bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of administration of melatonin on agitation and duration of stay in patients of traumatic brain injury admitted to neurosurgical intensive care unit –A retrospective study
Authors: Zulfiqar Ali  , Iqra Nazir  , Shahid Ahmad Mir  , Zoya Sehar  , Aymen Masood  , Eman Aftab  , Muqtashid Rashid
Published: January 2025

Background: Agitation is frequently encountered in patients recovering from traumatic brain injury in intensive care unit .The etiopathology for agitation is multifactorial.  Melatonin has been widely used to study the effects of delirium in intensive care unit, however its effect on agitation are not well studied.
Objectives: To assess the effect of melatonin administration on the prevalence of agitation and length of stay in patients with severe traumatic brain injury, managed conservatively or undergoing decompressive craniectomy.
Study design: A retrospective observational study.
Participants: 70 patients undergoing various decompressive craniotomy or managed conservatively, and admitted to NSICU were included in the study. 36 patients were recruited from the control group and 34 patients received melatonin during their stay in the intensive care unit.
Methods: In this study, records of 70 patients who had suffered isolated traumatic brain injury with no associated injuries were analysed. The patients had a Glasgow coma score of 3-14 on admission to intensive care unit. The patients were managed as per the standard protocols, as per the existing guidelines, based on traumatic brain injury guidelines.
Results: A non-significant decreasing trend of agitation and reduced duration of ICU stay was noted in patients who received melatonin compared with the control group. The prevalence of agitation observed on modified Ramsay scale (Mean±SD) in patients who received melatonin  on Day 3, Day 4 , Day 5, Day 6 , Day 7 , Day 8, Day 9 were -1.67 ± 3.01;-1.61 ± 2.82;-1.2 ± 2.55;-1.23 ± 2.51; -1.23 ± 2.11;-1.05 ± 2.09 and 0.76 ±2.03 respectively. These scores were slightly lower than observed in the control group  on  Day 3, Day 4 , Day 5, Day 6 , Day 7 , Day 8, Day 9 as -1.58 ± 3.16;-1.33 ± 2.72;-1.08 ± 2.46;-1.13 ± 2.25; -0.94 ± 1.87;-0.52 ± 1.7 and 0.52 ±1.36 respectively. The mean± SD duration of stay in intensive care unit of patients receiving melatonin (13.14 ±3.37) and not receiving melatonin (14.52±3.73) was comparable (p value = 0.1.)
Conclusions: Though there was a decreased prevalence of agitation and a decrease in mean duration of the ICU stay in patients who received oral melatonin, these beneficial effects did not show any statistical significance once compared with the control group.
The prevalence of internet addiction and associated factors among undergraduate medical students in government medical college, Almora
Authors: Preeti  , Masroof Hasan Khan  , Sneha Mittal  , Vikram Singh Dhapola
Published: January 2025

Background: The internet, computers, smartphones, and other electronic device’s use has increased suddenly over recent decades. Although this increase has benefits to the users, but also excessive use often leads negative health consequences.
Aims and Objectives: The objective of this study was to measure the prevalence of internet addiction (IA) and stress among undergraduate medical students.
Materials and Methods: A descriptive cross-sectional study was conducted among 299 undergraduate medical students enrolled in the government medical college, Almora. A 20-item Young’s IA test which is a Likert scale-based interview schedule was used to measure the prevalence of IA and the perceived stress scale 14 scale is used to assess stress among them.
Results: Among the 299 study subjects, 49.5% were males and 50.5% were females. Males were more addicted to the internet than females. The prevalence of IA among the study subjects in the present study was 45.4% mild, 13.8% moderate, while 40.8% of students reported normal internet usage.
Conclusion: IA is a growing health problem among medical students these days, thus necessary preventive and therapeutic interventions are very important to promote healthy and safe usage of the internet.
Clinicoetiological profile and outcome of patients of acute febrile encephalopathy in a tertiary care hospital in New Delhi - A prospective observational study
Authors: Maqsood Ahmad Dar  , Eijaz Ahmed Bhat  , Ajay Kotwal  , Mir Sadaqat Hassan Zaffer  , Owvass Hamid Dar
Published: January 2025

Background: Acute febrile encephalopathy (AFE) in spite of being a common clinical condition is less known to the general population thereby resulting in delay in seeking medical attention with detrimental consequences. The causes can range from infectious central nervous system (CNS) and systemic diseases to non-infectious conditions such as neuroleptic malignant syndrome, poisoning, and drug overdose. Early diagnosis and prompt medical management can result in good clinical outcome in terms of morbidity and mortality.
Aims and Objectives: The aims and objectives are to study the clinical profile, etiology, seasonal variation, and outcome in patients admitted as case of AFE in a tertiary care hospital.
Materials and Methods: All patients of AFE fulfilling the inclusion and exclusion criteria admitted in the departments of neurology and general medicine in Batra Hospital and Medical Research Centre (BHMRC) New Delhi, a tertiary care hospital were subjected to study analysis. The patients underwent detailed history, examination, baseline, and special investigations such as cerebrospinal fluid and magnetic resonance imaging brain whenever needed. Patients of AFE were studied according to the prevalence, etiological diagnosis, and seasonal variations. The final outcome at discharge was based on modified Rankin scale (mRs).
Results: About 122 serially admitted patients diagnosed with AFE were found eligible and included in the study. About 47 (45%) patients had acute pyogenic CNS infection while as 36 (35%) had non-pyogenic CNS infection followed by malarial, tubercular, and cryptococcal CNS infection. We found maximum number of cases (n=61, 50%) of AFE during monsoon followed by 36 patients (30%) in post-monsoon, 15 patients (12%) were in summer, and only 10 cases (8%) during winter. We found higher and statistically significant disability in CNS infection group, patients with delayed hospitalization (P=0.001), and lower Glasgow coma scale (0.00001).
Conclusion: AFE being a condition with serious consequences, we conclude that clinical suspicion, sensitization, and swift response from the treating physicians are required to avoid worse outcomes associated with the delayed diagnosis and late hospitalization of these patients.
Determining the factors which impact management of acute poisonings due to therapeutic medicines
Authors: Aishwarya Sudan  , Princy Louis Palatty  , Mamatha Jayachandran  , Sabarish Balachandran
Published: January 2025

