INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY

Computed Tomography Findings in a Case of Situs Ambiguous with Polysplenia: A Case Report

2022-05-17T07:46:01+00:00

Eternity has rightly established the fact that nature hates symmetry and to cite a perfect example of it, we present a
rare entity, situs ambiguous before you. Situs ambiguous is a congenital anomaly in which the major visceral organs are
distributed abnormally within the chest and abdomen. We report a case of a 44-year-old lady, presented to our casualty
department with waxing and waning pain abdomen and vomiting. Patient’s contrast-enhanced computed tomography
(CECT) was done which had features of left isomerism of heterotaxy syndrome. Our case describes about the findings of
situs ambiguous with polysplenia which is a rare entity. Early diagnosis by appropriate imaging modality results in reduction
of the fatal consequences.

Invasive Paranasal and Pulmonary Aspergillosis in a Post-COVID Patient with Diabetes

2022-05-17T07:48:32+00:00

COVID-positive patients and those recovering from COVID affliction are more susceptible to fungal infections. It is especially
true in patients who are diabetic, on prolonged glucocorticoid medications and transplant patients. In critically ill patients,
invasive fungal infections have a bad prognosis resulting in grim figures of morbidity. Glucocorticoid medications may aggravate
hyperglycemia in patients with diabetes which present a favorable ground for fungal infections. In this case, we have come
across a patient who has a long-standing history of diabetes. She has been suffering from invasive pulmonary aspergillosis
while recovering from COVID-19. The diagnosis of invasive aspergillosis is difficult using clinical criteria, thus imaging modalities
are the mainstay for diagnosis. Intravenous voriconazole (400 mg BD tapered down to 200 mg) has been used to treat her
condition. Patients who are on glucocorticoids, have deteriorating pulmonary functions, and are diabetic have increased risk
of developing aspergillosis.

Autosomal Dominant Polycystic Kidney Disease: A Risk Factor for Berry Aneurysm

2022-05-17T07:49:06+00:00

Autosomal dominant polycystic kidney disease is a genetical disorder caused by changes occurred in PKD1 and PKD2 genes and
is characterized mainly by the growth of multiple kidney cysts. It is progressive disorder with symptoms of high blood pressure,
pain in the back and the sides, and also headache. Patients having ADPKD are having a high risk of formation of intracranial
aneurysms. Presenting a case of ADPKD associated with subarachnoid hemorrhage with berry aneurysm and discussed about
the diagnostic approach with imaging modalities in this patient and the treatment.

Acute Pancreatitis as a Manifestation of Primary Hyperparathyroidism: An Uncommon Association

2022-05-17T07:49:31+00:00

The manifestation of primary hyperparathyroidism (PHPT) as acute pancreatitis (AP) is a rare entity. We report a case of a
55-year-old female, admitted to the intensive care unit of the general surgery department presenting with features of acute
abdomen with a clinical and radiological diagnosis of AP. Further evaluation revealed hypercalcemia and PHPT due to
parathyroid adenoma. Hypercalcemia due to PHPT plays a vital role in the pathogenesis of pancreatitis. The patient underwent
parathyroidectomy and pathological examination of the parathyroid gland confirmed a parathyroid adenoma. After aggressive
medical management of AP and hypercalcemia, parathyroidectomy has been shown to improve clinical outcomes and prevent
further recurrences of pancreatitis.

Randomized Controlled Trial of Comparison of Absorbable Extra Long-Term (Poly Hydroxy Butyrate) Suture Versus Non-Absorbable (Polypropylene) Suture for Abdominal Wall Closure

2021-09-30T04:07:47+00:00

Introduction: In patients undergoing midline incisions, rectus sheath can be closed with continuous or interrupted suture using
absorbable or non-absorbable materials. Despite major improvements in antibiotics, better anesthesia, superior instruments,
earlier diagnosis of surgical problems, and improved techniques for post-operative vigilance, post-operative complications such as
incisional hernias, burst abdomen, and wound infections continue to occur, which causes significant surgical health-care problem.
Aims and Objectives: The objectives of the study were to continuous technique with non-absorbable sutures (polypropylene)
– Group I and to interrupt technique with non-absorbable suture (polypropylene) – Group II.
Materials and Methods: Randomized controlled, prospective study on 271 patients with primary elective midline laparotomy
in Mahatma Gandhi Memorial Hospital. Patients operated from January 2018 to June 2019 are included in this study and are
followed up for a minimum period of 1 year.
Observation and Results: Group I includes 102 patients with continuous technique using non-absorbable polypropylene, Group
II includes 91 patients with interrupted technique using non-absorbable polypropylene, and Group III includes 78 patients with
continuous slowly absorbable polyhydroxybutyrate.

