosis. Studies have shown that nerve biopsy improves treatment in up-to 60% patients. Present study was conducted to evaluate the clinical profile and usefulness of sural nerve biopsy in peripheral neuropathy.Methods: A prospective study was conducted in the Department of Neurology in collaboration with Department of Pathology, Medanta: The Medicity, Gurugram, for a period of six months from January 2019- June 2019. Out of total 82 randomly selected patients, 43 patients were selected for nerve biopsy.Results: Mean age in the biopsy group was 45.61±19.24 years. Duration of illness was less than 1 year in 60.5% patients. In 39.5% of cases, nerve biopsies established the diagnosis and in total 77% of cases it was worthwhile.  Hansen’s disease was diagnosed in 44%, CIDP in 12%, Vasculitis in 14%, and diabetes in 7% patients. Biopsy proved more diagnostic when tingling and numbness was there. Diminished DTRs was also statistically significant symptom in biopsy favoring group. Nerve biopsy in multiple mononeuropathy (65.1%) proved more beneficial than in polyneuropathy (32.6%). Similarly, motor-sensory was a predominant presentation in 28 (65.1%) patients with nerve biopsy being more valuable.Conclusions: Nerve biopsy, having a good diagnostic yield, can be a useful aid in cases with multiple mono-neuropathy. It can be the key to prevent long term neurological complications in patients. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Gender based differences in lipid profile and other novel atherogenic risk
           factors in type-2 diabetes mellitus patients

    • Authors: Arpita Jaidev, Hitesh Shah, Mayank K. Chaturvedi
      Pages: 3099 - 3104
      Abstract: Background: Utilization of lipids and lipoproteins gets altered in diabetes mellitus (DM) leading to atherogenic dyslipidemia. This study evaluates cardiovascular risk profile of diabetic men and women, including conventional lipid profile and novel risk factors namely lipid ratios, atherogenic coefficient and atherogenic index.Methods: In all 200 diabetic patients (100 males and 100 females) aged 18-65 years who were under treatment were randomly sampled for the study. Socio-demographic data were collected. Glycated hemoglobin levels, lipid profile, fasting blood sugar, were estimated using standard procedures. Anthropometric variables such body mass index (BMI) was measured, systolic and diastolic blood pressures were also taken. There was no difference between men and women with respect to duration of DM and type of treatment.Results: Lipid profile estimates showed that diabetic females had higher level of total cholesterol (TC) (198.07 vs 169.5 mg/dl) and higher level of high-density lipoprotein (HDL)-C (43.99 vs. 41 mg/dl) as compared to males. All the parameters that are raised total cholesterol, triglyceride levels and low-density lipoprotein (LDL) levels were observed in significantly higher proportion of females as compared to males. The values of atherogenic indices [CR1, CR2, AC and atherogenic index of plasma (AIP)] for both genders were higher than the baseline value. In this study females had higher mean non-HDL 154 mg/dl as compared to males mean non-HDL 129 mg/dl and this study showed that female participants held on in high-risk AIP category and so they were at a higher risk of developing coronary heart condition.Conclusions: Dyslipidemia was observed in a greater proportion of female diabetic patients than male diabetic patients.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Alcohol state markers- facility and utility for clinical management of
           alcohol use disorders: study from a tertiary care centre in South India

    • Authors: Liji M. J., P. R. Varghese, Susheela Jacob Innah, Praveenlal Kuttichira
      Pages: 3105 - 3109
      Abstract: Background: Alcoholism is broadly any drinking of alcohol resulting in significant psychological and physiological health problems. As alcoholism is not a recognized diagnostic entity the detection and monitoring of the clinical manifestations of alcoholism is of great importance in the alcohol use disorders (AUD) treatment. Hence, the use of alcohol biomarkers plays a vital role in the diagnosis, treatment and prognosis of AUDs.Methods: This study aimed to understand the utility of state markers in alcohol related distress, both for diagnosis and prognosis in a tertiary care centre. The relative number and the frequency of the alcohol biomarker tests such as AST (aspartate aminotransferase), ALT (alanine aminotransferase), MCV (mean corpuscular volume) and GGT (gamma-glutamyl transferase) investigated in the hospital departments (32 departments) were collected. Test requests and results in January to March on five consecutive years from 2016 to 2020 were analyzed, by comparing psychiatry department with all other departments and AUD with non-AUD cases.Results: The study findings revealed that, the tests AST, ALT and MCV were well utilized for the AUD treatment procedure in the tertiary care centre, irrespective of the department the patient got admitted. Since GGT was the least preferred test, the figures of GGT could not be analysed because of the exceptionally low number.Conclusions: The utility of the commonly available alcohol biomarker tests is especially useful for the clinical management of AUD patients and these are well utilized in an appreciable manner in the study centre. Development of more accurate, specific, and sensitive panel of biomarker tests may further motivate clinicians to better monitor individuals who suffer from alcoholism.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Role of dorsal onlay buccal mucosal graft urethroplasty for long anterior
           urethral strictures

