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

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Intl. J. of Advances in Medicine     Open Access   (Followers: 5)
Intl. J. of Basic & Clinical Pharmacology     Open Access   (Followers: 4)
Intl. J. of Clinical Trials     Open Access   (Followers: 5)
Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 8)
Intl. J. of Contemporary Pediatrics     Open Access   (Followers: 11)
Intl. J. of Otorhinolaryngology and Head and Neck Surgery     Open Access   (Followers: 1)
Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 17)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 7)
Intl. J. of Research in Orthopaedics     Open Access   (Followers: 1)
Intl. J. of Scientific Reports     Open Access   (Followers: 4)
Intl. Surgery J.     Open Access   (Followers: 5)
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International Journal of Advances in Medicine
Number of Followers: 5  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2349-3925 - ISSN (Online) 2349-3933
Published by Medip Academy Homepage  [12 journals]
  • Prevalence of domestic violence and abuse among Saudi women: an online
           based cross-sectional study

    • Authors: Ahmad Hamad Aldosary
      Pages: 1458 - 1466
      Abstract: Background: Domestic violence and abuse (DVA) has a major impact on women's lives, their psychological, physical, and reproductive health and mostly occurring behind closed doors. The objective of this study was to explore the prevalence of DVA among Saudi women, to determine factors related to each type of abuse, identify sources of abuse, and level of disclosure.Methods: A cross-sectional study was conducted through an online survey using social networking platforms. Four hundred and twenty-one women completed the validated Arabic version of the NorVold domestic abuse questionnaire.Results: The lifetime prevalence of DVA was 69.9%. The most prevalent type of violence was emotional abuse, followed by physical abuse (47%), and subsequently sexual abuse (35%). Among the abused women, 25.6% (n=75) had experienced all types of abuse. Fathers, mothers, and brothers were the main perpetrators of emotional violence, while brothers, mothers, and fathers were the main perpetrators of physical abuse; relatives (not from the family) and brothers were the main perpetrators of sexual violence. Approximately 26% of the emotionally abused try to seek help, 78.7% did not disclose the abuse to their doctors, and 16.5% of the physically abused try to seek help; however, 82.2% were unable to inform their doctors after abuse, only 8.7% of sexually abused women try to get help after abuse, and 90% cannot inform their doctors.Conclusions: DVA against Saudi women is unacknowledged, and national research data are urgently required to assess the prevalence of DVA and risk factors for abused women.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Lack of nitric oxide bioavailability in early pregnancy predisposes to
           dyslipidemia and surges preeclampsia and fetal growth retardation

    • Authors: Aida A. Korish
      Pages: 1467 - 1477
      Abstract: Background: Hyperlipidemia has been reported in preeclampsia (PrE) and is linked to poor pregnancy outcome and long-term cardiovascular complications. This study aimed to elucidate the relationship between nitric oxide (NO) and blood lipids levels during normal pregnancy and in NG-nitro-l-arginine methyl ester (L-NAME) - induced preeclampsia before and after magnesium sulphate (MgSO4) therapy and its effect on the pregnancy outcome.Methods: Forty female Wistar rats were divided into four groups: non pregnant (NP) group - non pregnant healthy rats receiving no treatment, control pregnant (Con-P) group - control pregnant rats receiving no treatment, pregnant (PE) group - pregnant animals with untreated PrE, and the pregnant MgSO4 (PE-Mg) group - pregnant animals with PrE- treated with MgSO4. The nitric oxide synthase inhibitor L-NAME was used to induce experimental model of PrE in the PE and the PE-Mg groups. The changes in total NO production, total cholesterol (TC), triglycerides (TG), low density lipoproteins (LDL-C), high density lipoproteins (HDL), LDL-C/HDL-C ratio, soluble vascular endothelial growth factor receptor-1 (sVEGFR1) also known as sFlt-1, blood pressure, kidney functions, body weight, and pregnancy outcome were assessed.Results: Decreased NO production in the PE group was associated with elevated TC, TG, LDL-C/HDL-C ratio, hypertension, proteinuria, increased urea, creatinine, and sFlt-1 levels, and poor pregnancy outcome demonstrated by high pup mortality rate and low birth weight. Increased NO production in the PE-Mg group treated with MgSO4 therapy was associated with decreased signs of preeclampsia and hypolipidemia and increased pup viability and birth weight.Conclusions: NO bioavailability is crucial for the homeostasis of the lipid profile in normal pregnancy and the prevention of preeclampsia. Routine periodic assessments of the blood lipid profile and the NO production in the pregnant females may be a helpful tool in early prediction of preeclampsia.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • The incidence of osteoporosis and vertebral fracture in women with
           postmenopausal type 2 diabetes mellitus and predisposing factors of
           vertebral fractures

    • Authors: Tugcan Alp Kirkizlar, Mehmet Burak Aktuglu
      Pages: 1478 - 1482
      Abstract: Background: Type 2 diabetes mellitus (DM) has an increased fracture risk due to loss of bone quality and tendency to falling. The aim of the study was to analyze the incidence of osteoporosis and vertebral fractures (VF) in postmenopausal women with type 2 DM and to define the risk factors of VF in terms of clinical, metabolic characteristics and diabetes related microvascular complications.Methods: The 42 postmenopausal patients with type 2 DM were included to the study in Haseki Training and Research Hospital outpatient clinics.Results: Osteoporosis with regard to lumbar spine (LS) and femur neck (FN) was 8.4%, 19.4%, respectively. Vertebral fracture ratio was 31%. There was no statistical significance between vertebral fracture and osteoporosis. In logistic regression analysis, longer postmenopausal period, higher postprandial blood glucose (PBG), presence of peripheral neuropathy was found associated with vertebral fracture (p=0.04, 0.04, and 0.05, respectively).Conclusions: In this study we suggest to consider the length of postmenopausal period, PBG and peripheral neuropathy for assessing the risk of VF.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • General public awareness of indications and complications of sleeve
           gastrectomy in Al'qassim region, Saudi Arabia