Outcome in Moderate and Severe Traumatic Brain Injury among Elderly Individuals Analytical Study in Government Rajaji Hospital Madurai

2021-09-30T04:50:32+00:00

Background: Head injuries are among the most common types of trauma encountered in emergency department. Many
patients with severe brain injuries die before reaching a hospital; in fact, nearly 90% of pre hospital trauma related deaths
involve brain injury.
Objectives: Aim of the study was to study the age as an important prognostic factor in the prediction of outcome in Head
Injury patients, to find out the incidence and type of traumatic intracranial lesions in the elderly, to study and analyze the cause
of head injury among elderly patients, and to compare conservative, medical, emergency surgical treatment, and outcome.
Results: The poor outcome at all levels in the elderly patients, even with good Glasgow coma scale (GCS) on admission.
Although they have lower impact injuries and multiple injuries, their computed tomography scan show more number of intracranial
mass lesions, sub arachnoid hemorrhage, and midline shift. Age has been cited as a significant risk factor for the poor outcome
in this study.
Conclusion: The mortality rate increases with age mainly from the medical complications to prolonged coma. GCS is a good
reliable predictor of prognosis even in the 1st day after admission. If the doctors are persuaded to elicit and record them carefully,
predictions can be made reasonably accurate at the bed side

A Comparative Study of Cartridge-based Nucleic Acid Amplification Test, Histopathological Examination, and Culture and Sensitivity in Suspicious Cases of Tubercular Lymphadenopathy

2021-09-30T05:12:13+00:00

Introduction: Tuberculosis (TB) is one of the most important diseases in the history of mankind and remains as an extraordinary
burden to humanity even today. Tuberculous lymphadenitis (TBLN) is the most common extrapulmonary TB which accounts for
25–30% of TB cases. Lymph node (LN) TB is frequent among HIV infected patients. TBLN, abdominal, or cervical is caused
largely due to Mycobacterium tuberculosis which was once caused by Mycobacterium bovis. In this study, we evaluated the
performance of cartridge-based Nucleic Acid Amplification Test (CB-NAAT) for the diagnosis of TBLN on histopathological
examination (HPE) of excisional LN biopsy and culture and sensitivity.
Aims and Objective: (1) The objective of the study was to evaluate and compare three modalities, that is, CBNAAT, HPE and
Culture and Sensitivity for diagnosis of TB in cases of lymphadenopathy, (2) sensitivity and specificity of each modality, (3) to
assess efficacy of CBNAAT over other modality, and (4) to identify Rifampicin-resistant cases.
Materials and Methods: Enlarged LN is biopsied. One part of this material was put in a sterile container and sent for CB-NAAT
and the other part was smeared on 2–3 slides and send for Lowenstein Jensen culture. Third part of the biopsy sample taken
in sterile container with 10% formalin sent for HPE.
Result: CBNAAT is the most sensitive technique. As the rate of drug resistant TB is in increasing trend, it is essential to use a
rapid method which detects M. tuberculosis and rifampicin resistance simultaneously. Thus, CBNAAT is the best method in the
diagnosis of TB. Earlier detection can reduce the death rate and prevent the spread of TB in the community.

Role of Otoacoustic Emission Test in Active Rheumatoid Arthritis Patients

2021-09-30T05:35:31+00:00

Introduction: Rheumatoid arthritis (RA) is an autoimmune, chronic systemic inflammatory disease affecting the small joints
and also has extra-articular manifestations. The early active stage of RA shows increased titer of anticyclic citrullinated
protein antibodies in serum. Cochlear involvement resulting in Sensorineural hearing loss is one of the extra-articular
manifestations in its active stage which can be identified at its subclinical level by screening with otoacoustic emission
(OAE) test. OAE are sounds produced by healthy hair cells of the cochlea which shows a decrease or disappearance in
active RA.
Materials and Methods: Thirty RA patients in active stage satisfying 2010 American College of Rheumatism/European League
Against Rheumatism and Disease Activity Score IV criteria with normal hearing ability between 25 and 45 years of age and 30
age- and sex-matched controls were subjected to OAE test. Both males and females were included in the study.
Results: Statistical analysis was done using software SPSS version 21. All controls PASSed the test indicating normal hair
cell function in both ears (60 ears). Thirty active stage patients were tested for both ears (60 ears). Out of 60, 19 PASSed the
test and 41 showed REFER indicating subclinical hair cell dysfunction.
Conclusion: Study revealed subclinical hair cell dysfunction in 2/3rd of cases. Thus, OAE has a key role in screening, diagnosing
and in preventing hearing disability in RA patients.

