bluuebunny/crossref_metadata_2025 huggingface dataset:
Dual versus conventional cardiac resynchronization: A pilot study
Authors: Pradip Kumar Ghoshal  , Subhraprakash Pramanik  , Tanmoy Kanti Goswami  , Rajarshi Mondal  , Arunava Biswas  , Asish Biswas
Published: January 2025

Background: Systolic heart failure treatment now includes cardiac resynchronization therapy (CRT) as a necessary element. CRT has been shown to have advantageous impacts on mortality, hospitalization rates, and quality of life. Approximately 30% of patients fail to respond to traditional CRT implantation.
Aims and Objectives: This study aimed to compare the outcome of dual resynchronization by placing the right ventricular pacing lead at His bundle or left bundle branch area against conventional CRT.
Materials and Methods: This longitudinal follow-up study of a total of 35 patients undergoing CRT device placement for assessment of safety, efficacy, and feasibility of the procedure and post-procedural complications and correlation with parameters obtained from electrocardiogram and echocardiography parameters in a tertiary care set up in India.
Results: Among this matched population (mean age 64 years) there was a higher responder rate with the newer technique of dual resynchronization compared to conventional CRT (83% vs. 70%).
Conclusion: Dual resynchronization therapy is feasible and safe and provides better electrical resynchronization compared to conventional CRT and could be a better alternative, especially when suboptimal electrical resynchronization is obtained.
A study to observe the association of left ventricular ejection fraction and wall motion score index with duration of early systolic lengthening in patients with non-ST-elevation acute coronary syndrome
Authors: Dayanand Paswan  , Lipika Adhikari  , Sandip Sarkar
Published: January 2025

Background: Management of non-ST elevation myocardial infarction acute coronary syndrome (NSTEMI ACS) patients is not well defined as that of ST elevation myocardial infarction. The accuracy of results of conventional echocardiography is significantly compromised when imaging is suboptimal, myocardial damage is in small areas, and compensatory hyperkinesias of healthy segment.
Aims and Objectives: Duration of early systolic lengthening (DESL) may be employed to identify early myocardial ischemia and thus, may help to prepare treatment strategies for NSTEMI patients.
Materials and Methods: A total of 57 patients with NSTEMI ACS attending the cardiology department were included in the study group.
Results: More than 80% of patients of NSTEMI have normal or near normal ejection fraction and wall motion score index. In our study, the DESL is prolonged in a significant number of non-ST-elevation acute coronary syndrome patients.
Conclusion: As DESL is afterload independent, it is superior to global longitudinal strain in assessing myocardial damage. Several studies including ourselves show that DESL of <50 ms may be the cutoff value to reveal minimal myocardial damage.
Comparison of operative outcome of open versus laparoscopic inguinal hernia in rural tertiary care hospital in Haryana: A randomized controlled study
Authors: Sanjeev Singla  , Pranav Bansal  , Garima Dwivedi  , Madhan Pranesh R  , Chanderbhan
Published: January 2025

Background: Hernia surgery is one of the commonly done procedures in General surgery. A hernia is defined as an abnormal protrusion of an organ or tissue through a defect in its surrounding walls.
Aims and Objectives: Comparison of morbidity in terms of total analgesic usage, mean length of hospital stay, comparison among open and TEP repair of hernias in primary inguinal hernias among males.
Material and Methods: This study was done on 80 patients with clinical diagnosis of primary inguinal hernia over a period of one year to compare the result of two surgeries, open lichenstein repair (n=40) and TEP repair (n=40).
Results: Postoperative pain using VAS was found to be lower in patients having laparoscopic TEP hernia repair when compared to open lichenstein tension free repair (p <0.01). Operating time was observed to be more with TEP group with mean of 59 ± 17.02 minutes compared with open group which had mean of 44.92±12 minutes. Mean number of analgesic in open cases was 6.65 ± 1.81 whereas in case of TEP group it was 4.35±1.47 over a period of one month.
Conclusion: Lichtenstein tension free mesh hernioplasty still remains the gold standard operation done for inguinal hernia. TEP repair has proven to be superior in terms of perioperative hemorrhage and post-operative analgesia requirement. Study concluded that laparoscopic TEP repair of inguinal repair have a considerable clinical advantage over open hernia repair in terms of postoperative pain and analgesia requirement, hospital stay and postoperative complications.
Role of platelet-rich plasma in insertion tendinitis
Authors: Nibin Sunny  , Saurabh Agarwal  , Mahesh Navadaya  , Mayank Kumar Singh
Published: January 2025

Background: Platelet-rich plasma (PRP) helps in the treatment of various insertion tendinitis, and the recurrence rate will be low. In this study, we used intralesional injections of autologous PRP for the treatment of insertion tendinitis.
Aims and Objectives: Assessment of pain relief following PRP treatment for insertion tendinitis and ascertaining the efficacy of PRP as a treatment option for insertion tendinitis.
Materials and Methods: The study was done at Maharani Laxmi Bai Medical College, Jhansi, between January 2021 and June 2022, including 100 patients were applied for the treatment of PRP. We assessed patients before treatment and at three follow-up time points: 2, 4, and 6 months after the end of treatment. During each evaluation, three parameters were noted: Victorian Institute of Sports Assessment- Achilles (VISA-A) score, the Visual Analog Scale, and patient satisfaction according to the roles and Maudsley score.
Results: This was a prospective trial by study design conducted on 100 patients, which included 44 patients with plantar fasciitis and 56 patients with tennis elbow. The response to PRP injection in patients with plantar fasciitis was assessed by the VISA-A score. The pre-injection VISA-A score of patients with plantar fasciitis was 56.82 (mean with SD of 18.015), which improved to 65.45 in the 2nd month (mean with SD −18.857), 4th month with 69.77 (mean with SD–19.823), and at 6 months 71.82 (mean with SD–20.829). Statistical analysis with an analysis of variance test gave a P=0.001. In our study, the patients had gradual sequential improvement in VISA-A score throughout the follow-up, with maximum improvement from the pre-injection score were observed in 2 months (65.45 with SD 18.85).
Conclusion: Autologous PRP injection is a safe and useful modality of treatment in the treatment of insertion tendinitis.
A retrospective study on hearing outcomes of infants of COVID-19 mothers pre-vaccination era
Authors: Shenbagavalli S  , Ashok Kumar Subramaniyam  , Yuvaraj Radhakrishnan  , Thalapathy Ramkumar  , Venkatesan R  , Manisha T
Published: January 2025

