JK Science Journal of Medical Education and Research

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https://imsear.searo.who.int/handle/123456789/151076

Editor in chief: Vishal R. Tandon
Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.jkscience.org/index.php

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Vitamin D Deficiency in Patients with Type 2 Diabetes Mellitus in Jammu Region
(JK Science, 2020-10) Sabharwal, Rachna; Mahajan, Pallavi; Mahajan, Animesh
Purpose: The present study was undertaken to estimate the serum vitamin D levels in type 2 diabetic patientsand compare it with normal healthy individuals. Material and Methods: The study was conducted in thedepartment of Biochemistry, Government Medical College, Jammu. 50 patients with type 2 diabetes mellitusdiagnosed on the basis of raised serum glucose levels and 50 healthy adults in the age group of 40 years andabove were selected irrespective of their sex. Serum sample was taken for the estimation of serum glucoselevels and the vitamin D levels in both the groups. Results: The mean levels of vitamin D in diabetic maleswere 24.27 ng/dl which was much less as compared to normal healthy males in whom the levels were 34.11ng/dl, and the difference was statistically significant (P=0.0042). Similarly, the levels of vitamin D in diabeticfemales were 19.56 ng/dl which was very low, as compared to the healthy females, and the p-value was alsostatistically significant (0.0041). Conclusion: It was observed, that the type 2 diabetic patients had significantlylower vitamin D levels irrespective of their gender.
Management of Renal Colic during Pregnancy
(JK Science, 2019-01) Gandotra, Umesh; Mohan, Narinder; Kesar, Ashutosh; Suri, Amit
To determine an optimal medical and invasive intervention for renal colic patients during pregnancy. Amongthe available interventions, we investigated the reliability of a medical and inavasive interventions duringpregnancy. Between Nov 2015 and Nov 2016, a total of 200 pregnant patients came to the obstetrics andgynaecology opd, and 15 of these patients had renal colic that were referred to urological opd. The meanpatient age was 30.49 years. In this retrospective cohort study, the charts of the patients were reviewed tocollect data that included age, symptoms, the lateralities and locations of urolithiasis, trimester, pain followingtreatment and pregnancy complications. Based on ultrasonography diagnosis, 15 patients had urolithiasis,all had ureteric calculi with one having hydronephrosis and pyonephrosis and other one patient havingsevere hydronephrosis, pyonephrosis and sepsis. Conservative treatment was successful in 13 patients.Five patients were in the first trimester and ten patients in the second trimester. Out of the five patients inthe first trimester four were managed conservatively using antibiotics, hydrations and analgesics and oneamong them had severe hydronephrosis with pyonephrosis with sepsis with upper ureteric calculi in whomconservative management failed and patient was counselled and MTP was done and following that PCNLwas done as a definitive procedure. Ten patients in the second trimester medical expulsive therapy usingTamsulosin .4mg was used and complete stone clearance was achieved in Nine patients and one didn'tresponded , developed severe hydronephrosis and pyonephrosis in whom USG guided PCN was placedfor rest of the gestational period and after delivery patient underwent PCNL and complete stone clearancewas achieved. Only one patient required urological intervention that is PCN insertion. Renal colic due tocalculus during pregnancy can be effectively managed by conservative measures using hydration,antibiotics,analgesics and tamsulosin .4mg in most of the instances. Cases who do not respond to the conservativemeasure or who develops severe hydronephrosis, pyonephrosis PCN insertion and Ureteral stent insertioncan be done and patient in who develops life threatening sepsis MTP should be done followed by definitivetreatment that is PCNL.
