bluuebunny/crossref_metadata_2025 huggingface dataset:
Religious Circumcision (Khatna) and Circumcision Mishaps in Kashmiri Children
Authors: Hassan Yaqoob , Rasool Humayoon , Rather Ajaz Ahmad , Ahmad Younis , Rasool Insha
Published: May 2024

Background:

Male circumcision is recommended practice in Muslim tradition and one of the oldest operations performed all over the world. Male circumcision is universal in our Muslim-dominated valley of Kashmir for religious reasons. It can be performed by different techniques such as the conventional open methods, the device methods and sutureless methods. The objective of this study was to report our practice of male circumcision amongst children and compare the different common surgical techniques and highlight the circumcision mishaps conducted by quacks in the Kashmir Valley.

Materials and Methods:

This was a comparative observational study conducted at SKIMS Medical College and Hospital, from 2017 to 2021. Children who presented for primary circumcision were subjected to one of two different surgical techniques; the dorsal slit or Guillotine method. The prospective analysis of children managed for circumcision mishaps conducted by non-professionals was also included in the study. Circumcisions done after 2 years of age were defined as delayed. The data were collected analysed using SPSS software (SPSS version 22, IBM, Armonk, NY, USA).

Results:

Total of 689 Kashmiri Muslim male children between 1 day and 10 years of age over a period of 5 years were studied. Six hundred and fifty-five children for primary circumcision and 34 children managed for circumcision mishaps were included in the study. Amongst the subjects for primary circumcision, the most number of children were between 1 and 2 years of age (33.28%). One hundred and fourteen (25.73%) hospital-delivered babies and 201 (94.81%) home-delivered babies had delayed circumcision that is after 2 years of age (P = 0.00001). Religious requirement was the only indication for circumcision in this study. Three hundred and ninety-six (60.46%) children were circumcised with dorsal slit and 259 (39.54%) with guillotine method using computer-generated random numbers. Complications were found 8.08% of subjects in dorsal slit method as compared to 16.60% in guillotine technique (P = 0.008). Out of 34 children managed for circumcision mishaps, 11 (32.35%) presented with massive bleeding after primary circumcision by half doctors, 18 (52.94%) had incomplete circumcision, 3 (8.82%) had multiple skin bridges and 2 (5.88%) had incomplete circumcision with glans injury. All the patients with circumcision mishaps were treated with good outcome. There was no mortality.

Conclusion:

Circumcision occurs at a wide range of ages and male circumcision is universal in our Muslim-dominated valley for religious reasons. Circumcision by quacks and the associated complications are still prevalent in our society. The procedure is safe and free of any major complications when conducted by trained medical personnel under aseptic conditions of the operation theatre and hence should be encouraged.
Congenital Heart Defects in Orofacial Cleft
Authors: Erinoso Olufemi A. , James Olutayo , Sokunbi Ogochukwu J , Adamson Olawale O. , Adekunle Adeola A. , Agbogidi Olusola F. , Ogunlewe Ajoke O. , Ekure Ekanem N. , Adeyemo Wasiu L. , Ladeinde Akinola L. , Ogunlewe Olugbemiga M.
Published: May 2024

Background:

Congenital heart defects (CHDs) are one of the most common associated anomalies in patients with an orofacial cleft (OFC). However, few studies have shown the association between cleft type and CHDs in our population. This study aimed to assess the prevalence of CHDs in a cohort of OFC patients at a tertiary health facility in Nigeria, as well as assess the risk of CHD by OFC type.

Materials and Methods:

This was a prospective study design. Patients with an OFC were consecutively enrolled at a single OFC treatment facility. All subjects were assessed by a paediatric cardiologist and had echocardiography done. They were categorised based on the presence of CHDs, as well as the OFC phenotypic type (cleft lip and/or alveolus, cleft lip and palate and cleft palate only). Statistical analysis was done using STATA version 14 (College Station, Texas), and significance was set at P < 0.05.

Results:

A total of 150 subjects enrolled in the study over a period of 2 years (2018–2020). The median age of subjects was 6 months (interquartile range: 2–24), and 54.7% were female. The prevalence of CHDs in the subjects reviewed was 30.7%. Based on the severity of CHDs, the majority presented with simple defects (95.6%). Overall, the most common presentation was patent foramen ovale (12.7%), followed by septal defects (8.0%). There was no significant association between cleft type and the odds of a CHD.

Conclusion:

The study reports a relatively high prevalence of CHDs in patients with OFC; however, there was no association between the risk of CHD by cleft type. Although a majority of CHDs may pose a low operative risk, cardiac evaluation is recommended for all cases of OFC to aid the identification of potentially high-risk cases.
Laparoscopic-assisted Transanal Pull-through for Hirschsprung's Children Older than 3 Years
Authors: Arafa Ahmed , Mohamed Wesam , Taher Heba , Ragab Moutaz , Abouelfadl Mohamed Hamed
Published: May 2024

Context:

Hirschsprung's disease (HD) is a congenital anomaly affecting the enteric nervous system commonly the rectosigmoid region. Treatment is surgical where the aganglionic segment is resected, and bowel continuity is restored by a coloanal anastomosis. In 1999, Georgeson et al. proposed a new technique of primary laparoscopic-assisted pull-through for HD as a new gold standard.