Background: A COVID-19 infection can result in a variety of symptoms. Findings must be carefully reviewed because there is still a dispute over the potential involvement of the audiovestibular system. Moreover, there is debate over the intrauterine transfer of COVID-19 infection from mother to fetus in pregnant people. There are not many investigations on the audiovestibular symptomatology of infants exposed to COVID-19 during pregnancy.
Aims and Objectives: This study looks at any potential links between the COVID-19 gestational infection and the start of hearing impairment in babies. The verification of hearing’s engagement in COVID-19 allows for the planning of the time and methods for children’s audiological evaluations.
Materials and Methods: Newborns had audiological examination and screening for hearing loss. The automatic transient evoked otoacoustic emissions (OAEs) test is used to evaluate newborns for hearing impairments before they are released from the hospital. By employing the COVID-19 case history, otoscopy, acoustic immittance test, transient evoked OAEs test, and mother, pregnancy, and perinatal case histories, an audiological examination is conducted on children under 3 months of age, with 2 weeks, 1 month and 3 months of age follow-up.
Results: The research comprised 100 children. Of these infants, 90% were part of the neonatal hearing screening initiative. Due to isolation protocols, the remaining 10 neonates did not undergo hearing screening; instead, a direct audiological examination was performed on them. Out of the 90 newborns that were tested, only 11 had a bilateral REFER test result, but the audiological examination revealed a normal hearing threshold.
Conclusion: There is no data in this study that a mother’s COVID-19 infection results in hearing loss in newborn.
A comparative study of efficacy of intravenous dexmedetomidine with perineural dexmedetomidine as adjuvant to ropivacaine in supraclavicular brachial plexus block in upper limb surgery
Authors: Nabanita Roy  , Md. Babrak Manuar  , Moumita Roy  , Bimal Kumar Hajra
Published: January 2025

Background: In supraclavicular brachial plexus block, to prolong the duration of analgesia, many adjuvants have been tried in the past in many studies but an ideal adjuvant remains yet to be discovered. Dexmedetomidine, a selective Alfa-2 adrenergic agonist when added to local anesthetic has been reported to prolong the block duration and post-operative analgesia in various regional blocks.
Aims and Objectives: The aims and objectives are to study the onset and duration of sensory and motor blockade, postoperative analgesia, and hemodynamic effects of addition of dexmedetomidine with ropivacaine in supraclavicular brachial plexus block.
Materials and Methods: Sixty patients aged between 18 and 60 years, American Society of Anesthesiologists class I and II, of both sexes, scheduled for upper limb surgery under supraclavicular brachial plexus block were randomly allocated into 2 groups. Group-A received 20 mL of 0.5% ropivacaine in brachial plexus block with 1 μg/kg dexmedetomidine as adjuvant perineurally and Group-B received 20 mL 0.5% ropivacaine in brachial plexus block with dexmedetomidine intravenous infusion at 1 μg/kg over 10 min. Intraoperatively non-invasive blood pressure, heart rate, SpO2, and sedation were recorded every 5 min for the first 10 min and every 15 min thereafter till the end. Time of first rescue analgesic, intensity of postoperative pain, and total analgesic required were recorded.
Results: Onset of sensory and motor block was faster in Group-A than Group-B. Duration of analgesia was prolonged in Group-A than Group-B. Hemodynamic stability was better maintained in Group-A than Group-B. Sedation was better in Group B.
Conclusion: Dexmedetomidine as adjuvant to ropivacaine in supraclavicular brachial plexus block is more efficacious in providing faster onset of motor and sensory blocks and prolonging duration of postoperative analgesia with better hemodynamic stability.
Safety and effectiveness of ultrasound-guided single injection of 5% dextrose for median nerve hydrodissection in carpal tunnel syndrome
Authors: Nitya Jha  , Chandan Kumar Jha
Published: January 2025

