International Journal of Contemporary Medical Research
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Editor-in-Chief: Dr. Devanand Gupta
ISSN: 2393-915X
Frequency: Quarterly
Language: Half yearly
Open Access Peer-reviewed journal
Web site: https://www.ijcmr.com/
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Item Submuscular Plating vs Flexible Intramedullary Nailing in the Management of Paediatric Femoral Shaft Fractures(International Journal of Contemporary Medical Research, 2023-02) Haq, Inam Ul; Sultan, Asif; Rashid, ShafatIntroduction: The aim of this study was to compare the outcome in terms of patient characteristics, intraoperative blood loss, operative time, length of hospital stay and complications after insertion and removal of submuscular plates (SMPs) and flexible nails (FNs) for pediatric femoral shaft fractures. Material and methods: 40 children between the age of 6 to 14 years of age who underwent treatment with SMPs (n=22) and FNs (n=18) from 2018 to 2020. Results: insertion of FNs was associated with shorter operative time (mean= 61.2 minutes) and less blood loss (mean=92 ml) compared to SMPs. The FNs group had a shorter length of hospital stay (mean 4.9 days) compared with SMPs (mean=8.6 days). Removal of FNs was also associated with shorter operative time and less blood loss compared to SMPs. Two patients treated with SMPs and one patient treated with FNs developed surgical site infections. Two patients treated with SMPs and three treated with FNs developed implant irritation that resolved with removal. Two patients treated with SMPs and one treated with FNs developed knee stiffness requiring aggressive physiotherapy protocol. One patient treated with FNs developed burisitis at nail insertion site. No other complications occurred. Conclusion: When compared with SMPs, FNs are associated with less operative time, decreased blood loss and less duration of hospital stay in patients with femur fractures.Item To Determine the Role of Color Doppler Ultrasonography (CDUS) as a Routine Investigational Method for Diagnosis of Scrotal Pathologies(International Journal of Contemporary Medical Research, 2023-02) Haq, Ahatsham ul; Sharma, Sumit; Kumar, Akshit; Sharma, Rajesh; Sodhi, Amitoj SinghIntroduction: Colour Doppler ultrasonography (CDUS) is an important tool for diagnosis of scrotal diseases because of its ability to depict anatomy and perfusion in real time. Diagnosis of scrotal diseases has always been a challenge for the clinician due to non-specific signs and symptoms. The causes of scrotal swelling are broadly classified as neoplastic and non-neoplastic. This distinction between these is important because the plan for the management differ in each cause .Ultrasonography plays a major role in distinguishing neoplastic and nonneoplastic scrotal pathologies. To determine the role of color Doppler ultrasonography as a routine investigational method for diagnosis of scrotal pathologies. Materials and Methods: This prospective observational study (case series) was carried out over a period of 12 months on 50 patients in the age range of 0 to 80 years, presenting with scrotal swellings and pain. After adequate history and examination, B mode and CDUS was performed. The CDUS findings were compared with final outcome, based on course and outcome of the disease, fine needle aspiration cytology results and operative findings. Results: In our study the final diagnoses were acute epididymitis or epididymo-orchitis (7), hydrocele (6), varicocele (7), testicular malignancy (5), orchitis (1), testicular torsion (1), hematocele (3), spermatocele (2) and others. Conclusion: Color Doppler ultrasonography is an excellent method for evaluating patients with scrotal pathologies. It aids in diagnosing testicular tumors and reduces the number of unnecessary explorations. It is especially important in conditions like testicular torsion where immediate diagnosis is required.Item Multi-dimensional Problem Scoring in the Continuing Management of Elderly Patients(International Journal of Contemporary Medical Research, 2023-02) Chandrasekhar, G. Mohan; Rao, Nallapu Samson SanjeevaIntroduction: Usual diagnosis in hospitalised elderly addresses mainly their physical ailment. However, there is a need to also take into account various other issues like the psychological