Biomedical Waste Management: A Study of Knowledge, Attitude, and Practice Among Medical, Dental and Nursing Students in a Teaching College
(JK Science, 2020-10) Sharma, Mukesh; Chakravarti, Anita; Broor, Shobha; Praveen, Gazala
Background: Bio-medical waste is perilous and can be a health hazard. Medical, dental and nursing graduatesspend maximum time during their clinical posting with the patients which increases their chance of exposureand risk related to biomedical waste. Therefore, they need to be aware about biomedical waste management.Purpose: To assess the Knowledge, Attitude and Practices (KAP) regarding biomedical waste managementamong medical, dental and nursing students. Material and Methods: This cross-sectional study was carriedout to access the knowledge and awareness about biomedical waste. The structured self-administeredquestionnaires were used for data collection. Results: Out of the total 300 students enrolled in this study(Group I: Medical, Group 2: Dental, Group 3: Nursing students), 20 medical 13 dental and 23 nursing failed torespond to the questionnaire. MBBS students had more knowledge but better attitude towards BMWmanagement guidelines were seen in nursing students (p<0.001). 86% of the participating candidates hadcorrect knowledge about definition of BMW. Only around 38% of candidates had knowledge of segregationof waste but none had knowledge of correct colour coding. 88% of candidates confirmed that recordmaintenance was essential but they did lack to answer what kinds of records are important to maintain forbiomedical waste management. 94% of the participating candidates said that BMW is teamwork. Conclusion:There is a need for rigorous training programme and monitoring for medical students
Domestic Violence: A Community based cross sectional study among rural married females in North West India
(JK Science, 2019-01) Gupta, Rajiv K; Kumari, Rashmi; Singh, Parveen; Langer, Bhavna
Violence against women a social evil in the society despite a lot of talk of women empowerment. Assessmentof burden in terms of prevalence will go a long way in planning the services for those affected bydomestic violence. To find the prevalence of domestic violence and associated risk factors among marriedfemales in a rural area of Jammu. This community based cross-sectional study was conducted amongrural married females using a structured and pretested questionnaire. Data was analysed using simpleproportions, chi-square test and logistic regression. 171/301(56.6%) of the respondents reported someform of the domestic violence. Psychological, physical and sexual violence rates were found to be32.16%, 9.9% and 2.33% respectively. A statistically significant association was found with variables likeliteracy, type of family, family income, sex of children etc. Relatively high levels of domestic violence inthis rural setting calls for a multidisciplinary approach involving improvement of literacy levels amongfemales, creating awareness about legal aid and screening the victims at primary health centres to mitigatethis problem.
Systemic Scleroderma with Complete Heart Block
(JK Science, 2020-10) Kinra, Kanika; Suri1, Pawan Kumar; Trakroo, Vinod Kumar
For patients with Systemic Sclerosis (SSc), cardiac involvement (CI) is directly caused by myocardial fibrosisor ischemia or is secondary to pulmonary arterial hypertension1 Here we present a similar case of a femalepatient aged 45 yr old female who presented with complaint of recurrent syncopal attacks, and difficulty inswallowing food and liquids. She had typical CREST Syndrome manifestations with complete heart block(CHB). For which pacemaker implantation was done.
E-Learning Versus Traditional Teaching in Medical Education: A Comparative Study
(JK Science, 2020-10) Sharma, Ashok K; Sharma, Hans Raj; Choudhary, Uzma
Background: Traditional method of learning via face to face lecture has been in curriculum since timesimmemorial. E-learning via multimedia has been a recent introduction in education system. Purpose: Tocompare e-learning with the traditional method of teaching in medical education. Material and Methods: Thetwo different methods of teaching were applied on the same group of students. A total of six lectures wereconducted. Three of them were taught by traditional method of teaching and three by e-leaning. Formativeassessment in the form of written examination was carried out, followed by qualitative assessment at the endof session. Results: The mean marks obtained after Exam-1 (i.e. following traditional teaching method) was6.46 ± 1.48 and mean marks obtained after Exam-2 (i.e. following e-learning) was 8.37 ± 1.27. The meandifference score was 1.91 ± 1.55. The paired t-test was applied, and the value of t was 11.96 with p-value<0.001. The results between two teaching methods were statistically significant. For qualitative analysisLikert scale was used. 66% of students strongly agreed that e-learning is a superior method than traditionalmethod of learning. Conclusion: The e-learning proved to be more efficient and uniform method of studentlearning with revision facilities.
