Indian Medical Gazette

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https://imsear.searo.who.int/handle/123456789/152655

Editor: Mr. Amar Pandeya
ISSN: 0019 – 5863

Frequency: Monthly

Language: English

Open Access Peer-reviewed journal

Web site: https://medind.nic.in/ice/icem.shtml

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Now showing 1 - 20 of 381

Fallopian Tube Torsion During Pregnancy.
(2015-06) Gupta, Vineeta; Kumari, Nidhi; Nanda, Anuja; Tandon, Archna
Isolated fallopian tube torsion during pregnancy is a very rare condition. We report a case of twisted left fallopian tube during pregnancy who presented as a case of acute abdomen at 23 weeks and laparotomy was carried out. Subsequently she had a healthy baby by assisted vaginal breech delivery. Isolated fallopian tube torsion should be suspected in case of acute pelvic pain and prompt intervention is necessary as surgical detorsion may prevent irreversible vascular changes.
A Case of Live Ovarian Pregnancy at 12.1 Weeks of Gestational Age.
(2015-06) Bhakta, Abhijit; Misra, Malabika; Burman, Sougata Kumar; Mistri, Sujay; Meyur, Rudradeb; Bandyopadhyay, Maitreyi
Ovarian pregnancy is a rare type of ectopic pregnancy its incidence is 1-3% of all ectopic pregnancies. Clinical presentation of ovarian pregnancy is similar to that of tubal ectopic pregnancy. Most of the cases diagnosis is made at laparotomy and is confirmed by histological examination. Here we are reporting a case of un-ruptured ovarian pregnancy at 12.1 weeks of gestational age.
Churg Strauss Syndrome — A Rare Case Report.
(2015-06) Puranik, Shila C.; Rathod, Kalpana B.; Ingle, Anjali P.
A 25 year old male was diagnosed as a case of churg strauss syndrome (allergic granulomatosis and angitis) with history of loose motion, generalized weakness, blanch able erythematous rash on trunk seen along with severe joint tenderness was diagnosed on postmortem autopsy .The aim of this case report is the possibility of churg strauss syndrome in the patient presenting with loose motion and skin rash.
Giant Cell Tumour of the Tendon Sheath — Arising from Iliotibial Band.
(2015-06) Mukherjee, Debojyoti; Pal, Dilip Kumar; Dutta, Soumyadip; Deb, Hironmay; Mondal, Rahul
Chassaignac first described about a benign soft-tissue mass in 1852, characterised by a pleomorphic cell population, which includes lipid-laden foam cells, multinucleated giant cells and round or polygonal stromal cells, often with deposits of haemosiderin in a collagenous stroma. and he overstated their biologic potential in referring to them as fibrous xantoma or Giant-cell tumour of the tendon sheath. They are of two types, Localized (common) and Diffuse (rare) .The rare diffuse form is considered the soft tissue counterpart of diffuse pigmented villonodular synovitis (PVNS) and typically affects the lower extremities1 .Its anatomic distribution parallels that of PVNS, with lesions most commonly found around the knee, followed by the ankle and foot; however, it occasionally affects the hand.
A Comparative Study of Cardiovascular Risk Factors in Cases of Smoked Nicotine and Chewed Nicotine Users.
(2015-06) Tabrez, Shams; Imteyaz, Salamah Parveen; Hassan, Mohammad Jaseem; Imran, Mohammad; Singhal, Sangeeta; Gulati, Rajiv
Objective: To study the cardiovascular risk factors exposed to tobacco chewing and compare these findings with that of smokers and control subjects. Methods: This study was conducted at Jawaharlal Nehru Medical College, Aligarh. 180 subjects were included in this study. The subjects were divided in three groups. Group I (Tobacco chewers-chewed nicotine), Group II (Smokers-smoked nicotine) and Group III (control subjects). Each group consists of 60 subjects. Various anthropometric and cardiovascular parameters were recorded and compared among these three groups. Results: Significant difference was found for weight and body mass index (p<0.001) between smokers and control subjects. When compared to control subjects, tobacco chewers had significantly higher pulse rate (p<0.001), systolic blood pressure (p<0.011), diastolic blood pressure (p<0.004) and mean arterial pressure (p<0.001) but no significant difference was found between tobacco chewers and smokers.
A Randomized, Open Label, Prospective, Comparative Study Evaluating the Efficacy and Safety of Fixed Dose Combination of Cefpodoxime 200 Mg + Clavulanic Acid 125 Mg Vs Cefpodoxime 200 Mg in Acute Bacterial Sinusitis.
