bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyzing variability of craniometric parameters using computed tomography scan in Indian population
Authors: Sandeep B V  , Raj Swaroop Lavadi  , Banga Manpreet Singh , Sangamesh Halhalli  , Anantha Kishan  , Hiba Salam
Published: November 2022

Background: The craniovertebral junction (CVJ) is a crucial region of the spine designed for optimal movements of head and is also a frequent site for various pathological processes. The importance of knowing the CVJ parameters in normal population cannot be overstated when instrumentation and correction of deformities in this region is so frequently being performed. There is paucity of data defining the craniometrics of CVJ osteology in Indian population on the literature search. Accordingly, we present a study in an attempt to quantitate the normal craniometric indices for anatomically normal CVJ in Indian population and compare them with the existing literature from other regions.
Aims and Objectives: The aims of this study were to quantitate the normal craniometric indices for anatomically normal CVJ in Indian population and compare them with the existing literature from other regions.
Materials and Methods: Two hundred and forty computed tomography (CTs) belonging to Indians were looked at over a 6-month period retrospectively. These patients had normal CVJs and were ordered imaging for other health reasons. A total of eight parameters were analyzed for each CT.
Results: There were 166 (69.2%) males and 74 (30.8%) females in our study. The values (in mm) were as follows: anterior atlantodental interval (AADI), 1.78±0.42; PADI (posterior atlantodental interval), 18.12±1.97; distance of tip of odontoid process to chamberlain’s line, –2.73±2.63; distance of tip of odontoid process to McGregor’s line, –2.29±2.79; distance of tip of odontoid process to McRae’s line, –5.91±1.4; Clivus-canal angle, 160.82°±7.14°; basion dens interval, 5.6±1.45; and powers ratio, 0.71±0.07. No patient had an odontoid process extending beyond the McRae’s line. Males were more likely to have higher AADI and PADI values than females. Our study shared significant differences between the other studies (even the studies where an Indian population was used) except one. The AADI, from our study, did not vary significantly when compared to the AADI from a Chinese study.
Conclusion: Due to the significant differences from our study and the available literature, a greater compilation of studies belonging to different races will be required to understand the flexibility of the CVJ metrics.
Changes of trends in contraception in pandemic – A hospital-based study
Authors: Sarkar Suvobrata , Bhadra Banasree , Mukherjee Jayeeta , Roy Chowdhury Ranita , Ananya Arnna
Published: November 2022

Background: With the onset of COVID-19 pandemic, the life of humankind had changed a lot. With a change in health-care approach, contraception became a non-essential service and faced a downfall.
Aims and Objective: This study objective is to find out the changes in contraceptive usage in a tertiary care center.
Materials and Methods: The study is a retrospective observational study, in which contraceptive usage was compared between 2019 and 2020. Data obtained from record section of the institute were used as source. Attendance in Gynecological Outpatient Department, admission in maternity ward, and delivery rates were also compared between 2 years.
Results: Total contraceptive usage was decreased by 11.1% in 2020. Long-acting reversible contraceptives or short-acting both types were decreased in 2020, but maximum decrease was barrier method condom by 25.1% and oral contraceptive pills by 24.9%. Hospital maternity ward admission was less by 7% and delivery rates by 2.4%. Only medical termination of pregnancy showed an increased trend in 2020.
Conclusion: Pandemic also had caused a toll in family planning, and thus, overall decrease in usage was seen which can be detrimental to population control.
Iron deficiency as risk factor for febrile convulsion and the association of iron deficiency anemia and febrile convulsion
Authors: Mohammad Neyazuddin  , Rajendra Nistane
Published: November 2022

Background: Febrile seizure occurs in 2–5% of neurologically healthy infants and children. The recurrence of febrile seizures is 30% after single episode, 50% after 2 or more episodes, and 50% when febrile seizures occur in infants. Their incidence of febrile seizures in India is 10–17% which is higher than in developed countries (2–7%).
Aims and Objectives: The purpose of this study was to evaluate iron deficiency (ID) as a risk factor for febrile convulsion and the association of ID anemia with febrile convulsions.
Materials and Methods: This was an observational case–control study conducted in tertiary care center in central India between December 2019 and June 2021. All patients with febrile seizures taken as cases and control from similar age group with febrile illness. Body temperature of children in both the groups was measured and recorded. The blood tests of complete blood count, serum iron, and TIBC were performed.
Results: In the present study, mean age was 2.33 years in case and mean age was 2.204 years in control. The mean hemoglobin levels were 8.25±1 g/dL in the febrile seizure case group and 9.86±1.49 g/dL in the control group; and their statistical difference was significant. Serum ferritin values was significantly lower among cases group than the control group. The average of MCV, MCH, and MCHC for the case group was less than that of the control group. The present study also demonstrates an association between ID and febrile seizures. Thus, ID is one of the possible risk factors for febrile seizures.
Conclusion: The present study showed that hemoglobin, MCV, serum ferritin, and serum iron levels are significantly lower in children suffering from febrile seizures, suggesting that a low iron status has an important role in children with febrile seizures. Thus, ID is predictor for febrile convulsion.
Occurrence of hypoalbuminemia in cases of rhino-orbito-cererbral mucormycosis and its relationship with the disease severity according to staging, a tertiary care center-based study
Authors: Shyamash Mandal  , Monoj Mukherjee  , Satish Reddy Satty  , Souvik Das  , Atanu Chandra
Published: November 2022

