bluuebunny/crossref_metadata_2025 huggingface dataset:
Demographic correlates of nicotine dependence in psychiatric patients
Authors: Singh Yogendra , Sisodia Anil , Gaur Anil , Agarwal Vikrant
Published: January 2021

Background: Tobacco and nicotine dependence has high prevalence in patients with psychiatric disorders. The present study was conducted to delineate demographic correlates of tobacco and nicotine dependence in psychiatric patients.Methods: 102 patients were sampled from Institute of Mental Health and Hospital, Agra. Fagerström Test for Nicotine Dependence for Smoking, Fagerström Test for Nicotine Dependence for Smokeless Tobacco, The Drug Abuse Screening Test (DAST), Alcohol Use Disorders Identification Test (AUDIT) were used along with a proforma for recording demographic and clinical details of the patients.Results: The results suggested that the severity of nicotine dependence in total sample was as Very Low in 2.9%, Low in 15.7%, medium in 42.2%, and High in 39.2%. The results of association between demographic variables and nicotine dependence suggested that there was statistically significant association between nicotine dependence and gender, place of residence, marital status, type of family, annual income, history of mental illness, History of substance use and duration of tobacco use.Conclusions: The medium and high level of nicotine dependence amount to 81.40% sample is of true concern which warrant for an active intervention for tobacco cessation programs in majority of the patients.
A comparison of intrathecal 0.5% hyperbaric ropivacaine with 0.5% hyperbaric bupivacaine for elective surgery: a prospective, randomized, double-blind, controlled study
Authors: Kharat Pallavi Amol , Deopujari Rajshree Chandrashekhar
Published: January 2021

Background: To compare the onset of action, intensity and duration of motor block of 0.5% hyperbaric ropivacaine with 0.5% hyperbaric bupivacaine for elective lower abdominal, perineal and lower-limb surgeries.Methods: 70 patients undergoing elective lower abdominal, perineal and lower limb surgery receiving spinal anesthesia were divided randomly into two groups, Group B, (bupivacaine 5 mg/ml with glucose 80 mg/ml;4 ml, and Group R, (ropivacaine 5 mg/ml with glucose 80 mg/ml; 4 ml).Results: The results were analyzed and compared using Chi-square test, student ‘s t-test and Fisher’s exact tests. The onset of sensory block was more rapid with bupivacaine (p<0.05). The maximum cephalad spread was similar in both groups. However, the time required to maximum extent of cephalic spread was less in Group B (p<0.05). Motor block 3 according to modified bromage scale was obtained in both groups and the time to achieve the same was not significant. The duration of motor blockade i.e., time to complete regression of motor block was significantly greater with Group B than with Group R (0.0001). We found that there was no significant difference in the time taken to achieve grade 3 motor block but ropivacaine gave a lesser degree of motor block which regressed faster than bupivacaine (118 min versus 156 min; p<0.0001). There was no significant difference in hemodynamic parameters except that diastolic and mean pressures remained on lower side in group B (p<0.05).Conclusions: We conclude that 0.5% hyperbaric ropivacaine provides a sensory block of similar onset and extent, shorter duration of action and less frequency of hypotension as compared to 0.5% hyperbaric bupivacaine.
A community based study on dengue awareness and preventive practices among urban slum population in Hyderabad, South India
Authors: Varma Pavani , Mohandas Anu , Pattnaik Snigdha , N. Balakrishna , G. Kumar Kranthi
Published: January 2021

Background: Dengue is identified as public health problem due to its rapid spread throughout the world. In India raising trend of dengue cases in monsoon is being observed. Objectives were to determine the level of awareness regarding dengue fever and practice of preventive measures and its association with socio-demographic factors; and to find out the association between awareness and practice of preventive measures.Methods: A community based cross sectional study was conducted among 150 residents of urban slum area, Shaikpet. Mean scores of awareness and practices were found and with a cut off >60% categorized as good. Chi-square test was used to find association with socio-demographic factors. Logistic regression was done for risk estimation.Results: The awareness regarding dengue fever was only 22.7% with a mean score, 8.1 (SD=3.74). Good practices were shown by 55.3% with a mean score of 10.7 (SD=5). Among those who were aware majority belonged to higher educational level (p=0.048). A significant difference was observed between income and occupation with practices. A positive correlation was found between awareness and practices in dengue fever (r=0.511, p<0.001). Females (OR=2.5) and school level education (OR=3.4) were predictors of poor awareness while professionals and low income were predictors of poor practices (p<0.05).Conclusions: Better aware people were found to practice preventive measures. So, grass root level workers can provide health education among households focusing on behaviour change, regarding preventive measures. Appropriate use of information, education and communication through mass media and social network will be beneficial.
A clinical study of optic nerve involvement in patients with tuberculosis attending a tertiary health care center in North East
Authors: Borooah Mitali , Malakar Amar Jyoti
Published: January 2021