To Study the Effect of I.V. Dexmedetomidine by Two Different Means for Prevention of Pain Due to Propofol Injection
(JK Science, 2020-10) Mahajan, Rajesh; Mehta, Anjali; Gupta, Vikas
Background: The incidence of propofol injection pain during induction of general anaesthesia varies from28% to 85%. Purpose: To Study the Effect of I.V. Dexmedetomidine by Two Different Means for Preventionof Pain Due to Propofol Injection. Material and Methods: This prospective, randomized study we evaluatedthe effect of dexmedetomidine for reducing the incidence and severity of propofol injection pain by twodifferent approaches while evaluating the hemodynamic stability. 120 Patients undergoing elective surgicalprocedures were randomly divided into four groups; in group I and II with the aim of keeping the drug withinthe vein the forearm was squeezed with a tourniquet up to 70 mmHg for 20 sec; the patients were administered0.5µg/kg dexmedetomidine in Group 1 (n 30), 0.75µg/kg dexmedetomidine in Group 2 (n 30) for 5 min,followed by 15 ml of 1% propofol in all patients over 25 seconds to induce anaesthesia. In Group 3 and 4;0.5µg/kg and 0.75µg/kg dexmedetomidine was premixed with 15ml propofol respectively and administeredfor induction. Pain is graded on a 0– 6 scale. Results: Overall median propofol injection pain score reductionwas 65.75% with the maximum reduction of 80% seen in group 4 and minimum reduction of 50% in group1. There were statistically significant differences (p Â0.05) in both SBP and DBP and heart rate with themaximum decrease in all hemodynamic parameters in group 2 and 4. Conclusion: Pre-treatment withintravenous dexmedetomidine 0.75µg/kg, 5min prior to injection of long-chain triglyceride propofol is effectiveand safe in reducing the incidence and severity of pain due to propofol injection.
Synchronous Renal Cell Carcinoma Metastasis Masquerading as Subcutaneous and Thyroid Swellings, Diagnosed on FNAC- A Case Report
(JK Science, 2020-10) Bhardwaj, Subhash; Syed, Sabina
Renal cell carcinoma (RCC) is one of the most aggressive genitourinary cancers accounting for about 3% ofadult malignancies. The most common symptoms at the time of presentation are hematuria, lion pain and/oran abdominal mass. However, about a quarter of patients with RCC present with metastatic disease; withlungs, lymph nodes and bone as prototypical metastatic sites. RCC notoriously may metastasize to bizarrelocations like subcutaneous tissue and thyroid. We report a case of simultaneous subcutaneous and thyroidsynchronous metastasis of RCC in an 80year old female diagnosed on FNAC.
Evaluation of Vitamin D Status in Children with Nephrotic Syndrome in Remission in a Tertiary Care Hospital of North India
(JK Science, 2020-04) Badyal, Ashima; Kumar, Koushal
Childhood nephrotic syndrome (NS) is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemiaassociated with peripheral edema. Children with NS lose 25-OH vitamin D binding protein in urine, and canhave low blood levels of this metabolite. The present hospital-based study was carried out on a total of 50children with nephrotic syndrome who are in remission, in the age group of 1-15 years of either gender,attending to our pediatric nephrology clinic. 46% had clear deficiency of vitamin D, while insufficiency waspresent in 28% and normal levels in only 26% of patients. There was significant difference (p<0.05) in 25-OHvitamin D levels between frequent relapsers (FR) as compared to infrequent relapsers (IR) and first episode ofnephrotic syndrome. Hypocalcemia was present in 86% of patients, hypophosphatemia in 10% of patients,hyperphosphatemia in 50% and raised alkaline phosphatase in 36% of patients. Strong positive correlation isobserved between serum calcium and vitamin D levels (r=0.720; p<0.001) and moderate negative correlationbetween phosphorous and vitamin D levels (r= -0.577; p<0.001, but insignificant relation between vitamin Dand alkaline phosphate levels (r= -0.248; p<0.082). It is concluded that vitamin D deficiency is commonamong children with nephrotic syndrome even after remission of proteinuria. There exists a strong positivecorrelation between serum calcium and vitamin D levels.