status, financial status, ability of activities of daily living, family support which will help plan continuing care at the home after discharge. This study aims to look at various aspects in the care of an elderly person and to make a multi-dimensional problem identification structure for them before discharge. Method and materials: This descriptive study done over 3 months at the NRI Medical College General Hospital involved 120 inpatients (equal males & females) aged above 65 years. After taking an informed consent, a predetermined instrument covering 10 different dimensions i.e. physical, mental, emotional, spiritual, nutritional, family support, social, occupational, financial, and home environment was administered. A total of 40 responses were assigned appropriate scores, the minimum being 40 for those doing well and maximum being 105 indicating severity in all dimensions. The collected data was entered in Microsoft Excel and presented in tables and graphs. Important findings were subjected to tests of significance like Chi square and Z tests at 5% LOS. Results: The prepared scoring instrument showed a Cronbach's Alpha value of 0.78 which indicates internal consistency and an acceptable level of reliability. The mean score was 71 (range 50 – 95, Standard deviation 10.7). High scores show an inverse relationship to the financial situation of the patient (Chi square 32.4, p value < 0.0001). When the purpose in life for the elderly was weak, the score was higher (Chi square 53.7, p value < 0.00001). Discussion: The study indicates the need for a problem scoring system which looks at all aspects of an elderly person’s life i.e. psychological, emotional, social etc. in addition to the physical diagnosis. Elderly patients living alone, widowed or financially weak are prone to neglect and depression. Patients who feel lonely or have a poor will to live are also at risk. Conclusion: A multi-dimensional problem identification system for elderly hospitalised patients can yield a comprehensive understanding of the patient’s real life circumstances and help make better post discharge care plans.Item Ultrasonographic Evaluation of First Trimester Vaginal Bleeding(International Journal of Contemporary Medical Research, 2023-02) Puri, Jigyasa; Sodhi, Amitoj, Singh; Hamdani, Hanna; Sharma, Rajesh; Haq, Ahatsham ulIntroduction: Vaginal bleeding after confirmation with a positive pregnancy test requires further assessment in order to identify normal or abnormal development of the pregnancy or a pathological condition that requires intervention. To evaluate the role of ultrasonography in patients with bleeding in the first trimester of pregnancy and to correlate ultrasonographic findings with clinical diagnosis thus helping the treating obstetrician in deciding the management protocol. Materials and methods: The study included all the patients (inpatient and outpatient) with history of vaginal bleeding in the first trimester of pregnancy, referred from the Department of Obstetrics and Gynaecology. 158 patients presenting with bleeding in the first trimester of pregnancy were enrolled for the study. Results: In our study fetal cardiac activity with closed internal os on USG was seen in 45 patients.38 patients showed heterogenous thickened endometrium, no fetal cardiac activity was seen in 27 patients, intrauterine gestational sac without yolk sac or fetal node was seen in 17 patients. Sonographic features suggestive of ectopic pregnancy were present in 19 patients. 6 patients had homogenous apposed endometrium. USG showed echogenic mass with cystic areas in 6 patients. Conclusion: The common causes of bleeding during first trimester of pregnancy include abortions, ectopic pregnancy and molar pregnancy. Ultrasound is a non-invasive, nonionizing and easily available method of investigation that helps in the differentiation of causes of first trimester vaginal bleeding.Item Expression of Her2/Neu, VEGF, and Ki-67 in Epithelial Ovarian Carcinomas: An Experience from a Tertiary Care Center, West Bengal, India(International Journal of Contemporary Medical Research, 2024-02) Bhattacharyya, Palas; Das, Rama; Lath, Abhisek; Guha, DebasishIntroduction: Ovarian carcinomas is still maintaining pivotal role among gynecological malignancy regarding cancer death in women. This study aims