Acta Medica International

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https://imsear.searo.who.int/handle/123456789/157542

Chief Editor: Prof. S. K. Jain
ISSN (Print): 2349-0578 (Online): 2349-0896

Frequency: Biannual

Language: English

Open Access Peer-reviewed journal

Web site: www.actamedicainternational.com

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Now showing 1 - 20 of 301

Hydration Therapy to Improve Amniotic Fluid Index and its Association with Improved Obstetric Outcome in a Teaching Hospital of Eastern India
(Wolters Kluwer - Medknow, 2022-06) Biswas, huma; Mondal, Swarnakamal; Dasgupta, Shyamal; Datta, Mousumi; Khatun, Nasima; Jyothi, Lakavath
Introduction: Oligohydramnios is associated with fetal complications and a higher incidence of maternal operative morbidity. A study was planned to determine the effect of hydration therapy in the correction of oligohydramnios in pregnancy and to assess if improvement in amniotic fluid index (AFI) is associated with better obstetric outcomes. MaterialsandMethods: Analytical study with a prospective design, conducted over 1 year from July 2020 to December 2021. Pregnant women in their third trimester with singleton pregnancy and intact membranes, diagnosed to have oligohydramnios were the participants. All women undertook oral rehydration therapy. The proportion of women achieving posthydration cutoff values of AFI and single deepest vertical pocket, was recorded by abdominal ultrasound examination at 24, 48, and 72 h. Adequacy of hydration was assessed by urinary specific gravity, before and after hydration therapy. Results: There were 120 participants. The mean age of the participants was 25.6 years (standard deviation = 5.7). Majority were multigravida. About 60%–80% of women improved with hydration therapy and the proportion of women showing improvement increased with time. Women with uncorrected AFI (<5 cm) at 24 and 48 h had significantly higher odds of preterm delivery, cesarean delivery, low‑birth‑weight baby, baby having 5 min Apgar score < 6, higher likelihood of Sick Newborn Care Unit admission and neonatal death. Conclusion: Maternal hydration therapy can be of value to improve the fetomaternal outcome in pregnancies with oligohydramnios by preventing preterm termination and reducing cesarean deliveries with good neonatal outcomes. Such simple intervention can be home based and assures universal health coverage
Nutritional Status of Tribal Under‑Five Children in a Community Development Block of Birbhum District, West Bengal: A Cross‑Sectional Study
(Wolters Kluwer - Medknow, 2022-06) Goswami, Prosun; Chakraborty, Amitava; Mitra, Kaushik; Das, Dilip Kumar; Ray, Soumalya
Introduction: One of the essential components for maintaining health is having proper and adequate nutrition. The absence of this might affect majorly the physical domain of health, especially in under‑five children as it is the age of development. The present study was conducted among the tribal under‑five children in a tribal predominant block, Mohammad Bazar in Birbhum District of West Bengal to find out their nutritional status, along with the estimation of prevalence of anemia among them; and the association, if any, between the nutritional status of the study population with their demographic, socioeconomic, and environmental characteristics. Materials and Methods: This community‑based cross‑sectional study was conducted among 378 tribal under‑five children residing in 21 villages of Mohammad Bazar Block during September 2018–August 2020 using Lot Quality Assurance Sampling (LQAS) technique. A predesigned, pretested schedule was used to collect necessary information regarding background characteristics. Anthropometric measurements (height and weight) and biochemical estimation (hemoglobin level in blood) were done to evaluate nutritional status. Ethical permission was obtained from Institutional Ethics Committee, Burdwan Medical College. Data were analyzed using the Statistical Package for the Social Sciences, version 20. Results: The present study showed that 31.0% of under‑five children were underweight, 16.6% severely underweight, 31.5% stunted, 17.2% severely stunted, 21.7% wasted, and 7.7% severely wasted. Nearly one‑third of the study participants were suffering from anemia and most of them (91.5%) had mild anemia. As per LQAS, none of the villages had acceptable nutritional status as far as the weight for age and height for age was concerned. Conclusions:This research unveiled that the undernutrition in various forms still persists among the tribal under‑five children. Rigorous implementation of various schemes, missions, and programs by both state and Central Government are the need of the hour to overcome this downhearted situation