Disorders among Dentists in Punjab: A Questionnaire Study

2021-09-30T06:15:51+00:00

Background: The prevalence of musculoskeletal disorders (MSDs) in neck and back was investigated, along with the risk
factors in association with MSDs were evaluated among dentists in Punjab.
Methods: This cross-sectional study was carried out among dentists using self-administered, Nordic musculoskeletal questionnaire.
Descriptive statistics and Chi-square test were used for the data analysis. Statistical analysis were done using SPSS version 20.
Results: A total of 160 dentists were included in the study. More than half of the respondents had experienced symptoms in
the neck (67.5%), upper back (56.25%), and lower back (63.75%). The prevalence of trouble in the neck increased when the
number of days worked per week increased. Risk factors (P < 0.05) included being >40 years of age, body mass index <18.5
as well as more than 24, no physical activity, increasing years of practice, and working with no more than one dental assistant.
Conclusion: There is a dire need to address and to change the way dentistry is practiced to the lower the risks to dental
practitioners. Dental professionals should be cautious and well trained to stop certain behaviors that can put their health at risk
as well as posture issues and ergonomics be inculcated in the educational system of dentistry.

Outcome of Augmented Versus Anastomotic Urethroplasty Comparison in Bulbar Stricture Urethra of 2–3 cm Length

2021-09-30T11:16:14+00:00

Introduction: Stricture urethra, that is, fibrous narrowing of urethra is one of the challenging urethral conditions which occur
due to inflammation of urethra, trauma to urethra, or due to idiopathic cause. There are various methods of the treatment of
stricture urethra which depends on length, location, depth, and density. Because the bulbar urethra is relatively mobile, removal
of the narrowing of lesser size and re-join the ends over a catheter is called anastomotic urethroplasty. Longer, recurrent,
or complicated strictures need to be widened by cutting into the narrowed area and inserting a graft material is known as
augmentation urethroplasty.
Aim: This study aims to know outcome of augmented and anastomotic urethroplasty in strictures of 2–3 cm by retrospective
analysis.
Materials and Methods: This was a retrospective study performed in 64 patients of bulbar urethral strictures equal or <3 cm
admitted to the department of urology. It is compare of success rate, complications, and patient satisfaction in two types of
urethroplasties augmented versus anastomotic. Patient’s basic demographic parameters, diagnostic investigations for the
urethral strictures, pre-operative uroflowmetry, surgical procedures, post-operative complications, and follow-up uroflowmetry
and cystoscopy findings were analyzed and compared.
Results: Most of the patients in the age groups of 31–40 and trauma is the leading cause of stricture. Anastomotic group
patients stayed more in the hospital. Augmented urethroplasty had very superior success rates (100%) than to the anastomotic
urethroplasty (84.6%). Complications were also more in anastomotic urethroplasty.
Conclusion: In this study augmented, urethroplasty is superior to anastomotic urethroplasty with fewer post-operative
complications.

Introduction to Early Clinical Exposure as a Learning Tool in the 1st Year Medical Students

2021-09-30T11:27:40+00:00

Objective: As medical education moves to new curricular models, including competency based education with defined
objectives, benchmarks and outcomes and more standardized approaches, it is important to understand and set objectives
for early clinical exposure.
Method: The study was conducted in MGM Medical College, Jamshedpur in October, 2019. 50 students participated with their
consent. The department faculty was sensitized to ECE, and the feedback questionnaire was approved by them.
Result: ECE is associated with better co-relation clinically (52%), building concept (26%), making subject interesting(48%),
retention (26%) and interactive (26%).
Conclusion: It can be summarized that teaching physiology in clinical context is the need of the hour.

Empathy and its Correlates among Undergraduate Medical Students at a Medical College in India

2021-10-01T03:24:11+00:00

Introduction: Empathy is a highly desirable professional trait, since empathic communication skills promote patient satisfaction,
establish trust, reduce anxiety, increase adherence to treatment regimens, improve health outcomes, as well as decreasing the
likelihood of malpractice suits. It is beneficial to the physician as well, cognitively defined empathy can lead to personal growth,
career satisfaction resulting from the optimal clinical outcomes.
Purpose: The purpose of the study was to assess empathy level of medical students and its correlates.
Methodology: A cross-sectional observational study was conducted among undergraduate medical students of Veer Chandra
Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Uttarakhand, with a survey tool employing
Jefferson Scale of Physician Empathy (JSE-S). JSE-S comprising certain details such as age, gender, year of medical school,
specialty of choice, and an inventory of 20 questions half of which are negatively phrased. The students recorded their response
on a scale of 1 of the 7, provided on a Likert scale in response to each item (1 = strongly disagree and 7 = strongly agree).
Scale is reversed (that is, 1 = strongly agree and 7 = strongly disagree) for the negatively phrased items.
Results: The mean empathy score among males was 103.4 (standard deviation [SD] – 17.33), and among females, it was
109.4 (SD – 15.37). In our study, this difference was found to statistically significant. A majority of students reported having
made the decision to enter the medical profession on their own accord, n = 355 (68.5%). For the rest, it was either their family
member’s decision or a combined decision, n = 66, 12.7% and n = 97, 18.7%, respectively. A majority of students, n = 360,
69.5%, preferred to join a medical specialty involving direct patient contact.
Conclusion: The empathy score varied with gender, with a higher mean score for females. It was also more for those satisfied
with their career choice compared to those who were unsatisfied. Semester wise, there was no increasing or decreasing pattern
of scores and was found to be variable. An impetus for empathy was provided with the introduction of foundation course for
medical students where life skills education is being imparted.