Background: In a developing country such as India, intentional poisoning is associated with a high degree of morbidity and mortality. Historically, the use of agricultural poisons for attempted deliberate self-harm (DSH) has taken precedence. However, urbanization and stringent laws governing sale of agricultural chemicals, in recent years, may have shifted the focus of seekers toward commercially available therapeutic medications. Further, urbanization, high health-care seeking behavior, and poor regulation on sale of medicines, in Kerala, provide a conducive environment for such attempts.
Aims and Objectives: The objective of this study was to determine the contribution of therapeutic medication toward acute poisoning as a means of DSH and the factors contributing to the same.
Materials and Methods: Patients who obtained treatment for acute poisoning after DSH, between 2017 and 2023, were screened, those who employed therapeutic medication for the same were further determined. Sociodemographic details, clinical profile, and history of previous such attempts and treatment history including toxicological screening report were gathered and analyzed.
Results: In our study of 154 patients arriving at the emergency department with history of DSH, 41% used therapeutic medicines for the same. Majority were women (75%) and most had a high school education (64%) or above. The most common agents were determined as paracetamol (23%) and benzodiazepine (10.6%). Tox screen was performed for 45% of patients. Organ failure developed in 36% patients with drug levels above and 42% of those with levels below the therapeutic range. However, 48% of those who did not undergo toxicological screening developed organ failure. Organ failure developed in 42% of patients, with acute liver injury being the most common culprit (25%). Management was symptomatic unless an antidote was available.
Conclusion: Prescription drugs utilization for DSH was common in women and patients with higher educational status. Over-the-counter drugs and psychiatric medication were frequently used. Lack of prompt access to healthcare may contribute to organ failure. Tox-screen is recommended for drug detection.
A comparative study of clinical characteristics and quality of life between obese and non-obese asthmatics
Authors: Shobitha Rao  , Rakesh Bilagi  , Radhe B K  , Ruchik Hiregoudar  , Vishnu Narayanan
Published: January 2025

Background: Asthma is a chronic inflammatory disorder arising from heterogenic geneenvironment interactions. Obesity is one of the risk factors for asthma. Evidence shows that several inflammatory markers are active in obese and overweight patients. There is growing evidence that obesity can affect the course and control of asthma.
Aims and Objectives: The study was done to compare clinical characteristics, spirometry variables, and quality of life among obese and non-obese asthmatics.
Materials and Methods: The study was a crosssectional comparative study conducted in a tertiary care hospital using a semi-structured pre-tested questionnaire. Detailed history and examination, quality of life using AQLQ score, and spirometry severity were assessed.
Results: A total of 80 patients, 40 obese asthmatics and 40 non-obese asthmatics were included in the study. The study found that most subjects belonged to the age group of 31–40 years and body mass index of 30.89±1.94 among the obese group and 23.19±3.77 in non-obese, respectively. The majority had symptoms of breathlessness and wheezing in both groups. The mean forced expiratory volume in 1 s was similar in both groups. However, the mean forced vital capacity was lower in the obese group. The asthma control test (ACT) score was poorer in obese group as compared to nonobese group (7 in obese vs. 15 in non-obese). The dosage of inhaled steroids was higher in the obese group.
Conclusion: The symptomatology was similar among the two groups. Restrictive abnormalities, higher asthma symptoms with lower ACT scores, and higher dosages of medications were seen in obese asthmatics as compared to non-obese patients.
Effectiveness of adjunctive ultrasound after mammography in improving breast cancer screening findings from a study in Malaysian women
Authors: Mohamed Ibrahim Wahid  , Nurul Alia Azmi  , Pei Yun Tan  , Bao Jing Chen
Published: January 2025

Background: Breast cancer is a significant health issue affecting women worldwide, including Malaysia, where the incidence of breast cancer is increasing. Early detection of breast cancer plays a crucial role in improving treatment outcomes and reducing mortality rates.
Aims and Objectives: This study examines the impact of adjunctive breast ultrasound (BUS) on screening for Malaysian women, offering evidence to enhance future protocols and decisions in the early detection.
Materials and Methods: This study involved 5807 women aged 40 and above undergoing breast screening at Beacon Hospital from January to December 2022. Data collected included mammography and BUS results, categorized by breast imaging reporting and data system (BI-RADS) and diagnostic criteria. Suspicious cases on both modalities had histopathology examination (HPE) for confirmation. A subset of 1690 cases underwent both mammography and BUS screening and was compared to those who only had mammography using BI-RADS scores.
Results: This study revealed that the majority of mammograms, 94.69% (5499 cases), were categorized as BI-RADS category 0, 1, 2, and 3, while 5.3% (307 cases) were classified as BI-RADS 4 and 5. Among the cases that underwent ultrasound (1688 cases), 23.43% of them were categorized as BI-RADS 4–5. Using ultrasound in addition to mammography increased the number of cases (BI-RADS 4–5) by 33.48%, resulting in a total of 460 cases identified compared to 307 cases, detected by mammography alone. Significantly, 39% (74 cases) of the 190 cases with confirmed malignancies (BI-RADS 6) by HPE were initially classified as negative mammography (BI-RADS 0–3) but were later identified as BI-RADS 5 on ultrasound.
Conclusion: Ultrasound as a supplementary screening method holds the potential for boosting breast cancer detection sensitivity and reducing false negatives, thereby aiding in early detection and better treatment outcomes.
Minimum inhibitory concentration creep in Enterobacterales – A rising concern
Authors: Soumyya Mondal  , Anwesha Mandal  , Sipra Saha  , Partha Sarathi Chakrabarty  , Debalina Das
Published: January 2025