    • Authors: Abdullah S. Alayaaf, Hamad S. Alsaeed, Abdullah N. AlSamani, Emad A. Alfadhel, Maha M. Aldhilan, Rabab A. Alswyan
      Pages: 1483 - 1489
      Abstract: Background: Obesity is risingly becoming a health care problem. After ineffective tries to lose weight with lifestyle-based conservative methods, the most effective obesity treatment will become bariatric surgery. Objective of this study aimed to assess the awareness of the general public about indications and complications of sleeve gastrectomy in Al'Qassim region, Saudi Arabia.Methods: This was a cross-sectional study conducted among the general population living in Al'Qassim region, Saudi Arabia. A validated Arabic/English questionnaires were distributed among the targeted individual using an online platform. Questionnaires included demographic data, general knowledge about gastric sleeve and the knowledge toward the indication and complication of sleeve gastrectomy. All statistical analyses were performed using SPSS version 26.Results: Nearly all participants were aware of sleeve gastrectomy (99.1%). The prevalence of participants who knew the indications and complications of sleeve gastrectomy were 60.9% and 72.2%, respectively. Furthermore, approximately three quarters (70.3%) were confident that the most common indication of the gastric sleeve was an adult with BMI >40 kg/m2. Statistical tests revealed that the knowledge toward the indication and complication of sleeve gastrectomy were more common among those who have heard about BMI and those who knew the BMI range of obese person (p<0.05).Conclusions: Although, general population awareness toward the indication and complication of sleeve gastrectomy was moderate, however, their knowledge about the BMI seems to be lacking. Having better knowledge about BMI likely influenced their awareness of the indications and complications of gastric sleeve.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Comparison of personality factors among alcoholics and non-alcoholics
           attending a tertiary care center in Puducherry

    • Authors: Praveen Kumar R., Umesh G., Karthikeyan V. U.
      Pages: 1490 - 1493
      Abstract: Background: Alcohol consumption is a addictive behavior, which eventually leads to personality disorder, stress. However, in recent times it was noted that duration of alcohol consumption is an important factor for the changes in personality profile. Hence this study was conducted to assess the personality disorders among the person who started consuming alcohol in the past 1-5 years with those of non-alcoholics.Methods: This prospective cross sectional study was conducted to assess the personality profile among alcoholics and non-alcoholic individuals in the department of psychiatry in Sri Venkateshwara medical college hospital and research institute, Puducherry during the January 2019 to June 2019. A total of 80 participants with 40 alcohol consuming cases and 40 controls were included in this study. For assessing the personality disorder, 16 personality factor (PF) questionnaires were used.Results: Personality profile like factor F which represents liveliness and Q4 which represents primary factor regarding tension were found to be greatly affected among cases who consume alcohol compared to non-alcoholic controls.Conclusions: Significant changes noted in personality profile among cases who consume alcohol occurred within 1-5 years of starting alcohol consumption.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Serum procalcitonin as a biomarker of sepsis

    • Authors: Nyamnyei Konyak, Linda Marangmei, Medo M. Kuotsu, Laishram Chittaranjan Singh, L. Shaini Devi, S. Bhagyabati Devi
      Pages: 1494 - 1498
      Abstract: Background: The overlap of clinical presentation between sepsis and SIRS has presented diagnostic difficulty in these two close common scenarios. Blood culture remains the gold standard for detection of specific micro-organism, the non-availability of culture report early and difficulty in culture of many organisms is a challenge in differentiation of sepsis from its mimickers. Keeping this background, a simple tool is needed to guide sepsis management while awaiting the culture report. Therefore, the present study is conducted to determine the procalcitonin level in the setting suspicious of sepsis and to differentiate it from SIRS. The objective of the study was to determine Serum procalcitonin level as a biomarker of early diagnosis of sepsis and also to differentiate sepsis from severe inflammatory response syndrome.Methods: Cross sectional study on 79 patients aged above 18 years with suspected sepsis admitted in medicine ward. Serum procalcitonin levels were measured and analysed to look for any association with sepsis.Results: Culture was positive in 41 patients and 38 patients were procalcitonin positive. The sensitivity, specificity, positive predictive value and negative predictive values of serum procalcitonin were found as 96.68%, 94.74%, 95% and 92.30% respectively.Conclusions: There was a significant association between serum procalcitonin and culture positivity. Procalcitonin levels was found to have high sensitivity and high positive predictive value which may aid in the early diagnosis and guide initiation of anti-microbial therapy in sepsis.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Study correlating interleukin-6 levels with demographics, symptomatology
           and clinical outcomes among COVID-19 patients

