International Journal of Research in Medical Sciences

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https://imsear.searo.who.int/handle/123456789/150276

Editor: Dr. Bhaven Kataria

ISSN: 2320-6071 Online : 2320-6012

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.msjonline.org/index.php >

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Now showing 1 - 20 of 4399

Purple urine bag syndrome- changing hue.
(2013-01) Sharma, Sadhna; Babu, Butchi; Rao, Bhaskar; Govind, Biju
Purple Urine Bag Syndrome (PUBS) is a unique disease entity characterised by purple discoloration of urine secondary to recurrent urinary tract infections with indigo and indirubin producing bacteria and is predominantly seen in constipated, chronically debilitated and catheterised women with alkaline urine. This syndrome indicates underlying recurrent urinary tract infections (UTIs) associated with higher incidence of mortality and morbidity than urinary tract infection alone without this occurrence. This article is about an elderly hypothyroid woman with PUBS and reviews the need to be aware of this entity.
Apert syndrome (Acrocephalosyndactyly): a case report.
(2013-01) Saritha, S; Sumangala; Supriya, G; Kumar, M Praveen
Apert syndrome is named for the French physician. Eugene Apert in 1906 described the syndrome acrocephalosyndactylia. It is a rare autosomal dominant disorder characterized by craniosynostosis, craniofacial anomalies, and severe symmetrical syndactyly of the hands and feet (i.e. cutaneous and bony fusion refers to webbing of fingers and toes). Apert syndrome is characterized by the premature fusion of certain skull bones (craniosynostosis). This early fusion prevents the skull from growing normally and affects the shape of the head and face. In addition, a varied number of fingers and toes are fused together (syndactyly). Most cases of Apert syndrome are sporadic, may result from new mutations in the gene. The purpose of this paper is to report a case of Apert syndrome in a female fetus of 30 weeks with asymmetrical skull confirmed by prenatal ultrasonography. Pregnancy was terminated and fetus was submitted for detailed autopsy in anatomy dissection hall. The findings and review of literature were presented in this article.
The "Authorship Index" - a simple way to measure an author's contribution to literature.
(2013-01) Kaushik, Robin
Myocardial FFR (Fractional Flow Reserve) in patients with angiographically intermediate coronary artery stenosis - an initial institutional experience.
(2013-01) Ramaiah, Jagadish H; Ramegowda, Raghu T; Chikkaswamy, Srinivas B; Nanjappa, Manjunath C
RESEARCH ARTICLE January-March 2013 | Volume 1 | Issue 1 | Page: 4-11 Myocardial FFR (Fractional Flow Reserve) in patients with angiographically intermediate coronary artery stenosis - an initial institutional experience Jagadish H. Ramaiah*, Raghu T. Ramegowda, Srinivas B. Chikkaswamy, Manjunath C. Nanjappa Sri Jayadeva Institute of Cardiovascular Sciences & Research, Jaya Nagar 9th Block, BG Road, Bangalore - 560069, Karnataka, INDIA Correspondence to: Dr. Jagadish H. Ramaiah, Email: jagadishhr@rediffmail.com Background: The clinical significance of coronary artery stenosis of intermediate severity can be difficult to determine. The management of intermediate coronary lesions, defined by a diameter stenosis of ≥40% to ≤70%, continues to be a therapeutic dilemma for cardiologists. The 2-dimensional representation of the arterial lesion provided by angiography is limited in distinguishing intermediate lesions that require stenting from those that simply need appropriate medical therapy. In the era of drug-eluting stents, some might propose that stenting all intermediate coronary lesions is an appropriate solution. However, the possibility of procedural complications such as coronary dissection, no reflow phenomenon, in-stent restenosis, and stent thrombosis requires accurate stratification of patients with intermediate coronary lesions to appropriate therapy. Myocardial fractional flow reserve (FFR) is an index of the functional severity of coronary stenosis that is calculated from pressure measurements made during coronary angiography. The objective of the study is to evaluate the usefulness of FFR in patients with angiographically intermediate coronary artery stenosis. Methods: 20 patients with intermediate coronary stenosis and chest pain of uncertain origin. The Exercise Electrocardiography (TMT), Myocardial Perfusion Imaging study (MPI), Quantitative Coronary Angiography (QCA) were compared with the results of FFR measurements. Results: 20 patients were undergone FFR measurement during the study period. With the mean age of 57.25±11.2 and male patients were 16 (80%), female patients 4 (20%), in all 13 patients with an FFR of <0.75, reversible myocardial ischemia was demonstrated unequivocally on at least one noninvasive test. In contrast, 5 of 7 patients with an FFR of >0.75 tested negative for reversible myocardial ischemia on TMT and MPI study. No revascularization procedures were performed in 7 (35%) patients, and no adverse cardiovascular events were noted in all these patients during 6 months of follow-up. Conclusions: In patients with coronary stenosis of intermediate severity, FFR appears to be a useful index of the functional severity of the stenosis and the need for coronary revascularization
A study of neonatal and maternal outcomes of asthma during pregnancy.