Background: The irrational use of antibiotics has led to the emergence of multidrug-resistant pathogens. The phenomenon of minimum inhibitory concentration (MIC) creeps occurs when organisms start showing raised MIC but within susceptible range giving an indication of the prevalence of rise in resistant pathogens in an area.
Aims and Objectives: The aims and objectives of the study are to observe the susceptibility pattern among uropathogens and the possibility of MIC creeps among the Escherichia coli isolates sensitive to nitrofurantoin.
Materials and Methods: This retrospective study was done in a tertiary care hospital in Kolkata to observe the susceptibility pattern among uropathogens and the possibility of MIC creeps. We took the data from all inpatient department and outpatient department patients sent for urine culture and sensitivity from October 1st, 2022, to September 30th, 2023. The antimicrobial susceptibility testing and MIC were conducted by VITEK Compact 2. The MIC of nitrofurantoin, one of the most widely used antibiotics for lower urinary tract infections, was calculated to investigate the phenomenon of MIC creep. All the statistical analyses were carried out using the Excel spreadsheet and OpenEpi version 3.01 platform.
Results: In our study, a total of 631 urine samples were analyzed: 368 were positive with the most common isolate being E. coli (53%) followed by Klebsiella spp. (12%). Two percent of resistance was observed for fosfomycin and 8% for nitrofurantoin. Extended spectrum beta-lactamase (ESBL) producers E. coli was 127 (35%). Overall, 23/368 samples had a MIC ≥128 for nitrofurantoin. Among the ESBL producers, 13/127 had MIC ≥128 for nitrofurantoin.
Conclusion: In the present study, it was observed that E. coli showed a reduced susceptibility for nitrofurantoin indicated by a creeping increase in MIC within normal range. Trends in rising MIC can be an alarming sign for using drugs such as nitrofurantoin judiciously. Antimicrobial stewardship practice should be strongly implemented in hospitals to curb rising resistance and for better prognosis of patients having infectious diseases.
Sensory processing patterns in children with attention-deficit hyperactivity disorder: A case–control study
Authors: Aritra Bandyopadhyay  , Saswati Nath  , Uday Sankar Mandal  , Sreeprova Ghoshal  , Abhishek Dandapath  , Suchismita Mallick
Published: January 2025

Background: Sensory processing (SP) indicates the ability of the nervous system to receive, analyze, process, and respond to external sensory input and coordinates motor movements accordingly. Children with various neurodevelopmental disorders, like autism spectrum disorder, have SP issues. However, studies regarding SP issues in attention-deficit/hyperactivity disorder (ADHD) compared to typically developing children are relatively less.
Aims and Objectives: To study the SP pattern of children with ADHD, to compare with the control group, and to study the correlation of symptom severity with SP deficit in children with ADHD.
Materials and Methods: All children attending the child guidance clinic at R. G. Kar Medical College and Hospital were screened, and children with ADHD without any other comorbid disorder as diagnosed by Diagnostic and Statistical Manual 5 were selected. Their ADHD symptom severity was assessed using the ADHD test, and SP was assessed using the Short Sensory Profile (SSP).
Results: The SSP mean score of the children with ADHD was significantly different than the mean score of the control group, and the percentage of children having a definite difference in SP was significantly different in the ADHD children group compared to the control group. The severity of the SP deficit also correlates with the severity of ADHD symptoms, as found by the correlation study.
Conclusion: Children with ADHD have shown a definite difference in SP compared to controls, and the severity of the sensory problem is proportionate to the severity of the symptoms of ADHD.
Cytohistopathological evaluation of salivary gland lesions in tertiary care center of Eastern Nepal
Authors: Diksha Karki  , Purbesh Adhikari  , Mona Dahal
Published: January 2025

Background: Salivary gland tumors consist of a group of heterogeneous lesion with complex clinicopathological characteristics. Fine needle aspiration (FNA) cytology has been used as a quick, non-invasive diagnostic tool for the diagnosis of neoplastic and non-neoplastic lesion of salivary gland.
Aims and Objectives: The aims and objectives of the study are to perform the cytopathological evaluation of minor and major salivary gland lesions (neoplastic and non-neoplastic) in terms of its various types, frequency, site, demographic distribution and to correlate with histopathology findings whenever available.
Materials and Methods: This is a hospital-based 3-year study in which 155 cases of patient underwent FNA cytology for salivary gland swelling (non-neoplastic and neoplastic) of which seven cases were excluded due to scant and inadequate aspirate, and thus, only 148 cases were included in this study and histopathological correlation was available in 42 cases. Any metastatic lesion, repeat samples from same patient were excluded from the study.
Results: Out of 148 cases, male patients were 72 (49%) and female patients were 76 (51%) with M: F ratio of 0.9:1. Benign lesion was commonly seen in 31–40 years, non-neoplastic lesion at 41–60 years (n=18, 37.6%), and malignant lesions at 61–90 years (n=9, 37.5%). Parotid was the most common salivary gland involved by neoplastic and non-neoplastic lesion accounting 65.5% (n=97) followed by submandibular gland 29.7% (n=34). Pleomorphic adenoma was most frequently diagnosed among all salivary gland lesions (60%). Mucoepidermoid carcinoma outnumbered the category (14%) of malignant salivary gland lesion. On histopathology correlation, 33 cases were correctly diagnosed in cytopathology whereas 9 cases showed discordant result. FNA cytology sensitivity was 66.6%, specificity was 93.3%, positive predictive value was 80.0%, and negative predictive value was 87.5%, respectively. Diagnostic accuracy was found to be 85.7%.
Conclusion: Cytopathology examination of salivary gland can be used as safe and reliable method in primary diagnosis of lesions of salivary gland.
Cross-sectional study of the prevalence of inter-arm blood pressure difference in offspring of normotensive and hypertensive parents among students of tertiary care teaching hospital, Hyderabad
Authors: Prashanthi M  , Santa Kumari A  , Abdul Raoof Omer Siddiqui  , Mudassir Mirza
Published: January 2025