Male Contraception- An Update
(JK Science, 2020-10) Gupta, Rajiv Kumar; Kumari, Rashmi
COVID 19 - Endangering Women’s Mental and Reproductive Health
(JK Science, 2020-10) Sharma, Pallavi; Jamwal, Deepika; Mehta, Anil; Pannu1, Jitewshwar Singh
With spikes in domestic violence, sexual harassment and limited access to health care globally, the healthauthorities are battling hard to prevent serious consequences on women health. Older women and womenwith disabilities along with pregnant women form a special group of women as they lose access to vital healthservices and social support. COVID is having a huge impact on women health. The COVID-19 pandemic isshowing a negative effect on the production and transportation of contraceptive commodities. Medical societiesare asking to defer pregnancy till we have a more clear insight on the effect on pregnancy. Cancer screeningand cancer treatment has also taken a backlog
Comparative Effect of Static Stretching and Mulligan Stretching on Hip Adductor Flexibility in Footballers - A Two Group Trial
(JK Science, 2020-04) Bali, Seveka; Guru, Karthikeyan
Groin pain due to adductor strain is commonly seen in footballers. Many methods of stretching a muscle likeballistic stretching, static stretching etc are used to increase flexibility of hip adductors and prevent groinstrain. Static hip adductor stretching till now is more favored technique whereas mulligan adductor stretchingis very new and popular method of increasing muscle flexibility. The present study was undertaken to comparethe effectiveness of 2 stretching programs i.e. Mulligan adductor stretching and static stretching on tight hipadductor. In this trial, 42 athletes who fulfilled the selection criteria were selected and then divided into twogroups based on block randomization. Group-1 received Mulligan’s adductor stretching while Group-2 receivedstatic stretching of hip adductors for 3 alternative days. Hip abduction range of motion (Abd-ROM) wasmeasured on baseline, after first day treatment and finally after third day treatment by a universal goniometer.Mean difference of Abd-ROM within groups on baseline, 1st day after treatment and 3rd day after treatmentwere -8.07, -12.76, -4.69 which shows highly significant difference (p = 0.00) between 3 sessions. MeanAbd-ROM between two groups has not shown significant different (F = 2.99, p > 0.05). It is concluded thatMulligan’s adductor stretching and static stretching both are equally effective in increasing Abd-ROM
Microalbuminuria and Essential Hypertension: A Critical Evaluation
(JK Science, 2020-10) Kothari, Saurabh; Trikha, Mehak; Gupta, Dinesh
Background: Recent advancements in diagnostic modalities for microalbuminuria have shown that urinaryexcretion of albumin is more in hypertensive patients as compared to subjects with normal blood pressure.Microalbuminuria is known to be associated with certain complications like dyslipidemia, cardiac complications,atherosclerosis and kidney disease. Purpose: To analyze the prevalence of microalbuminuria and its clinicalcorrelation with essential hypertension. Material and Methods: The study was of cross-sectional design,which was carried out in outpatient and inpatient departments of Medicine in DY Patil Medical School andHospital, Nerul, Navi Mumbai. Results: Out of total 190 study participants 96 were normotensive controls,while 94 were hypertensive patients. Mean age in control group was 48 ± 9.4 years, while that in hypertensivegroup, it was 49.2 ± 10.2 years. The 24 hours mean urinary excretion of albumin in hypertensive patients withmicroalbuminuria was found to be 80.21, while it was 12.91 and 7.89 in hypertensive patients withoutmicroalbuminuria and control groups, respectively. Conclusion: Early screening to detect microalbuminuriain early stages will help to initiate appropriate treatment regimen and prevent the risk of complications and thusimprovement in prognosis.