Background: Mucormycosis is a serious but rare fungal infection with increasing incidence of rhino-orbito-cerebral mucormycosis (ROCM) in the setting of COVID-19. Some studies have shown presence of hypoalbuminemia in cases of mucormycosis, which can affect the prognosis, outcome, and also the drug toxicity in a significant way. A staging of ROCM was proposed and is being used widely based on clinical symptoms and signs, evaluation, and diagnosis.
Aims and Objectives: Our objective was to look for any relationship between two factors, occurrence of hypoalbuminemia and severity of ROCM according to staging.
Materials and Methods: The study was a hospital-based prospective cross-sectional study done on 41 ROCM patients. All patients of diagnosed ROCM were included by complete enumeration method. Serum albumin of every patient was measured using standard biochemical procedures and patients were divided into groups of normoalbuminemia (Serum albumin level >3.5 gm/dl), mild hypoalbuminemia (Serum albumin level 2.5–3.5 gm/dl), and severe hypoalbuminemia (Serum albumin level <2.5 gm/dl). All the patients were divided into Stage 1, 2, 3, and 4 according to severity of ROCM. Then, the occurrence of hypoalbuminemia was calculated among the patients and correlation between ROCM stages and severity of hypoalbuminemia was measured using standard statistical tools.
Results: Among the patients of ROCM, 15% patients did not develop any hypoalbuminemia. About 51% developed mild hypoalbuminemia and 34% developed severe hypoalbuminemia. Maximum number of severe hypoalbuminemia patients were found in the Stage 3 group [total 6 (35%)], but the incidence of the same was maximum in the Stage 4 group (56%). Mild hypoalbuminemia is most common (10) and also most prevalent in the Stage 3 group (59%).
Conclusion: We found out that serum albumin level is significantly affected by ROCM severity, that is, more severe the disease, more chance to develop hypoalbuminemia.
Management of symptomatic urolithiasis during pregnancy: Clinical experience from a tertiary centre
Authors: Shukla Abhishek , Dixit Vishakha , Jain Divya , Patel Shailendra , Jain Manish
Published: November 2022

Background: Urolithiasis during pregnancy is a complex health problem that can affect maternal and fetal health, needs adequate understanding of the management options available and their relative pros and cons. Patient management needs involvement of obstetrician, radiologist and urologist, as a multidisciplinary team, to avoid any obstetric complications, such as spontaneous abortion and preterm delivery.
Aims and Objectives: The aim of the study was to evaluate urolithiasis and its management in pregnant women at our tertiary care center.
Materials and Methods: We analyzed data of 45 patients diagnosed with urolithiasis during pregnancy between January 2017 and March 2022.We evaluated patients age, gestational age history of urolithiasis, physical examination findings, routine laboratory findings, location, and size of the stone. The effectiveness and complications of the applied treatment methods were also evaluated.
Results: The mean age of 45 patients included in our study was 25 (25.2±4.8) years with mean gestational age of 18.2 weeks. The mean stone size was 10.2 mm and the most common symptom at the time of presentation to hospital was flank pain (73%). Kidney stones were detected in 26 patients and ureteral stones in 19 patients. Although conservative treatment was sufficient in 22 (48.9%) patients, 31 (51.1%) patients required surgical intervention. Major obstetric complications, such as preterm delivery and miscarriage, did not occur in any patients.
Conclusion: Urolithiasis during pregnancy can pose a challenge to urologists, obstetricians, and radiologists, requiring a prompt diagnosis and urgent treatment. On failure of medical management, definitive endoscopic treatment of an acute stone event is a reasonable strategy. In determining the treatment options, fetal and maternal health should be of utmost importance.
Diagnostic utility of endoscopic duodenal biopsies and histopathological finding in upper gastrointestinal diseases: A 2-year analysis
Authors: Amruta Ashok Patil  , Sagar More  , Arpana Shinde
Published: November 2022

Background: Diseases of gastrointestinal (GI) tract present wit myriad signs and symptoms. Appropriate management of these diseases involves proper evaluation. Upper GI endoscopies are becoming increasingly popular because it helps in first localizing the lesion and then biopsy specimens can be obtained from affected area. Duodenal biopsy followed by histopathological examination may clinch the diagnosis in majority of the cases.
Aims and Objectives: The aim of the study was to find out diagnostic utility of endoscopic duodenal biopsies and histopathological finding in the upper GI diseases. (1) To analyze duodenal endoscopic biopsy samples obtained from patients presenting with the upper GI symptoms. (2) To correlate endoscopic and histopathological findings in studied cases.
Materials and Methods: A retrospective and prospective observational study was carried out at the private histopathology center over a period of 2 years. All the patients underwent upper GI endoscopy with duodenal biopsies using flexible endoscope. Histopathology of the samples obtained from endoscopic duodenal biopsies in patients presenting with the upper GI symptoms were analyzed. The endoscopic findings such as mass lesion or ulcerative lesion were correlated with histopathological findings.
Results: Out of these 704 biopsies, 303 (43.04%) were esophageal biopsies, 220 [31.25%] were gastric, and 181 [25.71%] were duodenal biopsies. There were 129 (71.27%) males and 52 (28.73%) females with a M: F ratio of 2.5: 1. The mean age of the cases was found to be 54.7±12.32 years. Out of 181 biopsies which were performed in this study, 100 (55.25%) lesions were found to be having neoplastic etiology whereas 81 (44.75%) lesions were found to have non-neoplastic etiology. Among patients who were found to have duodenal growth on endoscopy well differentiated adenocarcinoma (15.47%) followed by moderately differentiated adenocarcinoma (6.63%) were the common pathologies. In cases of non-neoplastic etiology, non-specific duodenitis was most common pathology (17.13%).
Conclusion: Endoscopic biopsy followed by histopathological examination is cornerstone of the management of patients presenting with intractable upper GI symptomatology.
Role of computed tomography in non-traumatic acute abdomen in adults
Authors: Rachna Chaurasia  , Pratyush Kumar
Published: November 2022