Background: Hypertension (HTN) incidence and progression are monitored by regular blood pressure (BP) measurement; one of the most ignored components of regular check-up is the measurement of inter-arm difference (IAD) in BP.
Aims and Objectives: The objective of this study was to estimate the prevalence of IAD in BP among offspring of hypertensive parents compared to normotensive parents.
Materials and Methods: This cross-sectional study was conducted on 100 male students at Osmania Medical College, Hyderabad, Telangana for a period of 6 months. After IEC clearance, the subjects were divided into two groups, 50 students in each group: Group I had offspring with hypertensive parents and Group II had offspring with normotensive parents. Age, height, weight, and body mass index (BMI) were recorded. IAD was calculated as the difference between BP (Systolic BP [SBP] and diastolic BP [DBP]) in the right arm and left arm. Subjects with a history of structural, functional cardiovascular disease disorders, endocrine disorders, Diabetes mellitus, and addictions such as smoking and alcohol were excluded from the study. Data were statistically analyzed using Microsoft Excel software.
Results: Among 100 subjects, Group I and II IAD in SBP was 8.68±6.02 and 5.00±3.24 (P<0.0002), respectively, and Group I and II IAD in DBP was 5.12±4.48 4.79±3.56 (P<0.7117), respectively. BMI of the two groups is almost within the similar range (23.44±4.04, 22.098±3.15, respectively) and not statistically significant (P=0.0694), a positive correlation of 0.12, 011 was found between BMI, systolic IAD,and diastolic IAD, respectively.
Conclusion: The above results show a significant association between IAD in systolic BP and family history of HTN.
Navigating the transition: Implementing competency-based medical education in medical curriculum in India
Authors: Aditi Aikat
Published: January 2025

The road to implementation of competency-based medical education (CBME) in the medical curriculum in India has both challenges and windows of opportunities in its folds. The hindrances identified were reluctance to change, capacity building of faculties, lack of infrastructural support, and methods of assessment. Notwithstanding, CBME has the potential to ensure that the Indian medical graduates are equipped with better clinical skills, and learner-centric education, that aligns well with individual competence, and community healthcare needs. Effective navigation through this transition calls for collaborative efforts among academicians, regulatory bodies, and related stakeholders while drawing from relevant successful models of our country itself. It is imperative to address the challenges concerning capacity building of faculties, resource allocation, and assessment methodology for successful implementation. Given appropriate adoption, the CBME-based curriculum can go a long way to deliver quality healthcare.
Jejunogastric intussusception: A case report of unusual cause of upper gastrointestinal bleeding after gastrojejunostomy
Authors: Swaminathan Rajan  , Sivasankar Amarapathy  , Somasekar Durairajan
Published: January 2025

Upper gastrointestinal bleeding is following gastrojejunostomy due to stromal ulceration, marginal ulcer bleeding from anastomotic site, remnant cancer. Gastrojejunostomy done for benign gastric outlet obstruction has many complications. Jejunogastric intussusceptions (JGI) is a rare complication of gastrojejunostomy surgery (<0.1% of cases), yet requires an urgent diagnosis. Mortality rates range from 10% to 50% based on delay in diagnosis and surgical intervention. Vomiting, abdominal pain, and hematemesis are the most common symptoms. We report a 53-year-old man admitted to the emergency department, complaining of epigastric pain and recurrent hematemesis for 3 days. Abdominopelvic computed tomography scan also showed a target sign in favor of jejunal intussusception. Midline emergency laparotomy was done and the gangrenous jejunum was resected with reconstruction Roux en Y loop was done. The patient was discharged without any further complications. In patients presented with hematemesis and abdominal pain and a history of gastrojejunostomy, JGI must consider a possible cause because early diagnosis and treatment are necessary to prevent further complications.
Sprengel’s deformity and unilateral absent kidney: A case report
Authors: Amit Sarkar  , Amitabha Bandyopadhyay  , Shovan Kumar Das  , Koushik Mondal  , Sanjai Kumar Singh
Published: January 2025

The Sprengel’s deformity is a congenital condition where the scapula on one or both sides are underdeveloped or abnormally high in position. An interesting rare case of Sprengel’s deformity and unilateral absent kidney is being reported. The Sprengel’s deformity should not be left undiagnosed.
DOI: http://dx.doi.org/10.3126/ajms.v5i4.9494
Asian Journal of Medical Sciences 2014 Vol.5(4); 97-99
Umbilical myiasis with sepsis in a neonate
Authors: Monojit Mondal  , Tanmoy Biswas  , Nayan Banerji  , Sayan Bose  , Biswajit Biswas  , Pijush Kanti Mandal
Published: January 2025