Background: To screen for ocular finding of optic nerve involvement in patients with tuberculosis and documents these findings.Methods: The hospital based observational study was carried out in a tertiary care hospital in Assam  for  the duration of July 2018 to June 2019 in 384 diagnosed cases of tuberculosis patients who fulfil  the inclusion criteria during the study period.Results: 11 cases with optic nerve involvement was found out of 384 tuberculosis patients. Most common presenting complain was blurring of vision. Unilateral involvement was maximum. Most common finding was disc oedema.  Ocular TB cases was higher in extrapulmonary TB patients.Conclusions: Diagnosis of ocular Tb is mainly presumptive, based on history, clinical examination, adjunctive diagnostic tests and response to anti tuberculous therapy. Amongst 384 TB cases ocular manifestations were found in 11 cases and therefore, we can conclude that ocular manifestations hold significance in extra pulmonary manifestations of TB. So, TB patients need to have routine ocular examination for the early diagnosis and timely management.
Right ventricular involvement and conduction disturbances in acute inferior wall myocardial infarction patients and their angiographic correlation
Authors: Misra Amitava , Choudhury Sankar Paul
Published: January 2021

Background: Right ventricular myocardial infarction (RVMI) in the setting of inferior wall myocardial infarction (IWMI) is associated with adverse events. The study aimed to evaluate right ventricular (RV) systolic function in the first episode of IWMI by echocardiography; determine incidence of different conduction abnormalities during hospitalization in IWMI patients with and without RVMI; and determine association of these parameters with the location of significant lesion in the infarct related artery.Methods: This was a prospective study conducted from March 2014 to February 2015. Patients diagnosed with a first episode of acute ST-segment elevation IWMI who presented within 12 hours of symptom onset participated in the study. Patients were divided into two groups according to location of myocardial infarction based on electrocardiographic (ECG) findings. Four echocardiographic parameters of RV systolic function: tricuspid annular plane systolic excursion (TAPSE); systolic excursion velocity of lateral tricuspid annulus (S'); myocardial performance index by pulsed Doppler method (MPI-PD); and right ventricular fraction area change (RV-FAC) were measured.Results: Clinical presentation such as Kussmaul sign (<0.05), hypotension (<0.05), and raised jugular venous pressure (<0.05) were higher in the IWMI+RVMI group than the IWMI group. ECG-based criteria, ST elevation in V4R to predict RVMI revealed 78.84% sensitivity, 88.86% and 87.46% positive predictive value (p<0.05). TAPSE (13.44±1.46 versus 21.0±1.16 mm, p<0.05), S’ (9.03±1.51 versus 16.26±1.21 cm/sec, p<0.05) and RV-FAC (31.24±3.15 versus 47.17±3.65%, p<0.05) were lower in the IWMI+RVMI group compared to the IWMI group.Conclusions: Cut-off values of TAPSE, S’, MPI-PD, and RV-FAC have high sensitivity and specificity for predicting proximal right coronary artery lesions.
Profile of highly active antiretroviral therapy failure human immunodeficiency virus patients at a tertiary health care centre of India: a success story of NACP
Authors: Chavan Digvijay G. , Bhattacharya Meenakshi , Salve Madhukar , Ghatge Jyoti , Shaikh Ruhi
Published: January 2021

Background: Although HAART has successfully controlled the progression of HIV and helped to prevent the disease significantly, new challenges are heading up and ART failure despite of good adherence is becoming a major hurdle in the way of HIV control. Considering these facts present study was planned with an objective to study clinical and immunological profile of antiretroviral therapy failure HIV patients.Methods: This observational study was conducted at ART plus centre of one of the tertiary health care centre of India from February 2018 to September 2019. Patients satisfying inclusion and exclusion criteria were interviewed by using semi-structured questionnaire and were examined and investigated for any opportunistic infections and their CD4 counts were studied.Results: Among total 4098 patients alive on ART at present study centre 90.6% were responding well to the 1st line of ART, while 8.7% had failed to 1st line of ART but responding well to the 2nd line whereas 0.7% had failed to 2nd line and were initiated on 3rd line of ART. Failure of ART was the cause for change in regimen among 84.9% of patients. Median of rise in CD4 count at 6 months from switch to 2nd line was 137 cells/mm3.Conclusions: Antiretroviral therapy has significantly improved outcome of the disease. Failure of ART is the major cause for change in ART regimen. Majority of patients in failure had WHO clinical stage 1 and 2.
Demographic and clinical characteristics of patients presenting with conversion disorder in a tertiary care hospital in north India
Authors: Ismail Haamid , Qadri Sabreena , Hussain Arshad , Ismail Nadia
Published: January 2021

Background: Conversion (functional neurological symptom) disorder refers to patients who have neurological symptoms in the absence of neurological disease, encompassing one or more symptoms of altered voluntary motor or sensory function. Aim of the study was to study the demographic and clinical characteristics of patients with conversion disorder.Methods: The study population comprised all the patients (both inpatients and outpatients) of conversion disorder attending department of psychiatry, government medical college Srinagar over a period of 6 months who fulfilled the inclusion criteria of the study were evaluated on a semi-structured proforma for demographic variables and clinical characteristics.Results: A total of 76 patients of conversion disorder were included in our study. Conversion disorder is more common in age group of 20-29 years (52.6%), females (93.4%) and among students (71.1%) belonging to rural background. Motor symptoms were the predominant presentation with pseudo seizure (69.7%) being the commonest. A majority of the patients had an obvious psychosocial stressor, of which family-related (36.8%) and relationship- related (15.8%) problems accounted for the major types.Conclusions: Conversion disorders are commonly seen in young adult females, students and in those from rural background. They are mostly preceded by psychosocial stressors.
Comparative study of hypoglycemic effects of oral vildagliptin and voglibose on fasting blood sugar level in albino rats
Authors: Kumar Mukesh , Kumar Mukesh , Chandra Akash , Keshri Uma Shankar Prasad , Kumar Rajiv
Published: January 2021