Background: In carpal tunnel syndrome (CTS), conservative management did not show satisfactory results, and some patients required revision surgery due to persistent or recurrent symptoms. Ultrasound (USG)-guided median nerve (MN) hydrodissection with a 5% dextrose injection is an advanced approach for treating symptoms of CTS. We prospectively investigated the patients to demonstrate the safety and effectiveness of this approach.
Aims and Objectives: This study aims to evaluate the effect of USG-guided nerve hydrodissection using single injection of 5% dextrose on pain, MN conduction parameters, and functional status in patients with CTS of mild–to-moderate grade. The study also predicts about the safety of the procedure.
Materials and Methods: A study was performed in the pain clinic of the tertiary care teaching institute of India for one year. The study included 15 patients diagnosed with mild-to-moderate CTS. The diagnosis was done on the basis of history, physical examination, and a nerve conduction velocity (NCV) study. Patients were given analgesics and NSAIDS and enrolled in the procedure. Parameters used for statistical analysis were Visual Analog Scale (VAS) scores, NCV study data (sensory conduction velocity [SNCV] and distal motor latency [DML]), and Boston carpal tunnel questionnaire (BCTQ) scores. Pre-injection parameters were compared with parameters 3 months after the injection to show the usefulness of this procedure.
Results: A statistically significant reduction in VAS score was found in 74% of the cases (P<0.05). The nerve conduction study parameters have shown significantly higher SNCV and lower DML latency in 60% of cases (P=0.001 and P=0.001, respectively). Improved BCTQ scores were found in 80% of cases (for the symptom severity scale, P=0.001 and for the functional status scale, P<0.01). No complications such as allergic reactions, sensory loss, or paresis were recorded post-injection. However, transient injection site pain was present in all patients which did not last for more than 24 h.
Conclusion: MN hydrodissection using a single injection of 5% dextrose under USG is a safe and effective approach offering pain relief, better MN conduction, and improved functional status in patients with CTS of mild-to-moderate grade.
Demographics and ultrasonography findings of mastalgia in a tier 2 city of India
Authors: Shivangi Tomar  , Rekha Agrawal  , Harshit Shrivastava  , Akhilendra Singh Parihar
Published: January 2025

Background: Breast pain is the second most common breast symptom (after breast lump) for which women seeks medical attention. Breast pain can affect daily life, including sleeping, or physical, social, and work-school life. Mastalgia is one of the common causes for women in tier 2 city visiting health care facility but there are only few studies which focus on demographic findings and ultrasonographic findings in mastalgia.
Aims and Objectives: The objective of this study was to study demographics of breast pain in a tier 2 city and ultrasound evaluation of mastalgia.
Materials and Methods: In this prospective study, 143 patients presenting with mastalgia irrespective of focality, duration, or cyclical nature were included. In these patients, we studied demographic profile and ultrasonographic findings in mastalgia.
Results: About 37% women were in 20–29 years of age group and least number was in 70–79 years of age group. About 86% of women in our study were in reproductive age group. Most patient with mastalgia have associated palpable lump (58%) followed by 43% patients with mastalgia and nipple discharge, only 27% of patients have mastalgia alone whereas 4% women have pain with skin changes. The majority (49%) of mastalgia cases fall under the breast imaging-reporting data system (BI-RADS)-I category while cases in BI-RADS-IV and V category were 2 and 1, respectively.
Conclusion: Women in their reproductive age group and in their 3rd decade of life are more prone for mastalgia. Ultrasonography is also helpful in detecting cancers in setups where routine mammography is not possible.
A study of the association of lipid ratios with thyroid dysfunction in a tertiary medical college in Eastern India
Authors: Sayani Chaudhuri  , Arnab Chowdhury  , Sayak Biswas
Published: January 2025

Background: Thyroid hormones play a crucial role in major metabolic pathways in the body and dyslipidemia is a major metabolic abnormality seen in thyroid disorders. Cardiovascular diseases (CVDs) are now emerging as the leading cause of morbidity and mortality worldwide and the most important risk factor for CVDs is dyslipidemia. The lipid ratios that have a positive association with CVD risk are atherogenic index of plasma (AIP), Castelli’s risk index (CRI)-I and II, and atherogenic coefficient (AC). Clinically, both an excess and deficiency of thyroid hormones can exacerbate or induce CVDs and lipid ratio can be used as an inexpensive marker for predicting CVD risk.
Aims and Objectives: This study aims to evaluate the lipid ratios (AIP, CRI-I, CRI-II, AC) in patients with thyroid dysfunction and compare the results with lipid ratios in euthyroid individuals. This study also aims to find any correlation, if exists, between lipid ratios and serum thyroid-stimulating hormone (TSH) levels in thyroid dysfunction.
Materials and Methods: The serum TSH and lipid profile were evaluated in fifty euthyroid, fifty hypothyroid, fifty subclinical hypothyroid, and fifty hyperthyroid patients. The lipid ratios (AIP, CRI-I, CRI-II, AC) were calculated from the lipid profile.
Results: The mean lipid ratios were higher in hypothyroid, followed by subclinical hypothyroid cases when compared to euthyroid controls and hyperthyroid patients. A positive correlation was observed between the TSH and lipid ratios in euthyroid, hypothyroid, and subclinical hypothyroid subjects. There was no significant correlation between TSH and lipid ratios in hyperthyroid patients.
Conclusion: This study demonstrates that the evaluation of lipid ratios along with TSH can provide an effective screening tool to assess the cardiovascular risk in patients with subclinical and overt hypothyroidism, especially in the absence of imaging techniques in resource-limited centers.
Fungal keratitis among inpatients with corneal ulcers in Thai Binh, Vietnam: A retrospective observational study
Authors: Nguyen Thi Anh Van  , Pham Ngoc Bich  , Bui Thi Ngoc Ha  , Nguyen Thu Huong
Published: January 2025