Background: The objective of this study was to study, assess, and diagnose causes of acute abdomen accurately, to determine the accuracy of multidetector computed tomography (CT) for confirmation of negative, diagnosed, or equivocal ultrasonography (USG) cases, and to establish role of CT as the primary imaging modality.
Aims and Objective: To study, assess and diagnose causes of acute abdomen accurately, To determine the accuracy of MDCT for confirmation of Negative, diagnosed or equivocal USG cases & To establish role of CT as the primary imaging modality.
Materials and Methods: One hundred and twenty random patients were included in this prospective study. USG and CT were done in all patients. Axial, coronal, and sagittal reformatted images were studied. Intravenous and oral contrast were also used depending on the clinical condition. All these patients were followed up diagnosis obtained before and after CT were compared with intraoperative findings or final clinical diagnosis at discharge.
Results: Among 120 patients, confirmative CT diagnosis was made in 111 cases and was discordant in seven cases, while two cases could not be followed up. Forty-five cases underwent surgical management and rest of them were managed medically.
Conclusion: CT abdomen done in patients presenting with non-traumatic acute abdominal pain which helps to make accurate diagnosis and planning the appropriate treatment.
Surgical outcomes of canalicular tear repair with self-retaining Mini-Monoka stent in a tertiary care hospital in Kashmir in North India
Authors: Birjees Hakak  , Junaid S Wani
Published: November 2022

Background: Canalicular lacerations contribute to approximately 16% of the eye lid injuries. The torn medial end is to be identified, cut end sutured, and then the canaliculus intubated to restore patency. Silicone being inert, flexible, easily available, and cost effective is the material of choice for lacrimal stenting.
Aims and Objectives: The aim of this study was to determine the surgical outcomes of the canalicular tear repair with the self-retaining Mini-Monoka stent in a tertiary care hospital in North India.
Materials and Methods: Patients presenting to tertiary care hospital in Kashmir, North India with canalicular tear from August 2019 to December 2020 were included in this prospective study and repaired with self-retaining Mini-Monoka stent under microscope. All the patients were analyzed for demographic data, mode of injury, complications, and outcomes and followed up after a week, 6 weeks, and 3 months and stent removed after 6 weeks.
Results: The study was conducted on 18 patients. The mean age of the patients was 37.5 years with male: female ratio of 5:1. The lower canaliculus was most commonly involved and road traffic accidents was the most common mode of injury (27.7%). The most common associated injury was lid injury (50%). The mean time of stent removal was 6 weeks±2 weeks. Syringing was done in all the patients except children. At last follow-up, 17 out of 18 patients had functional and anatomical success in terms of absence of epiphora and patent syringing and all the patients were cosmetically satisfied.
Conclusion: Our study concludes that surgical repair of canalicular tear with Mini-Monoka stent is a safe and simple reliable technique, cosmetically satisfying with minimal manipulation giving high functional and anatomical success rate post repair.
Evaluation of drug promotional literatures on angiotensin receptor blockers using World Health Organization criteria
Authors: Bhaumik Debasree , Das Lakshman , Bhattacharjee Prithul , Chakraborty Maitrayee , Ghosh Ranjib
Published: November 2022

Background: Drug promotional literatures (DPLs) are one of the well-known promotional activities of pharmaceutical industries which are sometimes inaccurate as well as of poor educational value. Angiotensin receptor blockers (ARBs) are one of the most commonly used antihypertensives. Therefore, this study was done to estimate the accuracy of DPLs on ARBs as per the World Health Organization (WHO) criteria.
Aims and Objectives: The aims of this study were to estimate the accuracy of DPLs on ARBs as per the WHO and to estimate the DPLs for types of claims and appropriateness of claims.
Materials and Methods: A cross-sectional observational study was carried out for 1 month. All the required information of selected DPLs on ARBs were recorded in a pro forma and were evaluated according to the WHO criteria.
Results: In this study, a total of 20 (twenty) DPLs were evaluated only on ARBs. It was observed that none of the DPLs fulfilled all the WHO criteria. In this study, some DPLs made multiple claims, as much as five per DPL. Claims were, further, analyzed and divided into appropriate and inappropriate. We have observed that 65.96% claims were appropriate and 34.04% claims were inappropriate.
Conclusion: This type of study can contribute to make prescribing practices rational as promotional activities influence the prescribing behavior of the health-care provider.
Patient load and spectrum of dental problems amongst the population attending outpatient services of a tertiary care medical college hospital, Arunachal Pradesh
Authors: Tumbi Lollen  , TageTamo  , Moji Jini  , Boro Pallavi , Naba Jyoti Saikia
Published: November 2022