Myiasis is the invasion of host’s tissues by the larval stage (maggot) of non?biting flies. It usually infects domestic and wild animals, but sometimes also affects human and is commonly found in the tropical and subtropical areas. Umbilical myiasis in the neonatal period associated with sepsis is a rare occurrence with few reported cases in the literature. We report a case of a 20?days?old neonate from a rural area of West Bengal, India, presented with neonatal sepsis due to umbilical myiasis caused by larval form of blow fly (Chrysomya megacephala).
DOI: http://dx.doi.org/10.3126/ajms.v5i4.10004
Asian Journal of Medical Sciences 2014 Vol.5(4); 106-107
Cystic and florid squamous metaplasia in pleomorphic adenoma of palate – A diagnostic dilemma
Authors: H Kaveri  , K Gopalkrishnana  , Anehosur Venkatesh
Published: January 2025

Pleomorphic adenoma is a benign tumor of salivary gland. Controversy regarding the origin of various mesenchymal components exists and myoepithelial cell has a key role. Metaplastic process is triggered by minor trauma and probable etiology for this change is ischemia. It is diagnostically challenging, because diagnostic pit falls in the presence of mucinous and squamous metaplasia. Report a case of pleomorphic adenoma in the palate of a 35 years old Indian female. Biopsy revealed epithelial component with extensive squamous metaplasia and cystic degeneration. Here we discuss the role of myoepithelial cells in the pathogenesis of pleomorphic adenoma and diagnostic pit falls.
DOI: http://dx.doi.org/10.3126/ajms.v5i4.10434
Asian Journal of Medical Sciences 2014 Vol.5(4); 108-110
Long-course chemoradiation versus short-course radiation for rectal cancer and overall comparison
Authors: Subhrokanti Kundu
Published: January 2025

DOI: http://dx.doi.org/10.3126/ajms.v5i4.9976
Asian Journal of Medical Sciences 2014 Vol.5(4); 122-124
Head shape determination and cranial evaluation using anatomical landmarks in children with sickle cell disease (SCD)
Authors: MA Musa  , AD Zagga  , K Musa  , M Danfulani  , H Ahmed
Published: January 2025

Background: Sickle cell disease is one of the commonest diseases widespread in sub-Saharan Africa and Nigeria in particular. This study investigated the possible effects of sickle cell disease (SCD) on the cranial index and pattern of head shapes of children with sickle cell disease in comparison with that of children without SCD.
Methods: The head length, head width of 103 children (54 males and 49 females) with sickle cell disease and 218 normal growing non-sickle cell disease children (121 males and 97 females) aged 0-18 years old were measured and their cranial indices calculated.
Results: The mean CI for normal growing non sickle cell disease children was 79.82±3.35 and that of the sickle cell disease children was 80.12±3.39 which was not statistically signifi cant (p=0.4526). However, the difference between the mean CI of males in both groups was not signifi cant (p=0.9535) likewise in females (p=0.3127). The mean head circumference in sickle cell disease children was 48.89±3.15 as against that of the normal growing non-sickle cell disease children 44.97±6.07 and this difference was also not statistically signifi cant (p=>0.05).
Conclusion: The head shapes as per the present study could be classifi ed as mesocephalic in normal growing non-sickle cell disease children and brachycephalic in sickle cell disease children. Thus, it has been deduced that sickle cell disease could probably have an effect on head length, head width, cranial index and head circumference of affected children. 
DOI: http://dx.doi.org/10.3126/ajms.v6i1.9160  
Asian Journal of Medical Sciences Vol.6(1) 2015 98-102
Haemoptysis: An unusual initial presentation of achalasia cardia
Authors: Sumit Roy Tapadar  , Jaydip Deb  , Aparup Dhua  , Soumya Bhattacharya  , Tapan Das Bairagya  , Uttam Biswas
Published: January 2025

A 31 year old male presented with haemoptysis, fever and cough. Chest Radiography showed patchy consolidation with breakdown in lower lobe of left lung. Further evaluation revealed the presence of achalasia cardia that resulted haemoptysis due to aspiration pneumonia. This report highlights the uncommon initial presentation of achalasia cardia in the form of haemoptysis in a previously asymptomatic individual. Although haemoptysis occurs commonly due to pulmonary disorders, it may also be an initial symptom of some rare nonpulmonary disorder. Thorough workup with strict vigilance is extremely important to elicit that type of rare aetiology.
DOI: http://dx.doi.org/10.3126/ajms.v6i1.10800  
Asian Journal of Medical Sciences Vol.6(1) 2015 103-105
Post traumatic anterior angulation of the distal tibia following malunion: A case report of management in a resource constrained setting
Authors: EM Dim  , JC Itie  , UC Inyang  , A Nwashindi  , ME Ugbeye  , UM Dim
Published: January 2025

Fractures of the shaft of the tibia and fibula are common. Complications are minimal following careful application of principles during treatment by the Orthopaedic Surgeon. However, in our environment, not all patients present to the Orthopaedic Surgeon as they opt for some form of unconventional treatment, usually with the traditional bone setters. Such treatments sometimes lead to clinically unacceptable outcomes. This is a case report of a 42-year old female Nigerian with a 4-year history of post traumatic anterior angulation of the distal right tibia with severely contracted Achilles tendon following traditional bone setter’s treatment for open fractures of the distal tibia and fibula. There was 7 cm of right lower limb shortening and 45 degrees anterior angulation of a tibial malunion. She had a two- stage operation to correct the deformities. Patient achieved a plantigrade foot and fracture union without limb length discrepancy.
DOI: http://dx.doi.org/10.3126/ajms.v6i1.10198  
Asian Journal of Medical Sciences Vol.6(1) 2015 108-111
An uncommon cause of common presentation – Gall stone ileus: A case report and review of literature
Authors: Anand Munghate  , Sushil Mittal  , Harnam Singh  , Anjna Garg  , Gurpreet Singh  , Jyoti Sharma
Published: January 2025

