Publisher: Nepal Journals Online   (Total: 154 journals)

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Showing 1 - 154 of 154 Journals sorted alphabetically
AMC J.     Open Access   (Followers: 27)
Annals of Clinical Chemistry and Laboratory Medicine     Open Access   (Followers: 6)
Asian J. of Medical Sciences     Open Access   (Followers: 2)
Asian J. of Population Sciences     Open Access   (Followers: 9)
Banking J.     Open Access   (Followers: 7)
Banko Janakari     Open Access  
BIBECHANA     Open Access  
Birat J. of Health Sciences     Open Access  
BMC J. of Scientific Research     Open Access   (Followers: 10)
Bodhi : An Interdisciplinary J.     Open Access   (Followers: 1)
Botanica Orientalis : J. of Plant Science     Open Access  
Bulletin of the Department of Geology     Open Access   (Followers: 2)
Conservation Science     Open Access   (Followers: 29)
Contemporary Research: An Interdisciplinary Academic J.     Open Access   (Followers: 7)
Curriculum Development J.     Open Access   (Followers: 6)
Dhaulagiri J. of Sociology and Anthropology     Open Access  
Eastern Green Neurosurgery     Open Access   (Followers: 2)
Ecoprint : An Intl. J. of Ecology     Open Access   (Followers: 4)
Forestry : J. of Institute of Forestry, Nepal     Open Access  
Gaze: J. of Tourism and Hospitality     Open Access  
Geographical J. of Nepal     Open Access  
Grande Medical J.     Open Access  
Health Prospect     Open Access  
Himalayan J. of Science and Technology     Open Access  
Himalayan Physics     Open Access   (Followers: 9)
Humanities and Social Sciences J.     Open Access   (Followers: 10)
Interdisciplinary Research in Education     Open Access   (Followers: 1)
Intl. J. of Applied Sciences and Biotechnology     Open Access   (Followers: 1)
Intl. J. of Environment     Open Access   (Followers: 3)
Intl. J. of Infection and Microbiology     Open Access   (Followers: 4)
Intl. J. of Occupational Safety and Health     Open Access   (Followers: 35)
Intl. J. of Social Sciences and Management     Open Access   (Followers: 2)
Intl. Research J. of Management Science     Open Access   (Followers: 10)
J. of Advanced Academic Research     Open Access   (Followers: 3)
J. of Advanced College of Engineering and Management     Open Access  
J. of Advances in Internal Medicine     Open Access  
J. of Agriculture and Natural Resources     Open Access  
J. of APF Command and Staff College     Open Access   (Followers: 1)
J. of Balkumari College     Open Access   (Followers: 12)
J. of Biomedical Sciences     Open Access  
J. of Business and Management Research     Open Access   (Followers: 1)
J. of Business and Social Sciences     Open Access  
J. of Business and Social Sciences Research     Open Access  
J. of Chitwan Medical College     Open Access  
J. of College of Medical Sciences-Nepal     Open Access  
J. of Development and Administrative Studies     Open Access   (Followers: 1)
J. of Diabetes and Endocrinology Assocation of Nepal     Open Access  
J. of Education and Research     Open Access   (Followers: 6)
J. of Fine Arts Campus     Open Access   (Followers: 10)
J. of Food Science and Technology Nepal     Open Access  
J. of Forest and Natural Resource Management     Open Access  
J. of Gandaki Medical College-Nepal     Open Access  
J. of Health Promotion     Open Access   (Followers: 1)
J. of Hydrology and Meteorology     Open Access   (Followers: 39)
J. of Institute of Medicine     Open Access  
J. of Institute of Science and Technology     Open Access  
J. of Intl. Affairs     Open Access   (Followers: 4)
J. of Kathmandu Medical College     Open Access  
J. of Lumbini Medical College     Open Access  
J. of Maize Research and Development     Open Access   (Followers: 2)
J. of Management and Development Studies     Open Access   (Followers: 1)
J. of Manmohan Memorial Institute of Health Sciences     Open Access  
J. of NELTA     Open Access  
J. of NELTA Gandaki     Open Access  
J. of NELTA Surkhet     Open Access  
J. of Nepal Agricultural Research Council     Open Access  
J. of Nepal Geological Society     Open Access  
J. of Nepal Paediatric Society     Open Access   (SJR: 0.112, CiteScore: 0)
J. of Nepal Physical Society     Open Access  
J. of Nepalese Association of Pediatric Dentistry     Open Access   (Followers: 8)
J. of Nepalese Business Studies     Open Access  
J. of Nepalese Prosthodontic Society (JNPS)     Open Access  
J. of Nepalese Society of Periodontology and Oral Implantology     Open Access  
J. of Nepalgunj Medical College     Open Access  
J. of Nobel Medical College     Open Access  
J. of Patan Academy of Health Sciences     Open Access  
J. of Pathology of Nepal     Open Access   (Followers: 1)
J. of Political Science     Open Access   (Followers: 4)
J. of Psychiatrists' Association of Nepal     Open Access  
J. of Research and Development     Open Access   (Followers: 9)
J. of Science and Engineering     Open Access   (Followers: 1)
J. of Society of Anesthesiologists of Nepal     Open Access  
J. of Society of Surgeons of Nepal     Open Access  
J. of Sustainability and Environmental Management     Open Access   (Followers: 11)
J. of the Institute of Engineering     Open Access  
J. of Tourism & Adventure     Open Access   (Followers: 1)
J. of Tourism and Himalayan Adventures     Open Access   (Followers: 8)
J. of Tourism and Hospitality Education     Open Access  
J. of Training and Development     Open Access   (Followers: 6)
J. of Universal College of Medical Sciences     Open Access  
J. on Geoinformatics, Nepal     Open Access   (Followers: 9)
Janaki Medical College J. of Medical Science     Open Access  
Janapriya J. of Interdisciplinary Studies     Open Access  
Kathford J. of Engineering and Management     Open Access  
Kaumodaki: J. of Multidisciplinary Studies     Open Access   (Followers: 8)
Madhyabindu J.     Open Access   (Followers: 7)
Management Dynamics     Open Access  
Mangal Research J.     Open Access   (Followers: 12)
Marsyangdi J.     Open Access   (Followers: 12)
Mathematics Education Forum Chitwan     Open Access   (Followers: 2)
Med Phoenix     Open Access  
Medical J. of Pokhara Academy of Health Sciences     Open Access  
Medical J. of Shree Birendra Hospital     Open Access  
MedS Alliance J. of Medicine and Medical Sciences     Open Access   (Followers: 13)
Molung Educational Frontier     Open Access  
NCC J.     Open Access  
Nepal J. of Civil Engineering     Open Access   (Followers: 5)
Nepal J. of Dermatology, Venereology & Leprology     Open Access   (Followers: 1)
Nepal J. of Environmental Science     Open Access   (Followers: 9)
Nepal J. of Epidemiology     Open Access  
Nepal J. of Health Sciences     Open Access   (Followers: 10)
Nepal J. of Medical Sciences     Open Access  
Nepal J. of Multidisciplinary Research     Open Access   (Followers: 8)
Nepal J. of Neuroscience     Open Access  
Nepal J. of Obstetrics and Gynaecology     Open Access   (Followers: 2)
Nepal J. of Science and Technology     Open Access  
Nepal Medical College J.     Open Access  
Nepal Population J.     Open Access  
Nepal Public Policy Review     Open Access   (Followers: 9)
Nepalese Culture     Open Access   (Followers: 13)
Nepalese Heart J.     Open Access  
Nepalese J. of Cancer     Open Access   (Followers: 12)
Nepalese J. of Development and Rural Studies     Open Access  
Nepalese J. of Hospitality and Tourism Management     Open Access   (Followers: 6)
Nepalese J. of Ophthalmology     Open Access  
Nepalese J. of Radiology     Open Access   (Followers: 1)
Nepalese J. of Statistics     Open Access   (Followers: 1)
Nepalese Medical J.     Open Access  
Nepalese Veterinary J.     Open Access  
NUTA J.     Open Access  
Orthodontic J. of Nepal     Open Access  
Our Nature     Open Access   (Followers: 2)
Prashasan: Nepalese J. of Public Administration     Open Access   (Followers: 14)
Pravaha     Open Access  
Prithvi Academic J.     Open Access   (Followers: 9)
Quest J. of Management and Social Sciences     Open Access   (Followers: 5)
Research Nepal J. of Development Studies     Open Access   (Followers: 1)
Researcher : A Research J. of Culture and Society     Open Access   (Followers: 5)
SAARC J. of Tuberculosis, Lung Diseases and HIV/AIDS     Open Access   (Followers: 3)
Saptagandaki J.     Open Access  
SCHOLARS: J. of Arts & Humanities     Open Access   (Followers: 14)
Scientific World     Open Access  
SCITECH Nepal     Open Access  
SIRJANĀ – A J. on Arts and Art Education     Open Access   (Followers: 7)
Social Inquiry : J. of Social Science Research     Open Access  
Studies in ELT and Applied Linguistics     Open Access   (Followers: 14)
Technical J.     Open Access   (Followers: 8)
The Batuk     Open Access   (Followers: 10)
The EFFORTS, J. of Education and Research     Open Access   (Followers: 8)
The Geographic Base     Open Access   (Followers: 10)
The Harvest     Open Access   (Followers: 10)
Third Pole: J. of Geography Education     Open Access  
Tribhuvan University J. of Microbiology     Open Access   (Followers: 9)
Voice of Teacher     Open Access   (Followers: 8)

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Asian Journal of Medical Sciences
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2467-9100 - ISSN (Online) 2091-0576
Published by Nepal Journals Online Homepage  [154 journals]
  • Challenges faced in the peer review system in open access journals

    • Authors: Arun Kumar, Shah Newaz Ahmed
      Pages: 1 - 3
      Abstract: The whole mechanism of academic journal’s peer review system process effectively depends on how editors manage the journal work. The handling of the peer review system will determine how stupendously the reviewers are dedicated to the peer review system and it impacts the reputation of the journal’s timely publication. Ideally there should be a centralized system and have a clear stages of peer review, but often journals make the system harder than it is needed, either due to overly complex process or lack of coordination among the editor and the reviewers. On one hand the researchers spend a lot many years in studying a hypothesis or a novel concept, preparing themselves for some ground breaking findings assuming to make an impact in their field of study, but when it comes for publication, it is one of the biggest hurdle they need to overcome. Only after a trustworthy peer review process, the research article would find a space in a journal for publication. Struggle to find Qualified Reviewers It is a major struggle for an editor to find reviewers who are willing to perform peer reviews, but it is also difficult to find qualified reviewers who are competent enough to make criticisms in the manuscripts. There will always be a pool of academicians who are willing to be in the editorial board and to be a part of peer review, but finding and selecting qualified professionals with specific knowledge in the scope of publication is the real challenge for an editor. Sometimes there is a pressure to publish issue quickly within the time schedule, and then there are no excuses for lagging editorial development. So there is a need of timely review within the allocated time. When it comes to double blind peer review, the editor must be careful because sometimes the authors make recommendation for suggested reviewers who could be known to them with intent to overcome the review system. The Waiting begins The editor’s frustrations with the peer review systems begin when the deadlines are given to the reviewers to complete the manuscript evaluations, but it is not met with the timely response by the reviewers. Sometimes, the reviewer’s seldom responds to review requests. This is eventually noticed by the editors when the deadlines are completed and pop-up message comes to the editors. Unfortunately, the editors have to prepare themselves and re-assign to external reviewers and reset the deadlines to the authors for completion of review. This is the major reason, why the loyal and punctual reviewers are so highly valued for academic publications. Many a times, it might so happen that the selected reviewers are simply too busy in their academic commitments, so the request to review is denied by them. This denial is better as it saves times for the peer review process as the editor assigns to another potential reviewer. The things become worst for the editor, when the reviewers agree to complete the assigned task of reviewing but they do not respond even when the deadline is completed. On the other hand, the authors are eagerly waiting for the decision of their submitted manuscripts. The peer review matter is more problematic as most of the publications require minimum of two peer reviews before an editorial decision can be made. Therefore, the peer reviewed journals usually take more time for proper peer review process to get fulfilled. Retainment and Reformation of Editorial board Yet another obstacle for editors is urging the reviewers to remain in the editorial board. Those reviewers, who are really busy, put the peer review duties to the bottom of their priorities they pass the manuscript to their junior colleagues or subordinates, which effects the quality of review. The editors continually search for qualified reviewers, while at the same time they have to keep motivated the existing reviewers and board members for future evaluations. Those reviewers, who are honest and dedicated, are loaded with more articles for review which further deteriorates the quality of review. On the other side, the editors have to reform the entire editorial board time to time, in order to fill up with qualified and dedicated reviewers and remove those who have not performed any reviews. Initially the reviewers are enthusiastic but with time, they become sluggish and get demotivated. Frustration of
      Authors When the authors submits their articles with the journal, they are usually told about the turnaround time from submission to publication, or approximately how long will the peer review process take. Eventually, if the review reports are not generated within the deadline, they have to wait until the review is completed. Some of the authors who need publication for promotions become restless and this delay can seriously burden young scholars and academicians for their career growth and academic advancements. Allocating External Reviewers Sometimes peer reviewers fail to understand the article is a comprehensive manner and inserts lots of criticism in the article with multiple flaws for which the editor are criticised and they have to apologize to authors for ineffective review. In such cases, the editor has to re-assign the article to the external reviewers for unbiased reviews How to overcome these obstacles and challenges The editors can establish some means for proper recognition of the reviewers who have contributed enormously in the peer review, by issuing the certificate of Peer Reviewer or enlisting their names on the website. It is often practiced to include the name of the peer reviewer in the published manuscript which can encourage more reviewer’s participation. The editors can decrease the turnaround time for manuscript evaluations and this can be eventually met by adopting a fast track review system. In this the assigned reviewers gets paid and...
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.49361
      Issue No: Vol. 13, No. 12 (2022)
  • A study of rural domestic helpers knowledge, attitude, and practice of
           COVID-19 in Mizoram, India

