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  Citation statistics : Table of Contents
   2017| September-December  | Volume 44 | Issue 3  
    Online since February 14, 2018

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Implementing the world health organization's package of essential noncommunicable disease interventions in primary care settings
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
September-December 2017, 44(3):165-166
  2 1,684 177
Estimation of serum malondialdehyde as a marker of lipid peroxidation in medical students undergoing examination-induced psychological stress
Jyotibala Banjare, Megha Salunke, Kavita Indapurkar, Umesh Ghate, Supriya Bhalerao
September-December 2017, 44(3):137-139
Background: When oxidant compounds target lipids, they can initiate the lipid peroxidation process, a chain reaction that produces multiple breakdown molecules, such as Malondialdehyde (MDA). Psychological stress is reported to induce enhancement of lipid peroxidation in the brain. Objective: The present study was therefore planned to evaluate whether there is increase in oxidative stress in medical students undergoing examination induced psychological stress. Materials and Method: Institutional Ethics Committee permission and seventy nine students of either sex between the age group 19 to 21 years. Students studying in first year of medical college were recruited in the study. All students signed the written informed consent before collecting blood samples. 5 ml of blood was collected from each student in a plain vaccutainer just before appearing for viva examination. Serum was separated immediately by centrifugation and MDA was estimated using (TBA) thiobarbituric acid method. Result: We observed that in 24 individuals lipid peroxidation was higher (>3 nmol/ml) than normal level (0-3 nmol/ml). The number of female students showing higher values of MDA was higher than male students with similar values of MDA (p<0.05). Conclusion: Our study thus highlights the relation between lipid peroxidation and psychological stress and also the sex wise difference in the stress levels.
  1 3,713 337
Clinicopathological profile of patients with non-hodgkin's lymphoma at a regional cancer center in Northeast India
Adhikarimayum Ambika Devi, Takhenchangbam Dhaneshor Sharma, Yengkhom Indibor Singh, Hage Sonia
September-December 2017, 44(3):140-144
Context: Incidence of non-Hodgkin's lymphoma (NHL) is increasing in all parts of the world, especially over the past few decades. An insight into the clinical presentation may help in the prevention, control, and treatment of NHL. Aim: To observe the clinicopathological patterns of NHL among patients in Northeast India. Subjects and Methods: A retrospective case study on 100 proven cases of NHL registered at the Regional Institute of Medical Sciences, Manipur, during the period January 2013–May 2017 was conducted, and data were reviewed and analyzed. Statistical Analysis Used: Data were analyzed using SPSS-21 and results were presented in percentages and simple frequency. Results: Majority (43.0%) of the patients were in the age group of 41 and 60 years. The mean age was 54.01 ± 18.1 years. Male:female ratio was 1.2:1. The most common presenting symptom was neck swelling (57.0%), and peripheral lymphadenopathy (76.0%) was the most common sign. Primary site distribution was nodal (57.0%) and extra-nodal NHL (43.0%). Most common nodal site involved was cervical lymph nodes (65.0%), and gastrointestinal tract (17.0%) was the most common extranodal subsite. Majority of the patients were in stage II (36.0%) at the time of diagnosis. B-cell NHL accounts for 66.0% compared to T-cell lymphoma (23.0%). Diffuse large B-cell lymphoma was the most frequent B-cell lymphoma (45.0%), and anaplastic large cell lymphoma was the most common T-cell variant (15.0%). Conclusions: A thorough insight into the clinical spectrum of NHL is necessary for optimum management and improved treatment outcome.
  1 3,719 359
Spectrum of the causes of lower gastrointestinal bleeding in geriatric patients in tertiary care hospital
Dnyanesh Nivruti Morkar, Santosh Hazare,
September-December 2017, 44(3):148-151
Context: Lower gastrointestinal bleeding (LGIB) patients in geriatric are the common indication of hospital admissions, with marked geographic variation in the frequency of different etiologies. Colonoscopy is considered as first-line diagnostic procedure of choice in evaluation of patients with bleeding per rectum. Aims: This study aims to determine spectrum of LGIB in our region using lower gastrointestinal (GI) endoscopy. Settings and Design: A retrospective study of 2-year period from August 2010 to July 2012, 2 years study in tertiary hospital. Subjects and Methods: The clinical data of patients admitted with per rectal bleeding were collected including age, sex, site of bleeding and the underlying cause. In all cases proctoscopy was done and colonoscopy after preparation and stabilization of the patients. Statistical Analysis Used: SPSS analysis. Results: During 2-year follow-up study, 45 patients were admitted with LGIB with mean age of 67.5 years, the bleeding site was in the colorectal causes found in 33 (73.3%) cases, while perianal in 6 (13.3%) of cases. Carcinoma was the most common cause. Conclusions: Bleeding per rectum is a common cause in geriatric patients admitted to Gastroenterology Department. Carcinoma is the most common cause of bleeding per rectum. There is wide geographic variation regarding the etiologies of LGIB. Lower GI endoscopy is very useful tool in evaluating patients with bleeding per rectum.
