bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocular biometry and anthropometric measurements in young myopes – A case–control study
Authors: Venipriya Sigamani  , Viswesh Kathavarayan  , Lalithambigai Chellamuthu  , Ravichandran Kandasamy  , Hannah Ranjee Prasanth
Published: January 2025

Background: The prevalence of myopia in the 5–15-year age group in India has been 7.5% over the past four decades. While ocular growth and physical growth occur simultaneously during early life, the existence of a common regulatory system for both is still debated.
Aims and Objectives: This study aims to analyze the ocular biometry and anthropometric values of young myopes and emmetropes aged 18–25 years.
Materials and Methods: This case–control study involved a sample size of 86 participants. Corneal curvature was measured using keratometry, while A-scan ultrasonography was utilized to measure axial length, lens thickness, anterior chamber depth, and vitreous chamber depth.
Results: The results indicated that there were no significant differences in ocular biometry and anthropometric values between the case and control groups, except for corneal thickness and axial length. The mean corneal thickness was found to be 549.64 μm in the case group and 566.05 μm in the control group, while the mean axial length was 24.70 mm in the case group and 23.41 mm in the control group. An increase in height was correlated with longer axial length in myopes.
Conclusion: There was no difference in anthropometry and ocular biometry in emmetropes and myopes in the age group of 18–25 years of age. Myopes tend to have thinner corneas, which should be taken into consideration before performing refractive surgeries. The presence of thin corneas in individuals with myopia can result in inaccurately low measurements of intraocular pressure, potentially hampering the early detection of glaucoma within this high-risk demographic.
Association between suction tip culture and surgical site infection in elective clean orthopedic lower limb surgeries
Authors: Adam Zaneen  , Jeevan Pereira  , Neha Heswani
Published: January 2025

Background: Surgical site infections (SSIs) can be caused by various factors, including contamination of the surgical field. Perioperative cultures can be employed in clean orthopedic procedures to detect bacterial contamination that may occur during surgery.
Aims and Objectives: The study aimed to evaluate the correlation between suction tip cultures and surgical wounds in clean orthopedic surgeries.
Materials and Methods: A cross-sectional study was conducted at Yenepoya Medical College Hospital, Mangalore, Karnataka, with 250 patients in whom drain tips were sent for culture and followed up for 3 months to assess for SSI. Skin commensals from the nasal and groin samples were analyzed for the presence of bacteria.
Results: A total of 250 patients meeting the inclusion and exclusion criteria were included. Thirty patients were positive for drain tip culture, and 12 (4.8%) patients had SSI during the 3rd month follow-up period, showing a statistically significant relationship between drain tip culture and SSIs (P=0.001). Skin commensals constituted 67% (nasal) and 100% in the groin of perioperative contaminants, accounting for 4.8% of SSIs.
Conclusion: Suction drain tip culture and skin commensal analysis may be good predictors of SSIs. Intraoperative surgical site contaminants can be identified using perioperative cultures. Timely administration of suitable antibiotics and local wound care for perioperative contamination can help minimize the incidence of SSI.
Advanced serological tests – A paradigm shift in the diagnosis of febrile illnesses even with some atypical manifestations
Authors: Sharmila Gupta
Published: January 2025

Background: Fever is a symptom, not a disease. It is the non-specific manifestation of several underlying illnesses.
Aims and Objectives: The aims and objectives of this study were to determine the serological profile of patients with febrile illnesses, to study their different unusual presentations, and to study patients with coinfections with more than one type of disease.
Materials and Methods: Blood samples from 15,000 febrile patients were collected during the study period of 6 months. Different serological tests were performed in our laboratory based on clinical suspicion and in a few patients, more than one type of tests were done. The unusual presentations of different diseases were studied.
Results: Various percentages of male and female patients were seen suffering from different types of febrile illnesses. The different positive results out of total tests done for respective diseases were dengue (848/7708), vivax malaria (64/800), falciparum malaria (4/800), leptospirosis (95/798), scrub typhus (77/2433), enteric fever (75/1506), hepatitis B (143/9368), hepatitis C (11/9368), human immunodeficiency virus (HIV) (37/10900), systemic lupus erythematosus (5/158), acute renal failure (66/158), and syphilis (54/583). Different unusual presentations among patients with several diseases were noted, along with their percentages of occurrence. Coinfections among dengue and enteric fever (3%), mixed infection with Plasmodium vivax and Plasmodium falciparum (0.25%), scrub typhus and Leptospira (15.6%), hepatitis B and hepatitis C (0.649%), hepatitis B and HIV (5%), hepatitis C and HIV (8.33%), and syphilis and HIV (27.68%).
Conclusion: Dengue fever was found to be the most common of all febrile illnesses. The different unusual presentations of those diseases should suggest an improved clinical suspicion and better diagnostic stewardship. Coinfection was most commonly seen among syphilis and HIV and these data must suggest to always looking for associated illnesses in a patient with a single diagnosis.
Comparative study between dexmedetomidine and midazolam as pre-medication for the prevention of etomidate-induced myoclonus and attenuation of stress response at endotracheal intubation in laparoscopic cholecystectomies
Authors: Sandesh Rathod  , Maidul Haque  , Sayak Patra  , Chaitali Biswas
Published: January 2025