Aim:

The aim of the study was to evaluate the outcome of the laparoscopic-aided transanal pull-through procedure for the management of HD in children older than 3 years of age.

Methods:

This study was conducted on 15 consecutive patients presented to a university hospital, diagnosed as having HD relying on their clinical features, barium enema study and rectal biopsy. In all cases, laparoscopic-assisted transanal pull-through was attempted. The laparoscopic part included transition zone identification, seromuscular biopsy for fresh frozen histopathology and sigmoid and rectal mobilisation as much as possible down the peritoneal reflection. The transanal part included mobilisation of the rectal lower segment by 2–3 cm, resection till the ganglionic segment, and full-thickness two-layer coloanal anastomosis was done.

Results:

Early complications occurred in eight cases: enterocolitis in four cases and perianal excoriation occurred in four cases. There were no cases of anastomotic leak. Late complications occurred in seven patients: four cases developed stricture at the site of coloanal anastomosis and three cases experienced enterocolitis at 6 and 9 months postoperatively.

Conclusion:

Laparoscopic-aided transanal pull-through procedure is a safe, feasible modality for the management of HD in children more than 3 years.
Cecal Volvulus in Children
Authors: Saiad Mohamed Oulad , Aballa Najoua
Published: May 2024

Cecal volvulus is a rare complication of malfixation anomalies and intestinal malrotation in children. Only few cases have been reported. The rarity of the condition, frequently leads to diagnostic delay and complications. The best option for cecal volvulus repair remains unclear. Our aim is to increase the awareness of surgeons about cecal volvulus and to discuss its management.
Giant Juvenile Fibroadenoma of the Breast in a 12-Year-Old Girl
Authors: Dasgupta Rituparna , Rajak Tapas Kumar , Kaushal Shalini , Ritolia Nikhil
Published: May 2024

Giant juvenile fibroadenomas, encountered usually in adolescents, are rapidly growing benign breast masses which lead to discomfort, anxiety and significant psychological stress. The breasts are in their early formative years, and thus, it is important to rule out malignancy as well as plan treatment options to preserve as much breast tissue as is possible. This report highlights a case of giant juvenile fibroadenoma diagnosed in a 12-year-old female child and our endeavour to achieve a good aesthetic result.
External and Internal Parasitic Conjoined Twinning
Authors: Menon Prema , Solanki Shailesh , Samujh Ram , Kakkar Nandita , Bhatia Anmol , Mohanty Suravi , N. Rao K. L.
Published: May 2024

Background:

Parasitic conjoined twin is a rare but well-known entity with unclear embryopathogenesis. Abnormal conjoined twinning can result in an externally attached parasitic twin (PT), an enclosed foetus in foetu, or a mature teratoma. The treatment requires complete excision and reconstruction of local anatomy which is not always straightforward.

Materials and Methods:

PT cases presenting over 12 years were analysed. Patients with complete data, histopathological diagnosis and follow-up were included in the study. During follow-up, specific complications and related investigations were considered.

Results:

A total of five patients at four different sites were identified: two retroperitoneal foetus in foetu and three externally attached PTs which were located in the lumbar region, sacrococcygeal area and on the lower anterior abdominal wall. All patients underwent complete surgical excision. In foetus in foetu cases, the blood supply was directly from the aorta with a short stump while the three externally located ones required meticulous and careful dissection with the reconstruction of local anatomy.

Conclusion:

Parasitic conjoined twinning can present at different sites and surgical challenges vary accordingly. For surface lesions, reconstruction may be as complicated as excision. Prognosis can be affected by the excellence of anatomical restoration. Long-term follow-up is essential to address problems specific to the site of lesion and method of surgical reconstruction.
Posterior Urethral Polyp in Children
Authors: Aballa Najoua , Saiad Mohamed Oulad
Published: May 2024

Background:

Polyps of the urethra is a rare cause of obstruction of the lower urinary tract. The clinical presentation is not specific; the symptoms vary and may be isolated or associated, including acute retention of urine, dysuria, and hematuria. Ultrasound and voiding urethrocystography guide the diagnosis. Urethrocystoscopy confirms the diagnosis and allow the treatment. Our aim is to bring to light this rare condition and report our experience in the management of posterior urethral polyps.

Subject and Methods:

A retrospective study of posterior urethral polyp presented from 2008 to 2019 was performed. Charts were evaluated for clinical presentation, management, pathology findings, and long term follow-up.

Results:

Six patients were recorded. Dysuria and hematuria are the most reported features. Ultrasonography and voiding cystourethrogram made the diagnosis in 4 patients out of 6. Urethrocystoscopy made the diagnosis and transurethral resection in all our patients.

Conclusions:

Posterior urethral polyp is a rare benign tumor in children. Urethrocystscopy allow both diagnostic and therapeutic.
A Prospective Observational Study to Evaluate the Change in Inhibin-B as a Marker of Sertoli Cell Function in Children Subjected to Surgical Correction for Undescended Testes
Authors: Raman V Shankar , Khanna Sanath , Verma Vishesh
Published: May 2024

Background and Objectives:

Undescended testes (UDT) or cryptorchidism is a common congenital disability characterised by the absence of at least one testicle from the scrotum. The primary aim of surgical correction is to preserve fertility potential and prevent complications including trauma, malignancy, hernia and torsion. Often, children, especially in developing countries, present late with UDT. The effect of surgical correction in the recovery of Sertoli cell function in children aged more than 2 years is not apparent. The present study was conducted to study the change in inhibin-B level as a marker of Sertoli cell function in surgically corrected UDT in a heterogeneous population.

