bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical case of Parry–Romberg syndrome
Authors: Voitenkov V. B. , Komantsev V. N. , Ekusheva E. V. , Skripchenko N. V. , Marchenko N. V.
Published: April 2019

PParry–Romberg syndrome, also known as progressive hemifacial atrophy, is a rare clinical entity of unknown origin with atrophy of skin and subcutaneous fat changes. A classic case of Parry–Romberg syndrome in a woman age 43 is presented. Initial facial changes appeared at the age of 20 years amid complete well-being and in the next 21 years a subcutaneous fat atrophy of the left half face developed, resulting in characteristic deformity changes. No other complaints and manifestations of the disease (epileptic seizures, headache, involvement of the other half of the face and/or extremities) were present at the timeof survey. The analysis of blink reflex, galvanic skin reflex, needle electromyography of the m. orbicularis oris from two sides, computed tomography of the skull bones revealed no pathological changes. The face infrared thermography confirmed asymmetric reduction of temperature on the ipsilateral side. Magnetic resonance scan showed hypotrophy of the left masticatory muscle, the left submandibular salivary gland, thinning of subcutaneous fat layer, changes in the white matter of the brain. Despite the typical clinical features the Parry - Romberg syndrome is a diagnostic challenge known and it is necessary to inform doctors about the latest achievements in the study of etiology, management and prognosis of the disorder.
Effect of Basil (Ocimum americanum L.) Proportion on Physical and Organoleptical Properties of Basil Cracker
Authors: Pratama Yoga , Ulfah Tsurayya , Bintoro Valentinus Priyo
Published: April 2019

Basil contains flavonoid, saponin, tannin, and essential oils namely sineol and eugenol. Basil has been known as appetite stimulant, laxative, fragrance, and breast milk stimulator. This study aimed to determine the effect of basil addition to linear expansion, crispiness, color, and organoleptic of basil cracker. Complete Randomized Design was used in this research with 4 treatments and 5 replications i.e. T1 (10% basil, 90% tapioca), T2 (15% basil, 85% tapioca), T3 (20% basil, 80% tapioca), T4 (25% basil, 75% tapioca). Linear expansion was measured using ruler, hardness/crispiness using texture analyzer, color using digital colormeter, and organoleptic testing was done by 25 panelists. The research showed that basil cracker had linear expansion of 166-235%; hardness of 1264.8-1837.6 gF; L* value of 22,47-40,40 and a* value of -20.73 to -12.67. Variation of basil proportion gave significant effects to linear expansion, crispiness, and color of basil cracker. The best treatment was T2 (15% basil, 85% tapioca) because it had high linear expansion and bright color, was crispy, and preferred by panelists.
Effect of High Fructose Syrup (HFS) Addition on Chemical and Organoleptic Properies of Green Coconut Water Kefir
Authors: Surja Lita Lusiana , Dwiloka Bambang , Rizqiati Heni
Published: April 2019

This research aims to determine the effect of High Fructose Syrup (HFS) addition to carbon dioxide (CO2) content, ethanol content and organoleptic properties of green coconut water kefir, and to determine the ideal HFS concentration for green coconut water kefir. Complete Randomized Design is used in this research with 5 treatments and 4 replications i.e. T0 (0% v/v HFS), T1 (2.5% v/v HFS), T2 (5% v/v HFS), T3 (7.5% v/v HFS), and T4 (10% v/v HFS). The CO2 content is measured by sodium carbonate (Na2CO3) titration, ethanol content is measured by distillation, while the organoleptic properties that included level of sourness, level of sweetness, soda sensation, sour aroma, and viscosity are done by 25 panelists. The results show that the addition of HFS is statistically gave significant effect to the CO2 content and organoleptic properties (P<0,05). However, the ethanol content, which analyzed using empirical model of quadratic polynomial regression, show that the addition of HFS is incompatible to the ethanol content of green coconut water kefir. The most optimal HFS concentration is 7.5% v/v, resulting CO2 content of 0.096%; ethanol content 1.545%; and desirable organoleptic properties, which are low level of sourness, high level of sweetness, very high soda sensation, low sour aroma, and high viscosity.
Protein Content in Snake Fruit Cultivar Pondoh (Salacca edulis Reinw.) with Aseptic Condition in Room Storage
Authors: Handoko Yulian Dwi Anggraeni Puspa , Al-Baarri Ahmad Ni'matullah , Legowo Anang Mohamad , Hadipernata Mulyana , Broto Wisnu
Published: April 2019

Snake fruit is a type of tropical fruit with high market demand, however it is easily damaged and approximately ± 7 days at room temperature of shelf life. After 3 days of harvest, quality of snake fruit has decrease in chemical components, such as color, hardness, and proximate. The decline in the quality may also be caused by microbial contamination. This study aimed to determine the protein content of snake fruit during storage at room temperature under aseptic condition. This study was done in storage temperature of 25±5ºC and carried out at 3 times repetition. The protein content of snake fruit was observed for 3 days. The results showed that protein content of snake fruit at the beginning of storage were about 0.5%. Then, the protein content decreased until undetectable by the Kjeldahl method on the third day of storage. As conclusion, the three days of decrease in the protein content could be determined.
External validation of Tzanakis scoring system in acute appendicitis in a rural hospital
Authors: Lattoo Mohd Riyaz , Mir Shabir Ahmad , Ganie Nayeemul Hassan , Rather Shabir Hussain
Published: April 2019