Association of Nonalcoholic Fatty Liver Disease with Coronary Artery Disease in Type 2 Diabetes Mellitus: A Cross‑Sectional Study from a Tertiary Care Medical College Hospital
(Wolters Kluwer - Medknow, 2022-06) Ramya, Neelakandan; Karthikeya, Golepu; Shankar, SethuPrabhu
Introduction:Nonalcoholic fatty liver disease (NAFLD) is a risk factor for increased morbidity, mortality, and cardiovascular disease. This study was done to assess the association of NAFLD with coronary artery disease (CAD) in type 2 diabetes mellitus. Materials and Methods: The study was done as a cross‑sectional study in a tertiary care medical college hospital for 2 years among 218 adults patients of both sexes with type 2 diabetes mellitus. The study protocol was approved by the institutional ethics committee of the hospital. Age, sex, lifestyle, hypertension, personal history for smoking, and details of any previous CAD were recorded. Electrocardiogram (ECG) and ultrasonography of the abdomen were done. The association of NAFLD in type 2 diabetes mellitus patients with symptoms of angina according to modified rose and ECG changes using Minnesota codes was studied. Data collected were analyzed with Statistical Package for the Social Sciences (SPSS) version 20. Results: Of the total 218 diabetic patients, there were 92 (42.2%) were in the age group of 65–74 years. One hundred and forty‑two (65.1%) had NAFLD and 76 (34.9%) had normal liver. Eighty‑eight males and 54 female diabetic patients had NAFLD. Of the NAFLD patients 88 (58%) were smokers, 77 (54%) were obese, and 72 (51%) had hypertension. Low‑density lipoprotein was increased in 132 (93%) patients with NAFLD. Angina symptoms according to modified rose questionnaire was present in 26 (18%) of NAFLD patients. Probable ST/T and Q/QS ECG changes according to Minnesota coding was present in 32 (22.53%) and in 26 (18.3%) of diabetic patients with NAFLD. Conclusion: There is significant association of coronary artery disease and cardiovascular risk factors with NAFLD in type 2 diabetes.
Age‑Appropriate Feeding Practices and Nutritional Status of Slum‑Dwelling Young Children in Kolkata during COVID‑19 Pandemic: A Cross‑Sectional Study
(Wolters Kluwer - Medknow, 2022-06) Das, Nivedita; Chatterjee, Supantha; Mukhopadhyay, Dipta Kanti; Ray, Soumalya; Sarkar, Mrittika; Seal, Moumita
Introduction: COVID‑19 pandemic was postulated to affect the infant and young child feeding (IYCF) practices and their nutritional status. This study was planned to assess IYCF practices and nutritional status of infant and young children residing in slum areas and their association with selected background characteristics. Materials and Methods: Acommunity‑based, cross‑sectional study was conducted in slums of Kolkata Municipal Corporation among 161 mother–child dyads from October to December 2020. After obtaining informed consent, mothers were interviewed to collect information about their socioeconomic status, hardship faced during pandemic, and IYCF practices of their children using indicators proposed by the World Health Organization and Government of India. Weight and height were measured using the standard operating protocol. The proportion was used to express descriptive statistics. Binary logistic regression models were used for calculating the adjusted odds ratio (AOR) using PSPP (v 1.20). Results: Only 64 (39.8%) children received age‑appropriate feeding; 73 (45.3%) had single/multiple anthropometric failure(s). Reduction of family income was reported by 142 (88.2%) respondents. Children aged 6–8 months (AOR = 17.08, 6.43–45.42) were more likely to not have appropriate feeding. Association of female gender (AOR = 2.00, 1.01–4.00), maternal education less than middle class (AOR = 2.58, 1.22–5.46), and lack of appropriate feeding (AOR = 2.57, 1.08–6.12) were statistically significant with the presence of anthropometric failure. Conclusions: The study revealed a dismal scenario of child feeding and nutritional status of young children in the urban slums of Kolkata. Pandemic and imposed restrictions hit the families hard by reducing income and increasing food‑related costs.
Comparison of the Locoregional Outcome, Toxicities, and Compliance between Hypofractionated and Conventional Chemoradiotherapy for Head‑and‑Neck Cancers
(Wolters Kluwer - Medknow, 2022-06) Sharma, Jyoti; Loyal, Anushree; Dhal, Shikha; Goyal, Sumit; Kapoor, Tapan; Rajendra, Ishitaa; Singh, D.P.