to observe expression pattern of VEGF, Her2/Neu and Ki-67 in lieu of targeted therapy for ovarian carcinoma. Materials and Methods: It was retrospective observational study carried out for last 3 years (2020-2022). A total of 160 cases of Ovarian tumors were received from different departments. The specimens were processed, histopathological sections were examined under Hematoxylin and Eosin stain, Immunohistochemical stains like VEGF, Her2/Neu and Ki-67. Evaluation was done by trained and independent pathologists. Correlation of Histological type, grade, age group. FIGO stage with expression of VEGF, Her2/Neu, and Ki-67 done. Results: Out of 160 specimens of histological examination proved 143 EOC- serous type constituted maximum (53.1 %) number. Among them (63.7%) were high grade and most of the cases belonged to 41.3% (59/143) in FIGO stage I in our study. Grade 3+ HER2/neu immunostaining was identified in 22.37% cases and had significantly correlated with tumor grade (?2 = 19.7981 with Yates correction; P <0.00001) and FIGO Staging (p=0.00024). Among High grade EOC, High proliferation index (HPI) was 19.5% for Ki-67. we could observe significant statistical association of Ki-67 HPI and tumor differentiation. Moreover, significant correlations was found between the high-grade EOC and HPI of Ki-67/Her2- neu co-expression (p<0.05). Though significant association was found between tumor grade and VEGF expression (?2 = 11.1041; P = .000861) but no correlation were in VEGF/Her-2/neu HPI and the degree of tumor differentiation (chi-square, p>0.05). Conclusion: Role of Her2/Neu and Ki-67 expression and their association should be considered in the progression and tumor grade and stage of EOC.Item Management of Periarthritis of Shoulder Joint by Supra-scapular Nerve Block(International Journal of Contemporary Medical Research, 2024-01) Chowdhary, Bashir Mohammed; Bhat, Mudasir AhmadPeriarthritis is a chronic, inflammatory disorder of the shoulder and surrounding soft tissues, caused by injury, leading to pain and lack of use. Various therapeutic methods and surgical treatments have been introduced for shoulder periarthritis. This observational study was carried out on 16 patients clinically and radiologically diagnosed with periarthritis of shoulder to assess the efficacy of SSNB in the treatment of periarthritis of the shoulder. In this study the mean abduction increased and reached from 72.3° ± 3.10° to 116.3°± 4.8° at the follow-up of 12-weeks. Mean flexion, mean internal rotation and mean external rotation shows an improvement of 41.50, 19.8° and 23.50 respectively at 12-weeks follow-up. The mean VAS score was 7.25 ± 0.9, which shows a significant reduction at different time intervals. In this study we conclude that supra-scapular nerve block (SSNB) is an effective method for controlling pain and accelerating recovery of shoulder motion in patients with periarthritis of shoulder.Item Assessing the Anatomical Variations of Lingual Foramen and its Bony Canals with CBCT taken from 120 Patients(International Journal of Contemporary Medical Research, 2023-02) Chalkoo, Altaf Hussain; Rajput, DeekshaIntroduction: The lingual foramen is situated in the midline, level with or superior to the genial tubercles. It contains blood vessels that supply the anterior mandible. This study was conducted with aim of assessing the anatomical variations of lingual foramen & its bony canals with Cone Beam Computed Tomography imaging within the local population.Also,to evaluate the correlation between various measurements taken with Age and Sex. Material and methods: This retrospective radiographic study was conducted in the department of oral medicine and Radiology, Govt Dental College & Hospital, Srinagar which included 120 patients (60 males and 60 females). Their CBCT were subjected to various measurements in cognizance with objectives of the study.Radiographic types and morphometric measurement were recorded. Radiographically subtypes of lingual foramen were recorded according to classifation given by Sekerci AE(2014) Results: In our study, all 120(100%) patients showed median lingual foramen, some patients also showed paramedian position (4 males and 3 females) Double lingual foramen (55.8%) is shown in most of the cases followed by single foramen (38.3%) .There was significant difference