Background: Myoclonus is a common issue in etomidate anesthesia induction, and various drugs have been used to reduce its incidence, highlighting the ongoing search for better alternatives in anesthesiology.
Aims and Objectives: The study analyzed the impact of dexmedetomidine (DEX) and midazolam pre-treatment on etomidate-induced myoclonus incidence, stress response at laryngoscopy, and intubation during etomidate induction.
Materials and Methods: A prospective randomized controlled intervention study (superiority trial) was done involving 42 patients of age 20–60 years, randomly allocated in two equal groups (Group D: Inj. DEX was given as infusion (0.5 μg/kg) in 10 mL 0.9% normal saline over 10 min and 5 min before induction. Group M: Inj. Midazolam was given 0.02 mg/kg, prepared in 10 mL 0.9% normal saline, to be infused over 10 min and 5 min before induction). Myoclonus was graded after intravenous administration of etomidate (0.3 mg/kg) and hemodynamic response to laryngoscopy and intubation were observed at various time intervals. Statistical analysis was done using SPSS version 27.0. Independent t-test/Mann–Whitney test (for non-parametric data) and Chi-square test/Fisher’s exact test were used to compare variables. A P<0.05 was considered statistically significant.
Results: The study found that DEX effectively suppressed stress response due to intubation compared to midazolam, with mean myoclonus gradation (Mean±SD) in Group-D and Group-M being 0.6190±0.7400 and 1.6667±0.8563, respectively, indicating a significant distribution with group.
Conclusion: DEX was found to be more effective than midazolam in preventing etomidate-induced myoclonus and attenuating stress response compared to midazolam.
Assessing the efficacy of anticoagulation therapy in the management of atrial fibrillation: An observational study
Authors: Swathi G  , Yerakala Ramesh  , Pragna S
Published: January 2025

Background: Atrial fibrillation (AF) substantially elevates stroke risk. Managing AF with anticoagulation therapy is crucial to reduce this risk, yet assessing the balance between its efficacy in preventing strokes and the potential for bleeding complications is essential.
Aims and Objectives: The aim of this study is to evaluate the efficacy and safety of anticoagulation therapy in the management of AF.
Materials and Methods: This observational study followed 100 AF patients at a government general hospital over 8 months to evaluate the efficacy and safety of anticoagulation therapy. We analyzed stroke occurrence, bleeding complications, treatment adherence, patient satisfaction, and improvements in quality of life (QoL). In addition, we recorded patient demographics and baseline characteristics, such as body mass index, smoking status, and CHA2DS2-VASc scores.
Results: The study population was at a moderate-to-high risk of stroke, with an average CHA2DS2-VASc score of 2.9. The efficacy of stroke prevention was confirmed, with a 2% incidence of stroke events. Bleeding complications included major bleeding in 4% of the patients, with minor bleeding predominantly occurring in the first 3 months of therapy. Treatment adherence was noteworthy, with 75% of patients not missing any doses. High levels of patient satisfaction were observed, with 90% of participants reporting being satisfied or very satisfied with their treatment. QoL, measured through the AF-QoL questionnaire, showed significant improvement from a baseline score of 58–76.
Conclusion: Anticoagulation therapy in AF patients was effective in stroke prevention with a manageable risk of bleeding. High treatment adherence and patient satisfaction further support the therapeutic value of anticoagulation in AF management.
A study on clinicoradiological profile of patients with hydropneumothorax in a tertiary care hospital in Eastern India
Authors: Falguni Mandi  , Pranab Mandal  , Agnishwar Mukherjee  , Aparup Dhua  , Pinaki Maiti
Published: January 2025

Background: Hydropneumothorax is an abnormal presence of air and fluid in the pleural space. It is a common presentation in the Indian scenario. However, there is a scarcity of studies from Eastern India.
Aims and Objectives: The study aimed to evaluate the clinical and radiological presentation, etiological factors, treatment modalities, and outcome of patients of hydropneumothorax.
Materials and Methods: Descriptive, observational, cross-sectional study conducted in a tertiary care hospital for 1 year. Adult patients of both genders presenting with a diagnosis of hydropneumothorax were studied. Detailed history and clinical examination were recorded. Chest X-ray, blood, pleural fluid, sputum investigations, and computed tomography (CT) thorax were done. An intercostal drainage (ICD) tube was inserted and the duration of ICD stay was noted.
Results: Thirty-six patients were studied. The mean age of presentation is 40.8±14.8 (Mean±SD) years with male predominance. Breathlessness and cough were the most common symptoms (86.1%). Right-sided hydropneumothorax was more common (52.7%). All patients had exudative pleural fluid. Cavity (38.9%) was the most commonly associated radiological finding in CT thorax. Tuberculosis (TB) was the most common etiology (61.1%), followed by acute bacterial infection (36.1%), and malignancy (2.7%). All patients have undergone ICD insertion. About 61.11% of patients had an ICD stay of less or equal to 15 days.
Conclusion: Pleural fluid analysis is essential in establishing the etiological diagnosis of hydropneumothorax. TB is the common etiology. ICD insertion along with appropriate chemotherapy are essential components of management.
Assessing the impact of appendicectomy in daily activities/social life of children
Authors: Srinivasan K  , Divakar Pandian
Published: January 2025