Background: Infectious keratitis can be caused by bacteria, fungi, and viruses. Fungi are a common pathogen, especially in developing countries like India, Nepal, and Bangladesh where the prevalence ranges from 20% to 60%. In Vietnam, fungal keratitis accounted for the highest number of keratitis cases in a study conducted at the central eye hospital over a 5-year period (57%). Therefore, it is necessary to collect specific background information connected to the types of fungal keratitis in corneal ulcer cases in this region.
Aims and Objectives: The aim of this study was to investigate the prevalence of fungal keratitis and the epidemiological features in 216 cases of fungal keratitis out of a total of 240 cases of infectious keratitis.
Materials and Methods: This retrospective study collected secondary data from medical records of 240 inpatients with infectious keratitis who were treated at the ophthalmology hospital in Thai Binh, Vietnam, from January 01st, 2021 to June 30th, 2022. Patients with a positive fungal-directed smear were analyzed in detail for the type of fungus isolated, sociodemographic data, predisposing risk factors, prior treatment modalities, and laboratory results for the distribution pattern of fungus species.
Results: Among the 240 cases, 126 (52.5%) were diagnosed with fungal keratitis by direct microscopic examination. Culture results showed the highest rate of Fusarium spp. (43.3%). The age group of 41–60 years was most commonly involved (40.5%). Males were more affected by fungal keratitis than females, (53.2% compared to 46.8%), with farmers being the most common occupation correlated with fungal keratitis (55.6%). The rate of fungal keratitis patients due to agricultural injuries was the highest compared to other risks (47.6%) and most patients self-medicated before going to the hospital, with many not knowing or remembering what medications they had taken (52.4%).
Conclusion: The study revealed a high rate of fungal keratitis among the total of infectious keratitis cases in Thai Binh, Vietnam. Fusarium spp. was the most commonly isolated fungi. The study also highlighted the impact of agricultural injuries on fungal keratitis, especially in regions like Thai Binh.
Serum NT-proBNP levels in diabetes and its association with obesity, inflammation and glycemic status
Authors: Saurav Dey  , Swati Bhattacharyya  , Manali Sinharay
Published: January 2025

Background: Type 2 diabetes mellitus (T2DM) patients are more prone to develop cardiovascular complications, and there is a dire need of a routine screening tool for risk assessment of heart failure (HF) in them.
Aims and Objectives: The current study was conducted to estimate the levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in subjects with and without T2DM and evaluate the association between NT-proBNP and body mass index (BMI), waist circumference as markers of obesity, hemoglobin A1c (HbA1c), plasma fasting blood sugar (FBS), plasma postprandial blood sugar (PPBS),duration of diabetes as markers of glycemic control and serum C-reactive protein (CRP),an inflammatory marker in diabetic subjects.
Materials and Methods: A hospital-based cross-sectional non-interventional study was done with 82 non-diabetic healthy volunteers and 82 T2DM patients. Anthropometric measurements (waist circumference [WC] and body mass index [BMI]) were recorded, and blood was analyzed for serum NT-proBNP, C-reactive protein (CRP), plasma fasting blood sugar (FBS), postprandial blood sugar (PPBS), and hemoglobin A1c (HBA1c). Data collected were analyzed by statistical software with P<0.05 as the significance level.
Results: Serum NT-proBNP level was significantly higher in diabetic group (P<0.001) compared to non-diabetic group statistically. Correlation analysis in diabetic subjects showed a significant positive correlation of NT-proBNP with CRP (ρ+0.576, P<0.001), duration of diabetes (ρ+0.780, P<0.001), plasma FBS (ρ+0.524, P=0.003), plasma PPBS (ρ+0.673, P=0.013), and HbA1c (ρ+0.571, P=0.001) but there was no statistically significant correlation of NT-proBNP with BMI or WC values although the correlation was negative for both.
Conclusion: The present study provides a novel perspective that measuring serum NT-proBNP may help in the earlier identification of impending HF in diabetic individuals assisting in prompt intervention which may be further confirmed by larger studies.
Graham’s patch omentopexy versus modified Graham’s patch omentopexy in duodenal perforation – A comparative study
Authors: Atul Kumar Khare  , Kuldip Pratap Patel  , Ashok Kumar Chopra  , Pankaj Goyal  , Ashish Paliwal  , Aditya J Baindur  , Kirti Singh  , Ravi Pratap Singh
Published: January 2025

Background: Peptic ulcer perforation is a serious complication which affects 2–10% of peptic ulcer patients. Peptic ulcer perforation presents with an overall mortality of 10% although various authors had reported incidence between 1.3% and 20%. Being a life-threatening complication of peptic ulcer disease, it needs special attention with prompt resuscitation and appropriate surgical management if morbidity and mortality are to be contained.
Aims and Objectives: The aim of the study was to the comparative study of Graham’s omentopexy versus modified Graham’s omentopexy in duodenal perforation.
Materials and Methods: This prospective and single-center study was done in Birsa Munda, GMC Shahdol Madhya Pradesh from 2021 to 2023 for 2 years of periods. A total of 160 patients divided into two groups-Graham’s omentopexy 80 cases group “A” and modified Graham’s omentopexy 80 cases group “B.”
Results: One hundred and forty-six (91%) were male and 14 (9%) were female with M:F Ratio 10:1. Most of the patients were 20–78 years of age in both groups. Post-operative leakage was 7.5% and 1.25%, respectively. Mortality rate in Group A (3.75%) and in Group B (1.25%). The overall mortality rate was 7.14%. In this study, average hospital stay was 12.4 days in Group A and 9.0 days in Group B.
Conclusion: This study showed that modified Graham’s patch repair is as effective as Graham’s patch repair in terms of the mean operative time period, the timing of oral feed allow, and mean hospital stay timing.
Comparison of nebulization with lignocaine and dexamethasone for attenuation of post-operative sore throat: A randomized controlled trial
Authors: Rahul Saini  , Sanjay Johar  , Rahul Deora  , Pritam Yadav  , Preeti Gehlaut  , Prashant Kumar
Published: January 2025