Introduction:Head‑and‑neck cancer (HNC) treatments are elusive, and the hunt for an appropriate radiation strategy continues.Hypofractionation has the potential to provide several advantages, including a shorter overall duration that reduces rapid repopulation, dosage escalation with a higher biologically effective dose, and patient convenience. Hypofractionation is also beneficial in minimizing the danger of catching an infectious agent by reducing the number of hospital visits during the height of the COVID‑19 epidemic. Materials and Methods: Between January 2020 and August 2021, 120 patients with squamous cell carcinoma of the head‑and‑neck subsites were randomly allocated to either the hypofractionated arm A (n = 60) or the standard fractionation arm B (n = 60) with concomitant treatment. Results:Locoregional tumor response, acute and late toxicity, and compliance were the study’s endpoints. The normal tissue toxicities of each patient undergoing radiation were monitored weekly. Clinical and radiographic evaluations of locoregional control were conducted. Conclusion:Hypofractionation effectively overcomes tumor repopulation in rapidly growing tumors such as HNC, and we conclude in our study that the hypofractionated chemoradiation schedule appears to be more efficacious, with relatively superior locoregional control when compared to conventional chemoradiation with comparable normal tissue toxicities and compliance
Comparative Study on the Effects and Complications of Transverse Insertion of Two Fine Gauge Quincke’s Spinal Needles 26 and 29 G in Spinal Anesthesia
(Wolters Kluwer - Medknow, 2023-06) Varghese, Becki Susan; Wahi, Ajay; Duggal, Geetashu; Bansal, Sapna; Singh, Prabhdeep; Gargamenities, Manvi
Introduction:Spinal anesthesia is one of the most commonly used techniques in modern anesthesia. Spinal needles have evolved over time to increase efficacy and decrease complications. Fine gauge spinal needles technically consume more time but are advisable in certain clinical conditions such as raised intracranial pressure and when patient well‑being and comfort are the priorities. Hence, we undertook this study to compare the effects and complication of transverse insertion of Quincke’s spinal needle 26 G (gauge) and 29 G. Materials and Methods: Hundred patients of age 18–40 years posted for lower abdominal and lower limb surgeries were allocated into two groups of 50 each to receive spinal anesthesia with 3 ml of 0.5% bupivacaine using 26 G or 29 G Quincke’s spinal needle. All the patients were evaluated for the time of drug administration, number of attempts, time to attain sensory blockade up to T8 level, time to attain motor blockade up to bromage Grade 3, and incidence of post‑dural puncture headache (PDPH) and post‑dural puncture backache. Results: Demographic data were comparable in both groups. The PDPH incidence on 3rd day for 29 G Quincke’s was 0% while for 26 G Quincke’s was 12%. There was statistically significant difference when 26 G Quincke’s was compared with 29 G Quincke’s for number of attempts, time of drug administration, time to attain motor and sensory block. Conclusion: 29 G Quincke’s spinal could be used to provide spinal anesthesia in young adult patients owing to adequate sensory and motor blockade with no incidence of PDPH and backache.
Squatting Facets and Trochlear Extensions of Talus Bone in Indian Population
(Wolters Kluwer - Medknow, 2023-06) Biswas, Rintu Biswas; Pankaj, Arvind Kumar; Anand, Akriti; Verma, Rakesh Kumar; Manik, Punita; Rani, Archana
Introduction:The talus is a tarsal bone articulated with the tibia, fibula, navicular, and calcaneus bones to form supratalar, pretalar, and subtalar joints, respectively. A squatting facet is a kind of anomaly that forms on the surfaces where the tibia and talus articulate. The squatting facet states the daily activities and living style of society. Squatting is described as the hyperflexion of the hip and the knee and the movement of hyperdorsiflexion between the leg and the ankle. Materials and Methods: In the present cross‑sectional study, 600 dry adult human tali were taken from the osteology laboratory in the Department of Anatomy, King George’s Medical University, UP, Lucknow. Each talus was examined for the presence of various patterns of articular facets on the neck of the talus and extensions of its trochlear surface. Ethical clearance was obtained from the Institutional Ethics Committee, King George’s Medical University, Lucknow, as reference code: 121 ECMIIA/P3. Results: In our study, we observed that the lateral, medial, and combined squatting faces are 282 (47.64%), 49 (8.28%), and 22 (3.72%), respectively. Lateral, medial, and continuous trochlear extensions are 126 (21.12%), 120 (20.58%), and 31 (5.36%), respectively, in the Indian population. Conclusion: Modifications of the neck of the talus (squatting facets and trochlear extensions) are the result of prolonged squatting positions, which is a common habit of the Indian population, and incidences of these variations can be used as an anthropological marker for racial and regional differentiation of unidentified bones.