To Evaluate Role of Transvaginal Sonography over Transabdominal Sonography in Delineating Adnexal Masses
(JK Science, 2019-01) Sharma, Rajesh
To compare and find diagnostic accuracy of Transvaginal sonography (TVS) over Transabdominalsonography (TAS) in evaluation of adnexal lesions. A cross sectional comparative study of 50 patientsincluding both pre and postmenopausal women who were clinically suspected to have adnexal masswere scanned on Logiq GE C5 Premium ultrasonography unit. TAS was performed with 3.5MHzelectronic macro convex probe followed by TVS with 6.5 MHz end firing electronic TVS probe. TVSwas found to be superior in diagnosing adnexal lesions. In comparison with TAS, TVS diagnosedbenign cystic teratomas (100% versus 40%), endometriomas (90% versus 57.1%), haemorrhagic ovarian cysts (85.7% versus 50%, hydrosalpinx (75% versus 25%), pyosalpinx/tubo-ovarian mass (75%versus 75%), and ectopic pregnancy (100% versus 77.7%). In our study ovarian cancers were betterdetected by TAS due to their large size. TVS was found to be superior in diagnosing adnexal masses ascompared to TAS with more accurate delineation of internal architectural features as wall thicknessand complexity, nodules, septae, papillary projections, internal echoes thereby narrowing the differentials.
Exploring Biodiversity for Prevention and Control of Cancer and other Non-Communicable Diseases using Indigenous Environmental Resources: An Interdisciplinary Research
(JK Science, 2020-10) Jain, Richa; Gumashta1, Raghvendra
Background: An interdisciplinary research of public health, biomedical and pharmaceutical sciences is neededfor integrating qualitative and quantitative researches undertaken. It hence requires focus on public beneficencefor non-communicable diseases. Purpose: To study anticancer activities of soil samples of Central India andits stability for applied public health use. Material and Methods: Screening on Actinomycetes isolates obtainedfrom rural and urban farm soils illustrating arginase production was conducted from equated soil samples ofgeo-representative localities and adjoining areas of Bhopal, India. Enrichment Technique (CDSEA) was usedfor detection of extracellular production of L-arginase and their anticancer activities using MTT 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay along with characterization and probioticproperties of selected isolate. Results: L-Arginase activity quantified by ornithine (21.06-117.92 U/mg) wasfound in isolates BRD-21, KAR-73, BHA-162, BAR-199, ARH-210, HAB-228. Urea release (15.88 – 59.79 U/mg protein) depicted L- arginase activity in crude enzyme samples. It shows noticeable anticancer activity.Morphological and biochemical characterization of these isolates revealed metabolic diversity. Isolate KAR 73produced collagenase (specific activity 57.8 U/mg), L-asparaginase (specific activity 116 U/mg) and L-arginasewith tolerance to higher temperature (45°C) and salt concentration (2-8% w/v). Equal concentrations ofcrude L- arginase from these isolates inhibited growth and proliferation of colorectal adenocarcinoma celllines (19.99%-38.65%) under in-vitro conditions. Conclusion: Arginine depletion through arginase activity isevidenced for potential effectiveness in cancer treatment especially adenocarcinomas and squamous cellcarcinoma. It is useful for wider public health purposes
Prescribing Pattern and Medication Inappropriateness in Geriatric Patients in a Tertiary Care Teaching Hospital
(JK Science, 2020-10) Khurana, Ieti; Bhutani, Garima; Rani, Seema; Saini, Rahul
Background: Altered hepatic, renal and GIT function along with multiple comorbidities makes use of certaindrugs inappropriate in geriatric population. Identification and rectification of mistakes and lacunae in thecurrent prescribing pattern is crucial for ensuring appropriate and rational prescribing. Purpose: To study theprescribing pattern and medication inappropriateness in geriatric patients in a tertiary care teaching hospital.Material and Methods: Details of the prescribed drugs were obtained from the files of the 60 hospitalisedgeriatric patients and the prescribing pattern was studied. Medication inappropriateness was assessed and theinappropriate drugs were classified into various categories using Beers criteria given by American GeriatricSociety. Number of prescriptions having potential for drug interactions was also calculated. Results: Averagenumber of drugs per prescription was 7.7 with antibiotics being the most commonly prescribed drugs.49.13% were prescribed by brand names. 12.12% drugs were prescribed inappropriately and 20% prescriptionshad one or more inappropriate drug. Potential drug-drug interactions that should be avoided in older adultswere found in 11.6% prescriptions. Conclusion: A considerable fraction of the prescriptions of geriatricpatients were inappropriate and incidence of polypharmacy was very high. There is a pressing need to educatethe physicians about the mistakes in the prescribing pattern of geriatric patients and the adverse effect it canhave on the health of these patients.
