Online Journal of Health and Allied Sciences

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https://imsear.searo.who.int/handle/123456789/151077

Chief Editor: B. S. Kakkilaya
ISSN: 0972-5997

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.ojhas.org/

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Now showing 1 - 20 of 60

Spectrum of Reactive Morphological Alterations in Leucocytes in HIV Patients.
(Light House Polyclinic, 2022-03) Srivastav, S; Mardi, K; Prasad, V.
Background: The earliest hematological manifestation of HIV infection can occur at the time of primary infection. Several peripheral blood abnormalities are known in HIV. However, not many studies have reported morphological changes in white blood cells in antiviral naïve patients and even fewer have compared them with HIV seropositive patients. Material and methods: Peripheral blood smears from 100 patients were studied. 50 of them were newly diagnosed HIV seropositive cases and 50 were HIV seronegative. A peripheral blood smear was made to study morphology of various white blood cells A written informed consent was taken. Statistical analysis of the data obtained was done. Results: Morphological abnormalities in the lymphocytes had been the most significant finding, which included nuclear lobulation, nuclear convolution and plasmacytoid and monocytoid features. Neutrophils also showed various morphological abnormalities. Most common were hypogranulation, hypersegmented nuclei and cytoplasmic vacuolations in descending order of frequency. Monocytes also revealed few morphological abnormalities including nuclear irregularities and cytoplasmic vacuolations. Conclusion: The observations from this study will serve as a guide to clinicians as treatment of these patients should include supplements to monitor and improve these changes.
Gender Determination Using Morphological Analysis of Palatal Rugae Patterns – A Retrospective Study.
(Light House Polyclinic, 2022-03) Premakumar, P; Azeez, M; Sivakumar, R; Deepa, MS; Siraj, SE.
Background: Palatal rugae are unique for an individual and remain unchanged during individual's lifetime. Application of palatal rugae analysis as a method in gender identification needs to be confirmed with more scientific studies. The objectives of the present study were to assess the distribution of the palatal rugae patterns in Kerala population and compare the distribution of these parameters between males and females. Materials & Methods: A retrospective cross-sectional study was conducted by evaluating the casts of 100 dentate individuals, between the age of 18 and 30 years. The rugae were divided into two halves and patterns were then assessed as per Thomas and Kotze classification. Independent sample t-test was used to assess the significant difference of each type of palatal rugae between males and females. Results: Wavy rugae (mean – 5.6 ± 0.7) was predominant among males whereas curved (mean – 4.6 ± 0.6) and circular rugae (mean – 0.9 ± 0.3) were more in females, and were found to be statistically significant (p<0.05). The mean number of secondary rugae in females (1.5 ± 0.5) was greater than that of males (1.3 ± 0.4), and was found to be statistically significant (p<0.05). The diverging type was commonly found in females compared to males. Conclusion: Our findings showed statistically significant differences in the shapes and patterns of rugae between males and females among Kerala population. Thus, morphological analysis of palatal rugae can be considered as an additional aid in forensic odontology for gender differentiation.
Quantifying Maxillofacial Traumatic Injury for Holistic Management.
(Light House Polyclinic, 2022-03) Gupta, S; Patheja, S; Bansal, RN.
Introduction: The maxillofacial region serves many essential functions of human body. Maxillofacial traumatic injury (MFTI) or sometimes called as facial trauma is the injury to the face, jaws and related structures such as head. Hard tissue / soft tissue injury may range from simple nasal bone fracture to gross facial comminution. The complex maxillofacial trauma has the potential to cause facial disfigurement and difficulty in jaw movement. This study focused on relationship between existing scoring systems as the clinical assessment for MFTI, as a tool for predicting prognosis, morbidity, social and psychological impact. Materials and Method: Data collection included demographics, etiology, MFTI clinical parameters, treatment and psychosocial loss. Data was obtained from the medical records, patient interview at each hospital visit and telephonic interviews as required. A predefined question was prepared containing closed and open ended questions and published scales. Results and conclusion: Mandibular fractures were observed in 69% MFTI cases of which 50% were mandibular only fractures. Need for holistic treatment and management approach was observed. Existing widely used FISS score was found to be predictor for few of the parameters only. Other factors required for holistic treatment approach and planning not predictable by FISS score have also been identified.