between gender seen in single lingual foramen (p-value 0.024). Type I lingual foramen was most (33.3%) commonly found followed by type VI(30.85%) Conclusion: There is wide range of anatomical variation of lingual vascular canals in respects of number, position and dimension.CBCT is a three-dimensional radiographic imaging modality with greatly reduced doses of radiation and high accuracy.Results will be discussed in detail in presentation.Item Profile of Gynaecologic Malignancies Reported at a Tertiary Care Centre in Rajasthan(International Journal of Contemporary Medical Research, 2023-11) Ghosh, Manashi; Bhatt, Gull Mohammad; Bairwa, Sandeep; Rajpurohit, Annu; Kumar, BrajeshBackground: worldwide the incidence of cancer had shown increasing trends in last few years, and India also follows the same path. In Indian female, breast cancer is the leading site for new cases followed by Carcinoma Cervix. Worldwide incidence for breast cancer far exceeds those of other cancers, followed by colorectal cancer, lung, and cervical cancer. The aim of this study was to study pprofile of gynaecologic malignancies who reported at a tertiary care centre in Rajasthan. Material and Methods: The study was an observational study which was conducted at a NIMS Hospital situated in Jaipur which is a Tertiary Care Centre. All the female with gynecological malignancies, who visited the hospital between May 2022 to May 2023 (01 year) were enrolled in the study. Information on their primary site of malignancy, incidence, grade, stage and histological subtypes were collected. Results: A total of 153 patients with histopathological proven gynecological malignancies attended the oncology department at our hospital from May 2022 to May 2023. Carcinoma Cervix was the leading gynecological malignancy accounting for almost 58 percent of cases. It was followed by Ovarian (30%), Uterine (5.9%). Most of the patient of Carcinoma Cervix, Ovary, Uterus and Vagina presented in stage III. However in Carcinoma Vagina most common stage of presentation was Stage II. In this study squamous cell carcinoma was the commonest histological subtype for Carcinoma cervix, vulva and vagina. In patients with CA Ovary Serous variety of epithelial tumour was the most common histological presentation followed by mucinous and dysgerminoma.Item Surface Pre-Treatments and Bonding Materials for Indirect Zirconia Dental Restorations: A Systematic Review(International Journal of Contemporary Medical Research, 2024-04) Varghese, Col Bensy; Sundaram, R KumaraA large variety of materials used for dental restorations especially for the fabrication of Fixed Dental Prostheses (FDP’s) in contemporary clinical dental practice rely heavily on optimal bonding of prostheses and the tooth structure so as to achieve long term clinical success. Luting cements provide a linkage between the prepared tooth surfaces and a fixed prosthesis used for the rehabilitation of lost esthetics and function in a patient caused due to partial or complete loss of dentition. Nonetheless, due to variance in environment of chemical bonding between two dissimilar constituents’ viz., tooth and fixed denture prosthesis frameworks, the strength of the bond at the unification interface may be weak that there are no substantial values exists in the oral environment that determines durability and long term success of the restorations thus bonded. The recent advances in various restorative systems are due to the patient’s consistent esthetic demand for long lasting esthetic and functional restorations. Due to high flexural strength and ease in fabrication of dental restorations using CAD-CAM technologies, non-glass-based polycrystalline ceramics like zirconia gained popularity, even though they are less translucent and more opaque. Achieving optimal bonding between tooth material and zirconia restoration is really a challenging task considering the noncrystalline nature of zirconia. This article reviews the various techniques, bonding materials and method of application on zirconia used for dental restoration with the main aim to recommend improved bonding and high success rate in terms of zirconia-based restoration for long term use..Item Corelation of Significant Asymptomatic Bacteriuria in Pregnancy with Preterm Labour(International Journal of Contemporary Medical