Era's Journal of Medical Research

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Aberrant Form Of Klebsiella Pneumoniae In Fulminant Emphysematous Hepatitis With Polymicrobial Infection
(Era's Lucknow Medical College and Hospital, 2017-01) Kinsley, Jemima D; T, Parameeswaran Nisheeth; Francis, Gnanaprakasam; CN, Srinivas
Klebsiella pneumoniae is a gram negative, rod shaped and non-motile bacterium of the family Enterobacteriaceae. It is encapsulated, facultative anaerobic bacteria. Bacterial morphology can be altered by various factors, including antibiotics. Unusually shaped, large, swollen organisms were observed in the liver abscess obtained from a patient with Fulminant emphysematous hepatitis with polymicrobial infection in blood. The organism was identified as Klebsiella pneumoniae by the Vitek 2 compact system.
ACCESSORY BREAST TISSUE WITH COEXISTENT ADNEXAL TUMOR IN MALE – RARE CASE
(Era's Lucknow Medical College & Hospital, Lucknow, 2021-12) Sharma, S; Agrawal, V; Ali, S.S; Gupta, P.
Accessory breast tissue occurs due to failure of resolution of embryonic mammary ridges present from axilla to groin bilaterally. It may be functional or non-functional. This condition is more commonly seen in the females and very few cases have been reported in males. Development of ectopic breast tissue is dependent on hormonal stimulation similar to normal breast.It remains asymptomatic usually and increases in size after a hormonal stimulation at the time or after puberty. Majority of the occurrences are completely benign, but this condition also has the potential to convert into a malignant lesion. Apocrine hidrocystoma is regarded as cystic retention and adenomatous proliferation of apocrine sweat glands. It commonly occurs on the head & neck, but can infrequently be present in other locations like axilla, vulva, penis. This is the report of case of apocrine hidrocystoma with accessory breast tissue in a 30 year old male presented with left axillary swelling. Cytomorphological assessment revealed benign epithelial lesion and a diagnosis was established only after a histopathological examination. It emphasises the role of histopathology in diagnosis of axillary breast lesions
Accidental Finding Of Dentigerous Cyst In Relation To Maxillary Impacted Canine- A Case Report
(Era's Lucknow Medical College and Hospital, 2018-01) Patil, Viren; Tapadiya, Vishal; Ramanojam, Shandilya; Limbhore, Mayur; Gelada, Kalyani; Pathan, Wasim
Most common developmental odontogenic cysts are dentigerous cysts. They are usually derived from the epithelial remnants of tooth forming organs. Dentigerous cysts gradually increase in size. There may also be associated with bone resorption. Developmental odontogenic cysts account for 25% of all odontogenic cysts of the jaw. They are commonly associated with impacted or embedded teeth like mandibular/maxillary third molar and maxillary canines. It is always better to manage dentigerous cyst conservatively and thereby maintain the vitality of adjacent structures.
Aceclofenac Induced Stevens Johnson Syndrome: A Rare Case Report
(Era's Lucknow Medical College and Hospital, 2017-01) Hasan, R; Abidi, A; Ahmad, A.; Saxena, K.; Rizvi, D.A; Thadani, A
Aceclofenac is commonly used Non Steroidal Anti-Inflammatory Drugs (NSAIDs) for musculoskeletal pain. Though mostly it is a safe drug but there were some spurious reports of Adverse Drug Reaction (ADR) by this drug. Here we report a rare occurrence of Stevens-Johnson syndrome (SJS) / Toxic Epidermal Necrolysis (TEN) after the use of Aceclofenac. An elderly female presented to dermatology OPD with complaints of eye discharge, blackish disclouration and oedema around both the eyes and lips and a rapidly evolving rash over face and bullaes and blisters all over the body. On taking history patient stated that she is taking Tab. Aceclofenac 100 mg BD since 2 days for sprain in her Right Foot. It was diagnosed as a case of drug induced SJS and Naranjo score for this adverse drug event was six, thereby making it a
ACUTE PANCREATITIS IN PREGNANCY CHALLENGES
(Era's Lucknow Medical College & Hospital, Lucknow, 2022-12) Nishad, S; Ahmad, A; Gupta, U; Singh, S.