    • Authors: Vedamurthy Reddy Pogula, Ershad Hussain Galeti, Venkatesh Velivela, Bhargava Reddy Kanchi
      Pages: 3110 - 3114
      Abstract: Background: Treatment of the urethral strictures is challenging and with appropriate evaluation preoperatively and surgery planning it is possible to achieve good results. The objective of the study was to evaluate the efficacy of dorsal onlay buccal mucosal graft urethroplasty in treating long anterior urethral strictures.Methods: Between August 2018 to July 2019 a total of 25 patients with anterior urethral stricture were treated with dorsal onlay buccal mucosal graft urethroplasty. Age, etiology of the stricture, stricture length (≤ 7 cm, and > 7 cm), and site of the stricture were assessed as the factors affecting the success rate.Results: The clinical outcome as Success was defined as the patient not needing any form of urethral instrumentation postoperatively. The mean follow-up period was 18 months. Of 25 patients, 22 (92%) were successful and 3 (8%) were a failure. There was no statistically significant difference between the age groups, etiology of the stricture and success rate (p=0.21 and p=0.444). The statistical difference was significant for the site and length of the stricture by means of success (p=0.005 and p=0.025).Conclusions: Our results show stricture length and localization are the most important variables for good success. Because of less failure rate, single-stage dorsal onlay buccal mucosal graft urethroplasty may be offered as an alternative to staged urethroplasty in case of long urethral strictures.  
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Clinicopathological features of uterine fibroid in a tertiary care
           teaching hospital

    • Authors: Priyanka Singh, Sadaf Mirza, Pawan Trivedi, Tanya Singh
      Pages: 3115 - 3119
      Abstract: Background: Uterine fibroids are one of the common benign tumours of uterus seen in women of reproductive age group. These constitute 5-10% of all these tumours.Methods: Total of 56 patients above 21 years of age reporting to OPD or emergency of gynaecology department of the Mayo Institute and found to be suffering from leiomyoma of the uterus were included in the study.Results: Clinical manifestations seen in cases with uterine fibroid. Menstrual irregularities were seen in 69.64% of cases. 39.28% suffered from abdominal pain and infertility was seen in 10.71% cases. Endometrial changes during the histopathological examination. In 71.42% of cases, proliferative endometrium was found. Secretory endometrium was seen in 14.28% and atrophic in 8.92%.  Conclusions: Leiomyoma is the most well-known uterine tumor seen in gynecological practice. Feminine aggravations are the commonest manifestation of which menorrhagia is the most well-known show. The vast majority of these tumors are intramural in area. The most widely recognized example of endometrium noticed is proliferative. Hyaline degeneration, myxoid degeneration and cystic degeneration are the normal auxiliary changes found in fibroid uterus.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • A study of the knowledge, attitude and behavior among patients with
           psoriasis vulgaris during the COVID-19 lockdown period

    • Authors: Sukanya G., Richa Jotwani, Manoharan D., Shreya Srinivasan
      Pages: 3120 - 3123
      Abstract: Background: Patients with psoriasis may have been directly impacted by the COVID-19 lockdown and this may have had a significant effect on disease severity and treatment compliance. This study aims to investigate the knowledge, attitude and the behavioral practices of patients with psoriasis during the lockdown period.Methods: A self-assessed questionnaire was employed for the purpose of this study and was answered by 100 patients of clinically diagnosed psoriasis.Results: Although several patients were aware of their condition and its implications, a significant number of responders were found to have a faulty treatment compliance due to the COVID-19 lockdown.Conclusions: To our knowledge, this is the first study that evaluates the knowledge, attitude and behaviour during the COVID-19 lockdown period of individuals who have been clinically diagnosed with psoriasis. This study raises the possibility that the sustained psychosocial stress induced by the current pandemic can potentially lead to exacerbations or onset of common inflammatory skin conditions like psoriasis. The overall compliance to dermatologic therapy was slightly poor as there were frequent concerns regarding the safety of visiting a hospital or a doctor as well as possible financial constraints. As per this study, there is an urgent need to convey the right information about managing psoriasis during the COVID-19 pandemic among both the general population and patients alike. 
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Awareness, knowledge, and barriers to low vision services among eye care
           practitioners in Maharashtra