Background: Diabetes mellitus is a metabolic disorder in which there is increased blood sugar level, glycosuria, dyslipidemia and sometimes ketonemia occurs. Increased blood sugar level leads to characteristic symptoms such as polydipsia, polyurea, blurring of vision, polyphagia and weight loss.Methods: Healthy male Wister rats weighing between 150-250 gm were taken. Total 2 groups A and B were prepared and each group contains 6 animals. Group A was administered voglibose as 0.6 mg/70 kg body weight. Group B was administered vildagliptin as 100 mg/70 kg body weight. Diabetes was induced in group A and B by administration of 120 mg/kg body weight of nicotinamide and 60 mg/kg body weight of streptozocin intraperitoneally. Streptozocin was administered after 15-20 minutes of administration of nicotinamide. After 72 hours of streptozotocin injection, fasting blood glucose level was determined and induction of diabetes was confirmed. The fasting blood samples were collected from all the groups on further days 7, 14, 21 and 28 day to determine the glucose level by glucometer. Results: The decline in fasting blood sugar level by voglibose was 36.4% on day 7, 40.2% on day 14, 43.94% on day 21 and 46.4% on day 28. The reduction in Fasting blood sugar level by vildagliptin was 49% on day 7, 52.25% on day 14 and 54% on day 21 and 28. Thus in group B rats, decline was maximal on day 7 and little fall was recorded on subsequent days. It suggests good efficacy as vildagliptin normalized the blood glucose level effectively.  Conclusions: Vildagliptin was found significantly more effective in lowering fasting blood glucose level than voglibose.
Diabetic nephropathy: early markers for monitoring and prevention
Authors: Gokhale Vijayashree S. , Sajjan Kshithija R. , Parati Rupesh , Mehta Keyuri
Published: January 2021

Background: Type 2 diabetes, with its complications is perpetually on the rise more so in India .Diabetic Nephropathy progresses silently, and manifests at a stage where, patient can be offered only renal replacement. This study was undertaken to detect early markers of Diabetic Nephropathy. Aims and objective of the study was to study early nephropathy by UACR (urinary albumin/creatinine ratio), RFT (renal function test) and e-GFR in Type 2 diabetic patients of more than 2 years duration, with and without hypertension.Methods: A hospital based cross-sectional observational study, of 100 patients, 18-60 years of age, of type 2 Diabetes of 2 year duration and above, of which 50 were only diabetic and 50 had diabetes and hypertension. Patients who had an established renal disease were excluded from study.Results: Our study of 100 patients, 18-60 years of age, had 23 male and 77 female patients. Maximum patients were in age group 41-50 years, and 52% had diabetes of 2-4 years duration. Of the renal parameters studied, BUN was normal in 72% and S. Creatinine normal in 67%. UACR was normal in only 38%, and e-GFR was normal in 49%.Conclusions: In our study age and sex, duration of Diabetes and HbA1c did not have any bearing on renal parameters. UACR followed by e-GFR, were deranged early. UACR was more deranged in diabetics with hypertension.
Uric acid levels in chronic kidney disease- a hospital based cross-sectional study in RIMS, Ranchi, Jharkhand
Authors: . Nivedita , Kumar Abhishek , Sinha Abhishek , Mitra J. K. , Sinha Rashmi
Published: January 2021

Background: Uric acid is the final end product of purine metabolism and is excreted mainly by proximal tubules of the kidney. Raised uric acid levels may lead to proximal tubular injury, endothelial dysfunction, oxidative stress and intra renal inflammation in patients with normal renal function. Uric acid has been deemed as an independent risk factor for progression of CKD. Aim was to study the uric acid levels in different stages of chronic kidney disease and its association with age, sex and other co-morbidities.Methods: 140 patients of chronic kidney disease admitted in RIMS, Ranchi were included in this study and their serum uric acid level were analyzed. Uric acid level more than 7 mg/dl was considered as hyperuricemia. The study was approved by the Institutional Ethics Committee, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India. Informed consent was taken from every patient included in the study.Results: Median age±SD was 55±13.47 years (IQR: 45,65; Range: 19-80). Mean±SD uric acid levels in stage 3 CKD was 4.4±1.9 mg/dl, stage 4 CKD was 6.5±4.1 mg/dl, stage 5 CKD was 8.8±3.1 mg/dl (p<0.05). Females were 31.4% and males were 69.6%. Male to female ratio was 2.2:1. The prevalence of hyperuricemia was 50% in females and 66.6% in males.Conclusions: Hyperuricemia is common among CKD patients and more common among males. Uric acid levels increase with progressive decline in eGFR. Monitoring and follow-up of such patients by may lead to delay in onset and progression of complications of CKD.
A study of clinical profile and factors affecting mortality in patients with acute on chronic liver failure in a tertiary hospital in north east India
Authors: Bhattacharyya Mallika , Barman Narendra Nath , Goswami Bhabadev , Choudhury Bikash Narayan
Published: January 2021