(2015-06) Das, Srirupa; Fegade, Tushar
Background: Fixed dose combination of cefpodoximeclavulanic acid and cefpodoxime both are commonly used in the treatment acute bacterial sinusitis. However, comparative clinical studies between the fixed dose combination of cefpodoxime-clavulanic acid versus cefpodoxime alone are not available. Objective: A postmarketing study was conducted to evaluate the efficacy and safety of fixed dose combination of cefpodoxime proxetil plus potassium clavulonate versus cefpodoxime proxetil in treatment of acute bacterial sinusitis. Material and methods: A total of 202 patients were enrolled in an open label, randomized, parallel group, two arms multicentric study. Patients were treated either with fixed dose combination of cefpodoxime 200 mg plus clavulanic acid 125 mg or cefpodoxime 200 mg; both given as one tablet twice daily for ten days. The efficacy was evaluated at baseline, day three, day five and day ten while the safety was assessed at screening and day 10. Statistical analysis: Intention to treat population was used to analyse the safety results while efficacy was evaluated in per protocol population. Chi square test was used to evaluate the efficacy parameters on six point Likert scale, global evaluation of efficacy and safety by investigators and patients. Results: Cure rate was higher in study group (58.43%) compared to control group (46.81%), however, the difference was not significant. No significant difference was seen in
A Clinicoepidemiological Study of Pemphigus in India.
(2015-06) Sharma, Lata; Deepak, V.
Introduction: Pemphigus is a group of autoimmune bullous disorder affecting skin and mucosa. There are reports of some factors that can provoke the disease in genetically predisposed individuals and some have a protective effect. Aims and Objectives: To study the clinical features of pemphigus and possible epidemiological risk factors. Materials and Methods: Hundred cases with clinical diagnosis of pemphigus and equal number of controls were selected for the study. The clinical features of the disease and possible epidemiological risk factors were studied and compared with controls. Routine blood tests were also advised. Observations: There were 78 cases of pemphigus vulgaris (PV), 21 of foliaceous (PF) and 1 of erythematosus (PE). Ratio of male: female was 0.92:1. Mean age of cases was 40.905 ± 14.011 and of controls 42.64 ± 12.756. History of (h/o) exposure to pesticides in fields, intake of food containing garlic, number of pregnancies and use of cosmetics (Kajal) were significantly high in cases whereas smoking, tobacco chewing, herpes infection and mental stress were high in controls. Exposure to fertilizers, intake of alcohol and oral contraceptives were equal in both. Conclusion: Pemphigus had slight female preponderance in lower socioeconomic strata of rural areas. Exposure to pesticides, garlic intake, use of cosmetics and higher number of pregnancies may be predisposing where as smoking or tobacco chewing was not. Avoiding such risk factors may be helpful in prevention or fast recovery of pemphigus.
Carriage of ESBL and AmpC-Positive Enterobacteriaceae in Gastrointestinal Tract of Healthy Community Subjects and Hospitalized Patients and Detection of blaCTX-M Gene in ESBL Positive Isolates.
(2015-06) Mohd, Rashid; Modi, Syamal; Sarwat, Tarana; Chander, Yogesh; Rastogi, Vichal; Manocha, Harmesh
Aim: The study aimed at analyzing ESBL and AmpC positive Enterobacteriaceae in the gastrointestinal tracts of healthy community subjects and hospitalized patients and detection of blaCTX-M type gene in ESBL positive isolates. Methods: Bacteria were isolated from stool samples of the study population. Production of ESBL-type beta-lactamases was screened by double-disk synergy test as well as automated system, and AmpC enzyme production was detected by the AmpC disk test. ESBL positive isolates were subjected to detection of the blaCTX-M gene. Results: A total of 792 stool samples (50% from healthy subjects and 50% from hospitalized patients) were studied. The prevalence rates of ESBL-positive Enterobacteriaceae were 9.3% in hospitalized patients and 4.4% in healthy community subjects. Production of the AmpC enzyme was detected in
Assessment of Clinico-Morphological Patterns of Palpable Breast Lumps in Tripura.