  1 2,498 217
Cultural practices related to postnatal care: A hospital-based study
Rekha Udgiri
September-December 2017, 44(3):152-155
Introduction: Culture is a learned behavior consisting of customs, beliefs, laws, religion etc acquired through generation, which has a profound influence on health and disease. Most of the cultural practice are based on centuries of keen observation, trial and error. These cultural practices and beliefs are not the same throughout India. with vast variations in language, food habits, dress, economics condition, tradition, beliefs. It has also absorbed, adopted and adapted outside cultures and influences, which have merged into Indian society. Not all customs and beliefs are harmful, some of them have positive values while others may be useless or positively harmful to mother health. Hence an understanding of various traditional postnatal care practices is therefore essential ,if effective behavior change strategies are to be developed and help the planners to formulate effective intervention strategies and provide timely assistance to the mothers. Therefore the present study is undertaken to know the cultural practices related postnatal care of mother in north Karnataka state. Objectives: (1) To explore the traditional belief and practices related to postnatal care. (2) To provide health education to all postnatal mothers regarding harmful practices. Methodology: Study design: cross sectional study. Study period; 2 months. Study population; All the postnatal mothers during the study period were included in study Sample size; Based on Hospital records and considering the frequency of delivery occurring in the BLDEU shri BMPMC,vijayapura ,a minimum of 200 postnatal mothers (purposive sampling)will be interviewed during the study period. Statisistical test; proportion, chi-square test.
  1 4,673 342
Primary ureterocalicostomy in a child: Operative steps
Rajendra B Nerli, K Shankar, Vishal Kadeli, Shridhar C Ghagane
September-December 2017, 44(3):158-160
Ureterocalicostomy completely excludes the renal pelvis and the stenotic ureteropelvic junction (UPJ) area and establishes urinary drainage from the lower calyx directly into the ureter. Technically, a successful ureterocalicostomy includes a generous spatulation of a healthy ureter, adequate excision of lower pole renal parenchyma, and a tension-free, precise, mucosa-to-mucosa uretero-caliceal anastomosis. We report a case of primary UPJ obstruction in a child with a small renal pelvis surrounded by multiple branches of renal vessels treated with primary ureterocalicostomy.
  - 2,067 137
Fluvoxamine-induced neuroleptic malignant syndrome
Adarsh Bellad, Vinayak Koparde, Sandeep Patil, Sameeran Chate
September-December 2017, 44(3):161-162
Neuroleptic malignant syndrome (NMS) is an uncommon but life-threatening idiosyncratic drug reaction that occurs following neuroleptic drug exposure. The estimated incidence of NMS is though very low, resulting mortality rates range between 4% and 30%. There is increasing evidence that “Atypical” antipsychotics are associated with NMS that has a different character. NMS occurring with selective serotonin reuptake inhibitors' use is extremely rare, and it should be differentiated from serotonin syndrome. Here, we report a rare case of NMS induced by fluvoxamine.
  - 2,025 112
Subserosal lipoleiomyoma of the cervix in a postmenopausal woman: A rare case report
Hema Basappa Bannur, Vijayalaxmi Veerbasappa Suranagi, Reshma Davanageri
September-December 2017, 44(3):163-164
Uterine lipoleiomyomas are rare benign tumors in which there is admixture of smooth muscle cells and mature adipocytes. Cervical lipoleiomyomas are still rarer, occurring in obese perimenopausal and postmenopausal women. These tumors are usually asymptomatic and can be accidental finding in hysterectomy specimen. We present a case of subserosal cervical lipoleiomyoma in a postmenopausal woman who presented with III uterovaginal prolapse. Literature search reveals few cases reported so far.