Background: Data regarding Acute on Chronic Liver Failure (ACLF) patients from North East India is scarce and presentation to hospital is often late. We aim to study their clinical profile, aetiology of underlying chronic liver disease, precipitating factors, predictors of mortality and their short term outcome (3 months).Methods: Among 1000 consecutive patients of any form of acute decompensation, 245 patients diagnosed as ACLF were prospectively studied. Comparison was done between survivors versus non survivors of ACLF and between ACLF and Non ACLF patients.Results: Mean age of ACLF patients was 44.2±10.3 years and male:female ratio was 13.4:1. Common causes of underlying cirrhosis in ACLF was alcoholic liver disease, 210 (85.7%), Hepatitis B virus related cirrhosis, 20 (8.2%), Hepatitis C virus related cirrhosis, 6 (2.4%) and cryptogenic in 8 (3.3%). Precipitating causes were alcoholic hepatitis in 98 (46.6%) among alcoholic cirrhosis, acute flare of Hepatitis B infection in 12 patients (60%) among Hepatitis B related cirrhosis, recent use of drugs in 110 (44.8%), sepsis in 71 (28.9%), spontaneous bacterial peritonitis (SBP) in 36 (14.7%), urinary tract infection in 36 (14.7%), acute hepatitis A in 5 (2%) and acute hepatitis E in 3 (1.2%). hepatic encephalopathy, low sodium, high International Normalised Ratio (INR) were found to be significantly associated with high mortality. Increasing number of organ failures is associated with increasing risk of death.Conclusions: ACLF is characterized by rapid deterioration especially when multiorgan failure sets in due to certain precipitating factors in a previously diagnosed or undiagnosed chronic liver disease.
Matily herbal drink could be a prophylaxis and therapy against COVID-19: a possibility
Authors: Eapen John T.
Published: January 2021

COVID-19 (SARS-CoV-2) known as coronavirus is a pandemic and a threat to humans the world over. There are no medicines available to kill the virus; we can control only its spread to some extent. Under such conditions, they have suggested the use of surfactant to kill viruses. We propose the use of a herbal concoction with ingredients available in every kitchen. It has not only emulsification and surfactant properties which inactivate the virus but also subsides Gastroesophageal Reflux Disease (GERD) associated with COVID-19 infection with no proton pump inhibitor. This will favour the inactivation of coronavirus by low pH in the gastric region. Thus, Matily Herbal Drink may act as a prophylaxis and treatment for COVID-19.
Determination of predictive factors for difficult laparoscopic cholecystectomy
Authors: Bhattarai Sameer , Bhusal Ishory
Published: January 2021

Background: Cholelithiasis is the most common biliary pathology, with a prevalence of 10 to 15%. It is symptomatic in approximately 1 to 2% of patients. In about 5 to 10% of laparoscopic cholecystectomy, conversion to open cholecystectomy may be needed for safe removal of gallbladder. Laparoscopic cholecystectomy (LC) may be rendered difficult by various problems encountered during surgery. The objective of this study was to predict difficulty of LC before surgery using the clinical and ultrasonographic criteria.Methods: The present study comprised of 45 cases admitted to National Medical College Teaching Hospital (NMCTH), Birgunj (Nepal) for a period of 12 months from 1st August 2013 to 30th September 2014. The cases confirmed by Ultrasonography were evaluated with following risk factors: age >50 years, male sex, BMI 25.1 to 27.5 and >27.5, previous surgery, prior hospitalization, palpable gall bladder, gall bladder wall thickening, impacted stone, pericholecystic collection and presence of adhesions. Each risk factor was given a score. The total score up to 5 predicted easy, 6 to 10 difficult and more than 10 very difficult.Results: The highest age incidence of Cholelithiasis was in the 2nd to 4th decade and was more common in females. Ultrasonography detected gallbladder stones in all patients, wall thickening in 15 and pericholecystic collection in 8. BMI >27.5 presence of adhesions, male sex and pericholecystic collection were significant predictors of difficult laparoscopic cholecystectomy.Conclusions: Numerous clinical, radiological and pre-operative features make LC sometimes difficult. Early determination of these predictive factors decreases the difficulty that we will be facing with LC.
Past, present and future of the national surgical residency program: residents' concerns and post COVID-19 pandemic preparedness
Authors: Khalid Muhammad Zaeem , Majid Haroon Javaid , Anwar Muhammad Imran , Azad Junaid
Published: January 2021

Background: The pandemic affected the day-to-day routine of millions of people, with the healthcare sector being at the frontline.  The surgical units have seen a drastic decrease in the amount of patient load, elective surgical procedures, and consequently a decrease in the quality of surgical training.Methods: A cross-sectional study was conducted using a self-structured questionnaire, containing questions about concerns during COVID-19 Pandemic, availability of PPEs and the effect of surgical training during the pandemic, administered on already enrolled surgical trainees of major tertiary care hospitals of the country. A total of 207 surgical trainees were conveniently enrolled in this descriptive study. Results: Out of a total of 207 surgical trainees, 41.7% were first-year residents, 37.9% were second-year, 1.9% were third, 4.4% were forth and 14.1% were fifth-year surgical trainees. 62.6% of doctors reported that their stress levels have increased, most of them were worried about transmitting the infection to their families and vulnerable patients (p<0.01). 56.4% of surgical trainees reported being satisfied with their department’s response to the pandemic, 30.1% doctors said that the testing capacity was insufficient but 60.7% were satisfied with the support of their own hospital. Only 1.9% of doctors were satisfied from their training during the pandemic (p<0.01)Conclusions: The system needs an urgent improvement in the provision of safety measures, an increase in the use of technology for the purpose of training and an easy provision of psychological support to trainees.
The effect of peroperative erythrocyte transfusion on infectious complications in patients with gastric cancer undergoing curative gastrectomy
Authors: Ergin Ahmet Sencer , Erşen Ogün , Mercan Ümit , Yüksel Cemil , Demirci Salim
Published: January 2021