Effectiveness of Lactobacillus rhamnosusGG as an Adjunct in the Treatment of Enteric Fever in Children: A Double‑Blinded Randomized Controlled Trial in Southern India
(Wolters Kluwer - Medknow, 2023-06) Rajamanickam, Ramya; Jayaraman, Aparna; Sivathanu, Shobhana
Introduction:Aprobiotic used as an adjunct in Salmonella typhi infection along with antibiotic is postulated to interfere with the virulence and growth of Salmonella. To determine the effectiveness of Lactobacillus rhamnosusGG (LGG), as an adjunct with intravenous ceftriaxone, compared with a placebo in defervescence and toxemia resolution in children with enteric fever. Settings and Design: This hospital‑based randomized double‑blinded controlled trial was conducted among 56 study participants who were children below the age of 12 years, admitted as inpatients with fever and whose blood culture grew S. typhi. Materials and Methods: Study participants were equally allocated into intervention or control group by simple randomization. The intervention group received injection ceftriaxone and oral LGG (probiotic) for 7 days while the control group received an injection ceftriaxone and oral placebo for 7 days. Statistical Analysis: Kaplan–Meier curves and mantel cox log‑rank test were used to compare the duration for defervescence and toxemia resolution after treatment initiation. Results: Mean duration for defervescence in the intervention and control groups was 3.87 (1.57) days and 3.35 (1.19) days, respectively. The mean time taken for the resolution of toxemia was 3.00 (1.15) days in the intervention group and 2.64 (0.87) days in the control group. Conclusions:The addition of oral LGG at a dose of 3 × 109 colony‑forming units for 7 days to the standard antibiotic therapy for enteric fever did not show a significant reduction in the time taken for defervescence (P = 0.099) or resolution of toxemia (P = 0.148)
Prevalence and the Factors Associated with Self‑Medication Practice: A Community‑Based Cross‑Sectional Study in an Urban Area of Purba Bardhaman, West Bengal, India
(Wolters Kluwer - Medknow, 2023-06) Shaw, Priya; Mandal, Sutapa; Samsuzzaman, Md; Das, Sulagna
Introduction:Self‑medication (SM) is popular globally but leads to the wastage of resources, health hazards, and resistance to pathogens. This study aims to ascertain the frequency and manner, in which SM practices were employed by the urban population of Purba Bardhaman district, West Bengal. Materials and Methods: The study was an observational cross‑sectional one conducted in Burdwan Municipality, West Bengal, India, using a sample size of 180 adults (aged at least 18 years), residing in the study area, i.e., urban slum area for at least 6 months and conducted over 2 months. The data have been collected through a semi‑structured schedule consisting of questions on the sociodemographic characteristics of the study subjects and their SM practices. The data were thereafter analyzed, wherein descriptive statistics and a Chi‑square test were used. Results: It was found that SM was prevalent among 48.9% of the study population, with most participants practicing SM for body pain, headache, and fever. Among the different classes of drugs used, analgesics were the most common (31.8%), followed by antipyretics (25.0%) and antacids (20.5%). The correlation between sociodemographic characteristics and the practice of SM showed that individuals below the age of 36 were found to be more likely to engage in SM, along with individuals who had a low monthly income, and no comorbidities. These subjects were practicing SM more than their counterparts and it was statistically significant with theP < 0.05. Conclusion: The study emphasizes the importance of awareness and education regarding the proper use of over‑the‑counter drugs and recommends educating pharmacists and the public about the same. Public health programs should be introduced for the people living in slums to create cautiousness about SM.
A Comparative Study on Comprehension of Informed Consent Before Emergency and Elective Surgical Operative Procedures
(Wolters Kluwer - Medknow, 2022-12) Mondal, Soumitra; Bhattacharya, Saikat; Jana, Pulak Kumar; Mitra, Kaushik
Introduction: Ahealth‑care beneficiary should comprehend different aspects of medical and surgical interventions before giving consent to perform those. There is no defined way to find out adequate patient comprehension as part of the decision‑making procedure to give consent. This study was conducted to find out the disparity of comprehensiveness between emergency and elective surgical operative procedures both in terms of knowledge dissemination and knowledge comprehension. MaterialsandMethods: Across‑sectional comparative study was conducted at the General Surgery Department of Medical College, Kolkata, during September and October 2021. An interviewer‑administered questionnaire was used on patients undergoing emergency and elective surgical procedures. The comprehension level of informed consent (IC) form was scored as 1, 2, and 3 and compared between two groups using an unpaired t‑test and Mann–Whitney U‑test. Result: Data collection was done from 39 patients for emergency operative procedures and 52 for elective surgical procedures. A composite comprehension score was calculated after adjusting for questions not asked while taking IC. The mean comprehension score for emergency procedures was 18.86 and for planned surgery, it was 20.14. Unpaired t‑test showed significantly high mean comprehension for planned procedures than the emergency procedures (P = 0.007). Comprehension is significantly poorer in emergency conditions even after controlling for age and literacy denoting difficulty in decision‑making in emergency scenarios. Conclusion: It is suggested that the procedure of consent taking should be more structured and interactive so that even in stressful conditions participant understand better about the procedures and take their own decision instead of relying blindly on doctors.