Background: Evidences suggest relationship between periodontitis and systemic diseases such as cardiovascular diseases, diabetes mellitus, adverse pregnancy outcome, osteoporosis and chronic kidney diseases. Except for acute toothache and complicated local infection, other dental problems are often considered trivial, hence dental health is often neglected or omitted in health related discourses.
Aims and Objectives: (1) To assess the patient load in dental OPD compared to other outpatient departments and (2) examine the distribution of dental diseases among different age, gender and caste of dental patients in a tertiary care hospital over a 5 year period.
Materials and Methods: A hospital based retrospective study was conducted using data from Medical Record department of all OPD attendees (1,174,605) during the period from January 2016 to December 2020 in the tertiary care hospital of Arunachal Pradesh. The total number of dental OPD patients (57,198) was compared with the total and department wise OPD attendees during the same period. Out of all Dental patients , data of 11,225 were found to be complet ( cross checked MRD record with OPD register) hence analysed for distribution of disease as per age/ sex/ ethnicity.
Results: Emergency and Casualty department reported highest patient load, lowest in cardiology. Overall dental patient OPD load was highest in 2019 and lowest in 2020. Common dental problems were caries and its complications, root stamp/retained tooth, dental calculus, stain, and trauma related dental problems. Most of the trauma related cases were males, whereas other conditions like dental caries, root stamp, complication of caries, and dental calculus/stain were more common in females.
Conclusion: Data shows that the number of dental patients among all OPD attendees is high and the dental problems they present with are diverse in nature. The treatment provisions available in most health care centres are largely inadequate. Inclusion of Oral and Dental health in Planning of community health programs, sensitisation of all health care providers the importance of interdepartmental consultation with dental department and education of the masses in oral and dental care/hygiene are of paramount importance.
Study of histopathological spectrum of non-neoplastic lesions of the lung in autopsy specimen
Authors: Guru Aayushi , Meena Hariom , Sanjuna Dharmalingam  , Singh Nikita , Suresh Kumar Sutrakar
Published: November 2022

Background: Lungs are the major organ involved in infectious and occupational diseases almost secondarily involved in all forms of terminal diseases. Autopsy plays an important role in identifying and understanding the pathology of various respiratory diseases and lung lesions to find out the parenchymal pathology.
Aims and Objectives: This study aims to study the histopathological spectrum of non-neoplastic lung lesions in medicolegal autopsy and to assess the frequency of spectrum of lung lesions.
Materials and Methods: The present retrospective study was carried out in the Department of Pathology, Shyam Shah Medical College, Rewa, M.P., for a period of 18 months from July 2020 to January 2022. All 98 consecutive specimens of medicolegal autopsy were included with age from newborn to 70 years irrespective of gender and cause of death. The results were analyzed based on gross and microscopic findings.
Results: Among the 98 cases studied, 82 cases (84%) were of diseased and 16 cases (16%) were of non-diseased lung. The most common age group affected was 30–39 years with 30% of affected cases followed by 20–29 years with 21% of affected cases. Among 82 cases, the most common pulmonary lesion was pneumonia in 46% (45/98) of the total cases followed by congestion and edema seen in 22% (21/98) of the cases.
Conclusion: Histopathological study of lung autopsy helps in providing information for clinical diagnosis of non-neoplastic lung lesions that act as a tool for better clinical assessment and help to establish a correct prophylactic measure. The histopathological examination (HPE) helps in establishing the final cause of death. The HPE helps in establishing the final cause of death. Therefore, autopsy study is very helpful in refining the vision and diagnostic setup for better evaluation.
Methicillin-resistant Staphylococcus aureus causing ocular infections in a tertiary care center in north India
Authors: Shariq Wadood Khan  , Adil Raza  , Shaik Mohammed Zakir  , Haris Manzoor Khan  , Mohammad Shahid
Published: November 2022

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is often the cause of serious ocular infections that are difficult to treat, and these ocular infections are a significant public health problem.
Aims and Objective: The study aimed to determine the prevalence and antimicrobial susceptibility pattern of MRSA in ocular infections.
Materials and Methods: The patients were recruited from the outpatient and inpatient departments from July 2018 to February 2021 from the Institute of Ophthalmology and study was done in the Department of Microbiology, JNMC, AMU, Aligarh (UP). MRSA was identified by Cefoxitin disk diffusionmethod. Polymerase chain reaction was used for detection of mecA gene.
Results: Seventy-six S. aureus were found in 350 patients with clinically suspected various bacterial infections. Among all S. aureus, 41 (53.94%) were MRSA. Maximum 10 (24.4%) MRSA were isolated from lacrimal apparatus infection followed by 7 (17%) in lid infection, and 6 (14.6%) in keratitis. All MRSA isolates were positive for mec A gene. MRSA isolates showed 85.3% sensitivity to amikacin and 100% to vancomycin. Fluoroquinolones showed resistance to the majority of MRSA strains.
Conclusion: MRSA is the main pathogen of ocular infections, resistant to a wide range of antibiotics. The monitoring of antibiotic sensitivity patterns, regular surveillance of associated ocular diseases, and strict antibiotics policy should be followed in an institute.
A randomized, controlled, and clinical trial to evaluate the efficacy of electrical vestibular stimulation, compared to a sham control for the management of sleep and autonomic parameters in patients with Parkinson’s disease
Authors: Goothy Sai Sailesh kumar , Gawarikar Sudhir , Choudhary Anita , Potey Gajanan Govind  , Purohit Manju , Pathak Ashish , Chouhan Rohit Singh , Mahadik Vijay Khanderao
Published: November 2022