Background: In this study, the effect of perioperative blood transfusion on infectious complications in patients undergoing curative surgery for gastric adenocarcinoma was investigated.Methods: The clinicopathological results of 312 patients who underwent curative gastrectomy were retrospectively analyzed. The effect of blood transfusion on the development of postoperative infectious complications were statistically analyzed.Results: In the subgroup of patients with intraoperative transfusion, surgical site infection incidence was found to be significantly higher in patient with 2U above ES transfusions. (p=0.014). In the subgroup of patients with postoperative transfusion, hospital stay (p<0.001), postoperative CRP values (p<0.001), surgical site infection incidence (p=0.049) and anastomosis leakage incidence (p<0.001) were found to be significantly higher in patient with 2U above ES transfusions. In the subgroup of patients with both intraoperative and postoperative transfusion, SSI, anastomotic leakage and any infective complication incidences were found to be significantly higher in patients with 2U and above transfusions. In multivariate analysis, age (p=0.015), BMI (p=0.011), intraoperative transfusion (p=0.011) and both intraoperative and postoperative transfusion (p=0.045) were found to be independent risk factors for infective complications.Conclusions: It was found that performing peroperative ES transfusion is associated with increased rates of infectious complications in patients undergoing curative gastrectomy for gastric cancer by causing immunomodulation.
Harmonic scalpel thyroidectomy versus conventional haemostasis thyroidectomy
Authors: Haq Ajaz U. , Mahmood Tariq , Kumari Sheetal , Afzal Aneesa
Published: January 2021

Background: As there is paucity of data on harmonic scalpel thyroidectomy from Jammu and Kashmir belt. So, we conducted this study to bridge this gap and also to create awareness about the use of harmonic scalpel. Thyroidectomy has become one of the most common and frequent surgery. Hemostasis in thyroid surgery is of utmost importance for a successful surgery. Our aim was to compare operative factors, postoperative outcomes of thyroidectomy using the Harmonic Scalpel (HS) and Conventional Haemostasis (CH).Methods: In this randomized control trial study, 100 patients who underwent thyroidectomy were enrolled and randomly divided in two groups- HS group and CH group. The inclusion criteria were age>18years, acceptance to participate in the study (signed informed consent form) and scheduled total thyroidectomy. The groups were compared with regards to age, gender, operative time, post-operative drainage volume, postoperative pain, and hospital stay.Results: The mean age in years was 39.8 years for HS group and 43.8 years for CH group with female preponderance. There was a significant difference with regards to operative time, post-operative drainage volume, postoperative pain, and hospital stay (p<0.001). Harmonic Scalpel shortens the operative time. And there was less post-operative drainage volume and postoperative pain in HS group. Hospital stay was also less as compared to CH group.Conclusions: HS is superior then CH thyroidectomy and is considered as a safe and better tool in thyroidectomy.
Post-operative complications and pain comparison between modified Bassini’s repair and Lichtestein’s hernioplasty in inguinal hernia repair
Authors: Kumar Sunil , . Sreenivasa
Published: January 2021

Background: Bassini’s repair and the Lichtenstein’s tension free mesh hernioplasty are commonly used hernia repair techniques and yet there is no uniform opinion as to which is the best technique. This study was undertaken to compare the postoperative complications so as to determine the best suitable of the two procedures.Methods: A comparative randomized study was conducted on a total of 80 patients reporting to our hospital with inguinal hernia and were subjected to detailed examination, operated upon by either of technique and followed up. The post operative complications & pain were observed, analyzed and compared with other similar studies.Results: In this randomised study pain after 12 and 24 hours was significantly less in the Lichtenstein’s group when compared with Modified Bassini’s repair. However there was no significant difference at 36 hours. Chronic pain after 1, 3 & 6 months was also not significant.Conclusions: The Lichtenstein’s hernioplasty was comparatively better than Modified Bassini’s repair due to its simplicity, less dissection, lesser complications & lesser early pain and chronic pain in our study.
Analytic study of hormone receptor status of breast cancer patients visiting in a tertiary care hospital of North-West India
Authors: Kakkar Vikas , Kaushal Arvind , Hanspal Swaraj , Singh Karanvir , Randhawa Anmol , Kaur Harpreet
Published: January 2021

Background: Increasing evidence shows the importance of young age, estrogen receptor (ER), progesterone receptor (PR) status, and HER-2 expression in patients with breast cancers. Breast tumors in younger age groups were more likely to be of higher grade, hormone receptor– negative, poorly differentiated, and aneuploid, and to have high S-phase fraction, abnormal expression of P53, greater extent of lymphovascular invasion, and over-expression of human epidermal growth factor receptor 2 (HER-2) than breast tumors in older age groups.  Methods: We organised a retrospective study of 600 women diagnosed with breast cancer, who have been operated from 2016 to 2020. We evaluated age, size, hormone receptor status, HER-2 receptor status. Estrogen receptor and progesterone receptor status were evaluated by immunohistochemistry. Results: Total 600 patient data was evaluated in this study. Rate of hormone positivity is more in older patients than in younger patients.  Conclusions: In this study we conclude that the hormone positivity in younger patient is less as compared to older patients.
Role of centchroman versus danazol in treatment of benign breast disorders
Authors: Khoja Hanuman Ram , Barala Bodu Ram , Sharma Saurabh , Om Prabha , Saini Devendra
Published: January 2021