Background: Appendicectomy is a common surgical procedure for children presenting with appendicitis. Understanding the impact of appendicectomy on daily activities and social life is crucial for optimizing patient outcomes.
Aims and Objectives: This study aimed to assess the impact of appendicectomy on children’s daily activities and social lives.
Materials and Methods: A retrospective analysis was conducted of patients aged ≥5 years who underwent appendicectomy at our center between April 2022 and April 2023. Data on demographics, surgical approach (open or laparoscopic), post-operative outcomes, and return to daily activities were collected using a standardized questionnaire.
Results: Among the 70 identified cases, there was a male predominance (63%), with most presenting with acute appendicitis (85%). Laparoscopic appendectomy was the predominant surgical approach used (80%). Post-operative symptoms included pain (n=12), vomiting (n=3), fever (n=2), and wound infection (n=6). Appendicular abscesses were found in 9% of laparoscopic surgeries and 14% of open surgeries. The average duration of hospital stay was shorter in laparoscopic cases. Return to school and normal diet varied between surgical approaches, with laparoscopic cases generally showing a quicker recovery.
Conclusion: Although appendicectomy is commonly performed, it has implications for children’s daily routines and social interactions. Parental anxiety plays a crucial role in post-operative recovery. Future studies should focus on addressing these social determinants to optimize patient outcomes.
A comparative study of levobupivacaine 0.25% with dexmedetomidine and dexamethasone as adjuvant in caudal block for pediatric patients undergoing infraumbilical surgeries
Authors: Batula Shravani  , Neelima Tandon  , Man Mohan Jindal  , Kushal Jethani
Published: January 2025

Background: The caudal epidural block is one of the most commonly used regional techniques for post-operative pain management in pediatric age group patients undergoing infraumbilical surgeries. Adjuvants use increase the duration of analgesia and decrease local anesthetic dose requirement, thereby decreasing the risk of toxicity.
Aims and Objectives: The aim of the present study was to compare the prolongation of the duration of analgesia, hemodynamic parameters, and side effects if any, provided by the addition of dexmedetomidine (DEX) or dexamethasone as an adjuvant to levobupivacaine in the caudal block.
Materials and Methods: A total of 60 patients with the American Society of Anesthesiologists grade I/II scheduled for elective infraumbilical surgeries were randomly allocated into two groups of 30 each. Group 1 received levobupivacaine 0.25% 1 mL/kg+DEX 1 mcg/kg and Group 2 received levobupivacaine 0.25% 1 mL/kg+dexamethasone 0.1 mg/kg for caudal block. The duration of analgesia, hemodynamic parameters, and adverse events during the post-operative period were noted.
Results: There was no statistically significant difference in hemodynamic parameters between Group 1 and Group 2. Post-operative face, leg, activity, cry, consolability, (FLACC) pain scores were significantly lower in Group 1 when compared with Group 2. The mean duration of analgesia was prolonged in Group 1 at 824.23±53.53 min than in Group 2 with a mean duration of analgesia 480.50±31.66 min which was statistically significant (P<0.005). Adverse events were comparable between the two groups and were statistically not significant (P>0.05).
Conclusion: The addition of DEX to levobupivacaine in caudal block significantly prolongs the duration of analgesia in post-operative period in comparison to the addition of dexamethasone with levobupivacaine. It also provides more hemodynamic stability during the intraoperative and post-operative period, lower FLACC pain scores, and is associated with minimal side effects.
A fascinating case of complex congenital heart disease
Authors: Soumya Divvela  , Jensy Jaison  , Rajoo Ramachandran
Published: January 2025

Complex congenital heart disease (CHD) constitutes a significant non-infectious contributor to childhood morbidity and mortality, particularly prevalent in developing countries with an estimated incidence of nearly 1/100 births. The spectrum of CHD spans from isolated atrial septal defects that necessitate no immediate intervention to intricate structural cardiovascular abnormalities demanding multiple interventions early in the neonatal period. Patients afflicted with complex CHD often manifest symptoms such as respiratory distress, cyanosis of the skin, feeding difficulties, and failure to thrive, becoming evident within the initial 48 h post-birth. In this context, we present an intriguing case of a male child with complex CHD. This case study is accompanied by a concise exploration of the embryology of the heart, shedding light on the intricate developmental processes that may underlie such congenital anomalies.
Granulomatous mastitis and other inflammatory mastitis simulating breast neoplasms – A retrospective study in the fine needle aspiration cytology clinic of a tertiary care center in eastern India
Authors: Pamela Nayak  , Meghadipa Mandal  , Srishtidhar Mangal
Published: January 2025

Background: Fine needle aspiration cytology (FNAC) is an important diagnostic modality in palpable breast lesions. This together with imaging modality is important in distinguishing benign from malignant lesions of the breast. Granulomatous/inflammatory mastitis forms a small subset of breast lesions that may present as a breast lump. Clinical and radiological features in these cases may mimic malignant breast pathology.
Aims and Objectives: The aim of this study was to study the frequency of granulomatous mastitis and other inflammatory mastitis with respect to other neoplastic lesions of the breast, presented in FNAC clinics and to correlate the cytological findings with the clinical presentation of granulomatous and other inflammatory mastitis.
Materials and Methods: A retrospective study was conducted in the Department of Pathology in a tertiary care center in Eastern India for duration of 4 years 5 months. Details of all patients who underwent FNAC for breast lesions during the study period were recorded in terms of their clinical presentation, cytological findings, imaging, and ancillary investigations. The findings were then tabulated in a master sheet and analysis done by descriptive statistics using SPSS 25.
Results: A total of 154 cases were included with 5 cases (3.2%) of granulomatous and 12 cases (7.8%) of inflammatory mastitis. Age range for granulomatous/inflammatory mastitis was 20–70 years. Lump and pain were the most common complaints followed by inflammatory skin changes and nipple discharge. Very few cases also showed nipple retractions and very occasional systemic symptoms like fever. History of lactation was seen among five cases. Three cases showed positive acid-fast bacilli in Ziehl–Neelsen stain. Radiology was discordant with cytological findings in three cases, where the former suggested a breast neoplastic process.
Conclusion: Granulomatous/inflammatory mastitis is a rarely diagnosed entity in breast cytopathology with no standard guidelines for management. Antibiotics antitubercular therapy and corticosteroids are some proposed lines of medical management. In treatment-resistant cases, wide local excision may be done depending on available resources and surveillance opportunities.
A comparative study of ultrasonography versus peripheral nerve stimulator-guided obturator nerve block for transurethral resection of bladder tumor under spinal anesthesia
Authors: Mandakini Sahu  , Alok Pratap Singh  , Kuldeep Kumar Patel
Published: January 2025