(2013-01) Meena, Babu Lal; Singh, V B; Sameja, Parvej; Tundwal, Vijay; Beniwal, Sanjay
Background: Asthma is a common problem all around the world with variable prevalence ranging from 1%–18% in different age and geographical distribution. There are proximately 300 million affected individuals. There are growing prevalence and morbidity, due to asthma associated with pregnancy. The course of asthma in pregnancy is unpredictable. Methods: 2400 consecutive pregnant women attending the antenatal clinic of S.P. Medical College and AG of Hospitals, Bikaner, were screened using asthma questionnaire translated in Hindi based on the questionnaire developed for International Union against Tuberculosis and Lung Disease. 52 patients diagnosed as asthma were subjected for PFT and classified according to clinical severity as per GINA guidelines, 2006. All subjects were followed till delivery and postpartum charts reviewed to see neonate and maternal outcome. Results: The prevalence of asthma during pregnancy was 2.1%, among them, 25 (48.1%) were categorized as having intermittent asthma, 6 (11.5%) with mild persistent asthma, 10 (19.2%) with moderate persistent asthma and 11 (21.2%) having severe persistent asthma. During the course of pregnancy, 36% had no change in the symptomatology, while (32.5%) experienced improvement and (32.5%) of worsening of asthma. 22 (42.31%) women were newly diagnosed during our study. There was no significant adverse maternal and fetal outcome in asthmatic group compared to control. Conclusions: Asthma is an under diagnosed and under treated disorder, especially during pregnancy and overall morbidity of asthma among women & neonates does not change during pregnancy.
Origin of cystic artery from hepatic artery proper and its surgical implications.
(2013-01) Patil, Sachin; Rana, Kumkum; Kakar, Smita; Mittal, Anilkumar
Cystic artery is usually a branch of right hepatic artery given in the Calot’s triangle. Variations in the origin of cystic artery have been reported but there is paucity of literature regarding these in Indian subjects. The present case describes the origin of cystic artery from the hepatic artery proper, with an unusual course, which was detected during routine cadaveric dissection. The development of biliary vasculature is quite complex and it accounts for many variations. Knowledge of cystic artery variability facilitates intraoperative identification of vessels in both classical and laparoscopic surgery of the bile ducts. This emphasises the importance of a thorough knowledge of the cystic arterial variations that often occur and may be encountered during both laparoscopic and open cholecystectomy. Uncontrolled bleeding from the cystic artery and its branches is a serious problem that may increase the risk of intraoperative lesions to vital vascular and biliary structures during hepatobiliary surgery.
Detection of extended spectrum β-lactamase among gram negative clinical isolates from a tertiary care hospital in South India.