Background: The breast is a dynamic structure that undergoes cyclical changes throughout the menstrual cycle. Any aberration from normal physiological changes in breast produces different problem in breast. Many drugs are used for treatment for these disorders like Danazol, Bromocriptine, Tamoxifen and LH-RH analogue but still no consensus for any drug is present.Methods: The aim of our study was to analyze the effectiveness of drug Centchroman and its comparison with Danazol in treatment of benign breast disorders in respect to symptoms relief, decrease in nodularity and lump size, recurrence, cost and side effects of drug. This prospective study was conducted on 250 patients of benign breast disorders attending surgical OPD between May 2018 to September 2019 in SMS medical college and Hospital, Jaipur.Results: Tolerance and improvements in symptoms in centchroman group was more than danazol (100% vs 92.8%) with less recurrence in former group. While side effects varied between the two groups with menstrual irregularities more common in centchroman group.Conclusions: The study shows that centchroman is safe, more effective and less expensive to Danazol for the treatment of benign breast disorders in long term.
A comparative study to evaluate milligan morgan hemorrhoidectomy versus pile suture method in management of haemorrhoids
Authors: . Aditya , Raj Kuldeep , Agarwal P. N. , Nasar Md Abu
Published: January 2021

Background: A pile suture technique was described originally by the Farag in 1978 was better in terms of post- operative pain, bleeding, hospital stay and early return to work which are the distressing effects of conventional Milligan Morgan  Hemorrhoidectomy which is well accepted surgical procedure for haemorrhoids. This study is designed to compare the pile suture and Milligan Morgan Hemorrhoidectomy.Methods: After fulfilling the criteria, 60 patients were randomly allocated to the group A (Pile Suture [PS] n -30) and group B (Milligan Morgan Hemorrhoidectomy [MM] n – 30). The techniques were evaluated with respect to the operative time, pain scores, bleeding, hospital stay, return to work, and recurrence.Results: The mean age of patients was 44.33 years and 42.77 years in the pile suture group and MM group respectively. Grade III or IV hemorrhoids were more common in men (i.e., 80% and 60% in the pile suture and MM group, respectively). The mean operative time was shorter in the PS 20.10 minutes versus 51.47 minutes in the MM group (P .001). The bleeding and pain scores were less in the PS. Mean hospital stay was 4 days and 6.6 days  in the PS and MM group, respectively. The patients in the pile suture group returned to their routine activities earlier (i.e., within 7.33 days) as compared with 16.87 days in the MM group.Conclusions: Therefore, pile suture method can be considered as less traumatic for the patients and method can be recommended as a safer alternative to Milligan Morgan haemorrhoidectomy.
Surgical outcome of radioguided parathyroidectomy in primary hyperparathyroidism
Authors: Nalbo Dinesh , Dahiya Divya , Sood Ashwani , Bhadada Sanjay Kumar , Behera Arunanshu , Nahar Uma
Published: January 2021

Background: Focused parathyroidectomy is the adequate treatment for primary hyperparathyroidism for localised disease. Adequacy of resection is confirmed by the availability of intraoperative parathormone assay (iOPTH). In the absence of availability of iOPTH assay, the radio guided surgery is an option. The aim of this study was to evaluate the feasibility of radioguided parathyroidectomy in tertiary care centre in India and to compare the overall success rate, operative time, hospital stay and postoperative outcome between focused open and radioguided parathyroidectomy.Methods: This was a prospective study which included 30 primary hyperparathyroidism patients with a single gland disease localised on Tc99m Sesta MIBI scan. Patients were randomized into two equal groups, and they underwent focused open or radioguided parathyroidectomy. Patients were followed up for three months.Results: All patients achieved biochemical cure as evident by the normalization of serum calcium and parathormone levels after surgery. The mean incision length, and operative time in this study was significantly better for radioguided parathyroidectomy (p=0.0001, <0.0001 respectively). There was no perioperative complications like recurrent laryngeal nerve injury, gland rupture, or bleeding in either group. However, there seems to be higher grade of pain experience by the patients who underwent open focused parathyroidectomy (p<0.0001).Conclusions: Radioguided parathyroidectomy has excellent cure rate for PHPT with an added advantage of short operative time & incision length and less post-operative pain. Radioguided parathyroidectomy seems to be a good alternative in the absence of availability of iOPTH assay and frozen section.
Ileal intussusception due to primary intestinal melanoma with generalized lymph node metastases- a rare cause of small bowel obstruction
Authors: Rajendharan Keerthi Andi , Balakrishnan Gurushankari , Sundaramurthi Sudharsanan , Krishnaraj Balamourougan , Sistla Sarath Chandra
Published: January 2021