    • Authors: Mantasha Dilkash, Susmita Banerjee, Gaurav Dubey, Vibha Kumari, Ragni Kumari, Deepak Gupta
      Pages: 3124 - 3130
      Abstract: Background: Visual impairment is an important global health issue. 90% of the world's blind people reside in underdeveloped countries. According to population-based statistics, India has the most visually impaired persons (about 9 million). The world health organization (WHO) estimates that 285 million people worldwide are blind or have impaired eyesight. Hence it is necessary to have information about knowledge and awareness of low vision services among eye care practitioners to improve the low vision care in the world.Methods: A prospective cross-sectional survey was done at Dr. D. Y. Patil medical college and research centre (Ophthalmology department) between eye care practitioners practicing in Maharashtra, India, through a pre-tested standardized questionnaire.Results: In this study, retinal problems (76.1%) and glaucoma (11.1%) were reported as two major causes of low vision. Provision of best spectacle correction, rehabilitation, and referral to other hospitals/specialized centers was considered by 31.7%, 4.7%, and 23.8% practitioners, respectively. Magnifiers were found to be the most commonly prescribed low vision device (73%).Conclusions: Low eyesight is a big health issue all over the world. Low vision services assist patients in improving and maintain their functional vision. It also enhances the quality of life and everyday living skills. There are many barriers and a lack of understanding about low vision services. They assess eye care providers' awareness, knowledge, and challenges to poor vision services in Maharashtra. This study results showed a lack of awareness (33.3%) and training (33.3%) among the practitioners were the significant barriers restricting low vision services.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Dexmedetomidine versus dexamethasone as adjunct to ropivacaine in erector
           spinae plane block for patients undergoing breast surgery: a randomized,
           prospective, double blinded study

    • Authors: Jili Basing, Arun Deka, Upasana Majumdar
      Pages: 3131 - 3136
      Abstract: Background: Loco-regional anaesthesia (GA) has been extensively applied in the clinical field for achieving post-operative analgesia. Erector spinae plane block (ESPB) which is a novel inter-fascial plane block has been widely used for breast surgery. Dexmedetomidine and dexamethasone as an adjunct to local anaesthesia have been widely reported to reduce postoperative pain and analgesic consumption but there are no studies comparing both these drugs in ESPB for breast surgery.Methods: Sixty ASA I-II patients scheduled for breast surgery were randomly allocated into two groups-Group DX and group DM. Group DX received 20 ml ropivacaine 0.2% with dexmedetomidine 0.5 mcg/kg while group DM received 20 ml ropivacaine 0.2 % with 8 mg dexamethasone in ESPB preemptively. All the patients were induced with standard GA and extubated at the end of surgery. In the post-operative period visual analogue scale (VAS) pain score, total tramadol consumption, time for first rescue analgesia and side effects were noted for 24 hours.Results: The demographical parameters were comparable between both the groups. The VAS score, total tramadol consumption and time for first rescue analgesia were both similar in both the groups without any significant difference. No side effects were noted in any patients in both the groups.Conclusions: Dexmedetomidine (0.5 mcg/kg) and dexamethasone (8 mg) as an adjunct to ropivacaine reduces postoperative pain and analgesic consumption with no significant difference when used in ESPB for patients undergoing breast surgery without any side effects.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Effectiveness of topical sunscreen use to prevent skin cancers: systematic

    • Authors: Luh Putu Venny Cempaka Sari
      Pages: 3137 - 3142
      Abstract: Topical sunscreen is a potential modality to prevent skin cancer development in vulnerable people although few study has evaluated its effectiveness in clinical setting. This study is aimed to review most recently available evidence on the clinical effectiveness of topical sunscreen in preventing skin cancers. We identified literature from online databases including Pubmed and Google Scholar and included population-based study evaluating the effect of sunscreen usage and risk of skin cancers, including melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) either as primary objective or as a confounder in multivariate analysis. Data form included articles was harvested and analyzed with thematic analysis. Final analysis included 11 articles. Of these, 6 reported results on melanoma, 4 reported on BCC, and 3 on SCC. Overall, there was conflicting evidence on the effectiveness of topical sunscreen in preventing skin cancer. Available evidence found that topical sunscreen was most effective in preventing melanoma and SCC. However, there was considerable heterogenicity in study design and definition of sunscreen treatment between included articles that may affect the results. There are no consensus among included articles, including among RCTs, on the ideal topical sunscreen regiment to prevent skin cancer. There are conflicting evidence on the clinical effectiveness of topical sunscreen to prevent skin cancer although evidence suggest that it would be effective in preventing melanoma and SCC. More clinical studies should be conducted with special emphasis on ensuring subject apply the sunscreen correctly and consistently.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Prevalence of early T-cell precursor acute lymphoblastic leukemia among
           immunophenotypically categorised acute T-cell lymphoblastic leukaemia