Research, 2024-05) Mantoo, Azmat Jahan; Shakil, Bushra; Bhat, Mufeed Ahmad; Younis, ZohraIntroduction: There is a correlation between asymptomatic bacteriuria and adverse pregnancy outcomes like increased risk of preterm labour. As asymptomatic bacteriuria is detectable and treatable, screening during pregnancy may be justified. It provides obstetrician an opportunity to prevent a significant complication of pregnancy. Objective to study the risk of preterm labour in pregnant women with significant asymptomatic bacteriuria and prevalence of asymptomatic bacteriuria in antenatal women. Material and methods: A total of one thousand pregnant patients were screened for symptomatic bacteriuria by using two rapid reagent strip tests and urine culture. One hundred twenty six screened positive for asymptomatic bacteriuria among whom one hundred patients with single positive urine culture were taken as cases. Out of those screened negative, one hundred patients were randomly selected and followed as controls. Results: Our study reflects a definite corelation of asymptomatic bacteriuria with preterm labour. The prevalence of asymptomatic bacteriuria was 12.6%. There is a positive corelation of asymptomatic bacteriuria with lower socioeconomic status and lower hemoglobin levels.Item Study to Determine the Common Substances that Caused Deaths due to Ingestion brought for autopsy in Tertiary Care Hospital, Hyderabad, Telangana, India(International Journal of Contemporary Medical Research, 2023-12) Siddiqui, Mohammed Abdul Mujeeb; Siddiqui, Zahraa Mohammed; Siddiqui, Azra; Parvathi, KatkuriBackgound: This study was conducted to know the common substances that caused deaths by ingestion, brought for autopsy to Osmania General Hospital, Hyderabad, Telangana State, India for a period three years. The cases of deaths due to poisoning were selected from the autopsies conducted and analyzed for the most commonly ingested substance. Material and methods: The samples were collected for three consecutive years from January 2012 to December 2014. The contents of the stomach were examined grossly and the samples were collected in three containers during autopsy for each individual case. Portion of stomach and its contents, portions of liver, kidney, blood and body fluids were collected labeled and sent to the State Forensic Science Laboratory for analysis of unknown poison. The reports were analyzed. The data collected was arranged according to age, sex and substances detected. Results: A total of 1196 cases of poisoning in three years were studied. Most of the deaths occurred, were due the ingestion of Organophosphates. It is the commonest insecticide used by farmers in fields. The common age group involved is between 21 years to 30 years ingesting organophosphates. In the deaths due to poisonings, men are predominantly involved compared to women. Conclusion: In the study it was concluded that the ingestion of poisonous substance organophosphate is usually intentional and is used to commit suicide. In children it is mostly accidental. Poison can also be used as homicide to kill a personItem Dermatitis Artefacta in a Young Female: A Case Report(International Journal of Contemporary Medical Research, 2023-10) Mori, Pankil; Maheshwari, Pragya; Swarup, Prerna; Bajaj, Kamal; Pardal, PKDermatitis artefacta is a self-inflicted dermatological condition where the underlying motive is to assume a sick role. The act of self-harm is to discharge the inner sense of isolation and emotional distress, which is too great to endure. Rarity may be attributed to masquerading presentation, leading to misdiagno? sis and paucity of awareness among the physicians. Lack of proper identification of the under? lying psychiatric disturbances may be the major cause of the loss of follow-ups. we were fortunate enough to identify the emotional need of the patient. A flexible, non con?frontational yet strong therapeutic rapport is required to improve the therapeutic outcomes.. This case report highlights a 19 year old young unmarried female patient, who presented to OPD with multiple skin lesions on accessible parts of her body, she was carrying prescriptions from multiple dermatologists. She was admitted in psychiatry ward for further observationItem Study of Pattern of Admissions and Outcomes in a Level II NICU in