    • Authors: Abdul Hassan Wahid, Vallish Shenoy, Ravi K.
      Pages: 1499 - 1508
      Abstract: Background: The objective of this study was to estimate the Interleukin-6 levels of COVID 19 patients and to find any associations between Interleukin-6 levels and age, gender, co-morbidities, symptoms, clinical outcomes and other biochemical parameters among COVID19 patients.Methods: It was a cross sectional observational study conducted on 150 patients admitted to Victoria Hospital, Bangalore medical college from May 2020 to September 2020. Case record form with follow up chart was used to record the relevant demographic details, clinical data including symptoms, co-morbid conditions and various laboratory data. COVID 19 infection was diagnosed by RTPCR technique and severity of COVID-19 disease was classified according to WHO guidelines and guidelines laid by Ministry of Health and Family Welfare, India. Interleukin-6 levels were correlated with the above parameters.Results: It was found that IL6 was elevated and found to be statistically significant with the presence of co-morbid conditions including Hypertension, with the presence of symptoms including fever, cough, breathlessness, with the severity of the disease, with the presence of intubation, with the mortality of the illness and strong association with neutrophil count, C-reactive protein, Ferritin and Neutrophil-Lymphocyte ratio.Conclusions: IL6 can be used as a viable biomarker for knowing the severity of COVID19, to predict the outcome and prognosis of the patient and associations with various presenting symptoms, co-morbid conditions and other laboratory values.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Comparison of the anti-nociceptive effect of dexmedetomidine with that of
           clonidine immediately prior to propofol injection in alleviating propofol
           injection pain

    • Authors: Reshma Sultana, Mohammed Mohsin Ali
      Pages: 1509 - 1516
      Abstract: Background: Propofol is the drug of choice for induction of anaesthesia because of its rapid onset and short duration of action, easy titration, and favourable profile for side effects. But three out of five patients experience pain on injection of propofol.  Alleviation of Propofol injection pain (PIP) is thus a major concern and several interventions have been investigated to alleviate the pain associated with propofol injection. Clonidine was found to alleviate the pain of injected propofol effectively. Dexmedetomidine is also an alpha-2 adrenoceptor agonist but is more selective than clonidine and has analgesic and sedative properties. The aim of the study was to compare the anti-nociceptive effect of dexmedetomidine with that of clonidine immediately prior to propofol injection in alleviating propofol injection pain.Methods: A randomized controlled study was conducted on 60 patients admitted in Malla Reddy Institute of Medical Sciences, undergoing elective surgeries under general anaesthesia (GA) for 2 years from October 2015 to September 2017. The patients were randomly divided into two groups (30 each). Group A was administered intravenous injection clonidine 0.5 µg/kg. Group B was administered intravenous injection dexmedetomidine 0.5 µg/kg.Results: In the present study, difference between the study groups in their mean age, mean weight, gender, ASA grading was not found to be statistically significant. The difference between the groups in incidence of pain on propofol injection was found to be significant statistically. The mean baseline heart rate was declining and mean arterial blood pressure was increasing in both the groups but the difference was not found to be statistically significant.Conclusions: Pre-treatment with 0.5 µg/kg of IV dexmedetomidine is more effective as compared to IV clonidine in alleviating propofol injection pain. 
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Clinical profile of young females with systemic lupus erythematosus: an
           observational study

    • Authors: Rishman Tandi, Tanvi Kumar, Atamjeet Singh, Harmanpal Kathura
      Pages: 1517 - 1523
      Abstract: Background: Systemic lupus erythematosus (SLE) is an autoimmune disorder predominantly affecting women of child bearing age group and is known to require significant lifestyle modifications. The manifestations of SLE are myriad and it may virtually affect every system of affected individual. We Undertook this study to know the clinical profile of young female patients having SLE. The aim of the study was to study clinical features and medical therapy of young female patients having SLE.Methods: This was a prospective study in which 60 female patients diagnosed to be having lupus were included on the basis of a predefined inclusion and exclusion criteria. Investigations relevant to the diagnosis such as Antinuclear antibodies, Antiphospholipid Antibodies, Anti B2GP1 IgG, Anti-dsDNA antibody, Anti Smith Antibody and complement (C3 and C4) levels were done in all the cases. Other investigations such as imaging studies were done in selected cases. Clinical features and medical management being taken by these patients were analyzed. SSPS 21.0 software was used for statistical purpose.Results: The mean duration of the disease in studied cases was found to be 6.96±4.51 years. Malar rash was the commonest type of rash seen in these patients and was present in 53 (88.33%). Arthralgia with or without arthritis was seen in 54 (90%) of the cases. Anemia was the most common hematological abnormality and was seen in 17 (28.33%) patients. Renal involvement in the form of proteinuria was seen in 25 (41.67%) cases. The most common form of pulmonary involvement was pleural effusion which was seen in 4 (6.67%) patients. Cardiovascular manifestations were seen in 11 patients (18.33%).Conclusions: SLE usually affect women of child bearing age group and have a myriad clinical presentation. A thorough knowledge of various clinical presentations and a high index of suspicion is necessary to diagnose SLE particularly in its early stages.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Peripheral neuropathy in people living with human immunodeficiency virus
           and acquired immunodeficiency syndrome on antiretroviral therapy