Various Commercially Available Flexible Denture Base Materials at Various Time Intervals – An In Vitro Study

2021-10-01T03:37:39+00:00

methacrylate) is still being used for the fabrication of dentures. Flexible denture base materials are the best alternative to
conventionally used denture base resins, which provide excellent aesthetics, comfort, and flexibility.
Aim: The aim of this study is to evaluate and compare flexural strength, color stability, surface roughness, and weight change
of four commercially available flexible denture base materials immersed in artificial saliva for various time intervals.
Materials and Methods: Stainless steel die prepared with the dimension 40 mm × 10 mm × 3 mm. One hundred and twenty
samples were prepared and divided into four groups based on the materials. Materials used are Valplast, Breflex, TCS
unbreakable, and Iflex. Initial measurements were recorded for color stability, surface roughness, and water sorption. For flexural
strength, the initial measurements were taken as control. Samples were stored in artificial saliva for 1 month and 3 months,
respectively, and final measurements were noted. Three-point bend test was done in universal testing machine for flexural
strength; color stability with Vita easy shade spectrophotometer. Surface roughness with profilometer and the weight change
was evaluated using an analytical balance.
Results: A statistically significant difference was seen (P < 0.01) between Valplast, Breflex, TCS, and Iflex for flexural strength,
color stability, surface roughness, and weight change with significant difference between time intervals. An increase in surface
roughness and weight with increased immersion from 1 month to 3 months was observed whereas flexural strength and color
stability decreased from 1 month and 3 months.
Conclusion: Increase in immersion time increases the surface roughness, weight and decreases the color stability and flexural
strength of Valplast, Breflex, TCS, and Iflex. Better properties were exhibited by Breflex after 1 month and 3 months of immersion
in artificial saliva than Valpalst, TCS, and Iflex.

Knowledge, Attitude, and Practice Regarding Biomedical Waste Management among Dentists

2021-10-01T03:48:01+00:00

Background: With increase in number of dental clinics every year, biomedical waste (BMW) production increases accordingly.
Management of these wastes is a major part of clinical practice.
Aim and Objective: The objective of this study is to assess knowledge, attitude, and practice of BMW management among
dental students and practitioners.
Materials and Methods: This study involved 105 participants from undergraduates to private practitioners. The self-structured
questionnaire survey comprised 30 questions and it was conducted online. The data collected were transferred to version 20
SPSS software for statistical analysis.
Results: This study shows that about 60–80% of participants were aware of different categories of waste segregation, steps
in waste disposal and they also practice it. Around 70% of them practice the correct method for mercury disposal and 84% in
disposal of sharp needles. The major concern is about radiological waste disposal. Only 34% knew about desilvering of fixer
solution and 24% about recycling lead. More than 80% of the participants propose for proper training of the staffs handling
BMWs.
Conclusion: In this study, the postgraduates and interns had more awareness compared to the undergraduate students. There
is a lot of inadequacy in knowledge and practice which can be rectified from proper education and training at their early days
of clinical practice.

Stress-related Orofacial Diseases in Information Technology Professionals

2021-10-01T04:20:20+00:00

Introduction: Stress is believed to have major impact on the physical well-being of the individual and it does not spare the oral
cavity as well. These stress-induced orofacial disorders have various manifestations and are more prevalent in professionals
working in information technology (IT) field due to prolonged working hours and unreasonable deadlines.
Aim: This study aims to determine the prevalence of stress and stress-related orofacial diseases among the IT professionals.
Materials and Methods: A cross-sectional study was carried among 109 IT professionals working in a private firm after
obtaining clearance from the Institutional Ethical Committee and concerned authorities. It is performed by history taking using
a questionnaire based on perceived stress scale that had 14 questions and clinical examination. The data collected were
statistically evaluated.
Results: Among the 109 participants, 88 were male and 21 were female. This study revealed that they were stressed due to
the job and that xerostomia and aphthous ulcer were more prevalent (22.9%) in IT professionals followed by bruxism, burning
mouth syndrome, and temporomandibular joint disorders

International Journal of Scientific Study | July 2021 | Vol 9 | Issue 4 86 Comparative Study to Find Out the Role of Nutritional Factors in Hair Growth between Tribal and Semi-Urban Population