    • Authors: Monika Gupta, Pinki Devi, Anjali Bishley, Sant Prakash Kataria, Rajeev Sen
      Pages: 3143 - 3147
      Abstract: Acute lymphoblastic leukaemia is the most common hematopoietic malignancy in childhood, comprising of B-cell lineage (85%) and T-cell lineage (15%). Recent studies have identified a subtype of T-cell acute lymphoblastic leukaemia (T-ALL) termed “early T-cell precursors (ETP)” recognised as a new provisional entity in 2016 update to the World Health Organization (WHO) classification of acute leukaemia, early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is characterized by a unique immunophenotype and genetic profile and its origin has been found to be from migration of cells from thymus to bone marrow. Hence, our study aims at reporting the prevalence of ETP-ALL among immunophenotypically categorised acute T-cell lymphoblastic leukaemia cases. Present work is a retrospective observation of acute T-cell lymphoblastic leukemias and reporting ETP-ALL cases seen during the period of over two years (from August 2018 to August 2020) received for flowcytometry in the department of Pathology, PGIMS, Rohtak, Haryana. Peripheral blood showed features of acute leukemia and immunophenotyping was performed. Fourteen cases were received for flowcytometry showing features of acute leukemia and immunophenotyping was performed revealing two ETP-ALL cases with positivity for cytCD3, CD7 (T-cell markers), HLA-DR, CD13 (myeloid marker-aberrant expression), sCD34, CD117 (stem cell markers), CD19 (B-cell marker) and dim expression of CD45. This study is a supportive data for immunophenotypic identification of ETP-ALL cases in centres where genetic study and other ancillary techniques are not available. It needs to be differentiated from non ETP-ALLs as this entity has been reported to show treatment failure with the treatment modalities for non ETP-ALLs.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Su Jok therapy by twist and seed method of therapy to reduce the level of
           fear on COVID-19’s patient: a case series

    • Authors: Intansari Nurjannah, Zakiah Novianti, Agus Suharto, Muhammad Yasir Sudarmo, Ki Hariyadi
      Pages: 3148 - 3155
      Abstract: Patients with COVID-19 not only experience suffering from physiological symptoms but also psychological dimensions such as fear. Fear is part of life and the threat of self-existence will increase the fear level. Increased levels of fear will influence the process of healing by disturbing the immunity function. This case series reports the results of Su Jok therapy using the twist and seed method of therapy in reducing the level of fear of patients with COVID-19. Twenty cases of respondents with the average level of fear toward COVID-19 of ≥4 were included in this case reports. Fear level was measured by using the fear scale measurement (FSM). Su Jok therapy was conducted by twisting (120 times) and putting fenugreek seed on the joint of the patients’ index finger in Triorigin fixed joint correspondent of fear. Posttest of fear scale was measured after intervention in the intervals 5, 10 and 15 minutes. In all three interval measurements, there were significant improvements in the fear scale before and after Su Jok therapy (p=0.0001, p<0.05).
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Compassionate use of convalescent plasma for the management of severe
           pneumonia in critically ill COVID-19 patients-a single center experience,
           Kerala, India

    • Authors: Mobin Paul, Priyanka C. G., Sophy M. P., Latha Abraham, Rajesh Venkitakrishnan, Renji Jos, Jaicob Varghese
      Pages: 3156 - 3162
      Abstract: We assessed treatment effectiveness with convalescent plasma in critically ill COVID-19 pneumonia patients and their association with reduction in C reactive protein level as a sensitive inflammatory marker to the ongoing cytokine storm. Retrospective cohort study based on the detailed electronic medical chart review. The primary outcome was a clinical improvement on day 14, defined as the reduction in cytokine storm as demonstrated by a drop in acute phase reactant C reactive protein; de-escalation from the prior mode of oxygen delivery or not on mechanical ventilation in critically ill COVID-19 patients. C reactive protein was measured by using immunoturbidimetry. IgG antibody against spike protein S1 was measured by chemiluminescent immunoassay. Of 14 patients, all had severe COVID-19 pneumonia [category C], and 9 (64%) were mechanically ventilated soon after the admission into the medical intensive care unit. De-escalation of the oxygenation strategy mode was noted in 11 (79%) patients after convalescent plasma infusion. All patients showed a significant drop in C reactive protein when compared to pre-infusion and post-infusion day 5.  Early compassionate use of convalescent plasma with higher titters of IgG antibodies against S1may positively benefit the overall outcome in critically ill COVID-19 patients with severe pneumonia.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Male breast carcinoma: study from a tertiary care centre in North India

    • Authors: Sant Prakash Kataria, Pinki Devi, Sanjay Kumar, Gajender Singh, Sonia Chhabra, Promil Jain, Sunita Singh
      Pages: 3163 - 3166
      Abstract: Male breast cancer is a rare malignancy. In recent years a rise in the number of male breast cancer cases has been seen. Due to rarity of the disease the reporting of such cases is important to support the present status of this aggressive malignancy. Fine needle aspiration method for breast FNA is an invasive procedure but can provide a diagnosis without causing much morbidity to the patient. Hence, objective of the present work was to report and study the clinico-pathological behaviour of male breast cancer at a tertiary care centre in North India using fine needle aspiration-based diagnosis. Present study includes cytologically diagnosed male breast carcinoma cases over a period of 4 years. Eleven cases of male breast cancer were identified. Median age of presentation was 57years. All the eleven patients presented with main complaint of swelling in breast (100%), nine (81.8%) patients presenting in left breast and two (18.2%) in right breast. Four cases presented with nipple retraction. Also, axillary lymphadenopathy was evident in four (34.4%) patients. Male breast cancer an aggressive disease having distinct clinical presentation, can be cytologically diagnosed easily as other benign conditions are rare in male breast.  
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Intentional replantation: case report