Materials and Methods:

A prospective observational study conducted over a 3-year period at a tertiary care paediatric surgery centre recruited 76 children with UDT undergoing surgical correction. Inhibin-B as a marker for Sertoli cell function was studied preoperatively and postoperatively. Continuous variables were summarised by calculating mean, standard deviation, median and interquartile range (IQR). Quantile versus quantile plotting was done to assess the distribution of the data. Data were analysed in two groups, with participants aged <2 years (Group A) and more than 2 years (Group B). Wilcoxon signed-rank test was used to compare the pre-operative and post-operative value.

Results:

In Group A (n =39), the median (IQR) of pre-operative inhibin-B was 181 pg/ml (148–254) and post-operative inhibin-B was 230 pg/ml (176–296). In Group B, the median (IQR) of pre-operative inhibin was 70 pg/ml (44–104) and post-operative inhibin was 102 pg/ml (46–176). There was a significant increase in post-operative inhibin when compared to the pre-operative inhibin (P = 0.015 and 0.012, respectively, in Group A and B). Luteinizing hormone (LH) showed a significant decrease (P = 0.002) in Group A following surgery but bordering on significance in Group B (P = 0.43). On the other hand, follicle-stimulating hormone showed a significant decrease (P < 0.01) in Group B following surgery but not in Group A (P = 0.87).

Conclusion:

The mean post-operative inhibin-B levels were increased significantly as compared to the pre-operative levels indicating either a successful orchiopexy/adequate germ cell number or both. The benefit of orchiopexy may extend even to children presenting late for evaluation.
A study on serum ferritin, C-reactive protein, and its correlation with HBA1c in type 2 diabetes mellitus
Authors: Rangappa Nikitha , Bentoor Sanjeevkumar Neelakantappa
Published: May 2024

Introduction:

Diabetes mellitus is a multifaceted metabolic disorder with impaired glucose status in the human body relative to insulin deficiency. Resistance to its action causes impaired glucose tolerance and hyperglycemia. Serum ferritin and C-reactive protein (CRP) are acute-phase reactants correlated with glycated haemoglobin (HBA1c) in a diagnosed diabetic patient as chronic inflammatory markers.

Aim:

The study aimed to study the relationship between HBA1c in diabetes patients and inflammatory markers such as serum ferritin and CRP.

Materials and Methods:

The study group comprised 106 subjects who met the criteria of type 2 diabetes mellitus, an age group between 30 and 90, involving both genders; inclusion and exclusion criteria were added to the study group. Fasting blood sugar, postprandial blood sugar, HBA1c, urine routine, lipid profile, serum ferritin, and CRP were assessed in all study subjects. Data were statistically analyzed and compared the relationship among HBA1c, serum ferritin, and CRP.

Results:

In this study, 31.1% constituted the age group between 50 and 60. A total of 51.9% were males. A total of 64.2% were on oral hypoglycaemics, and 18% had urine albumin on examination. On Spearman’s rho correlation between serum ferritin and HbA1c, the r value is 0.011, and the P value is 0.911 having a positive correlation. On Spearman’s rho correlation between CRP and HbA1c, the r value is 0.017, and the P value is 0.865 showing a positive correlation.

Conclusion:

In this study, inflammatory indicators, including serum ferritin and CRP levels, have a positive correlation with HbA1c values, though statistically not significant, showing higher HbA1c values with elevated serum ferritin and CRP levels. Raised inflammatory markers suggest a chronic inflammatory process in a condition or disease such as diabetes mellitus. By measuring these parameters, we can discover essential aspects of screening, the course of diabetes, its complications, and prevention.
Sleep Quality and Processed Food Consumption among Female College Students
Authors: Aneesh Mitravinda , Chaganty Ananya
Published: May 2024

Background:

Shorter sleep duration and processed food intake have been associated with higher body mass index and increased risk to metabolic syndrome. We conducted a cross-sectional study to find the association between processed food intake and sleep quality.

Materials and Methods:

We recruited 100 female college students aged 18–24 years. Height, weight, and waist circumference were measured. We used Pittsburgh Sleep Quality Index to assess sleep quality. Processed food intake was estimated by using a semiquantitative food frequency questionnaire.

Results:

Half of the students had poor sleep quality. One-fourth of the students slept for more than 7 h/day. Fast food intake was associated poorer sleep quality and higher daytime dysfunction (P < 0.05). Consumption of high sugar foods was associated with the shorter duration of sleep (P < 0.05).