Background: Acute appendicitis is one of the most common cause of acute abdomen surgery. Several scoring systems have been adopted by physicians to aid in the diagnosis and decrease the negative appendicectomy rate. Tzanakis scoring system is one such score. Objective of present study was the validation of this scoring system in our population and compare its accuracy with histopathological examination (HPE).Methods: A retrospective study was carried out at the Department of Surgery at Mohammad Afzal Beigh Memorial Hospital Anantnag India. Tzanakis score was calculated in 288 patients who underwent appendicectomy from September 2016-2018 and HPE results were analysed.Results: 276 patients were eligible for the study. The sensitivity and specificity of Tzanakis score in diagnosing appendicitis was 90.66% and 73.68% respectively. The overall diagnostic accuracy was 86.23% with positive predictive value of 97.89% and negative predictive value of 36.84%.Conclusions: Tzanakis scoring system is an accurate modality in establishing the diagnosis of acute appendicitis and preventing a negative laparotomy.
Role of special stains as a useful complementary tool in the diagnosis of renal diseases: a case series study
Authors: Venkatesh Veenaa , Malaichamy Vinuta
Published: April 2019

Background: Renal diseases constitute a major cause of morbidity in clinical practice and their incidence is on rise. Investigation usually requires division into even smaller samples to permit the application of specialized techniques.Methods: This is a prospective study conducted over a period of one year from January 2018 to December 2018 in the Department of Pathology, Coimbatore. A total of 58 renal biopsies were received from the Nephrology Department and the tissues were subjected to light microscopic and special stain studies.Results: Total 53 patients (91.38%) had high blood urea nitrogen value more than 20.0 mg/dl. 48 patients (82.76%) had high serum creatinine value more than 1.2 mg/dl. Out of 58 biopsy specimens, 46 (79.31%) showed primary glomerular lesions, 10 (17.24%) showed secondary glomerular lesion and 2 (3.45%) showed tubulointerstitial nephritis. Jones’s methanamine silver stain along with PAS stain helped in typing/staging of membranous glomerulopathy and membranoproliferative glomerulonephritis. Various changes in GBM like spike formation, thickening and moth-eaten appearance of GBM was noted which is seen in MGN stage II, IV and III respectively. Double contour and thickening of GBM was noted which is seen in type I and II MPGN respectively. In Myeloma cast nephropathy, tubular casts stained negative with Congo red which was used to differentiate it from amyloid deposition.Conclusions: The special stains used in this study helped in supplementing the light microscopic findings for diagnosis of kidney lesions. However, the use of other ancillary techniques like immunofluorescence and electron microscopy would help the pathologists in better and more accurate diagnosis.
A study of age as a risk factor in ischemic stroke of elderly
Authors: Reddy Hari Priya , A. Jaganath , N. Nagaraj , Y. J. Visweswara Reddy
Published: April 2019

Background: The aim of the study was to determine the effect of age as a risk factor and a determinant of outcome in elderly ischemic stroke patients.Methods: This is an observational study. One hundred, successive elderly patients aged 60 years and above, admitted with acute ischemic stroke in PESIMSR over a period of 18 months were prospectively studied. Patients with hemorrhagic stroke, neurological deficits following trauma or following infection were excluded. Demographics, risk factors, stroke severity at admission were estimated by NIHSS. Risk factors and clinical profile were noted and compared among male and female patients. Outcome at discharge was measured by-mRS-modified ranking score.Results: Patients in age group 60-75 years presented with less severe stroke and better mRS when compared to >75 years age group. Complications were significantly higher among the older age group.Conclusions: The risk factors identified for ischemic stroke in the present study are diabetes, hypertension, dyslipidaemia, obesity, smoking, and alcohol. Severity of stroke at presentation, clinical outcome and complication rate during the in-hospital stay were all significantly affected by the age, more so in ischemic stroke. Age specific factors of stroke prevention are crucial for successful prevention and implementation of well-organized stroke care.
Hyperuricemia is a risk factor for cardiovascular risk?
Authors: Krisnan Venkata , Soren Bhimasen , Ramalingam K. , Naidu M. Prasad , G. Akhil , Chegireddy Meghana
Published: April 2019

Background: Uric acid is the end product of purine metabolism in humans degraded by the hepatic enzyme, urate oxidase (uricase), to allantoin, which is freely excreted in the urine. However, during the Miocene epoch (20 to 5 million years ago), 2 parallel but distinct mutations occurred in early hominoids that rendered the uricase gene non-functional. Uric acid (UA) is a known endogenous scavenger, which provides a major part of the antioxidant capacity against oxidative and radical injury.Methods: The present study was conducted over a period of one year on outpatients attending the General Medicine Department at Narayana General Hospital, Nellore. The study was included 998 subjects (500 male and 498 female) and authors excluded other complications. Data were analyzed by SPSS software.Results: Serum uric acid of the subjects were measured. The mean and standard deviation were calculated for all the Biochemical parameter. The significance between the groups was determined using Student t-test for equality of means. The two-tailed P value is less than 0.0001, which is statistically significant. Confidence interval: the hypothetical mean is 1.0000 and the actual mean is 6.4600. The difference between these two values is 5.4600. The 95% confidence interval of this difference from 5.3489 to 5.5711. Intermediate values used in calculations; t = 96.4583, df = 999 and standard error of difference p = 0.057.Conclusions: About 53% of the subjects of the study are hyperuricemia, with about 74% of these subjects (or about 39% of the total) diagnosed with hypertension or diabetes mellitus or both, indicating a high CVD risk.
Role of image guided fine needle aspiration cytology in the diagnosis of intra-abdominal and intra-thoracic lesions
Authors: Choudhary Mehnaz , Gupta Rajat , Singh Kuldeep
Published: April 2019