(2015-06) Ghosh, Sumana; Nath, Sanjay; Islam, Habibul
Background : With growing awareness in the general population, especially about breast pathologies, a lady with a breast lump is one of the commonest presentations in outpatient departments. Clinical examination would be followed in most patients with a confirmatory diagnosis under the microscope. Aim : The aim of the study is to evaluate the clinico-morphological patterns of palpable breast lump in Tripura. Methods: This retrospective study was conducted from January 2010 to January 2015 in Tripura Medical College and Dr BRAM Teaching Hospital. Study included all diagnosed cases of female breast lump during the above mentioned period. Detailed clinical data including age, site, side, family history and histological reports were retrieved from the records section. Observation: A total number of 140 cases studied ranging from 18 years to 80 years having a mean age of 49 years. Most common age group was seen in 18-30 years for benign lesions and 40- 60 years for malignant lesions. The commonest type of benign lesion was Fibroadenoma with 58 cases (76.3%) and in malignant lesions Infiltrating duct carcinoma was the commonest type with 32 cases (50%), followed by medullary carcinoma with 16 cases (25%). The disease was found on the left side in 91 cases (65%) and on the right side in 48 cases (34.3%) and bilateral in 1 case (0.71%). In cases of malignancy TNM Staging was available in 32 cases. Majority of the cases were stage II,
Left Ventricle Hydatid Cyst of Heart Removed Under Cardiopulmonary Bypass – Anesthesia Management.
(2015-05) Pawar, Dharamsingh; Ramtani, Umesh; Varshney, Sauabh; Deshmukh, Durgesh G.; Mankar, Shital N.
Hydatid cyst uncommon in heart, echinococcosis is endemine in our country. Hydatid cyst in a heart may causes disturbances in conducting system, pericarditis congestive cardiac failure. The surgery and anesthetic management became very challenging in this case.We are describing the successful management of such a case of left ventricle hydatid cyst remove under cardio pulmonary bypass in a female
Topical Effect of Turmeric in Superficial Burns.
(2015-05) Chowdhary, Sanjeew Kumar; Thawani, Vijay
Sterilized ethanol extract of turmeric in petroleum jelly gauze was used topically in 306 patients of superficial burns which were compared with petroleum jelly gauze application at another burn site in same patient thereby providing advantage of self-controls. On third day of the application of turmeric, the burn wounds were found clinically clean and healthy, without any apparent infection in 52% as compared to 16% in control sites. With turmeric a clean, healthy and dry area was seen, which was less pronounced in control wounds. On day 11 of the therapy, 16% of turmeric sites showed signs of wound infection as against 82% of control sites. The swab culture correlated well with the clinical findings. With the use of turmeric the healing was rapid, with good epithelialization.
A Comparative Study of Management of Fracture Shaft of Femur by Open Versus Closed Intramedullary Interlocking Nailing.
(2015-05) Mukherjee, Debojyoti
Background: Orthopaedic surgeons often encounter diaphyseal femur fractures, which most often result from high-energy trauma, one must have high index of suspicion for complications. Currently surgery is indicated for most femur fractures because of high rate of union, low rate of complications and advantage of early rehabilitation which decreases the morbidity and mortality rate in patients. While the main stay of the treatment has been reamed interlocking intramedullary nailing. Objectives: To compare the time taken for bone union and the functional outcome in patients with fracture shaft of femur treated with interlocking intramedullary nail. Open versus closed method. Methods: Patients who were admitted with fracture shaft of femur to the department of Orthopaedics in R.L .Jalappa Hospital & Research Centre, attached to Sri Devraj Urs Medical College, Tamaka, Kolar. Duration of study 2 years. The time taken for bone union, range of movements and the complications encountered during the procedure and later were compared between open versus closed method of intramedullary nailing for fracture shaft of femur. Results: In our series age was between 16-70 years, the mean age was 43 years and the incidence was high in the age group of 21-30 years. 57 fractures were in men and 3 fractures were in females. 52 fractures were as a result of road traffic accident, 4 cases were due to direct trauma to the femur and 4 cases were due to fall from height . 40 patients had fracture on the right side and 20 patients had fracture on the left side. Based on Razaq MNU et al16 modification of