Conclusion:

This study suggests that the quality of food can potentially influence the quality of sleep.
Benign Megalencephaly
Authors: Hambire Chaitali , Hambire Umesh
Published: May 2024

Measurement of head circumference 2 standard deviations above the age-related mean is called megalencephaly and macrocephaly. A distinction between these two entities is appropriate for proper clinical workup, overall prognosis, and treatment. Macrocephaly is a nonspecific clinical finding without implications about the underlying cause. Megalencephaly is an increased growth of cerebral structures related to dysfunctional anomalies during the various steps of brain development in the neuronal proliferation and/or migration phases or as a consequence of postnatal abnormal events.
Immediate Customized Zirconia Crown in Deciduous Tooth by Digital Workflow
Authors: Gupta Gaurav , Gupta D. K. , Gupta Priyanka , Shah Parth , Khairwa Abhishek , Gupta Neelja
Published: May 2024

Catering a tooth colour restoration is the fundamental objective of chairside digital Dentistry in a single sitting with computer-aided design or computer-assisted manufacturing (CAD/CAM) technology, which has become a legitimate reality with the initiation of the CEREC workflow. Nowadays, CAD/CAM of dental restorations has become an ingrained fabrication process, especially for customized Zirconium restorations. In this case report, we will discuss the clinical use of chairside digital dentistry in grossly decayed primary canine treated by pulpectomy followed by CEREC workflow for the fabrication of customized Zirconia crown thus restoring the form, function, and occlusion.
Evaluation of the Efficacy of a Coronally Repositioned Flap with Collagen Membrane for Root Coverage of Miller’s Class I and Class II Recession
Authors: Pal Kirti , Bali Shweta , Aggarwal Priyanka , Nautiyal Aruna , Singhal Deepali
Published: May 2024

Objective:

This study aimed to clinically evaluate the efficacy of coronally repositioned flap in the treatment of isolated Miller’s class I and II gingival recession.

Materials and Methods:

Twelve patients with Miller’s class I and class II recession were selected. Patients were randomly divided into two groups: Group A (control group): coronally repositioned flap and Group B (test group): coronally repositioned flap with bioabsorbable collagen membrane. Clinical evaluation parameters such as probing depth (PD), clinical attachment level (CAL), width of keratinized tissue (WKT), gingival biotype (thickness), recession width (RW), and recession depth (RD) were recorded at baseline and at 1, 3, and 6 months post-operatively using an acrylic stent.

Results:

A significant gain in CAL (−0.6, −0.78, and −0.60 mm) and WKT (0.25, 0.48, and 0.83 mm) was observed in both the groups from baseline to 1, 3, and 6 months, respectively. However, the gain was more in the test group than the control group. Similarly, a significant decrease in mean RD and RW was more in the test group when compared with the control group (significant P-value <0.001) 6 months post-operatively. Also, no statistically significant change was found in the two groups in terms of PD and gingival tissue at 6 months.

Conclusion:

The results of this study suggest that collagen can improve the clinical outcomes of the coronally repositioned flap operation in the therapy of localized recession defects.
Pilomatrixoma of the Nasal Vestibule
Authors: Singh Shikha , Anshu  , Nagpure Prakash S , Gangane Nitin M
Published: May 2024

Orbital foreign bodies are still serious diagnostic problem even after the development of diagnostic imaging techniques. We present an interesting case report of a 42-year-old man who presented with a history of sudden loss of vision after sustaining injury to the left eye due to metallic piece while working. Grayscale ultrasound and computed tomography findings are discussed.
Knowledge, Perceptions, and Barriers to Personal Protective Equipment usage with Suggested Remedial Measures among Health-Care Workers during COVID-19 Pandemic
Authors: Kapoor Suraj , Vardhan Prem , Anand Vivek , Bhaskar S Vijay , Yadav Arun Kumar , Mahajan Saurabh , Kaur Mandeep , Kumar Surinder
Published: May 2024

Introduction:

Personal protective equipment (PPE) is the most powerful method to protect health-care professionals from contact with infectious agent. This study was conducted with an aim to assess knowledge, perceptions, and barriers to PPE usage among health-care workers (HCWs) with assessment of suggested remedial measures against COVID-19.

Materials and Methods:

A cross-sectional descriptive study was conducted among health-care professionals involved in COVID care across the country.

Results:

A total of 167 study participants were included in the study with a mean age of 31 years with standard deviation of 4.4. A total of 123 (74%) of the participants had a knowledge score of 5 or more out of 11 (above average), while 44 (26%) had score <5 suggesting poor knowledge. On inquiring about various barriers/challenges faced while using PPEs, visual problem due to fogging of goggles was found to be most common among 158 (94%) of the study participants. On assessing various remedial measures suggested by study participants to improve vision due to fogging, 54% of participants suggested application of thin layer of clear shower gel or any high-viscosity clear liquid on inner side of protective goggles before donning, while about 20% of study participants suggested application of micropore/elastoplast over the nose bridge to seal the mask properly. To overcome communication/hearing problem, about 32% of the study participants suggested use of microphone along with a portable speaker to amplify the voice.

