Era's Journal of Medical Research

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Cerebellar Cystic Mass Causing Obstructive Hydrocephalous
(Era's Lucknow Medical College and Hospital, 2014-07) Karoli, R; Fatima, J; Shukla, V; Siddiqui, Z
A Rare Case Of Mullerian Anomaly- (HEMATOMETRA With Cervical Agenesis)
(Era's Lucknow Medical College and Hospital, 2014-07) Srivastava, KR; Rizvi, HF; Katiyar, G
Cervical Agenesis is a relatively infrequent mullerian anomaly. Sixteen years old, unmarried girl presented to ELMC&H Lucknow, with complaints of primary amenorrhoea and cyclical abdominal pain for 1 year. On Per-rectal examination, tense cystic mass was felt on right side, approximately 5x5 cm in size, tender and freely mobile. Cervix could not be palpated. Small knob like structure was felt on left side, 1.5x1.5 cm in size, firm in consistency and freely mobile. USG showed uterus of size 5x4x3 cm with collection in endrometrial cavity with? hypoplastic cervix suggestive of- Hematometra with cervical agenesis. On laparotomy, tense unicornuate uterus on right side and solid rudimentary horn on left side was found, which was attached to the uterus by peritoneal fold. Cervix was absent. Both ovaries and tubes were normal. Right cornua of uterus was completely excised leaving both the tubes and ovaries.
Neonatal And Obstetric Transfusion
(Era's Lucknow Medical College and Hospital, 2014-07) Mehdi, S. Riaz; Mustaqueem, Fiza; Tandon, Nishi
Up to four weeks of birth a newborn is considered a neonate. Most often, these neonates are in need of blood or one of its components. The naturally occurring ABO antibodies are not fully developed in neonates and the presence of Wharton’s jelly poses problems in routine grouping and cross matching procedures. Indications and the guidelines for transfusion are different in cases of neonates. Extra precautions are recommended. The proper choice of component is of utmost importance. Hemolytic Disease of Newborn (HDN) is a frequently encountered disorder, occasionally requiring exchange transfusion. The indications, procedure and the complications of Exchange Transfusion have to be understood properly by the pediatricians before employing the procedure, especially in low birth weight babies. The transfusion in obstetric cases and in post partum hemorrhage (PPH) too requires guidelines, which have to be followed. Most of the deaths in obstetrics take place due to PPH which is preventable if the obstetricians take precautions and start the transfusion timely. Beside PPH, perioperative hemorrhage is often an indication for transfusion. All pregnant women must be monitored regularly for iron deficiency anaemia , hemoglobinopathies and alloantibodies during their antenatal period. Neonates quite often require blood transfusion and their requirements are different and unique. A normal neonate has approximately 85 ml/kg of blood volume. Frequent blood collection for laboratory investigations leads to iatrogenic blood loss and need for transfusion.
Seroprevalence Of Hepatitis B Virus In Patients Admitted To Eraâ€™S Lucknow Medical College And Hospital
(Era's Lucknow Medical College and Hospital, 2014-07) Shahi N T; Shahi U; Shukla P; Singh Y I
Hepatitis-B Virus infections are a serious global and public health problem. To assess the magnitude and dynamics of disease transmission and for its prevention and control, the study of its seroprevalence is important. A medical college catering to the needs of a large population represents an important centre for serological surveys. Available data, on the seroprevalence of these bloodborne pathogens is also very limited. A study was undertaken to estimate the seroprevalence of Hepatitis-B Surface Antigen (HBsAg) in both the sexes and different age groups in a hospital-based population. Serum samples collected over a period of 24 months from patients admitted to various IPDs of Era’s Lucknow Medical College and Hospital, Lucknow were subjected within the hospital-based microbiology lab for the detection of HBsAg using ELISA test. The seroprevalence of HBsAg was found to be 1.92%. The study throws light on the magnitude of viral transmission in the community in Lucknow city and provides a reference for future studies.