Extramammary Metastases to the Breast: A Clinical and Diagnostic Masquerader.
(Light House Polyclinic, 2023-03) Thomas, E; Vairamuthu, P; Kumar, RS.
Although breast carcinoma is common, metastatic deposits to the breast from extramammary neoplasms are rare. Clinically and radiologically, metastatic neoplasms may mimic primary benign and malignant neoplasms of the breast. A correct diagnosis of metastasis to the breast is of considerable importance since the treatment of primary and secondary malignancies of the breast is different. We report 4 cases of extra mammary primary cancers metastasizing to the breast, diagnosed by biopsy, in a period of 5 years in our tertiary care centre. Each of the cases had different characteristics. A good knowledge of cytomorphology and histomorphology, together with clinical correlation and comparison with previous histopathological evidence, will prevent a misdiagnosis and aid in optimal management and therapy.
Lupus Vulgaris Coexisting with Sinonasal Tuberculosis and Tuberculous Dacrocystitis.
(Light House Polyclinic, 2023-03) Manickam, N; Palaniappan, D; Vellaisamy, SG; Gopalan, K.
We describe the case of a 72-year-old female diabetic who presented with epiphora and purulent discharge from the right eye for the past 2 years and multiple skin lesions over the right upper eyelid and right arm for 1 year. Computed tomography of the paranasal sinuses revealed mucosal thickening in the frontal and ethmoidal sinuses, with a polypoidal mass from the right side of the nasal septum and dacrocystitis. The histopathology of the skin lesion was suggestive of lupus vulgaris (LV). There was no evidence of pulmonary tuberculosis. This case was a rare coexistence of LV with sinonasal tuberculosis and dacrocystitis.
An Inter District Analysis of Public Healthcare Infrastructure Disparities in Assam.
(Light House Polyclinic, 2023-03) Neog, N; Baruah, M; Biswas, K; Hazarika, H.
Background: Sufficient and quality healthcare services are basic requirement for overall development of a nation. Public healthcare infrastructure is one of the major determinants of health outcomes in a country, and public healthcare services have a considerable impact on people's health status. The rural population primarily relies on public healthcare services. Assam is not an exception in this regard, where the insufficiency of public healthcare services is still an issue. 86 % of the population of Assam lives in rural areas. Objectives: The present work attempts to study the inter-district variation regarding public health infrastructure in 33 districts of Assam. Methods: The Inter district variation is estimated with a composite index of public health infrastructure. Principal Component Analysis (PCA) is adopted to construct a composite index using nine health infrastructure indicators. Results: The study has observed variations in health infrastructure among the various districts of Assam, reflecting the shortage of health infrastructure-physical and human in rural and remote areas of the state. The study finds inter-district variations in the state.
Evaluation of Efficacy of IAC Yokahama Reporting System For Breast Cytology – A Single Institutional Experience.
(Light House Polyclinic, 2023-03) Amita, K; Dhanlakshmi, B; Sanjay, M.
Purpose: Breast fine needle aspiration cytology (FNAC) has a long history of providing accurate, rapid and cost-effective diagnosis of palpable breast lesions. Recently, International Academy of Cytology (IAC) at Yokohama proposed a new reporting system for breast cytology, in order to bring uniformity across the globe. Any new classification system needs to be validated for its practical applicability. Objectives: This study was conducted to categorize the breast lesions as per this classification and further determine the diagnostic efficacy and risk of malignancy in each category. Material and methods: This was a cross sectional observational analytical study. All the cases presenting to cytology OPD from Janurary 2020 upto December 2022, (N=296) with breast lesions for FNAC were included in the study. All the cases were divided into five categories as per the newly proposed IAC Yokohama reporting system. The risk of malignancy for each category was determined and diagnostic efficacy was evaluated.Results:The sample were distributed as follows: insufficient material 4.39%, benign 66.21%, atypical 10.47%, suspicious for malignancy 1.35% and malignancy 17.56%. Histopathology was obtained in 88 cases, out of which 82 (93.18%) showed concordant diagnosis. The sensitivity and specificity were 85.71% and 98.11% respectively. Risk of malignancy (ROM) in each category was as follows-benign (0.01%), atypia (71.4%), suspicious (100%) and malignancy (96.66%) respectively.Conclusion:The high efficacy of FNAC obtained in the present study, when IAC Yokohama reporting system was applied, confirms the usefulness of this scheme in reporting breast lesions. A risk-based stratification is essential in the present era to guide and alert the clinician about the subsequent management plan and the ROM.