Background: Intrathoracic and intra-abdominal tumors at inaccessible sites pose difficulty in diagnosis. Ultrasonography and computed tomography guided fine needle aspiration cytology has an important role in the diagnosis and distinguishing them as benign and malignant lesions. Image guided FNA has proved to be safe, quick, reliable and cost-effective method for obtaining tissue for cytopathological examination. The objective was to describe the pattern of intra-abdominal and intra thoracic masses on FNAC.Methods: This cross-sectional study was done in the postgraduate Department of pathology Government, Medical college Jammu i.e. 1st September 2017 to 30th September,2018 for a period of one year under image guided FNAC. Air dried and wet fixed smears were stained with may Grunwald Giemsa (MGG) and Papinacolau (PAP) stains respectively. Acid fast bacilli stain was done on additional smears in case of suspected tubercular lesions.Results: A total of 60 patients were subjected to ultrasonography and CT guided intra-abdominal and intra thoracic FNACs in a period of one year. FNAC was performed from various anatomical sites of which intra-abdominal lesions were 40 (liver:21 cases, gallbladder:8 cases, ovary: 3 cases, lymph nodes 3 cases, pancreas: 2 cases, omentum 2 cases, GIT 1 case).  Intrathoracic lesions were twenty (20); out of which lung cases were eighteen (18) and two (2) were mediastinal aspirations.Conclusions: Percutaneous fine needle aspiration cytology under image guidance well described the pattern of deep-seated lesions.
Efficacy of magnetic resonance imaging in assessment of myometrial invasion of carcinoma endometrium
Authors: James Sheen Maria , Ambooken Robert P. , K. Rahul Raj , Krishnan Vipin , Joseph Manu
Published: April 2019

Background: Endometrial carcinoma is the fourth most common cancer in females and the most common malignancy of the female reproductive tract. The prognosis of endometrial carcinoma depends on a number of factors, including stage, depth of myometrial invasion, lympho-vascular invasion, nodal status and histologic grade. Preoperative assessment with MRI is essential for planning surgery and lymph node sampling. The objectives of this study were to determine the myometrial invasion of endometrial carcinoma by MRI and to obtain histopathology in surgically resected specimen, to compare the MRI findings of myometrial invasion in endometrial carcinoma with histopathology in respectable cases.Methods: Authors analyzed 41 cases in whom, histopathological diagnosis of carcinoma endometrium was established by means of pre-treatment biopsy. Consenting patients were taken up for preoperative MRI FIGO staging. MR images were reviewed for parameters like depth of myometrial invasion. Further surgical management followed by histopathological FIGO staging was done.Results: The study showed MRI was highly sensitive and specific tool for identifying depth of myometrial invasion, cervical invasion, serosal invasion, vaginal and parametrial invasion.Conclusions: There was statistically significant difference between histopathological and MRI assessment of local invasion of endometrial carcinoma.
Efficacy of intracuff dexamethasone in reducing the incidence of post-operative sore throat: an original article
Authors: Sugathan Reshma , Raj Sumesh
Published: April 2019

Background: Postoperative sore throat is the most common and most distressing complaint of patients after general anaesthesia with cuffed endotracheal tube. By this study our aim was to assess the efficacy of intracuff dexamethasone in reducing the incidence of this distressing postoperative symptom.Methods: Patients were divided into two groups D and N depending on cuff filling with dexamethasone and normal saline respectively. The cuff was prefilled with dexamethasone or normal saline  one hour prior to intubation to allow time for cuff to be saturated following which the cuff was deflated. General anaesthesia was administered and patients were intubated, and cuff inflated with drug according to group allocated. Patients were assessed and graded for sore throat using VAS scale both at rest and with swallowing. Assessment was done one hour, six, 12 and 24hours post operatively. Presence of hoarseness of voice and cough was assessed on a 2-point scale 0=absent and 1=present, 24hrs after surgery.Results: The incidence of sore throat at 24hours postoperative was reduced in group D than in group N. 4 patients (8%) in group D had sore throat while 27 patients (57%) in group N had sore throat at 24hours. This was statistically significant (p<0.05). The cough incidence was reduced in group D while there was no difference in incidence of hoarseness of voice between the two groups.Conclusions: Intracuff dexamethasone decreases the incidence of postoperative sore throat when compared to intracuff normal saline. Dexamethasone also reduces postoperative cough incidence but does not reduce the incidence of hoarseness of voice.
Comparison of postoperative analgesia and sedation responses of intravenous dexmedetomidine and esmolol during laparoscopic cholecystectomy
Authors: Zuberi Azka , Masoodi Tahir Ahamad , Rastogi Bhawana , Gupta Rajni , Malik Anita , Farooqui Raza
Published: April 2019