  - 1,631 136
Urinary tumor markers in prostate cancer
Shridhar C Ghagane, Rajendra B Nerli
September-December 2017, 44(3):119-120
  - 2,721 1,707
Impact of management protocols of intrauterine fetal death on perceived stress: A comparative study
Mita Mandal, Arunima Chaudhuri, Debdut Banerjee, Priyankar Kanrar, Samir Kumar Hazra
September-December 2017, 44(3):121-125
Background: Pregnancy loss is a distressing problem and retention of dead fetus in utero has its own ill effects on physical, psychological, and social aspects, and hence, it is better to recommend medical induction, provided this can be safely undertaken. Aims: The aim of this study is to compare the efficacy, tolerability, induction-delivery interval, and perceived stress scores between induction methods in late intrauterine fetal death (IUFD) with misoprostol alone and mifepristone with misoprostol combination in a rural population of Eastern India. Materials and Methods: This pilot study was conducted on 125 patients after taking institutional ethical clearance and informed consent of the patients in a time span of 1 year. Group 2 patients received 200 mg of mifepristone per orally and observed for 48 h, followed by 50 μg misoprostol administered in the posterior vaginal fornix, and repeated 6th hourly up to a maximum of four doses. Group 1 received 50 μg misoprostol per vaginally 6 hourly for four doses. Induction-delivery interval was calculated. Perceived stress level was calculated on admission and before discharge. Results: Significantly lower induction-delivery interval was observed in Group 2 as compared to Group 1 with P < 0.001. There was no significant difference of Cohen's perceived stress scores on admission, but the difference was significantly lower in Group 2 on discharge with the value of P = 0.03. Group 1 had significantly lower hospital stay in days as compared to Group 2 of patients with P < 0.001. Conclusions: Patients with IUFD administered misoprostol per vaginally only may require shorter hospital stay as compared to patients administered with oral mifepristone followed by misoprostol vaginally but the delivery induction time increases significantly and may increase perceived stress levels which may have short- and long-term negative psychological impact.
  - 3,753 1,260
Ear, nose, and throat disorders in a nigerian rural community
Waheed Atilade Adegbiji, Shuaib Kayode Aremu, O Akeem Laisi
September-December 2017, 44(3):126-129
Aims and Objectives: This study aimed at assessing the prevalence of ear, nose, and throat with head and neck diseases in a rural community in Oyo State, Nigeria. Materials and Methods: This is a prospective community-based study of ear, nose, and throat diseases. The study was carried out over a period of 3 months (January to March 2017). Verbal consent was obtained from the village head and participants. A total of 738 individuals were enrolled into the study. Interview-assisted questionnaire was administered to obtain bio data and otorhinolaryngological history from all participants, followed by examination and investigation. Data obtained were collated and statistically analyzed using SPSS version 16. Results: A total of 738 consented participants had various forms of ear, nose, and throat disorders. They constituted 435 (58.9%) males and 303 (41.1%) females, with a male: female ratio of 1:1. Majority of enrollee were dependent age groups. These age groups were 27.4% (1–10), 25.5% (11–20), and 14.1% (51–60). The occupational status revealed that 28.9% were employed; 9.3% were retired; 45.5% were children/students/apprenticeship; and 16.3% were artisans, homemakers, and farmers. Nasal diseases (34.4%) were the most common otorhinolaryngological, head and neck disorders while ear, nose, and throat with head and neck diseases were responsible for 43.4%, 14.6%, and 7.6%, respectively. The common diseases were wax impaction (11.7%), sinusitis (14.4%), and allergic rhinitis (22.6%). Less prevalent otorhinolaryngological, head and neck diseases were vertigo/balance disorder (0.9%), cervical spondylosis (1.6%), and pharyngitis/tonsillitis (2.0%). Common procedures performed included impacted earwax removal (22.8%), aural toilet/dressing (14.4%), pure tone audiometry (32.5%), tympanometry (18.4%), endoscopy (9.8%), and antral irrigation (5.7%). Referred cases of 7.2% were recorded. The barriers experienced by these villagers in seeking otorhinolaryngological, head and neck services were distance/transport (42.8%), cost of hospital service (38.4%), fear of surgery (24.1%), hospital protocol (37.0%), cumbersome investigation (17.5%), and hospital workers (27.6%). Conclusions: This study revealed that the nasal diseases were most prevalent in the community and highlighted the major challenges encountered in seeking otorhinolaryngological, head, and neck cares.