    • Authors: Ganesh Shanmugasundaram Anusuya, Manoj Balaji Patki, Vanlal Hruaii, Ralte Lalengkimi, Lalfak Zuali, Kasi Marimuthu, Lalchhandami Tochhawng, John Zothanzama, Nachimuthu Senthil Kumar, Sang Zuala
      Pages: 4 - 10
      Abstract: Background: In times of an epidemic such as coronavirus disease 2019 (COVID-19), the public’s knowledge and attitude toward the disease affects the ability to abide to different preventive measures. Aims and Objectives: (1) to assess the knowledge and awareness of the domestic helpers in a tribal population, (2) whether the domestic helpers practice appropriate preventative measures that are recommended by WHO. Materials and Methods: This cross-sectional study was designed and carried out using questionnaire among rural domestic workers in Mizoram, above 14 years of age belonging to both Mizo and Non-Mizo ethnicity. Data were collected from 105 participants and analyzed through t-test, one-way analysis of variance and Pearson correlation analysis. Results: Majority of the respondents had higher secondary level of education (78.1%) and 95.2% could identify COVID-19 as a communicable disease. Almost all the participants (97.1%) were afraid of infection and the majority (92.4%) had fear of dying with the disease. Three-fourth of the participants were working during the pandemic of which 44.8% had volunteered. Media (68.6%) was the most common source of information about the disease. The education level was significantly associated with knowledge and attitude scores whereas there were no significant differences with respect to the practice (P>0.05). Conclusion: Our findings indicate an overall good KAP of the rural domestic workers. Since these workers move from house to house and also take care of the vulnerable, and that they themselves and the families, they work for may be at an increased risk of infection with COVID-19, these findings are important from a health campaign perspective.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46069
      Issue No: Vol. 13, No. 12 (2022)
  • Knowledge, practice, and barriers of optimal mask usage among general
           public – A cross-sectional study from Kerala, South India

    • Authors: Aditya Ashok, Akhilesh Kunoor, Midhun Rajeev, Soumya Melepurakkal, Aravind Mohankumar Syamala, Sarath Venugopal, Vishnu Gopalakrishnan, Tajik Muhammed Shafi
      Pages: 11 - 16
      Abstract: Background: Social distancing, mask, and sanitizers are advised to cut the chain of transmission of the droplet and airborne infection since the first case of COVID-19 was reported from Wuhan. Universal mask usage is advised by the center for disease control. Despite this, it is assumed that there is no adequate mask practice. Aims and Objectives: The objectives of the study are as follows: (1) To assess the knowledge and practice regarding optimal mask usage in a different setting by the general community. (2) To identify the barriers for optimal mask usage as experienced by users. Materials and Methods: We did a cross-sectional study in Kerala using self-made validated questionnaire translated to Malayalam, the regional language distributed by web based Google form. The sample size was calculated as 200 with an assumption of awareness regarding mask usage among the general public to be at least 60% with a confidence interval of 95 and allowable error of 10% Knowledge was considered as high if 80–100%, moderate if 60–79% and low if 0–59%. The practice was considered as good if >75, 74–50 satisfactory and if <50, it is termed as unsatisfactory. Results: Overall knowledge regarding masks and their usage was 52. 88% which is low. Only 38% were doing satisfactory practice. There were lacunae in knowledge regarding mask reusage (39.9%), ideal masks in hospital settings (43.3%). Only 26.4% practiced optimal method of mask removal and 38.4% safe mask disposal. Major barriers for mask usage were suffocation (49.3%) and exertional dyspnea (46.9%). Conclusion: More awareness needs to be created among the public for COVID appropriate behavior with a focus on mask usage. There is a need to address the commonly observed barriers for adhering to mask practice.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46262
      Issue No: Vol. 13, No. 12 (2022)
  • Challenges faced by anesthesiologists during the cesarean section of
           COVID-19 patients – An observational study

    • Authors: Mahima Lakhanapal, Ritesh Kumar, Amit Kumar, Isha Yadav
      Pages: 17 - 20
      Abstract: Background: The health-care system has encountered exceptional circumstances, experiencing unique challenges, and manifesting as acute challenges in health-care services due to the spread of COVID-19. Aims and Objectives: The present study aimed to report the difficulties faced by the anesthetists while performing a cesarean section under the subarachnoid block (SAB) in COVID-19 patients at a dedicated COVID Level 3 hospital. Materials and Methods: Twenty healthy anesthetists (six consultants and 14 postgraduate) aged 20–40 years performed 60 elective or emergency cesarean sections of known COVID-19-positive gravida patients aged 20–35 years with no comorbidity and no spine abnormality under the SAB. Anesthetist;s responses to the challenges faced while performing procedures wearing the Level 3 personal protective equipment were recorded using a pre-structure self-administered questionnaire. To quantify the intensity of these problems, all the physical and psychological difficulties were graded as mild, moderate, and severe. Results: In the present study, 75% experienced moderate-to-severe sweating, and 60% experienced moderate-to-severe headaches. A total of 45% experienced moderate-to-severe breathlessness. Though there was little difficulty in communication among doctors and staff, almost 75% of anesthetists faced it. The fear of contracting the disease and spreading it to the family members was expressed by 75–80% of anesthetists. Conclusion: The present scenario has increased physical stress and other psychological problems among health workers. Therefore, hospital support with regular psychological counseling sessions is needed for healthcare workers to cope with the current situation.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.44423
      Issue No: Vol. 13, No. 12 (2022)
  • Chlorhexidine (2.5%)–alcohol versus povidone-iodine (10%) alcohol for
           surgical site antisepsis in cesarean section in a tertiary care hospital
           – A prospective observational and analytical study

    • Authors: Shyamal Dasgupta, Pallabi Das, Avijit Pan, Chiranjit Ghosh, Poulami Roy, Srijita Mukherjee, Medha Barua, Hetal Patel, Avijit Biswas
      Pages: 21 - 28
      Abstract: Background: Rising trends of cesarean section globally demand identification of most suitable pre-operative antiseptic agent to minimize surgical site infections (SSI) and its consequences. Aims and Objectives: The aims of this study were to determine, compare, and analyze SSI developing following the use of chlorhexidine (2.5%)–alcohol and povidone-iodine (10%) alcohol as pre-operative antiseptic agents in cesarean section. Materials and Methods: A prospective, observational, and analytical study was conducted in a tertiary care center for 1 year, where 300 women receiving pre-cesarean surgical site antisepsis with chlorhexidine (2.5%)–alcohol were compared with another 300 receiving povidone-iodine (10%) alcohol. Results: The two study groups were compared in terms of various sociodemographic and clinical parameters which might act as confounding factors and were found to be similar. As compared to women receiving povidone-iodine (10%) alcohol, women receiving chlorhexidine (2.5%)–alcohol had significantly lesser incidence of overall (P<0.001), superficial (P<0.001), and deep (P<0.05) SSI, infections developing at 48 h–5 days (P<0.001) and at 5 days–30 days (P<0.05). There was no significant difference among the two groups with respect to wound swab culture reports and post-SSI inflammatory markers. As compared to the povidone-iodine group, in the chlorhexidine group, a significantly (P<0.05) greater percentage healed with meager dressing and a significantly (P<0.05) lesser percentage required secondary suturing and readmissions and had a significantly (P<0.05) lesser mean duration of hospital stay. Conclusion: Chlorhexidine (2.5%)–alcohol appears to be a better pre-operative surgical site anti-septic agent than povidone-iodine (10%) alcohol in cesarean section.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46971
      Issue No: Vol. 13, No. 12 (2022)
  • Effect of pre-emptive intravenous paracetamol, magnesium sulfate, and
           lignocaine on hemodynamic variables during perioperative period in
           pre-eclampsia patients scheduled for lower segment cesarean section under
           general anesthesia: A prospective randomized study

    • Authors: Dilip Kothari, Anjali Bansal, Seethal Ann Sunny
      Pages: 29 - 36
      Abstract: Background: Hemodynamic alterations during general anesthesia with endotracheal intubation are due to stimulation of the sympathetic nervous system and catecholamine release. Therefore, it is important to attenuate these responses in pre-eclampsia patients who are already under stress. Aims and Objectives: The present study aimed to evaluate the combined efficacy of paracetamol, magnesium sulfate, and lignocaine in attenuating hemodynamic responses during intubation and perioperative period. Materials and Methods: Eighty ASA II pre-eclampsia patients were randomly divided into two groups. Group PLM received intravenous infusion of paracetamol (1 g) and magnesium sulfate (30 mg/kg) in 100 ml normal saline and IV bolus Inj. lignocaine (1.5 mg/kg) 15 min before induction. Group C received only IV infusion of 100 ml normal saline. Pulse rate (PR), blood pressure (BP), and oxygen saturation were measured at various time intervals up to 40 min of delivery of baby and in up to 240 min in post-operative period. Post-operative visual analog score (VAS) and the time for first rescue analgesia (TRA I) were recorded. Results: Demographic and baseline hemodynamic parameters were comparable in both groups (P>0.05). Changes in PR and BP during laryngoscopy, intubation, and perioperative period were significantly lesser in Group PLM as compared to Group C (P<0.05). The post-operative VAS score was significantly lower whereas TRA I was significantly longer in Group PLM than in Group C at all measuring times (P<0.05). Conclusion: Combination of paracetamol, magnesium sulfate, and lignocaine attenuates hemodynamic responses during laryngoscopy, intubation, and perioperative period along with prolonged post-operative analgesia in cesarean section under general anesthesia in pre-eclampsia patients.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.44663
      Issue No: Vol. 13, No. 12 (2022)
  • Comparison of conventional awake extubation with endotracheal tube –
           laryngeal mask airway exchange extubation for evaluation of respiratory
           and hemodynamic parameters during emergence in neurosurgical patients

    • Authors: Amit Vyas, Kamalraj Singh Baghel, Pawan Nandurkar, Sonali Tripathi
      Pages: 37 - 42
      Abstract: Background: Emergence from general anesthesia and tracheal extubation may be associated with tremendous physiological and metabolic stress in patients which could be major concern for the anesthesiologist in patients especially with neurosurgical patients. Aims and Objectives: The study was designed to find a novel method to achieving a smooth extubation in neurosurgery by compare the respiratory complications and hemodynamic stress response between conventional awake extubation of an endotracheal tube (ETT) and that following exchange extubation of ETT using a laryngeal mask airway (LMA) in craniotomy surgeries. Materials and Methods: A total of 60 patients of American Society of Anesthesiologists physical status I and II between ages 18 and 60 years undergoing neurosurgery were evaluated for respiratory events such as bucking, coughing, desaturation, and hemodynamic changes due to sympathetic stimulation such as tachycardia, hypertension, and any other complications that have occurred in any of the two extubation methods. Results: In Group A, 86.67% patients have shown significant events of bucking and coughing while desaturation events were comparable between two groups. Manipulation events, that is, chin lift and jaw thrust had to perform in 66.67% and 21.67%, respectively, in patients of Group A compared to only 03.33% patients in Group L. (P<0.05). In Group A, 97.33% patients shown tachycardia compared to 30% in Group L where only 30%. Similarly, mean arterial pressure after extubation found to be significantly high in 63.33% of the patients in Group A with 63.33% as compared to13.33% of patients in Group L (P<0.05). Conclusion: ETT/LMA exchange is the most effective technique for achieving the clinical endpoints of the study, that is, prevention of emergence hypertension and respiratory complications compared to awake extubation methods. The exchange of ETT with LMA in deeper plane of anesthesia significantly reduces emergence related the hemodynamic and respiratory unwonted events.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47827
      Issue No: Vol. 13, No. 12 (2022)
  • Morphological and histological study of coronary sinus in human hearts
           from north-western region of Uttar Pradesh and its clinical implication

    • Authors: Jolly Agarwal, Anurag Agarwal, Virendra Kumar, Devendra Nath Sinha, Sudhahar Tamizhan, Manisha Naithani
      Pages: 43 - 47
      Abstract: Background: Coronary sinus (CS) is the largest diameter vessel in the coronary venous network, which serves as the primary collector of cardiac venous blood. Because the coronary venous system is not prone to the effects of atherosclerotic disease, it may also serve as a potential avenue for coronary artery bypass. Aims and Objectives: The aim of the study was to provide morphological and histological data of CS for making an interventional device. Materials and Methods: The present study cross-sectional study. Thirty hearts of different ages and of both sexes (22 males and 8 females) and duration of study is 2 years procured from cadavers available in the Department of Anatomy, SRMS IMS, Bareilly, U.P, India, were taken. Results: The mean length of the CS is 36.83±17.29 mm. The width of CS at the point of opening in to right atrium is 4.92±3.53 mm. The mean length of CS in males was 41.44±11.37 mm. While in females the mean length of CS was 39.29±11.17 mm. Histological study by Orcein stain show different amount of elastic fibers in proximal, middle, and distal part. Conclusion: Morphological and histological study of the CS suggests this structure to be an independent, cardiac chamber with a mural structure similar to atrial myocardium and it may be target for study and ablation, in the future therapy of atrial arrhythmias.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.48019
      Issue No: Vol. 13, No. 12 (2022)
  • Variations in the branching pattern of renal artery