Background: Although, the concept of laparoscopic surgeries has revolutionised the surgical practice and has markedly reduced the incidence of complications especially postoperative pain. However, the menace of postoperative pain still remains challenge, especially in first 24 hours. The present study was conducted to comparatively analyse the postoperative pain and sedation using intravenous dexmedetomidine and intravenous esmolol during laparoscopic cholecystectomy.Methods: Study was conducted on 90 adult patients aged 18-60 years of ASA grade I or II of both genders, scheduled for laparoscopic cholecystectomy under general anaesthesia. Patients were randomized into three groups of 30 patients each. Patients of group A received esmolol infusion (loading: 1 mg/kg and maintenance: 5-15 µg/kg/min), patients of group B received dexmedetomidine infusion (loading: 0.7 µg/kg and maintenance: 0.4 µg/kg/hour) and group C (control group) received normal saline infusion. During the post-operative period of 24 hours, patient were monitored for sedation using Ramsay sedation score like pain, using visual analogue score (VAS), incidence of post-operative nausea and vomiting and use of any drug for pain, vomiting and any other side effect.Results: Frequency of pain was highest in group C at all post periods, followed by group A and was least in group B. The mean sedation score of group B was comparatively higher as compared to both group C and group A.Conclusions: The inference authors drew was that dexmedetomidine is better analgesic with aurousable sedation.
Management and pattern of pellet gun injuries in war conflicted Kashmir Valley, India
Authors: Mala Tariq Ahmed , Ahmad Syeed Rayees , Malla Shahid Amin
Published: April 2019

AbstractBackground: The pellet gun is a shot gun weapon which is used by law enforcement agencies to maintain law and order in conflict zones whenever need arises. Sometimes these minute sized pellets may lead to grave injuries to vital structures of the body which may sometimes led to permanent disability. The objective of this study was to investigations and manages these fatal injuries in war conflicted valley. Methods: The prospective study conducted in a tertiary care hospital of Government Medical College Srinagar at the time of civilian unrest in 2016 and onwards when thousands of people were injured with pellets by security agencies. Results: Maximum number (67.1%) of patients had injuries to eyes and face, among the total number of patients 69 (17.2%) of patients had abdominal injuries. CECT abdomen showed pellets in all 69 (100%) of patients, pellets in gut lumen in 48 (69.5%) of patients. In the abdominal group 40 patients underwent laparotomy which showed hemoperitoneum in 49 (71.01%), pneumoperitoneum in 6 (8.69%) of patients. Conclusion: Pellet gun weapon has become a common arsenal to suppress the unarmed civilian agitation which may lead to fatal injuries to vital structures of body, where prognosis remained poor despite of best available treatment.
Clinicopathological study of skin tumours
Authors: Shrivastava Vaidik , Tangde Ashwini , Joshi Anil , Bindu Rajan
Published: April 2019

Background: Skin cancers are relatively uncommon malignancies worldwide, but the incidence of skin cancers has progressively increased over the last few decades. The distinction between benign and malignant neoplasm are more difficult to define when they appear in skin than when found elsewhere and histopathological examination is frequently required to establish a definitive diagnosis. Diagnosis of any skin tumours can be done by correlating clinical features and histological features. The aim and objective were to study age-sex wise distribution, clinical presentation and histopathological spectrum of various skin tumours.Methods: This is a retrospective study of three years conducted in the Department of Pathology, Government Medical College, Aurangabad, India from December 2015 to December 2018. Specimens received from Department of Dermatology were fixed in formalin and after adequately processing the sections were stained routinely with H and E stain and properly evaluated for histopathological examination. This study includes tumors of epidermis along with melanogenic tumors and skin appendageal tumors. The data collected was tabulated, analysed and compared to other similar studies.Results: The study consists of 130 cases. The ratio of male to female was 1.24:1. Head and neck region (48.46%) was the most common site observed where skin lesions were present followed by extremities (37.69%). Most of the malignant tumours were presented with non-healing ulcers (30.76%) and Noduloulcerative lesions (20.33%). Out of 130 cases, 83 (63.84%) were benign whereas 47 (36.15%) were malignant tumour. According to WHO classification, keratinocytic tumour 55 (42.30%) was the most common tumour type in the present study. Skin adnexal tumours and melanocytic tumours were observed in 54 (41.53%) and 21 (16.15%) respectively.Conclusions: The skin is a complex organ. Because of complexity of skin, a wide range of diseases can develop from the skin. The majority of benign neoplasms are from skin adnexal group whereas most common malignant neoplasm were from keratinocytic group. Skin adnexal tumors can occur anywhere in the body, however head and neck region constitute the most common site. Skin adnexal tumours are clinically often misdiagnosed, so histopathological examination remains gold standard for their correct diagnosis and for their differentiation between benign and malignant neoplasm.
Spectrum of non-fermenting gram negative bacilli isolated from patients with blood stream infections in a tertiary care hospital in North India
Authors: Nazir Asifa , Peerzada Bushra Yousuf , Sana Ifshana
Published: April 2019

