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   Table of Contents - Current issue
Coverpage
September-December 2019
Volume 46 | Issue 3
Page Nos. 73-114

Online since Tuesday, January 28, 2020

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EDITORIAL  

Cinemeducation: Using films to teach medical students Highly accessed article p. 73
Deepti Mohan Kadeangadi, Shivaswamy Shivamallappa Mudigunda
DOI:10.4103/jss.JSS_1_20  
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REVIEW ARTICLE Top

Medicalization – A growing problem Highly accessed article p. 75
Sajid Hameed
DOI:10.4103/jss.JSS_3_19  
Medicalization is the latest growing trend of our modern society. The Western scholars have debated for decades about its merits and demerits. Medical profession has always been blamed for the medicalization, but there are also other factors that contribute to this process. The commercialism, mass media misinformation, and our own impatience are some of the factors that contribute to our excess dependence on the medical profession to solve our problems. Being an underdeveloped country, our resources are limited, and diverting them to less serious conditions will create a big vacuum to fill. It is high time to deeply discuss its origin and propose a solution. Medicalization needs periodic checking; otherwise, excessive medicines will paralyze our society.
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ORIGINAL ARTICLES Top

Epidemiological determinants of road traffic accidents in a largely rural hilly population p. 79
Bhanu Awasthi, Sunil Kumar Raina, Lucky Verma
DOI:10.4103/jss.JSS_38_19  
Background: Although Himachal Pradesh contributes less in terms of total number of road traffic accidents (RTAs), the RTA is of huge concern in terms of accident rate per thousand vehicles registered in this Hill state. In terms of death due to RTA/100,000 population Himachal Pradesh ranks in top ten states while in terms of number of persons killed/10,000 vehicle Himachal Pradesh ranks fourth. In view of these facts, it was planned to identify the epidemiological determinants (in terms of person, place, and time) of RTA in a largely rural and hilly population. Material and Methods: The study was conducted among patients of RTAs of all age groups, presenting to a tertiary care center in a rural area of Himachal Pradesh between 2014 and 2015. The epidemiological determinants were identified after collecting information on a structured per forma specially designed for the purpose. Results: A total of 313 patients of RTA were included in the study. The epidemiological determinants were classified as person, place, and time profiles. Under each profile-specific determinants were analyzed. Age, sex, occupation, day, and time of the accident were identified as important determinants. Conclusion: Despite contributing less to the total RTA burden across India, Himachal Pradesh is fast emerging as a state with far reaching consequences of increase in vehicular traffic.
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Analysis of predonation deferral of blood donors in a tertiary care hospital p. 86
Sonal Hemanth Kumar, S Sudhamani, Prakash Roplekar
DOI:10.4103/jss.JSS_40_19  
Background: Transfusion medicine forms an important part of healthcare practice. Healthy blood donors are the starting point for blood transfusion safety. Blood donors can be rejected for various reasons, either temporary or permanent. To ensure safety and good quality of blood donation, donor selection becomes an important criterion for the safety of both the donor and recipient. Therefore, it is important to study the pattern of deferrals, to reduce unnecessary deferrals, and to encourage blood donation. Objectives: The objective was to study and analyze various causes of deferral of blood donors and to categorize donors according to the type of deferrals, age, and gender. Materials and Methods: This was a retrospective analysis carried out at a tertiary hospital for 3 years. Details of their age, gender, and physical and laboratory tests were recorded as per the standard protocol. Results were then statistically analyzed with emphasis to know the causes of deferral. Results: A total of 1522 (13.1%) out of 11,665 donors were rejected. Among them, 638 were men (41.9%) and 884 were women (58.1%) with a female-to-male ratio of 1.4:1. Majority donors belonged to the age group of 18–30 years (65.5%). The most common reason for temporary deferral was low hemoglobin (54.6%) while that of permanent deferral was hypertension (4.1%). Conclusion: This study emphasized the need for better nutrition to improve the hemoglobin level which was the most common cause for temporary deferral and increased awareness to decrease the other causes of deferrals of blood donors.
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Persistence and appearance of vesicoureteral reflux/obstruction following open reimplantation for vesicoureteral reflux p. 90
RB Nerli, Sanjay Vijay Pujar, Shridhar C Ghagane, Murigendra B Hiremath, Neeraj S Dixit
DOI:10.4103/jss.JSS_18_19  
Introduction: Appearance or persistence of vesicoureteral reflux (VUR) and other obstructive complications after open reimplantation of ureters is well known and up to 7.5% of cases require reoperation. In this study, we have assessed children presenting with recurrent urinary tract infection (UTI) following open reimplantation for VUR. Materials and Methods: We retrospectively collected hospital data of 14 children referred to us for management of recurrent UTIs following open ureteric reimplantation for vesicoureteric reflux from January 2006 to December 2015. Results: Fourteen children presented to our center at a mean age of 31.85 ± 10.17 months. The mean serum creatinine was 0.77 ± 0.26 mg% (range 0.5–1.3). Urine culture was positive in all with Escherichia coli being the most common organism grown on culture. Two children had obstruction at the vesicoureteric junction, and the remaining twelve children had 14 ureteral units with VUR. Two children underwent reimplantation into Boari flap, five underwent open reimplantation, and the remaining seven underwent endoscopic Deflux injection. Repeat voiding cystourethrogram done within 1 year of surgery revealed no VUR in any child. Conclusions: Appearance or persistence of VUR and obstructive complications after open reimplantation surgery is a matter of great concern for the parents of these children as well as the treating pediatric urologists. Appropriately selected open/endoscopic treatment can help in resolving these complications.
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Histopathological study of endometrium in abnormal uterine bleeding in perimenopausal and postmenopausal women p. 95
Ritika Bhat, S Sudhamani, Prakash Roplekar
DOI:10.4103/jss.JSS_39_19  
Background: Abnormal uterine bleeding (AUB) is defined as any change in the frequency of menstruation, duration of flow, or amount of blood loss. Histopathological study of endometrium gives valuable information to arrive at correct diagnosis. Objective: The study was aimed to detect the frequency of various pathological conditions which can cause AUB in perimenopausal and postmenopausal women and to know the distribution of functional changes as well as malignancy causing AUB. Materials and Methods: This is a retrospective study on 200 patients of perimenopausal and postmenopausal women who presented with AUB from May 2016 to May 2018 (2 years), selected on the basis of simple random sampling. Histopathological study was done on the specimens for diagnostic and therapeutic purposes. Histomorphological details were recorded as per standard pro forma along with clinical and other details and entered on a master chart. A statistical analysis was done to record the frequency of distribution and mean of various parameters. Results: Out of 200 cases, the most common histopathological finding was proliferative phase in 65 cases (42.4%), followed by disordered proliferation in 46 cases (30%). Primary endometrioid adenocarcinoma comprised only 6 cases (3%). Conclusion: The most common endometrial pathology found in our study was functional endometrial changes, and the occurrence of malignancy increased with the increasing age of patients.
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CASE REPORTS Top