    • Authors: Cristhal Duque-Urióstegui, Luis A. Alvarez Hernández, Yanirethe I. Muñoz-Ramírez, Verónica Vallejo Ochoa, Noemí Méndez Hernández, Karen I. González Madó, Emmanuel Poceros Angeles, Carlos Briseño Flores, Carla B. Duque-Urióstegui, Alicia M. Corona Maya, Gabriela Castañeda-Palacios, Baltazar Barrera-Mera, Alan I. Valderrama -Treviño
      Pages: 3167 - 3170
      Abstract: Intentional reimplantation is a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth. We present the case of a 50-year-old male patient who came to the consultation due to incrustation detachment in tooth #37, when performing the radiographic study an extensive apical lesion was observed in tooth #36 with a sinuous path and the presence of purulent exudate. The tooth #36 was extracted, apicoectomy, retro preparation and retrograde filling were carried out for later reimplantation, showing bone regeneration after one year of evolution.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Total atrioventricular block in patient with late onset acute inferior
           myocardial infarction

    • Authors: Ken Christian Kawilarang, I. Kadek H. Hermawan, Febryanti Hartono
      Pages: 3171 - 3174
      Abstract: TAVB is common complication of acute inferior myocardial infarction (AMI). Total atrioventricular block (TAVB) occurs when none of the impulses are conducted from atrium to ventricles and move independently without coordination. In our case, A 61-year-old woman came to the emergency room (ER) with chief complaint of general weakness and nausea without any other complaints since 4 days before going to ER. She had TAVB which is a complication of undiagnosed AMI due to silent ischemia. She didn't get reperfusion therapy because of patient delay and limited resources. Pharmacological therapy had been given while awaiting implantation of temporary pacemaker (TPM). Two days after insertion, the heart rhythm returned to sinus rhythm, therefore permanent pacemaker implantation was not required. TAVB in AMI usually resolves spontaneously. Therefore, it is important to identify TAVB in AMI, so we can quickly diagnose and promptly treat the patient. Thus, it can reduce mortality and increase the probability of spontaneous resolution of TAVB, so physician practice management (PPM) insertion can be avoided.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Edwardsiella ictaluri, an unusual cause of bacteraemia in a Nigerian child
           with acute bloody diarrhoea

    • Authors: Akinlolu A. Adepoju, Adesola O. Adelaja, Abimbola Amoo, Adebola E. Orimadegun, Olusegun O. Akinyinka
      Pages: 3175 - 3178
      Abstract: Enteric septicaemia of catfish was first detected in 1976 as an economically significant disease associated with commercial catfish production. Initially, Edwardsiella ictaluri was a host specific pathogen of catfish species but has also been reported from other hosts other than the catfish such as the zebrafish. E. ictaluri has not been isolated in humans hence it is not a zoonotic infection. There has been no previous report of isolation of this organism in humans. This was a case report of a 5 year old boy who presented with fever, vomiting, passage of bloody stool of 6 days and abdominal pain of a day duration. In the case of this 5 year old boy who presented with features of dysentery, blood culture using BACTEC™ grew E. ictaluri. E. ictaluri may be a pathogen which can infect humans just like another closely related species, Edwardsiella tarda. Although, E. ictaluri has not been reported in humans, could this be the first case' Non availability of diagnostic technique appropriate for its diagnosis may explain the rare incidence of the organism in humans, hence many cases would have been treated without isolating the organism.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Immature teratoma with a rare finding of choroid plexus

    • Authors: Mehak Kashyap, Neelam Gupta, Vikas Dubey, Nechal Kaur
      Pages: 3179 - 3181
      Abstract: Mature cystic teratoma of the ovary is the most common ovarian tumour in young women. Immature teratoma is a very rare tumour, representing only 1% of all ovarian cancers. Paediatric ovarian tumours are rare, with a reported incidence rate of 2.2/100,000 in girls aged 0 to 15 years. In the case report presented here, was 12-year-old suspected to have serous cystadenoma of ovary based on CT scan, which was ultimately diagnosed with immature teratoma grade 3 after histopathological examination was done.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Double plate fixation technique for prolonged non-weight baring induced
           severe disuse atrophy in hypertrophic non-union of left femur: a case

    • Authors: Cokorda Gde Oka Dharmayuda, Cokorda Krishna Dalem Pemayun, I. Ketut Wahyu Trisaputra, Richard Afandi, Sri Mahadhana, Made Winatra Satya Putra, I. Gusti Ngurah Indra Wiguna
      Pages: 3182 - 3185
      Abstract: Hypertrophic non-union differs from other forms of non-union due to its the biological capacity for union, in which it results from mechanical instability, namely the implant being unable to provide long lasting stability. Non-weight bearing state will cause bone resorption and further bone-mass loss with worsened prognosis. A 64-year-old female patient presented with inability to walk normally resulting from prolonged non-weight bearing-induced severe disuse atrophy in hypertrophic non-union of the left femur. Implant revision and osteoclasis were performed, followed by an urgent implant revision a few days later using double plating technique by placing the second plate on the anterior part of the femur. Post-operative X-ray showed satisfactory two implants placement and physiological alignment was achieved. Inappropriate initial treatment on the acute phase has led to prolonged non weight bearing state, resulting in disuse atrophy of the bone. This should have been predicted during the first implant revision on drilling both cortices, since even the slightest distraction resulted in severe consequences. Double plating system leads to absolute stability so acceptable union can be achieved. Initial treatment on acute setting of fracture should maximize every effort to restore proper functional state and should promote early mobilization. Any maltreatment will result in prolonged morbidity and will require more reconstruction effort with less than normal end result. Robust fixation and alignment can be achieved with double plating system; however, prolonged immobilization should be anticipated.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Limited palmar fasciectomy for bilateral Dupuytren’s contracture