Ki‑67 Expression in Oral Potential Malignant and Malignant Lesions and Correlation of Mitotic Index with MIB‑1 Labeling Index
(Wolters Kluwer - Medknow, 2022-06) Mittal, Ankita; Awasthi, Seema; Chauhan, Rashmi; Ahmad, Faiyaz; Kumar, Ashutosh; Mitra, Nishant
Introduction: Oral cancers are the most serious health issues in underdeveloped countries such as India and considered as the main cause of death. Among them, oral squamous cell carcinoma is the most common type (90%) of all malignancies. Various oral potential malignant lesions (OPMLs) can transform into malignancies. This study was conducted to determine the significance of Ki‑67 expression in oral potential malignant and malignant lesions (MLs) as well as correlation of mitotic index (MI) with MIB‑1 labeling index (LI) in these lesions. MaterialsandMethods: The study was performed on 60 cases in a tertiary care center over a period of 2 years. Ki‑67 expression, MI and MIB‑1 LI were calculated and correlated. Results: In the studied population, there were 49 (81.7%) males and 11 (18.3%) females. The mean age was 46.60 ± 9.94 (23–68 years), with majority of patients in 41–60 years of age group (46/60 cases). Anterior 2/3rd tongue is the most affected site, presented ulcer as the most common lesion. Smoking, tobacco, and betel nutchewing addiction were presented in 72% of the patients. Among 60 cases, 45 (75%) were OPMLs, while 15 (25%) cases were MLs. MI increases in OPMLs and MLs and comparison was significant (P < 0.01). MIB‑1 LI was significant (P < 0.01) on comparison to dysplasia III and MLs. A positive correlation (0.01) was established between MI and MIB‑1 LI of OPMLs and MLs. Conclusion: Ki‑67 expression was found correlated with the progression of disease from OPMLs to MLs. Therefore, it is considered a proliferative marker that corresponds with disease progression. Both proliferative indices (MI and MIB‑1 LI) are positively correlated
Morphological Study of Small Cardiac Vein, Right Marginal Vein, Posterior Vein of the Left Ventricle, Left Marginal Vein, Oblique Vein of Marshall, and Anterior Cardiac Veins in Human Hearts of Western Region of U.P – Clinical Implication
(Wolters Kluwer - Medknow, 2023-06) Agarwal, Jolly; Gopal, Krishna; Agrawal, Anurag; Naithani, Manisha; Tamizhan, Sudhahar
Introduction:Cardiac venous system is an important system for various cardiac interventional procedures such as cardiac catheterization. Various veins like right marginal vein, small cardiac vein (SCV), posterior vein of the left ventricle, left marginal vein, oblique vein of Marshall drain into coronary sinus. While anterior cardiac veins drain right ventricular wall directly into right atrium. Materials and Methods: An observational cross‑sectional study was conducted on thirty cadaveric hearts during a 2‑year period in Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Anatomy Department. The length, diameter of SCV, left marginal vein, posterior vein of the left ventricle, right marginal vein, and oblique vein of Marshall were taken. Results: The study reveals the length of SCV as 28.12 ± 22.87 mm. The length of right marginal vein and posterior vein of the left ventricle is having a significant correlation with age. The length of oblique vein of Marshall is lower in males as compared to females. A number of ACVs were significantly related to weight of cadaver in males. Conclusions: The present study provides data of cardiac veins for various cardiac interventional procedures.