    • Authors: Joshua L, Medo M. Kuotsu, Nyamnyei Konyak, Ksh Birendra Singh, N. Biplab Singh, Labresai Mog, Senjele Kath, Japheth Thono
      Pages: 1524 - 1529
      Abstract: Background: Peripheral neuropathy is a common neurological complication in people with human immunodeficiency virus (HIV) infection. HIV-associated sensory neuropathy (HIV-SN) is defined as the presence of neuropathic symptoms and at least an abnormal perception of vibrations of a 128 Hz tuning fork on the great toe or abnormal ankle reflexes or both. Brief peripheral neuropathy screening (BPNS) tool is employed in identifying HIV-SN based on a directed symptom questionnaire and limited clinical examination. The present study was conducted to determine the prevalence and drug regimens related to peripheral neuropathy in people living with HIV and Acquired immunodeficiency syndrome (AIDS) on antiretroviral therapy (ART) so as to help improve the care for those on ART. The objective was to study the prevalence of peripheral neuropathy in people living with HIV and AIDS on ART using AIDS clinical trials group validated BPNS tools.Methods: Cross-sectional study on 198 HIV-seropositive cases aged above 18 years on ART attending centre of excellence (CoE) ART centre, RIMS Imphal. The presence of peripheral neuropathy was examined by using a BPNS among the participants.Results: Peripheral neuropathy was found in 46 (23.2%) out of 198 participants using BPNS. In this study a positive association between the duration of treatment with ART and use of protease inhibitor regimes with the development of peripheral neuropathy was significant.Conclusions: Peripheral neuropathy in patient with HIV and AIDS on ART had significant association with duration of treatment with ART and use of protease inhibitor combination in the ART regime. 
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Eosinopenia as a marker of outcome in acute exacerbation of chronic
           obstructive pulmonary disease

    • Authors: Sneha Biradar, Balakrishna Teli, Prashanth V. N.
      Pages: 1530 - 1535
      Abstract: Background: Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the world.Acute exacerbation of COPD has 10% mortality rate at admission and 1/3rd die within a year of hospitalization. Eosinopenia typically accompanies the response to acute inflammation or infection. The objective of this study was to know whether eosinopenia is an economical marker in predicting the outcome in patients hospitalized due to acute exacerbation of COPD.Methods: This is a prospective study conducted on 121 patients presenting with AECOPD satisfying inclusion and exclusion criteria admitted in hospitals attached to Bangalore Medical College and Research Institute. All necessary investigations were done. Patients with AECOPD were divided in two groups: One with eosinopenia and other without eosinopenia. Duration of hospitalization, need for mechanical ventilation and in-hospital mortality was assessed in both the groups.  Results: Among 121 patients with AECOPD, 56 were eosinopenic and 65 patients were non-eosinopenic. Majority of patients belonged to age group of 51-60 years with mean age was 62.06±10.783 years. Duration of hospitalization of patients with eosinopenia was 9.04±5.18 days and that of patients without eosinopenia was 6.15±2.89 (p value<0.001). Among them, 41 (73.2%) patients with eosinopenia and 21 (32.3%) patients without eosinopenia needed mechanical ventilation (p≤0.001). In-hospital mortality rates among eosinopenic and non-eosinopenic patients were 53.6% and 15.4% respectively.  Conclusions: There is a significant relationship between eosinopenia and outcomes of patients with AECOPD. Thus, eosinopenia is a useful, easy-to-measure, inexpensive biomarker for predicting the prognosis and outcome in patients with AECOPD.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Knowledge, attitude and behaviour towards the role of diet in acne
           vulgaris among students

    • Authors: D. Manoharan, K. V. Udhayini, K. Manoharan, N. Ashok Kumar
      Pages: 1536 - 1538
      Abstract: Background: Acne is one of the most common chronic inflammatory conditions reported on daily basis in a skin clinic. It’s pathology lies at the level of pilosebaceous apparatus and is influenced by various factors like hormones, certain foods, drug intake and so on. There are several discrepancies surrounding the role of diet in acne. The aim of the study was to explore the knowledge, attitude and behaviour towards the role of diet in acne vulgaris among students.Methods: This was a cross sectional study conducted in Sree Balaji Medical College and Hospital, Chennai during January 2021 to May 2021. 107 random medical students with acne were enrolled in the study. Students with acne vulgaris not willing to participate in the study and students with acneiform eruptions were excluded. Data was collected using a standard, semi-structured questionnaire. Questionnaire was presented in English through a google form. The questionnaire comprised of socio-demographic data like age and gender. Data was entered in Microsoft word and represented in frequency and percentage.Results: Among the 107 students enrolled in the study, 37 were males and 70 were females. 56 students were in 17-20 age group and remaining 51 were in 21-24 years age group. Our study showed that 64.5% (69) agreed that there was an association between diet and acne vulgaris, while 9.3% (10) denied it and 26.2% (28) were unsure about the association between the two. Majority of them encountered acne localized to face mainly involving cheeks, only 2 people reported acne over trunk. Out of 97 students who opined of the association of diet with acne, only 13 students consulted a dermatologist and opted for medication. Out of 13, only 7 reported to have a positive outcome with combination of advised medication and stoppage of triggered foods. Out of 97 students who opined of the association of diet with acne, only 13 students consulted a dermatologist and opted for medication.Conclusions: The understanding of the disease and the ways adopted by these students look decent enough but mandate few changes in their attitude and behaviour.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Serum calcium levels in newly detected essential hypertensive patients