About 1%-4% of all cases of mechanical intestinal obstruction were caused by rare disease gallstone ileus. It is an uncommon complication of cholelithiasis. The formation of a fistula between the gallbladder and the duodenum may allow a gallstone to enter the intestinal tract. Gallstone ileus usually occurs in the elderly with a female predominance and is associated with a high mortality rate. The diagnosis of gallstone ileus entails a clinical challenge, especially in older patients in whom it may be easily overlooked. Here we report a case of 75 year old female patient presented in emergency with 4 day history of nausea, vomiting and pain in epigastric region. Emergent laparotomy was done and it was surprise to see that the cause of obstruction was gall stone ileus, enterolithotomy and repair was done.
DOI: http://dx.doi.org/10.3126/ajms.v6i1.9307
Asian Journal of Medical Sciences Vol.6(1) 2015 112-114
Common origin of both coronary arteries from LSV
Authors: Avanish Kumar  , Md Jawed Akhtar  , Lalit Mohan
Published: January 2025

During routine dissection of a male cadaver aged about 60 years in dept. of Anatomy at IGIMS Patna a rare anomalous single coronary artery has been detected. In this case a single trunk is taking origin from LSV. Both the coronary arteries are arising from this trunk. Heart’s shape, size and weight are within normal range. On gross examination no other major congenital malformation and pathological changes is detected. In addition to this, further during dissection in other region of the body no other major vascular malformation is found.
DOI: http://dx.doi.org/10.3126/ajms.v6i1.9583
Asian Journal of Medical Sciences Vol.6(1) 2015 117-118
Intravenous magnesium sulphate as an adjuvant in acute severe asthma refractory to conventional therapy
Authors: Aswini Kumar Sahoo  , SC Mohapatra
Published: January 2025

DOI: http://dx.doi.org/10.3126/ajms.v6i1.9609
Asian Journal of Medical Sciences Vol.6(1) 2015 134-135
Polymorphic ventricular tachycardia on a young patient
Authors: Osman Can Yontar  , Erhan Tenekecioglu  , Kemal Karaagac  , Ahmet Tutuncu
Published: January 2025

Twelve-lead electrocardiogram is the most frequently utilized device for cardiologists. Although it is a basic device, great attention must be paid when it comes to give vital decisions.
DOI: http://dx.doi.org/10.3126/ajms.v6i1.10804
Asian Journal of Medical Sciences Vol.6(1) 2015 127-128
Split-hand/split-foot malformation (SHFM)
Authors: Monojit Mondal  , Kriti Sundar Rana  , Nayan Banerji  , Sayan Bose  , Tanmoy Biswas  , Biswajit Biswas  , Pijush Kanti Mandal
Published: January 2025

Split-hand/split-foot malformation (SHFM), also known as ectrodactyly or lobster claw hand is a congenital limb malformation, characterized by a deep median cleft of the hand and/or foot due to the absence of the central rays of the autopod. It may occur singly or in association with syndromes, former being mostly autosomal dominant but autosomal recessive variety is rare. We are reporting a case of ectrodactyly with autosomal recessive mode of inheritance
DOI: http://dx.doi.org/10.3126/ajms.v6i1.10018  
Asian Journal of Medical Sciences Vol.6(1) 2015 122-123
Congenital malformation of lamina orbitalis ossis ethmoidalis
Authors: Kosuri Kalyan Chakravarthi  , Nelluri Venumadhav  , KS Siddaraju
Published: January 2025

Background: The thinnest portion of the medial wall of the orbit is Lamina orbitalis ossis ethmoidalis which separates the ethmoidal sinuses from the orbit. Congenital bony malformation of orbit and anatomical variation of ethmoidal sinuses are important in terms of the risk of complication development during endoscopic sinus surgery and to understanding the pathophysiology and spread of sinus disease.
Materials and Methods: Accordingly the present study was designed to fi nd out the congenital malformation of medial wall of the orbit in relation to lamina orbitalis ossis ethmoidalis. The study was carried out using 100 dried adult human skulls and twenty six human cadavers irrespective of sex were obtained from the Department of Anatomy - Mayo Institute of Medical Sciences-Barabanki, Department of Anatomy - Melaka Manipal Medical College - Manipal and Department of Anatomy - KMCT Medical College, Manassery - Calicut.
Results: In three skulls (2.380%) we noted unilateral unusual hole at the junction of medial wall and roof of orbit with dimensions of 2.3 cm long and 1 cm height in two skulls and another unusual vertical hole at the anterior part of medial wall and roof of orbit with dimensions of 2 cm height and 1 cm width. We also noted few ethmoidal cells extended in to the orbital plate and fovea ethmoidalis of the frontal bone.
Conclusion: Congenital defective formation of bony orbit and variable anatomy of paranasal sinuses noted in this study is may be due to the defective formation of Lamina orbitalis ossis ethmoidalis from the lateral part of the nasal capsule near the fronto ethmoidal suture such comprehensive knowledge is necessary to understand the various disorders of this region and to avoid complications during surgical procedures involving this area.
DOI: http://dx.doi.org/10.3126/ajms.v6i2.10534
Asian Journal of Medical Sciences Vol.6(2) 2015 91-94
Determinants of child malnutrition in Bangladesh - A Multivariate Approach
Authors: Ahbab Mohammad Fazle Rabbi  , Shamal Chandra Karmaker
Published: January 2025

