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   Table of Contents - Current issue
September-December 2018
Volume 45 | Issue 3
Page Nos. 111-154

Online since Friday, June 28, 2019

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Audio-visual consent process in clinical research p. 111
Jayaprakash S Appajigol
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Laparoscopic-assisted percutaneous nephrolithotomy in ectopic kidney p. 113
Shreyas Bhadranavar, RB Nerli, Shridhar C Ghagane, Murigendra B Hiremath
Renal calculi pose challenges to the health of a person with a normal anatomically positioned kidney. If renal stones occur in a pelvic ectopic kidney, then the health risk it poses is even higher and challenging for urologists. Various approaches have been suggested for the treatment of diverse forms of kidney stones and grounded on the stone distribution and location. The elimination rate of those kidney stones depends principally on the size of the stones, position, and the success of prior attempts. In patients with ectopic kidneys, laparoscopic-assisted percutaneous nephrolithotomy (PCNL) is an option. In this paper, we have reviewed the findings from various studies and have arrived at the same conclusion that PCNL is safe and effective in managing pelvic renal kidney stones when it is done alongside laparoscopy.
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Study of “Discard Rate” of Whole Human Blood: Useful Blood Center Quality Indicator p. 116
Gopeswar Mukherjee, Sandipan Ghosh, Sumitra Halder, Subrata Mondal
Background: Blood is a valuable, life-saving material which should not be discarded or wasted to have the required blood supply to the patients. Aims and Objectives: The aim of the present study is to find out the major causes of blood discard from the blood center so that preventive strategies can be undertaken by proper training of blood center personnel, awareness of blood donor motivators. Materials and Methods: In this study, the number of discarded blood units and the total number of units collected have been taken from blood center registers for each year and then the discard rate has been calculated. Results: Discard rate has been found more in this study due to transfusion transmissible infections positive cases in comparison to discard due to insufficient quantity. No discard due to other causes recorded in the Blood Centre Registers. Conclusion: From this study, it is concluded that proper screening of blood donors by proper medical examination and donor counseling are very important in this connection. Moreover, proper training of the blood center personnel and blood donor motivators are equally important.
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A survey of antibiotics dispensing pattern in a community pharmacy of Pune city p. 119
Akshay V Mule, Mayur Champalal Sharma, Akhila Raghunath, Prasanna R Deshpande
Background: A community pharmacist is generally involved in the activities such as dispensing of drugs and medication aids, billing, patient counseling, and provision of pharmaceutical care. Even though there is huge scope to conduct research about all these aspects in India, community pharmacy-based research is found very rarely in literature. Aim: This study aims to assess dispensing pattern and economic aspects of antibiotics in a community pharmacy on an outpatient basis. Materials and Methods: A prospective, observational study was conducted in a community pharmacy of Pune city on outpatient basis. Patient demographics and antibiotics details with cost were obtained in a log book. Various average values and defined daily doses (DDD) were determined. Chi-square test was used to determine the association between different parameters. Results: A total of 460 patients were involved in the study. Important findings were average total cost of antibiotics – INR 61.42, highest total DDD – azithromycin (107.83 g), and highest antibiotic dispensed – amoxicillin + clavulanic acid (22.61%). The parameters, prescriber and duration, age and frequency, and prescriber and frequency showed statistically significant association (P < 0.05). Conclusion: This was one of the rare studies conducted in a community pharmacy setup on outpatient basis. Further studies are needed for better understanding and documentation of the data.
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Effect of ondansetron in the prevention of spinal anesthesia-induced hypotension p. 125
K Raghu, Shishir Kumar, G Rajaram, N Nikhil, P Damodar
Background and Aims: Hypotension and bradycardia are the common side effects seen after spinal anesthesia. Multiple strategies are tested to prevent the postspinal anesthesia-induced hypotension. Recently, Ondansetron, a 5-HT3 antagonist commonly used as an antiemetic was found to be effective in preventing spinal anesthesia-induced hypotension. The aim of this study is to evaluate the effect of ondansetron in the prevention of spinal anesthesia-induced hypotension. Materials and Methods: A prospective, randomized, and double-blind study was conducted on 110 elderly patients, aged 50–70 years, of the American Society of Anesthesiologists Grade I or II category, scheduled for various surgeries under spinal anesthesia. The patients were randomly divided into two groups of 55 each to receive either ondansetron 8 mg (Group A) or saline (Group B) before spinal anesthesia. The primary outcome of the study was the incidence of hypotension (systolic blood pressure <100 mm Hg or fall >20% in the baseline values). Secondary outcomes, such as the requirement of ephedrine, the incidence of bradycardia, nausea, and vomiting were also recorded during the study. Results: Group A and Group B were comparable with respect to age, sex, height, and weight. Thirty-four patients in Group B (60.7%) and 22 patients in Group A developed hypotension (39.3%) (P = 0.0359) [Table 1]. The use of ephedrine was greater in Group B than that of Group A (mean 4.61 ± 1.80 vs. 3.45 ± 1.09, P = 0.0107). Thirteen patients in Group B and four patients in Group A had bradycardia (P = 0.0176). Nine patients in Group B and two patients in Group A had vomiting (P = 0.0261). Conclusion: We conclude that prophylactic administration of ondansetron is effective in reducing the incidence of spinal anesthesia-induced hypotension.