    • Authors: Arumugam Aashish, Jayasingh Kannaiyan
      Pages: 1539 - 1543
      Abstract: Background: Systemic hypertension is global disease responsible for significant mortality and morbidity. Essential or primary hypertension accounts for the majority of people with hypertension. Although our understanding of the pathophysiology of essential hypertension has grown a lot, its aetiology still remains hypothetical. Few studies in literature have found some correlation with serum calcium levels and blood pressure of the individuals.Methods: A total 200 patients, 100 newly diagnosed essential hypertensive and 100 normotensive patients were included in the study. A detailed history and clinical profile was taken. Blood sample was collected and serum calcium, serum albumin were determined and corrected calcium was calculated and the results were tabulated and appropriate statistical analysis was done.Results: The mean total serum calcium and corrected calcium levels were significantly lowered in essential hypertensive compared to the normotensive individuals. There was no correlation between total serum and corrected calcium levels against systolic and diastolic blood pressure. There was also no difference in serum total and corrected calcium levels among different subsets in essential hypertensive group.Conclusion: Essential hypertension still remains the most common form of hypertension present worldwide causing significant mortality and morbidity. Despite increased advances in medicine and large number of studies done in context with the cause of essential hypertension, its aetiology still remains hypothetical. Even though studies have shown some correlation of calcium fractions with hypertension, the aetiology is still unclear.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Correlation of aspartate aminotransferase-to-platelet ratio index with
           child-turcotte-pugh score and model for end stage liver disease score in
           patients of liver cirrhosis

    • Authors: Princi Jain, Yatish Agarwal, Bijender Kumar Tripathi, Anil Kumar Jain, Divesh Jalan, Gurmeet Kaur, Pulin Kumar Gupta, Monu Sareen
      Pages: 1544 - 1550
      Abstract: Background: Though liver biopsy is considered to be a gold standard for the diagnosis and severity of liver cirrhosis, recently many non-invasive markers have come up for the same. In the current study, we investigated the correlation of aspartate aminotransferase-to-platelet ratio index with other severity scores of liver cirrhosis namely child-turcotte-Pugh score and model for end stage liver disease score.Methods: Fifty-one patients with cirrhosis, identified on the basis of abdomen ultrasonographic findings were enrolled in the study. APRI was calculated for every patient using the formula, (AST/upper limit of normal/platelet count;109/l)×100. The MELD score was calculated according to the original formula proposed by the Mayo clinic group: 3.8×loge (bilirubin; mg/dl)+11.2×loge(INR)+ 9.6×loge (creatinine; mg/dl)+6.4. CTP scoring was calculated based on the severity of hepatic encephalopathy, ascites, total bilirubin, albumin, and INR. Correlation of APRI with MELD and CTP score was established using Pearson correlation coefficient.Results: APRI scores correlated well with the severity of the cirrhosis. With the progression of the CTP class from A to C and with increase in the MELD score, increase in the APRI index was also observed.Conclusions: APRI showed positive correlation with CTP and MELD score.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Effectiveness and tolerability of eight-week treatment with dosulepin
           hydrochloride in patients with major depressive disorder not responding to
           four consecutive weeks of treatment with single selective serotonin
           reuptake inhibitor

    • Authors: M. Suresh Kumar, Amrit Pattojoshi
      Pages: 1551 - 1559
      Abstract: Background: Though manageable, major depressive disorder remains an underdiagnosed and undertreated condition. The objective of this study was to assess the effectiveness and safety of 8 weeks of treatment with the tricyclic antidepressant dosulepin hydrochloride in patients with depressive episodes not responsive to 4 consecutive weeks of treatment with a single selective serotonin reuptake inhibitor (SSRI).Methods: Patients diagnosed with depressive episode without psychotic symptoms (by ICD-10 diagnostic criteria for research), mini-mental state examination score of ≥24, and not responsive to four weeks of treatment with SSRIs (<50% reduction in depressive symptoms) were enrolled. The main outcome measures were mean change in the Hamilton depression, Hamilton anxiety, and insomnia severity index scores at Week 8 compared to baseline. Adverse events were recorded for safety assessment.Results: A total of 94 patients were enrolled, of which, 90 (95.7%) patients completed the study. Compared to baseline, 8 weeks of treatment significantly changed the HAM-D score by -12.7 (p<0.0001), HAM-A score by -8.3 (p<0.0001), and ISI score by -10.5 (p<0.0001). One patient reported anemia and was withdrawn from the study. Dry mouth and insomnia followed by headache, blurred vision, and drowsiness were the most commonly reported side effects as measured with the antidepressant side-effects checklist. Most side effects were of mild intensity and were related to study medication.Conclusions: Eight weeks of treatment with dosulepin hydrochloride resulted in significant and clinically relevant improvements in depression, anxiety, and insomnia symptoms in Indian patients with MDD.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Study on knowledge, attitude and behaviour of patient towards
           dermatophytosis and importance of maintaining personal hygiene

    • Authors: Sivaramakrishnan Sangaiah S., Arun Karthikeyan S., Ashok Kumar N., Sukanya G.
      Pages: 1560 - 1565
      Abstract: Background: Dermatophytosis is considered as a silent epidemic with a global prevalence of 25%. In India, it has been reported in various studies with high prevalence of 27% and it is important to find the modifiable contributing factors for dermatophytosis, so as to prevent the high morbidity affecting the social and occupational health.Methods: A total of 100 patients participated in this cross-sectional study conducted in dermatology outpatient department (OPD) at tertiary care hospital. After obtaining informed written consent, all patients above 18 years of age diagnosed with superficial fungal Skin infections were subjected to pretested, semi-structured questionnaire to collect data regarding the knowledge, attitude and practices towards the dermatophytosis.Results: Out of 100 patients in this study, 45% of patients has knowledge about the spread of fungal infection from person to person and 55% patients not agreeing with it. The study also revealed that 84% of patients reported correctly about the association of sweating with sweat feeling index (SFI) and 76% of patients know about the possible sites of dermatophyte infection. 91% and 96% of patients had no knowledge about the spread of infection through sharing clothes and collective washing clothes of other family members.Conclusions: Despite the patients demonstrating good knowledge about mode of spread of dermatophytosis, still most of the patients are failed to implement the knowledge in maintaining personal hygiene practices. There is a need to improve the gap between the knowledge about the dermatophytosis and their personal hygiene practices towards the infection. It is important to communicate with the patient about the treatment of other family members and changing their attitude towards the infection. This approach will help to improve the adherence of treatment and also prevents the recurrence of dermatophytosis.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Study of aetiology and clinical spectrum of patients with acute
           undifferentiated fever, in a tertiary care setting: a descriptive
           cross-sectional study

