Journal of International Medicine and Dentistry

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https://imsear.searo.who.int/handle/123456789/160525

Editor-in-Chief: Dr. Prashanth H. V.
ISSN: 2350-045X

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.jimd.in/

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Now showing 1 - 20 of 46

Study of variations in medial sural cutaneous nerve, lateral sural cutaneous nerve and peroneal communicating nerve.
(2014-07) Kavyashree, A N; Subhash, Lakshmi Prabha; Asha, K R; Bindurani, M K
The sural nerve complex includes the Medial sural cutaneous nerve (MSCN), Lateral sural cutaneous nerve (LSCN), Peroneal communicating nerve (PCN) and Sural nerve. The sural nerve is the most frequently used donor nerve for peripheral nerve grafting. LSCN can be an alternative to sural nerve in situations requiring a limited length of nerve graft material, the peroneal communicating nerve may also be harvested. Fifty lower limb specimens were dissected and data was collected. The study included 16 male and 9 female cadavers. MSCN was observed in all 50 specimens, out of which 74% specimens had normal course and 22% had a transmuscular course. LSCN was present in 82% of specimens. PCN was arising from Common Peroneal Nerve (CPN) directly in 16% and as a common trunk with LSCN in 14% of specimens. PCN was absent in 28% of cases. So knowledge of variation in these nerves will help the surgeons while considering these nerves for nerve grafting.
A study to assess the effectiveness of self instructional module on prevention of nosocomial infection in Neonatal Intensive Care Unit ( NICU) among staff nurses in selected hospitals at Mangalore.
(2014-07) Jacob, Jane Mary; D’Souza, Lolita S M; John, Joicy
Health care associated infections (nosocomial) are responsible for significant morbidity and mortality among neonatal intensive care patients. The purpose of the study was to assess the effectiveness of Self instructional module in the prevention of nosocomial infection. The study also aimed at improving the knowledge of staff nurses regarding prevention of nosocomial infection. An evaluative approach with one group pre-test post-test design was used in the study.
The result of the study showed that in the pre-test knowledge assessment, the mean percentage of response was 50.73% with mean and SD of 15.223 ± 2.5, which was increased to 92.83% with mean and SD of 27.85± 1.20 in the post-test. The results showed a significant difference suggesting that the self instructional module was effective in increasing the knowledge of staff nurses regarding prevention of nosocomial infection (t =26.82, p < 0.05).
Prescribing pattern of iron preparations in antenatal women in a tertiary care hospital.
(2014-07) Bhandare, Basavaraj; Satyanarayana, V; Kauser, Safina
Iron deficiency anemia in pregnant women is a major health problem in India. According to WHO, anemia in pregnant women is described as Hb% < 11g/dl or hematocrit < 33% and all pregnant women are to be given a standard dose of 60mg and 120mg elemental iron for prophylaxis and treatment of anemia respectively. As per ICMR guidelines, the dosage has increased from 60 to 100mg for treatment of anemia. This study was done to study the prescribing pattern of iron preparations in antenatal women and to compare the elemental iron content in the drug. Fifty pregnant women were included in the study. Prescription analysis showed that 94% were given oral iron preparations and 6% were given I.V. injections. The commonly prescribed drugs were Ferrous Ascorbate(42%) and Sodium Feredetate(40%) containing elemental iron 100mg and 33mg respectively. The I.V. preparation used was mainly iron sucrose (6%). Since both the oral iron preparations were prescribed once daily, Ferrous Ascorbate should be preferred over Sodium Feredetate since the total elemental iron in Sodium Feredetate is not sufficient as per WHO and ICMR guidelines.
From the Chief Editor’s Desk.
(2014-07) Journal of International Medicine and Dentistry
Rectus sheath hematoma – An uncommon complication following caesarean delivery.