2021-10-01T05:44:47+00:00

Introduction: Hair is an important appendageal structure in the skin and hair growth is influenced by various factors like
nutritional, hormonal, psychosocial and genetic factors. All these factors affect hair growth by altering the microenvironment of
hair follicle which inturn results in changes in the hair cycle.
Materials and Methods: Our study was aimed to determine the role of nutritional factors such as Zinc, Iron, Calcium and
Protein in promoting hair growth and decreasing chronic hair loss in tribal and semiurban population. A set of questionnaire
were used to analyse the role of life style, nature of work and stress factors in influencing hair fall. The serum values of zinc,
iron, calcium and protein were measured for each individual in both tribal and semiurban population and the mean value of
all the four nutritional parameters were calculated separately and the results were analysed.
Results: The mean serum values of zinc, calcium and protein were almost similar in both tribal and urban people except
serum ferritin value which was more in tribal people. We compared the role of stress influencing hair cycle in semiurban and
tribal groups by analyzing the questionnaire.
Conclusion: The lifestyle without stress, good iron reserve with high ferritin level, usage of natural hair care products and
genetic factors could be the reason for healthy hair growth in tribal population. Reduction of stress factors in daily life, adequate
sleep and improving nutritional status may help to reduce hair fall in semiurban and urban population.

Impact of Different Endodontic Sealers on Retentive Strength of Fiber Posts – An In Vitro Study

2021-10-01T05:58:30+00:00

Aim: The aim of the study was to evaluate the effect of two different root canal sealers in relation to the retention of the
prefabricated fiber posts.
Materials and Methods: Twenty extracted single-rooted mandibular premolar teeth were prepared and randomly divided into two
groups. In Group 1, eugenol-based sealer was used while in Group 2, a resin-based root canal sealer was used. Prefabricated
fiber posts were luted into the prepared post-spaces with the same composite resin cement in both the groups. After calculating
the pullout forces required for dislodgment of posts post-spaces, the data were recorded and statistically analyzed.
Results: The resin-based root canal sealer group had significantly greater retentive strengths for the posts as compared to
eugenol-based sealers group (P > 0.0001).
Conclusion: The retentive strength for prefabricated fiber posts luted with resin cement was much more than those luted with
eugenol-based sealers. This was attributed to the different chemical composition of the two dealers.

Ultrasound-Guided Percutaneous Transhepatic Biliary Drainage Outcome at Tertiary Care Centre of North India

2021-10-01T06:29:01+00:00

Aims: The aim of this study is to know the feasibility and outcome of ultrasound-guided percutaneous transhepatic biliary
drainage (PTBD) at tertiary care center of North India.
Materials and Methods: This is a prospective observational study conducted on patients affected by biliary tree obstruction
with jaundice referred to department of radiodiagnosis for management of obstructive jaundice. Procedure (PTBD) has been
performed by single step puncturing the biliary system under ultrasound guidance.
Results: 110 patients affected by biliary tree obstruction were included in this study. The biliary obstruction was malignant
in 102 and benign in eight cases. Technical success considered as positioning of a drainage tube into the biliary tree by only
ultrasound guidance and single step puncture was 100%.
Conclusions: Only ultrasound guidance to access the biliary tree and single step puncture of bile duct for PTBD was a safe,
low cost, and effective technique for the management of obstructive biliary pathology.

Perspective Study of Elevated First Trimester C-reactive Protein as Predictor of Gestational Diabetes in South Karnataka Population: A Retrospective Study

2021-10-01T08:56:58+00:00

Background: The C-reactive protein (CRP) derived from the liver is sensitive and systemic biomarker of inflammation and has
been associated with increased risk of developing diabetes mellitus in pregnancy.
Materials and Methods: Ninety-two pregnant women having gestational diabetes of the first trimester and same number of
normal pregnant women of controlled group were studied. Blood sugar (fasting and postprandial) and CRP, body mass index
(BMI), age, and period of gestation/weeks of gestation were compared in both groups.
Results: The BMI of gestational diabetes group was 26.05 (SD ± 3.40) and 22.80 (SD ± 2.14), t-test was 7.75, and P-value
was highly significant. Laboratory findings, blood glucose (fasting and post-meal), and CRP (mg/l) were higher in gestation
diabetes and P-values were highly significant (P < 0.00). CRP values were more or less constant in blood glucose (fasting and
post-meal) hence P-value was insignificant (P > 0.98).
Conclusion: CRP values were higher in gestational diabetes due to inflammation and oxidative stress. These finding are
important for obstetrics and gynecologist to treat such patient efficiently to prevent morbidity and mortality of fetus and
mother too.