Primary melanomas of small intestine are rare and most of them are metastases from cutaneous melanoma. The features distinguishing primary from metastatic intestinal melanoma are still under debate. Primary intestinal melanoma (PIM) is associated with a worse prognosis and a more aggressive behaviour due to its rapid growth. Hence, we report a case of primary ileal melanoma presenting as intussusception with generalized lymph node metastasis. A 69-year-old lady presented with recurrent abdominal pain, vomiting, distension and low grade fever. On examination, a 4*4 cm right inguinal lymph node was noted with no abnormalities on abdominal and per rectal examination. Computed tomography (CT) revealed ileoileal intussusception which was confirmed on laparotomy and diagnosed as primary ileal melanoma on histopathological examination (HPE). Whole-body Positron Emission Tomography (PET) CT revealed metastasis to lymph nodes all over the body. Intestinal melanomas are rare and mostly occur secondary to primary cutaneous melanoma. The clinical picture of intestinal melanoma is varied, ranging from chronic vague symptoms to surgical emergency such obstruction and bleeding. Treatment of both primary as well as metastatic intestinal melanoma is surgical excision. Intestinal melanoma, in general, carries a bad prognosis than cutaneous melanoma. Owing to the rarity and vague presentation, early diagnosis of intestinal melanoma requires a high index of suspicion, multimodal imaging and timely surgical intervention with adequate resection margins.
Hepatobiliary scintigraphy and its clinical implications: mini review
Authors: Afzal Muniba , Ali Syed Muhammad , Khairy Ahmed Talaat , Khattabi Mazin , Shahid Fakhar , Ramzee Ahmed Faidh , Ahmed Khalid
Published: January 2021

The advent of modern investigations like ultrasound and Magnetic Resonance Imaging has completely revolutionized the diagnosis of gallstones and biliary diseases. However, role of biliary scintigraphy has remained pivotal in some of the biliary tract pathologies especially in detecting the functional problems, leaks and bile reflux. HIDA (hepatobiliary iminodiacetic acid) scintigraphy is conventionally used to diagnose these pathologies and not associated with many harmful effects, although it is time consuming.  We reviewed this investigation and its utility in detail encompassing the recent evidence and efficacy.
The era of virtual reality in medical education: do we still need the dissection table?
Authors: Sarma Vivek Parameswara
Published: January 2021

For the benefit of the uninitiated, the MBBS course begins with the three basic subjects, anatomy, physiology and biochemistry. Of these, the most intensive and gruelling for most is the subject of anatomy. And within the said subject, the most demanding is the human dissection table. It can even be considered as the ultimate icon of initiation into medical education. It has tragedy, dark comedy and drama in different measures. The image of young students huddled around a shrivelled human body, usually referred to medically as a ‘Cadaver, on a non-descript table, ever endures in mind of all doctors, for better or worse. This happens in a hall ever filled by the suffocating smell of formalin and the dread of the watchful eye of demonstrators trained like hounds. The course in anatomy is split into different sections on limbs, thorax, abdomen, head and neck etc, with corresponding dissection studies to be made on the cadaver, which shall henceforth be referred to as the 'body'.
Peran Orang Tua Mencegah Dampak Negatif Gadget Melalui Pendekatakan Komunikasi dan Psikologi
Authors: Sari Intan Permata , Wardhani Rama W Kusuma , Amal Ahmad Syaiful
Published: January 2021

AbstractThis study aims to reveal the role of parents in preventing the negative impact of gadgets with communication and psychological approaches in Batu Gane Village, Selangit District, Musi Rawas Regency, South Sumatra Province. This research method is qualitative research, the source of research data is to conduct interviews with several parents in the village who have children aged 13-15 years. The results of the study explain the implementation of parental communication in preventing the impact of the influence of gadgets with forms of communication and psychological approaches. In its application in the family is not the same, there are those who use interpersonal communication, verbal communication and also non-verbal communication, through the management and psychological approaches of parents and parenting that are in accordance with the character of children who have their own type of style, such as authoritarian style, democratic style, laissez-faire style and transactional style. In addition, in parental management, it is necessary to provide direction through motivation to children's attitudes and behavior, and evaluation of communication applied to children. AbstrakPenelitian ini bertujuan mengungkapkan peran orang tua dalam mencegah dampak negatif gadget dengan pendekatan komunikasi dan psikologi di Desa Batu Gane, Kecamatan Selangit, Kabupaten Musi Rawas, Provinsi Sumatera Selatan. Metode penelitian ini adalah penelitian kualitif, sumber data penelitian yakni melakukan wawancara pada beberapa orang tua di Desa tersebut yang memiliki anak usia 13-15 tahun. Hasil penelitian menjelaskan implementasi komunikasi orang tua dalam mencegah dampak pengaruh gadget dengan bentuk komunikasi dan pendekatan psikologi. Pada penerapannya dalam keluarga tidak sama, ada yang menggunakan komunikasi interpersonal, komunikasi verbal dan juga komunikasi non verbal, melalui manajemen dan pendekatakan psikis orang tua dan pola asuh yang sesuai dengan karakter anak yang memiliki tipe gaya masing-masing, seperti gaya otoriter, gaya demokrasi, gaya laissez-faire dan gaya transaksional. Selain itu dalam manajemen orang tua perlu memberikan pengarahan melalui motivasi terhadap sikap dan prilaku anak, dan evaluasi komunikasi yang diterapkan kepada anak.
Keragaan Permesinan dan Keteguhan Rekat Kayu Jati Cepat Tumbuh Terdensifikasi
Authors: Siahaan Herianto , Wahyudi Imam
Published: January 2021