Background: Non-fermenting Gram-negative bacilli (NFGNB) are emerging as important causes of blood stream infections (BSI) and they are a major cause of morbidity and mortality worldwide. High intrinsic resistance of NFGNB to antimicrobial compounds makes the treatment of BSIs caused by them difficult and expensive. The aim of this study was to assess frequency and antibiotic susceptibility pattern of non-fermenting gram-negative rods isolated from blood culture of patients.Methods: A total of 3016 blood samples were received in the Department of Microbiology during the study period. All samples were processed according to standard microbiological procedures. Blood culture was done by automated blood culture system, (BacT/Alert) and identification and antibiotic susceptibility of non-fermenting gram negative bacilli was done by VITEK2 Compact System.Results: A total of 120 NFGNB were identified out of which the most common non-fermenters isolated were Acinetobacter sp. (95) followed by Pseudomonas aeruginosa (11), Burkholderia cepacia (09) Sternotrophomonas maltophilia (03) and Sphingomonas sp. (02). Most of the non -fermenters were multi drug resistant showing a high level of antibiotic resistance to most of the first- and second-line drugs. The most effective drugs were colistin and tigecycline.Conclusions: This study underlines the need to identify NFGNB in tertiary care hospitals and to monitor their susceptibility pattern to guide the clinician for better care and management of patients. Improved antibiotic stewardship and strict infection control measures especially hand washing need to be implemented to prevent emergence and spread of multidrug resistant NFGNB in health care settings.
Immunohistochemical profile and its association with clinicopathological parameters in carcinoma breast: a prospective study in central India
Authors: Walke Vaishali , Gunjkar Gajanan
Published: April 2019

Background: Carcinoma breast is one of the most common malignancies of women in India. The current study was conducted with the objective of assessing estrogen receptor (ER), progesterone receptor (PR), Her-2/neu (human epidermal growth factor receptor-2) expression and Ki67 index of breast carcinomas and its correlation with histological grade, tumour size and lymph node metastasis.Methods: Forty-seven lumpectomy or modified mastectomy specimens diagnosed as Infiltrating duct carcinoma (IDC): NOS, were selected for panel of imuno histochemistry (IHC) markers on tissue microarray blocks prepared from each case.Results: Maximum of our patients belonged to premenopausal 24/47 (51%) and 20% to younger age group (<30 year). Tumour size of 2-5 cm was observed in maximum females 29 (61%); while 13(27%) had size >5.0cm. The majority of cases diagnosed as grade I (40%) and lymph node involvement was seen in 31/47 (65%). Molecular classification revealed 10 (21%) luminal A, 4 (8%) luminal B, 9 (19%) Her2/neu positive, while triple negative phenotype comprised of maximum 24 (51%) patients. Most of the Luminal group tumours were low grade (14/15); while majority of Her2/neu positive 7/9(77%) and triple negative tumours 19/24 (80%) belonged to higher grades.Conclusions: Breast carcinoma among our patient is characterized by a large percentage of triple negative phenotype that is less susceptible to hormonal therapy. The empirical treatment with tamoxifen should therefore be reconsidered as it would be less effective. Assessment of prognostic markers in breast carcinoma is strongly advocated in order to provide the best therapeutic options.
Urinary trypsinogen-2 dipstick test for point-of-care screening of acute pancreatitis
Authors: Raja Bhuvaneswari , T. S. Srinath Kumar , V. Viju Wilben
Published: April 2019

Background: Acute pancreatitis (AP) is associated with high mortality in its severe form. Conventional laboratory tests used in its diagnosis are fraught with multiple shortcomings. Early institution of intravenous fluid resuscitation can reduce morbidity and mortality. Measurement of urinary trypsinogen-2 using a bedside urine dipstick test may prove useful in early identification of AP.Methods: Patients with symptoms consistent with AP, attending the emergency department, at a tertiary care hospital in southern India, between November 2014 and November 2016, were included in a prospective observational study. The patients underwent routine investigations and additionally were tested with a urinary trypsinogen-2 dipstick test (UTT). The diagnostic performance and the time to reporting of the different investigations were compared with those of UTT. Final diagnosis of AP, made by clinicians, served as the standard.Results: The sensitivities of serum amylase, serum lipase, UTT, ultrasonography (USG) and contrast-enhanced computed tomography (CECT) were 97.1%, 94.1%, 92.7%, 98.3% and 100%, respectively. The respective specificities were 92.4%, 98.5%, 98.5%, 100% and 100%. The average time required to obtain the test report was about half hour from admission in case of UTT, compared to about 3 hours for serum amylase/lipase, 4 hours for USG and 6 hours for CECT.Conclusions: The results indicate that UTT test, due to its high performance indices, simplicity and faster availability of reports, can serve as an ideal screening test for AP and help in early institution of treatment.
Epidemiological review and clinicopathological study of gastric adenocarcinoma cases in a tertiary care center in North Chennai, India
Authors: Padmavathi R. , Priyadharisini J.
Published: April 2019