    • Authors: Aishwarya Thanigai Arasu, Muniappan Veerappan , Sundarapandian Subramanian, Ananthi Varadharajan
      Pages: 48 - 54
      Abstract: Background: In terms of living kidney transplantation programs worldwide, India is only second to the United States of America. Every year, over 7500 renal transplants are done in India, with 90% of the transplants coming from living donors and the rest from deceased donors. Aims and Objectives: The aim of the study is to examine and describe differences in human renal arteries, compare past studies with the present study, and report the occurrence of major categories of variation. Materials and Methods: This observational study was carried out on 25 well-embalmed adult cadavers in the Department of Anatomy, Rajah Muthiah Medical College, Annamalai Nagar, Chidambaram from December 2016 to October 2018. In all the 25 specimens, the renal artery took its origin from the lateral side of the abdominal aorta. Results: We observed that there is a 92% correlation between L1 and L2, 8% between L3 and L1, and zero between L1 and L2. Accessory renal artery (ARA) was discovered in 18 specimens (36%), with 10 on the right side and eight on the left. Superior polar arteries – 4 (8%), inferior polar arteries – 1 (2%), and hilar arteries – 5% on the right side (10%). Superior polar arteries – 6%, inferior polar arteries – 0%, and hilar arteries – 5% on the left side (10%). Conclusion: Living donor grafts have become a primary source for preserving the donor pool as the need for kidney transplantation rises, and a successful allograft with numerous arteries has become a must. All major vascular channels have not entirely regressed if there are polar or numerous renal arteries to a regularly positioned kidney.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47325
      Issue No: Vol. 13, No. 12 (2022)
  • Effect of serum uric acid level on maternal and neonatal outcome in
           patients with hypertensive disorders of pregnancy at HSK Hospital,
           Bagalkot: A prospective and observational study

    • Authors: Neel Prajapati, Sujay Heranjal, Varsha Chakrakodi Raghuram, Santosh Rathod , Ashalata Mallapur
      Pages: 55 - 60
      Abstract: Background: Uric acid, a metabolite of purine metabolism, is considered as a marker of hypertensive disorder of pregnancy (HDP) severity. An increase in serum uric acid level in pregnant mothers has been found to be associated with the disease severity. Aims and Objectives: The present study intended to evaluate the effect of serum uric acid level in maternal and neonatal outcome in cases of hypertensive disorders of pregnancy. Materials and Methods: This prospective and observational study was conducted on patients with HDP from December 2017 to April 2019. The study was conducted on 274 subjects who visited the Department of Obstetrics and Gynecology, HSK Hospital, Bagalkot. The participants were categorized into two groups according to their serum uric acid level (<6 mg/dL and ≥6 mg/dL). Serum uric acid was estimated by enzymatic colorimetric method. Maternal and neonatal outcomes were recorded. Follow-up was done till the discharge of the mother and child from the hospital. Data were analyzed using coGuide software. Results: The majority of the participants were in the age group of 18–23 year (52.91%). No significant association was observed between serum uric acid groups and maternal parameters such asparity, gestational age, onset of labor, mode of delivery, and maternal complications (P>0.05). There was statistically no significant difference between serum uric acid groups in neonatal outcomes such as Apgar score 1 min and 5 min, IGUR, NICU admission, and reason for NICU admission (P>0.05) except for still birth. Still birth was found to be more in patients with serum uric acid ≥6mg/dl (19.64%) group compared to <6 mg/dl (8.64%) with P=0.008. Conclusion: This study shows that there was no significant association between adverse maternal and neonatal outcomes with increased level of serum uric acid.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47723
      Issue No: Vol. 13, No. 12 (2022)
  • A comparative study of liver function test between normal neonates and
           neonates with different stages of hypoxic ischemic encephalopathy in a
           district medical college of Eastern India

    • Authors: Kanai Lal Barik, Barnika Purkayastha, Nilanjan Ghosh, Sumanta Laha, Amit Adhikary, Sayan Bera
      Pages: 61 - 65
      Abstract: Background: Hepatic dysfunction is a known complication in neonates with hypoxic ischemic encephalopathy (HIE). Aims and Objectives: We conducted this study to compare hepatic function between normal and asphyxiated newborn and whether the changes in liver function vary with the grade of HIE. Materials and Methods: This observational analytical cross-sectional study was done in a rural medical college of eastern India for 1 year with 51 HIE (17 each in HIE I, II, and III group) and 51 healthy neonates as control. Biochemical parameters of liver function such as alanine transferase (ALT), aspartate transferase (AST), alkaline phosphatase (ALP), total serum bilirubin (TSB), serum albumin, and prothrombin time (PT) were measured in both groups between 48 and 72 h of birth. Results: We found that TSB, liver enzymes, and PT ware significantly elevated and serum albumin reduced in HIE group in comparison to control group. However, TSB, PT, and serum albumin does not differ much among three stages of HIE. By contrast, liver enzymes increases significantly among three stages of HIE, and also, there is significant difference in ALT, AST, and ALP between survivor and non-survivor of HIE babies. Conclusion: Hence, liver function test may serve as an useful early marker of perinatal asphyxia when the history of birth asphyxia is lacking and it can also be used as a prognostic indicator as there is more rise of liver enzymes from low to high grade of HIE and from survived to expired HIE babies.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.48007
      Issue No: Vol. 13, No. 12 (2022)
  • Relationship of low serum 25 (OH) Vitamin D and dementia – A
           cross-sectional observational study from a neurology teaching hospital in
           East India: Relationship of low serum 25 (OH) Vitamin D and dementia in
           East India

    • Authors: Amar Kumar Misra, Annesh Bhattacharjee, Joydeep Mukherjee, Sanjay Kumar, Bijendra Mohanty
      Pages: 66 - 72
      Abstract: Background: In view of the rapidly growing number of aged population with dementia in India, widespread hypovitaminosis D in the elderly individual, high frequency of dementia of unknown etiology, many studies showing a definite role of Vitamin D in dementia as well as some of the literature showing inconsistent results and reverse causality of hypovitaminosis D in dementia, we planned to investigate the relation between low vitamin D and risk of dementia. Aims and Objective: The aim of the current study was to find out any relationship of Vitamin D with dementia. Materials and Methods: This cross-sectional observational study was performed at a neurology-teaching hospital, Kolkata, India. Ethical clearance was obtained from the hospital ethics committee. A total of fifty adults completed interviews on a semi-structured questionnaire. In addition, general medical and neurological examination and detailed cognitive assessment, including MMSE, were carried out after taking written consent. All individuals with dementia, and age-gender-matched healthy volunteers provided blood samples for routine and relevant biochemical examination, including the estimation of serum 25(OH) Vitamin D by Chemiluminescence Immuno Assay (CLIA). In addition, appropriate statistical methods were applied to analyse the results. Results: Overall, ninety percent of participants had low serum 25(OH)Vitamin D, defined as 25(OH)D < 20mg/ml. Hypovitaminosis D was associated with early and late-stage dementia and was statistically significant. Only five individuals were found to have sufficient 25 (OH) Vitamin D. Conclusion: The mean vitamin D level of demented patients was significantly lower compared to the control population. Our observations provide an association between Vitamin D deficiency and dementia and provides a background of longitudinal prospective study in future to show cause and effect relationship between dementia and hypovitaminosis D.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.48716
      Issue No: Vol. 13, No. 12 (2022)
  • A comparative study showing effect of local insulin injection on wound
           vascularization seen in color Doppler imaging in patients with diabetic
           foot ulcer disease before and after therapy

    • Authors: Mayurika Singh, Saurabh Singh, Sanjay Singh, Sarthak Uttam
      Pages: 73 - 78
      Abstract: Background: Diabetic foot ulcer disease is one of the most common complications of diabetes, especially in developing nations like India. Management and successful treatment of diabetic ulcers have been under rigorous research and interventions for the past few decades now. This study is an attempt to analyze the effects of a relatively newer treatment modality for diabetic foot ulcers. Aims and Objectives: The primary objective of this study was to determine results after treating patients of diabetic foot ulcers with local insulin injection therapy and compare with the placebo group after 1 week of treatment. Materials and Methods: In this study, 50 patients with diabetic foot ulcer disease were enrolled, of which 25 patients were randomly selected for the intervention group and the rest were kept in a control group. In the intervention group, patients were treated by injecting insulin preparation at the ulcer site whereas in control group, normal saline was used. Wound assessment was done by measuring the ulcer size and by determining the ankle peak systolic velocity (APSV) using color Doppler technique before and after the treatment in both intervention and control groups. Results: Mean ulcer size before the treatment (7.19 cm2) was higher than post-treatment size (3.48 cm2) and the difference was statistically highly significant (P=0.00) while there was no significant difference in ulcer size post-treatment by insulin or non-insulin (normal saline) group (P=0.274). Mean APSV before the treatment (30.75 cm/s) was lower than post-treatment velocity (43.50 cm/s) and the difference was statistically highly significant (P=0.00) while there was no significant difference in APSV post-treatment by insulin or non-insulin (normal saline) group (P=0.061). Conclusion: It meant that insulin and normal saline were equally effective in reducing ulcer size and improving APSV without being superior to one another.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.44757
      Issue No: Vol. 13, No. 12 (2022)
  • Chronic prostatic inflammation as a prognostic marker for post-operative
           improvement in clinical parameters after transurethral resection of

    • Authors: Venkatesh Velivela, Ifrah Ahmad Qazi, Tappa Mahammad Mustaqrasool, Vedamurthy Reddy Pogula, Sandeep Kumar Reddy
      Pages: 79 - 84
      Abstract: Background: Medical therapy of prostatic symptoms and reduce study on benign prostatic hyperplasia (BPH) recently demonstrated a link between histological prostatic inflammation and prostate enlargement or symptoms scores. Aims and Objectives: Prognostication of symptoms of lower urinary tract based on pathological diagnosis following transurethral resection of prostate (TURP). Materials and Methods: This was a prospective observational study. A total of 60 BPH patients who underwent TURP were studied; 30 patients in each group, BPH without inflammation (Group I), and BPH with inflammation (Group II). Pre-operative and post-operative international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), and uroflowmetry were compared in both groups. Chronic prostatic inflammation was assessed by the grade (lymphocyte density), extent (lymphocyte distribution), and location of inflammation. Results: The prostate volume was significantly higher in Group II as compared to Group I (53.2±1.29 vs. 50.87±1.48). The improvement in IPSS and OABSS in each group, before and after surgery, was significant but the between-group difference was not significant. The post-operative voided volume (in ml) in Group I was 273.27±52.34 and in Group II, it was 289.47±34.25 (P=0.03). The post-operative post-void residual volume (in ml) was 21.97±2.55 in Group I and 13.28±2.11 in Group II (P=0.017). The post-operative Qmax (ml/s) in Group I was 15.41±2.1 and in Group II it was 19.28±2.11. (P=0.041). Conclusion: Surgical resection of the prostate helps in a higher degree of improvement in post-operative clinical parameters in BPH patients with inflammation.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47647
      Issue No: Vol. 13, No. 12 (2022)
  • Assessment of Vitamin D3 level in patients of rheumatoid arthritis and its
           relationship with disease activity using DAS 28-CRP in tertiary care
           center of Bihar, India

    • Authors: Poonam Sinha, Rekha Kumari, Ritesh Runu, Sudhir Kumar, Ranjay Kumar Ranjan, Ravi Shekhar, Jiut Ram Keshari, Sweta Kumari
      Pages: 85 - 91
      Abstract: Background: Rheumatoid arthritis (RA) is most common type of inflammatory arthritis. It is chronic autoimmune disease that affects joints as well as extra-articular structures. The prevalence of this condition could be due to both genetic and non-genetic factors (e.g., environmental, viral, and hormonal). Aims and Objectives: The aim of the study was to determine and correlate 25(OH) D level with disease severity in patients of RA. Materials and Methods: The prospective observational study consists of 70 patients of RA and 70 healthy controls. Assessed level of 25(OH) D, C-reactive protein (CRP), anti-cyclic citrullinated peptide (CCP), erythrocyte sedimentation rate (ESR), and Disease Activity Score (DAS) 28-CRP score were compared in both cases and controls. Correlation of Vitamin D level with parameters such as CRP, Anti-CCP, and ESR was performed. Correlation between Vitamin D level deficiency and disease activity among the RA patients was assessed. Results: The mean age of patients in the RA group was 37.77±13.31 years. The mean CRP in cases was 40.57±25.94 mg/L and in controls was 3.26±1.95 mg/L with significant intergroup difference (P<0.001). The mean anti-CCP in cases was 62.18±27.21 U/mL and in controls was 4.99±1.52 U/mL with significant intergroup difference (P<0.001). The mean 25(OH) D level in cases was 12.65±5.88 and in controls was 32.18±10.22. The 25(OH) D was significantly decreased in cases than controls (P<0.001). A significant inverse relationship between serum 25(OH) D levels and DAS28 was observed. Receiver operating characteristic (ROC) curves results showed that 25(OH) D<11.7 ng/mL indicates severe disease activity (Area under ROC curve=84%, Sensitivity 77.78%, and specificity 83.33%,). 25(OH) D between 11.7 ng/mL and 19.83 ng/mL indicates moderate disease activity. 25(OH) D˃19.83 ng/mL indicates low disease activity value below 4.13 is alarming situation. Conclusion: The study reveals high prevalence of Vitamin D deficiency and insufficiency in RA patients. There is also significant inverse correlation exist between serum Vitamin D levels and RA disease activity. Vitamin D level is good disease activity predictor in patients of RA.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46979
      Issue No: Vol. 13, No. 12 (2022)
  • Serum neuron-specific enolase as a biomarker in diagnosing diabetic
           peripheral neuropathy: A cross-sectional study

    • Authors: Sangeetha Kandasamy, Babu Krishnan, Shivkumar Gopalakrishnan, Harissh Ganesan
      Pages: 92 - 96
      Abstract: Background: Diabetic peripheral neuropathy remains asymptomatic until the late stages. Hence, a need exists for a reliable and sensitive biomarker for the early diagnosis of diabetic peripheral neuropathy. Aims and Objectives: This study aimed to evaluate serum neuron-specific enolase (NSE) reliability as a biomarker in diagnosing diabetic peripheral neuropathy. Materials and Methods: In the department of biochemistry and internal medicine, a cross-sectional study was conducted at Government Villupuram Medical College from May 2018 to January 2020. One hundred diabetes patients with peripheral neuropathy were compared with 100 patients without peripheral neuropathy. A diabetic neuropathy symptom (DNS) questionnaire and diabetic neuropathy examination (DNE) score were used for diagnosis. In addition, vibration position sense and NSE values were compared between the two groups. For statistical analysis, R studio and coGuide were used. Results: Comparisons between groups were based on age, sex, and other baseline parameters. Statistically, significance was observed between the two groups in outcome parameters such as VPB (right), VPB (left), and DNS (P<0.05). There was a weak positive correlation between NSE and DNS (rs value: 0.514, P<0.001). On the other hand, there was a strong positive correlation between NSE and DNE (rs value: 0.937, P<0.001). The NSE of 6.50 and above had a sensitivity of 53% (95%CI 42.76–63.06%) and specificity of 57% (95% CI 46.71–66.86%). Conclusion: NSE acts as a biomarker for diabetic peripheral neuropathy. Therefore, NSE can be used for the early diagnosis of diabetic peripheral neuropathy, thereby preventing a severe form of the disease.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46183
      Issue No: Vol. 13, No. 12 (2022)
  • Evaluation of toxic effects of Coleus forskohlii extract on various body
           organs of experimental animals-rats