Conclusion:

To promote good infection prevention and control strategies, it is necessary to impart training in the field of appropriate use of PPEs. This study may serve as a guide to health administrators as well as other HCWs in adopting ways and means to ameliorate the problems encountered in the use of PPE kits.
Team-Based Learning in Pathology
Authors: Bhargava Shruti , Jain Monica , Grover Mohnish , Pathak Deepali
Published: May 2024

Introduction:

Team-based learning (TBL) is an approach where the learners are organized in groups where they learn from each other. This TBL is a student-centric approach, which ensures active participation of each member and also promotes teamwork and learning ability. Looking at the teacher-centric approach of the conventional teaching–learning (CTL) methods in medical education, where the students are mere passive learners and the sessions can be monotonous, TBL seems to be extremely relevant today as a more student-centric teaching–learning method.

Methods:

This randomized crossover study was conducted in the department of pathology, at one of the largest government medical colleges, on students of II MBBS, wherein they were exposed to TBL session and their learning outcome and perception was compared to that after CTL method that is lecture (CTL). The data were analyzed using Primer version 6 software.

Results:

In this study, there was a statistically significant improvement in the score of students after exposure to TBL. Furthermore, there was a significant difference in the learning outcome of students of TBL as compared to CTL. The student perception trends reveal a positive tilt toward TBL.

Conclusion:

Our pilot study concludes that TBL can be used as a supplement to the conventional lectures for improving the learning as well as teamwork and leadership skills of students.
Peripheral Blood Smear Findings in COVID Infection - A Review Article
Authors: Rathod Gunvanti B. , Parmar Pragnesh B. , Kundapur Rashmi
Published: May 2024

Coronavirus disease-2019 (COVID-19) infection caused worldwide morbidity and mortality with complications and still, it is going on. After the Spanish flu, no other illness has obtained such a heavy toll on the human population such as the severe acute respiratory syndrome coronavirus 2. The most common symptoms of COVID-19 infection were fever, cough, dyspnea, expectoration, headache, myalgia, or fatigue and gastrointestinal symptoms. Complete blood count parameters with morphological findings can help a pathologist to alert the physician of future disease progression. Collective findings of various articles were noted down and crux of it was presented here. Lymphocytopenia, neutrophilia, eosinopenia were the common findings with morphological abnormality in lymphocytes and neutrophils in COVID-19 infection. To reach a definite conclusion regarding the specificity and the reliability of these viral cytopathic effects in the peripheral smear, more research is required in this field.
Accuracy of PoCUS in Diagnosing Acute Dyspnea in ED
Authors: Salfi Ponnankandy , Bharadwaj Adithya Venkataram , Tasneem Afza , D’Cunha Delma
Published: May 2024

Introduction:

Acute dyspnea is a common symptom in the emergency department (ED). Diagnosis and management of patients presenting with acute dyspnea is one of the major challenges for physicians in the ED. A correct diagnosis is frequently delayed and difficult to ascertain, and clinical uncertainty is common, explaining the need for rapid diagnosis and a management plan. The standard approach to dyspnea often relies on radiologic and laboratory results, causing an excessive delay before adequate therapy is started. The use of an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis, while maintaining an acceptable safety profile.

Materials and Methods:

This was a prospective study on 88 patients aged above 18 years who came with a complaint of acute dyspnea to emergency room of a tertiary care center in Mangalore, Karnataka, over a period of 1 year from September 2017 to September 2018.

Results:

The accuracy of PoCUS in diagnosing acute dyspneic patients was found to be 93.8% in our study.

Conclusion:

PoCUS is a great tool in all emergency settings to deliver a better care.
Perception of the MBBS students regarding the educational environment in Bankura Sammilani Medical College, West Bengal
Authors: Sarkar Aditya Prasad , Ghewade Babaji
Published: May 2024

Context:

The education environment (EE) is defined as everything that is happening in the classroom, hospital, wards, department, faculty, and university which is known to affect students’ performance.

Settings and Design:

This was a descriptive study with cross-sectional design in a Medical College.

Materials and Methods:

The study was conducted from November 2019 to March 2020 among MBBS students of the college. However, only three batches (1st year, 2nd year, and 3rd year) were available for study. From each batch, 30 students were selected using a simple random sampling method. From 1st and 3rd year, 31 students each participated making a total of 92. A self-administered questionnaire containing baseline information maintaining anonymity and the Dundy Ready EE measure (DREEM) Questionnaire were used.

Statistical Analysis Used:

Statistical analysis was performed with the help of SPSS 22.0. Mean, standard deviation, and proportion were used.

Results:

The global score was 128.0 among students meaning more positive than negative EE. The difference in score in between years of students in students’ perceptions of learning domain, in students’ academic self-perception, students’ perceptions of atmosphere, and students’ social self-perceptions domain was statistically significant (P < 0.05). From the students’ perception, stress on factual learning, authoritarian teachers, problem of memorizing, and lack of good support system during stress were revealed.

Conclusions:

The study revealed that overall EE is good. However, stress on factual learning, authoritarian teachers, and problem of memorizing and lack of good support system should be taken care of.
A Clinical Study of Pleural Effusion and its Radiological, Biochemical, Bacteriological, and Cytological Correlation
Authors: Narayan Mood , Karre Saritha , Darivemula Surendra Babu
Published: May 2024

Background:

Pleural effusion refers to excessive or abnormal accumulation of fluid in the pleural space. It is a commonly encountered medical problem caused by a variety of underlying pathological conditions. Collection of fluid in the pleural cavity has varied etiological factors. Because of the various etiologies that can cause pleural effusion, it often presents a diagnostic problem, even after extensive investigations.