Background: Post-operative sore throat (POST) is a very common anesthesia-related event which may hamper patient satisfaction and increase treatment cost.
Aims and Objectives: This study aimed to compare the effectiveness of nebulization with dexamethasone and lignocaine to prevent POST.
Materials and Methods: This randomized controlled study involved 135 patients randomly divided into three equal groups: Group D – (n=45) received 8 mg (2 mL) dexamethasone plus 3 mL of distilled water, Group L – (n=45) received 80 mg (4% lignocaine 2 mL) plus 3 mL distilled, and Group S – (n=45) received nebulization with 5 mL normal saline.
Results: At 4 h postoperatively, the incidence of POST was 15.6% in the dexamethasone group, 33.3% in the lignocaine group, and 73.3% in the saline group. The score was significantly higher in the saline group (P=0.001) compared to the dexamethasone and lignocaine group, while it was comparable between dexamethasone and lignocaine group (P=0.188). Similarly, dexamethasone and lignocaine groups were comparable at immediately post-operative, 2, 8, 12, and 24 h post-operative time points. Post-operative hoarseness scores of all three groups were comparable at all-time points. A significant increase in the heart rate (HR) and mean arterial pressure (MAP) after intubation was observed in the saline and dexamethasone group as compared to the lignocaine group (P=0.001) while HR and MAP were comparable in dexamethasone and saline group (P=1.000).
Conclusion: Dexamethasone and lignocaine nebulization are both effective and comparable prophylaxis for POST and lignocaine nebulization has added advantage of blunting pressor response to endotracheal intubation over dexamethasone nebulization.
Twist and turn of an unusual entity: A rare case report of torsion of huge epididymal cyst from a tertiary hospital
Authors: Manojit Sarkar  , Arup Kumar Ghosh  , Purnendu Dutta  , Amit Ray
Published: January 2025

An epididymal cyst (EC) is a benign lesion. It arises due to cystic degeneration of the epididymis. The torsion of it is extremely rare. The usual presentation of the cyst is asymptomatic scrotal swelling. The swelling has a lobulated surface and feels like a bunch of grapes. The huge EC is rare and moreover, it is associated with torsion-rarest presentation.
Deciphering nasal septum deviation: Computed tomography insights into age and gender trends for optimized clinical care
Authors: Shalini Sharma  , Garima Sehgal  , Noor Us Saba  , Jyoti Chopra  , Gopal Tiwari
Published: January 2025

Background: Deviation of the nasal septum (DNS) is defined as any deviation of the septum from the midline and is one of the most common variations of the sinonasal anatomy.
Aims and Objectives: The purpose of this study was to observe the prevalence of DNS and its relation with age, gender, and sidedness.
Materials and Methods: Sinonasal computed tomographic images of 100 subjects obtained from the Department of Radiodiagnosis, King George’s Medical University, Lucknow, UP, in the period August 2013–July 2014 were analyzed to determine the prevalence of DNS and its relation with age, gender, and sidedness.
Results: Of a total of 100 subjects, normal midline nasal septum was seen in 27 subjects whereas 73 subjects (73%) displayed a deviation in its position. The prevalence of nasal septal deviation (NSD) was significantly higher in females (84.21%) as compared to males (66.13%) (P=0.048). We also compared the prevalence of NSD in different age groups and found it to be higher in subjects aged >46 years (83.33%) as compared to other age groups but this difference was not found to be statistically significant (P=0.619).
Conclusion: Nasal septu the septum toward the right. No correlation between age intervals and prevalence of DNS was found.
Clinicopathological study of skin tumors
Authors: Neetha Unnikrishnan  , Letha V
Published: January 2025

Background: The diagnosis of skin tumors can cause difficulties due to their wide variety of overlapping differentiation and complicated nomenclature. Histopathological study is the most valuable means of diagnosis. Keeping in view these facts, an attempt is made to study the different varieties of tumors of the skin.
Aims and Objectives: (1) The aim of this study was to study the histomorphology of different skin tumors with ancillary technique necessary and to correlate with the clinical features. (2) To find the proportion of various skin tumors. (3) To classify and identify various skin tumors and study its variation according to age, sex, site, etc., which will bear an impact on patient management and prognosis.
Materials and Methods: This observational study included all cases of skin tumors received in the Department of Pathology, Kottayam Medical College, during a period of 1 year. Biopsy samples were collected, fixed in 10% formalin, processed and embedded in paraffin blocks, and stained with hematoxylin and eosin (H and E). The stained sections were studied under a microscope and histopathological diagnosis was correlated with clinical diagnosis.
Results: Out of the 227 cases of skin tumors, 102 (44.9%) were male and 125 (55.1%) were female. The incidence of skin tumors peaks in individuals older than 60 years of age. The most common sites affected were face (40%). Keratinocytic tumors constituted the largest proportion of tumors (43%), followed by melanocytic tumors (31%), soft-tissue tumors (13%), appendage tumors (11%), neural (1%), and hematolymphoid tumors (1%).
Conclusion: Out of the 227 cases in the present study, the clinical diagnosis of only 169 cases was correlating with the histopathological diagnosis. This emphasizes the role of microscopy in the correct diagnosis of skin tumors.
Early diagnosis of small airway disease in asymptomatic polishing sector workers of a leather factory
Authors: Sruthi Priyadarsini S  , Chandrasekar Chokalingam  , Balamurugan Shanthalingam  , Manikandan Nagesh  , Manoj Ramanathan
Published: January 2025