Background: Electrical vestibular nerve stimulation (VeNs) was simple, non-invasive, and can administer the stimulus in a controlled manner. The studies related to the application of electrical VeNs in the management of sleep and autonomic parameters were sparse in the Indian population.
Aims and Objectives: The present study was undertaken to observe the effectiveness of electrical VeNs in the management of sleep and autonomic parameters in patients with Parkinson’s disease (PD).
Materials and Methods: Thirty cases of PD, both the genders, were recruited in the study by convenient sampling after obtaining written informed consent. After recording baseline parameters of Insomnia Severity Index (ISI), systolic and diastolic blood pressure (DBP), and pulse rate, electrical VeNs was administered to the intervention group and placebo stimulation was administered to the control group for 12 weeks. Post-intervention parameters were recorded after 6 weeks and after 12 weeks after the intervention in both control and intervention groups.
Results: There was a significant decrease in the ISI scores, pulse rate, and systolic blood pressure after the intervention in the participants of the intervention group. DBP was decreased but was not statistically significant. There was no significant difference in the ISI scores, pulse rate, and systolic and DBP before and after the intervention in the participants of the control group.
Conclusion: The present study results support the improvement of sleep followed by electrical VeNs. The study recommends detailed studies in this area to support the incorporation of electrical VeNs in the management strategy of PD.
Study of fetomaternal outcomes in eclampsia in correlation to coagulation profile in a tertiary care center in Mumbai
Authors: Ashrulina Pal Banerjee  , Patra Kajal Kumar , Ritam De
Published: November 2022

Background: Eclampsia is the leading cause of maternal and perinatal mortality as well as morbidity. The present study was conducted to assess the severity of eclampsia and coagulopathy by a method that is rapid, cheaper, and easily available and to assess the clinical evaluation and comparison of the fetomaternal outcomes in eclampsia with normal and deranged coagulation profiles.
Aims and Objectives: This study aims to assess the severity of eclampsia and coagulopathy by a method that is rapid, cheaper, and easily available and to assess the clinical evaluation and comparison of the fetomaternal outcomes in eclampsia with normal and deranged coagulation profiles.
Materials and Methods: A hospital-based prospective case–control study was done at tertiary care institute in the department of obstetrics and gynecology over a period of 1½ years from February 2018 to August 2019. Template was generated in MS Excel sheet and analysis was done on SPSS software.
Results: Overall incidence of eclampsia was found to be 2.4%. Majority of the eclampsia patients in both normal coagulation profile group and deranged coagulation profile group were in the age group of 21–25 years (42.8% and 46.6%, respectively). The most common maternal outcome in the eclampsia patients with both normal (50%) and deranged (36.6%) coagulation profile was operative intervention, that is, lower segment cesarean section, followed by the requirement of maternal intensive care in critical care unit or medical intensive care unit. The least common fetal outcome among those with normal coagulation profile being neonatal death and still birth accounting for 2.85% of cases each whereas among those with deranged coagulation profile, the least common outcome being very low birth weight accounting for 3.33% of cases. Of the 46 eclampsia mothers who underwent operative intervention, 93.47% had normal platelet counts and 6.52% had thrombocytopenia. Of the eight neonatal deaths, 50% were among those of eclampsia mothers with normal platelet count and 50% among those with thrombocytopenia.
Conclusion: In the present study, eclampsia accounted for 2.3% of all deliveries. Hence, relevant investigations need to be promptly done to identify the derangement of the coagulation profile in cases of eclampsia and pre-eclampsia which can alert the obstetrician of the severity of the disease so that appropriate and timely management can be initiated to prevent adverse outcomes.
Posterior reversible encephalopathy syndrome: An uncommon sequelae of Eclampsia
Authors: Biswas Jhuma , Banerjee Prosenjit , Datta Mallika , Bhattacharya Namrata , Maitra Arghya , Mitra Divyangana , Ghosh Utsa
Published: November 2022

Posterior reversible encephalopathy syndrome (PRES) refers to a clinical neuro-radiologic entity with characteristic features on neuro-imaging depicting posterior cerebral white matter edema. Clinical symptoms include headache, visual disturbances, confusion, and seizures. We report six cases of acute PRES who had eclampsia and presented with recurrent episodes of convulsions and hypertension. Magnetic resonance imaging scan showed diffuse abnormal signal intensities involving deep white matter of occipital region. Follow-up examination after 2 weeks of conservative management, showed marked improvement clinically and on neuro-imaging following which patients were discharged in stable condition.
Depression, anxiety, and stress among undergraduate medical students: A cross-sectional study in Kancheepuram, India
Authors: Recharla Chenchu Karthik  , Balaji Arumugam  , Ajay Chandrasekar VS  , Anusuya Ganesh Shanmugasundaram , Karthick Malarvannan
Published: November 2022