Demographic and Clinical Profile of Celiac Disease in Kashmiri Children: An Observational Study

2021-10-01T09:13:16+00:00

Introduction: Celiac disease is a common disorder in North India. No study is available regarding its clinicopathological
profile in Kashmiri children. Kashmir valley is abode to three different ethnicities principally constituted by Kashmiris and small
population of Pahari and Gujjar.
Aims and Objective: This study aims to study demographic and clinical profile of celiac disease in Kashmiri children.
Materials and Methods: The current study is hospital-based descriptive observational study conducted over 11/2 year. All patients
in the age group of 6 months–12 years presenting with chronic diarrhea and unexplained failure to thrive were evaluated for
celiac disease. A total of 62 patients were evaluated during the study period and 12 came positive for celiac disease (19%).
Results: Mean age of presentation is 6 years. Regarding principal modes of presentation, chronic diarrhea is observed in
10 (83%), unexplained failure to thrive 2 (16%), short stature 4 (33%), 7 out of 12 with wasting (58%), anemia 6 (50%), electrolyte
disturbance like hypokalemia in 7 (58%), with severe hypokalemia (k+<2) in three patients, and isolated hypertransaminasemia
in 4 (33%). Majority of the patients are Pahari/Gujjar (66%) despite constituting very little of whole population. This means that
a case of chronic diarrhea and unexplained failure to thrive is more likely to be celiac if belonging to this section of society.
Conclusion: Celiac disease is well present in Kashmiri children with case positivity rate among chronic diarrhea and unexplained
failure to thrive comparable to rest of North India and clinical spectrum shows malnutrition, anemia, and dyselectrolytemia in
majority of patients. Its prevalence varies between different ethnic groups being more in Pahari and Gujjar children as compared
to ethnic Kashmiri population.

Development and Evaluation of Gastroretentive Floating Matrix Tablets of Quetiapine Fumarate

2021-10-01T09:26:58+00:00

Introduction: The present study was carried out to evaluate gastroretentive floating matrix tablets of Quetiapine Fumarate
(QFR) to reduce the dose frequency and higher bioavailability.
Materials and Methods: Floating matrix tablets of QFR were prepared by employing gel-forming polymers such as hydroxypropyl
methylcellulose (HPMC) (K100M, K15M), methyl cellulose (MC), and xanthan gum (XG). The formulations were evaluated for
various physicochemical characteristics (weight, thickness, hardness, and diameter), drug and polymers compatibility, in vitro
buoyancy, swelling index (SI), in vitro drug release characterization, and in vivo X-ray studies.
Results: The differential scanning calorimetry studies revealed no interaction between the drug and polymers. All the
physicochemical properties of the developed formulations were found within the specified limits. Formulation containing HPMC
K100M and a higher concentration of MC floated immediately, followed by formulations with HPMC K15M. The SI was directly
associated with polymers concentrations (HPMC K100M, HPMC K15M and XG). The in vitro release studies showed that the
formulation F1 (HPMC K100M 80%) sustained the drug release (101.01%) for about 12 h. All the formulations followed zeroorder
kinetics and non-Fickian diffusion mechanism. In vivo X-ray studies of the selected formulation F1 (HPMC K100M 80%)
showed gastric retention time of about 12 h.
Conclusion: The present study results indicated a successful approach to achieve controlled release of QFR in the stomach
for 12 h. Further studies can be pursued to confirm improve the bioavailability of the QFR from the present formulation

Diabetic Foot: A Clinical Study

2021-10-01T09:31:37+00:00

Introduction: Diabetic foot complications remain major medical, social, economic problems that are seen in all types if diabetes
in every country; however, the reported frequencies of amputation and ulceration vary considerably as a consequence of
different diagnostic criteria used.
Aim: The aim of the study was to study the etiology, presentation, and the management of diabetic foot ulcers to study the
prognostic factors of diabetic foot in relation to plan of treatment and to increase the meager awareness of diabetic foot problems.
Materials and Methods: In this case study, 50 patients were studied. This study was conducted from September 2017 to
November 2019.The protocol for the study was approved both by the Department of General Surgery, Mahatma Gandhi Memorial
hospital, Kakatiya Medical College, Warangal.
Results: Findings were tabulated according to age and other clinical aspects.
Conclusion: Age, gender, duration of diabetes, mode of treatment of diabetes, and tobacco smoking did influence whether or
not a diabetic with a foot lesion will have major amputation, an unsatisfactory outcome of primary treatment, prolonged hospital
stay or will die Furthermore, the presence of foot infections alone, microangiopathy (nephropathy, retinopathy), foot ischemia
alone or neuropathy alone had no relationship to poor prognostic indices.