Rural-Urban Comparison of Polycystic Ovary Syndrome in Assam, India: A Hospital Based Cross-sectional Study.
(Light House Polyclinic, 2023-03) Das, C; Baruah, T; Mondal, N.
Background: Polycystic ovarian syndrome (PCOS) is an endocrine disorder adversely affecting fertility and reproductive health with diverse clinical manifestations in women. Aim: The objectives of the present study are to determine and compare the prevalence of PCOS between rural and urban Assamese women in Guwahati, Assam. Methods: A total of 150 (75 rural; 75 urban) Assamese women aged 18-35 years have been collected at Pratiksha Hospital, Guwahati, Assam. The relevant data were collected through self-administered pre-structured and interview methods. Results: Higher prevalence of PCOS was found in the urban areas living in nuclear families in comparison to rural areas. Recent weight gain and obesity with a higher prevalence of oligomenorrhea were found to be higher among the urban participants. An excess androgen activity evidenced by increased hirsutism was higher in the urban areas as compared to rural areas in association with increased levels of serum insulin. Conclusion: A long-term personalized management program is required for effectively treating individuals with PCOS which may help in regulating the symptoms and various other metabolic complications.
Etiology and Prognosis in Burning of Children and Adolescents During 2009-2019.
(Light House Polyclinic, 2023-03) Kouchek, M; Soltani, S; Memarian, A; Aghakhani, K.
Introduction: This study aimed to evaluate the etiology and prognosis in burn children and adolescents referred to Shahid Motahari Trauma and Burn hospital. Materials and Methods: This cross-sectional study was conducted on burn children and adolescents who were hospitalized in Shahid Motahari Burns Hospital between 2009 and 2019 due to burns. Results: In this study, 3,520 patients were studied; of which 2,151 subjects were boys (61.1%) and 1,369 subjects were girls (38.9%). The mean age of the subjects was 2.84 ± 3.66 years. 138 (3.9%) patients died in the study. The relationship between mortality and gender was not statistically significant (P value = 0.336). The highest percentage of burns was 10 to 19% in 1284 patients (36.63%) and the lowest was 80 to 89% burns in 7 patients (0.19%). In terms of burn site, the most areas related to the trunk, lower limbs except the legs and upper limbs except the hands with 22.56%, 18.95%, and 18.45%, respectively, and the lowest related to the legs and the whole body with 6.39% and 8.46%. Also, the highest cause of burning was boiling water in 1915 patients (56.12%). Conclusion: The study showed that boys were more likely to be the victim of burns. Also, the highest percentage of burns was less than 20% and most of the areas are related to the trunk, limbs. The mortality rate was 3.9%. In addition, these evaluations showed that the most common cause of burns was boiling water.
Clinical and Etiopathological Correlation of Acute Infective Hepatitis and Fulminant Hepatic Failure in Pediatric Patients.
(Light House Polyclinic, 2022-03) Choudhary, A; Avasarala, S; Agrawa,l R; Tanwar, GS; Poonia, R.
Introduction: In India, infectious Hepatitis is one of the major health care burdens, with viral hepatitis being the most common culprit, followed by dengue, typhoid, and malarial hepatitis. Fulminant hepatitis manifests as a sudden abnormality in liver function enzymes in a child with no prior hepatic pathology. Aims and Objects: This study was aimed at identifying the various etiological factors and correlating clinical features of viral hepatitis, and fulminant liver failure. Materials and Methods: This observational study was conducted in the paediatrics in-patient department of S.P. Medical College & P.B.M. Associated Group of Hospitals, Bikaner (Rajasthan) over a period of one year. A total of 125 children with a clinical and lab-confirmed diagnosis of acute infective hepatitis were included. Data including clinical signs, symptoms, and laboratory parameters were obtained and analyzed. Results: Most commonly affected age group was between 5-10 years with the mean age being 7.1±4.6 years. The most common etiology was hepatitis A (n=39), followed by hepatitis E (n=24) and mixed hepatitis A virus (HAV)/hepatitis E virus (HAE) infection (n=20). Other causative organisms were dengue virus (n=16), typhoid (n=13), malaria (n=9), and hepatitis B. The most common clinical symptoms were fever, jaundice, loss of appetite, and vomiting/nausea. There were some clinical features seen more commonly in case of infection with certain organisms. High frequency of diarrhoea, arthralgia, and thrombocytopenia was seen with HAV. Neurological, renal complications and high mortality were associated with HEV or HAV/HEV co-infection. While retroorbital pain and purpuric rash were exclusive with dengue, malarial hepatitis was strongly associated with pallor and altered sensorium. Conclusion: Acute infective hepatitis is most commonly caused by HAV and HEV in Western Rajasthan. It is imperative to educate the masses regarding the prevention of common infections transmissible by infected drinking water, poor hand hygiene, improper waste disposal, and open defecation.