    • Authors: Vinay Jishtu, Pramod K. Jaret, Prem Chand Machhan, Nidhi Chauhan
      Pages: 1566 - 1570
      Abstract: Background: Acute undifferentiated fever illness (AUFI) is a common cause of morbidity and mortality in developing countries, owing to its non-specific features. The aim of the study was to delineate the causes and clinical parameters associated with AUFI.Methods: A cross-sectional study was done among 156 patients of AUFI, admitted in the Department of Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from November 2018 to October 2019.Results: The mean age of the study participants was 37.37±14.2 years. The study participants admitted for acute undifferentiated febrile illness had fever with mean duration of 8.38±3.7 days before hospitalization. The most common aetiology of AUFI was found to be enteric fever (44%), followed by scrub typhus (35%). The majority of the cases presented from the month of September to December.Conclusions: The aetiology and clinical spectrum of AUFI is wide and variable. To outline a proper algorithm to contain it, meticulous analysis of the hospital data at each level is necessary.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Clinical profile of patients with diabetes: a hospital based cross
           sectional study

    • Authors: Abhishek Sabbani, Keerthana Medidhi
      Pages: 1571 - 1575
      Abstract: Background: Diabetes is a leading cause of morbidity and mortality. Early identification of complications and management of the same is important to prevent the morbidity and mortality. The objective of the study was to study the clinical profile of patients with diabetes.Methods: A hospital based cross sectional study was carried out among 25 diabetic individuals. Baseline demographic details, risk factors and complications were noted. Investigations like fasting blood sugar, lipid profile and blood pressure were carried out for all patients. Their treatment status was noted.Results: Majority (56%) belonged to age group of 40-59 years. Males were more (64%) than females (36%). Only 28% were normal weight. 52% admitted that they consumed alcohol. 72% were non-smokers and only 8% were tobacco chewers. Hypertension was the most common complication associated with diabetes in 64% of the cases. 4% each had coronary heart disease, stroke, and neuropathy. No one was found to have cataract. 12% had diabetic foot while 8% had kidney disease. Mean levels of total cholesterol was 164.76; mean level of triglyceride was 169.28; mean level of HDL was 45.08; mean level of LDL was 91.32; mean level of Fasting blood sugar was 186; mean Systolic blood pressure was 168.48 and mean Diastolic blood pressure was 114.4. Majority (76%) were on Oral hypoglycemic drugs only and only 4% were on insulin. 20% were on Oral hypoglycemic drugs + insulin.Conclusions: Males were affected more with diabetes. Hypertension was the most common complication. Significant number had developed serious complications and hence early screening for complications in all diabetes patients is required.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Electrophysiological study of peripheral neuropathies in chronic kidney
           disease patients and relation of severity of peripheral neuropathy with
           degree of renal failure

    • Authors: Razeen Fatima, Prakhar Kumar, Mujahid Beg
      Pages: 1576 - 1581
      Abstract: Background: Patients with chronic kidney disease (CKD) are frequently afflicted with neurological complications. Peripheral neuropathy occurs in 60-100% patients of CKD. Nerve conduction study is the gold standard method to diagnose uremic neuropathy. In this study we have examined the correlation of nerve conduction latency, amplitude and nerve conduction velocity with serum creatinine, blood urea, serum uric acid levels and compared these parameters among dialysis and non-dialysis dependent CKD patients.Methods: The present cross-sectional study was conducted on 100 adult patients diagnosed to have and treated for CKD. All cases were subjected to nerve conduction study (NCS) which was performed on median nerve, ulnar nerve, common peroneal nerve, tibial nerve and sural nerve.Results: The prevalence of neuropathy was 68% in both dialysis and non-dialysis dependent groups. The most involved nerve was sural nerve. On NCS, there was prolongation of nerve latency, decrease in nerve amplitude and nerve conduction velocity with rising blood urea and serum creatinine levels. All these abnormalities were more evident in dialysis dependent patients as compared to non-dialysis dependent patients. Depressed amplitude was the most common abnormality in all the tested nerves.Conclusions: The nerve latency, amplitude and nerve conduction velocity worsened with rise in blood urea, serum creatinine and decrease in eGFR suggesting that neuropathy progress with increased severity of renal failure. Nerve conduction abnormalities were more prominent in dialysis dependent patients and therefore was associated with more advanced stage of CKD. 
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • A smartphone use and its impact on academic performance of medical
           students: a cross sectional study