    • Authors: Haritha Yadav KC, Yakaiah Vangoori, Suresh Babu Sayana
      Pages: 97 - 103
      Abstract: Background: The study aimed observation of pharmacological actions and any adverse effects on various body organs of rats with Coleus forskohlii (CF) extract. Aims and Objectives: The present study was undertaken to evaluate toxic effects of CF extract in experiments animals. Materials and Methods: In the single-dose oral toxicity study, groups of five healthy male and female rats were dosed orally with CF extract at 2000mg/kg BW as per organization of economic cooperation and development guidelines and were observed once daily for 14 consecutive days for toxicity, general behavior, and pharmacological effects. In sub-acute oral toxicity, the test substance was administered for 28 days with daily doses of 200, 400, and 800 mg/kg body weight. In subacute oral toxicity study, groups of five male and five female rats were subjected to 10% forskolin for 28 days. Initially autonomic symptoms (gross behavioral study), followed by hematological, biochemical, and histological parameters, were evaluated. Results: No deaths were reported in all the toxicity studies performed. No significant changes were observed in the hematology and serum biochemistry values from the control group animals. The body weight changes and necropsy results were normal. There was no apparent progression of organ damage in any of these toxicity tests. Furthermore, CF extract did not produce any significant toxic effects in Wistar rats at 2000 mg/kg body weight and had no potential to induce organ damage. Conclusion: The “no observed adverse effect level” of CF extract was determined up to 2000 mg/kg.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.49018
      Issue No: Vol. 13, No. 12 (2022)
  • Screening of aqueous extract of fenugreek seeds for its anti-inflammatory
           potential in albino rats

    • Authors: Brahadeesh Mayathevar
      Pages: 104 - 110
      Abstract: Background: Inflammation is a common defense mechanism that involves a complicated network of cell-cell, cell-mediator, and tissue interaction. Fenugreek (Trigonella foenumgraecum L.) seeds are used for the treatment of many inflammatory conditions. Aims and Objectives: The aim of the study was to analyze the anti-inflammatory properties of aqueous extracts of fenugreek seeds in albino rats and compare it to control and standard anti-inflammatory treatments in animal models of acute and chronic inflammation. Materials and Methods: The methods employed to study the anti-inflammatory activity are carrageenan-induced rat paw edema and turpentine induced arthritis model in rats for acute inflammatory model and cotton wool pellet granuloma in rats for chronic inflammatory model
      following acquisition of the Institutional Ethics Committee approval. The control group was given 1% gum acacia, standard group was given 10 mg/kg Indomethacin dissolved in distilled water and test group was given 200 mg/kg of aqueous extract of fenugreek seeds suspended in 1% gum acacia orally. Results: The test group displayed almost equal increase in paw volume edema as that of the standard group under experimental conditions. In Carrageenan-induced rat paw edema model and turpentine induced arthritis model, aqueous extract of fenugreek seeds and indomethacin had comparable anti-inflammatory effect. The anti-granuloma effect of aqueous extract of fenugreek seeds was of moderate degree compared to the standard under the present experimental conditions. Conclusion: When compared to standard indomethacin, the aqueous extract of fenugreek seeds demonstrated significant anti-inflammatory activity in acute models of inflammation and moderate activity in chronic models of inflammation.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47403
      Issue No: Vol. 13, No. 12 (2022)
  • Study of clinical profile and pattern of stroke in diabetic and
           non-diabetic patients in a hospital of Kumaon region

    • Authors: Deepali Joshi , Mohd Maroof, Subhash Chandra Joshi, Vivekanand Satyawali
      Pages: 111 - 116
      Abstract: Background: Diabetes enhances the risk of stroke which is one of the leading causes of morbidity and mortality. Aims and Objectives: The study was done to analyze the clinical profile and pattern of stroke in diabetic and non-diabetic patients. Materials and Methods: This was a hospital-based cross-sectional study done in 130 stroke patients (with/without diabetes – 65 each) presenting to outpatient department\inpatient department general medicine department, Dr. Sushila Tiwari Hospital of Government Medical College, Haldwani during January 2020–September 2021. A detailed history, neurological examination along with assessment of risk factors, pattern, and subtype were done. Results: The mean age was significantly higher among stroke patients with diabetes (66.38±11.99 years). The proportion of systemic hypertension was significantly higher in stroke patients without diabetes (89.2%). Abnormal ECG was significantly more reported in stroke patients without diabetes (73.8%). The mean hemoglobin and mean random blood sugar were significantly higher in stroke patients with diabetes (8.82±1.72 and 291.17±107.39, respectively). The mean high-density lipoprotein was significantly higher in stroke patients without diabetes (43.06±5.1), whereas mean low-density lipoprotein, mean triglycerides, and mean total cholesterol were significantly higher in stroke patients with diabetes (126.28±33.19; 186.97±45.91; and 229.31±39.83, respectively). The presenting complaints observed were altered consciousness (67.7%) right hemiparesis (55.4%), left hemiparesis (41.5%), abnormal body movement (28.5%), etc. Ischemic stroke was significantly higher in patients with diabetes (90.8%). Lacunar (34%), basal ganglia (27%), cortical (23%), etc., were stroke subtypes seen among study patients. Conclusion: Significant difference was observed between stroke patients with/without diabetes in terms of age, several risk factors, presenting symptoms, pattern, and its subtype.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46668
      Issue No: Vol. 13, No. 12 (2022)
  • A study on incidence of stress hyperglycemia in acute ischemic stroke in
           non-diabetic patients and its prognostic significance

    • Authors: Habibur Rahaman, Soumyasil Das, Angan Karmakar, Linkon Biswas, Subrata Kumar Pal
      Pages: 117 - 122
      Abstract: Background: Hyperglycemia detected during acute illness-like ischemic stroke is associated with adverse outcomes more than in normoglycemic patients. However,very limited data regarding stress hyperglycemia and its prognostic value are available for our Indian population. Aims and Objectives: This study was aimed at comparing the stress hyperglycemic and normoglycemic patients in terms of mortality and functional recovery during 28 days follow-up assessed by the Barthel index for Activities of Daily Living. Materials and Methods: Adult non-diabetic patients with ischemic stroke were assessed for random venous blood glucose and HbA1c levels and divided into two groups: Patients with hyperglycemia and normoglycemia. The Barthel Index for Activities of Daily Living was used to compare mortality and functional recovery on the day of admission, day 3, and day 28 after stroke. Results: Mortality over the 28 days follow-up was significantly higher in hyperglycemic patients (45% vs. 20%,P=0.02). The Barthel Index score on admission (day 0) was 8.75±7.41 among stress hyperglycemic patient whereas it was13.54±11.12 among normoglycemic patient, which was significantly different (P=0.028). Similarly, day 3 (18.89±6.08 vs. 23.26±13.05, P<0.05) and day 28 scores (83.24±7.49 vs. 84.55±12.84, P=0.039) were significantly better in normoglycemic patients. Conclusion: The mortality rate was much higher and functional recovery was much poorer in stress hyperglycemic patients. Further studies should be directed toward determining complications in long-term follow-up related to stress hyperglycemia and the effects of management on patient outcome.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47436
      Issue No: Vol. 13, No. 12 (2022)
  • A study to observe the association of pupil-to-limbus diameter ratio with
           blood pressure and pulse rate in type 2 diabetic patients

    • Authors: Yuvraj Subramani Sagadevan, Shyma Parapurath, Sai Sailesh kumar Goothy, Anita Choudhary, Rohit Singh Chouhan
      Pages: 123 - 126
      Abstract: Background: Understanding the autonomic activity in the early hand helps to begin with effective treatment for the benefit of the individual with type 2 diabetes. Aims and Objectives: The present study was undertaken to observe the association of pupil-to-limbus diameter ratio with blood pressure and pulse rate in type 2 diabetic patients. Materials and Methods: A total of 100 participants with type 2 diabetes were part of the study after obtaining written, voluntary, and informed consent. Recording of the pupil-to-limbus diameter (PLD) ratio was performed using two box method which is a standard method mentioned in the literature. Blood pressure and pulse rate were used using a diamond digital sphygmomanometer (BPDG024). Results: There was a significant (P<0.00001) positive correlation between the PLD ratio of the right eye and pulse rate. There was a significant (P<0.05) negative correlation between the PLD ratio of the right eye and systolic blood pressure (SBP). There was a significant (P<0.05) negative correlation between the PLD ratio of the right eye and diastolic blood pressure (DBP). There was a significant (P<0.00001) positive correlation between the PLD ratio of the left eye and pulse rate. There was a significant (P=0.000076) negative correlation between the PLD ratio of the left eye and SBP. There was a significant (P=0.000458) negative correlation between the PLD ratio of the left eye and DBP. Conclusion: The study results revealed a significant positive correlation between the PLD ratio of the right and left eye with the pulse rate. There was a significant negative correlation between the PLD ratio of the right and left eye with both systolic and DBP.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47278
      Issue No: Vol. 13, No. 12 (2022)
  • Study on coagulation profile in women with pregnancy-induced hypertension
           in South Indian population

    • Authors: Arjun Shekar, Lokesh Mustoor Raman, Shivakumar Pujari, Prashanthkumar Goudappala
      Pages: 127 - 130
      Abstract: Background: Pregnancy-induced hypertension (PIH) complicates about 6–10% of pregnancies around the world. According to the WHO, PIH is one of the leading causes of maternal, fetal, and neonatal mortality and morbidity. PIH causes many hematological aberrations in women and any abnormalities in the coagulation of blood lead to hemorrhages. Aims and Objectives: The objectives of this study were as follows: 1. To study the coagulation profile which includes platelet count, bleeding time (BT), clotting time, prothrombin time, and activated partial thromboplastin time (aPTT) in PIH patients. 2. To compare the above parameters between the normal pregnant subjects and pregnancy-induced hypertensive patients. 3. To compare the above parameters between preeclampsia (PE) and eclampsia patients. Materials and Methods: A cross-sectional study was conducted on 120 pregnant women. Among them, 60 patients (Cases) who were diagnosed with PIH, and another 60 (controls) having age and anthropometrically-matched healthy pregnant women were taken as control. Their coagulation profile, which includes total platelet count (TPC), prothrombin time (PT), aPTT coagulation time (CT), and BT were studied. The parameters were compared using Student’s t-test. Results: There was a significantly lower TPC, and increased PT, aPTT, CT, and BT in women with PIH when compared to normal pregnant women. However, there was no significant difference between women with PE and eclampsia. Conclusion: The present study shows significant changes in coagulation profile in women with PIH.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.48624
      Issue No: Vol. 13, No. 12 (2022)
  • To evaluate the efficacy and safety of intravenous ferrous carboxymaltose
           compared with Iron sucrose in treating iron deficiency anemia in
           postpartum period

    • Authors: Akriti Gupta, Ashkrit Gupta, Uttara Gupta, Anand Gupta
      Pages: 131 - 137
      Abstract: Background: Iron deficiency anemia continues to be a serious problem in developing countries resulting in spectrum of adverse events in pregnant women. The first choice for prophylaxis and treatment of mild IDA in pregnancy is oral iron therapy. However, in patients with moderate and severe anemia, oral therapy takes very long time and compliance could be a big issue in our country. Thus, pregnant women with moderate anemia should be better treated with parenteral iron therapy. Postpartum women were eligible for the study with hemoglobin level <10 g/dl, while those with sickle cell anemia, aplastic anemia, megaloblastic anemia, etc., or having allergy to parental iron were considered not eligible for this study. The eligible women were randomly categorized to receive intravenous iron sucrose and intravenous ferrous carboxymaltose. Aims and Objectives: (1) To Compare ferrous carboxymaltose with iron sucrose in treating iron deficiency anemia in postpartum period (2) To assess the adverse effects and patient compliance. Materials and Methods: A comparative, prospective, and randomized distributed in 50 patients within the Department of Obstetrics and Gynecology, MGM Medical College and Hospital, Navi Mumbai. The subjects were randomized into two group, first group receiving iron sucrose, whereas second group receiving ferrous carboxymaltose. Results: Study, 25 women received iron sucrose and 25 women received ferrous carboxymaltose. There was significant higher increase in hemoglobin levels at 6 weeks in ferric carboxymaltose (FCM) group as compared iron sucrose group hemoglobin levels. There was significant higher increase in ferritin levels at 2 and 6 weeks in FCM group as compared iron sucrose group hemoglobin levels. There was significant higher increase in reticulocyte count at 6 week in FCM group as compared iron sucrose group reticulocyte count. Conclusion: Ferric carboxymaltose is safe and efficient in treatment of iron deficiency anemia in postpartum women as compared to iron sucrose with lesser adverse effect and better patient compliance.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i11.45461
      Issue No: Vol. 13, No. 12 (2022)
  • Assessment of right atrial function in inferior wall AMI