Background: The leather industry stands as one of India’s burgeoning sectors, boasting significant manpower. Workers in the finishing sector, particularly those involved in polishing, face heightened risks due to exposure to formaldehyde, aniline, and resins, which can lead to respiratory complications.
Aims and Objectives: The aims and objectives of the study are to determine the small airway obstruction in asymptomatic finishing sector workers of a leather factory.
Materials and Methods: The current study was a cross-sectional study conducted in a leather factory located in Chennai, Tamil Nadu. A random sample of 60 workers was drawn from different sectors of a leather factory. Basic demographic details, smoking history, nature of work, exposure to irritants along with duration, and respiratory symptoms were collected. All workers were subjected to spirometry as per ATS guidelines and the results were analyzed. Association between length (years) of exposure, respiratory symptoms, and spirometry impairment among the workers were analysed.
Results: Out of 60 samples, 38 were exposed to irritants and 22 were not exposed to irritants. Out of 38, 25 had small airway disease, seven had large airway obstruction, one had a restrictive pattern, and five had normal spirometry. 42.1% of them were asymptomatic.
Conclusion: Small airway obstruction is notably prevalent, especially among asymptomatic workers in the polishing sector. Prolonged exposure is associated with the development of large airway obstructive disease. This study underscores the importance of continuous monitoring for airway diseases in occupationally exposed workers, advocating for timely preventive and protective measures to curb disease progression.
Study on extrahepatic manifestations in patients with hepatitis A in a tertiary care hospital
Authors: Asish Banerjee  , Aneesh Debbarman  , Sumaita Ahmed
Published: January 2025

Background: Hepatitis A is a common self-limiting infection of the liver. In recent times, there is a change in the pattern of hepatitis A infection producing extrahepatic manifestations.
Aims and Objective: Our aim of the study is to find the profile of extrahepatic manifestations of hepatitis A. The secondary objective is to find a correlation of liver function test values with extrahepatic manifestations.
Materials and Methods: A retrospective study was conducted over 3 years. 169 seropositive school-going cases were presented with signs and symptoms of hepatitis A and were clinically assessed.
Results: Among 169 immunoglobulin M (+)ve hepatitis A, 36% of patients (61 cases) presented with extrahepatic features. Among the 61 patients, 41 patients presented with aspartate transaminase (AST):alanine transaminase (ALT) >2:1 and 20 patients presented with AST:ALT <2:1.
Conclusion: In recent times, there has been a changing pattern in the presentation of hepatitis A producing extrahepatic manifestations in the pediatric age group.
Granulomatous response within draining axillary lymph nodes in patients with Breast cancer: A series of 4 cases
Authors: Pradhan Rajashree , Mondal Sajeeb , Chatterjee Suman , Upasana Mukherjee
Published: January 2025

Granulomatous response associated with breast cancer and within the draining lymph nodes is an extremely rare phenomenon. In this study, we are presenting a series of 4 cases of invasive ductal carcinoma showing both caseating and noncaseating granulomas within the ipsilateral draining axillary lymph nodes. We also discussed the pathogenesis of granulomatous response and its clinicopathologic significance.
An observational study to compare the pain relief scores of epidural midazolam and buprenorphine for post-operative patients
Authors: Shankarappa RV  , Bharat Kiran  , Padmanabha BV  , Sai Sailesh Kumar Goothy  , Mukkadan JK
Published: January 2025

Background: As it was mentioned, the risk of adverse effects and complications is more than what is expected. Hence, the use of epidural analgesia (EA) was decreased in the management of post-operative pain. Hence, there is a need for another pharmacological agent that is more effective. Manly studies reported that buprenorphine transdermal and sublingual both have significant pain relief scores.
Aims and Objectives: The present study was undertaken to compare the pain relief scores of epidural midazolam and buprenorphine for post-operative patients.
Materials and Methods: A total of 60 male and female participants, within the age group with the American Society of Anesthesiologists grades I and II were recruited. After recruiting, they were randomly divided into two groups. Soon after the surgery, the pain scores were recorded using the Visual Analog Scale. Soon after recording the pain scores, the corresponding drugs were administered to the participants. Epidural midazolam 30 g/kg and buprenorphine 0.15 mg diluted in normal saline were administered to the corresponding groups for 24 h.
Results: There is no significant difference in the demographic data of the participants in both groups. There was no significant difference observed between the two groups. Both are equally effective. Nausea and vomiting are the mild side effects observed in the majority of the patients in both groups.
Conclusion: In the present study, we have observed similar actions by both drugs in the management of post-operative pain. The study not only adds to the literature about the effectiveness of these drugs but also explains the mild side effects. Hence, the study recommends the use of both these drugs in the management of post-operative pain so that patient satisfaction can be improved and the patient stay at the hospital can be minimized. Further, detailed and multi-center studies are recommended to generalize the results.
Etiology of pancytopenia with reference to bone marrow biopsy in a tertiary care hospital: A hospital-based study
Authors: Aparna Kamal  , Harbamon Engti  , Asha Borah  , Padmashri Ronghangpi  , Adity Sharma  , Mrigen Choudhury
Published: January 2025