Background: Medical education is recognized as a stressful education that often negatively impacts academic performance, physical health, and psychological health.
Aims and Objectives: Hence, the aims and objectives of this study was to assess the prevalence of depression, anxiety, and stress levels among undergraduate medical students.
Materials and Methods: A cross-sectional study was conducted at tertiary medical college in Kancheepuram from November 1, 2019, to December 31, 2019. A total of 360 undergraduate medical students were recruited from the 1st year to the final year. Each year was considered a stratum, and from each stratum through simple random sampling, 90 students were selected. A self-administered, pre-designed, pre-tested anonymous questionnaire-depression anxiety and stress scale 21 was used for data collection. CoGuide software was used for statistical analysis.
Results: Out of 360 medical students, 157 were male and 203 were female with a mean age of 19.98±1.17. Sixty-six (18.33%) study participants had a family history of mental illness. The overall prevalence of depression was 48.33%, 60.56% had anxiety, and 27.22% had stress. Females were more affected than their male counterparts. The prevalence was significantly more among those having a family history of mental illness.
Conclusion: The prevalence of depression was 48.33%, anxiety was 60.56%, and stress was 27.22%. Regular health education, stress counseling, and peer group sessions can reduce the level of mental distress among medical students.
Quality of life of Indian head and neck cancer patients before and after treatment: A prospective study from a tertiary cancer center
Authors: Aparajita Sadhya  , Saptarshi Banerjee  , Sharmista Daripa  , Srikrishna Mandal  , Anjan Bera
Published: November 2022

Background: Health-related quality of life (HRQoL) is defined as a specific subset of QoL, assessing symptoms, psychological aspects, and function. It is very important for healthcare professionals to recognize the issue-related to the QoL of head and neck cancer patients.
Aims and Objectives: This study intended to measure different domains of QoL in head and neck cancer patients before and at the time of radiotherapy (RT) treatment completion, 3 and 6 months after treatment completion, and to discover the relationship between the type of treatment and QoL.
Materials and Methods: An assessment of pre- and post-RT QoL of sixty head and neck cancer patients was done at our RT department, using the European Organization for Research and treatment of cancer QoL questionnaire head and neck cancer module (EORTC QLQ H&N 35).
Results: Statistically significant differences were observed compared to baseline (P < 0.001) at the completion of radiotherapy in pain, swallowing, speech, cough, dry mouth, mouth opening, and senses scale and at 3.6 months of follow-up, while the HNSS (sticky saliva) scale showed statistically insignificant result at Zero (0) months (at the time of completion of radiation).
Conclusion: The results of our study showed that QoL in head and neck carcinoma patients is affected in various functional and symptoms-related domains and their overall health and QoL perceived were not very satisfactory. These post-treatment-related complications were not preventable and should be talked about with the patients before starting RT.
Effectiveness of 12 weeks of electrical vestibular nerve stimulation in the management of obesity: A pilot study
Authors: Goothy Sai Sailesh kumar , Santoshkumar Bhise  , Shyma Parapurath  , Anita Choudhary  , Sudhir Gawarikar  , Rajagopalan Vijayaraghavan  , Vijay Khanderao Mahadik
Published: November 2022

Background: It was hypothesized that electrical vestibular nerve stimulation (VeNs) was an effective therapy in the management of obesity.
Aims and Objectives: The present pilot study was undertaken to observe the efficacy of 12-week electrical VeNs in the management of obesity.
Materials and Methods: As this is a pilot study, a total of ten obese male and female participants were recruited after obtaining written, informed consent. After recording the baseline values, electrical VeNs was administered as an intervention for 12 weeks. The post-interventional assessment was done after 12 weeks.
Results: There was a significant decrease in the serum cholesterol, VLDL, and HbA1C followed by the vestibular stimulation for 12 weeks. Although the body weight was decreased, it was not statistically significant.
Conclusion: The present pilot study results support the positive impact of electrical VeNs in the management of obesity. Further, detailed studies with higher sample size were recommended to provide adequate scientific evidence to adopt electrical VeNs as an alternative therapy for the management of obesity.
Etiology, clinical profile, and immediate outcome of neonatal encephalopathy in Northeast India: A hospital-based cross-sectional study
Authors: Kumari Anamika , Dutta Sudip , Pradhan Ashish , Kumar Sudesh , Ojha Maitreyi
Published: November 2022