Northern India: An Experience(International Journal of Contemporary Medical Research, 2023-08) Maitri, Ayoniza; Kumar, RajeshIntroduction: Neonatal mortality, defined as the number of neonatal deaths (below age of 28 days) per 1000 live births is the most important cause of Under Five mortality in developing nations like India.NICU facilities available in a region are an important indicator of neonatal mortality and play an important role in reduction of neonatal deaths especially among poor urban populations in the country. Aims: Analysis of NICU admissions helps to identify the common causes of admissions, their prognostic implications and potential for prevention of risk factors associated with neonatal mortality and morbidity. Material and Methods: A retrospective study was performed on 751 neonates over a period of six months at the NICU at Kasturba Hospital, Delhi, India.The neonates were categorised on the basis of their weight and causes of admission and the outcomes were followed to determine major causes of neonatal mortality. Results: In our study, the maximum number of admissions were of children belonging to the Low Birth Weight category followed by Normal Birth Weight. The least number of admissions were seen in the Extremely Low Birth Weight class.The death rate in the NICU for the period in our study was 5.99% with 45 deaths occurring among the 751 admissions.Respiratory Distress Syndrome and Sepsis (pneumonia/meningitis/septicaemia) were jointly found to be the leading causes of neonatal mortality. Severe Birth Asphyxia, Prematurity and Meconium Aspiration were among the other major causes of deaths in NICU. Conclusion: Adherence to more stringent asepsis guidelines, timely identification of risk factors for birth complications and appropriate interventions including immediate referral to higher Center when required could further decrease the likelihood of neonatal deaths.Item Surgical Management and Traction of Impacted Maxillary Canine in a Patient with Mixed Dentition: A Case Series.(International Journal of Contemporary Medical Research, 2023-08) Gupta, Sonal; Gumro, Menia; Baby, AbiaIntroduction: Maxillary canines are crucial for the smile and facial esthetics, its impaction is a commonly seen condition which is always challenging to bring the tooth to the normal position. Case report: We present two case reports of a 13-year-old girl and a 12-year old boy with impacted left maxillary canine teeth. Thorough clinical examination and investigation was made with panoramic radiograph and CBCT, then surgical and orthodontic treatment was performed to correct impacted teeth and to achieve good aesthetic and functional results. Conclusion: The management of impacted canine requires skilful handling and careful observation. If any tooth is absent in the dental arch after the normal time of eruption has lapsed, the dentist must investigate and intervene as early as possible.Item Assessment of Developmental Co-Ordination Disorder in Normal School Going: A Cross Sectional Study(International Journal of Contemporary Medical Research, 2023-09) Jain, Aishwarya; Ganvir, Shyam D.; Shinde, Sonal; Shastri, Kshipra; Kalantri, Gayatri; Pawar, AnushreeIntroduction: Developmental Co-ordination disorder may occur alone or with other developmental co-ordination disorder such as autism and cerebral palsy. Developmental coordination disorder is a neurodevelopmental condition characterized by poor motor proficiency that interferes with an individual’s activities of daily living. Present in approximately 5-6% of school-aged children, developmental coordination disorder is a disability. Hence this study aimed to assess the developmental co-ordination disorder among normal school going children. Material and methods:- This cross-sectional study was carried out in school on 30 children aged 7 to 12 years. After taking institutional ethical clearance and informed consent the developmental co-ordination disorders were assessed using Developmental Coordination Disorder Questionnaire. Result: Mean age of participants in the study was 10.7 ± 0.71. While the mean score for gross motor, fine motor, general coordination and total was 26.4 ± 5.3, 17.05 ± 2.17, 21.5 ± 3.30 and 65.05 ± 8.6 respectively. Conclusion: The study concluded that developmental coordination disorder is not