Materials and Methods:

A prospective study was carried out with the aim was to arrive at the etiological diagnosis by analysis of history, clinical presentation, biochemical, radiological, cytological, and bacteriological methods. The inclusion criteria were total 100 patients of adult age and either sex were taken, with age >18 years, and chest X-ray showing evidence of pleural effusion. Already diagnosed with pleural effusion were excluded from the study. Diagnosis was made on clinical examination, radiological examination, and analysis of laboratory data.

Results:

A total of 106 patients were enrolled with a mean age of 42.8 years and standard deviation of ± 15.1, respectively. Out of 106, the maximum number of cases of pleural effusion were tuberculosis 59 (55.7%) among them more than three-fourth of them were affected on the right side and only 13 (12.2%) were affected on the left side. After tuberculosis, malignancy 17 (16.0%) and congestive heart failure 10 (9.4%) respectively. Most of the cases were affected on the right side 57 (53.7%), followed by 35 (33.1%) and only 14 (13.2%) were affected bilaterally. The most common presenting symptoms are 99 (93.3%) and had shortness of breath, 87 (86.0%). Among the plural effusion cases, majority 90 (84.9%) of them had diagnosed with thoracocentesis. Almost 89 (83.9%) exudative effusions are more common and only 17 (16.1%) transudative effusion.

Conclusion:

A maximum number of cases of pleural effusion were tuberculosis followed by malignancy. Thoracentesis and pleural fluid analysis were the most common diagnostic technique. Thoracoscopy was required in few cases which are difficult to diagnose cases.
Fungal Laryngitis
Authors: Ujval M , Sharma Vikas , Fatima Shamim S , Dangwal Vidhu Dhar , Nitin Shantha
Published: May 2024

Fungal laryngitis is a rare clinical entity in an immunocompetent patient. This case report describes the case of a 50-year-old singer who presented with hoarseness. The patient underwent microlaryngoscopy with excision of cyst. Primary laryngeal lesion with no tissue invasion, no systemic fungal manifestations immunocompetent state of the patient and a good response to surgery is characteristic of fungal laryngitis.
Methicillin-resistant Staphylococcus aureus
Authors: Mangalgi Smita S. , Agarwal Astha , Sajjan Annapurna G. , Math Muragesh
Published: May 2024

Background:

Ever-increasing numbers of infections by methicillin-resistant Staphylococcus aureus (MRSA) strains are being reported in the hospitals. Healthcare workers (HCWs) become colonized with MRSA and act as source as well as vectors for the transmission of MRSA infections to the patients.

Aim and Objectives:

The aim of this article is to detect the carrier rate of methicillin-sensitive Staphylococcus aureus (MSSA) and MRSA among the HCWs and to determine the antimicrobial susceptibility of the isolates to commonly used antimicrobial agents.

Materials and Methods:

Nasal swabs from 265 HCWs were collected between October 2018 and April 2019. The swabs were processed using standard laboratory techniques.

Results:

Of the 265 samples collected from HCWs, 46 (17.35%) showed the growth of S. aureus and among them 38 were found to be MRSA. The overall carrier rate of MRSA was 14.33%. The maximum carriage rate for MRSA was seen among nursing staff and that for MSSA among undergraduate medical students. Overall knowledge and attitude levels of HCWs though were found to be better proper preventive practices were not followed. Most of the MRSA strains were sensitive to vancomycin and linezolid, but more than 50% were resistant to commonly used antimicrobial agents in our hospital.

Conclusion:

Along with strict enforcement of infection control practices, regular surveillance of HCWs for MRSA colonization is necessary to limit the spread of MRSA by HCWs to susceptible patients.
Assessment of Morbidity Profile of Rural Population Residing in the Field Practice Area of a Government Medical College
Authors: Bhure Bhagyashri S. , Ankushe Rajendra T.
Published: May 2024

Background:

Morbidity can be defined as any deviation from the state of normal physical and mental well-being. The health of an individual does have a direct relationship with human resources, development and economic development of a nation. The existing hospital based, disease – oriented health care model has provided health benefits mainly to the urban elite, approximately 80% of health facilities are concentrated in urban areas. The rural areas where nearly 69% of the population live, do not enjoy the benefits of the modern curative and preventive health services. Therefore the present study was undertaken with the objective to assess the health needs of the rural population in terms of morbidity.

Materials and Methods:

The Cross-sectional study was conducted in a village which comes under field practice area of the Department of Community Medicine. The village was selected by using lottery method out of all the villages which comes under the field practice area. All villagers in the village constituted the study population. 2270 Study population (420 families) were involved in the study. A house to house survey was done using interview technique as a tool for data collection. Predesigned questionnaire was used to record the necessary information. Data regarding socio demographic factors and any disease condition among family members was collected.