We report a case of a 24 years old lady at 32 weeks 5 days of gestation, who was referred to our hospital with severe pain the upper abdomen and radiating to the back , associated with vomiting with history of raised blood pressure. After investigations she was diagnosed with acute pancreatitis with non severe pre eclampsia. She was managed by multidisciplinary team approach and improved.
AMELANOTIC MELANOMA- RARE CASE REPORT
(Era's Lucknow Medical College & Hospital, Lucknow, 2022-06) Parveen, H; Naziya, S; Shukla, S; Chaudhary, R; Verma, P; Lal, N.
Amelanotic melanoma is an uncommon type of of melanoma which lacks melanin pigment (1). Of all the melanoma cases, approximately 2- 8% cases represents amelanotic melanoma. The exact prevalence of this malignancy is more due to misdiagnosis. Due to lack of clinical criteria and pigmentation, the condition often detected late (2). Amelanotic melanomas are commonly found on the face, which shows microscopically the characteristics of desmoplasia (desmoplastic melanoma), but other body parts can also be involved (4)
Anaplastic Lymphoma Kinase (ALK) Gene Rearrangement Detection Using Fluorescene In-Situ Hybridization (FISH) In Lung Cancer Prognostication
(Era's Lucknow Medical College and Hospital, 2016-07) Singh, Alok; Srivastava, A.N.; Singh, Pooja
Lung cancer is a leading cause of cancer related death worldwide. It is increasing at a very fast rate in both men and women. Some significant mutations occurring at molecular level in lung adenocarcinoma, like ALK, EGFR, KRAS, MET, and, ALK (anaplastic lymphoma kinase) gene mutations for an ALK encoded transmembrane receptor tyrosine kinase domain and subsequently participating in the progression of Non-Small Cell Lung Adenocarcinoma (NSCLC). Some fusion partner genes involved in this process are EML-4, KLC1, KIF5B and TFG. The ALK-EML-4 rearrangement is the second most common oncogenic mutation in the nonsmall cell lung adenocarcinoma. There is 3-7% ALK mutation occurring in early or never-smokers in accompanying NSCLC. The NSCLC with ALK gene mutation generally do not have EGFR or KRAS gene mutation which are also molecular markers, which get mutated in cancer. For the detection of ALK mutation in NSCLC, different types of techniques like Fluorescence in situ Hybridization (FISH), Immunohistochemistry (IHC) and Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) are being used. On the basis of sensitivity and specificity, FISH is gold standard in detecting the mutation when compared with other methodologies like IHC and RT- PCR. However in the Indian setting, FISH is more expensive and hence not available everywhere. In this review the efficacy of these different techniques in detecting ALK mutation and the detailed interpretation of results obtained with FISH has been discussed. For the treatment of ALK/MET mutated NSCLC patients an orally administered drug, crizotinib drug (tyrosine kinase inhibitor) has been approved by Food and Drug Administration (FDA) of United States. Highly sensitive and specific techniques are used for the detection of ALK gene mutation in NSCLC patients which have to be given for crizotinib treatment.
ANGIOKERATOMA: A RARE MANIFESTATION
(Era's Lucknow Medical College & Hospital, Lucknow, 2022-12) Zehra, A; Tandon, N; Chaudhary, R; Shukla, S; Lal, N
Angiokeratoma shows dilatation of capillaries in the upper dermis and it also shows some epidermal changes, like- hyperkeratosis, papillomatosis, and thickening of epidermis or acanthosis .Clinical presentation of angiokeratoma includes plaques over the skin of lower limbs, mostly on the buttocks or thigh. It is usually identified clinically but a definitive diagnosis is made only on histopathological examination.A deeper biopsy of the lesion is empirically essential to make a concrete diagnosis as the characteristic changes seen in angiokeratoma, are limited to superficial dermis. Our case report has a 24 years old female presenting with unilateral, linear, bluish-black verrucous plaque on the back of left elbow.