Background: Transurethral resection of bladder tumor (TURBT) is usually done spinal anesthesia but it does not prevent the obturator reflex leading to bladder perforation, bleeding, or incompletely resection of resection of the tumor which could be prevented by obturator nerve block (ONB) in TURBT.
Aims and Objectives: The aim of our study is to compare the effectiveness of ONB by peripheral nerve stimulator (PNS) and ultrasonography (USG) in TURBT and also compare morbidity between USG- and PNS-guided ONB in TURBT under spinal anesthesia.
Materials and Methods: Sixty patients were randomly divided into two groups. Group (1) patients had a PNS-guided ONB and Group (2) patients had ONB-guided ONB. The presence or absence of adductor muscles reflexes was recorded. Bladder perforation and bleeding during surgery were also recorded.
Results: A success rate of 90% was achieved in the Group (2) compared to 66% in Group (1) which was clinically significant with P=0.049. Complete bladder perforation was detected in four patients in Group (1) whereas no perforation was observed in Group (2). Bleeding was observed in both groups but severe bleeding was present in five patients in Group (1) and required a blood transfusion.
Conclusion: We concluded that USG-guided ONB is more efficient and safer as compared to PNS-guided ONB.
The clinical, hematological, and biochemical profiles of patients with complications due to Plasmodium vivax malaria: A case series
Authors: Amrita Jha  , Sanjay Kumar Mandal  , Ranjan Mondal  , Sadhan Barman  , Golam Muztaba  , Krishnendu Das
Published: January 2025

Malaria, a protozoal infection caused by the six species of the genus Plasmodium, is one of the most important diseases known to humankind, with most infections caused by either of the two species – Plasmodium vivax and Plasmodium falciparum. Previously, it was held that falciparum malaria was responsible for causing severe, life-threatening disease, with vivax malaria causing mild or uncomplicated infections. In this case series, the clinical, hematological, and biochemical profiles of eight patients with features of complications due to P. vivax malaria, along with their clinical course, response to treatment, and clinical outcomes have been described. Among these, the most common clinical features were fever, headache, and myalgias. Five patients had altered mental status, two were prostrated, two were hypotensive, and one had recurrent generalized seizures. Three patients had pancytopenia, two had both anemia and thrombocytopenia, and one had evidence of disseminated intravascular coagulation. Six patients had clinical jaundice, four had elevated transaminases, and four had acute kidney injury. All cases showed excellent response to anti-malarial therapy. Hence, this case series revealed that P. vivax is capable of causing severe, life-threatening organ dysfunction akin to those seen in P. falciparum malaria and that early diagnosis and treatment initiation are associated with positive patient end outcomes.
A comparative study of head-elevated positions at 25° versus 45° for intubation in obese patients posted for elective surgery under general anesthesia
Authors: Koel Mitra  , Fayeza Nasrin  , Subhrangsu Chatterjee  , Pratibha Bhunia
Published: January 2025

Background: Obese patients generally present with an increased risk of difficult intubation. The head-elevated position has been shown to improve laryngeal view, reduce airway complications, and prolong safe apnea time during intubation as compared to the sniffing position.
Aims and Objectives: The aim of this study is to compare the head-elevated positions at 25° versus 45° for intubation in obese patients, in terms of ease of intubation assessed by first-attempt intubation success rate and laryngeal exposure using Cormack–Lehane grading and to assess intubation time, use of intubation aides, changes in hemodynamic parameters, and hypoxia.
Materials and Methods: In this randomized controlled trial, 100 consenting patients undergoing elective surgery requiring general anesthesia were selected who fulfilled the eligibility criteria and assigned to either of the two groups by block randomization: Group A – 25° or Group B – 45° head-elevated positions for intubation in a tertiary care hospital (February 2021–July 2022).
Results: The 45° head-elevated position was found to provide a better laryngeal exposure, the mean time to intubate was lesser and the first attempt success rate was also higher. Further, 45° head-elevated position is better chosen as per anesthesiologist comfort, using Likert scale grading.
Conclusion: This study concluded that 45° head-elevated position provides better ease of intubation in obese patients as compared to 25° head-elevation.
Utilization of blood and blood components in the department of clinical hematology of a tertiary care hospital: A prospective hospital-based study
Authors: Rubiya Ryhan  , Mohd Zubair Qureshi  , Fayaz Ahmad Bhat  , Rumana H Makhdoomi  , Reashma Roshan  , Afaq Ahmad Khan  , Sajad Ahmad Rather  , Kaneez Fatima
Published: January 2025