(2014-07) Dwarakanath, L; Shobha, U N; Jamuna, R; Hema, K R; Sowmya, G
Rectus sheath hematoma is a well documented clinical entity, though uncommon and often clinically misdiagnosed cause of acute abdomen. The non-specific nature of presentation combined with a lower incidence of the disorder leads to difficulty in diagnosing. Our patient presented with rectus sheath hematoma, following caesarean section on 9th post-operative day. She presented with wound discharge and lower abdominal pain. The case report is presented to increase the awareness in considering this entity in the differential diagnosis and management of acute lower abdominal pain. Rectus sheath hematoma’s early diagnosis and appropriate treatment may help to prevent complications.
Clinico-microbiological study of infections in the intensive care unit and study of antimicrobial resistance in bacterial isolates.
(2014-07) Vijaya, ,; Saldanha, Dominic R M; Shenoy, Shalini
Infectious disease specialists have long recognized that the risk of ICU patients acquiring nosocomial infections is 5-10 times greater than those in general wards. Several factors such as severe underlying disease, multiple illnesses, malnutrition, extremes of age, immunosuppression, use of invasive medical devices, ICU crowding and animate reservoirs increase the risk of acquiring infections in the ICU. Out of 113 isolates obtained in our study, 32.7% were from ventilator-associated pneumonia patients and 17.7% from urinary tract infection patients. The major isolates were Staphylococcus aureus (21.2%) and Klebsiella spp. (20.4%). Methicillin resistant Staphylococcus aureus (MRSA) and ESBL producing Klebsiella and E. coli were the major drug resistant bacteria isolated and associated with significant mortality. Control of these infections poses a major problem in treating the patients because of the rising trend of drug resistance among these bacteria.
P2L2A0 Emergency Lower Segment Caesarean Section (LSCS) with Atrial Septal Defect (ASD) with severe Pulmonary Arterial Hypertension (PAH) with Bidirectional flow with Pulmonary Edema with Sepsis.
(2014-07) D’Souza, Lolita S M; John, Joicy; Anand, Prabha
Severe pulmonary Arterial Hypertension with Pulmonary Edema with Sepsis in a postnatal mother with Atrial Septal Defect (ASD) followed by LSCS is uncommon. Atrial Septal Defect (ASD) is the commonest adult congenital heart defect (CHD). 15 % of these patients will eventually develop pulmonary hypertension if left untreated. ASD closure is not recommended when pulmonary hypertension is irreversible. Congenital heart disease should be considered in the evaluation of dyspnoea in a young adult. The management of ASD with associated pulmonary hypertension is difficult. It is pertinent that a detailed hemodynamic assessment be undertaken. The present case report focusses on a patient with severe ASD with pulmonary hypertension with pulmonary edema and sepsis who was with 35 weeks of gestation and the control of symptoms during Caesarean section.
Prevalence of Group A beta- hemolytic streptococcal carriers in school going children.
(2014-07) Kausar, Athiya; Prashanth, H V; Prakash, R; Krishnamurthy, Veena
Group A Streptococci (GAS) are one of the common pathogens responsible for causing tonsillitis and pharyngitis in both children and young adults. The asymptomatic pharyngeal carriage of GAS in children may lead to spread of respiratory infection in the community. Children aged 5 to 15 years with no signs and symptoms of upper respiratory tract infections and no history of antibiotic therapy within last two weeks were included in study. Throat swabs collected were cultured on blood agar. GAS was identified by conventional method and serogrouped using latex agglutination assay. GAS was isolated from 7 children, out of 250 children. The carrier rate was 3.6% which correlated well with other South Asian studies. Our study showed the importance of surveillance programme to keep carriers in check.
Relation between Calcium Loss and Its Effect on Microhardness of Root Canal Dentin Following Treatment With 17% Ethylene Diamine Tetraacetic Acid(EDTA) at Different Time Intervals: An Ex-Vivo Study.