ASSOCIATION OF ?-GLUTAMYLTRANSFERASES (GGT) WITH AND WITHOUT HYPERTENSIVE RETINOPATHY IN NORTH INDIAN POPULATION
(Era's Lucknow Medical College & Hospital, Lucknow, 2022-12) Nigam, B; Chaturvedi, A; Sharma, K.
?-Glutamyltransferase (GGT) has been extensively studied because it mediates the intracellular uptake of extracellular glutathione, a key component of the antioxidant mechanism. The most common modifiable risk factor for cardiovascular disease is hypertension, and has been found to be associated with serum GGT levels, especially in middle-aged and older adults. Serum GGT is involved in the pathogenesis of hypertension. A case-control study was conducted for 24 months with patients with pre-diagnosed hypertension in the ophthalmology department. Patients were classified into two groups, group 1 with 50 patients previously diagnosed hypertensive patients aged 40 years without hypertensive retinopathy and group 2 (100 patients) with had hypertensive retinopathy. Serum gamma-glutamyl- transferase was measured using the CORAL Colorimetric Assay Kit. Majority of patients were aged between 40 to 59 years and were females. SBP, DBP and MAP significantly increased in group 2 when compared with group 1. Majority of group 2 patients had GGT levels >40 U/l (89.0%), while the majority of group 1 had her GGT levels less than <40 U/L (62.0%). According to our study, GGT was significantly increased in patients with high blood pressure (SBP and DBP) and a family history of hypertension.
Association Of Angiotensin-Converting Enzyme (ACE) And Glutathione S-Transferase (GST) Gene Polymorphisms With Diabetic Nephropathy
(Era's Lucknow Medical College and Hospital, 2017-07) Raza, Syed Tasleem; Eba, Ale; Singh, Sachendra P.; Raza, Syed Tahseen; Mahdi, Farzana
Diabetic nephropathy accounts for the most serious microvascular complication of diabetes mellitus. It is suggested that the prevalence of diabetic nephropathy will continue to increase in future pretense a major challenge to the healthcare system resulting in increased morbidity and mortality. It occurs as a result of interaction between both genetic and environmental factors in individuals with T2DM-Type 2 diabetes mellitus. Genetic susceptibility has been offered as an important factor for the development of diabetic nephropathy, and various research efforts are being executed worldwide to identify the susceptibility gene for diabetic nephropathy. Several single nucleotide polymorphisms have been found in various genes giving rise to various gene variants which have been found to play a role in genetic susceptibility to diabetic nephropathy. The risk of developing diabetic nephropathy is increased several times by inheriting risk alleles at susceptibility loci of various genes like ACE, GST, TNF-α, COL4A1, eNOS, GLUT, etc. The identification of these genetic variants at a biomarker level could thus, let the detection of those individuals at high risk for diabetic nephropathy which could thus help in the treatment, diagnosis and early prevention of the disease. The present review discusses about the ACE-Angiotensin Converting Enzymeand GST-Glutathione S Transferase gene variants associated with diabetic nephropathy.
THE ATP-BINDING CASSETTE TRANSPORTER A1 GENE POLYMORPHISMS AND TYPE 2 DIABETES MELLITUS.
(Era's Lucknow Medical College & Hospital, Lucknow, 2022-06) J, Al-Awaida W; J, Al-Ameer H; Sharab, A; Fatima, G; R, Hadi N
Insulin resistance (IR), secretion of insulin, and abnormalities of lipid metabolism are all markers of type 2 diabetes (T2DM), which is a progressive and complex metabolic disorder. Major risk factors for the development of T2DM were identified as genetic, environmental, and lifestyle factors. Several studies found that many genes contribute to T2DM susceptibility after glucose tolerance. Adenosine Binding Cassette Transporter Proteins 1 is a member of the ABC gene superfamily that is involved in cholesterol transport and HDL cholesterol (HDL-C) biosynthesis. Abnormal cholesterol metabolism, particularly high-density lipoprotein, has been related to genetic variations in the ABCA1 gene (HDL-C). Previous research suggested that ABCA1 gene polymorphisms may a hereditary risk factor for type 2 diabetes, along with lower HDL levels in various populations.