Prognostic Significance of Lymphatic Vessel Density by D2-40 Immune Marker and Mast Cell Density in Invasive Breast Cancer: A Cross Sectional Study at Tertiary Care Hospital in South India.
(Light House Polyclinic, 2022-03) Dhanlakshmi, B; Amita, K; Prashantha, K.
Background: Tumour induced lymphangiogenesis plays a crucial role in metastasis and tumour progression. The intratumoural and peritumoral lymphatics are supposed to have different biological effects. The aim of present study was to investigate the correlation of intratumoral lymphatic vessel density (I LVD), peritumoral lymphatic vessel density (P LVD), intratumoral mast cell density (I MCD) and peritumoral mast cell density (P MCD) with prognostic parameters in primary breast carcinoma. Methods: Lymphangiogenesis was detected using D2-40 monoclonal antibody and mast cell by using toludine blue stain in 50 cases of primary breast carcinoma. Positively stained lymphatic vessels were counted at 40 x in dense lymphatic vascular foci (hot-spot) within the tumour. Chi square, ANOVA test and Pearsons correlation was applied to determine the relationship amongst various variables, with statistical significance set at p <0.05. Results: Mean P LVD was significantly higher than I LVD (6.25±21 vs 2.75±2.27,p <0.005). Significant correlation was noted between I LVD and P LVD and age, tumour laterality, tumour size and overall staging. However, there was no correlation between I LVD and P LVD with other important clinicopathologic prognostic markers like grade, lymphnode status and lymphovascular invasion. MCD was higher in both intratumoral and peritumoral location as compared to normal tissue. There was an association noted between P MCD with pathological staging and perineural invasion. However, there was no significant association of I MCD and P MCD with other prognostic markers like grade and lymphnode status. No significant correlation was noted between I LVD, P LVD, I MCD and P MCD. Conclusion: The evidences from our study support the utility of D2-40 stain in determining the lymphatic density in IBC. The study findings also establish the existence of lymphangiogenesis in both intratumoral and peritumoral location. For now, the data presented herein do not permit us to promote the utility of LVD and MCD as predictors of prognosis in invasive breast carcinoma.
Trends and Race/Ethnic Differences in Levels of TC/HDL-C Ratio in the US Among Individuals Aged 6-80 Years: NHANES 2005-2020.
(Light House Polyclinic, 2023-03) Wang, I; Spector, AL; Gliedt, JA; Rahman, MH; Ritchie, D.
Objective: Reliable and disaggregated population-based data for cholesterol trends are needed to evaluate overall cardiovascular health, assess the effects of nutritional policies and pharmacological interventions, and guide priority setting. This study aimed to examine the trends and differences in serum total cholesterol-to-high density lipoprotein cholesterol (TC/HDL-C) ratio among U.S. residents by race/ethnicity. Study Design and Setting: Blood lipid measurements, taken from 53,964 noninstitutionalized participants, aged 6 to 80, were obtained from the National Health and Nutrition Examination Survey (NHANES) study. We described the distributions of TC/HDL-C ratio across the life span in four distinct cross-sectional surveys during 2005-2008, 2009-2012, 2013-2016, and 2017-2020, and compared the ratio levels by race/ethnicity. Results: Between 2005 and 2020, favorable trends in lipid ratio levels were observed. In youth aged < 20 years, mean TC/HDL-C ratios were 3.17, 3.15, 3.02, and 3.06 in males; and 3.12, 3.13, 3.03, and 3.02 in females from 2005 to 2020. In adults 20 years old and older, mean TC/HDL ratios declined from 4.30 in 2005-2008, to 4.27 in 2009-2012, 4.17 in 2013-2016, to 3.96 in 2017-2020 in males; while mean TC/HDL-C ratios declined from 3.67 in 2005-2008, to 3.66 in 2009-2012, to 3.54 in 2013-2016, to 3.46 in 2017-2020 in females. Overall, non-Hispanic black individuals tended to have lower mean TC/HDL ratio levels than other groups, while Mexican American individuals tended to have higher TC/HDL ratio levels on average. Conclusion: Further research is needed to determine how racial/ethnic differences in cholesterol ratio affect racial/ethnic differences in cardiovascular disease rates.