    • Authors: Abhijit Das, Lipika Adhikari, Sandip Sarkar
      Pages: 138 - 143
      Abstract: Background: Approximately 30–50% of patients with inferior infarction have some involvement of the right ventricle. The right ventricular (RV) infarction almost invariably develops in association with a large infarction of the adjacent septum and inferior 0 walls, but isolated infarction of the right ventricle is seen in just 3–5% of autopsy-proven cases of MI. This study is designed to assess the right atrial (RA) functions in inferior wall acute myocardial infarction (AMI) (IWMI) echocardiographically and to compare it with patients who do not have history of ischemic heart disease (IHD) but having risk factors for IHD. Aims and Objectives: The aims of this study were to study the patients presenting with Inferior wall MI IWMI for RA function. Materials and Methods: Patients admitted in the Cardiology ward of R G Kar Medical College and Hospital with IWMI from March 2020 to March 2022 were included in the study. Results: Average Measurement of RA volume index (RAVI) and RA Pressure (RAP) was highest among patients with IWMI+RV myocardial infarction (RVMI). Out of 100 IWMI patients, 33 had high RAVI and RAP and out of 100 non-IHD patients none had high RAVI. Conclusion: In our study, there was no statistically significant difference in average RAVI and RAP in patients presenting with IWMI and in patients with risk factors for myocardial infarction but without AMI. However, patients presented with IWMI+RVMI showed statistically significant increased RAVI and RAP as compared to inferior wall AMI only.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46788
      Issue No: Vol. 13, No. 12 (2022)
  • Leprosy in posteradication era – A clinicopathological correlation: How
           far we have achieved'

    • Authors: Deepti Gangwar, Amitosh Mishra, Sara Siddiqui, Sangeeta Bohara, Bushra Khanam
      Pages: 144 - 148
      Abstract: Background: Leprosy or “Hansen Disease” is chronic inflammatory disease caused by Mycobacterium leprae. This disease is the oldest disease known to mankind. Leprosy is also known as “Kushtaroga.”. Leprosy was considered as an eradicated disease in 2005 but still a large number of leprosy cases are being reported in India. Aims and Objectives: The aim of the study was to demonstrate that leprosy even being eradicated continuous to be a major health concern with changing trends. Materials and Methods: This study is a a hospital-based crossectional study; it involves all new patients of leprosy attending dermatology O.P.D HIMS, Safedabad, Barabanki, U.P. from 2015 to 2016. The cases were classified as per Ridley – jopling classification. Skin biopsies were taken from all clinically suspected cases of leprosy and these biopsies were studied using H&E stain. Results: In our study, 53 leprosy cases were registered from April 2015 to April 2016. According to demographic details of leprosy cases, maximum number of cases were in the age group 31–40 years 38.9% and in individuals <20 years 10.5%. Majority of cases were males (11.3%). The family history of leprosy was present in 9.4% of patients. Hypopigmented lesion on skin was most common symptom (32.1%). TT was most common clinical diagnosis (26.4%). IL was common histopathological diagnosis (26.4%). Atrophy of epidermis was seen in 50.9% of patients. Paucibacillary was seen in 62.3% of patients. Most of the cases were from Safedabad. Conclusion: Leprosy although reported to be eradicated still continues to be one of the common communicable disease in Uttar Pradesh, India. This necessitates to strengthen screening of cases, early detection, and revival of our knowledge regarding the disease.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46493
      Issue No: Vol. 13, No. 12 (2022)
  • A cross-sectional study on burden of disability among leprosy patients in
           a tertiary care center of West Bengal, India

    • Authors: Shibasish Banerjee, Chinmay Nandi, Soumitra Mondal, Kaushik Mitra
      Pages: 149 - 156
      Abstract: Background: Leprosy, an infectious disease caused by Mycobacterium leprae, mainly affects skin, peripheral nerves, mucosa of the upper respiratory tract, and eyes. New goal of the WHO is to decrease the rate of disabilities in new cases among 10 lakhs population 35% with compare to base line 2010. Burden of disabilities continues to rise in society and they are in need of prevention and/or rehabilitation services. Prevention of disability consists of early detection and treatment of reactions and nerve damage. Aims and Objectives: The objectives of the study were to find out the proportion of disability among leprosy cases and the factors associated with disability. Materials and Methods: This observational, cross-sectional, and descriptive study was conducted at Dermatology, Venerology, and Leprosy Department of a tertiary hospital from May 2015 to January 2016. Data were collected from all the study population by interviewing the study subjects and clinical examination of patients with pre-designed and pre-tested schedule and disability assessment form available from National leprosy eradication program (NLEP). Skin examination was done as per NLEP guideline and palpation of all the nerve and function of the nerve by voluntary muscle testing (VMT) done as stated national guideline. Data were analyzed using R Studio. Results: Among the study population, 87.9% of patients had disability and 61.7% of patients had Grade 2 disability. EHF score of most of the patients (59.8%) was ranged between 4 and 6. Among participants 33.6% had foot ulcer, 28% had ulnar claw hand, and 15.6% had lagophthalmos. Proportions of the upper limb digit loss, median claw hand, wrist drop, foot drop, and lower limb digit loss were 5.6%, 13.1%, 3.7%, 9.3%, and 12.1%, respectively. Conclusion: The present study reflected that a large number of cases with leprosy have presented with complication and disability. There was significant association of disability with multibacillary cases, number of nerve thickening, and number of functionally impaired nerve as assessed by VMT, lepra reaction, presence of nodular skin lesion and patch in skin and delayed initiation of treatment since the onset of symptoms.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.48487
      Issue No: Vol. 13, No. 12 (2022)
  • Facial indicator in the determination of maxillary central incisor length
           in Nepalese population – A clinical study

    • Authors: Suraksha Shrestha, Santosh Kumar Yadav
      Pages: 157 - 161
      Abstract: Background: The maxillary anterior teeth are important in achieving pleasing facial and dental esthetics. Among those, the central incisor has a key role in determining the esthetic as they are the most dominant and visible teeth during smile. Determining the proper size of these teeth is important but difficult in the absence of pre extraction records in edentulous condition. Aims and Objectives: This study was conducted to find a suitable guide in determining the length of the central incisor by correlating it with some independent facial structure like nose length in a small population of Chitwan district. Materials and Methods: The distance from the bridge of the nose to the base was compared to the length of the maxillary central incisor in 321 patients of both sexes between the age groups of 20–35 years. The actual length of the maxillary incisor was measured and also calculated by regression analysis to determine some fixed ratio. The calculated value by this ratio was compared to the actual measured value to find if the difference was significant. Results: The difference between the calculated distances and the actual measured distance was found to be 0.340 in males and 0.266 in females, which was statistically significant (P<0.001). Conclusion: The distance from the bridge of the nose to base of the nose may be used as a reference to estimate the length of the central incisor in the Nepalese population, although sample included subjects from the central Chitwan District of Nepal.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.32207
      Issue No: Vol. 13, No. 12 (2022)
  • Dengue infection in Agra region, Uttar Pradesh: An observational study of
           seroprevalence, clinicoepidemiological profile, and serotype of dengue
           virus from tertiary care center

    • Authors: Vikas Kumar, Mridul Chaturvedi, Arti Agrawal, Geetu Singh, Pavan Maurya, Ankur Goyal, Sanjeev Kumar
      Pages: 162 - 168
      Abstract: Background: Dengue is the most widespread mosquito-borne viral infection, found in tropical and subtropical climates worldwide. The World Health Organization has included dengue as one of the 10 threats to global health in 2019 with rapidly evolving epidemiology. Aims and Objectives: Given the limitation of data in regard to dengue burden, we have planned the present study with the objectives to provide a comprehensive overview of the seroprevalence, clinicoepidemiological profile, and serotype of dengue virus in Agra region of Uttar Pradesh. Materials and Methods: We conducted an observational study at viral diagnostic and research laboratory, Sarojini Naidu Medical College, Agra, Uttar Pradesh, from August to December 2021. Our study included all blood specimens received at virology laboratory from clinically suspected cases of dengue infection. For the identification of serotype, NS1-positive samples were sent to King Georges Medical University, Lucknow. For clinical-epidemiological profile of dengue positive patients, data were obtained from records of 203 patients from our hospital. Results: We received total of 5457 serum samples from suspected patients for dengue serology during the study period. In total, positivity rate was 27.29% (1489/5457) and peak of cases was reported in month of October. Median age of dengue positive cases was 17 years. Dengue hemorrhagic fever (DHS) was diagnosed in almost 41% of patients of 203 patients admitted in our hospital. DEN-2 was reported to be most common serotype (97.1%). In our analsyis, we found that in most patients fall in platelets levels below 50,000 happened during the 5th and 6th day in Dengue fever. Conclusion: We conclude that our study showed higher seroprevalence of dengue in Agra region with the age group of 0–20 years being infected most. DEN-2 was most prevalent circulating strain, which leads to more severe dengue infection.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47909
      Issue No: Vol. 13, No. 12 (2022)
  • Study of computer vision syndrome among medical undergraduates of Kumaon
           region, Uttarakhand

    • Authors: Mohd Maroof, Mohd Masjood, Preeti, Mohd Najmul Aqib Khan, Sadhana Awasthi, Shanti Pandey
      Pages: 169 - 173
      Abstract: Background: Activity on digital screen has increased so much during the COVID era that there is surge in persons complaining of symptoms of computer vision syndrome (CVS). Aims and Objectives: The aim of the study was to determine the prevalence of CVS among the medical students and its associated factors during COVID period and to compare it with pre-COVID period. Materials and Methods: A cross-sectional study was conducted among 337 undergraduate medical students at Government Medical College, Haldwani, Uttarakhand using pretested structured questionnaire which was filled through Google form for which link was circulated in class WhatsApp group. Data were analyzed using SPSS version 16. Frequency, percentage, binary logistic regression, and McNemar test was applied. P<0.05 was considered significant. Results: The prevalence of CVS was significantly higher during COVID period, 54.9% (95% CI=49.7–60.1) that was significantly higher than non-COVID period. Eye strain (16.6%) was the most common CVS symptom during both pre-COVID and COVID period. The prevalence of CVS was significantly associated with use of preventive measures. During COVID period, average hours spent in digital screen was significantly higher as compared to non-COVID period. Conclusion: This study showed that there was increase in CVS among the study participants during COVID era as there was increase in spending hours on digital screen and not or reduction in adopting preventive measures. It is important to increase awareness regarding the symptoms and precautions related to CVS.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46351
      Issue No: Vol. 13, No. 12 (2022)
  • A study to assess the prevalence of anemia among patients attending an
           urban health training center in Bihar: One year experience of anemia Mukt
           Bharat test and treat campaign

    • Authors: Neha Chaudhary, Purushottam Kumar, Haripriya Hari, Rubina Saha, Shamshad Ahmad, Pragya Kumar, Asiff Nathi Aneef
      Pages: 174 - 178
      Abstract: Background: Anemia is a major and serious public health problem. Its prevalence is disproportionately high in developing countries due to its low socio-economic status and poor access to health services. Consequently, this study was conducted to sought the prevalence of anemia as well as its association with the sociodemographic characteristics among the beneficiaries of Anemia Mukt Bharat test and treat campaign in an Urban Health Training Centre in Bihar. Aims and Objectives: The aim of the study was to assess the prevalence of anemia among patients attending an Urban health training center in Bihar. Materials and Methods: It was a retrospective record based study conducted at Urban Health Training Centre running under Department of Community and Family Medicine of a Tertiary care teaching hospital. The registered cases from September 2018 to August 2019 were taken up and case records were retrieved. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS Inc., Chicago, State of Illinois, United States) version 21 software. Results: Screening of total 2042 was done over the study period of 1 year. The overall prevalence of anemia among the beneficiaries was 64.3% (95% CI: 62.3–66.5%) in the study. Significantly higher prevalence of anemia was noted among the adolescent girls (62.5%), pregnant women (62.4%), and reproductive age female (71.1%). Whereas, only 32.3% male were found to be anemic. Furthermore, illiteracy (73.5%), non-consumption of non-vegetarian diet (69.3%), and IFA tablet (84.6%) were found to be associated with anemia. Conclusion: The association of anemia with few socio demographic and dietary factors has been highlighted through the study findings. Screening programs for anemia, awareness campaigns, deworming program, fortification of food and salt with iron and folic acid, and non-pharmacological interventions such as cooking in iron utensils are some of the measures that can be implemented.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46835
      Issue No: Vol. 13, No. 12 (2022)
  • A comparison of treatment outcomes for levofloxacin versus doxycycline
           plus metronidazole for first-line treatment of uncomplicated pelvic
           inflammatory disease

    • Authors: Ritam De, Kajal Kumar Patra, Asoke Goswami, Barnali Maiti, Shubham Bhattacharya
      Pages: 179 - 184
      Abstract: Background: Pelvic inflammatory disease (PID), a common condition among women of reproductive age caused by various aerobic and anaerobic organisms, may sometimes lead to complications such as infertility, ectopic pregnancy, and chronic pelvic pain. Moxifloxacin is a broad-spectrum bactericidal acting against many Gram-positive, Gram-negative aerobic organisms and anaerobes. Rapid absorption and high bioavailability allow single daily dosing and improves compliance. Aims and Objectives: The present study was done to compare the treatment outcomes for levofloxacin versus doxycycline plus metronidazole for first-line treatment of uncomplicated in PID patients. Materials and Methods: This was hospital-based prospective, randomized, double-blind study conducted at gynecology outpatient department of Gouri Devi Institute of Medical Sciences and Hospital, Durgapur, West Bengal, from January 2019 to December 2019. The study group was divided into Group A 50 cases (receiving levofloxacin) and Group B 50 cases (receiving doxycycline plus metronidazole) were included in the study. Template was generated and analysis was done on SPSS software. Results: Among 50 patients of each group, mean age of the patients of Group A was 27.80 (±3.58) and mean age of Group B was 27.57 (±4.51). Mean parity of the patients of Group A was 1.93 (±1.11) and mean parity of Group B was 2.07 (±1.11). Past H/O PID in Group A was 17 and in Group B was 19. Visual analog scale (VAS) pain score of Group A was 3.80 (±1.827) and VAS pain score of Group B was 3.97 (±1.671). VAS pain score was 1.10 (±0.960) in Group A and 2.63 (±1.426) in Group B. VAS vaginal discharge was 1.40 (±1.276) in Group A and 3.00 (±1.619) in Group B. Conclusion: The management of uncomplicated PID requires broad-spectrum antibiotic regimens to cover all potential pathogens. This study confirmed that fluoroquinolones, specifically levofloxacin, are effective and well tolerated in the treatment of uncomplicated PID.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47518
      Issue No: Vol. 13, No. 12 (2022)
  • Is supine percutaneous nephrolithotomy an alternative to prone
           percutaneous nephrolithotomy' Our experience at a tertiary care center