Hypolipidemic Activity Of Cassia Tora Seeds In Hyperlipidemic Rats
(Era's Lucknow Medical College and Hospital, 2014-07) Kumar, Vishnu; Rathore, Brijesh; Ahmad, Sharique; Mahdi, Farzana; Chander, Ramesh; Khanna, Ashok Kumar; Saxena, Jitendra Kumar; Mahdi, Abbas Ali; Singh, Pradyumn; Singh, Raj Kumar
The hypolipidemic activity of Cassia tora (Chakvat, Chakunda) (Family: Caesalpiniaceae) seeds extract has been studied in two hyperlipidemic models of rat. These are triton injected and cholesterol rich HFD fed model of hyperlipidemia. In triton WR-1339 induced hyperlipidemia, feeding with root extract (500 mg/ kg body wt/ day p.o. ) exerted lipid lowering effect as assessed by reversal of plasma levels of total cholesterol (TC), phospholipids (PL), triglyceride (TG) and reactivation of Post Heparin Lipolytic Activity (PHLA) of plasma. The other model was fed with cholesterol rich HFD and seeds extract of Cassia tora (500 mg/ kg body wt/ day p.o.) simultaneously for 30 days. This also caused lowering of lipid levels in plasma and liver homogenate and reactivation of plasma post heparin lipolytic activity, hepatic total lipoprotein lipase activity. The hypolipidemic activity of Cassia tora seeds was compared with a standard drug guggulipid (200 mg/ kg body wt/ day p.o.), a known lipid lowering drug in both models.
Compression Neuropathy Due To Ossification Of Ligamentum Flavum
(Era's Lucknow Medical College and Hospital, 2014-07) Khanduri, S; Parashari, UC; Bhadury, S; Singh, G
We report a case of 50 years female suffering from compression neuropathy due to ossification of ligamentum flavum. This ossification of ligamentum flavum usually presents with neuropathy in the setting of thoracic spinal stenosis
Current Status And Future Trends In Medical Education
(Era's Lucknow Medical College and Hospital, 2014-07) Zaidi, Shabih H.
Pain Management By Who Step Ladder Pattern Protocol In Cases Of Cervical Cancer
(Era's Lucknow Medical College and Hospital, 2014-07) Namrata; Singh, U; Srivastava, AN; Singh, N; Shankhwar, PL
To assess pain in cases of cancer cervix and to evaluate the response to pain management according to WHO step ladder pattern in cases of cancer cervix, total 209 carcinoma cervix diagnosed and admitted case were recruited in the study. Baseline pain score was measured for each patient. For mild to moderate pain (VAS ≤ 7) , step 1 analgesic, NSAID, diclofenac sodium (50 mg TDS) was prescribed. Pain scores were reevaluated after 48 hrs and change of score was recorded. If pain persisted (same score), worsened (score increased) or score decreased but with a VAS score of > 4 , case was considered as non responder and patient was switched to step 2 analgesic. Step 2 was also applied directly to patients presenting with severe pain ( VAS >7) at the time of recruitment. Drugs used in step 2 was oral tramadol (50 mg QID ) along with Diclofenac ( 50 mg TDS) . VAS Score was reevaluated after 48 hrs. If score still remained above 4; adjuvant analgesics (Amitryptiline 25-75 mg OD, Prednisolone 5mg BD – 10 mg/day) were added to step 2. Step 2 non responders were treated with step3 protocol. In step 3, tab morphine (10 mg BD upto maximum 30 mg BD) was given after stopping all other drugs . After 48 hrs, scores were re evaluated; if scores remained >4; adjuvant analgesics ( Amitryptiline 25-75 mg OD, Prednisolone 5mg BD – 10 mg/day ) were added. After 48 hrs if still pain scores did not decrease to <4, case was declared as failure . The WHO algorithm was followed as per the response of the patients. Outcome showed decrease in pain score using Visual Analogue Scale Score. 209 patients were enrolled in the study. 60 patients had no pain at baseline. Out of 149 patients with pain, 44.9 % (67) patients achieved complete pain relief at step 1. Out of the remaining 82 patients , 5 were lost to follow up. 49.3 % (38) achieved complete relief at step 2 . Only 39 patients did not reach score of zero after step 2 but 35 (89.7%) out of them achieved complete relief after step 3. Out of 142 patients ( excluding lost to follow up ), 2 cases were declared as failure. Among these failure cases, one of them had metastasis of femur and symphysis pubis; bisphosphonates were started. Other patients had bladder and bowel involvement diagnosed on repeat cystoscopy. This WHO guideline implementation study supports use of algorithm in decision making for cancer pain management. Following the same we were able to achieve effective pain relief in 96% of our patients with failure rate of only 4%. It further helped to reduce patient’s agony and improved the quality of life.
Cytology Of Adrenal Lesions
(Era's Lucknow Medical College and Hospital, 2014-07) Jain, Manoj
Cystic and solid lesions in the adrenal glands commonly present as mass lesions and have varied etiology as infectious diseases, benign eysts, adrenal neoplastic lesions and metastasis. Smaller sized and nonfunctional small adrenal lesions, incidentaloma,are being picked up with the advancement in the radiological diagnostic modalities and widespread use of CT scans and USG. Main use of the FNA of adrenal lesions is to ascertain origin and character of cystic and solid adrenal masses, distinguishing benign adrenal nodules from metastatic tumors and diagnosis of infectious diseases commonly presenting as adrenal insufficiency (disseminated histoplasmosis). Radiological guided FNAC of adrenal gland provides an easy and quick method for the diagnosis of these lesions.