Application of the Milan System for Reporting Salivary Gland Cytology and Risk Stratification by Cytohistological Correlation
(Wolters Kluwer - Medknow, 2023-06) Iqbal, Zeeshan; Rana, Safia; Khetrapal, Shaan; Trisal, Monal; Ahmed, Nehal; Jetley, Sujata; Sharma, Arun Prakash; Jairajpuri, Zeeba Shamim
Introduction:Salivary gland neoplasms are uncommon tumors comprising <3%–10% of all head‑and‑neck neoplasms. Recent WHO classification of salivary gland tumor added many newer entities; however, no definite risk‑stratification system is specified to predict the likelihood of malignancy for each diagnostic category. The present study is designed to evaluate the salivary gland aspirates using the Milan System for Reporting Salivary Gland Cytology for reporting correlating with histological diagnosis which will lead to determine the malignancy risk for each diagnostic category. Risk of malignancy is calculated by the ratio of cytopathology cases with a malignant histopathology to the total number of cytopathology cases with follow‑up histopathology for that particular category. MaterialsandMethods: The present study was a cross‑sectional study done prospectively over a period of 2 years, and a total of 72 participants were selected. This study characterized the cytological features of spectrum of salivary gland lesions varying from benign to malignant. The lesions were evaluated and classified cytologically according to “the Milan System for Reporting Salivary Gland Cytopathology” for reporting salivary gland neoplasms. Histopathological correlation was done with cytological diagnosis wherever possible. Results: In our study of 72 patients with salivary gland lesions with the mean age of the patient being 50.6 years and maximum number of lesions involved the parotid gland followed by the submandibular gland and sublingual gland. Majority of the lesions in the present study were nonneoplastic in nature followed by lesions benign in nature. Malignant lesions were least common in occurrence. Among 72 cases, majority of the cases were seen in Milan category II (nonneoplastic) consisting of 34 cases (47.2%), followed by 31 cases (43.1%) in Milan category IV (benign). Final diagnostic categorization of 72 cases of salivary gland lesions was done according to the Milan system and the histopathological correlation was available in 23 of these cases. Out of the 34 cases in Milan system category II (nonneoplastic), histopathological evaluation was done in 2 cases. Both the cases were benign in nature, 31 cases in Milan system category IV (benign) histopathological evaluation was done in 16 cases where 15 cases were benign in nature and 1 lesion was malignant. Four cases were put in category VI of the Milan system, histopathological evaluation was done in all the 4 cases which were all malignant in nature. Conclusion: The current study validates fine‑needle aspiration cytology as a cost‑effective and noninvasive procedure for differentiating between benign and malignant lesions of the salivary gland, information of critical importance when determining the patient’s next course of treatment.
A Comparative Study of Fluticasone Propionate, Mometasone Furoate, and Saline Nasal Spray in the Treatment of Children with Adenoid Hypertrophy
(Wolters Kluwer - Medknow, 2023-06) Singh, Gurbax; Jolly, Pushkal; Prinja, Sumit; Bawa, A. G. S; Vignesh, A. K
Introduction:Adenoidectomy is currently considered the treatment of choice for relief of the nasal airway obstruction due to adenoid hypertrophy. Evidence suggests that topical nasal steroid sprays can cause a reduction in adenoid size. We aim to compare the effectiveness of fluticasone propionate, mometasone furoate (MF) and saline nasal sprays in relieving the signs and symptoms of adenoid hypertrophy and in reducing the size of the adenoids. MaterialsandMethods: We conducted a randomized comparative study on 60 patients divided into three groups A, B, C (20 each). Group A patients treated with fluticasone propionate nasal spray (400 μg/day), Group B patients treated with MF nasal spray (100 μg/day), and Group C patients treated with saline spray (0.65% w/v in purified water which is made isotonic and buffered). Treatment was given up to 12 weeks with follow‑up at 4, 8, and 12 weeks and at each follow‑up visit assessment was done. Final data were analyzed using SPSS software version 21 and numerical variables associated with different groups were analyzed and analysis of variance test was used. Results: Diagnostic nasal endoscopy and X‑ray grades at day 1 among the study groups were not statistically significant, whereas, at 12 weeks results among fluticasone and mometasone groups were significantly better (P < 0.001) as compared to the saline group. There was a significant improvement in the symptoms under all the categories with the use of fluticasone and mometasone. Conclusion: In our study, both fluticasone propionate and MF were able to effectively reduce symptoms and signs of adenoid hypertrophy as well as help in reducing the size of the enlarged adenoid. Both these drugs were well tolerated by the patients
Impact of an Assessment‑Based Training Module on Communication Skills in Phase I Indian Medical Undergraduates
(Wolters Kluwer - Medknow, 2023-06) Aggarwal, Prerana; Rawekar, Alka; Dey, Saikat Kumar; Roy, Rajarshi