(2014-12) Kamakshi, G; Suvarna, Nithin; Shetty, Harish Kumar; Khed, Jaishri
Decalcification and its effect on microhardness of root canal dentin by an aqueous solution of 17% EDTA at different time intervals were studied.Single rooted forty extracted human premolar teeth after adequate processing and embedded with acrylic resin were randomly divided into 8 groups based on different time intervals. Each sample group was assessed for Ca²⁺ release into the test solution by Atomic Absorption Spectrophotometer, respectively and then were subjected for microhardness testing.17% EDTA and 0.9% Saline, test solutions were used; EDTA was adjusted to 7.5 pH. Data analysis was done by One Way analysis of variance (ANOVA) and the comparison of means was done by using Tukey’s multiple comparison tests. The decalcifying activity of 17% EDTA solution was time dependent and increased immersion time showing very high significant influence on the amount of calcium extracted (F=154.304, p). The reduction in microhardness for 17% EDTA solution was time dependent and increased immersion time showing very high significant decrease in the microhardness among the different time intervals tested (F=249.925, p < 0.0005).Effect of 17 % EDTA solution as root canal irrigant is time dependent as evidenced by dentin microhardness reduction.
Advances in phototherapy for psoriasis.
(2014-12) Nagaraju, Umashankar
Ultraviolet light has a wide spectrum of effects on human skin depending on the wavelength. Ultraviolet light often used for therapy of psoriasis comprises of electromagnetic spectrum ranging from 200nm – 400nm. Phototherapy of psoriasis is frequently used in combination regimens to achieve higher clearance rates, longer disease-free intervals, and to reduce the patient`s cumulative radiation dose thereby lowering the carcinogenic risk. Phototherapy may be combined with topical or systemic agents. Topical agents most commonly used are anthralin, tar, vitamin D analogues and tazarotene. Among systemic agents, retinoids are the most widely used. Ultraviolet B wavelengths in the range of 300-313nm is more efficacious than conventional broad-band UV-B [Philips TL 40W/12 lamp] and causes greater remission of psoriatic lesions. 311nm narrow-band UV-B (TL-01) phototherapy is more effective and probably has no greater risk than conventional UV-B (TL-12) phototherapy in the treatment of psoriasis.
Agenesis of Isthmus of thyroid gland with presence of pyramidal lobe and levator glandulae thyroideae.
(2014-12) Kavyashree, A N; Asha, K R; Bindurani, M K; Subhash, Lakshmi Prabha
A wide range of morphological and developmental variations of thyroid gland like hypoplasia, ectopic thyroid tissue, hemiagenesis or agenesis of thyroid gland has been reported. Out of these agenesis of the thyroid isthmus is a very rare congenital anomaly. Thyroid isthmus agenesis does not manifest clinical symptoms, and it can be confused with other thyroid pathologies. Also the presence of levator glandulae thyroideae and its anatomical variations gain importance in the pathologies which are related to thyroid gland and their treatment modalities. We hereby, report the absence of isthmus and presence of levator glandulae thyroideae and pyramidal lobe in a middle aged male cadaver. The present case report is an attempt to highlight the implications of variation of thyroid gland from diagnostic, phylogenetic and functional perspectives.
Strengthening the healthcare services to prevent severe Pre-eclampsia and Eclampsia.
(2014-12) D’Souza, Lolita S M; Josin, Joicy
Preeclampsia is a hypertensive, multi-system disorder of pregnancy whose etiology remains unknown. Although management is evidence-based, preventive measures/screening tools are lacking, treatment remains symptomatic, and delivery remains the only cure. As in the past, the current role of physicians and nurses in the management of pre-eclampsia-eclampsia continues to revolve around the protection of maternal/foetal wellbeing and optimization of positive health outcomes. Given that effective preventive measures and screening tools is presently lacking, routine assessment of the signs/symptoms indicative of pre-eclampsia/eclampsia remains critical to the detection, monitoring, and effective management of pre-eclampsia/eclampsia. Patient education and the provision of a supportive environment are also essential to the optimal management of preeclampsia/ eclampsia. This article deals with the integration of health care services in preventing the complications of pre-eclampsia.
To study the effect of Yoga Training on auditory and visual reaction time.
(2014-12) Hanji, Chandrashekar V; Venkatesh, G
Reaction time is the easiest methods of assessing the sensory and motor performance of an individual. It is an indicator of performance in surgeons, sports personnel etc. Yoga can improve the reaction time. Hence, this study was undertaken to study the effect of yoga training on visual and auditory reaction time. Fifty healthy subjects aged between 18 and 25 years were selected. Auditory reaction time and visual reaction time were assessed before and after yoga training. There was significant decrease (p<0.05) in the alert values of both Auditory reaction time and Visual reaction time after two months of yoga training. Yoga training enhances the reaction times which are helpful in surgeons, sportsmen and skilled workers.