Results and Conclusions:

Present study comprises of 2270 study participants in all age groups. The most common morbidities more than 1% population affected (> 22 cases) were Anaemia 517(22.77%), Acute respiratory infection 260(11.45%), Diabetes and Hypertension 255(11.23%), Diarrhoea 93(4.09%), Refractory error and cataract 46(2.02%), Arthritis 44(1.93%) and Dental caries 34(1.49%). There is dual burden of communicable as well noncommunicable diseases in our study population.
Carcinoma en cuirasse of breast presenting as keloidal structures
Authors: Joshi Deepak , Mohapatra Manisha , Rao Gandikota Raghurama , Haritha Kollipara
Published: May 2024

Carcinoma en cuirasse, also known as scirrhous carcinoma, is a form of cutaneous metastasis of breast carcinoma. The incidence of “en cuirasse” is approximately 0.6%–10% of cases. The most common sites for cutaneous metastases are the chest wall and abdomen. It is characterized by an erythematous, indurated plaque, nodules, or morphea-like plaques over the chest wall. We report a rare case of carcinoma en cuirasse of breast presenting as keloidal-like nodules in a 55-year-old woman.
Achar Rasayana and its Clinical Importance in the Present Scenario
Authors: Shriwas Hari Krishna , Harzpal L C , Chandrakar Rupendra
Published: May 2024

Ayurveda emphasizes on prevention rather than cure and for this purpose, Achar Rasayan has been described like other preventive health measures, for example, Ritucharya, Swasthwritta, etc. Physical, mental, social, and spiritual aspects of our life have been explained in Achar Rasayan providing a ho-listic approach to a person and thereafter, formation of a peaceful and developed society. Unlike the dichotomous nature of modern medicine, Ayurveda always follows a holistic approach. Preventive and social medicine, which is presently known as commu-nity medicine is a specialized branch of modern medicine. The WHO also emphasizes to promote this branch because, this is con-cerned with the whole society, not just with a person. The utility of Achar Rasayan is increased in the present society suffering from sex and violence, greed and anger, etc.
Endodontic Management of Maxillary First Premolars with Three Root Canal
Authors: Rajasekhar Reshma , Karathkodiyil Ranjith , Muliyar Sabir , Thankachan Rekha P. , Sebastian Varsha Maria
Published: May 2024

Endodontic treatment success is obtained by thorough chemomechanical preparation and three dimensional obturation of the root canal system. Maxillary first premolar most commonly presents with two roots with two canals. The most common variation in maxillary first premolar is the presence of three canals and can be frequently missed leading to endodontic treatment failure. This case report describes two cases of endodontic management of maxillary first premolars with three canals. Additional canal was identified through exploration and multiple radiographs with mesial and distal eccentric shifts. Appropriate knowledge regarding the possible anatomic variations and good clinical skills are essential prerequisites for a successful endodontic treatment outcome. Missed canal and inadequate cleaning and shaping contributes to persistent pain, sensitivity leading to treatment failure.
Knowledge, attitude, and perception towards mob lynching among the general population of India: A cross-sectional study
Authors: Paul Fayaz A , Ali Arif , Dar Danishwar R , Banerjee Indrajeeet , Gogoi Rini , Das Monaspika , Saikia Priyanka
Published: May 2024

Background:

Mob lynching is violence by a crowd that results in the killing or maiming of a person or persons charged with or suspected of a crime. Lynching is an extrajudicial punishment to the accused or suspected person by a crowd or informal group without having any legal authority. In India, lynching and mob violence generally replicate internal tensions between several racial communities.

Objectives:

The objectives of the study are to check the attitude and gender differences and to see the predictors of mob lynching among the general population of India The study assessed the knowledge, attitude and perception of mob lynching among the general population of India.

Materials and Methods:

A web-based cross-sectional survey was carried out among 150 adults from March 3, 2022, to September 28, 2022. The survey was conducted online using a Google Form distributed through social media platform (E-mails, Whatsapp, or Messenger application). Participants aged 18 years and above, both male and female, consenting to participate in the study and able to understand English were included in the study. The survey took approximately 5–10 min to complete.

Results:

The findings of this study shows that gender, age, family income, religion, ethnicity, and education as variables that contributed significantly to the prediction of mob lynching among the general population of India [F (6,143) = 4.766; P < 0.01] at 16.7% (R
2 = 0.167) variance. The remaining 83.3% was attributed to the variables not included in the study.

Conclusion:

The study also indicates that most of the cases of mob lynching are committed due to fake news, rumors, and hate speeches that are circulated on social media.
Slump Sitting X-ray
Authors: Dhar Sanjay , Kumar Anirudh , Kale Sachin Yashwant , Kandagatla Sachin , Pandey Akshat , Johri Taarini
Published: May 2024

Study Design:

This was a prospective study.

Purpose:

The aim of this study was to introduce a new slump sitting method radiographs and to compare the angular range of motion (ROM) and displacement between conventional flexion view method and slump sitting radiograph.

Overview of Literature:

Most patients have mechanical low back pain and lumbar instability is considered to be responsible for most chronic and recurrent pain. Dynamic radiographs have been used to identify spinal instability.

Methods:

After ethics committee permission, this study was initiated. Sixty patients were enrolled in the study after obtaining written informed consent. Patients were randomly allocated into two groups: the first group underwent slump view then conventional view, and the second group underwent conventional view then slump view followed all patient’s extension radiographs taken. Angular and displacement measurements of the lumbar spine were carried out and compared.