Background: Pancytopenia is a common hematological entity and a striking feature of many life-threatening illnesses.
Aims and Objectives: The study was conducted to identify the etiology of pancytopenia. (i) To find out primary bone marrow (BM) causes of pancytopenia. (ii) To evaluate the spectrum of BM morphology in pancytopenia cases.
Materials and Methods: This hospital-based observational study was conducted between June 2021 and May 2022 in a tertiary care hospital in Dibrugarh in all pancytopenia cases of age above 12 years and meeting the inclusion criteria. After taking written consent, detailed history, clinical examination, and baseline investigations were done followed by BM examination.
Results: Mean age was 45.39±15.49 years. Majority were males 41 (56.9%) and 31 (43.1%) were females. The most common cause of pancytopenia was Megaloblastic anemia (30.5%) cases, followed by aplastic anemia (18%) and myelodysplastic syndromes (16.7%). About 72 (100%) had pallor followed by weakness (86.1%), bleeding tendencies (70.8%), and fever (52.8%).
Conclusion: The study underscores the critical role of BM biopsy in the diagnostic workup of pancytopenia. It confirms that BM biopsy is indispensable for identifying the diverse etiologies of pancytopenia and in implementing the appropriate therapy.
A cross-sectional study on the association of level of Vitamin D with severity of fibromyalgia syndrome in a tertiary care hospital, Kolkata
Authors: Mausumi Sen  , Sulagna Das  , Santanu Sen  , Nabanita Baidya Biswas  , Tanmoy Naskar  , Swapan Kumar Mishra  , Swati Bhattacharyya
Published: January 2025

Background: Fibromyalgia (FM) is a chronic disorder characterized by widespread pain associated with fatigue, stiffness, sleep disturbance, cognitive dysfunction, anxiety, and depression. The role of Vitamin D in the pathophysiology of FM is poorly known. Studies available to establish the association between Vitamin D and FM have inconsistent results. Some of the studies reported a positive association and others found no relation. It is not clear whether the pain is due to and/or associated with low levels of Vitamin D.
Aims and Objectives: The objective of the current study is to estimate Vitamin D levels in FM patients and to find the association between Vitamin D levels and severity of FM.
Materials and Methods: In this cross-sectional study, seventy patients who fulfilled the inclusion (American College of Rheumatology 2016 criteria) and exclusion criteria as has been considered for the study were enrolled and their serum 25 hydroxy-vitamin D level has been measured by enzyme-linked immunosorbent assay reader. Pre-designed questionnaires were prepared to measure FM severity. Pain intensity was measured by the Visual Analog Scale (VAS).
Results: A total of 70 patients who were diagnosed with FM were included in our study. The majority of them (80%) were female and the rest (20%) were male. The mean age is 48.2±9.2 years. Their mean body mass index (BMI) is 23.7±3.82. The mean Vitamin D serum level was 22.4±9.2 ng/dL. Vitamin D deficiency (VDD) was defined as patients with a serum level of 20 ng/mL and below. In our study, 62.8% (44) of the study population had VDD. According to VAS (0–10) pain scale, 15 (21.4%) subjects suffered from moderate pain and 55 (78.6%) subjects suffered from severe pain. The severity of FM was measured by the Fibromyalgia Severity Scale (FSS). The mean score of FSS was 22.7. To find the association between VDD and severity of FM, several covariates were identified and a multivariable logistic regression was done.
Conclusion: VDD increases with an increase in age, BMI, VAS, and FSS, all of which are predicators of FM syndrome.
A histomorphological and immunohistochemical analysis of invasive lobular carcinoma of breast: A case series
Authors: Suchiang Meera , Das Gunabhi Ram , Swagata Dowerah  , Julee Saikia  , Washima Rahman  , Mondita Borgohain  , Gayatri Gogoi
Published: January 2025

Invasive lobular carcinoma (ILC) is the second most common special subtype of invasive breast carcinoma comprising 5–15%. ILC defines as invasive carcinoma comprising non-cohesive single-file linear pattern in fibrous stroma. The aim of the study was to evaluate the histomorphological features and immunohistochemical analysis of ILC. A total of 19 cases were encountered from March 2020 to February 2024 out of 129 breast cancers. The sociodemographic profiles and clinicopathological parameters of the patients were studied with special emphasis on their morphology and hormone receptor status. The mean age of patients is 42.8 years. Out of 19 cases, 84.2% showed feature of classic type, 5.2% of tubule-lobular, and 10.5% of pleomorphic lobular carcinoma. The majority of cases (63.2%) showed histologic Grade 2, and 10.5% showed Grade 3. On immunohistochemistry examination, 79% were estrogen receptor (ER) and progesterone receptor (PR) positive with 10.5% of cases was human epidermal growth factor receptor 2/neu (HER2/neu) positive. Our study showed higher cases of classic type ILC, mostly of histologic Grade 2; higher ER-PR receptor positivity and HER2/neu negativity.
Analysis of Limb Injury Patterns in Victims of Two Wheeler Accidents
Authors: Anish Sam George
Published: January 2025

Objectives: A retrospective study was carried out to analyse the two wheeler accidents that presented over a one year period to a single institution and to study the pattern of limb injuries according to zones assigned to the limb. The mode of injury in the two wheeler accidents and the differences in limb injuries between the driver and the pillion riding passenger were also studied.
Methods: All the road traffic accidents that could be attributed to two wheelers were obtained with the help of trauma records and the nominal registers and ward records. Limb injuries were then assigned to various anatomical zones that were created for the purpose of the study. The upper limb and lower limb injuries were separately analysed for differences between the driver and the pillion rider.
Results: There were 242 two wheeler accidents seen between 1st jan 2008 to 31st dec 2008, of these 110 had limb injuries. 96 cases were eventually included and of these 67 were drivers. The most common mode of injury was a skid and fall of the vehicle ( 42%). Pillion riders were injured more often in collisions between two and four wheelers. The commonest injury in drivers was in wrist and hand regions of the upper limb and the tibia and ankle regions of the lower limb. In the pillion rider, lower limb injuries were commonest in the tibia and ankle whereas in the upper limb shoulder and wrist injuries predominated.
Conclusion: Two wheeler accidents cause significant morbidity in both the driver and pillion rider, the tibia and ankle are commonly injured in both the populations whereas minor differences in upper limb injury are seen between the two groups.
Keywords: Road traffic accidents; epidemiology; pattern of injuries.
DOI: 10.3126/ajms.v1i1.2794
Asian Journal of Medical Sciences Vol.1(1) 2010 p.14-15
Assessment of Ergonomical and Occupational Health Related Problems Among VDT Workers of West Bengal, India
Authors: Banibrata Das  , Tirthankar Ghosh
Published: January 2025