BARDET BIEDL SYNDROME IN PREGNANCY A CASE REPORT
(Era's Lucknow Medical College & Hospital, Lucknow, 2021-06) Kumari, S; Rizvi, S; Singh, A; Ahmad, A; Kashiv, S.
Bardet Biedl Syndrome (BBS) is a rare idiopathic autosomal recessive disorder which affects multiple organs and organ systems. In India less than 15 cases have been reported so far. We present case of 41 year old third gravida who presented at 17 weeks of gestation. She had a suspicious history of delayed milestones in the previous child and ultrasound findings of echogenic kidneys, bilateral talipes, and polydactyly. Index child evaluation showed type-6 variant of BBS. Amniocentesis in the present pregnancy showed the same mutation in the fetus. The couple decided on termination of t pregnancy.
BASALOID SQUAMOUS CELL CARCINOMA- A RARE METATYPICAL TUMOR- CASE REPORT
(Era's Lucknow Medical College & Hospital, Lucknow, 2022-12) Tiwari, K; Misra, V; GuptaV; Dhingra, K; Gupta, S.
A rare kind of squamous cell cancer is called basaloid squamous cell carcinoma occurring in sixth to seventh decade of life with male predilection. It preferentially occurring in upper aerodigestive tract. Rare case reports are presented in the classical age group with a poor prognosis. A 46 year's senior old male patient showed up to otorhinolaryngology department with chief complain of growth on base on left side of tongue and supra-glottic growth. On radiological evaluation by Multislice CT Scanning, a heterogeneously enhancing mass lesion measuring approximately 25×38 mm was noted at the base of tongue. On cytological evaluation of the lesion, highly cellular smear showed malignant morphology of the cells. Histological evaluation reveals a tumour mass in which neoplastic cells were composed of two different cell types – the majority of the cells population consisted of basaloid cells with abrupt association of foci of squamous cells suggesting basaloid variant of Squamous cell carcinoma. We brought this case for acknowledgment due to its rare occurrence, lower age of presentation, poor prognostic value as well as high metastatic potential.
BIBLIOMETRIC ANALYSIS OF EMERGENCY MEDICINE
(Era's Lucknow Medical College & Hospital, Lucknow, 2022-12) Can, D
Emergency medicine is a popular and new medical sub-specialty that provides rapid management of acute critical illness and injuries. In this study, it is aimed to perform bibliometric analysis of the articles about Emergency Medicine using the scientific mapping method. The Web of Science Core Collection (WoS) database was examined within the scope of this study and 3595 articles matching the search criteria were included in the research. For the analysis, the "bibliometrix 3.0" program which was developed in the R environment and "biblioshiny" web interface provider, which was developed for the use and visualization of this program, were used. It was found that the first article in the field of emergency medicine was published in 1980. It was also found that there was a significant increase in the number of articles after 1995 and peaked in 2021. Academic Emergency Medicine, Annals of Emergency Medicine and Journal of Emergency Medicine are the most influential journals in terms of publication and citation numbers and indexes. Professor Michelle Lin from the University of California, Professor Wendy C Coates from the UCLA Geffen School of Medicine, and Professor Gregory Luke Larkin from the Yale University School of Medicine are the most influential researchers in this field. Emory University, Michigan University, Brown University, which are American universities, are the most competent institutions in the field of emergency medicine. "Education" and "medical education" keywords are the most frequently used words along with emergency medicine. Recently “leadership”, “internsip” and “malpractice” issues are beginning to emerge. USA, Canada and United Kingdom are the leading countries in total number of publications, single-country and multi-country publications. It is considered that the research is original and its results will contribute to the relevant researchers about the publications in the field of emergency medicine.
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.
Biosimilars In Medicine
(Era's Lucknow Medical College and Hospital, 2017-01) Siddiqi, Zeba
Biopharmaceutical drugs or biologicals have become an essential part of modern pharmacotherapy. Biosimilars or similar biologics have been defined as drugs that have shown to have comparable quality, safety and efficacy to the original biopharmaceutical drugs. The past decade has seen a significant increase in interest in these products from the biotechnology industry. Major developments in order to establish a regulatory path for approval of these products have taken place . In order to understand how the different quality attributes of a biosimilar impact its safety and efficacy we need further efforts. India is globally regarded to have great potential for development and commercialization of biosimilars.