    • Authors: Praveen Kumar R. S., Kaki Aruna, Aravind Kumar, Venkatalakshmi P.
      Pages: 1582 - 1586
      Abstract: Background: Smartphones are unavoidable technology in this modern era. Though there are several advantages with the use of smartphones, there is another school of thought is that due to excessive use of smartphones and addiction behavior the academic performance of the students gets deteriorates. With this in background, this study was conducted to compare the use of smartphones with the student’s academic performances.Methods: This prospective cross-sectional study was conducted among the undergraduate medical students of Sri Venkateshwara medical college hospital and research institute, Puducherry, a tertiary care teaching hospital during the January 2019 to July 2019. A total of 370 students were included in this study. All were assessed for the demographic profile and questions related to usage of smart phones using a questionnaire. Data was analyzed using SPSS.Results: Sharing documents, assessing drug information, taking notes and reading journals articles and books was the academic reasons reported by 94.6%, 72.7%, 58.1% and 35.7% of participants, respectively. Among non-academic reasons games, social media and entertainments was recorded in 82.4% 75.4% and 33% of participants, respectively. Mean duration of smart phone usage in a day was 3.5 hours. However, there was no significant difference noted between the academic performance and use of smartphones.Conclusions: Though smartphone use has no significant impact on academic performance of medical students, with the view of steady increase in smartphone usage, there is a necessary for further monitoring, in order to prevent smartphone related complications like addiction.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • An extraordinary pulmonary artery involvement in granulomatosis with

    • Authors: Ahmad A. Alkhdairi, Ayman A. Alharbi
      Pages: 1587 - 1591
      Abstract: Granulomatosis with polyangiitis (GPA) is an autoimmune mediated systemic disease and characterized by pauci-immune vasculitis mainly of small and medium vessels with typical necrotizing granulomatous lesions in the affected tissues. A 44 year old lady who was known to have GPA presented with unusual presentation of its category with extraordinary large vessels involvement including pulmonary arteries and her condition improved with immunosuppressive therapy. We reported this case, to improve the awareness about other overlapping categories of vessels vasculitis that may involve large vessels and main pulmonary arteries and to avoid misdiagnosing these patients with category of classical large vessels vasculitis.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • A rare case of amoebic liver abscess as an immediate post-COVID-19
           complication in an immunocompetent female: our experience from KIMS

    • Authors: Praveen Kumar Kulkarni, Vinay Kumar, Daya Vaswani, Anant A. Takalkar
      Pages: 1592 - 1597
      Abstract: The coronavirus disease 2019 (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan, the capital city of the Hubei Province, China, in late 2019. It was declared a pandemic by the World Health Organization on March 11th, 2020(1). COVID-19 has challenged healthcare systems through its highly infectious nature and case fatality rate. Till date, numerous complications of COVID-19 have been reported including post COVID-19 Lung fibrosis, pulmonary thromboembolism, lung abscess, complications involving other organs apart from respiratory system like Acute coronary syndromes, Takotsubo cardiomyopathy, peripheral thromboembolic events, large vessel strokes, vasculitis. Direct hepatic injury or hepatitis has also been reported. But there is sparsity of data on occurrence of liver abscess as an immediate post COVID 19 complication. Hence, we present this case of a middle-aged immunocompetent female to highlight the importance of considering rare complications in COVID 19 patients.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Varied presentation of tuberculosis adenopathy: an immunological and
           diagnostic contemplation

    • Authors: Natesh Ganesan, Sachin Vidyasagar, Anbumaran Parivakkam Mani, Gangadharan Vadivelu
      Pages: 1598 - 1600
      Abstract: Tuberculous lymphadenitis is the most common presentation of extra pulmonary tuberculosis EPTB. Clinical and radiological presentation of disease may vary and differential diagnosis includes both benign and malignant conditions such as lymphomas and sarcoidosis. We present two case reports of tuberculous lymphadenitis with varied presentation. In case report Ⅰ, patient had undergone splenectomy due to traumatic splenic rupture had classical symptoms of tuberculosis, chest X-ray, CT thorax showed mediastinal and cervical lymphadenopathy. FNAC showed a picture of granulomatous lesion. In case report ⅠⅠ patient came with complaints of abdominal pain in hypochondriac region. CT and USG abdomen showed multiple enlarged retroperitoneal lymph nodes which led to a provisional diagnosis of lymphoma after which lymph node biopsy showed a granulomatous picture. This case report stresses the importance of early and quick diagnosis of tuberculosis in immunocompromised patients and highlights the risk of misdiagnosis of tuberculous lymphadenitis with other benign and malignant causes of lymphadenopathy and the importance of humoral mediated immunity in tuberculosis.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • An uncommon presentation of a common disease: a case of tertiary syphilis

    • Authors: Manjari Bhat, Ashique Hamza, Subin S., K. G. Sajeeth Kumar
      Pages: 1601 - 1603
      Abstract: Thoracic aortic aneurysm is one of the late and uncommon presentations of syphilis. If the aneurysm is large it causes symptoms suggesting mass effect. Syphilis being a common disease worldwide has recently re-emerged. Early syphilis if left untreated can lead to a significant morbidity. We reported a case of 44 years old man who was incidentally detected to have syphilitic thoracic aortic aneurysm with features of SVC compression.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • A case of Epstein-Barr virus presenting as spondyloarthritis