    • Authors: Nekkanti Rahul, Sandeep Kumar Reddy, Ifrah Ahmad Qazi, Vedamurthy Reddy Pogula, Venkatesh Velivela, Kashinath V Thakre
      Pages: 185 - 191
      Abstract: Background: Majority of urologists prefer the usual prone position for percutaneous nephrolithotomy (PCNL) but due to various disadvantages of prone PCNL, several alternative positions are being used. Aims and Objectives: The aim of the study was to compare the surgical outcomes of PCNL performed using supine position with those performed in the prone position. Materials and Methods: This was a prospective and observational study. After applying inclusion criteria, 60 renal calculi patients were randomly assigned to two groups, each with 30 patients, all demographic, operative, and post-operative characteristics were recorded. Results: Out of 60 patients, 38 (63%) patients were male and 22 (37%) were female. The mean age (in years) in prone PCNL was 45.03±17 while in supine, it was 51.7±15. Forty patients had mild, 12 had moderate, and eight had gross hydronephrosis. Stone size (mm) ranged from 20 to 55 with a mean stone size of 22.5±8.8 in prone PCNL and 23.9±13.5 in supine PCNL. The mean operative time (minutes) was 65.1±27.2 in prone PCNL and 68.7±16 in supine PCNL (P=0.068). Complete stone clearance was seen in 26 (86%) patients in prone PCNL versus 25 (83%) patients in supine PCNL. Five patients in supine PCNL had Grade 1–2 complications. There were no serious complications in either group. The mean post-operative hospital stay (days) was 3.53 in prone PCNL versus 3.63 in supine PCNL, (P=0.715). Conclusion: Supine PCNL is an effective and safe procedure with similar operative time, stone-free rate, and complications to prone PCNL.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.45934
      Issue No: Vol. 13, No. 12 (2022)
  • Analysis of burden and outcomes of anti-tuberculosis therapy-induced
           adverse drug effects at a tertiary care center

    • Authors: Kavita Joshi, Arnav Tongaonkar, Alhad Mulkalwar, Aman Goyal
      Pages: 192 - 198
      Abstract: Background: Tuberculosis (TB), one of the most ancient diseases known to mankind, is one of the ten major causes of mortality worldwide. Combinations of antibiotics, called anti-TB therapy (ATT), are given for a period of six months or more as treatment. Aims and Objectives: The aim of this study was to assess the incidence of adverse drug reactions (ADRs), clinical profile, severity and causality among the admitted patients taking ATT in a tertiary care hospital. Materials and Methods: This was a hospital-based, prospective, observational and non-interventional cohort study undertaken in the General Medicine wards of the hospital. This study was conducted from June 2017 to December 2018. The Patients’ data was recorded using a structured ADR reporting form. The baseline parameters, medical history and details of underlying diseases, clinical data, characteristics of ADRs and details of medication responsible for ADRs as well as medication for treatment of ADRs were recorded. The data was analyzed using descriptive statistics with the Statistical Packages for the Social Sciences (SPSS) version 26.0 software. Results: Out of the 164 patients admitted due to ADRs within the study period, 45 (27.4%) developed ADRs due to anti-TB treatment. Most ATT-related ADRs involved the liver (n=39). The severity of ADR was found to be mild in two patients (4.4%), moderate in 28 patients (62.5%) and severe in 15 patients (33.3%). 16 patients (35.6%) completely recovered, 23 patients (51.1%) were still recovering (at the time of the analysis of the data), one patient (2.2%) did not recover and five patients (11.1%) had a fatal outcome. The presence of systemic comorbidities and polypharmacy was found to be a significant risk factor associated with ATT associated ADRs. Conclusion: ATT is not without its side effects. About 27.4% of the patients on ATT in our study developed ADRs, a few resulting in fatality. Educating the patients about possible ADRs associated with ATT at the time of prescription can improve patient compliance and strengthen the doctor-patient relationship. Early diagnosis and treatment of ADRs associated with ATT is paramount. This requires a better surveillance system, which India is in a dire need for.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47517
      Issue No: Vol. 13, No. 12 (2022)
  • Ocular manifestations in HIV patients and its correlation with CD4 count
           before and after starting HAART

    • Authors: Shraddha More, Prashant More, Dhiraj Badale
      Pages: 199 - 202
      Abstract: Background: Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are a global pandemic, with cases reported from practically every country. The majority of information and studies regarding ophthalmic manifestations in India reflects the pre-HAART (highly active anti-retroviral therapy) era. India may be going through an intermediate stage, where the spectrum of the ophthalmological manifestations may be changing significantly. Aims and Objectives: The aims of this study were to study the age and gender distribution in HIV patients presenting with various ocular manifestation and to correlate the cluster of differentiation 4 (CD4) count with various ocular manifestation of AIDS. Materials and Methods: Prospective cross-sectional study was conducted on 120 patients. Ocular manifestations and WHO clinical stage of HIV were noted and CD4 count was calculated. The participants were followed up for at least 6 months on monthly basis when they come to take ART tables or as required for any ophthalmic disorder presented by patient. Any manifestation during this months was included in post HAART group. CD4 count after 6 months was taken into account in post HAART group. Results: Males predominated females. The number of males in Pre HAART was 60.8% and post-HAART 59.4%. Mean CD4 count in pre-HAART was 140.63 and post-HAART was 221.93. Majority (34 patients) in pre-HAART had CD4 count between 100 and 150, while in post-HAART, majority had count more than 200 (57 patients). Conclusion: Mean CD4 count of pre-HAART group patients raised significantly. Mean CD4 count of pre-HAART group is 140.63 with SD of 63.4, while it increased in post-HAART group to 222 which is statistically highly significant.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47368
      Issue No: Vol. 13, No. 12 (2022)
  • Clinico-epidemiological profile of childhood vitiligo: Experience from a
           tertiary care center of Northeast India

    • Authors: Swapan Majumder, Binita Singha, Animesh Sarkar, Pankaj Adhicari
      Pages: 203 - 207
      Abstract: Background: Vitiligo is a common acquired skin disease characterized by depigmented macules and patches due to loss of functional melanocytes. Childhood-onset vitiligo has distinct epidemiological and clinical characteristics as compared to that of late-onset disease. Studies on childhood vitiligo are rare from the North-eastern part of the country. Aims and Objectives: The aim of the study was to study the clinical pattern of childhood vitiligo and its systemic association. Materials and Methods: All children up to 13 years presenting with childhood vitiligo were taken as study participants. A detailed history, general physical examination, cutaneous examination including hair, nail, genitalia, mucosae, and systemic examination to note down associated diseases was done. Relevant investigations were carried out whenever necessary. Eye and ear examination was performed for each patient. The findings were recorded in a pro forma for analysis and interpretation of data. Results: A total of 2544 pediatric patients attended the dermatology outpatient department during the study period, of which 52 cases had vitiligo. Thus, the occurrence of childhood vitiligo in the outpatient pediatric population was 2.04%. The most common age group at presentation was between 5 and 10 years (29; 55.77%). The most common initial site of involvement was head and neck (27; 51.92%). Vitiligo vulgaris was the most common type seen in 26 (50%) patients. A positive family history of vitiligo was obtained in 10 (19.23%) of the vitiligo patients. Seven (13.46%) childhood vitiligo patients were reported to have other associated diseases. Conclusion: Childhood vitiligo is a common entity in this part of the country. Most patients of childhood vitiligo have a limited body surface area involvement and therefore have to be treated accordingly; avoiding systemic treatments whenever not necessary. Autoimmune and cutaneous associations are rare in childhood vitiligo, though may develop later on, lest the disease progresses.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47639
      Issue No: Vol. 13, No. 12 (2022)
  • Traumatic brain injury in pediatric patients –Clinical
           manifestations and outcome

    • Authors: Arijit Ghosh, Aniruddha Chattopadhyay , Jayanta Ghosal, Sumanta Sarkar
      Pages: 208 - 212
      Abstract: Background: Pediatric traumatic brain injury (TBI) is a global public health concern and is preventable, but there are no approved therapies to treat it definitely until date. Falls are the most frequent mode of injuries followed by road traffic accidents (RTA). Most of the TBIs have favorable outcome, though this is influenced by geographical, environmental, societal, and ethnic differences. Aims and Objectives: The aims of this study were to determine the several modes of injury, severity of injury, outcomes, and complications in the Eastern Indian population. Materials and Methods: Children-aged <18 years suffering from TBI who were attended to in Bangur Institute of Neurosciences, Institute of Post-Graduate Medical Education and Research, Kolkata, were prospectively studied for 1 year. Detailed history, clinical examinations, assessment of pupillary status, and Glasgow Coma Scale (GCS) score was recorded. Severity of TBI was done based on GCS score for each case. Computed tomography (CT) scan of head without contrast was the initial mode of neuro imaging and findings were recorded diligently. Patients were treated conservatively and surgically as required. Outcome was assessed in relation to age group, gender, initial GCS score, pupillary status, CT findings, intervention, and associated injuries. Simple statistical analysis was done. Results: Among the total 150 patients aged 1–18 years, most common mode of injury was fall in 56.66% followed by RTA in 23.33%, assault in 6.66%, and other modes such as sports, hit by object on head, and firearm injury in 13.33%. RTAs had a poor outcome in 14.29% and fall had a poor outcome in 14.12%. Poor outcome was associated with the highest (68%) being midline shift (MLS)>3 mm and it was 12.77% with MLS of <3 mm and it was 10.26% in patients with no MLS. It was noticed that chest, spinal, and multiple injuries were associated with poor outcome. Conclusion: The most important prognostic factors regarding pediatric TBI are GCS at presentation, pupillary status, associated injuries, and CT scan findings.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.44425
      Issue No: Vol. 13, No. 12 (2022)
  • Vitamin D status of children with lower respiratory tract infections and
           its correlation with severity of pneumonia: A comparative study

    • Authors: Mohammed Mujtaba Qureshi, Mohammed Saifuddin
      Pages: 213 - 217
      Abstract: Background: Acute lower respiratory tract infections (LRTI) is responsible for considerable morbidity and mortality among pediatric age group and remains one of the common causes for pediatric intensive care unit admissions. Vitamin D deficiency is one of the important risk factors not only for the occurrence but also for the increased severity of LRTI. We undertook this study to analyze vitamin D status of children admitted for LRTI and to find out its correlation with severity of LRTI. Aims and Objectives: The aims of this study were as follows: (1) To find out vitamin D status of children presenting with LRTI and (2) to find out correlation of vitamin D levels with severity of LRTI. Materials and Methods: This was a hospital-based comparative study, in which 60 children below age of 5 years and admitted for acute LRTI were included on the basis of a predefined inclusion and exclusion criteria (Group A). Sixty other children admitted for non-respiratory causes were included as control group (Group B). Vitamin D status of children in both the groups was determined. The severity of LRTI and its correlation with vitamin D status was determined. P<0.05 was taken as statistically significant. Results: There was a male predominance in both the groups. The mean age of patients in Group A and Group B was found to be 17.70±7.80 months and 18.41±7.11 months, respectively (P>0.005). In Group A, 42 (70%) patients were having bronchiolitis, whereas bronchopneumonia was seen in 16 (26.67%) patients and two patients (3.33%) were found to have lobar pneumonia. Forty-eight (80%) children were having pneumonia and remaining 12 (20%) children were found to have severe pneumonia. Higher number of children were either vitamin D inefficient or deficient in Group A as compared to Group B and the difference was found to be statistically highly significant (P<0.0001). The mean 25 (OH) D levels were found to be low in patients with severe pneumonia as compared to pneumonia and the difference was found to be statistically highly significant (P<0.0001). Conclusion: Lower levels of vitamin D were found to be a risk factor not only for the development but also for severity of LRTI. Determination and management of vitamin D deficiency status is one of the important parts of management of children with LRTI.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47642
      Issue No: Vol. 13, No. 12 (2022)
  • Neonatal versus postneonatal presentation of intestinal malrotation: A
           retrospective cross-sectional study in a tertiary care hospital at
           Hyderabad, India

    • Authors: Srinivas Srirampur, Kavimozhy Ilakkiya Poyyamozhy, Suresh Kumar Thanneeru, Nagarjuna Kumbha
      Pages: 218 - 223
      Abstract: Background: Malrotation commonly presents in neonates with bilious vomiting. It may also present in post neonatal age group with vague symptoms such as chronic abdominal pain, vomiting, and failure to thrive. These indistinct symptoms also result in delay of diagnosis. Aims and Objectives: This study is done with an objective to know whether age of presentation in malrotation determines morbidity and mortality. Materials and Methods: This is a retrospective study conducted in Gandhi medical college and Hospital, Hyderabad, from 2017 to 2020, based on the records of 50 patients who were diagnosed to have malrotation. The differences in clinical presentations, diagnosis, management, and outcomes were analyzed with respect to age. Results: Children who presented in neonatal period had classical symptoms (P<0.00001) and early diagnosis (P<0.0239). Children who presented later (>1 month of age) had higher incidence of atypical symptoms (P<0.00001) and delay in diagnosis (P<0.0239) compared to neonatal age group. Plain X-ray abdomen is readily diagnostic in neonatal age group (P<0.0004) and diagnosis was confirmed by contrast study, whereas in older children, plain abdomen X-ray findings were not always distinct and most of them needed contrast series to reach definitive diagnosis. The incidence of bowel gangrene and mortality was not statistically significant (P value of 1) between neonatal and post neonatal groups. Conclusion: In post neonatal age group, lack of classical presentation may lead to difficulty in diagnosing malrotation, but may not have significant difference in terms of morbidity and mortality. Considering malrotation early in differential diagnosis leads to timely intervention even in older age group children.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46460
      Issue No: Vol. 13, No. 12 (2022)
  • A comparative study on psychological distress and associated factors among
           mothers of severely acute malnourished children belonging to urban and
           rural area of Central India