Antibiotic Resistance in Non-humans and its Impact on Human Health.
(2014-12) Prakash, R; Krishnamurthy, Veena; Allavarapu, A Ramyasree
Antimicrobial drugs are magic bullets which are used in humans, animals and plants to treat and prevent bacterial infections. The inevitable side effects of the use of antibiotics are the emergence and dissemination of resistant bacteria. Their level of resistance is considered to be a good indicator for selection pressure by antibiotic use and for resistance problems to be expected in pathogens. At least twelve classes of antimicrobials namely arsenicals, polypeptides, glycolipids, tetracyclines, elfamycins, macrolides, lincosamides, polyethers, beta-lactams, quinoxalines, streptogramins, and sulfonamides have been used in veterinary practice. The effect of this selection pressure has been the appearance of numerous resistant strains of Escherichia coli , Salmonella species , Staphylococcus aureus , Pasteurella hemolytica, Pseudomonas aeruginosa, Klebsiella pneumoniae, Clostridium perfringens and many other bacterial species. Bacteria also acquire genes conferring resistance by a variety of mechanisms including acquisition of extrachromosomal plasmids that replicate apart from the chromosomal DNA. Damage caused by antibiotic resistant bacteria is a kind of pollution. The precise effect of agricultural antibiotic use on resistance levels in the general population is not known, but the evidence points to a link. Considerable attention has been focussed on a very small minority of bacteria that cause disease but a vast sea of commensal and environmental bacteria continuously and promiscuously exchange genes totally unnoticed. Immediate action has to be taken to prevent the antibiotic resistance in bacteria by judicious and rational use of antibiotics, effective hospital infection control programs and research for the development of new antibiotics or by combination therapy.
Ebola virus disease: Getting to know a new emerging foe.
(2014-12) Baliga, Shrikala; Shalini, M; Mithra, P Prasanna; Unnikrishnan, B; Rekha, T
Viral hemorrhagic fevers have been at the top of the severity scale in terms of morbidity and mortality among human beings. Many of the viruses have their reservoirs in animal kingdom and from time to time they get introduced to humans and cause sporadic outbreaks and epidemics. Thousands of people from the Western African region have already succumbed to the complications due to Ebola virus infection.
The South East Asian region including India has been affected by several outbreaks of communicable diseases like SARS, bird flu, swine flu etc. The current outbreak has been a global concern due to its spread beyond the African continent. WHO has declared EVD as an international health emergency and worldwide efforts have been enhanced to escalate research to find a vaccine or cure for the disease.
Heterodera: a spurious passenger or an irritator.
(2014-12) Prakash, R; Maulingkar, Saleel; Raghunatha, S
An Epidemiological study on Snakebite in Karwar.
(2014-12) Adiga, Usha; Adiga, Sachidananda
According to the World Health Organization, snakebites cause more death and disability and are more notorious than some tropical diseases. Snakebite is a leading medical emergency in Asia/Pacific. It is one of the major causes of mortality in India. The objective of the study was to gather epidemiological information on snakebite that will help to guide/design a snakebite prevention and treatment intervention in Karwar. A retrospective study was conducted, in which we have collected data of snakebite cases admitted to the district hospital from October 2010 to October 2014. Epidemiological and demographic profiles of three hundred victims were noted. Data was analyzed by using descriptive statistics. Three hundred snakebite cases were admitted to district hospital, Karwar over the period of four years. Incidence was highest in post monsoon (n=97). Victims affected were mainly in third decade. Male preponderance was clearly seen. Farmers or people involved in farming related activities accounted for more than half of the victims (n=196). Eighty seven percent (87%) (n=261) occurred on the lower limb. Snake bite is an important neglected health problem in Karwar and surrounding rural areas . Using this study as a guiding tool, awareness and education programs on prevention of snakebite can be planned. It is important to educate people regarding first aid treatment, dos and don’ts in case of snakebite. Medical personnel should be trained; facility should be improved in Karwar district hospital so as to manage even complicated cases.