Background: To have proper utilization of blood and its components adherence to established guidelines is essential. Hence, periodic review of blood components is necessary to improve transfusion practices and decrease the inappropriateness of blood components.
Aims and Objectives: Our study aims to assess the utilization and appropriateness of blood and blood components in the Department of Clinical Hematology SKIMS, Soura, Srinagar.
Materials and Methods: This prospective observational study was conducted in the Department of Blood Transfusion and Immunohematology, SKIMS, Soura, Srinagar, over a period of 1 year from August 2020 to July 2021 on patients admitted in Clinical Hematology requiring transfusion therapy. The number of all blood and blood component units supplied over a period of 1 year was assessed. The usage of different types of blood component was recorded and correlated with the patient’s diagnosis and indications for transfusion.
Results: A total of 250 patients were transfused with 2099 blood and blood components, among them 64.32% (1350) units were used appropriately and 35.68% (749) units were used inappropriately. Transfusions of packed red blood cells were found to be inappropriate in patients with asymptomatic chronic anemia with Hemoglobin >7 g/dL. Fresh frozen plasma was given inappropriately in cases of bleeding without derangement of coagulation tests. Inappropriate use of platelets was seen in patients who had received platelets prophylactically with platelet count above 10,000/μL.
Conclusion: Proper implementation of guidelines for the use of various blood components would help reduce their inappropriateness.
Pattern of substance abuse among patients in a rehabilitation center
Authors: SangeethaLakshmi GNS  , Sowmini K  , Geervani Arige  , Bharathi Uppu
Published: January 2025

Background: Substance use disorders have profound implications for individuals, their families, and society as a whole. At present, drug trafficking and addiction have ensnared every corner of the globe, impacting millions of individuals worldwide. This pressing issue of drug abuse is concerning due to the underlying conditions fueling it, including shifting cultural values, increasing economic stress, and weakened social support networks.
Aims and Objectives: This study aimed to identify the trends in drug abuse and its influencing factors among patients undergoing treatment for addiction in rehabilitation centers in Telangana.
Materials and Methods: The study, a descriptive cross-sectional analysis, involved 222 individuals grappling with drug addiction at the primary rehabilitation center for drug addiction treatment in Telangana. Information was gathered using a pre-tested, structured questionnaire between September and December 2022 under the Department of Pharmacology.
Results: Among the respondents, 95% were male and 5% were female, with a majority falling in the 21–30 age brackets. The religious breakdown comprised 151 Hindus, 32 Muslims, and 30 Christians, while 41% hailed from tribal regions. Injection emerged as the most prevalent method of substance abuse among 194 participants. The onset of drug abuse mostly occurred between ages 11 and 20, primarily driven by self or peer pressure. Notably, 89% of participants reported being compelled to consume substances.
Conclusion: The study found a significant correlation between male gender and drug consumption (P<0.05), as well as between the 21 and 30 age group and drug intake (P<0.05). Additionally, the research highlighted a high prevalence of drug dependence among educated individuals, with familial conflicts and peer pressure being cited as common triggers for various forms of substance abuse.
Comparison of the effect of intrathecal fentanyl citrate and magnesium sulfate as adjuvants to hyperbaric levobupivacaine 0.5% for spinal anesthesia in patients undergoing lower limb orthopedic surgeries
Authors: Tripathy Anusha , Tandon Neelima , Jain Namrata , Singh Devendra
Published: January 2025

Background: Subarachnoid blockade is a safe, reliable, and inexpensive technique that provides surgical anesthesia along with prolonged post-operative analgesia. The quality of subarachnoid block is enhanced by the addition of intrathecal adjuvants, such as fentanyl citrate and magnesium sulfate to hyperbaric levobupivacaine.
Aims and Objectives: The aim of this study was to compare the effects of fentanyl and magnesium sulfate as adjuvants to 0.5% hyperbaric levobupivacaine in orthopedic surgeries under subarachnoid block.
Materials and Methods: This prospective randomized study included 90 American Society of Anesthesiologists Grade I and II patients aged 18–60 years undergoing orthopedic surgeries. Group LS received 3 mL 0.5% levobupivacaine heavy+0.5 mL normal saline. Group LF received 3 mL 0.5% levobupivacaine heavy+fentanyl 25 μg, and Group LM, 3 mL 0.5% levobupivacaine heavy+magnesium sulphate 50 mg+0.4 mL normal saline. The onset and duration of sensory and motor block and intraoperative hemodynamics were recorded. In the post-operative period, duration of analgesia, Visual Analog Scales scores, and side effects were observed.
Results: The onset of sensory block was 4.04±0.74 min in Group LM (P<0.001) as compared to Groups LF (2.01±0.23 min) and LS (2±0.24 min). The onset of motor blockade took 5±1.14 min in the control group, 7.01±0.94 in group LF, and 8.11±1.33 min in group LM (P<0.001). The duration of analgesia in group LS was 183.73±12.08 min, 317±18.6 min in group LF, and 219.43±20.89 in group LM (P<0.001).
Conclusion: The addition of fentanyl and magnesium as adjuvants enhanced the quality of subarachnoid block when added to hyperbaric levobupivacaine. The duration of analgesia was longest in fentanyl, followed by magnesium and then control. The incidence of side effects was greatest in fentanyl, followed by control and nil in magnesium.
Clinical profile and risk factors of patients presenting with acute myocardial infarction at RIMS, Imphal
Authors: Medo M Kuotsu  , Dhanaraj Singh Chongtham  , Nyamnyei Konyak  , Lourembam Gayatri  , Bijoy M
Published: January 2025