Background: Neonatal encephalopathy (NE) is one of the important causes contributing to neonatal death and disability. Knowledge about associated probable risk factors of NE will be helpful in developing strategies for proper intervention and early management.
Aims and Objectives: This study aims to describe the etiology, clinical features, and immediate outcomes of NE in the northeastern part of India.
Materials and Methods: This hospital-based, cross-sectional observational study included cases of NE beyond 35 weeks of gestation from February 2018 to July 2019. Demographic profiles, risk factors, clinical features, laboratory investigations, imaging, and outcome data were collected and analyzed.
Results: A total of 82 patients comprising males (59.7%) and females (40.2%) were included in the study. The mean age of gestation in weeks is 37.60±3.5 SD. Meconium-stained liquor was the most frequent etiology (n=30; 36.5%), followed by dyselectrolytemia (n=8; 9.7%), abnormal hydramnios (oligo or poly) (n=5.6%), and twin pregnancy and instrumental delivery (n=4; 4.8%). Seizures (n=37; 45.1%) were the most common presentation followed by respiratory distress or difficulty (n=25; 30.4%). Around 41.4% suffered from dyselectrolytemia followed by positive sepsis screening of 39%. Most of the cases (87.8%) were discharged after receiving appropriate treatment.
Conclusion: The prevalence of neonates with NE as noted in this hospital-based, cross-sectional study was 2.8%. It was found that in most cases, the probable causative factors occurred during the antenatal and intranatal period. Convulsions were the most common clinical presentation among the affected neonates. Most of the admitted neonates had dyselectrolytemia, suggesting that the renal system was predominantly affected, while the immediate outcome was satisfactory.
An observational and cross-sectional study on prevalence of cognitive impairment and short-term changes in cognitive function after ischemic stroke in a tertiary care hospital
Authors: Pal Anushree , Chakraborty Durga Prasad , Mondal Soumya Sarathi , Mandal Mahadeb
Published: November 2022

Background: Stroke is a leading cause physical and cognitive disability.
Aims and Objectives: The aims of this study were to investigate the prevalence and pattern of cognitive impairment (CI) after first-ever ischemic stroke.
Materials and Methods: Sixty subjects with first-ever ischemic strokes, confirmed by magnetic resonance imaging (MRI), were selected. Their clinic-diagnostic and comorbidity data were collected. Mini mental state examination (MMSE) was done after 3–7 days on each patient. MRI was used to ascertain the side, vascular territory, extent, and neural tissues (cortical/subcortical) involved. CIs were categorized as normal, mild, and moderate-to-severe according to MMSE scores ≥ 24, 18–23, and 0–17, respectively. Data were summarized as mean±standard deviation (SD) for numerical variables and counts and percentages for categorical variables.
Results: (1) Elderly (61–70 years), male and higher educated patients were more prevalent, hypertension (HTN) was the most common comorbidity. (2) Subcortical, middle cerebral artery (MCA), and anterior cerebral artery (ACA) lesions and non-dominant side involvement were common. (3) 80% patients had CI (65% mild and 15% moderate-to-severe). (4) CI was the most common in patients aged 71–80 years, of lower educational status and having both diabetes and HTN. MCA territory strokes and non-dominant side involvement resulted in more moderate/severe CI. (5) Registration followed by recall was least affected whereas language and praxis were more affected domains.
Conclusion: Post-stroke cognitive decline is more common in elderly population and patients with lower education. CI is more in people with HTN and DM and in people with MCA territory infarct. Language and praxis were the most affected domain of all.
Study on spectrum of nephrotic syndrome in adults in a tertiary care hospital of eastern India
Authors: Pradeep Chakraborty  , Sujata Mazumdar  , Choudhury Sayan , Mondal Shyamosree
Published: November 2022

Background: Nephrotic syndrome is a very common yet perplexing kidney disease whose spectrum has undergone a gradual change globally over time. Within various Asian countries, the spectrum of adult nephrotic syndrome varies according to the place of origin.
Aims and Objectives: The purpose of this study is to know the clinical presentation, laboratory abnormalities, histopathological spectrum of adult nephrotic syndrome, and its changing trends compared to previous studies.
Materials and Methods: This observational cross-sectional study includes 50 cases of biopsy proven nephrotic syndrome admitted under general medicine department of a tertiary care hospital of Kolkata from March 2020 to February 2021. Proper history taking, clinical examination, and relevant laboratory investigations were done.
Results: The mean age of presentation was 34.56±12.033 years with 27 males and 23 females. Oliguria was the most common presentation. Facial puffiness was the most predominant clinical finding closely followed by generalized swelling, pedal edema and ascites. 44 (88%) patients had serum albumin level ≤3 g/dl and all 50 (100%) patients had serum cholesterol values >200 mg/dl. 46 (92%) patients had a 24 h urinary protein level >3.5 g whereas 33 (66%) patients had 3+grade and 8 (16%) patients had 4+grade albuminuria. The most predominant renal biopsy variety was found to be focal segmental glomerulosclerosis (FSGS), seen in 27 (54%) patients followed by minimal change disease in 14 (28%) patients. 44 (88%) patients had primary glomerular disease (PGD) and 6 (12%) patients had secondary glomerular disease (SGD). The most common type of PGD and SGD was FSGS (59.09%) and lupus nephritis (4%), respectively.
Conclusion: Widely varying etiology and clinical presentation makes early diagnosis by renal biopsy critical to properly categorize the disease and direct subsequent clinical approach in adults.
Survey of urologists over the management of benign prostatic hyperplasia in India
Authors: Pandey Meghna , Sharma Shweta , Yadav Dinesh Kumar , Gupta Yogendra Kumar , Komal
Published: November 2022