Comparison of Efficacy of Labetalol versus Alphamethyldopa in the Management of Preeclampsia

2021-10-01T09:37:48+00:00

risk of adverse outcomes. Preeclampsia is a multi-system disorder of unknown etiology, unique to pregnancy characterized by
the occurrence of gestational hypertension along with proteinuria after the 20th week of pregnancy in a previously normotensive
and non-proteinuric patient.
Aim: The aim of the study was to study the efficacy of oral labetalol versus oral Alpha-methyldopa in the management of
preeclampsia.
Methods: Hundred patients included in this study were assigned to two groups randomly of 50 patients in each group. Group 1:
Tablet Alpha-methyldopa (Aldomet) 250 mg was given thrice daily, and Group 2: Tablet Labetalol 100 mg was given twice daily.
Blood pressure (BP) and proteinuria were recorded every 12th h.
Results: Significant fall in the diastolic BP after 48 h occurred only in the labetalol group (P = 0.007). In the Alpha-methyldopa
group, there was a significant need to increase the drug dose after 48 h (P = 0.043). There appears to be no significant difference
in induction rate between the two groups (P = 0.585). The mean birth weight was significantly higher (P = 0.00) in the labetalol
group (3.11 kg) compared to the alpha methyldopa group (2.67 kg). There was no significant difference in the Appearance,
Pulse, Grimace, Activity, and Respiration scores (P = 0.090) and rate of neonatal admissions (P = 0.240) in both groups.
Conclusion: Labetalol controls systolic and diastolic BP more rapidly and effectively than methyldopa. The safety profile and
adverse effects of Labetalol and Methyldopa are similar to each other.

Clinical Study of Chronic Lower Limb Ischemia and Correlation with Color Doppler Scan

2021-10-01T09:48:42+00:00

Introduction: Chronic lower limb ischemia of the lower limb is a widely spread disease at the present time. It is a progressive
disease and mainly comprises of atherosclerosis and Buerger’s disease. Chronic critical limb ischemia is defined not only by
the clinical presentation but also by an objective measurement of impaired blood flow using radiological investigations like
color Doppler.
Aim: The aim of the study was to clinically evaluate patients of chronic lower limb ischemia and correlate the clinical findings
with color Doppler study.
Materials and Methods: This study includes 50 patients admitted at Index Medical College, Indore with symptoms of chronic
lower limb ischemia. Data were collected on basis of detailed history, clinical examination and color Doppler ultrasound findings.
Results: Out of the 50 patients observed the clinical diagnosis showed 24 patients as atherosclerosis and 26 patients as
Buerger’s disease. While color Doppler diagnosis revealed 26 patients as atherosclerosis and 24 patients to be Buerger’s disease.
Conclusion: Current study establishes a strong correlation between diagnosis made on clinical basis and color Doppler findings

Comparative Study of Intrathecal 0.5% Hyperbaric Bupivacaine with Dexmedetomidine and Fentanyl for Lower Abdominal Surgeries: A Randomized Double-blind Clinical Trial

2021-10-01T10:00:25+00:00

Background: In this modern year, the intrathecal adjuvants use has gained good acceptance in the field of anesthesiology. The
spinal anesthesia quality is very much improved with addition of opioids and other drugs and as we know, no drug is without
side effects. Spinal block has rapid onset, lower risk of infection rate and is very cost effective. However, post-operative pain
is a very significant problem as the drugs used have limited duration of action. Hence, the administration of analgesics plays
a key role postoperatively. To increase the duration and to reduce side effects, various local anesthetics and analgesics are
used in combination. Some of the drugs have been used as adjuvants in spinal anesthesia to prolong intra- and post-operative
analgesia which includes opioids, α2 agonists, vasoconstrictors, and other drugs.
Aim of the Study: The aim of the current study is to compare the efficacy of dexmedetomidine and fentanyl added to intrathecal
bupivacaine to evaluate the onset and duration of sensory and motor block, post-operative analgesia, hemodynamic effects,
and adverse effects of either drug in lower abdominal surgeries.
Materials and Methods: Sixty patients with the American Society of Anesthesiologists Grade I and II posted for lower abdominal
surgeries were allocated to two groups randomly (30 patients each): Group D received 2.5 ml 0.5% hyperbaric bupivacaine and
5 μg of dexmedetomidine intrathecally and Group F received 2.5 ml 0.5% hyperbaric bupivacaine and 25 μg of fentanyl intrathecally.
Results: Patients in Group F had faster onset of sensory block and motor block than Group D (P = 0.000). Patients in Group D
had significantly longer duration of motor and sensory blockade as compared to those in Group F (P = 0.000). Post-operative
analgesia was significantly longer in Group D than Group F (P = 0.000). Incidence of side effects among the two groups was
not statistically significant.
Conclusions: Fentanyl has its own benefits like faster onset compared with dexmedetomidine, but prolonged duration of motor
and sensory blockade with post-operative analgesia was seen with dexmedetomidine without significant side effects.