    • Authors: Mohan Varughese, Vishnu Chandran, Navya Mariam Koshy, Karol Sara Mathew
      Pages: 1604 - 1607
      Abstract: Viral arthritis can be caused by various viruses such as parvovirus, alphavirus, rubella, hepatitis B, C and flavivirus. High titre of antibodies to Epstein-Barr virus (EBV) is present in rheumatoid arthritis (RA) patients. EBV, a member of the herpes virus family, is one among the most common human viruses. Vitamin D deficiency can worsen the prognosis in such patients. Abnormalities in innate and adaptive immune reactions in response to EBV infection were one of the complications observed in RA patients. It was a self-limiting infection with a 90% lifetime prevalence. On the other hand, spondyloarthritis was rarely associated with viral infections. A 35 year old male patient who had a history of TB, admitted through OP, with complaints of intermittent fever, joint pain, pain radiating from back to lower limbs. On investigation, the patient was found to be vitamin D deficient. Differential diagnosis such as TB with reactive arthritis, lymphoma and CMV infection were ruled out. MRI of the spine and pelvis confirmed spondylarthritis. The serology for EBV showed that the EBV IgM levels had increased by two-fold. The on-going inflammatory status was well-managed with NSAIDS, as there was low evidence for antiviral therapy. EBV infection presenting as spondyloarthritis is a very rare presentation and here we are discussing a case of spondylarthritis in a patient with infectious mononucleosis. The patients with fever, polyarthritis, lymphadenopathy and spondylarthritis are to be investigated for EBV infection along with the other cause of polyarthritis.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • A case of acute limb ischemia

    • Authors: Kshiti Rai, K. G. Sajeeth Kumar, Danish Ekkalayil, Anoop Chanthu K. K.
      Pages: 1608 - 1610
      Abstract: Thromboembolism is a well-recognized complication of hematological malignancy. The incidence of symptomatic thrombosis at diagnosis is relatively low in AML (acute myeloid leukemia) patients, though its incidence increases on treatment with anthracyclines. We reported a case of 69 year old female with T2DM who presented with DVT and later on acute limb ischemia of the same lower limb. On hematological evaluation, she had leukocytosis and thrombocytopenia. Further evaluation revealed AML. Thromboembolism as a rare presentation of AML in adults with leukemic hyperleukocytosis has seldom been reported. In the absence of clear guidelines, early diagnosis and management are desirable.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Contamination in COVID-19 sample - the elaboration between medical and
           legal impact

    • Authors: Yohanes Firmansyah, Ernawati ., Darren Gosal, Imam Haryanto, Hendsun .
      Pages: 1611 - 1614
      Abstract: The impact of COVID-19 is enormous on various aspects of human life around the world, especially in the health system. The gold standard used to detect COVID-19 is nucleic acid amplification-based molecular testing. The fact in the field showed that this testing is prone to contamination, leading to misinterpretation and diagnosis. This error has the potential to have further legal implications. This study was a case report using a juridical-normative approach from various primary and secondary sources. A 26-year-old man has tested positive for COVID-19. After further investigation, it was found that there was a diagnosis error due to the contamination of the testing sample in the laboratory where the sample was examined. The contamination that occurs is not only the fault of health workers but is a series of impacts from problems in hospital regulations, the government, and the community's components. This incident affects legal responsibility for health workers and medical consequences on the community. COVID-19 infection is not only closely related to medical problems but also closely related to social and legal issues. Whoever, especially health workers, will receive legal and social impacts other than hospitals, the government and the community from this incident.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Active pulmonary Koch’s in a locally advanced recurrent head and neck
           malignancy: a case report

    • Authors: Shrikar S. Umarane, Chaitanya R. Patil, Kiran G. Bagul, Suraj B. Pawar
      Pages: 1615 - 1617
      Abstract: Even though the global incidence of tuberculosis (TB) has been showing a declining trend every year, it is still a significant public health problem in India. On the other hand, cancer has also been the reason for considerable mortality and morbidity across this population. The incidence of TB has been reportedly increasing in patients with both pulmonary and non-pulmonary cancers. Incidence of pulmonary TB in head and neck malignancy is around 3.1% to 6.6%. We present a case history of 50 years old with locally advanced recurrent head and neck malignancy with active pulmonary Koch’s. The decision was to provide him supportive care and treating the infection was pragmatic in spite of expected delay in anti-cancer treatment. It is extremely important to come up with a proper protocol for the need of prophylactic treatment, detection and the concurrent treatment of both cancer and TB.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
  • Maximizing treatment benefits in type 2 diabetes by affordable oral anti
           diabetes agents in India

    • Authors: Ashok K. Das, B. Krishnakumar, Ajish T. P., Raka Sheohare, Sachin Chittawar
      Pages: 1618 - 1626
      Abstract: Diabetes mellitus (DM) is a global epidemic with number of cases rising exponentially with each decade. What makes it more concerning is its association with numerous complications like cardiovascular diseases, end-stage renal disease, neuropathy, and retinopathy. In India, the management of this disease mainly involves out‑of‑pocket expense and contributes to catastrophic health expenditure and distress financing. Thus, the need of the hour is to make oral anti diabetes agents (OADs) affordable and accessible so that maximum number of patients can avail treatment benefits in diabetes care. This review article focuses on the currently available low cost OADs such as sulfonylureas, metformin, thiazolidinediones, alpha glucosidase inhibitors, dipeptidyl-peptidase 4 (DPP4) inhibitors and sodium-glucose co-transporter-2 (SGLT2) inhibitors explaining their efficacy and safety from recent clinical evidence and those going off patent and becoming much affordable in their generic form. This information will help family physicians make rational choices for their type 2 DM (T2DM) patients.
      PubDate: 2021-09-22
      Issue No: Vol. 8, No. 10 (2021)
School of Mathematical and Computer Sciences
Heriot-Watt University
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