only seen in children with any neurodevelopmental problems but also affects the healthy children and fine motor components were more affected.Item Heroin Chasers Versus Injection Heroin Users: A Study from Kashmir(International Journal of Contemporary Medical Research, 2023-01) Zahoor, Marya; Anjum, Ajmal; Bhat, Fazle Roub; Rather, Yasir Hassan; Younis, Sabah; Shah, Majid Shafi; Rasool, UbaidIntroduction: Opioids are the most harmful drugs in terms of their ill effects on human health. In India, heroin is the most commonly used opioid and is being used via different routes including intravenous and ‘chasing the dragon’ mode. Chasing is one of the most widely practiced methods in world including India. Research regarding comparison of the clinical features and outcome of these groups is scant. Material and Methods: Retrospective chart review of patients diagnosed with primary opioid dependence was made. Fifty heroin chasers attending de-addiction clinic of our institute consecutively were compared with fifty injection heroin users (IHUs) regarding socio demographic, clinical characteristics and outcomes. Results: Most of the treatment seekers for heroin dependence were in the age group of 20-34 years (74% IHU and 76% chasers, P value of 0.78). Mean scores on opioid dependence severity were higher (42.45 + 9.23) in injection users as compared to chasers (37.56 + 8.28, P < 0.01). There was no significant difference between two groups in overall quality of life (17.32 +3.33 for IHUs vs 19 + 4.32 for chasers, P =0.44). As compared to chasers, IHUs had 1.79 odds of receiving Buprenorphine (Confidence Interval:1.1-4.1) and this was statistically significant (P < 0.01). IHUs had lesser odds of drop out on first follow up as compared to chasers (6% vs 34%, OR: 0.12, CI : 0.03-0.45 , P < 0.01). Conclusion: Our findings indicate that there was no difference in most of socio demographic variables between IHUs and heroin chasers. IHUS were having higher severity of opioid dependence and had higher odds of receiving Buprenorphine as withdrawal management. They had higher retention rates as compared to chasers. There was no difference in overall quality of life scores between two groups.Item Deciphering the Upshots of Single and Second Dose of ChAdOx1-S Vaccination among Patients Hospitalized with COVID-19: A Multidimensional Approach(International Journal of Contemporary Medical Research, 2023-09) Shah, Mohd Younus; Bhat, Waseem Feeroze; Singh, Harminder; Singh, Gurjinder; Bhat, Mohd Yunis Saleem; Borole, Kumudini; Azad, Tariq PArvaizSevere acute respiratory syndrome coronavirus 2 (SARSCoV-2) is a dangerous infection throughout the world, despite the availability of affordable and effective management, remaining one of the major causes of death from a single infectious agent worldwide. To mitigate the backlash of the virus on public health the effect of single and second dose of ChAdOx1-S (Verity Pharmaceuticals Inc/Serum Institute of India, in partnership with AstraZeneca Canada Inc) vaccination or covishieldhas been advocated. It has been elucidated via different biochemical (LFT, KFT, and glucose)hematological (CBC) and antibody analysis (antibodies to SARS-CoV-2 IgG) to gain the outcome of single and second dose. Our study also provides empirical estimates of the effect of vaccination on the different age groups by estimation of values of these tests. The present study shows that simple, inexpensive, highly significant and specific tests should be employed routinely to check the etiology in patients of covid-19. This finding could be helpful in early clinical decision-making for the management of these patientsItem Detection of Micrometastasis in Lymph Nodes of Oral Squamous Cell Carcinoma - IHC Study(International Journal of Contemporary Medical Research, 2023-09) K N, Dinsha.; N S, Priya; Rao, KavitaIntroduction: Squamous cell carcinoma (SCC) of the head and neck is the eighth most common malignancy in the world, which exhibits poor survival due to the high rate of loco regional LN metastasis. Malignant tumors of epithelial origin often metastasize to the RLNs. Micrometastasis (MM) represents tumor deposits measuring less than 2 mm in diameter. It is very difficult to diagnose MM by routine histopathological examination. So detection of MM by immunostaining using Pancytokeratin