Tamsulosin vs Naftopidil in Medical Expulsive Therapy for Ureteral Stones — A Randomized Controlled Study.
(2015-05) Devi, N. Meena; Devi, P. Shyamasakhi; Devi, M. Medhabati; Devi, Kh. Krishnapramodini; Singh, Ak. Kaku
The aim of the present study was to compare the efficacy of naftopidil and tamsulosin in the management of ureteral stones. A total of 92 patients with symptomatic, single < 10 mm ureteral stone, were enrolled in a prospective study and randomized into two groups. Group 1, received 0.4 mg tamsulosin daily, whereas Group 2, received 50 mg naftopidil daily. Patients were followed –up for up to 6 weeks. The primary end point was stone expulsion rate and secondary end points were stone expulsion time , the rate of interventions such as uretero-renoscopy, ureteric stenting and extracorporeal shock wave lithotripsy and side effects. There were no significant differences between the groups with respect to age, sex, stone size and location. Stone expulsion rate were 76% and 56% in the tamsulosin and naftopidil group respectively. No significant difference in the stone expulsion time and the rate of interventions between the two groups. The finding suggest that tamsulosin is superior to naftopidil for stone expulsion therapy.
Persisting Menace of Pre Labour Rupture of Membranes Persisting Dilemmas.
(2015-05) Chhabra, S.; Kalra, P.; Shrivastava, P.
Objective : Prelabour rupture of membranes (PLROM) is common obstetric problem ,one of most common clinical events where normal pregnancy can turn into high risk situation for mother as well as fetus. Present study was to know incidence of term, preterm PLROM, association with parity ,body mass index, anaemia, cervical / vaginal colonization,cervical score, amniotic fluid index. Material and Methods : Study included 550 women of 18-35 years of age, 28-42 weeks of gestation who had presented with watery vaginal discharge in whom membrane rupture was confirmed. Results : Incidence of PLROM was 6.28% of births, 4.62% term births, 1.65% preterm births. Mean age of women was 24 years, mean BMI was 21.9. Ninety seven percent of women with PLROM were anaemic 18% of women had growth of microbes in cervical vaginal swabs.Forty eight percent women had cervical score less than zero, four percent had severe oligoamnios. Conclusion : Study revealed higher incidence of term,preterm PLROM in patients with anaemia, genital infection.By identifying, modifying risk factors we can help reduce maternal, fetal morbidity ,mortality associated with term, preterm PLROM
Clinical Profile of Co-Infections and Bacterimia in Adults with Malaria – An Experience from a Tertiary Care Hospital in Northeastern India.
(2015-05) Chakrabarti, Debaprasad; Saha, Soma; Trivedi, Anindya Sundar; Bhattacharyya, A. K.
Bacterial co-infection associated with malaria is potentially important but poorly documented. Published reports are mainly from African children while data from adult Indian population are limited. To determine the spectrum of concurrent bacterial infection in malaria the present study was conducted in department of Medicine at Tripura Medical College. Out of eighty patients, 58 had falciparum, 15 had dual infection and 7 had vivax malaria. Blood culture failed to confirm bacteraemia in any sample with the exception of one case of complicated malaria showing the growth of Escherichia Coli. Urine culture also grew Escherichia Coli in 2.5% of enrolled patients. Anti salmonella IgM antibody was detected in 7.5% of the study population. Sputum culture was positive of streptococcus pneumoniae in single patient with radiological evidence of consolidation. CSF culture was sterile in cases with cerebral malaria. Thus the present study shows that bacteraemia is uncommon in adults with malaria compared to children of endemic areas. Presence of other co-existent infections should be sought in clinically suspected cases only. We propose a restrictive antibiotic policy in the setting of malaria.
Platelet Distribution Width (PDW) in Thrombocytopenia.
(2015-05) Reddy, R. Shridhar; Khan, Mohd Inayatulla; Phansalkar, Manjiri Dilip