    • Authors: Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Narayanamurthy Sundaramurthy, Anand Prasath Jayachandiran, Suresh Rajendran
      Pages: 3186 - 3188
      Abstract: Dupuytren’s disease is a fibro-proliferative condition affecting the palmar and digital fascia. This disease is very common in Northern Europe but in India it uncommon as there are only a few cases reported, hence also called as ‘Viking Disease’. Surgical fasciectomy is the standard surgical treatment of choice for Dupuytren’s disease. Complications following surgery are high but there is no definitive cure for Dupuytren disease (DD), and recurrence of finger contractures after treatment is common.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Early onset type 1 diabetes mellitus in an infant during COVID-19
           pandemic: case report

    • Authors: Made Yuliantari Dwi Astiti, Putu Harrista Indra Pramana, I. Wayan Bikin Suryawan
      Pages: 3189 - 3193
      Abstract: Type 1 diabetes mellitus (T1DM) is an endocrine disorder, marked by elevated blood glucose level caused by autoimmune process destroying the β-cells of the pancreas which mostly affects children. It is an often-overlooked condition, with low awareness among clinicians and parents alike which led to late diagnosis and patients often presenting with acute complications. Often triggered by a viral infection, here we presented an interesting case of early onset T1DM presenting with Diabetic ketoacidosis (DKA) during a COVID-19 pandemic. A female infant, aged 1 years and 2 days old, presented with dyspnea and fever. Physical examination was otherwise normal, without any rhonchi or wheezing found during pulmonary auscultation. Nasopharyngeal swab and SARS-CoV-2 antigen test was found negative. Laboratory workup found random blood glucose level of 577 mg/dl accompanied by acidosis and ketonuria. The patient also had elevated white blood cells and platelet counts. She was admitted for treatment in the Pediatric intensive care unit (PICU) with therapeutic regiments consisting of slow intravenous insulin infusion, potassium chloride intravenous fluid, antibiotics, and antipyretics. Close monitoring of blood glucose ensues and the patient was treated for 5 days followed by outpatient therapy with mixed insulin treatment twice per day. This case was interesting as T1DM usually manifested in older children with median age of diagnosis ranging from 8 to 13 years old, depending on population. T1DM diagnosed in children younger than 6 years old are classified early onset and it is especially rare to found in infants. Although the patient tested negative for SARS-CoV-2 antigen, the onset of the case coincides with a recent surge of cases locally. It meant that we cannot rule out possibility of prior unknown exposure or infection which may precipitate the condition.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Management of a case of thromboembolism post spine surgery: a case report

    • Authors: Manoj K. S. Tomer, Kalpana Shah, Shilpa Bhojraj, Pinki Devi
      Pages: 3194 - 3196
      Abstract: Postoperative deep vein thrombosis (DVT) of lower limbs is often asymptomatic. In many patients, fatal pulmonary embolism (PE) is the first clinical manifestation of postoperative venous thromboembolism (VTE). Routine screening for asymptomatic DVT of the lower limbs has a low sensitivity and is quite impractical. For these reasons, routine and systematic prophylaxis in patients at risk, is the strategy of choice to reduce the burden of VTE after surgery. If used appropriately such prophylaxis is cost effective since it reduces the incidence of symptomatic thromboembolic events, which require costly diagnostic procedures and prolonged anticoagulation therapy. Here we report the post-operative course of a spine surgery patient, presenting with DVT in calf veins, which lodged into pulmonary artery and was managed successfully with low molecular weight heparin (LMWH), embolectomy, inferior vena cava (IVC) filter, and dabigatran.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • A case of acute myocardial infarction with anomalous origin of the right
           coronary artery from the contralateral aortic sinus

    • Authors: Krupal Reddy, Sandip Patil, Harminder Singh
      Pages: 3197 - 3199
      Abstract: Anomalous coronary anomalies are technically challenging. We describe the case of a 48-year-old male who suffered an acute inferior wall myocardial infarction due to thrombotic total occlusion in an anomalous right coronary artery arising from the contralateral aortic sinus.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Unani management of vesical calculus: a case report