Background: Gastric carcinoma is the third most common cause of cancer-related mortality worldwide. The Incidence of gastric carcinoma shows wide geographic and regional variation as well. The clinical presentation varies with the individual and hence histopathological evaluation plays a major role in the diagnosis and management of the patients. This study aims to evaluate the epidemiological and clinicopathological profile of gastric adenocarcinoma cases encountered in a tertiary care center in North Chennai where only limited statistical data available in literature.Methods: All the gastric adenocarcinoma cases diagnosed by histopathology who underwent total/subtotal gastrectomy were retrospectively collected for clinical as well as histopathological details for a year. Descriptive statistics were used for analysis.Results: The mean age of the study population is 59.3±11.3 with male: female sex ratio of 2.1:1. Higher prevalence noted in lower socioeconomic status (80%) and alcoholics (65%) with a history of high salted diet (62%). Most common presenting symptom was dyspepsia (94%). Upper GI endoscopy revealed antrum (42%) as the commonest site of tumor and majority were more than 5 cm size (75%). 62% of tumors were of moderately differentiated, predominantly intestinal type (86%) and mostly found to be in stage 3 (50%).Conclusions: Gastric adenocarcinoma was more common in elderly males and majority presented in advanced stage at the time of diagnosis. The General public needs to be creating awareness about variable nonspecific symptoms of an early stage of gastric carcinoma as well as the risk of poor dietary habits (high salted diet) and can enforce screening of high-risk category people.
Relationship between topography of the residential area of breastfeeding mothers with zinc and calcium level in breast-milk in West Sumatera
Authors: Sari Silvie Permata , Yanwirasti Yanwirasti , Desmawati Desmawati
Published: April 2019

Background: Natural environment, the topography of the residential area affects the nutritional intake of the community greatly. Geographically (including the topography of the residential area), the nutritional intake will affect breastfeeding mothers, because the quantity and quality of breast milk is influenced by the food consumed by mothers every day.Methods: This was observational research with a comparative cross-sectional design. The research was conducted at the Integrated Laboratory of LLDIKTI region X in December 2018 to January 2019 using the Atomic Absorption Spectrophotometer (AAS).  Samples were 80 breastfeeding mothers consisting of 40 mothers living in lowland and 40 mothers in Highland. Data analyzed using the Kolmogorov Smirnov normalization test and Mann-Whitney test, if p = 0.05, was considered significant.Results: Research showed that there was a significant relationship between the topography of residential area with zinc (p = 0.00) and calcium levels (p = 0.00).  Zinc and calcium levels in breastfeeding mothers were higher in mothers who live in the lowlands than in the highlands.Conclusions: The conclusion of this study, there is a significant relationship between the topography of the residential area of breastfeeding mothers with zinc and calcium levels in breast milk.
Magnetic resonance imaging in evaluation of juvenile nasopharyngeal angiofibroma in term of its diagnosis and pattern of spread
Authors: . Puran , Kardam Narendra Kumar
Published: April 2019

Background: Juvenile nasopharyngeal angiofibroma (JNA) is a tumor that shows a predictable spreading pattern. This study showed the characteristic MRI findings and its pattern of spread of JNA for diagnosis.Methods: This study consisted of 6 cases of JNA for diagnosis and pattern of spreading by using MRI as modality of choice.Results: The total patients included in study were 6 with age range from 9-20 years and all were male. The classification system used in the study was Radkowski and Onerci system. The tumor showed isointensity to muscle and hyperintensity on T1 and T2 sequences respectively on MR imaging. All lesions had internal signal void regions and showed intense enhancement after IV contrast administration. Diffusion restriction was not an associated features however high values of ADC were noted. The MR angiography of three patients showed blood supply of tumor was mainly from the internal maxillary branch of external carotid artery. The treatment was surgical excision of tumor which was decided on MRI Diagnosis and pattern of Extension described in Radiological report.Conclusions: MRI is a modality of choice for diagnosis and extension of JNA based on clinical and radiological findings, without performing a biopsy.
Immediate effect of dynamic oscillatory stretching vs. neurodynamic sliding technique on stretch tolerance, popliteal angle range and hamstring flexibility in apparently healthy individuals with hamstring tightness: a pre-post clinical trail
Authors: R. Ganesh B. , Marwah Veedika V. , Joshi Vidhi S.
Published: April 2019

Background: The hamstrings being postural muscles are prone to tightness which leads to muscular imbalances and inefficiency of daily living activities. Hence, the present study aims to compare two competent techniques Dynamic Oscillatory Stretching (DOS)vs. neurodynamic sliding (NDS) technique.Methods: A Total of 60 subjects were recruited (31 males, 29 females). passive 90-90 knee extension test, modified v sit to reach test and NPRS scale were used to evaluate the range, flexibility and stretch tolerance in participants pre intervention and were allotted into Group A (DOS) and Groups B. The subjects were then re-assessed immediately post intervention.Results: The results were obtained using the independent and dependent t-tests. Post intervention results were suggestive of a significant within group result with a p=0.0001 under all the parameters. Subjects in Group a showed a greater increase in the ROM while, Group B showed a better result in flexibility and stretch tolerance.Conclusions: Both the techniques are efficient and can be incorporated in sports rehabilitation to prevent on site injury thereby improving athlete’s performance.
Analysis of muscle strength and endurance in healthy young adults and association of muscle strength with muscle endurance
Authors: Bhattacharjya Jolly , Baishya Reeta , Dutta Bijit
Published: April 2019

Background: Muscle strength has been studied as a predictor of general health and many diseases.  Data on muscle strength of healthy adults are scarce in Assam. Aim of the study was to describe normative data for hand grip muscle strength and endurance among healthy young males and females of age group 18-21. Also, to find out any correlation between muscles strength and endurance.Methods: We have selected 79 healthy volunteers of both sexes of age group 18-21 years. We have measured muscle strength by hand grip dynamometer. Muscle endurance was calculated by asking the subjects to hold the dynamometer at one third of their muscle strength as long as they can.Results: In this study there were 46 males and 33 females. Mean muscle strength among the males is 27.09(SD7.05) and among the females is 10.76(SD6.19). Similarly mean endurance among males is 41.78(SD31.72) and among females is 16.15(SD9.81). These higher values of muscle strength and endurance in males are statistically significant. We have also found positive correlation between muscle strength and endurance in both the sexes.Conclusions: In this study we have seen that muscle strength and endurance of healthy young males are more than that of females. And also, muscle endurance increases with increase in muscle strength.
A histopathological study of sebaceous neoplasms and related lesions at a tertiary care centre
Authors: Dowerah Swagata , Harlalka Munmun
Published: April 2019