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Maternal predictors of low birth weights: Audit of data of delivery room register at a Tertiary Health Center of Sub-Himalayan Region p. 129
Manoj Kumar Gandhi, Mitasha Singh, Piyush Sharma, Ankush Kaushal, Chander Deep Sharma, Sunil Kumar Raina
Background: Birth weight is an indicator of social and economic development of any country. It predicts the status of women of country and the resources invested in them so that they deliver healthy child. The proportion of low birth weight (LBW) has reduced in India in the past few decades; however, we have still a long way to go. Objective: We aimed to conduct an audit of retrospective data from the records of labor room of a Tertiary Care Center of Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh. Methodology: A retrospective data mining of records of the labor room wards (delivery rooms) was conducted from January to June 2016 at Tertiary Care Center of Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh. LBW was our outcome of interest. Results: Out of the total 3738 deliveries conducted, 1251 (33.46%) of babies born were LBW, and there were 100 intrauterine deaths and 12 stillbirths with a total of 112 (2.9%) deaths. Age, height of mother, backward caste, history of pregnancy-induced hypertension, preterm delivery, one living child of mother, multiple fetuses, and cesarean section in current pregnancy were significant predictors after controlling for confounders. Conclusion: The higher proportion of LBW in tertiary center as compared to state-level data shows that secondary prevention in the form of early identification of high-risk cases, and timely referral to higher centers is functioning well in this part of the country. However, the community-based primary prevention efforts are still given a low preference.
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Lamina Papyracea Breach: Brunt of Amateur Kabaddi p. 136
Basavaraj P Belaldavar, JS Tejaswini, Paramita Debnath
The game of Kabaddi requires offensive and defensive skills that include consideration of the raid, taking cant and entry, tracing the path, footwork, attacking tactics, and returning back which makes the players prone to many types of sports-related injuries. It being a contact game many body parts are prone to injuries in which isolated orbital fractures are uncommon. Orbital emphysema is a clinical situation in which air gets trapped in the orbital adnexa. This happens invariably secondary to orbital blunt trauma where there is a breach of lamina papyracea which is well documented but has not merited much attention.
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Chemotherapy in a patient with advanced carcinoma of the bladder with renal insufficiency p. 139
RB Nerli, Shridhar C Ghagane, Abhijit Musale, Sushant Deole, Shyam Mohan, Neeraj S Dixit, Murigendra B Hiremath
A large proportion of patients with high-risk bladder cancer also have renal insufficiency. These patients are not fit enough to receive cisplatin-based chemotherapy based on impaired renal function. This finding is most strikingly seen in the elderly population. We report a case of an elderly male presenting with advanced carcinoma of the bladder and renal dysfunction.
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Granular cell tumor of urinary bladder in adult female: A rare case report p. 143
Ajay Kumar Guntaka, Kalyan Koti, BSR Prasad Babu, Anil Kumar Mutyala, Sindhuri Avuthu
A 47-year-old female presented with dysuria and vague discomfort in the suprapubic region that had lasted for the previous 3 months. On evaluation, ultrasonography kidney-ureter-bladder (KUB) and computerized tomographic scan KUB revealed a nodular growth noted in the urinary bladder measuring 2 cm × 2 cm. Urine cytology was negative for malignant cells. Cystoscopy showed a nodular tumor approximately 2 cm × 2 cm in diameter that was located supratrigonal and extended to the posterior wall of the bladder. The patient underwent transurethral resection of the tumor. Histological examination and immunohistochemical staining showed a granular cell tumor (GCT). There were no features suggesting a malignant phenotype. On follow-up, the patient has remained free of bladder recurrence. We herein report this rare case of a GCT of the urinary bladder and review the literature.
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Adenosquamous carcinoma of hard palate: A report of rare entity p. 147
R Dibin, Sibi Joseph, T Muhammad Ali, PK Alshakhir
Adenosquamous carcinoma of the head and neck (ADSC) is a rare and aggressive variant of squamous cell carcinoma (SCC), a locally aggressive malignancy characterized by the presence of two distinct components: A SCC and an adenocarcinoma. The purpose of this study was to report an additional rare case of adenosquamous carcinoma affecting the maxilla.
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Whose responsibility is to check plagiarism? p. 151
Himel Mondal, Shaikat Mondal
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Strengthening of the vector control measures on a global scale: World Health Organization p. 153
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
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