    • Authors: Shobhana Yadav, Yogesh Shukla
      Pages: 224 - 229
      Abstract: Background: Psychological distress commonly presents as comorbidities but is often unrecognized in clinical practice or undertreated as comorbidities in mothers of severe malnourished children. There is wide difference in psychological distress and associated factors among rural and urban area. Aims and Objectives: The objective of study was to compare the psychological distress and associated factors among the mothers of severely acute malnourished children belonging to urban or rural areas. Materials and Methods: This cross-sectional study was conducted on total 450 mothers of severely acute malnourished children admitted in nutritional rehabilitation centers (NRCs) of the central India from April 2019 to July 2020 using General Health Questionnaire. Results: Out of total 450 mothers, 94.7% (426) of mothers shown normal psychological state whereas 24 (5.3%) mothers shown probable case of psychological distress. Among the study participants, mean age of the mothers was found 23.54 years (SD 2.43). Majority of mother 311 (69.1%) belongs to rural area followed by 139 (30.9%) from urban area. Majority of the mothers 231 (51.3%) were from Scheduled Tribe caste followed by 123 (27.3%) other Backward Class caste. Majority of the mothers 404 (89.8%) were unemployed in our study. Conclusions: In the rural locality caste of the mother, primary caretaker of the child and money spent at health facility were the significant risk factors for the psychological distress among the rural mothers while in urban locality, wages loss during stay period at NRC and comorbidity present in the child were the significant risk factors for the psychological distress.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47824
      Issue No: Vol. 13, No. 12 (2022)
  • A study to determine the effectiveness of conjunctival autograft as an
           alternative to normal surgical procedures to reduce the recurrence of

    • Authors: Padala Venkateswara Prasad, Bhanumurthy Gangalapuram, Shyamprasad Bukkapatnam Ramachandra
      Pages: 230 - 233
      Abstract: Background: Pterygium is a chronic degenerative condition, in which a triangular fibrovascular growth of bulbar conjunctiva encroaches on the cornea. It is a cause of concern for both the patient due to its unsightly appearance and the surgeon due to its tendency to recur. Aims and Objectives: The present study was undertaken to determine the effectiveness of conjunctival autograft as an alternative to normal surgical procedures to reduce the recurrence of pterygium. Materials and Methods: A total of 30 patients with primary and recurrent pterygia who attended the ophthalmology, outpatient department were taken up for the study after obtaining informed consent. A standard surgical technique essentially similar to that described by Kenyon et al., was followed in all patients with a few minor modifications. All surgeries are performed using an operating microscope. Results: The majority of patients belonged to the 3rd and 4th decades. In our study of 30 cases, we had a recurrence rate of 3.0%. The results and outcome of pterygium surgery in our series stress the importance of conjunctival autograft as the procedure of choice for the surgical management of primary and recurrent pterygium in Indian eyes. The success of conjunctival autograft may be related to the significant learning curve and different surgical techniques for these procedures. Conclusion: Conjunctival autograft proves to be a simple safe and inexpensive technique with low recurrence rates for pterygium in young people. Although conjunctival autograft is a time-consuming procedure and has a significant learning curve, it is the procedure of choice for pterygium. Further detailed studies with a higher sample size are needed in this area.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47768
      Issue No: Vol. 13, No. 12 (2022)
  • Effectiveness of 8 weeks of vestibular exercises on stress, sleep, and
           cognitive parameters in hypertensive patients

    • Authors: Yuvaraj Subramani Sagadevan, Shyma Parapurath, Anurag Kesarwani, Sai Sailesh kumar Goothy, Anita Choudhary, Rohit Singh Chouhan, Potey Gajanan Govind, Prateek Prabhaker Awasthi
      Pages: 234 - 237
      Abstract: Background: It was hypothesized that vestibular stimulation causes beneficial effects in hypertensive patients as so as in diabetic individuals. Aims and Objectives: The present study was undertaken to observe the effectiveness of 8 weeks of vestibular exercises on stress, sleep, and cognitive parameters in hypertensive patients. Materials and Methods: A total of eighty male and female stage 1 hypertensive individuals were part of the study after obtaining voluntary, written informed consent. Vestibular exercises comprising three steps with a time period of 45 min per session were administered to the participants of the intervention group. Two sessions per week were administered as mentioned in the literature. Stress levels were assessed by the perceived stress scale. Sleep was assessed by the insomnia severity index. A spatial and verbal memory test was used to assess the spatial and verbal memory scores. Results: There was no significant difference in the demographical parameters of the control and intervention groups. There is no significant difference in stress, sleep scores, and spatial and verbal memory scores among the control and intervention groups. There was a significant decrease in the stress scores and insomnia scores, and a significant improvement in the spatial and verbal memory scores in the intervention group after the intervention when compared with the control group. Conclusion: The present study results suggest that vestibular exercises have a positive impact on reducing stress and improving sleep and cognition in hypertensive individuals. The study highlights the need for further detailed studies in this area to recommend the inclusion of vestibular exercises as adjunctive therapy in the management of hypertension.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47396
      Issue No: Vol. 13, No. 12 (2022)
  • Effect of backpack load on nerve conduction velocity and risk of
           peripheral neuropathy in upper extremities of undergraduate medical
           students carrying backpack

    • Authors: Jagdish C Hundekari, Amisha Rai, Sanjay Wasnik, Lokendra Kot
      Pages: 238 - 243
      Abstract: Background: Prolonged load carriage can potentially affect hand and upper limb use through compression of the nerves, reduction in blood flow, and muscle fatigue. Backpacks of undergraduate medical student are not much different from their syllabus. They carry heavy backpacks on regular basis and many times they wear it incorrectly. Aims and Objectives: We aimed to see the effect of backpack load on motor nerve conduction velocity and hand grip strength in the upper extremities. Materials and Methods: The present study included 31 undergraduate medical students between the age of 18 and 25 years. The procedure is conducted in three phases on different days. In each phase, participants were asked to walk for 5 min with load. In Phase 1, nerve conduction velocity and grip strength weere measured in unloaded condition and after carrying load <10% of body weight. To limit the effect of fatigue, participants are instructed to return to laboratory in next consecutive weeks to repeat the procedure for Phase 2 and 3 as in Phase 1 by increasing load to 10–20% and 20–30% of their body weight respectively. Results: Values of median and ulnar motor nerve conduction velocity obtained without and with increasing % of backpack load after 5 min walk were decreased non-significantly as load increased. There was significant (P>0.001) difference in grip strength of medical students carrying backpack with increasing load after 5 min walk. Conclusion: In this study, we aimed at quantifying the effects of load carriage on overall upper limb performance, with a focus on conduction velocity of motor nerves. This has implications for occupations such as soldiers, firefighters, paramedics, and others who may be required to operate machinery, equipment, tools, or systems that require precise motor control.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46170
      Issue No: Vol. 13, No. 12 (2022)
  • Functional outcome of displaced femoral neck fractures in young patients
           treated by dynamic hip screw with CC screws

    • Authors: Sujay Mahadik, Chandra Prakash Singh, Akshay Phule, Nikunjkumar Kheni, Shrikant Deshpande
      Pages: 244 - 250
      Abstract: Background: Although femoral neck fractures are common in elderly individuals, it is an uncommon occurrence in young patients. It is crucial to achieve anatomical reduction as well as stable fixation so as to avoid complications in young individuals who are expected to have considerable functional demand in post-surgical period. Dynamic hip screws are commonly used for internal fixation of these fractures. Although satisfactory functional outcomes have been reported in the patients treated by DHS, complications such as malunion and osteonecrosis remain an area of concern. Aims and Objectives: The aims of the study were to study the functional outcome of young patients with femoral neck fractures treated by DHS with CC screws and to study the complications in young patients with femoral neck fractures treated by DHS with CC screws. Materials and Methods: This was a prospective cohort study in which 80 young adults (below the age of 45 years) having femoral neck fractures and treated by DHS with 2CC screws were included in this study on the basis of a predefined inclusion and exclusion criteria. Gender and distribution, nature of injury, type of fracture, functional outcome, and complications were studied in studied cases. Open reduction and internal fixation was done using dynamic hip screw. The functional outcome was assessed using modified Harris hip score. All patients were assessed for complications such as non-union, malunion, and osteonecrosis. Statistical analysis was done using SSPS 21.0 software and P<0.05 was taken as statistically significant. Results: Out of 80 studied cases having femoral neck fractures, there were 54 (67.50%) males and 26 (32.50%) females with an M: F ratio of 1:0.48. The mean age of male and female patients was found to be 38.37±4.62 and 38.80±4.97 years, respectively. The most frequent cause of fracture was fall from height (48 cases) followed by road traffic accident (31 cases). Forty-six patients had complete fracture with partial displacement (Type III) and remaining 34 patients had complete fracture with total displacement (Type IV). Associated injuries were seen in 9 (11.25%) patients. Nine (11.25%) cases of avascular necrosis of femoral head were seen in our study. Surgery more than 48 h after injury and complete fracture with total displacement were associated with increased risk of avascular necrosis of femoral head (P<0.05). Conclusion: Femoral neck fractures in young patients treated by dynamic hip screws with CC screws have found to have excellent functional results in majority of cases. The complications such as osteonecrosis of femoral head can be minimized by decreased time duration between fracture and surgical intervention.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47226
      Issue No: Vol. 13, No. 12 (2022)
  • Incidence of renal artery stenosis and its hemodynamic significance in
           patients subjected to angiography for suspected coronary artery disease

    • Authors: Deepak Arun Khore, Sushilkumar Dharamraj Navsare
      Pages: 251 - 255
      Abstract: Background: Renal artery stenosis (RAS) may occur alone (isolated anatomical RAS) or in combination with hypertension (renovascular or essential hypertension), renal insufficiency (ischemic nephropathy), or both. Renal artery stenting can be performed safely with nearly uniform technical success without exposing them to significant incremental risk. Aims and Objectives: The objectives of the study are as follows: (A) To study the incidence of RAS in suspected coronary artery disease patients. (B) To study the hemodynamic significance of RAS in patients diagnosed having RAS. (C) Should patients undergoing coronary angiography be subjected to routine renal angiography during the procedure' Materials and Methods: We prospectively did renal angiography of consecutive 100 patients, who underwent coronary angiography for their suspected coronary artery disease. Data regarding risk factors were recorded for every patient. Results: Out of 12 patients with RAS, 10 had significant stenosis (>50%) out of which seven patients showed hemodynamically significant RAS on captopril renogram. These were the patients having stenosis of 70% or more on renal angiography. Three patients having RAS 50–70% on renal angiography were not having hemodynamically significant lesion on captopril renograms. Conclusion: Renal angiography should be performed in patients undergoing coronary angiography. Femoral artery should be the preferred access site for coronary angiography to approach renal arteries. The patients with RAS should undergo captopril renography to evaluate the hemodynamic significance of the stenosis.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.46855
      Issue No: Vol. 13, No. 12 (2022)
  • Assessment of clinical profile of patients with non-radiographic axial
           spondyloarthropathy in a tertiary health-care center

    • Authors: Saurabh Limaye, Shraddha More, Milind Nadkar, Alhad Mulkalwar, Hunaid Haider, Sujay Jaju
      Pages: 256 - 261
      Abstract: Background: Axial spondyloarthritis (nr-axSpA) is an inflammatory and immune-mediated condition comprising clinically differentiated ankylosing spondylitis (AS) and nonradiographic nr- axSpA. Clinically, as the name suggests, non-radiographic nr- axSpA has an absence of definitive plain X-ray evidence of structural damage to the sacroiliac joint. Aims and Objectives: The aim of the study was to assess and evaluate the clinical profile of patients with non-radiographic axial spondyloarthropathy. Materials and Methods: This study was conducted in the department of Medicine over 18 months in a tertiary health care institution, being a prospective and observational type done with 43 subjects. Results: We observed a major improvement as per ASDAS criteria present among 53.49% of subjects, followed by clinically significant improvement among 27.91% of subjects. About 18.60% of subjects did not show any improvement. About 9.3% of subjects showed radiological progression. Out of eight cases that did not show improvement, all presented with low back pain and morning stiffness. About 62.5% had peripheral arthritis. About 87.5% had Schober’s test positive, FABER test (62.50%) and sacroiliac joint tenderness found among 7.5% of subjects. A total of 4 (9.3%) patients showed radiological progression. All of them have low back ache and morning stiffness, and three of them having peripheral arthritis at presentation. We found that patients who showed progression had higher mean ESR and CRP (45 and 36.5, respectively) values and a very high disease activity as per ASDAS and BASDAI criteria. Conclusion: There is a great scope and need for research to differentiate the magnetic resonance imaging (MRI) changes in the normal population against the ones patients with spinal diseases to be able to use MRI with precision in patients with non-radiographic axial spondyloarthropathy (nr-axSpA). As assessed, currently physiotherapy and NSAIDS are first line therapy for patients suffering from non-radiographic axial spondyloarthropathy.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47576
      Issue No: Vol. 13, No. 12 (2022)
  • Ultrasonographic evaluation of cervical length and amniotic fluid index as
           predictor of pregnancy outcome in cases of preterm premature rupture of