will yield a greater incidence of positive cervical lymph node MM. Aim: To detect the presence of MM in clinically negative lymph nodes. Material and Methods: In this study clinically and histopathologically confirmed cases of SCC with neck dissection (n=30), retrieved from the department of oral and maxillofacial pathology. Demographic data and Grading of OSCC were collected . Results: The cytokeratin expression was positive in 2 cases (11.8%) and negative in 28 cases (88.2%). The obtained ‘p’ value was 0.47, which is not statistically significant. Reactive changes in lymph nodes of different grades of OSCC were observed using H&E stain, among the nodes studied, the chief pattern noted was lymphocyte predominance. Thus, with this small sample size it is difficult to attain more reliable results. Further studies are required to be done, using more reliable methods and larger sample size for accurate detection of MM in lymph nodes of OSCC.Item A Dedifferentiated Solitary Fibrous Tumor in Mesentry with Osteosarcomatous Differentiation(International Journal of Contemporary Medical Research, 2023-08) Gangoli, Aparna; Ghosh, Triparna; Chippalkatti, Komal D; Kulgod, SanjeevIntroduction: Solitary fibrous tumor, a mesenchymal neoplasm, was initially observed in pleura. Though they were later found in many extra pleural sites. It rarely occurs in mesentery. The biology of solitary fibrous tumor is unpredictable, it ranges from benign to overtly malignant. Dedifferentiation, a phenomenon which is morphologically characterized by abrupt transition between the well differentiated component and high-grade areas of tumor, is well described in soft tissue and bone tumors. However, dedifferentiation within solitary fibrous tumor is a rare phenomenon. Case report: We report a case of dedifferentiated solitary fibrous tumor arising in mesentery. Computed tomography revealed a large well-lobulated heterogeneously enhanced solid necrotic mass lesion involving the pelvic abdomen. Macroscopically, the resected tumor was 24 x 20 x 10 cm. microscopic examination revealed a malignant spindle cell tumor juxtaposed with osteosarcomatous component. The spindle cell component showed diffuse expression of SMA, CD34 & STAT6. The osteosarcomatous component showed diffuse expression of SATB2. Conclusion: This is a rare case of mesenteric dedifferentiated solitary fibrous tumor with osteosarcomatous differentiation.Item Defecation Syncope: A Rare Manifestation in Covid Patients(International Journal of Contemporary Medical Research, 2023-06) Gupta, Aditya Arun; Agarwal, Shikha; Anand, UditaIntroduction: Physical activity leads to raised oxygen demand. This causes desaturation in patients with moderate to severe ARDS. Case Report: A 65yr/M was admitted complaining of breathlessness, cough and fever. RT-PCR was positive, inflammatory markers raised and HRCT Thorax consistent with covid findings. The patient was a known hypertensive taking Tab. Telmisartan (40mg). He had received 1st dose of Covishield vaccine. Treatment was initiated according to covid protocol. Oxygen therapy via NRBM mask at 10-15 litres was started and saturation maintained at 90-95%. On 9th day of admission, pt’s. saturation fell to 77%, while defecating. Subsequently, similar episodes were noted. Saturation fell to 55% transiently prompting BiPAP intervention. On Day 12 a severe episode of desaturation was noted but patient improved, without needing intubation. Diagnosis of Defecation Syncope was made. Discussion: Defecation Syncope (DS) is a parasympathetic response to the exerted pressure on the rectum and diaphragm, and closure of the epiglottis during defecation. Initially there is rise in BP and bradycardia, then rapid fall in BP leading to decreased cerebral perfusion causing syncope. Secondly, raised intra-abdominal pressure causes the diaphragm to exert greater pressure on the thoracic cavity. A (V/Q) mismatch causes hypoxia and desaturation in such patients. Constipation predisposes to DS. Conclusion: While these patients perform voiding activity, adequate fluid therapy should be initiated. Oxygen flow should be increased. Laxatives should be used judiciously. Emergency trolley should be kept on standby. Occasionally, such patients may have fatal outcomes. Patients should be under vigilance of healthcare providers.