The objective of this study was to analyze machining performance (characteristic and quality), as well as bonding quality of densified wood, and then compared to those of un-treated (control) wood and boron-treated wood. Characteristic and quality of machining properties were directly evaluated by qualified technician during processing, while bonding quality was evaluated through its shear strength. The results showed that densification employed was able to improve machining performance and bonding quality of the 5-year-old faster-grown teakwood. Compared to control wood and boron-treated wood, machining performances of densified teakwood are greater, while bonding quality increased by 18.79 and 26.86%, respectively. The surface became much fine and even, and has similar colour to older teakwood. Analysis hierarchy process (AHP) proves that densified teakwood is the best raw material for furniture manufacturing since its machining performances, appearance, colour, and bonding quality are better either than control wood or boron-treated wood.

 

Keywords: AHP, bonding quality, densification, faster-grown teakwood, machining performance
Akumulasi Besi (Fe) pada Kerang Hijau di Perairan Tanjung Mas, Semarang
Authors: Astari Findiani Dwi , Lumban Batu Djamar Tumpal Floranthus , Setyobudiandi Isdradjad
Published: January 2021

The source of iron in waters can come from human activities that carry out activities such as waste disposal in household and industrial activities. Green mussels containing iron are very dangerous for the shells themselves and for human health if consumed in excess. This study aims to analyze the concentration of iron in green mussel meat, determine the safe limit of green mussel meat for consumption by humans, and calculate the value of bioconcentration factors. This research was conducted in the sea of Tanjung Mas, Semarang. Samples taken in the form of green mussels, sediments, and water were then analyzed for iron concentrations with Atomic Absorption Spectrophotometer. The results of the study showed that the range of iron concentration values in green mussels from July to November was 39–283,97 mg/kg. The range of MTI values for adults was 1.18–4.92, while for children the range was 0.24–0.98. The value of the bioconcentration factor of green mussels and water was 3271–24839, while the value of the bioconcentration factor of green mussels and sediments was 0.010–9.647.

 

Keywords: bioconcentration, green mussels, iron, maximum tolerable intake, Tanjung Mas
Nilai Ekonomi Sampah di Kawasan Wisata Pantai Tanjung Bira, Sulawesi Selatan
Authors: Inayah Husnul , Istiqomah Asti
Published: January 2021

Pantai Tanjung Bira merupakan salah satu wisata bahari yang terletak di Kecamatan Bonto Bahari, Kabupaten Bulukumba, Sulawesi Selatan. Jumlah kunjungan wisatawan Pantai Tanjung Bira terus mengalami peningkatan selama lima tahun terakhir dengan laju pertumbuhan tertinggi yaitu pada tahun 2018 sebesar 27,58%. Kondisi tersebut di satu sisi dapat meningkatkan perekonomian daerah, namun di sisi lain juga dapat memengaruhi kondisi lingkungan seperti meningkatnya jumlah timbulan sampah yang ada di kawasan wisata tersebut, baik sampah organik maupun anorganik.Tujuan penelitian ini adalah: 1) Mengidentifikasi potensi timbulan sampah yang dihasilkan kawasan wisata Pantai Tanjung Bira; dan 2) Mengestimasi nilai ekonomi sampah di kawasan wisata Pantai Tanjung Bira. Metode analisis yang digunakan yaitu analisis deskriptif kuantitatif dan pendekatan market price. Hasil penelitian menunjukkan bahwa potensi timbulan sampah dari kegiatan wisata di kawasan wisata Pantai Tanjung Bira sebesar 16.908,86 kg/tahun dimana mayoritas dihasilkan oleh wisatawan. Jenis sampah yang dihasilkan didominasi oleh sampah plastik baik yang bersumber dari wisatawan maupun pelaku usaha. Total nilai ekonomi sampah kawasan wisata Pantai Tanjung Bira yaitu Rp 20.298.215/tahun berasal dari sampah anorganik tidak diolah 97,60%, potensi plastik cacah 1,75%, dan potensi kompos 0,64%.
Respons Pertumbuhan, Fisiologi, dan Produksi Kedelai terhadap Pemberian Pupuk Nitrogen dengan Dosis dan Waktu yang Berbeda
Authors: Puja Santana Firdaus , Ghulamahdi Munif , Lubis Iskandar
Published: January 2021

Fertilization is needed to support the growth of soybean plants. Nitrogen is a type of fertilizer that is needed by soybeans in considerable amounts. Aplication of nitrogen at different times is able to affect the production and quality of soybean seeds. The purpose of this study was to attain information about the morphology, physiology, and production responses of two soybean varieties to the supply of N. This research was conducted at the Cikabayan Experimental Station, IPB University, Dramaga, Bogor Regency. This study used a completely randomized block design with two factors, namely two soybean varieties consisting of Tanggamus and Biosoy 1, and four combinations of N fertilizer doses that were without N fertilization, fertilized N at planting date, fertilized N at the seed filling phase, and fertilized N at planting date+seed filling phase with two replications. The dosage of urea fertilizer used was 25 kg ha-1, so that the N dosages is obtained 11,5 kg ha-1. The results showed that the application of N fertilizers at planting and during the seed filling phase (N3) was an effective time to increase soybean production.

 

Keywords: fertilization, morphology, seed quality