  - 3,425 257
Epidemiologic characteristics, predisposing risk factors, and etiologic diagnosis of corneal ulceration in Belagavi
Rekha Mudhol, Linda Maria Genoveva De Piedade Sequeira
September-December 2017, 44(3):130-133
Purpose: To evaluate the factors predisposing to the onset of corneal ulceration and to identify the specific causative organisms. Materials and Methods: This was a 1-year cross-sectional study. Fifty patients with infectious keratitis were included in the study. A detailed history with documenting his/her sociodemographic information, presenting complaints, previous treatment, predisposing ocular conditions, and associated risk factors was noted, followed by slit lamp biomicroscopy and scraping for staining and culture analysis. Results: Bacterial infections were noted more commonly (28%) than fungal infections (12%) with Streptococcus pneumoniae and Staphylococcus aureus accounting for the majority of bacterial ulcers (68.75%), and Fusarium species and Aspergillus species were equally (50% each) responsible for most of the fungal infections. The most common predisposing risk factor is ocular trauma (74%). Conclusion: Comprehensive surveys are necessary to assess the specific epidemiological characteristics of corneal ulceration, which are unique for each region and population. It in turn helps to define the magnitude of the problem and design efficient public health programs for its management.
  - 3,489 367
Viral diarrhea in children: Time to start rapid diagnosis and vaccination
Mohamed Usman Abdullah, Poongodi Lakshmi Santhana Kumaraswamy, Syed Ibrahim Ahamed Nagoor
September-December 2017, 44(3):134-136
Background: Acute diarrheal diseases are the most common cause of morbidity and mortality in children under 5 years of age throughout the world. This study was done to find out the incidence of rotavirus and adenovirus infection in children below 5 years of age. Materials and Methods: A total of 105 stool samples were collected from hospitalized children below 5 years of age with diarrhea from a private children hospital and tested for rotavirus and adenovirus antigen detection by rapid immunochromatography (RICT). Results: Of the 105 patients tested, 44 (42%) were positive for rotavirus, and two (2%) were positive for adenovirus by RICT. None of the children were positive for both rotavirus and adenovirus. Out of 105 children, only two had received rotavirus vaccine. They were negative for both rotavirus and adenovirus. Conclusion: The rotavirus vaccine can be included in the Universal Immunization Programme. Although the sensitivity and specificity of RICT were reported as 75% and 95% only, it is useful to detect viral diarrhea at the point of care for effective management and containment of diarrheal outbreaks at field level.
  - 2,090 193
Segmental absence of intestinal musculature: A rare cause of intestinal obstruction in infants
Hema Basappa Bannur, Vijayalaxmi Veerbasappa Suranagi, Reshma Davanageri
September-December 2017, 44(3):156-157
Segmental absence of intestinal musculature (SAIM) is a rare entity of unknown cause. Presenting features vary from intestinal obstruction, necrotizing enterocolitis, volvulus, and intussusception to spontaneous intestinal perforations. In majority of the cases, SAIM is a histological diagnosis. Here, we present a case of a 1-month female baby who presented with fever, abdominal distension, and vomiting. Resected segment of intestine histologically showed focal segmental absence of the muscularis propria. To the best of our knowledge, fewer than 50 cases of SAIM have been reported in the literature so far.
  - 1,816 136
Road geometry as a factor for musculoskeletal injuries due to road traffic accidents in Sub-Himalayan State of Himachal Pradesh
Sunil Kumar Raina, Bhanu Awasthi, Lucky Kumar, Sandeep Kalia, Lokesh Thakur
September-December 2017, 44(3):145-147
Background: Road traffic accidents (RTAs) kill 1.25 million people each year and injure between 20 and 50 million more people with many incurring a disability as a result of their injury. The road environment (design and geometry) can affect driver speed choice, thereby increasing chances of accidents.Materials and Methods: Patients attending tertiary care center for musculoskeletal injuries after an RTA were enrolled in the study. The data were collected using a standard questionnaire. The details on the geometry of the road (type of road; highway or other, metaled or nonmetaled, straight, and curved) were obtaine through inspection wherever possible. Results: Majority of the RTAs occurred on state highways (n = 154/313, 49.7%) followed by national highways (NH) (n = 94/313, 30%). Link roads account for comparatively less number (n = 65/313, 20.7%) of cases. Majority of the accidents occurred on metaled road (n = 268, 85.6%); however, the association of different vehicles involved in RTA with the condition of road was not found to be significant statistically (P > 0.5). Further, the majority of the RTA occurred on straight roads (n = 204, 65.1%). Conclusion: Road geometry is an important factor in RTAs as drivers generally tend to choose their speed based on their perception of the appropriate speed for the road geometry.
  - 1,584 125