Efficacy of Superoxide Solution (Oxum) as Compared to Povidone-iodine in Healing of Chronic Ulcers

2021-10-01T11:16:43+00:00

Background: Wound healing is a dynamic and complex process. The main purpose of wound dressings is to provide the suitable
environment for healing. Various treatment modalities have been discovered over the years in the form of different types of
wound dressings. As wounds are great burdens on the health-care system contributing to substantial mortality, morbidity and
costs hence the need for study.
Materials and Methods: The present study is a single-center, prospective, clinical trial comparing oxum (superoxidized water)
and betadine as a topical treatment of chronic wounds conducted in 100 Indian patients, with 50 patients in each group. All
patients underwent daily dressing, debridement when needed and appropriate antibiotics. Clinical findings were recorded on
day 1, 5, 7, 12, and 21 and compared.
Results: Reduction in wound size in oxum group was more as compared to betadine, however, it was not significant on day
5, 7, and 12 but results were significant for day 21. Rate of secondary infection for Group A was 22.22% and Group B was
38.44%. Appearance of granulation tissue and epithelization was earlier in Group A as compared to Group B. At day 12 in
Group A, 96% of patients developed granulation, and in Group B, 56% of patients had granulation. At day 12 in Group A, 68%
of patients had epithelization, and in Group B, 36% of patients had epithelization. Average duration of hospital stay for Group A
was 19.84 days with SD of 16.041 while average hospital stay time for Group B was 25.31 with ±6.129. No adverse reaction
was seen in either group.
Conclusion: In the management of lower limb ulcer, a superoxide solution (SOS) debrides necrotic tissue, reduces microbial
load, promotes granulation, and decreases the healing time, without damaging the normal tissue or complications. Those
patients, who have small superficial ulcers or not fit for definite surgery, can be managed conservatively with SOS only. Hence,
SOS is safe, more effective, and efficacious as compared to povidone-iodine for ulcer management.

Correlation of Bone Marrow Aspiration, Trephine Biopsy, and Imprint Cytology in Pancytopenia/ Bicytopenia Cases in Resource-Limited Area

2021-10-01T11:26:38+00:00

Context: Bone marrow aspiration is a simple method to study hematopoietic disorders whereas trephine biopsy is of greater
value in assessing large piece of marrow. At the same time, imprint is helpful in getting morphological details of individual cell.
Aims: The aim of the present study was to correlate the findings of bone marrow aspirate, bone marrow biopsy (BMB), and
touch imprints in the diagnosis of pancytopenia/bicytopenia.
Settings and Design: This was a cross-sectional study.
Subjects and Methods: This 2-year cross-sectional study of 50 cases from year 2017 to 2019 is conducted in the Department
of Pathology in GMC, Haldwani. The clinical features of pancytopenia/bicytopenia were noted. Bone marrow aspiration (BMA)
along with bone marrow imprint (BMI) was evaluated and BMB was performed in all cases. BMA and imprint smears were stained
with Leishman stain and biopsy section was stained with H.E., PAS, and reticulin stain. Findings were studied and analyzed.
Statistical Analysis Used: All the data were compiled and entered into MS Excel. Statistical analysis was performed using
software SPSS‑20.
Results: In all 50 cases, definite diagnosis was made on BMB and strong positive correlation was seen between BMA, BMI,
and BMB (P < 0.00001). Furthermore, 100% correlation was seen in combined nutritional anemia, immune thrombocytopenic
purpura, and metastasis; whereas 82.6% correlation was seen in megaloblastic anemia, 55.6% in reactive marrow, and 50%
in acute leukemia.
Conclusions: The present study concludes that BMA and BMI give good cytomorphological details and take lesser time in
reporting as compared to BMB. BMB whereas is useful for assessment of cellularity, topography, and fibrosis. BMA alone is
usually sufficient to diagnose nutritional anemia, metastasis, and immune thrombocytopenia whereas trephine biopsy is the
sole diagnostic tool in myelofibrosis, granulomatous disease, and aplastic anemia.

The Interruption of Administering Routine Measles Vaccine in Nepal: A Point of Contention During and Post the Coronavirus Disease 2019 Pandemic?

2021-10-01T12:52:42+00:00

The interruption of administering routine measles vaccinations has put a significant strain on Nepal’s already overburdened
health system. Over five significant measles outbreaks have occurred in Nepal since the country’s nationwide lockdown began,
including in Kathmandu, the Capital. The interruption of immunization programs, as well as a drop in the number of confirmed
cases, may have a devastating effect in the coming days, placing the target of eliminating measles by 2023 in jeopardy. In this
review, we weigh the long-term impact on public health and consequences of disrupting the national immunization program
against staying at home to flatten the coronavirus disease 2019 (COVID-19) surge curve. We speculate that during and post
the COVID-19 pandemic; the measles endemic is imminent, particularly due to socioeconomic gaps and unhygienic measures.