Introduction:Good communication skills (CSs) are not only the crux of a good doctor–patient relationship but also the foundation over which any human relationship is based. The aim of this study was to assess the impact of training on CS in Phase I MBBS students in a Government Medical College in West Bengal, India. MaterialsandMethods: One hundred and eighty‑four Phase I medical students were trained on how to communicate properly with their peers, seniors, teachers, college authorities, department staff, patient relatives, and other health professionals. Each participant underwent a set of three assessments (presession, postsession, and late postsession) for both knowledge and skills in CS. After postsession assessment, feedback by the faculties and peers was provided and reflections were obtained from the participants. A prevalidated questionnaire and Gap‑Kalamazoo CS Assessment Form (with some modification) were used for knowledge and skill’s assessment, respectively. At the end of the module, feedback was collected from the participants. Data were tabulated and results were compared and interpreted. Results: Mean score and standard deviation for knowledge assessment were 5.29 ±1.35, 9 ±1.20 and 8.55 ±0.97 in T1, T2, and T3 and for skills’ score were 17.78 ±4.89, 26.32 ±5.04 and 30.77 ±3.66 in SA1, SA2, and SA3, respectively. Most participants showed improvement in T2 with mean improvement score (T2–T1) of 79.57 ±47.25 and mean retention score (T3–T1) of 71.9 ±47.84. About 52% of participants showed deterioration in T3 with late deterioration score (T3–T2) of−4.06±11.42. 33% showed no change in knowledge, i.e., they retained their improvements, whereas 15% showed further improvement. Fifty‑two percent of participants showed skills’ improvement by scores of 7–12, 43% showed retention by 13–18, and late deterioration was shown by 82%, their scores dropped by 0–6. Conclusion: The training module was successfully implemented, and participants appreciated this type of participant centric assessment‑based teaching learning module. They learned about the effective ways of communication in a fun manner and were determined to apply all that they have learned
Evaluation of the Efficacy of Tranexamic Acid in Control of Bleeding in Total Knee Replacement: An Interventional Comparative Study
(Wolters Kluwer - Medknow, 2022-06) Satpathy, Goutam Kumar; Swain, Sabyasachi; Gouri, L.V; Nanda, Debi Prasad
Introduction: Among the various strategies for in routine total knee replacement (TKR), tranexamic acid (TA) has always been a safer and affordable method. Surgeons have used it in intravenous, intraarticular or in a combined manner to reduce blood loss because it is easily available and has an easy dosing regimen. We aim to find out its efficacy and associated complication when used intravenously. MaterialsandMethods: This study was done in our institute among 27 cases who was operated for primary TKR. They were distributed into two groups based on the use of TA. Hemodynamic parameters such as blood loss, reduction in hemoglobin (Hb), and blood transfusion were assessed. Student’s t‑test and ANOVA were utilized for tests of significance. Results: Out of 27 patients, 17 (62.9%) were female and in the age group of 51–60 years. Most 22 (81.5%) had osteoarthritis. The difference in blood loss across various pathologies and comorbidities was statistically insignificant. Average blood loss was 266.2 ml ± 64 ml (Range = 150–406 ml) per TKR in the 1st group. In 2nd, it was 667.5 ± 111.5 ml (Range = 414–860 ml) (P < 0.001). Mean Hb loss was 0.78 ± 0.275 g/dl (Range = 0.1–1.2 g/dl) in Group A. It was statistically significant comparing to Group B where it was 1.86 ± 0.55 g/dl (Range = 1.5–3.7 g/dl). Tourniquet used though decreased blood loss, it was not statistically significant. Conclusion: TA used in intravenously is very effective in decreasing the loss of blood and transfusion requirements in patients of primary TKR.
Histomorphological Analysis of Nephrectomy Specimens: Experience at a Tertiary Care Institute
(Wolters Kluwer - Medknow, 2022-12) Soumya, B. M; Devi, Rajkumari jayshree; Kulkarni, Sriharsha; Kulkarni, Vardendra G
Introduction: For a range of kidney abnormalities, including both neoplastic and nonneoplastic disorders, nephrectomy is a popular surgical treatment. We conducted this study to examine the range of lesions found in the nephrectomy specimens obtained and to ascertain the distribution of these lesions by age and sex. MaterialsandMethods: This study was conducted in the department of pathology, from 2017 to 2022. All nephrectomy specimens received during 5 years were included. Results: The spectrum of renal lesions observed in the study included both neoplastic (43.75%) and nonneoplastic (56.25%) conditions. Nineteen patients were males (59.37%) and 13 were females (40.62%) (M: F = 1.4:1). The most common entity in the nonneoplastic category was chronicpyelonephritis (n = 9, 28.12%). In our study, we documented two unusual cases of renal replacement lipomatosis (RRL), a type of pseudotumor related to nonfunctioning kidneys. Fourteen patients underwent nephrectomy for neoplastic conditions such as Wilm’stumor and renal cell carcinoma (RCC). Conclusion: Nephrectomy for the nonneoplastic condition was performed more frequentlyin our series. Histopathological evaluation of nonneoplastic nephrectomy specimens must be thoroughly considered, particularly in unusual circumstances such as RRL, where a preoperative erroneous initial impression of a malignant lesion such as angiomyolipoma or liposarcoma is possible.