Objective:
Musculoskeletal disorders are a common problem among computer users. The main aim of the study is to assess the prevalence of musculoskeletal and visual disorders among the VDT workers.
 
Material & Methods:
The study was conducted in the different office premises in Kolkata. After selections of the locations, 100 VDT workers are selected randomly comprising 50 male and 50 female. A detailed study based on a modified Nordic questionnaire was performed among these VDT workers for study period to measure the outcome of epidemiological studies on musculoskeletal disorders.
 
Results:
The main finding of this study was that the Lower back problem is the main problem among VDT workers. The both male and female VDT workers also suffered pain in neck, shoulder, fore arm, wrist, elbow and the different parts of the upper extremities. This study revealed that the female VDT workers suffer more discomfort feeling than male VDT workers. In this study it was clearly indicated that the discomfort feeling was relatively high among the aged VDT workers. Prolonged period of work in an awkward posture mainly lead to discomfort feeling among the VDT workers. Another finding of this study was that both male and female VDT workers suffered from visual stress due to prolonged period of work and without using of antiglare screen in a monitor.
 
Conclusion:
The VDT workers suffered pain mainly in the upper extremities and lower back of the body. They also suffered from visual stress. Females have a higher discomfort feeling than male VDT workers.
 
 
Key Words:
VDT workers; Discomfort feeling; Visual stress; Gender difference
 
 
DOI: 10.3126/ajms.v1i2.2992
 
 
Asian Journal of Medical Sciences
1 (2010) 26-31
The Level of Awareness and Utilization of Computer Shields among Computer users in a Nigerian Community
Authors: Chidi Oliver Ihemedu  , Charles Oluwole Omolase
Published: January 2025

Objective: This study was designed to determine the level of awareness and extent of use of computer shields among computer users in Owo, in South-West Nigeria. Material & Methods: The subjects were selected by a simple random sampling method. Data collection was through a combination of e-mail based on-line questionnaire using the survey monkey website, and the self administered semi structured hard copy questionnaire. The information obtained from the respondents with the questionnaire included their bio-data, extent of computer use, history of ocular symptoms, awareness and utilization of computer shields. The data obtained with the study instrument was collated and analyzed using the SPSS 15.0.1 statistical software, cross tabulation of attendants results were done with chi-square test and statistical significance was set at p ≤ 0.05. Results: 108 of 124 selected subjects filled their questionnaire to acceptable level. There were a large number of respondents who were aware of the various types of computer shields (70.5%) (p-value 0.002). However, the utilization level was not commensurate as only 39.8% (N= 43) utilized any of these shields, 49.1% (N= 53) were none users while 11.1% (N= 12) did not respond (p-value 0.062). Conclusion: Majority of the respondents were aware of computer shield. However, less than half of the respondents utilized computer shields. There is need to encourage all computer users on the use of computer shields to ensure better computer working time. Key Words: Awareness; Computer shields; Nigeria DOI: 10.3126/ajms.v1i2.2826Asian Journal of Medical Sciences 1 (2010) 49-52
Prevalence and Determinants of Cigarette Smoking among the College Students of Kathmandu Valley
Authors: Aryal Umesh Raj , Keshab Deuba  , Arjun Subedi  , Rachana Shrestha  , Laxmi Bhatta
Published: January 2025

Objective: To estimate the prevalence of smoking among the college students and to identify the factors associated with smoking. Material & Methods: This is a cross sectional study carried out on 304 college students in Kathmandu valley using purposive sampling during the months of December 2009 to January 2010. The self administrated questionnaire was adopted from Global Youth Tobacco Survey 2007 (GYTS) and data were collected after the verbal consent taken. The statistical analysis was done using descriptive statistics, univariate and binary logistic regression to measure prevalence of smoking and to identify the association between dependent and independent variables. Results: We found 7 in 10 students were currently smokers. Among currently smokers, 78% were established smokers. The mean age of smoking onset was 14.15 years (SD=2.62). The mean number of cigarettes smoked per day was 5.03(SD=3.72) and average daily expenditure was Rs. 15.18 (SD=7.87). About 90% students tried to quit smoking and 17% non smokers were susceptibility smokers. The following factors: sex (adjusted odds ratio(aor)=3.88,95% CI= 2.12;7.11), living with or without family members (aor=1.79,95% CI=1.01;3.17), father occupation (aor=1.85,95% CI=1.04;3.30), and friend's smoking habits (aor=4.60,95% CI =1.92;11.0) were associated with cigarette smoking. Conclusion: There is the need of effective intervention programs to control cigarette smoking among college students. Key Words: Cigarette smoking; College students; Prevalence of smoking; Risk factors DOI: 10.3126/ajms.v1i2.3279Asian Journal of Medical Sciences 1 (2010) 53-58