Background: Sebaceous lesions have intrigued pathologists and dermatologist alike causing a great deal of diagnostic confusion. Tumors and tumor like conditions of the sebaceous glands include sebaceous hyperplasia, Nevus sebaceus of Jadassohn, sebaceous adenoma, sebaceoma and sebaceous carcinoma.Methods: A three-year study of all lesions with sebaceous differentiation was carried out in the histopathology section of a tertiary care hospital to study the spectrum of lesions showing sebaceous differentiation. Patient records were noted, and paraffin embedded sections stained with haematoxylin and eosin were examined for histopathological diagnosis. Clinical correlation was done in all the cases.Results: The spectrum of lesions encountered included sebaceous carcinoma, Nevus sebaceous, sebaceous hyperplasia, sebaceous adenoma among others. Eyelid was the most common site followed by scalp. Clinicopathological correlation was found to be poor in these lesions with clinical examination failing to correctly identify most of the cases.Conclusions: Sebaceous neoplasms were seen to be rarer in our population as compared to other adnexal tumors. Histopathology, in the presence of typical features, is the mainstay of diagnosis with immunohistochemistry aiding in certain doubtful cases.
Trichobezoars as a cause of intestinal obstruction in a young female
Authors: Chodankar Shireesha U. , Kudchadkar Shantata J. , Amonkar Dilip
Published: April 2019

A bezoar is a mass found trapped in the gastrointestinal system, though it can occur in other locations. There are various types of bezoars including food boluses, lactobezoar, pharmacobezoar, phytobezoar, diospyrobezoar and trichobezoar. They are common in children and adolescents, and 90% of the patients are women. Complications may manifest as gastric outlet obstruction or bleeding and intestinal obstruction. CT is the preferred image modality for the evaluation of suspected trichobezoars in order to characterize the size, location, presence and level of obstruction and complications such as ischemia or perforation. Here authors present a case to stress the importance of considering trichobezoars as one of the causes for intestinal obstruction in young females.
Minimal invasive management of rare case of ureterocoele with stone: a diagnostic challenge
Authors: Thakkar Nimesh Bharatkumar , Chauhan Abhesinh
Published: April 2019

Ureterocoele is a cystic dilatation of the lower part of the ureter. One of its presentations in the adult population is the presence of a stone, usually a solitary stone, inside the ureterocoele. Authors present a rare case of Ureterocoele with stone in it managed with transurethral deroofing and cystolitholapaxy. This work has been reported in line with the SCARE criteria.
The multifarious oxytocin: a review
Authors: Kapur Arpita , Kapur Vinay
Published: April 2019

Oxytocin over centuries has always been regarded as the drug of paramount importance during childbirth. Oxytocin, a peptide hormone facilitates parturition and breastfeeding. These nine amino acid peptides have presently been found to be associated with a wide variety of pathophysiological functions associated with social behaviours. It has been recently recognised as an important modulator of human social behaviour. Its correlation as a common factor important in various neuropsychiatric disorders such as schizophrenia, personality disorders and autism, mood and anxiety disorders has been highlighted. Anticipatory role of oxytocin in osteoporosis, diabetes and cancer has been coaxing the researchers for developing new therapeutic modalities. Over a course of past 100 years, oxytocin has come a long way from being an insipid agent used as an aid in labour and delivery to the drug of neuropsychiatric conditions. This review article summarises the varied functions of oxytocin, its apt dosing when used therapeutically and reinforcement of development of new lines of treatment involving the use of oxytocin and antagonists for multiple human disorders.
Methelene blue stained temporalis fascia graft in myringoplasty: a clinical study
Authors: Prakash M. D. , . Rajashree
Published: April 2019

Background: The objective of the study were to know advantages of using methelene blue stained graft in tympanoplasty and to compare results between tympanoplasty with or without methelene blue stained graft.

Methods: This is a prospective study involving 60 patiens diagnosed with of chronic suppurative otitis media (CSOM) of mucosal type. Selected patients were aged between 20 years to 45 years. Those patients with active discharge, treated initially with antibiotics, to contro infection, and once dry ears maintained for minimum 6 weeks were planned for surgery. Among 60 cases, 30 patients underwent tympanoplasty (I) with methelene blue stained graft and other 30 patients underwent tympanoplasty (I) using unstained graft. Patients were followed up for 6 months.  

Results: Patients outcomes were compared in terms of graft uptake and hearing improvement. Among all patients graft uptake was better in cases where methelene blue stained graft was used, but the results were not statistically significant. Hearing improvement in terms of air bone gap closure was assessed, study showed there was better air bone gap closure in cases where methelene blue stained graft is used and results were statistically significant.