(2013-01) Balan, K
Background: The β lactamase enzymes produced by the organisms break down the structural beta-lactam ring of β lactam antibiotics. Many genera of gram negative bacteria possess a naturally occurring, chromosomally mediated β lactamase and also some are plasmid mediated β lactamases. The objective of the study was to detect extended spectrum β lactamases among gram negative clinical isolates. Methods: 200 clinical were subjected to routine disc diffusion technique and zone diameter of ≤27mm for Cefotaxime and ≤22mm for Ceftazidime or ≤25mm for Ceftriaxone were included in this study. The strains are subjected to double disc synergy test. Results: Of 200 samples, 174 yielded organisms belonging to enterobacteriaceae and 26 yielded growth of nonfermenters. Out of 174 members of enterobacteriaceae family, 122 were E. coli, 36 Klebsiella spp, 8 Proteus spp, 5 Enterobacter spp and 3 Citrobacter spp. Out of 26 nonfermenters, 18 were Pseudomonas spp and 8 were Acinetobacter. Conclusions: In the present study prevalence of ESBL was 23.3%, the high prevalence may be due to irrational use of third generation cephalosporins in both the hospital and community.
Extremely large size VSD with pulmonary stenosis.
(2013-01) Kumar, J Rajendra; Kumar, T Sanath
Defect in the ventricular septum with obstruction to right ventricular outflow tract encompass a wide anatomic, physiological & clinical spectrum. Large ventricular septal defects occur with pulmonary stenosis that varies from mild to severe to complete (pulmonary atresia). Very large VSD (size 6.4cm, in our case) with severe PS is a rare CHD & without surgical correction only 10% patients can survive beyond 20 year of age. With the help of noninvasive investigation (echocardiography) we can diagnose CHD very easily
Cadaveric study of accessory renal arteries and its surgical correlation.
(2013-01) Saritha, S; Jyothi, Naga; Kumar, M Praveen; Supriya, G
A thorough knowledge of the accessory renal arteries has grown in importance with the increasing number of renal transplants and other uroradiological procedures. The literature indicates that multiple renal arteries are found in 9-75% cases. Normal anatomy describes each kidney receives irrigation from single renal artery which arises from abdominal aorta at the level L1-L2 vertebrae just below the superior mesenteric artery. Renal artery variations include their origin, number and course. The most common is the presence of additional vessels (accessory arteries) arising above the usual trunk is more frequent than one arising below. The accessory renal arteries are always end arteries. The kidneys may receive a single artery although each organ may equally be supplied by as many as six end arteries. The right and left renal arteries may arise from the aorta by a common stem or arise at lower point than usual in which case the kidneys lie below their usual position. There may be several renal arteries on each side or the renal artery may divide close to its origin into several branches. Current literature reports great variability in renal blood supply, the number of renal arteries mentioned being the most frequently found variation. Normal renal arterial information is useful not only for planning and performing of endovascular, laparoscopic uroradiological procedures and renal transplants. In order to facilitate the clinical approaches, we studied renal arterial pattern in 25 formalin fixed cadavers, on 50 kidneys during the period of one year. The purpose of this present study was to establish the incidence of accessory (aberrant) renal arteries in human cadavers and also discuss its surgical correlation during uroradiological procedures and angiographic interventions.
A case of inferior lumbar hernia.
(2013-01) Sharma, Vidhyasagar M; Akruwala, Sushil D; Desai, Shashank; Dave, Rajendra I
In this article we report a case of inferior lumbar hernia. The patient underwent preperitoneal meshplasty. The patient is well on follow up with no recurrence. The relevant literature has been reviewed and management discussed in brief.
Characteristic and trends of malaria in Surat district of Gujarat: a hospital based study.