Results:

Of 60 patients, 40 patients and 26 patients were found instability with slump radiographs and conventional flexion radiographs, respectively. When slump and conventional method were compared, the lumbar flexions were larger in slump radiographs. There were 22.35° of additional global flexion (L1/S1) (P < 0.0001) in slump radiographs when compared with conventional radiographs. Greater global flexion using slump method was found at all lumbar segments with L1/L2 contributing 1.15°; P = 0.009, L2/L3 contributing 3.41°; P < 0001, L3/L4 contributing 5.25°; P < 0.001, L4/L5 5.23°; P < 0.001 with the main contributor being L5/S1 7.41°; P < 0001. When slump and conventional method were compared in terms of displacement, there were no significant differences.

Conclusion:

The slump siting radiographs in lumbar spine instability effectively show the increase in global flexion with significant improvement in segmental flexion. Slump siting radiograph produces more stress in the entire lumbar spine, especially in lower lumbar spine to diagnose lumbar spine instability. Hence, slump sitting dynamic radiograph was shown to be superior to the conventional forward flexion method in measuring the angular ROM and noninferior to the conventional method in the measurement of displacement
Cariprazine
Authors: Bhattacharyya Ranjan
Published: May 2024

Cariprazine is a partial agonist of dopamine and serotonin with high affinity for D3 receptor. There is excess endogenous dopamine both in schizophrenia and bipolar disorder. Cariprazine binds to D3/D2 receptor as antagonist and agonist in schizophrenia and bipolar depression, respectively. Thus, the dopamine pathway inhibited and stimulated in the respective cases. The United States Food and Drug Administration (USFDA) approval now covers the full-spectrum Bipolar I disorder, yet to hit the Indian market.
Physiotherapy in Psoriatic Arthritis
Authors: Dhake Pradnya , Shinde Sandeep B.
Published: May 2024

Psoriatic arthritis is an inflammatory joint condition. It is a chronic condition that includes pinkish-red plaque formation on the skin, leading to its changes. The purpose of this article is to review the literature on the role of physiotherapy in psoriatic arthritis. We performed a critical systematic review on the role of physiotherapy in psoriatic arthritis. The article selection process was systematic. The inclusion criteria of the review were (1) physiotherapy practice with psoriatic arthritis; (2) physical activity in psoriatic arthritis; and (3) chronic psoriatic arthritis and co-morbidities. The current review included 11 studies that fulfill these inclusion criteria. Evidence demonstrates that there is potential benefit of physiotherapy treatment and rehabilitation in psoriatic arthritis. Patients with psoriatic arthritis have impaired function and quality of life. It may involve co-morbidities such as obesity, musculoskeletal disease, cardiovascular disease, or fibromyalgia, which can be improved by non-pharmacological approach, such as aerobic exercise and cardiorespiratory exercise. Low level laser therapy increases not only self-repair activities of living tissues but also cell membrane permeability and metabolism, and education of patients is also necessary to improve clinical conditions. Hydrotherapy, resistance exercise, cryotherapy, and interferential therapy are also beneficial in psoriatic arthritis.
Digital eye strain and its determinants among medical staff and medical student: A cross-sectional study
Authors: Yasir Ziaul Haq , Sharma Rakesh , Kesarwani Divya , Gupta Shraddha , Gupta Kiran , Leong Pick Ling Marinette
Published: May 2024

Aim:

To determine the status of Digital Eye Strain (DES) among medical college staff and medical students.

Materials and Methods:

A cross-sectional questionnaire-based study was conducted. Those with congenital eye disease, history of previous eye trauma, ocular diseases other than myopia, hyperopia, and astigmatism were excluded. Inform consent was taken. Questions on demographics, frequency and pattern of computer usage and ocular discomfort were enquired. DES was graded as absent, Mild, Moderate and Severe. We used a p-value of<0.05 and a 95% confidence interval (CI).

Results:

Out of 455 enrolled, 452 (99.3%) completed the survey. 342 (75.7%) were aged between 21 to 30 years and 304 (67.3%) were medical student. Females were 244 (54%). Out of total 452 participants, 340 claimed that they had experienced at least one symptom of DES Overall prevalence was 75.2% (CI 95% 0.71: 0.79). participants aged ≥40 (P < 0.002), an female (P < 0.0001), refractive error (P< 0.0016), dry eye (P< 0.0024) and screen time ≥5 hours per day (P< 0.0005) were significantly associated to DES. Common complaints of DES included headache (51%) andmusculoskeletal pain (47%). DES was statistically significant among those who don’t take break (P < 0.0016) and among non user of lubricant (P < 0.0001) Regression analysis for DES was found to be effected by female > age > hour of screen use > dry eye > refractive error.

Conclusion:

DES is highly prevalent among medical students and medical staff. DES was affected by female, age, hour of screen use, dry eye and refractive error.
Penicillium chrysogenum
Authors: Singh Neha , Anand Kavita B. , Sondhi Aditi
Published: May 2024

Brain abscess is a severe intracranial infection with a very high mortality rate and usually secondary to an external infection. Fungal infections are now been increasingly reported especially with Candida sp. We present a case of brain abscess in a 63-year-old woman, which was managed successfully by surgical evacuation and was diagnosed radiologically as a fungal infection and on culture detected to have Penicillium chrysogenum.