    • Authors: Nidhi Gupta, Mohita Agarwal, Akanksha Gupta, Neha Shamshi
      Pages: 262 - 268
      Abstract: Background: Amniotic fluid index (AFI) and cervical length (CL) can be used to predict delivery latency, maternal, and neonatal outcome in cases of preterm premature rupture of membrane (PPROM). Aims and Objectives: The aims of this study were to study the AFI and CL as a predictor of pregnancy outcome in cases presenting with PPROM, to determine the AFI in cases presenting with PPROM, to determine CL ultrasonographically in cases presenting with PPROM, and to measure the efficacy of these parameters as a predictor of pregnancy outcome in cases presenting with PPROM. Materials and Methods: This was an ambispective observational study conducted from November 2019 to July 2021 in the Department of Obstetrics and Gynecology in S. N. Medical College, Agra. A total of 100 women with singleton pregnancy and vertex presentation who presented to hospital within 12 h of spontaneous rupture of membrane (PPROM) from period of gestation 28–34+6 weeks were enrolled in this study. Results: Delivery latency was inversely related to period of gestation at pprom (P<0.0001). Mean AFI in Group 1 was 5.15 cm and in Group 2 was 7.12 cm and the difference between both group was statistically significant (P<0.0001). Thus, our study shows positive correlation between AFI and delivery latency. Mean transvaginal CL (TVCL) in Group 1 was 2.47 cm and in Group 2 was 2.99 cm. Difference in terms of TVCL between both the groups was found to be statistically significant (P=0.00005). Need for neonatal intensive care unit admission was higher in Group 1 than Group 2 and this difference was statistically significant (P=0.020). Conclusion: Our study shows that there was an increase in positive predictive value when we combine AFI and TVCL in prediction of delivery latency, so women with AFI ≤5 and TVCL ≤2.5 cm had 85.6% risk of delivery within 7 days after PPROM. A long CL (TVCL >2.5 cm) and AFI >5 correlated with increased delivery latency and increased risk of maternal morbidity (chorioamnionitis, abruption, and cord prolapse).
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.45129
      Issue No: Vol. 13, No. 12 (2022)
  • Prospective comparative study of mesh fixation in laparoscopic TEP hernia
           repair using tacker versus cyanoacrylate versus fibrin glue tep mesh
           fixation with cyanoacrylate

    • Authors: Arvind Shukla, Meher Kalsi, Yogesh Shivaprasad , Srashti Shah, Tanuj Ahirwar, Aditi Sharma
      Pages: 269 - 273
      Abstract: Background: Laparoscopic inguinal hernia repairs done by totally extra peritoneal (TEP) or trans abdominal preperitoneal techniques require mesh fixation which is commonly done by either tackers or fibrin glue. In this study, we discuss about using cyanoacrylate glue for mesh fixation as a more cost effective but equally suitable alternate. Aims and Objectives: The aim of the study was to evaluation of suitability of using highly economical cyanoacrylate ($ 0.13) with tackers ($ 318.52) and fibrin glue ($ 11.94) for mesh fixation during TEP hernia repair. Materials and Methods: A comparative study was done in the Department of Surgery over a period of 3 years (2018–2021). This study included 210 patients who underwent laparoscopic TEP hernia repair. Cases were randomized into three groups of 70 subjects each: Group A - mesh was fixed with tacker, Group B - mesh was fixed using cyanoacrylate, and Group C - mesh was fixed with fibrin glue. Subjects were followed up for 3 months. Type of presentation, diagnosis, and type of mesh fixation were compared to post-operative complications that included pain, seroma, hematoma, and urinary retention findings were recorded and data were statistically analyzed using “SPSS” software. Results: Decreased incidence of post-operative pain (P=0.01) and hematoma was observed in Group B as compared to Groups A and C. Average hospital stay was significantly less in fibrin glue group (P=0.02) and cyanoacrylate group (P=0.02) as compared to tacker group. There was same incidence of postoperative urinary retention (P=0.520) and seroma (P=0.354) formation between all groups. Patients of Group B started daily activities earlier at 15 days follow-up (P=0.032) as compared to Groups A and C. Conclusion: Cyanoacrylate and fibrin glue fixation of mesh in laparoscopic TEP have better outcomes when compared to tackers. Furthermore, as cyanoacrylate is 300 times cheaper than tacker and 10 times cheaper than fibrin glue, this imparts a huge cost advantage to this technique in developing countries. Therefore, use of cyanoacrylate for mesh fixation in laparoscopic TEP can be safely advocated over tackers and fibrin glue.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47076
      Issue No: Vol. 13, No. 12 (2022)
  • A comparative study of laparoscopic versus open ventral hernia repair

    • Authors: Shyam Kishor Gupta, Albail Singh Yadav, Rajeev Sinha
      Pages: 274 - 280
      Abstract: Background: The use of laparoscope in the treatment of abdominal wall hernia repair was first reported in 1993 by LeBlanc and William. But with the passage of time and gaining of expertise, LVHR is now being perform more often but it is still not the gold standard of management. Today the proven advantage laparoscopic ventral hernia repair, open ventral hernia repair is less intraoperative blood loss, shorter hospital stays and early return to normal activity. We tried to compare laparoscopic ventral hernia repair versus open ventral hernia repair in primary ventral hernia. Aims and Objectives: The aim of this study was to compare laparoscopic ventral hernia repair (LVHR) and open ventral hernia repair with respect to the operating time, intraoperative blood loss, intraoperative enterotomy, post-operative complications, hospital stay, and return to normal activity. Retrospective cum prospective study. Materials and Methods: This retrospective cum prospective study was conducted in a tertiary care center teaching hospital, M.L.B. Medical College, Jhansi between January 2020 and June 2021. All consented patients after matching for age, sex, and type of ventral hernia, were allocated to either two groups: Groups A open ventral hernia repair (OVHR) 25 case versus Group B (Laparoscopic ventral hernia) repair 25 case. Results: In our study intraoperative blood loss, post-operative complication, hospital stay, return to normal activity was less in LVHR as compared to OVHR. Operating time was found to be non-significant between two groups and occurrence of inadvertent enterotomy although more in LVHR, was still insignificantly different. Conclusion: The findings of present study demonstrate that LVHR was safe and better when compared with OVHR.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.48172
      Issue No: Vol. 13, No. 12 (2022)
  • A comparative and prospective study of two different radiation
           fractionation schedules with concurrent chemotherapy in locally advanced
           head-and-neck squamous cell carcinoma

    • Authors: Chayan Roy, Linkon Biswas, Arabinda Roy, Shyam Sharma, Firdoushi Khatun, Srikrishna Mandal
      Pages: 281 - 286
      Abstract: Background: Accelerated fractionation radiotherapy has radiobiological advantage of preventing accelerated tumor repopulation and logistic advantage of treating more patients than conventionally fractionated radiotherapy because of its relatively shorter treatment duration. Aims and Objectives: In this study, we compared accelerated fractionation with conventionally fractionated radiotherapy in terms of tumor response and acute toxicities for the treatment of locally advanced head-and-neck carcinomas. Materials and Methods: Patients with Stage III and IVA carcinoma of head-and-neck region were randomized into two groups. The study group patients received accelerated radiotherapy to a total dose of 66Gy in 33 fractions, 2Gy/fraction, 6 fractions/week over a time period of 5.5 weeks. Control group received conventionally fractionated radiotherapy to same total dose and fraction size but 5 fractions/week, over a time period of 6.5 weeks. Both groups received concurrent weekly Cisplatin. All patients were followed up weekly for treatment related acute toxicity during the treatment and then at every month for 6 months after completion of treatment. Results: About 26.6% patients of study arm achieved complete response in comparison to 25.6% of control arm, but the difference was not statistically significant (P=0.957). Although statistically not significant, higher grade of skin toxicity (60%vs.35%, P=0.179) and xerostomia (46% vs. 29%, P=0.155) was also numerically higher in accelerated fractionation. Conclusion: For locally advanced head-and-neck carcinoma, accelerated fractionation radiotherapy with concurrent chemotherapy can be considered as an acceptable and effective alternative of conventionally fractionated concurrent chemoradiotherapy in terms of treatment response and acute toxicity profile.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47437
      Issue No: Vol. 13, No. 12 (2022)
  • Evaluation of various options for resurfacing of soft-tissue defects of
           dorsum of hand and their outcome assessment

    • Authors: Sasanka Nath, Subhashis Karmakar, Dipankar Mukherjee , Amitesh Kumar Jha
      Pages: 287 - 291
      Abstract: Background: Soft tissue defect of dorsum of hand is a difficult problem to deal with in reconstructive surgery. Various factors have to be considered for planning of the reconstruction. Aims and Objectives: To assess the overall incidence of soft tissue defect on dorsum of hand, evaluation of different options for coverage of soft tissue defect on dorsum of hand, assessment of outcome and complications (both primary and donor sites) of reconstructive procedures and coverage of defect with like for like tissue. Materials and Methods: We present our experience of resurfacing soft-tissue defects of dorsum of hand in 27 patients by split thickness skin grafting, local flaps, distant pedicled flaps, and free flaps. Results: Among total 27 patients, in whom resurfacing was done, distant pedicled flaps such as groin/abdominal flap were performed in 13 patients, regional flaps like posterior interosseous artery flap were done in seven patients, free flap like anterolateral thigh flap was the method in three patients, and skin grafting was used in two patients. Complications such as partial or complete flap necrosis were noted in one patient each of free and regional flap and none in distant pedicled flap. The operating time was relatively less in distant pedicled flaps. Conclusion: Skin grafting had limited use when underlying vital structures were exposed. Distant pedicled flaps such groin and abdominal flaps were very useful for resurfacing the defect especially in emergency situations. Regional and free flaps had limited indications.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47663
      Issue No: Vol. 13, No. 12 (2022)
  • A study to identify unrecognized bipolar disorder in patients of major
           depressive disorder taking antidepressants

    • Authors: Kinjal Bhupendrasinh Chauhan, Archana Surajprasad Kantak, Krupa Mukeshbhai Unadkat, Bharat Navinchandra Panchal, Ashok Ukabhai Vala
      Pages: 292 - 297
      Abstract: Background: Unrecognized bipolar spectrum disorder under cover diagnosis of major depression disorder leads to wrong medications (antidepressants in absence of mood stabilizer), which may switch to mania. Aim and Objectives: A study was to identify unrecognized bipolar disorder in patients of major depressive disorder taking antidepressants. Materials and Methods: This is an observational and cross-sectional study of 150 patients previously diagnosed as major depressive disorder taking antidepressants from tertiary care hospital. Patients were assessed by proforma containing demographic details, Questionnaire of mood disorder questionnaire (MDQ), and Hamilton depression rating scale (HAMD) followed by clinical interview according to DSM-5 to confirm diagnosis. Statistical analysis was done. Results: We found 6.67% depression patients screened positive on MDQ for bipolar disorder and diagnosis is confirmed by interview according to DSM-5. MDQ positive patients have early age of onset of depression(P=0.0109), long duration of depression(P=0.0478), presence of previous suicide attempt(P=0.0130), and family history of bipolar disorder(P=0.0361). No statistically significant difference was observed between mean HAMD score and severity of depression between MDQ positive and negative group. Conclusion: Among patients prescribed antidepressants for depression, there is a substantial proportion with unrecognized bipolar disorder and most of them had never received diagnosis of bipolar disorder. When seeing patients with depression disorder, clinicians should review the life history for screening of unrecognized bipolar disorder by looking for early age onset of depressive episode and long lifetime duration of depression, previous suicide attempt, and family history of bipolar disorder.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47372
      Issue No: Vol. 13, No. 12 (2022)
  • Pulmonary synovial sarcoma: A case series and review of literature

    • Authors: Amrutha Peter, Amarendra Kumar Shukla, Manish Kumar Gupta, Vikas Patel, Vijaya Kumar, Veerendra Arya, Pawan Tiwari, Jitendra Kishore Bhargava
      Pages: 298 - 302
      Abstract: Synovial sarcoma is a rare malignant mesenchymal tumor that can develop at any anatomic site. Pulmonary sarcomas constitute 0.1–0.5% of all primary lung malignancies. Primary pulmonary synovial sarcoma is highly uncommon. Most of the patients present with large intrathoracic masses with complaints of cough, chest pain, shortness of breath, or hemoptysis. Multimodality treatment in the form of wide excision, chemotherapy, and radiotherapy is the mainstay of therapy. Synovial sarcoma is considered a high-grade tumor with a poor prognosis. We hereby present three cases of histologically proven synovial sarcoma with predominantly pulmonary involvement, along with their management and in hospital outcome.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.48335
      Issue No: Vol. 13, No. 12 (2022)
  • Post-injection syndrome and olanzapine long-acting injection in patients
           with schizophrenia: A case series

    • Authors: Saheli Dey, Madhurima Khasnobis
      Pages: 303 - 306
      Abstract: Pamoate salt of atypical antipsychotic Olanzapine in long-acting injection depot formulation (OLAI) is often used in patients with schizophrenia having poor compliance. This depots formulation having a cluster of adverse events characterized by post-injection delirium/sedation syndrome (PDSS). Here, we present three cases of different age group, different gender suffering from Schizophrenia of varied duration of illness who developed PDSS after receiving OLAI, how they were identified and promptly managed with early intervention. PDSS noted in approximately 0.07% of the injections, in 1.3% of patients. Symptoms such as sedation, delirium, extrapyramidal symptoms, ataxia, autonomic dysfunction, aggression, and speech impairment were reported, onset was immediate to 3–5 h post-injection, patients recovered within 2–72 h. No such risk factors could be identified in any of the cases. PDSS following OLAI occurs when there is accidental intravascular release of high dose of olanzapine. The importance of post-injection syndrome in the above cases lies in the fact that following administration of OLAI a 3–4-h observation period in a health-care facility in the presence of an appropriate qualified personnel is of utmost importance. Furthermore, one should rule out other causes of acute sedation in such patients before establishing the diagnosis of PDSS. There is no specific antidote for olanzapine and almost all such patients improve with conservative and supportive treatment.
      PubDate: 2022-12-01
      DOI: 10.3126/ajms.v13i12.47620
      Issue No: Vol. 13, No. 12 (2022)
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