(2013-01) Kevadiya, Shraddha M; Patel, Mandakini M; Modi, Jigna; Gamit, Bhavna; Patel, Prashant R; Padsala, Suresh
Background: Malaria is a major health problem and infects many individuals despite of various efforts to control it. The present study was aimed to observe characteristics of malaria, seasonal variation and prevalence of malaria in our region. Methods: This retrospective study was conducted in our institute from period of January 2012 to December 2012. All the fever cases undergone investigations for malarial parasites were included in present study for defined time period. All the laboratory data of the patients having fever were retrieved from the Pathology Laboratory of our institute. Results: out of total 32674 reports studied 4907(15.01%) were positive for malaria with overall Slide positivity rate and slide falciparum rate were 15.01% and 38.29% respectively. Incidence of malaria occurs throughout year with increased incidence of P. falciparum in monsoon. Conclusion: In the present study incidence of malaria was higher in monsoon in comparison to other seasons. But throughout the year no declining trends in incidence of malaria was observed. P. vivax malaria was more commonly observed in our study but incidence of P. falciparum increased in monsoon.
A swelling on the fore head- the tip of the iceberg.
(2013-01) Shetty, Prathvi; Tauro, Leo Francis; Alex, Kavitha Mary; Bhallal, Chandra Kumar
An epidermoid cyst is a benign cyst usually found on the skin, developing out of ectodermal tissue. These are relatively uncommon benign cysts or tumors to arise over the surface of the brain. They are mostly intra dural and few percentages are located in the diploic space. We are reporting a case of 51 years old lady presenting with a swelling over forehead which was diagnosed to be an intradiploic epidermoid cyst of the frontal bone with an intracranial extension which is an unusual presentation causing clinical dilemma. Radiological findings led to a correct diagnosis and with complete removal patient is doing well.
Correlation between elevated serum ferritin and HbA1c in type 2 diabetes mellitus.
(2013-01) Raj, Sumesh; Rajan, G V
Background: Serum Ferritin, an acute phase reactant is a marker of iron stores in the body. Recent studies indicate that increased body iron stores and subclinical hemochromatosis has been associated with the development of glucose intolerance, type 2 diabetes, metabolic syndrome and possibly the development of diabetic retinopathy, nephropathy and vascular dysfunction. This study was carried out to examine and establish a relationship between Serum Ferritin with Type 2 diabetes mellitus and metabolic syndrome and to examine whether a correlation between S. ferritin and FBS, HbA1c exists. Methods: 86 type 2 diabetes subjects (M:F - 57:29, mean age 54.3±9.2 years, mean BMI 24.28kg/m2) which included 24 patients with metabolic syndrome were studied and compared with controls. S. ferritin, Hb, ESR, FBS, PPBS, HbA1c and fasting lipid profile were measured. Results: Serum ferritin was significantly higher in diabetic patients when compared to controls and serum ferritin had a positive correlation with increasing duration of diabetes. Conclusions: There was a positive correlation between serum ferritin and FBS, HbA1c. There was no correlation between serum ferritin and age, sex, metabolic syndrome, coexistent hypertension, total cholesterol, LDL and serum triglycerides.
A prospective study on the use of magnesium sulfate in prevention and management of eclampsia with emphasis on adverse drug reactions.
(2013-04) Shah, Heena; Sattigeri, B M; Brahmbhatt, Shruti; Singh, Parul; Parikh, Devang; Kumar, Ashok
Introduction: The hypertensive disorders in pregnancy are the leading causes of maternal and perinatal mortality. Management of preeclampsia and eclampsia remains controversial even today. Several drugs with different regimens are available at present. As a consequence; women are treated in various ways by different regimens. Aim: Our work aimed to study the use of various magnesium sulfate regimens used in management of eclampsia in a tertiary care teaching rural hospital. Methods: A prospective, observational, non-interventional study was carried out among the eclamptic patients admitted to obstetrics ward. After explaining the purpose and method of study, through the patient information sheet, patients willing to sign the informed consent form were enrolled for the study. Relevant data was gathered from their case files and by direct interview with the patients that were recorded in the case record form. Results: Of the 35 cases of eclampsia recorded during the study period, we observed that all the patients were treated with Pritchard’s regimen of Magnesium Sulfate. It was noticed that there was improvement in all the patients with no adverse drug reactions recorded during the time of management. Conclusion: Maternal and perinatal mortality can be reduced to major extent by prevention of eclampsia. Prompt diagnosis and institution of therapy by selecting an ideal anticonvulsant is essential as the maternal and perinatal mortality progressively rises with increase no of convulsions. Magnesium Sulfate is a potent anticonvulsant with mild antihypertensive activity with less adverse effects.