A case of relapsing and remitting ptosis p. 99
Radhakrishna Hari, Bimal Prasad Padhy, Harin M V Reddy
DOI:10.4103/jss.JSS_34_19  
Hypertrophic pachymeningitis is a chronic inflammation of the duramater. Idiopathic intracranial pachymeningitis is a rare disease, diagnosed after exclusion of all other possible etiologies like infections, non-infectious inflammatory diseases, malignancy and others. It needs confirmation by meningeal biopsy as the treatment includes prolonged course of immunosuppressant drugs. One such patient is described in this article where the diagnosis eluded for nearly ten years and the patient had to approach different specialists. Ultimately histopathological conformation by meningeal biopsy resulted in identification and treatment.
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Accidental diagnosis of a foreign body embedded in maxillary anterior tooth p. 103
Deepak Khandelwal, Namita Kalra, Rishi Tyagi, Amit Khatri
DOI:10.4103/jss.JSS_29_19  
Accidental ingestion or aspiration of a variety of foreign bodies is a common pediatric emergency. A foreign body in the tooth, however, is rare. Retrieval of foreign objects from the teeth in children is a challenging aspect of pediatric dental practice. In most of the situations, the foreign objects are diagnosed in routine radiographs, which play a vital role in analyzing the location, size, and type of the foreign object. Removal of the foreign body is not very difficult if it is confined to the pulp chamber or root canal. This article describes two cases of foreign object embedded in the teeth, the possible etiology, and treatment.
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Invasive aspergillosis of tympanomastoid cavity p. 106
Santosh Kumar Swain, Priyanka Debta, Ajit Kumar Bishoyi, Rabindranath Padhy
DOI:10.4103/jss.JSS_41_19  
Invasive aspergillosis of the tympanomastoid cavity is an extremely rare clinical incidence in comparison to the invasive fungal infections of the paranasal sinus and other parts of the body. Delay in the diagnosis and treatment of this rare clinical entity often leads to fatal complications such as skull base osteomyelitis and progressive multiple cranial nerve palsies. The invasive aspergillosis of the tympanomastoid region should be considered as a differential diagnosis for atypical mastoiditis in immunocompromised patients. Here, we report a case of invasive aspergillosis of the tympanomastoid region in a 60-year-old diabetic patient with facial nerve palsy. The diagnosis was done by the demonstration of fungi in the tissue with Gomori methenamine silver staining and confirmed with molecular diagnosis. Surgical debridement of the tympanomastoid region was done along with long-term voriconazole therapy.
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SHORT COMMUNICATION Top

Strengthening measures to quit tobacco and control the tobacco epidemic globally: World Health Organization p. 110
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/jss.JSS_33_19  
Tobacco has been identified a major global public health concern and it has been a major factor affecting the growth and development of a nation. The findings of a recently released report have drawn our attention towards assisting people to quit tobacco, as it is a reality that the global targets cannot be achieved until the existing users decide to quit the same and are successful as well. Even though, many users have expressed their intention to quit, the ground reality is that a total of only 23 nations in today's date are offering a holistic package of services in this regard. In conclusion, despite the progress reported on the fight against tobacco, we are still short in many areas and thus there is an immense need to strengthen all the interventions, especially offering help to people to quit these deadly products.
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LETTERS TO EDITOR Top

Medical research in Bangladesh p. 112
Rajat Sanker Roy Biswas, Shaikh Md Hasan Mamun
DOI:10.4103/jss.JSS_11_19  
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Minimizing the number of newborn deaths in vulnerable sections of the community p. 114
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/jss.JSS_30_19  
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