A Textbook Of Pathology
(Era's Lucknow Medical College and Hospital, 2014-07) Mrinali, Sant
Fine Needle Aspiration Cytology Of An Unusual Retropharyngeal Mass
(Era's Lucknow Medical College and Hospital, 2014-07) Jain, M; Kapoor, S
We describe a case of long standing goiter with retropharyngeal space mass. FNAC established the diagnosis of retropharyngeal mass as extension of the goiter into the retropharyngeal space. Long standing large goiter usually grows downwards through the thoracic inlet. This case highlights the rare possibility of extension of the goiter into the retropharyngeal space and presenting clinically as retropharyngeal mass.
Disaster Mitigation : Medical Perspectives
(Era's Lucknow Medical College and Hospital, 2014-07) Sharma, Ashok Kumar
Evaluation Of Macular Thickness In Type-2 Diabetics On Pioglitazone
(Era's Lucknow Medical College and Hospital, 2014-07) Agarwal, Swati; Gupta, Sanjiv; Rai, Navendu; Kumar, Dipak
Thiazolidinediones are oral hypoglycemic drugs that have been recently used for patients of type 2 diabetes. Review of literature shows that their side effect of systemic fluid retention aggravates diabetic macular edema. This research work was designed to see the effect of Thiazolidinediones (Pioglitazone) on early diabetic retinopathy. Optical Coherence Tomography (OCT) was used to measure average and central foveal thickness. 122 consecutive eyes of metabolically stable Type 2 diabetes were taken up for study and followed for three months who fulfilled the exclusion criteria. Patients were divided in two groups. Group one included patients with no diabetic retinopathy. Group two included patient with mild / moderate retinopathy without macular edema. As group two was further randomized into two subgroups. First subgroup received standard systemic medical therapy for diabetes and second subgroup received 30mg Pioglitazone in addition to standard treatment. All subjects underwent complete ocular systemic examination including Optical Coherence Tomography (OCT) at baseline, 6 weeks and 3 months. In this study, there was increase in central foveal thickness and average cube thickness in both the subgroups on Pioglitazone. Pioglitazone therapy is related to statistically significant increase in macular thickness at three month follow up. Optical Coherence Tomography (OCT) is an important tool for picking up subclinical changes in macular thickness that do not reflect in visual acuity.
A Rare Case Of Primary Lymphonodular Cryptococcosis In Hiv Positive Patient On Anti-Retroviral Therapy
(Era's Lucknow Medical College and Hospital, 2014-07) Yendigeri, SM; Ahmad, S; Patil, A.M.; Arifulla, KM; Fatima, N; Kolur, A
Cryptococcal infection is the most common life threatening opportunistic fungal infection in Human Immunodeficiency Virus infected individuals. (1) An early diagnosis is essential for a prompt treatment and to prevent dissemination, which is fatal. Pulmonary, intestinal, bone marrow and CNS involvement have been reported. There are only few cases of lymphonodular Cryptococcosis have been reported, we report a rare case of primary lymphonodular cryptococcosis without any pulmonary or CNS involvement. (2)
Bioresorbable Plates In Management Of Mandibular Angle Fracture
(Era's Lucknow Medical College and Hospital, 2015-01) Chandel, Siddharth
Rigid internal fixation of the jaw bones is a routine procedure for the management of facial fractures. Titanium plates and screws are routinely used for this purpose. The limitations of this system have led to the development of plates manufactured from bioresorbable materials which, in some cases, omits the necessity for the second surgery. However, concerns remain about the stability of fixation and the length of time required for their degradation and the possibility of foreign body reactions. The following case report tries to evaluate the treatment of mandibular angle fracture via a single biodegradable plate and address complication such as malocclusion, infection, soft tissue dehiscence and nonunion in these patients.