Limb body wall complex or body stalk complex or cyllosomas: a case report.
(2013-04) Saritha, S; Gouri; Sumangala
Limb body wall complex (LBWC) is also called Body stalk complex and Cyllosomas. We present this rare congenital malformation complex highlighting the importance of early sonographic imaging findings in LBWC along with differentiation from other anterior abdominal wall defects. Limb body wall complex / Body stalk anomaly refers to a rare complicated polymalformative fetal malformation syndrome of uncertain etiology and results in head, heart, lung, diaphragm, kidney or gonadal abnormalities. LBWC was first described by Van Allen et al; in (1987). The two of the three following anomalies must be present to establish the diagnosis: 1. Exencephaly / Encephalocele with facial clefts, 2. Thoraco-Abdominoschisis / ventral body wall defects and 3. Limb defects. LBWC arises as a result of early amnion disruptions or error in embryonic development. If all components of the syndrome are present, the condition is lethal. LBWC is invariably fatal and incompatible with life. No case of postnatal survival is reported so far. Serum alpha-fetoprotein measurement and ultrasonography examination is the key to the prenatal diagnosis and followed by medical termination of pregnancy. It presents two distinct phenotypes described by Russo et al (1993) and later Cusi et al in (1996), according to the foetoplacental relationships: 1. Placento-cranial and 2.Placento-abdominal types. Among the 168 live births at S.V.S. Medical College & hospital Mahabubnagar (INDIA) during the period of 2010-2011 we came across an aborted female fetus. It was weighing 1800gms, 30 weeks of gestation diagnosed by antenatal ultrasonography as ventral body wall defect. It was associated with ompholocele, severe scoliosis and limb defects. Its confirmation of the diagnosis of Limb body wall complex with Placento-abdominal type was done by postmortem fetography.
Dyslipidemia in psoriasis: as a risk for cardiovascular disease.
(2013-04) Dsouza, Priya Hilda; Kuruville, Maria
Background: Psoriasis is a common and recurrent proliferative inflammatory skin disease that has been associated with abnormal plasma lipid metabolism and with high frequency of cardiovascular morbidity and mortality. The prevalence seems to be related to the severity of psoriasis, as it occurs more frequently in patients presenting with large areas of the body affected with lesions. The aim of our work was to evaluate the development of dyslipidemia in psoriasis, and to look for a correlation between their levels and severity of diseases in which the risk factors and secondary causes of hyperlipidemia were excluded. Methods: We evaluated the fasting lipid profile in twenty-four patients with mild to moderate psoriasis and twenty-four age and gender matched healthy subjects as the control group. Results: Patients presented risk changes in lipid profile, serum total cholesterol (p<0.001), triglyceride (p<0.01), LDL-cholesterol (p<0.001), VLDL-cholesterol (p<0.01) and TC/HDL ratio (p<0.01) were found to be significantly higher than in control group. No significant statistical difference was observed between HDL levels of the two groups. Significant positive correlation in total cholesterol and LDL-cholesterol was found between mild and moderate psoriasis (PASI score) as compared with controls. Conclusion: Our data suggest that psoriasis patients must be considered as a group at high risk for cardiovascular, since psoriasis per se seems to be associated with risk changes in the lipid profile. We conclude that psoriatic patients should be evaluated and followed up for the risk of hyperlipidemia and cardiovascular diseases.
A demographic study on vitiligo (sheti) in Bangladesh.