Background: Platelet volume parameters are significant especially in diagnosis of causes of thrombocytopenia. The platelet parameters are widely available as part of full blood count with no extra cost. Thrombocytopenia is of varying etiology based on which it is broadly divided into three major categories (1) as increased destruction, (2) decreased production and (3) splenic sequestration/abnormal pooling. The present study was undertaken to understand relation between cause of thrombocytopenia and Platelet Distribution Width as well as other platelet parameters. Materials and Methods: 500 cases of Thrombocytopenia (TCP) and 300 control cases having normal platelet count were selected. TCP was defined as platelet count <1.5lakh/ìl. Analysis was done by Sysmex KX 21 cell counter and every case was reassessed by Peripheral Smear (P.S.) examination and if necessary also by manual method. Only those cases that had sufficient clinico-hematological work -up and the causes of low platelet count had been reliably established were included in the study. Results: The study was conducted on 500 cases they were broadly categorized into three groups Group A with accelerated platelet Destruction Group B with Impaired production and Group C with abnormal pooling. Out of 500 cases 272 (54%) were male and 228(46%) were female. A slight male preponderance was seen in overall picture as well as in almost all age groups. The overall male to female ratio being 1.19 : 1. Mean platelet volume [MPV] was statistically significant with ‘p’ values
Tetralogy of Fallot in a Case of Dextrocardia with Situs Solitus.
(2015-04) Das, Swapan Kumar; Mukherjee, Avik
Dextrocardia associated with situs solitus (so called ‘dextroversion’) is a cardiac positional anomaly in which the heart is located in the right hemithorax with its base-toapex axis directed to the right and caudad along with normal anatomical position of other intrathoracic and abdominal viscera. The malposition is intrinsic to the heart and not caused by extracardiac abnormalities. Dextroversion is the second most common type of dextrocardia. In dextroversion, there is a 90% incidence of additional cardiac malformations, including anomalous pulmonary venous return, Tetralogy of Fallot, septal defects, pulmonic stenosis, coarctation of the aorta, and corrected TGA.Here we report a rare case of Tetralogy of Fallot in a 17 year old male with dextroversion.
Low Dose Captopril in Insulin Receiving Diabetics.
(2015-04) Balani, N D; Paranjape, B D
Bioequivalence of Orally Inhaled Drug Products : Focus on Current Regulatory Perspectives.
(2015-04) Sapakal, Vinayak; Govindasamy, Jeyabalan
Asthma/chronic obstructive pulmonary disease (COPD) medication market is a fast growing market, especially in the emerging markets where drugs have not been launched due to high costs. Use of generic medicines has been increasing in recent years, primarily as a cost saving measure in healthcare provision. Orally inhaled products (OIPs) should continue to remain an attractive clinical proposition. At the same time, establishing bioequivalence of an inhaled therapeutic can be a challenging proposition. The purpose of establishing bioequivalence is to demonstrate equivalence between the generic medicine and the originator medicine in order to allow bridging of the pre-clinical and clinical testing performed on the originator drug. Methodologies to determine bioequivalence are well established for oral, systemically acting formulations. However, for inhaled drugs, there is currently no universally adopted methodology, and regulatory guidance in this area has been subject to debate. There is no one-size-fits-all programme. This review article mainly focused on current regulatory perspectives on bioequivalence of topically acting, orally inhaled drug products.
Protein Consumption in Diet of Adult Indians : A General Consumer Survey (PRODIGY).
(2015-04) Mahajan, Manish
A PROtein consumption in Diet of adult Indians, a consumer surveY (PRODIGY) was conducted in seven major cities in 1260 respondents across India in order to assess the consumer understanding of protein in their day to day life. It was observed that around 9 out of 10 consumers had a diet deficient in proteins. This was regardless of the gender and the socio-economic group A and B interviewed.

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