Objective: Malnutrition is referred as the greatest single threat to the world’s public health, especially for the developing countries. Nutritional status is determined anthropometrically and it is outcome of complex interactions between biological, socio-economical variables. This study is conducted to identify the significant determinants of child malnutrition in Bangladesh.
Method: Using BDHS-2007 data, Total 5312 cases are included in the present study. Multivariate techniques have been applied in this study to obtain significant determinants of child malnutrition.
Results: Factor analysis revealed six factors as covariate of malnutrition; where two factors are socio-economical, others are biological and bio-social. Hence linear discriminant analysis is used to clarify the efficiency of obtained factors in malnutrition scenario; which imply that the obtained factors are accurate for approximately 60 percent observations.
Conclusion: The obtained results suggest that, consciousness should be raised to improve socio-economic and maternal health conditions to improve the scenario of child malnutrition.
DOI: http://dx.doi.org/10.3126/ajms.v6i2.10404  
Asian Journal of Medical Sciences Vol.6(2) 2015 85-89
Usage of diuretics among diabetic-hypertensive patients
Authors: Rajeshwari Shastry  , M.R. Prabha Adhikari  , Sheetal D. Ullal  , Shashidhar Kotian
Published: January 2025

Background: Hypertension is more common in diabetics than in non-diabetic patients. An aggressive approach to the diagnosis and treatment of hypertension in patients with diabetes is required in order to substantially reduce the incidence of both macro-vascular and micro-vascular complications. The role of diuretics in the treatment of hypertension as first line or second line drugs is a provoking debate, hence we studied the usage of diuretics and their effects on BP and glycemic control among diabetic-hypertensive patients.
Methods: This cross sectional study was carried out for a period of six months in a tertiary care teaching hospital. Patients’ details such as age, gender, height, weight, comorbid diseases, blood pressure, eGFR along with duration of diabetes and hypertension and drugs prescribed for hypertension were noted. Data were analyzed using descriptive statistics.
Results: A total of 336 diabetic-hypertensiveswith a mean age of 64.55±9.51 years were included. Fortyfive patients were on diuretics,two (4.4%) of whom were on diuretic monotherapy, 16 (35.6%) on two drug combinations (Diuretic + ACEI or ARB), 21 (46.7%) on three drug combinations (diuretics + ARB & BBs or diuretic + ACEI & BB or diuretic + ARB &CCB) and six (13.3%) were on four drug combinations (diuretics + ARB, CCB & BB). Among the patients on diuretic combination therapy BP was well controlled in 23 (51%) patients and the glycemic control was comparable to those not on diuretics.
Conclusion: In the present study the usage of diuretics was consistent with the guidelines. About 13% of diabetic-hypertensive patients were on diuretic treatment. The control of BP in patients on diuretics was not satisfactory, but there was no worsening of glycemic control compared to other antihypertensive therapy. This shows that low dose thiazides in combination with other antihypertensives can be safe in diabetic-hypertensive patients however their efficacy needs further scrutiny. 
DOI: http://dx.doi.org/10.3126/ajms.v6i2.10582
Asian Journal of Medical Sciences Vol.6(2) 2015 15-18
A neglected case of Sacrococcygeal teratoma in a neonate
Authors: Monojit Mondal  , Biswajit Biswas  , Atanu Roy  , Abhijit Ari  , Kaustav Nayek  , Asok Kumar Datta  , Kriti Sundar Rana  , Nayan Banerji
Published: January 2025

Sacrococcygeal teratoma (SCT), although rare, is the most common congenital neoplasm in neonates. A mass in the sacrococcygeal region at the time of birth is the usual presentation. Routine antenatal abdominal ultrasound of mother can detect almost all the cases. The prognosis is favorable when diagnosis is done antenatally and proper management is instituted soon after the baby is born. Presented herein a 2 days old neonate with a neglected SCT who died unfortunately due to massive bleeding from the tumor. A brief review of the literature has been presented to make everyone aware of the condition so that future recurrence of such sad events may be avoided.
DOI: http://dx.doi.org/10.3126/ajms.v6i2.10448
Asian Journal of Medical Sciences Vol.6(2) 2015 108-110
Isolated Pulmonary Metastasis from Prostate Adenocarcinoma: Diagnosis by Fine Needle Aspiration Cytology
Authors: Anju Khairwa  , Gupta Nalini  , Singhal Manphool  , Kumar Santosh  , Rajwanshi Arvind
Published: January 2025

Prostate cancer usually metastasizes to regional lymph nodes and bone followed by distant organs. Here, we present a case of elderly man who had isolated respiratory symptoms and finally turned out to be metastasis from prostate cancer. Rarity of isolated pulmonary metastases of prostate cancer without bone and lymph node involment prompted us to report this case which was diagnosed by CT guided FNAC. 
DOI: http://dx.doi.org/10.3126/ajms.v6i2.11103
Asian Journal of Medical Sciences Vol.6(2) 2015 111-114
ERCP complicated by pseudoanerysm of right hepatic artery: A rare case report
Authors: Mohmed Imran Wagay  , Gh Mohammad Wani  , Naseer Ahmad Choh  , Owvass Hamied Dar
Published: January 2025

Endoscopic Retrograde Cholangio-Pancreatography (ERCP) has advantage of having bothdiagnostic and therapeutic utility and most common indication for endoscopic sphinterotomyis choledocholithiasis. Therapeutic ERCP is quite often associated with complications, mostcommon being acute pancreatitis followed by bleeding. Most common source of bleedingis small branches of pancreaticoduodenal artery (PDA) which lie close to papilla. We reporta rare case of leaking right hepatic artery pseudoanerysm following clearance of commonbile duct (CBD) stones by ERCP presenting with shock and upper GI bleed.
DOI: http://dx.doi.org/10.3126/ajms.v6i2.10546
Asian Journal of Medical Sciences Vol.6(2) 2015 115-117
Concurrent multiple brain tuberculomas with miliary tuberculosis - A rare presentation
Authors: Susmita Kundu  , Aparup Dhua  , Saswata Ghosh  , Rajesh Agarwal
Published: January 2025