    • Authors: Mohammad Shamim Khan, Qamrul Hasan Lari
      Pages: 3200 - 3202
      Abstract: Vesical calculus (Hisat-e-Masanah) accounts approximately 5% of all urinary tract stones. It has bimodal peaks age of incidence at 3 years in children in developing countries, and 60 years in adulthood. Despite advance technology of lithotripsy, the management of vesical calculus in children remains a challenge due to difficulty in passing of stone fragments and adverse effect of surgery. Hence alternative and safe treatment like Unani system of medicine can be adopted to avoid surgical procedure. The present paper deals with a case study in which a 10 years old male child patient suffered from a single vesical calculus was treated with Unani pharmacopeial medicine; Qurs Kaknaj (2 tablets), Qurs Kushta Hajrul Yahood (1 tablet) and Sharbat Buzoori Motadil (10 ml syrup) twice a day as oral administration, with the aim to evaluate the efficacy of drugs and to avoid surgery. Patient has shown excellent and significant result as 8×5 mm size of a stone flushed out at 3rd day of treatment without any operation.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Sister Mary Joseph nodule due to carcinosarcoma

    • Authors: Israel Salgado Adame
      Pages: 3203 - 3205
      Abstract: The Sister Mary Joseph Nodule is an eponymous term which describes a palpable umbilical nodule occurring as a result of metastasis of an intra-abdominal or pelvic malignancy. In approximately 50% of cases, this sign is associated with gastrointestinal malignancies. These include gastric, colonic and pancreatic (mainly body and tail) carcinoma. Gastrointestinal malignancy is found in 52% of the metastatic cases and gynecologic and genitourinary origin in 28%, with gastric and ovarian cancers being the most common. The next report is about a 62 year-old woman whose was referred to the surgery department due a painful mass on the abdominal wall that has appeared 3 months before as a fast-growing, with suspicious diagnosis of strangulated umbilical hernia.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Management in patient with rheumatoid arthritis and tuberculous arthritis:
           a case report

    • Authors: Thomas E. C. J. Huwae, Agung R. B. Santoso, Ahmad Heifan, Lasa D. Siahaan
      Pages: 3206 - 3208
      Abstract: Rheumatoid arthritis (RA) is mainly treated with immunosuppressive drugs, which affects the immunological system. Therefore, the risk of tuberculosis was increased two to ten times in RA patients. Moreover, immunosuppressant is contraindicated in patients with tuberculosis arthritis. A 51-year-old male was presented with pain in his left elbow after he slipped on the floor. He was diagnosed with RA for 16 years and only took prednisone for six years. Six months before, he came to a rheumatologist and was given corticosteroid for six months for RA. The left elbow radiograph and joint aspiration revealed a tuberculosis infection. The patient treated with chloroquine and oral antituberculosis for one year and showed good clinical outcomes. Other diseases should be suspected in RA with uncommon symptoms. Chloroquine is the drug of choice in RA patients with tuberculosis who are contraindicated in immunosuppressant therapy because chloroquine has no immunosuppressant effect.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Encapsulated cyst fat necrosis masquerading as cold abscess

    • Authors: Mehak Kashyap, Neelam Gupta, Vikas Dubey, Nechal Kaur
      Pages: 3209 - 3211
      Abstract: Encapsulated fat necrosis is a benign, usually asymptomatic and underreported condition. It is believed to be trauma‐related ischemia and necrosis of fat tissue that gradually detaches from its surroundings. Here we reported a case of encapsulated cyst fat necrosis in a 75 years old female following intramuscular injection, who was clinically diagnosed as cold abscess initially.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Tuberculosis tenosynovitis of the wrist: a rare case report

    • Authors: Surya Rao Rao Venkata Mahipathy, Alagar Raja Durairaj, Narayanamurthy Sundaramurthy, Anand Prasath Jayachandiran, Suresh Rajendran
      Pages: 3212 - 3215
      Abstract: Tuberculosis (TB) is a common disease of the Asian continent and has a varied presentation. Involvement of the musculoskeletal system is uncommon and presents in 10% of extrapulmonary tuberculosis. The atypical sites of tuberculous infection are the spine (51%) pelvis (12%), hip and femur (10%), knee and tibia (10%), and ribs (7%), but involvement of the wrist is rare. Tuberculosis tenosynovitis is a rare site of extra-articular TB. Delayed diagnosis and hence treatment is because it mimics many other disease processes and as a result, complications are common. Median nerve compression leading to carpal tunnel syndrome may also occur in these patients. Here, we present a case of tuberculous tenosynovitis involving the wrist flexors and the radial and ulnar bursae treated with surgery.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Anaesthesia management in a patient of interstitial lung disease with
           pulmonary hypertension for emergency laparotomy

    • Authors: Hardik A. Parekh, Prajakta D. Latkar, Ameya G. Nalavade, Hemant H. Mehta
      Pages: 3216 - 3218
      Abstract: We report the anesthaetic management of a patient with known case of interstitial lung disease (ILD) with profound fibrotic changes and bullae with severe pulmonary hypertension (PH) posted for exploratory laparotomy for cecal volvulus. Emergency exploratory laparotomy was done under combined spinal-epidural anaesthesia to avoid intra-operative and post-operative pulmonary complications associated with general anaesthesia and mechanical ventilation.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Current treatment of difficult airway: a practical review of advanced
           techniques for airway management