Wide Excision of a Desmoid Tumor of the Anterior Abdominal Wall with Subsequent Reconstruction.
(Light House Polyclinic, 2023-03) Shabunin, AV; Dolidze, DD; Lebedinsky, IN; Bagatelia, ZA; Dzhamilov, Sh.R; Sukhotko, AS; Kovaleva, MV; Covantsev, S.
Desmoid tumors are benign tumors of mesenchymal origin with a complex course of the disease, due to absence of a capsule, infiltrative growth, heterogeneous structure and shape, the true extent of which is difficult to assess before surgery. Despite its benign nature, the recurrence rate reaches 25-50% of cases, and surgical treatment is often accompanied by a number of difficulties with a decrease in the quality of life of patients. In the presented clinical case, a wide excision of desmoid tumor was performed, followed by reconstruction, which ensured a good postoperative result while preserving oncological principles.
An Unusual Case of DRESS Syndrome Presenting with Marked Leucocytosis.
(Light House Polyclinic, 2023-03) Bisht, P; Khetrapal, S; Sehgal, S; Jetley, S; Jain, V.
Drug reaction with eosinophilia and systemic symptom (DRESS) syndrome is a rare severe drug-induced idiosyncratic hypersensitivity characterized by maculopapular and/or erythrodermic eruption, fever, peripheral lymphadenopathy, eosinophilia or atypical lymphocytosis, and visceral organ involvement. The estimated incidence of this syndrome ranges from 1/1000 to 1/10,000 drug exposures. In this report, we describe a case of DRESS syndrome in a young female with a unique presentation. The DRESS syndrome can be difficult to diagnose as its clinical findings can mimic those of other systemic diseases. This case emphasizes the importance of incorporation of the patient’s clinical and medication history in the interpretation of hematological investigations.
A Serious Compromise in the Quality of Medical Education in India by Some Recently Established Private Medical Colleges.
(Light House Polyclinic, 2022-12) Kini, SB.
Medical colleges have become a business industry nowadays, where rich businessmen in the name of trust and foundations are resorting to making huge profits by collecting heavy amount of capitation fees from students without providing quality education to them. It has been observed especially in some of the recently established medical colleges, that the regulations laid by National Medical Council are flouted, and these medical colleges are run with very little patients in the hospital, poor infrastructure and huge number of "Ghost faculties", who are available only during the time of inspection by the regulatory authorities. The regular faculties who are working are overburdened with teaching work, and are also denied relieving and experience letter if they submit their resignation. There is a great need for the regulatory authorities to have a strict scrutiny on such institutions and implement remedial measures to correct these irregularities.
Renal Ganglioneuroma.
(Light House Polyclinic, 2023-03) Kumar, S; Ashok, S; Kumar, M; Kamath, AK; Pandey, H.
Background: Renal ganglioneuroma is an extremely rare benign tumour that affects neural crest cells. Here we report a case of renal ganglioneuroma with nodal metastasis managed by surgical resection. Case report: A 38-year-old female presented with anorexia and early satiety. On examination, she had a palpable mass per abdomen. CT scan revealed a large heterogenous mass in retroperitoneum in right suprarenal region with enlarged retrocrural lymph nodes. She underwent right radical nephrectomy as the mass was inseparable from the right kidney. Postoperative period was uneventful. HPE revealed renal ganglioneuroma. Conclusion: Primary renal ganglioneuroma is difficrult to differentiate from other etroperitoneal lesions. Surgical resection is the most effective treatment.
Effect of Household Air Pollution on Blood Pressure – A Review.