BLENDED LEARNING INNOVATIVE EFFECTIVE STUDENT CANTERED EDUCATIONAL STRATEGIES IN THE NURSING PROFESSION
(Era's Lucknow Medical College & Hospital, Lucknow, 2022-12) Ghosh, G; Anwar, S.
Blended learning, a pedagogical approach is nowadays widely accepted as a combination of both “face-to-face” and online learning components. Concerns have grown throughout time regarding an instructional methodology and a teaching and learning strategy. Several studies and reviews all over the world highlighted that Blended Learning is the most effective method of transferring knowledge to the students and implementation of this approach in professional fields like medical, nursing, and paramedical courses will not only improve the teaching- learning environment but also motivate the students in the self-directed learning approach. The term is specifically given to the educational practice of using a combination of traditional classroom teaching and digital learning. National and internationally this method are being used in an educational institution to motivate the students in effective learning. Computers and technology have their own impact on Integrated learning and the teaching-learning process utilizes these impacts to improve the learning methods of the students.
Book Review: Langman's Medical Embryology By: T.w. Sadler. 13 Edition
(Era's Lucknow Medical College and Hospital, 2018-01) Srivastava, Geetanjali
Cancer Cell Viability And Survival In Vitro As Function Of Cell Surface Electric Charge : An Analytical Study
(Era's Lucknow Medical College and Hospital, 2015-07) Khan, Mohsin Ali; Ahmad, Rumana; Srivastava, A.N.
Electrical charge is an indicator of the cellular state of health. In cells, the cell membrane is a leaky dielectric. Capacitors are composed of two conducting sheets separated by a thin layer of insulating material known as a dielectric. Cells contain several forms of biological capacitors, which consist of an insulating material (the membrane) covered on both sides by collection of charged dissolved minerals, which serve the function similar to a conducting metal plate. This means that any condition, illness or change in dietary intake that affects the composition of the cell membranes and their associated minerals can affect and alter cellular capacitance. Healthy cells have a higher whole cell and cytoplasm conductivity and higher membrane capacitance than the malignant cells. The electric charge of cell membranes of mammals is negative at physiological pH. It is well-known that surface of cancer and tumor cells carry negative charge in excess to that of normal cells which is responsible for their increased mobility and invasiveness. The high negative surface charge on malignant cells and trophoblasts may mediate the lack of immune rejection of these cells. Thus, neutralizing or removing the tumor cell negative charge may allow negatively charged lymphocytes to approach and destroy them and thereby, the viability and survival of the cancer cells may be affected at least in vitro. The present study serves to - test this hypothesis on invasive human breast carcinoma cell line MDA-MB-231 (ER ) using specially designed and constructed combination of circuits. Preliminary results showed that out of the 8 designed circuits, sets 1, 2 and 7 were able to produce significant growth inhibition of MDA cells in vitro. The application of electrostatic field through specially designed circuits is unique and has never been reported previously. Our long-term goal is to develop a minimally invasive device that will selectively target and destroy both metastatic and non-metastatic cancer cells in humans. Better understanding of effect of decreasing surface charge density of tumor cells may lead to device effective treatment strategy of human tumors in future.
Cancer Stem Cell In Glioblastoma Multiforme
(Era's Lucknow Medical College and Hospital, 2017-07) Lal, Bachchu
Glioblastoma multiforme (GBM) is an aggressive tumor that typically exhibits treatment failure with high mortality rates, is associated with the presence of cancer stem cells (CSCs) within the tumor. CSCs possess the ability for perpetual self-renewal and proliferation, producing downstream progenitor cells that drive tumor growth. Studies of many cancer types, have identified CSCs using specific markers, but it is still unclear as to where in the stem cell hierarchy these markers fall. This review examines the current knowledge on the CSCs markers SALL4, OCT-4, SOX2, STAT3, NANOG, c-Myc, KLF4, CD133, CD44, nestin, and glial fibrillary acidic protein, specifically focusing on their use and validity in GBM research and how they may be utilized for investigations into GBMs cancer biology.

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