    • Authors: Rodrigo A. Mendoza-Aceves, Enrique Ortega Madrid, Karen Meade Yovanovich, Brenda Bernal Barroeta, Francisco Fabián Gómez-Mendoza, Rodrigo Banegas-Ruiz, Baltazar Barrera-Mera, Alan I. Valderrama-Treviño
      Pages: 3219 - 3221
      Abstract: The airway by definition is a conduit through which the air passes; or it is the route by which the air travels from the nose or mouth to the lungs. An exhaustive review was performed with the available literature using the PubMed, ScienceDirect, Scopus and Cochrane databases from 2009 to 2021. The search criteria were formulated to identify reports related to difficult airway management. To allow controlled ventilation, the airway must meet two characteristics in priority order, be permeable and airtight. In assessing risk, in addition to looking for predictors of difficult airway, it was important to understand the global clinical circumstances. Faced with a patient with a difficult airway, decision-making must be agile and correct since any decision can modify the clinical outcome.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Brief chronological progress in the management of intussusception: 1674 to

    • Authors: Rajendra K. Ghritlaharey
      Pages: 3222 - 3227
      Abstract: This is a review of the literature related to the progress in the management of intussusception. Literature and other publication on the topic of “intussusception” were retrieved from 1674 to August 2021. The online literature search was – performed using various websites, i e, PubMed, PubMed central, ResearchGate, and Google - eBooks, Google Scholar, and Google Images. The important historical events that occurred in the management of intussusception were briefly presented in this manuscript.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Impact of the COVID-19 pandemic on healthcare workers

    • Authors: Versha Prasad
      Pages: 3228 - 3234
      Abstract: The coronavirus disease 2019 (COVID-19) pandemic has heavily burdened, and in many cases overwhelmed, healthcare systems including healthcare workers. The novel COVID-19 started from Wuhan in mainland China. Since then it has affected most of the nations and continents because of its rapid spread. Most commonly affected are the healthcare professionals who are working on the frontline. The COVID-19 epidemic has mushroomed globally, disrupting the existence of millions It is a generalized mental condition occurring without any trigger or stimulus. Various symptoms of depression are: anxious, sad and empty feelings, hopelessness, guilt and may be sense of helplessness, restless attitude, irritation, and lack of interest in various hobbies and activities and were once considered relax able and which are used to provide pleasure. Furthermore, healthcare workers reported mental health problems putatively associated with healthcare workers’ occupational activities during and up until years after epidemics, including symptoms of post-traumatic stress, burnout, depression and anxiety. As for lack of material, a high percentage of professionals are getting infected for not having adequate personal protection equipment (PPE) and not using it properly, having to re-use in many occasions equipment which is only recommended for one-time utilization. During work performed by healthcare workers, several pressure elements from different sources may impact on keeping optimal conditions for a healthy working environment, and because of the saturation of the sanitary facilities due to the high level of virus infection, the health of these professionals has been obviously affected. While the main focus is concentrated on laboratory testing, finding the disease cure and prevention of transmission, all individuals are undergoing a plethora of psychological problems while adjusting to current lifestyles and disease fear. In current study, an attempt has been made to find out the impact of this pandemic situation on psychological well-being of healthcare and non-healthcare workers. Our study has reported identical findings to those reported by numerous investigators working across the globe. The present paper has outlined the stressors which the frontline health care professionals have faced including fear of spreading disease to co-workers and members of the family, irregular sleep patterns, abrupt work cycles, and lack of adequate training skills in dealing with such a novel situation.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
  • Essential thrombocytosis: review of literature with a rare presentation of
           cerebral thrombosis treated with endovascular therapy

    • Authors: Aravind V. Datla, Sibasankar Dalai
      Pages: 3235 - 3242
      Abstract: Essential thrombocytosis (ET) is a clonal hematopoietic stem cell disorder. Clinically there is an over-production of platelets without a definable cause. ET is a myeloproliferative neoplasm (MPN). It has an incidence of 1 to 2 per 100,000 population and a distinct female predominance. Once considered a disease of the elderly and responsible for significant morbidity due to haemorrhage or thrombosis, it is now clear that ET can occur at any age in adults and often without symptoms or disturbances of hemostasis. ET can cause both thrombosis or haemorrhage and carries a risk of acute leukemic transformation. Being an MPN, in some cases, polycythemia vera (PV) or primary myelo-fibrosis (PMF) can present as ET. Though the average life expectancy only slightly deviates from the standard expected for age-matched individuals, a thorough understanding of its etiopathogenesis, clinical presentation, complication and management can make a world of difference to patients. Thrombosis is one such complication that has a significant impact on the mortality and morbidity of ET. We proposed using endovascular therapy (EVT) as a treatment modality for cerebral venous sinus thrombosis.
      PubDate: 2021-09-28
      Issue No: Vol. 9, No. 10 (2021)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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