(Light House Polyclinic, 2023-03) Shah, R; Agarwal, D; Patil, M; Parasnis, M; Juvekar, S.
High blood pressure (BP) remains a public health issue of concern in low- and middle-income countries (LMICs). Cooking with solid biomass fuel is common in LMICs, producing hazardous levels of household air pollution (HAP), and exposure to which results in significant morbidity and mortality. The primary victims are women, who are the immediate users. Therefore, a potential relationship between these factors would have massive public health reverberations. Our objective was thus to perform a literature review of the studies investigating the association between HAP and BP in women. We searched the PubMed, CORE, and Semantic Scholar databases from inception through March 2022 to identify reports investigating the relationship between BP and HAP from solid fuel use. The studies included in this report point to an increased risk of high BP from HAP generated as a consequence of using solid fuels for cooking. Conversely, few studies have reported a negative association between HAP and BP. Notably, this inconsistency and the limited evidence base necessitate confirmation of the association by more extensive and robust studies. Further, this report identifies a need to introduce and implement effective clean cooking solutions for public health benefits.
India's Healthcare System Performance Compared with the Kingdom of Saudi Arabia: An Observational Study.
(Light House Polyclinic, 2022-12) Nair, KS.
The objective of this study is to determine how the Indian health care system is performing relative to health care system of the Kingdom of Saudi Arabia (KSA), given that it is facing sustained financial pressure, increasing population and demand for quality care. This is an observational study using secondary data from major international organizations, ministries of health, other government and non- government agencies in India and KSA. In order to measure the performance of health care systems, four domains such as population and healthcare coverage, healthcare spending, health system capacity and health status were considered. In comparison with KSA, India spends a very low expenditure on healthcare and markedly lower health workforce density. Due to lower healthcare expenditure, India's health services outcomes and health status are low compared to KSA. Although Indian healthcare system has undergone notable progress in the last two decades, it is lagging behind in many healthcare system parameters. If India wants to reach a high performing and a nation with good health outcomes comparable with other G20 member countries, it needs to invest more on primary healthcare, health workforce, strengthening public healthcare system, and prevention and treatment for non-communicable diseases.
Post-Cholecystectomy Surgical Re-intervention for Cystic Duct Remnant - An Experience.
(Light House Polyclinic, 2022-12) Rather, AA; Salati, SA; Alfehaid, M.
Background: In laparoscopic cholecystectomy, cystic duct is typically separated closer to the gallbladder to prevent iatrogenic common bile duct damage, leaving behind a long cystic duct remnant that can potentially lead to postcholecystectomy syndrome. Methods: A retrospective analysis of the data from 2010 to 2021 was undertaken at SKIMS Medical College, Srinagar, Kashmir, India, of all the cases who had been surgically re-explored for cystic duct remnants post-laparoscopic cholecystectomy. Results: Twenty cases of both genders underwent surgical reintervention for cystic duct remnant. The mean time of presentation after an index cholecystectomy was 2 years. Surgical operations were conducted through an open approach in 17 (85%) and by laparoscopy in 3 (15%). 95% of patients were symptom-free in the follow-up period. Conclusions: Cystic duct remnants should be considered if a patient report with symptoms suggestive of postcholecystectomy syndrome. The condition once diagnosed, can be managed safely by surgical reintervention.
Challenges to Mental Wellbeing, Perceived Resources, and Felt Needs During COVID-19 Among College Youth in India.
(Light House Polyclinic, 2022-03) Bhattacharya, A; Mehrotra, S; Bhola, P.
COVID-19 has significantly impacted the mental health and well-being of college youth across the world. An online survey using checklists and open-ended questions was shared across various institutions in India to capture information about challenges faced, internal and external resources utilized to deal with the stress, existing support systems and suggestions for additional support for maintaining well-being by college youth. Thematic analysis was conducted to understand the emergent themes. Findings suggested that the most challenging aspect of the pandemic was worry about academics, career, and health of loved ones. The most useful self-management strategies to deal with stress were pursuing hobbies, learning new things, spending time with family, sharing concerns and positive self-talks. The students suggested more robust academic as well as mental health support mechanisms at the university level. At the community level students highlighted the need for community based mental health programs and more support from families. This is one of the very first exploratory studies on the potential mental health impact of the pandemic on Indian university students.

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