In Vitro Propagation of Chamomilla Recutita From Capitulum Inflorescence: A Medicinal Plant With Multiple Therapeutic Applications
(Era's Lucknow Medical College and Hospital, 2015-01) Ahmad, Rumana; Misra, Neelam
A protocol has been developed for induction of somatic embryogenesis from whole inflorescence explants of Chamomilla recutita L. (chamomile). Chamomile is a well-known medicinal plant from the Asteraceae family often referred to as the “star among medicinal species.” Nowadays, it is a highly favoured medicinal plant in folk and traditional medicine. Its multitherapeutic, cosmetic and nutritional values have been established through the years of traditional and scientific use and research. Chamomile has an established domestic (Indian) and international market, which is increasing day by day. Among the various major constituents, α-bisabolol and chamazulene have been reported to be more useful than others. Chamazulene occurs in the capitula of the flowers in minute quantities and has been demonstrated to exert antiinflammatory activity in-vivo. Moreover, chamomile is a seasonal 4-5 months winter crop in India but is extensively required in various medicinal applications. Therefore, to increase the overall yield of this plant, its in-vitro propagation is needed. In the present study, somatic embryos were developed from capitulum explants after 2-4 weeks of culture on MS medium supplemented with 26.8 µM NAA and 11.5 µM Kin. The somatic embryos were further subcultured in-vitro, where new plantlets regenerated from embryos. It is concluded that in-vitro propagation is possible in case of chamomile and can be used to increase the overall yield of chamazulene present in the capitula of flowers as well as augment the overall yield of this important plant, which is conventionally propagated by seeds.
Walthard Cell Rest Over Fallopian Tube Mimicking? Brenner Tumor- A Curious & Interesting Case Report
(Era's Lucknow Medical College and Hospital, 2015-01) Gupta, Parul; Irfan, Sumaiya; Siddiqui, Aqwam; Gupta, Pankhudi; Goel, Neeru; Srivastava, A.N.
Walthard cell rests are benign cluster of epithelial cells found in connective tissue of fallopian tubes and also seen in the mesovarium, mesosalpinx and ovarian hilus. It was proposed that Walthard cell rests may be a source of Brenner's tumor or primary urothelial cell carcinoma because of similar histogenetic origin of their cells. Here we report a case which not only during gross examination showed peculiar peritubal glistening tiny nodules but also demonstrated attention grabbing clusters of cell on histopathology, mimicking ? A tumor. A diagnosis of Walthard cell rest was made. One should always consider a differential diagnosis as Brenner's tumor (primary) or serosal implant from gynaecological, genitourinary or other tumors before making a confirmatory diagnosis of Walthard cell rest.
Control Of Multi Drug-Resistant Tuberculosis: Principles And Practices
(Era's Lucknow Medical College and Hospital, 2015-01) Prasad, Rajendra; Gupta, Nikhil
Spectrum Of Microorganisms Isolated From Blood Culture And Their Resistance Pattern
(Era's Lucknow Medical College and Hospital, 2015-01) Gulrez, Mohammad; Khare, Vinita; Varshney, Krati R
The aim of the present study was to determine the spectrum of microorganisms isolated from blood culture and their resistance pattern.This study was carried out between January 2014 and December 2014 in the Department of Microbiology , Era's Lucknow Medical college & Hospital, Lucknow . A total of 2278 blood culture samples of patients with suspected sepsis were included in the study. BHI broth and BACTEC aerobic & anaerobic culture bottles were used for taking cultures.All bottles were subcultured onto Blood and MacConkey's agar. In case of any growth , it was identified and antibiotic susceptibility test was done according to standard procedures.Cultures were positive in 278 samples (12.2%). Spectrum revealed that Coagulase Negative Staphylococci accounted for 34.89%,Staphylococcus aureus17.98% and Klebsiella spp9.35% . Staphylococcus strains showed Methicillin resistance in 10% of isolates. Extended spectrum beta lactamases constituted 26.92% each for Klebsiella and Escherichia coli strains and 40% of Citrobacter strains isolated .Vancomycin resistant Enterococcus strains accounted for 10% of strains isolated .A large proportion of patients presenting with sepsis at a tertiary care hospital, are already treated with antibiotics elsewhere. This leads to a low positive yield in blood culture.The present study highlights the increasing resistance in microorganisms causing sepsis Their early detection and resistance pattern will definitely help in modifying the treatments. Thus early blood culture report increases therapeutic compliance.
Drug Idiosyncrasy In Ophthalmic Practice
(Era's Lucknow Medical College and Hospital, 2015-01) Bundela, Rajendra Kr.; Singh, Luxmi; Lal, B B
Idiosyncratic drug reactions, denoting non-immunological hypersensitivity to a substance, have been a neglected entity. The idiosyncrasy, more often than not, is confused with hypersensitivity, which is an undesirable reaction of normal immune system. The present article gives an insight of the various aspects of idiosyncrasy and idiosyncratic responses of drugs commonly used in ophthalmic practice.

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