Background: Cardiovascular diseases are the leading cause of mortality in India. Ischemic heart disease is a result of an inadequate supply of blood to a portion of the myocardium caused by atherosclerotic disease of an epicardial coronary artery. The increasing incidence of myocardial infarction (MI) and associated mortality is a concern.
Aims and Objectives: The aims and objectives of the study were to evaluate the clinical profile and determine the association of risk factors in patients presenting with acute MI. The study highlights the trend of occurrence of acute MI so as appropriate measures can be taken to mitigate the incidence of coronary artery disease (CAD).
Materials and Methods: A cross-sectional study was conducted among 100 patients with acute MI admitted to the intensive coronary care unit and medicine wards of a tertiary center in North-East India. The study was carried out for a period of 2 years from September 2019 to August 2021.
Results: The mean age of the study population was 63.13±10.47 years, with an age range from 41 to 90 years. The study population had 75% males and 25% females. The most common presenting symptom was chest pain in 96% of patients. Hypertension in 75% of patients was the most common risk factor studied. About 97% of patients had at least one cardinal risk factor for MI. Inferior wall MI in 47% of patients was the most common site of MI. The highest mortality was seen in those who presented with Killip Class IV.
Conclusions: Increasing age and male gender predisposed to MI. The association of risk factors such as hypertension, diabetes, obesity, and family history was higher in females. To bring about a reduction in the risk of CAD, emphasis should be laid on the adoption of a healthy lifestyle particularly for those at risk of CAD.
Comparison of acromio-axillo-suprasternal notch index with thyromental height test to predict difficult visualization of larynx
Authors: Nandini CV  , Mohan Kumar KS  , Deeksha BG  , Santosh Kumar  , Harsoor SS
Published: January 2025

Background: Securing and maintaining a patent airway for the conduct of general anesthesia are a major concern for an anesthesiologist. Unanticipated difficult intubation in anesthetized patients is the main cause of morbidity or mortality. Several predictors are proposed to anticipate difficult tracheal intubation, but no predictor is found to be 100% accurate. Acromio-axillo-suprasternal notch index (AASI) is a recent addition to the list of predictors.
Aims and Objectives: The current study compared the usefulness of AASI and thyromental height test (TMHT) as predictors of difficult visualization of larynx (DVL).
Materials and Methods: Following approval by the Institutional Ethics Committee and CTRI registration, written informed consent was taken. The study was conducted on 300 patients aged 18–65 years belonging to American Society of Anesthesiologists’ physical status I and II, with modified Mallampati (MMP) Scores of 1 and 2, over a period of 6 months. Preoperatively all patient’s airway was evaluated using AASI and TMHT. The DVL during direct laryngoscopy was noted as assessed by Cormack and Lehane grading. We compared the sensitivity and specificity for DVL with regard to AASI and TMHT.
Results: The incidence of unanticipated DVL was 14%. The sensitivity, specificity, positive predictive value, and negative predictive value of AASI were 86.4%, 38.1%, 89.6%, and 31.4%, respectively, and for TMHT, they were 94.6%, 4.8%, 85.9%, and 12.5%, respectively. Pearson correlation coefficient was r = −0.068 (P=0.243) when AASI was compared with TMHT.
Conclusion: AASI was found to be less sensitive when compared to TMHT and there was statistically no significant correlation between the two parameters to predict the DVL.
A comparative study to evaluate the efficacy of cisatracurium and rocuronium for endotracheal intubation in pediatric patients: A prospective randomized study
Authors: Deepak R  , Seema Shende  , Namrata Jain  , Sanyukta Paul
Published: January 2025

Background: Cisatracurium and rocuronium are non-depolarizing neuromuscular blockers with an intermediate duration of action and are used safely in short and intermediate-duration surgical procedures in the pediatric population.
Aims and Objectives: A prospective randomized study is to assess the efficacy of cisatracurium compared to rocuronium in terms of intubating conditions, clinical duration of action, hemodynamic parameters, and side effects in pediatric patients undergoing surgeries under general anesthesia.
Materials and Methods: In this study, 50 patients aged 2–12 years with the American Society of Anesthesiologists grades I and II were randomly allocated into two groups: Group I received injection cisatracurium 0.15 mg/kg IV and Group II received injection rocuronium 0.6 mg/kg IV for intubation. Intubating conditions by Cooper et al., score, TOF count, hemodynamic parameters, signs of histamine release, and complications if any were noted.
Results: According to the Cooper et al., score, intubating conditions were excellent in 100% of patients in Group II and 84% of patients in Group I, which was statistically significant. The time required for the first maintenance dose was shorter in Group II (14.04±2.95 min) compared to Group I (20.08±3.68 min). Hemodynamic parameters and demographic profiles were comparable between the two groups. No associated signs of histamine release or any other complications were noted in either group.
Conclusion: We concluded that rocuronium 0.6 mg/kg provides better intubating conditions and a shorter duration of action compared to cisatracurium 0.15 mg/kg without any signs of histamine release in pediatric patients.
Immunohistochemical expression of CD44 in invasive breast carcinoma
Authors: Kapil Kumar Swami  , Renuka Verma  , Sunita Singh  , Sanjay Marwah  , Rachana Yadav  , Pooja Rathee  , Vibhuti Thukral
Published: January 2025