(2013-04) Rahman, Mohd Hafizur; Amin, Md Ziaul; Rahman, Matiar; Satter, Mohd Abdus
Vitiligo is quite prevalent and constitutes a major psychological health problem in Bangladesh. To determine the effects and extent distribution of Vitiligo among the people, we mainly focused on the sociodemographic studies on Vitiligo in Bangladesh. The patients volunteered in this study were randomly selected from the Skin and Venereal disease department of Rajshahi Medical college hospital, Rajshahi, Bangladesh during 2009-2011. In this sociodemographic studies 125 vitiligo patients of different age groups were carried out. Age distribution, Sex incidence, occupation, itching, life living status, food allergy, social problem were studied. In this study, disease incidence was the highest 44% among 11-20 years age group. In case of sex incidence the female patients were 56%, on the other hand, male recorded 44%. The demographic characteristic showed that the students were the highest percentage (48%) suffering with Vitiligo by occupation. Family history was the most important survey in this study. 32% patients said they had prior to family history. The maximum patients had living status of middle class (40%). In this study 24% patient complained about Food allergy and the participant patient also complained the social problem of Vitiligo. Eighty percent patients reported that most of the person avoids them because general people know that Vitiligo is an infectious disease. This study will give the social consciousness about Vitiligo i.e. it is not an infectious disease.
Surgery for inguinal hernia in pediatric age.
(2013-04) Suvera, Mukesh S; Damor, Panchshila B; Patel, Shaishav V
Inguinal hernia repair is one of the most frequently performed surgical procedures in pediatric patients. An inguinal hernia does not resolve spontaneously and must be repaired because of high risk of complications. A retrospective analysis was performed on the hospital records including operative notes of admitted pediatric patients, aged up to 12 years, who underwent inguinal herniotomy. On observation, male affect more than female , right side inguinal hernia more common than left, due to let decent of testis on right side. Early detection and repair of inguinal hernia in pediatric is essential to decrease the potential morbidity and operative complications rate. This needs an increase in popular and pediatric awareness.
Angiosomes of medial cord of brachial plexus.
(2013-04) Suseelamma, D; Deepthi, S; Chaitanya, K Krishna; Sharada, H R
This anatomical study analyzed the neurovascular relationship of the brachial plexus. Ten formalized specimens of brachial plexuses were examined after injection of lead oxide in to the subclavian artery. The vascular, anatomical features of the brachial plexus were documented .The specimens were analyzed by dissection method, subjected for microscopic study. The vascular supply was markedly rich, often with true anastomotic channels found within the nerves. There was much variation in supply, depending on the branching pattern of subclavian artery.
A prospective survey study on premenstrual syndrome in young and middle aged women with an emphasis on its management.
(2013-04) Brahmbhatt, Shruti; Sattigeri, B M; Shah, Heena; Kumar, Ashok; Parikh, Devang
Premenstrual syndrome (PMS) is defined as the recurrence of psychological and physical symptoms in the luteal phase, which remit in the follicular phase of the menstrual cycle. Symptoms of which fall in three domains: emotional, physical and behavioural e.g. irritability, anger, headache, fatigue, food cravings etc. The survey study of was conducted among 50 young & 50 middle aged women of S.B.K.S Medical Institute and Research Centre to find the prevalence of premenstrual syndrome with an emphasis on its management. Responses to a feedback questionnaire covering various aspects related PMS were obtained from 50 participants belonging to each group. The participants belonged to different range of literacy. It was found that 42% faced PMS regularly, while 58% occasionally. Of the 100 participants 68% suffered with backache, 64% leg cramps, 62% fatigue, breast tenderness and anger whereas 58% suffered with anxiety and generalized body ache. Of all the sufferers only 34% had received the treatment for PMS. Irrespective of the age PMS is common problem faced by women. With our study we observed that literacy has not mattered in the management of this health problem. Since there are reports stating that the severity of PMS can hamper the daily routine and even lead to suicidal tendency, it is essential that awareness programs need to be conducted to address the importance of managing the issue by pharmacological and non-pharmacological methods.

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