Clinico-microbiological study of neonatal sepsis.
(2015-04) Agarwal, Avinika; Bhat, Sevitha
Neonatal sepsis, a systemic infection manifesting in the first month of life is a leading cause of mortality in the newborn .Blood culture is the main stay in the diagnosis of neonatal sepsis. The present study focuses on the bacterial agents, the antibiogram and the clinical risk factors associated with neonatal sepsis. One hundred and ten neonates with clinical suspicion of neonatal sepsis were included in this study. Bacterial pathogens isolated in positive blood cultures were identified and the antibiotic susceptibility testing was performed. The risk factors were noted from the case records & statistical analysis was done using the Chi square test. Thirty six (32.72%) cultures were positive among 110 suspected cases of neonatal sepsis. 22(61.11%) cases presented with early onset sepsis and 14(38.89%) presented as late onset sepsis. The common bacteria isolated were Klebsiella spp., Escherichia coli & Staphylococcus aureus. Antibiotics effective against gram negative bacilli were cefaperazone/sulbactam and piperacillin/tazobactam. The rate of Methicillin resistant Staphylococcus aureus isolation was 57%. Gram negative bacilli predominate as agents of neonatal sepsis & antibiotic resistance among bacteria is on rise. Thus there is a need for continuous screening and surveillance for antibiotic resistance in NICU.
Clinico-microbiological study of Citrobacter isolates from various clinical specimens and detection of β-lactamase production.
(2015-04) Greeshma, Hareendranath; Saldanha, Dominic R M; Vishwas, Saralaya
Citrobacter species have been reported to cause a wide spectrum of infections in humans and invasive infections are associated with a high mortality rate, with 33 to 48% of patients succumbing to Citrobacter bacteraemia. The high mortality rate associated with Citrobacter infections may be due in part to ineffective empirical antibiotic therapy. Citrobacter has been found to produce SHV and TEM derived Extended spectrum beta lactamases in addition to chromosomal inducible AmpC beta - lactamases which could be contributing to increasing drug resistance. The aims of the study were to detect the prevalence of Citrobacter infections with its associated risk factors, antibiotic susceptibility patterns and determination of beta-lactamase activity- both extended spectrum beta - lactamase and AmpC beta-lactamase activity among Citrobacter isolates. The isolates were identified by standard microbiological procedures. ESBL detection was by double disc diffusion method and AmpC beta-lactamase detection was done using Cefotaxime and Cefoxitin discs. C. braakii (33.3%) was the commonest genomospecies identified followed by C. freundii (21.3%) and C. amalonaticus (16.66 %) among 150 Citrobacter isolates. Diabetes mellitus was the major risk factor. Imipenem (100%)was most effective whereas 98% showed resistance to Ampicillin; carbapenems and fourth generation Cefipime showed better sensitivity than third generation cephalosporins. The study highlights the need for informed antibiotic treatment guided by routine antimicrobial susceptibility and knowledge of the ESBL status of the isolate, the outcome of which undoubtedly will be better patient care.
Chronopharmacology: Tailoring Therapy to Endogenous Rhythms.
(2015-04) Satyanarayana, V; Krishnan, Pavithra
Chronopharmacology aims at the use of biological rhythms in the clinical treatment so as to enhance both effectiveness and tolerance and minimize the side effects of a drug by determining the best biological time for its administration. Chronopharmacology is useful to solve problems of drug optimization. In the human organs, the metabolic fate of a pharmacologic agent as well is not constant as a function of time. Thus, the chronobiological approach of drug administration involves a lesser risk of errors than the conventional homeostatic approach. Chronopharmacology is now used as a routine to treat various disorders like hypertension, angina, cancer and various psychotic disorders. The newer drug delivery systems that are designed with the chronopharmacological approach hold great scope for delivering better patient care in terms of efficacy, tolerance and safety parameters of the drug. This review aims at introducing chronopharmacology, the role of the regulatory system of biological clock in pharmacotherapy and the benefits it has conferred in various clinical conditions.

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