Conclusions: Advantages of methelene blue staining allows better identification and proper placement of the graft, gives good results in terms of improved graft uptake, as it has antimicrobial properties. Hearing improvement results in terms of closure of air-bone are good.
Status of contralateral ear in chronic otitis media and role of diagnostic otoendoscopy in it’s assessment
Authors: Soni Sweta , Nath Nandita
Published: April 2019

Background: Chronic suppurative otitis media doesn’t seem to be an isolated event that occurs in a particular patient. It seems rather be the product of a series of events constitutional of the individual. The precise and critical evaluation of both ears plays a fundamental role in the prognostic evaluation of the patient. Otoendoscopy is an upcoming day care procedure in the field of otology. It has several advantages over routine otoscopy for e.g. better resolution, wider field of vision, camera connectivity etc. We aimed to study the status of contralateral ear in chronic otitis media patients and evaluate the usefulness of diagnostic otoendoscopy.

Methods: A prospective study was done on CSOM patients attending ENT dept, SMCH using otoendoscopy, schuller radiography, pure tone audiometry, tympanometry and HRCT temporal bone. Data collected was analysed.  

Results: A total of 80 patients were evaluated out of which 70% were male, otoendoscopy revealed features of a diseased contralateral middle ear in 80% of them, PTA suggested hearing loss in opposite ear in 80% of them, schuller’s radiography showed sclerosed opposite mastoid in 22.5% and CT scan needed to be done in 24 patients of which 10 had disease in opposite middle ear.

Conclusions: It is imperative from this study that evaluation of contralateral ear in chronic otitis media is important to unmask the hidden pathology and otoendoscopy is very useful in diagnosing it.
Analysis of hearing improvement in patients with chronic mucosal otitis media after type-1 tympanoplasty
Authors: Karodpati Nayana S. , Kasliwal Anirudh
Published: April 2019

Background: Chronic mucosal otitis media implies a permanent abnormality of the pars tensa. It can be active, where there is pus formation and inflammation or it can be inactive, where there is no inflammation and pus formation. It may occur due to many etiological factors like recurrent Upper respiratory tract infection leading to Eustachian tube blockage, sequelae to unresolved acute otitis media etc. Patient is most commonly presented with pus discharge from ears and decreased hearing.

Methods: This prospective study was carried out in 44 patients, above the age of 18 years, with unilateral chronic mucosal otitis media. All patients underwent type 1 tympanoplasty. Pre and post treatment hearing was measured by pure tone audiometry.  

Results: The result shows that most patients were in the age group of 20-30 years of age. Most common symptom patients presented with was hearing loss and pus discharge. The pre treatment mean air bone gap was 34 db and the post treatment mean air bone gap was 14 db.

Conclusions: Most common age group was between 20-30 years. Patients presented with mostly hearing loss and discharge from the ear which was chronic in nature and mostly mucoid. All patients benefitted in hearing postoperatively after type 1 tympanoplasty was done. It shows that type 1 tympanoplasty is still one of the most used methods and produces effective results in patients with chronic mucosal otitis media.
Primary laryngeal tuberculosis
Authors: Brahmono Aditya , Purnami Nyilo , Yusuf Muhtarum
Published: April 2019

Primary laryngeal tuberculosis (TB) is a very rare disease that became the most common causes of granuloma disease in the larynx. The manifestasion of tuberculosis on the laryngeal is commonly local without systemic symptom. This case reported was 21 year old male that complained of hoarseness for 6 months. The results of the fiber optic laryngoscopy (FOL) is generally believed a papilloma of the larynx. Biopsy extraction with microlaryngeal surgery was a mandatory procedure that apparently showing an overview of TB based on the results of histopathology and polymerase chain reaction (PCR). Anti-tuberculosis drugs were given to the patients, the evaluation carried out six months after the patient obtain intensive therapy and continue therapy with good result. Due to the non spesific laryngeal sign that was observed on clinical examination, clinicians must consider the possibility of primary laryngeal tuberculosis. Biopsy the lession on larynx continued with histopathology examination must not hesitate to confirm the diagnosis. PCR can be considered the better way to detect the TB bacteria. 
 
Incudostapedial joint dislocation with conductive hearing loss: a case report
Authors: Dhingra Preeti , Pusalkar Ashutosh
Published: April 2019

Trauma to the ossicular chain is a common complication of fracture temporal bone, ossicular dislocation being more common than ossicular fracture. Most commonly affected ossicles are the incus and malleus, stapes being relatively more stable. The most common injury is the incudostapedial joint dislocation. We are presenting a case of unilateral conductive hearing loss in a patient with the pre operative diagnosis of otosclerosis, which intra-operative turned out to be incudostapedial joint dislocation with malleus fixation, successfully reconstructed with partial titanium implant.
Submental midline branchial cleft cyst: a first case report in literature
Authors: Narayana Mada Lakshmi , Viswambharan Vivek , Kumarguru B. N.
Published: April 2019

A branchial cleft cyst is a congenital abnormality typically located over the lateral aspect of neck. A 3 year old boy presented with a gradually progressive painless swelling below his chin since 1 year. CT scan demonstrated well defined cystic lesion in submental region. Excision was done and histopathology showed the cyst lined by stratified squamous epithelium and at places lined by pseudo stratified ciliated columnar epithelium with subepithelial lymphocytes suggesting branchial cyst. Branchial cleft cysts should also be considered as one of the differential diagnoses in cystic midline lesions of the neck, if it’s not moving with deglutition and with tongue protrusion.