Background: In India, breast cancer forms the most common malignancy, accounting for 28.2% of all female cancers. Breast cancer consists of phenotypically diverse group of diseases. Due to different relapse abilities, doubling times, and different infiltrative capacities, it is important to identify potential biomarkers that could be used to screen high-risk patient and predict breast cancer prognosis in conjunction with classical pathological parameters.
Aims and Objectives: The present study was conducted to evaluate immunohistochemical expression of CD44 in breast carcinoma and to correlate CD44 expression with other clinicopathological parameters and molecular classification of carcinoma breast.
Materials and Methods: The present study was a prospective descriptive study conducted on 100 cases of carcinoma breast diagnosed on modified radical mastectomy specimens that were submitted to the Department of Pathology, Pt. B. D. Sharma, PGIMS, Rohtak, Haryana, over the period of 2 years.
Results: Out of 100, 64 cases (64%) were CD44 positive. Out of these 64 cases, 9 (9%) cases were 1+, 34 (34%) cases were 2+, and 21 (21%) cases showed 3+ positive expression of CD44 in tumor cells. Loss of CD44 expression was seen in 36 (36%) cases. A statistically significant association of CD44 was seen with multifocality of the tumor, negative estrogen receptor/progesterone receptor (ER/PR) expression, and molecular subtypes. No statistically significant association of CD44 was seen with age, side of tumor, lymph node metastasis, lymphovascular invasion, ductal carcinoma in situ and Ki67, and HER2neu expression.
Conclusion: A high CD44 expression in breast carcinoma correlates with aggressive tumor characteristics such as multifocality, negative ER/PR expression, and belonging to the basal subtype which is associated with poor prognosis. Conversely, low CD44 expression is linked to Luminal A and Luminal B subtypes which have good prognosis. These indicate the role of CD44 as a prognostic biomarker in the carcinoma breast.
Ethanolic Leaf Extract of Psidium Guajava L. [Myrtaceae] Protects the Stomach against Ischemia-Reperfusion Induced Gastric Mucosal Injury
Authors: Yusuf Sadiq , Abdulkareem Agunu  , Nna Venessa Katung  , Uduak Umana
Published: January 2025

Objective: Decoction of the root, bark or leaves of Psidium guajava universally known guava has a long history of dietary and medicinal uses in Africa. This study was designed to investigate the gastric secretory and protective properties of leaf extract of guava on ischemia-reperfusion (I-R) induced gastric mucosal injury in rats.
Methods: Male Wistar rats (n = 40) were divided in eight groups. Group 1 served as control group, group 2 animals were subjected to I-R without treatment, groups 3, 4, 5 and 7 were pretreated with 25, 50, 100 mg/kg of the extract orally 10 mg/kg indomethacin intraperitoneally [i.p.] 30 min before I-R respectively. Group 6 animals were pretreated with indomethacin [10mg/kg, i.p.] without I-R while group 8 animals were administered with 100mg/kg guava extract 30   minutes before administration of indomethacin [10mg/kg, i. p.] and subjected to I-R. Extent of mucosal damage was assessed by calculating the ulcer index while adherent mucus was determined by the Alcian Blue method.
Results: The results obtained indicated that oral pretreatment of rats with extract of guava leaves significantly reduced and reversed I-R induced mucosal injury (P < 0.001), reduced gastric acid and adherent mucus on the gastric mucosa (P < 0.05) respectively. Indomethacin aggravated the mucosal injury induced by I-R which was reversed by 100 mg/kg extract of guava.
Conclusion: In conclusion, the stimulation of mucus secretion by guava extract may be responsible for its gastro-protective properties against I-R induced mucosal injury.
Keywords: guava extract; gastric mucosa; ischemia-reperfusion; indomethacin; Psidium guajava
DOI: 10.3126/ajms.v1i1.2452
Asian Journal of Medical Sciences Vol.1(1) 2010 p.1-3
Factors Associated with Nutritional Status of the Under Five Children
Authors: Amita Pradhan
Published: January 2025

Objective: To identify factors associated to the nutritional status of under five children.
Method: The data used in this analysis are from Demographic and Health Survey 2006 conducted in Nepal. Total 5262 cases are included in the present study. A multinomial logistic regression model is used to study the relation between various factors and nutritional status.
Results: Increasing body mass index of mothers and wealth index shows decreasing likelihood of malnutrition among children. Rural children show insignificant higher likelihood of different forms of underweight and wasting as compared to urban area. Frequency of listening radio does not show significant association in case of mild and moderate wasting and shown very high unusual odds ratio in case of severe wasting.  Similarly, lower frequency of watching television also does not show significantly higher likeliness of different form of stunting, underweight and wasting. Female children are more likely to be stunted, underweight and wasted as compared to male. Female headed households are more likely to have moderately and mildly stunted children and mixed results are observed for underweight and wasting. The likelihood for all forms of malnutrition is higher among children with smaller than average size at birth as compared to average or bigger size at birth.  Mixed results are observed regarding likelihood of different forms of malnutrition among children with mothers having different educational level.
Conclusion: Body mass index of mothers is found significant variable while explaining children's nutritional status. Similarly, Size at birth is significantly associated with nutrition during the childhood.
Keywords: Stunting; wasting; under weight; under five children
DOI: 10.3126/ajms.v1i1.2927Asian Journal of Medical Sciences Vol.1(1) 2010 p.6-8
Hepato-protective Potential of Hull Fraction from Indian Flaxseed Cultivar
Authors: J Rajesha  , A Ranga Rao  , M Karuna Kumar  , GA Ravishankar
Published: January 2025