Background: The benign enlargement of the prostate gland is known as benign prostatic hyperplasia (BPH). It refers to stromal and glandular epithelial hyperplasia that develops in the region of the prostate that surrounds the urethra known as the periurethral transition zone.
Aims and Objectives: The aim of the study was to perform a survey of urologists over the management of BPH in India.
Materials and Methods: A survey questionnaire was e-mailed to a random sample of 57 urologists of India through surveymonkey.com. The enrolled questionnaires were statistically analyzed. Of the 57 questionnaires sent, nine were returned, and 48 of those were included in the final analysis (response rate of 84.21%).
Results: Majority of urologists’ opinion is that USG-KUB with uroflowmetry is the most reliable investigation for diagnosis of BPH. Tamsulosin (tamsulosin 0.4 mg) was the most preferred α-1 selective blocker drug in BPH patients across all the age groups, whereas silodosin was the most preferred α-1 selective blocker drug in cardiac patients having BPH. The preferred 5-alpha reductase inhibiting drug and dose was recorded as dutasteride 0.5 mg/day. Solifenacin is the preferred anti-cholinergic drug for urinary urgency and incontinence. The IPSS score of the patient improved usually within 1–6 weeks of treatment with alpha blockers/5-alpha reductase inhibitor. As per Indian urologists, the drug therapy with alpha blockers gave the fastest symptomatic improvement in BPH patients.
Conclusion: In our conclusion, there is no uniformity in the treatment of acute urinary retention; however, the overall care must be individualized for the patient. Lack of understanding of the population’s history of BPH hinders advancement in appropriate care.
Assessment of Self Disinfecting Capacity and Dimensional Stability of Irreversible Hydrocolloid Impression Material Mixed With Different Concentrations of Chlorhexidine Solution-An Invitro Study
Authors: Pradhan B. , Joshi S. P. , Sah S. , Verma A.
Published: November 2022

Introduction: Impression materials are used to record the anatomical topography of oral tissues. Irreversible hydrocolloid is an impression material routinely used in dentistry. However, it retains bacteria, 2 to 3 times higher than other impression material. Spraying and immersion technique has been employed for disinfection of irreversible hydrocolloid with varying degree of success. Thus the need of impression material that has self-disinfecting capacity seems to be very important to have infection control in dentistry.
Materials and Methods: This invitro study was done in two parts. Assessment of self-disinfecting capacity of irreversible hydrocolloid impression material mixed with different concentrations of chlorhexidine solution and dimensional stability of irreversible hydrocolloid impression material mixed with different concentrations of chlorhexidine solution. For assessment of self-disinfecting capacity, irreversible hydrocolloid was mixed with various concentrations of chlorhexidine (0.05%, 0.1%, 0.2%) and distilled water. Total 64 culture plates were prepared, n=16 for each group of microorganisms (E. coli, S. aureus, Pseudomonas, Klebsiella). Inhibition zones were measured for each microorganism. For dimensional stability, the specimens were divided into four groups similar to specimen for self-disinfecting ability. Total 56 samples were prepared, n=14 for each group. Interpretation (IP), Mesiodistal (MD), Buccolingual (BL), Occlusogingival (OG) dimensions were measured by digital Vernier caliper. One-way analysis of variance was done for assessment of self-disinfecting capacity and for dimensional stability. Dunnett comparison test was performed to test the significance between test and control. P value was calculated under the predetermined level of significance (0.05).
Results: Zones of inhibition were observed around test specimens (groups 0.05, 0.1, 0.2), but not around control specimen (Group d/w). There was a significant difference in the mean diameters of the inhibition zones between test groups and control which was statistically highly significant (p < 0.001). In the test for dimensional stability, no significant differences were detected among groups for all the measured dimensions (p> 0.05).
Conclusion: Irreversible hydrocolloid impression material mixed with chlorhexidine exhibits varying degrees of self-disinfecting activity without influencing the dimensional stability of set material.
Relationship of Interalar and Intercommissural Distance with the Width of Maxillary Anterior Teeth
Authors: Ghimire B. , Dhital S. , Neupane P.
Published: November 2022

Introduction: The anterior teeth are primarily selected to satisfy esthetics. Their selection requires the dentist’s artistic skill and scientific knowledge. This clinical study was conducted to explore the relationship of interalar and intercommissural distance with the combined width of maxillary anterior teeth.
Materials and Methods: Measurements of the parameters was made using a Digital caliper. The patient was seated up right position and asked to look straight; the intercommisural and interalar width were measured between commissures and ala without applying pressure. The combined width of maxillary anteriors form the distal surface of left and right canines were measured with a dental floss, which was then sectioned and measured. Each parameter was measured three times and the average value was computed and recorded.
Results: Mean Interalar, intercommisural and intercanine distance were 34.72 mm, 48.9 mm and 49.61 mm respectively. Statistical analysis revealed a highly significant difference between the interalar width, intercommisural width and intercanine width of male and female respectively. Spearman’s rho analysis showed a highly significant correlation between Inter canine and both inter alar width (r=0.098, p <0.04) and Intercommisural width (r=0.234, p <0.05). Similarly, Spearman’s rho analysis in both sexes showed a highly significant correlation between intercanine and intercommisural width however such correlation was not seen between intercanine and inter alar width.
Conclusions: This study concluded that there is significant correlation between interalar and intercommissural width with the combined width of maxillary anterior teeth. The inter alar and inter commissural width may be a useful guideline for the selection and replacement of maxillary anterior artificial teeth.