Medical Record Keeping for Quality Patient Care: An Observational Study
(Wolters Kluwer - Medknow, 2023-06) Rudresh, S.A; Mathew, Sherry P
Introduction:Effective management of medical records is essential for delivering high‑quality treatment. The location, architecture, and personnel of a medical records department (MRD) can considerably impact its operational efficiency. This study seeks to examine hospital MRD and establishes whether its current configuration is suitable for effective medical record management. Materials and Methods: The descriptive method was utilized to evaluate the MRD of the hospital. The review analyzed the department’s physical layout, personnel, workload, training programs, and available equipment. The study also evaluated the influence of government and business restrictions on MRDs operations. Results: It was determined that the MRD of the hospital had an appropriate physical layout, with divisions positioned in optimal locations. The department’s personnel levels were adequate, with twenty employees managing the patient population’s workload. The analysis determined that the department required extra photocopiers and scanners to boost operational efficiency. In addition, the study underlined the significance of adhering to policies, protocols, and established processes in ensuring efficient workflow. Conclusion: The analysis concludes that the hospital MRD has an adequate physical layout, staffing levels, and task management. However, the present equipment could be enhanced to increase operational efficiency. The study also emphasizes the importance of adhering to policies, protocols, and written processes to ensure the department’s efficient workflow. The outcomes of this study may inform future decisions on MRD management in other health‑care organizations, especially those subject to comparable government and commercial regulations
A Study of the Medical Record Department’s Experience, Competence, and Application at a Tertiary Care Hospital
(Wolters Kluwer - Medknow, 2023-06) Mathew, Sherry P; Rudresh, S. A.
Introduction:The primary source of health information for a patient is medical record data. Thus, accurate, complete, and properly recorded patient data are important to provide the best treatment. The workload of the hospital may be reduced and operate more effectively in the hospital if staff members have the necessary knowledge, awareness, and desired clinical abilities, together with an understanding of medical records. Materials and Methods: From January 1 to December 31, 2017, the study was carried out at Tertiary Care Hospital Medical Record Department (MRD). The staff was evaluated for their competency and skill gaps using questionnaires. The complete use of the medical records was then evaluated per quarter for a year. Results: The staff showed adequate understanding of the various questions about medical records. Over the year, there was the highest utilization of files from the MRD, with medicine and obstetrics and gynecology in broad specialties and the department of cardiology with nephrology having the highest utilization in superspecialties. Conclusion: The job environment was pleasant for the staff, and the questionnaire revealed adequate knowledge. Increased satisfaction among MRD staff members, as well as among doctors, nurses, paramedics, and patients, may be related to the utilization being greater in MRD that has been scientifically designed, well‑planned, and appropriately structured, with the best physical amenities
A Morphometric Study of Typical and Atypical Lumbar Vertebrae in South Indian Population
(Wolters Kluwer - Medknow, 2023-06) Shalini, Ramanathan; Pushpa, Kaliyaperumal; Mangaiyarkkarasi, Ponnusamy; Thiagarajan, Sivakami
Introduction:The lumbar vertebrae are affected in conditions such as congenital defects, degenerative diseases, accidents, and cancer metastasis. A thorough knowledge of the morphometry of typical and atypical lumbar vertebrae in adults of South Indian population is needed for lumbar spine surgeries. MaterialsandMethods: Adescriptive study was done on 200 dry lumbar vertebrae, of which 100 were typical and 100 were atypical lumbar vertebrae. The following dimensions of both typical and atypical lumbar vertebrae were measured with digital vernier calipers: anteroposterior and transverse diameters of the body; anterior and posterior body heights; anteroposterior and transverse diameters of vertebral foramen; height, breadth, and width of the laminae; length, height, and width of the pedicles; transverse processes and spinous process; distance between the two superior articular processes; and the distance between the two inferior articular processes. All the measurements were tabulated. The mean and standard deviation were calculated for each of the parameters and the results were statistically analyzed. Results: The anteroposterior and transverse diameters of the body, the height of the laminae on both sides, the length and height of the spinous process, and the distance between the superior articular facets were significantly longer in atypical lumbar vertebrae than that of typical lumbar vertebrae (P < 0.05). There was no significant difference in measurements between both sides. Conclusion: The dimensions of vertebral foramen, transverse processes, spinous processes, and distance between articular processes were different from the dimensions of previous studies. The morphometric data obtained will be useful for orthopedic procedures on the lumbar vertebrae in South Indian population

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