A 45 year old immunocompetent female presented to us with fever, dry cough, vomitingand headache. There was a single episode of convulsion after hospital admission. ChestXray was normal. After through clinical examination and relevant investigations we came toknow that it was a case of concurrent multiple brain tuberculomas with miliary tuberculosis.Patient was managed with antitubercular drugs and other supportive therapy promptly and sheresponed well. Occurence of tuberculoma in the brain in a patient with miliary tuberculosisis a rare phenomenon.
DOI: http://dx.doi.org/10.3126/ajms.v6i2.10279
Asian Journal of Medical Sciences Vol.6(2) 2015 118-120
Four semesters of medical humanities at the Xavier University School of Medicine, Aruba
Authors: P. R. Shankar
Published: January 2025

Introduction: Medical humanities is using subjects traditionally known as the humanities for specific purposes in medical education.
Methods: In this report the author shares his experience of facilitating a module for four semesters at the Xavier University School of Medicine, Aruba.
Results: The sessions were conducted in small groups and used case scenarios, role-plays, paintings and debates among other modalities to explore various aspects of medical humanities.
Conclusion: The author has been successful in conducting medical humanities sessions in an offshore Caribbean medical school. 
DOI: http://dx.doi.org/10.3126/ajms.v6i2.10455
Asian Journal of Medical Sciences Vol.6(2) 2015 124-128
Free PSA: A better molecular marker than total PSA for breast cancer
Authors: Rachita Nanda
Published: January 2025

Serum total PSA (prostate specific antigen) has been considered since some time for diagnosis or prognosis of breast cancer. PSA is present both as free and complexed form. Many researchers have shown total PSA increases in all forms of breast disease, whether cancerous or benign lesions. Few scientists  have demonstrated that the free form of PSA is the predominant form in breast cancer.1,2  Also the observation that there is a marginal reduction in total PSA after surgery in comparison to a remarkable decrease in free PSA is a strong indicator that a large portion of total PSA is produced by normal tissue and that free PSA is produced by breast tumors.3,4,5 Moreover  free PSA as the predominant form was found to be highly specific for breast cancer when compared to benign and normal tissues.3 In India, Dash et al.,(2011) in their study in Indian population observed similar results using total and free PSA in patients of breast tumors 5 augmenting  its role as a prognostic marker.
With a heterogeneous  study population in India where breast cancer is commonly encountered, population based studies  are essential to study the molecular forms of PSA  with respect to  the disease process  like relapse or metastasis and therefore with future treatment.
DOI: http://dx.doi.org/10.3126/ajms.v6i2.11110
Asian Journal of Medical Sciences Vol.6(2) 2015 129
Adenoid squamous cell carcinoma of right gingivobuccal sulcus – A rare case report
Authors: Pankaj Pande  , Prakash Murigeppa Patil  , Mihir J. Bhalodia  , Jyotirling Savle  , Himanshu Mulay
Published: January 2025

Oral cancer is the sixth most common malignancy in the world and third most common in southeast Asia. When it does occur, it is most commonly seen on the tongue or lip. Cancers of the gingivobuccal sulcus are uncommon and reported infrequently. Here we report a case of 35 years female diagnosed with adenoid squamous cell carcinoma of right gingivobuccal sulcus. Most of these cancers are locally advanced stage due to delay in presentation and ignorance of population.  
DOI: http://dx.doi.org/10.3126/ajms.v6i3.10793
Asian Journal of Medical Sciences Vol.6(3) 2015 94-96
Rosai Dorfman disease- A rare entity: Case report in North Indian male
Authors: Ankur Baruah  , Parul Goyal  , K. L. Ramesh
Published: January 2025

Rosai Dorfman disease is a rare disease characterized by histiocytic proliferation of lymph node in young adults. We present here the case of a 67 years old Indian male presenting with lymphadenopathy and pyrexia of unknown origin for 16 months duration. Histopathological examination of lymph nodes revealed emperipolesis consistent with the diagnosis of Rosai Dorfman disease. The patient recovered with steroid treatment .Our case is one of the few cases of adult onset Rosai Dorfman Disease reported from India. 
DOI: http://dx.doi.org/10.3126/ajms.v6i3.10288
Asian Journal of Medical Sciences Vol.6(3) 2015 87-90
Pyogenic granuloma of tongue: A rare case report
Authors: Sonam Sharma  , Amita Sharma  , Ashok Kumar  , Shivani Kalhan  , Jasmine Kaur
Published: January 2025

Pyogenic granuloma (PG) is a kind of inflammatory hyperplasia in response to chronic irritation. Here, we report a case of 64 year old male patient with PG on midline of the dorsum of the posterior third of the tongue. Its differential diagnosis, the importance of biopsy findings in establishing definitive diagnosis and about the new approaches for its treatment is discussed. 
DOI: http://dx.doi.org/10.3126/ajms.v6i3.10619
Asian Journal of Medical Sciences Vol.6(3) 2015 84-86
Fungus infected atrial myxoma: A rare cause of infective endocarditis and chordae rupture
Authors: Gökhan Özmen  , Kübra Doganay  , Hasan Ari  , Tolga Dasli  , Ahmet Tutuncu  , Mehmet Melek  , Mehmet Demir  , Erhan Tenekecioglu
Published: January 2025

Case reports are increasing about infected myxomas. Infection with bacteria is relatively much more but fungus infected atrial myxomas are exteremely rare and may complicate the disease course. As our knowledge this is the first fungus infected myxoma report  in Turkish population.
DOI: http://dx.doi.org/10.3126/ajms.v6i3.11045
Asian Journal of Medical Sciences Vol.6(3) 2015 81-83