Objective: Secoisolariciresinol diglucoside (SDG) isolated from hull fraction of Indian flaxseed cultivar was studied for its hepatoprotective potential by measuring the level of hepatic enzymes such as catalase, peroxidase and superoxide desmutase (SOD) upon feeding to albino rats. Material & Methods: The animals were grouped into five groups (n=5): The first group served as normal and received normal diet without treatment of toxin and hull fraction of flaxseed. The second group was named the control and received a regular commercial diet. The third, fourth and fifth groups were fed with normal diet and supplemented with hull fraction of flaxseed (150 and 250 μg/kg) and standard SDG (150 μg/kg), that was mixed with olive oil for 14 days. Results: Pretreatment of rats with 150 μg/kg b.w hull fraction of flaxseed followed by CCl4 treatment caused restoration of catalase, SOD and peroxidase by 37.70%, 108.22% and 23.89% respectively as compared to control. The group treated with 250 μg/kg b.w hull fraction of flaxseed showed the restoration of 67.30%, 152.82% and 39.88% of catalase, SOD and peroxidase, respectively. Conclusion: In conclusion, SDG fed in the form of flaxseed hull is responsible for its hepatoprotective properties. Further, it can be used as a potential source of nutraceutical agent and studies are required in this field to examine its use in large scale for food and feed industries.
Keywords: Flaxseed; hull fraction; SDG; antioxidant enzymes
DOI: 10.3126/ajms.v1i2.2938Asian Journal of Medical Sciences 1 (2010) 20-25
Deleterious Effects of Ethanol on Hematological Parameters and Fertility in Albino Rats
Authors: OA Osonuga  , OI Osonuga  , AA Osonuga
Published: January 2025

Objective: Hematological disorders including anaemia are prevalent in alcoholics. The study was an attempt to find out the toxic effects of ethanol on blood values and semen parameters of albino rats. Material & Methods: 15 male albino rats with body weight (bwt) of 190 – 220 gm were used for the 2-phase study. 25% ethanol was administered via oral cannula to a group of 5 male rats each at daily dose of 0.6ml/200gm bwt respec-tively for 3 days during phase I. Phase II was a recovery study involving 5 male rats exposed to dose regimen as in phase I, and sacrificed after 3-day withdrawal of treatment. The control group of 5 male rats was given sterile water ad-libitum. Each animal was weighed before sacrifice to obtain difference in bwt relative to its basal value. Blood samples were collected by cardio-puncture from the rats for hematology and serum testosterone at the end of each phase. Semen parameters were determined and compared with controls. Results: Ethanol caused significant reduction (P< 0.05) in the hematological profile as well as in the serum testoster-one and semen parameters of the animals. Discontinuation of the drug use however showed gradual recovery of the depressed indices of the semen, serum testosterone and blood parameters. Conclusion: The ethanol could induce reversible changes in hematological profiles and semen parameters of rats, and by extension man. Hence, the study supported the use of alcohol with caution especially in infertile men and those prone to anemic tendencies. Key Words: Albino rats; ethanol; semen parameters; hematology DOI: 10.3126/ajms.v1i2.3350Asian Journal of Medical Sciences 1 (2010) 37-40
Cephalic Index: A Fetal Gestational Age Dependent Biometric Parameter
Authors: Emmanuel stephen mador  , HY Goncim  , IC Pam  , JT Mutihir  , GI Adoga  , JO Ogunranti
Published: January 2025

Objective: There is limited data on fetal cranial dimensions of Nigerian population. This is important because the study of normal and abnormal growth of children has become an increasingly important part of the practice and research in all fields related to child health; more so that prenatal and postnatal growth is one continuous process. Material & Methods: In a cross-sectional study conducted on 13,740 Nigerian fetuses ranging from 12 weeks to 42 weeks at the Centre for Reproductive Health Research Jos; biparietal diameter and occipitofrontal diameter were measured using ultrasound machine in order to calculate fetal cephalic index. The values were statistically analyzed after deriving the relevant indices. Results: The regression equation was calculated between gestational age and cephalic index of fetuses of Nigerian women. This equation y = 1.3x + 59.88; showed a linear relationship which was stronger from 12 to 16 weeks of gestation. Above 16 weeks gestation, the relationship was found to be quite weak. Coefficient of correlation is r2 = 0.9844 (p < 0.0001). Conclusion: The fetal skulls were found to be mesocephalic in the early weeks and brachycephalic at term. Key Words: Cranial dimensions; Cephalic index; Brachycephalic DOI: 10.3126/ajms.v1i2.3145Asian Journal of Medical Sciences 1 (2010) 45-48
Management of the Medically Compromised Cases in Orthodontic Practice
Authors: Gowri Sankar Singaraju  , Venkataramana Vannala  , Raja Sigamani K  , Kolasani Srinivasa Rao  , Irfan Adil
Published: January 2025

Orthodontic therapy is no longer restricted only for healthy patients. With the better management of serious medical problems and increased quality of life expectations, medically compromised individuals are now regular visitors to the orthodontic clinics in every part of the world. As such, there is no absolute contraindication of orthodontic treatment in most of these conditions. A slight modification of the normal orthodontic treatment protocol is obligatory in such patients according to their medical condition. This article reviews and suggests the orthodontic treatment protocol for some common medical conditions. Key Words: Medically Compromised; Orthodontic patients; Treatment protocol DOI: 10.3126/ajms.v1i2.2937Asian Journal of Medical Sciences 1 (2010) 68-74