Nicolau Syndrome: A Rare Event Following Intramuscular Diclofenac
(JK Science, 2020-04) Rodrigues, Almana; Sastry, Purushotham; Gurumurthy, B; UR, Rakshith; M, Prakash; KC, Nandish Kumar
Nicolau Syndrome (Embolia cutis medicamentosa) is a rare complication occurs after parenteral administrationof drugs. It has been reported in association with intramuscular, intravenous or rarely subcutaneous injections.We hereby report a case of Nicolau Syndrome in a 60-year-old male patient.
Computed Tomography Guided Fine Needle Aspiration of Lung Lesions Suspected to be Bronchogenic Carcinoma: Experience of a Tertiary Care Hospital
(JK Science, 2020-04) Bargotra, Rupali; Sharma, Rajesh
CT guided FNAC is a simple and safe procedure of diagnostic value in patients with lung lesionssuspected to have lung malignancy. We undertook a study on 41 patients and were able to diagnose/rule out malignancy in 85.37% of these patients, while in 14.63 % of patients the smears were nondiagnostic. Once malignancy was diagnosed in these patients, then the next most important step wasto categorize the lesions. 44% of patients had squamous cell carcinoma, 12.12 % had adenocarcinoma,9.75% had small cell carcinoma, 7.31 % had poorly differentiated carcinoma, 4.87% each hadmetastasis & tuberculosis and 2.43% had aspergillosis. Squamous cell carcinoma was the commonestsubtype in our study, which is contrary to changing trends in incidence of lung carcinoma whereadenocarcinoma has replaced squamous cell carcinoma as the commonest lung malignancy. Threeof our patients had minor complication in the form of mild pneumothorax, and it resolved in all patientswithin 24 hours.
Comparative Analysis of Leucocyte Count (Total and Differential) in Patients with Leucocytosis using Sysmex XN550-L Series (5 Part) Automated Analyzer and Conventional Manual Technique in a Tertiary Care Hospital in Rural Haryana
(JK Science, 2020-04) Sharma, Abhimanyu; Isha; Lone, Aasif Hamid; Kaur, Rupinder; Nijhawan, Vijay S
Normal concentration of WBCs in blood varies between 4000 and 11,000 per microliter and are classified intotwo variants namely granulocytes and agranulocytes on the basis of presence and absence of granules.Manual methods of calculation of TLC include- Neubauer chamber and estimating WBC on leishman stainedslides whereas automated methods are based on impedance or light scattering technology. The study comparedthe efficacy of both these methods in statistical terms using Chi Square test. 100 cases of leucocytosisanalyzed over a period of 1 year at MMIMSR, Mullana, Haryana revealed leucocytosis prevalent in 4-6 decadeof life with slight male predominance. The pearson coefficient for TLC came out to be p value =0.215 (notsignificant) but for DLC, calculations revealed p values for polymorphs, lymphocytes, eosinophils andmonocytes to be significant (p value =0.000 each). To conclude, standard manual methods should be advocatedas special practice where there is definite need of morphological and quantitative evaluation of WBCs and tovalidate the automated methods by which the laboratories can optimize patient care and not as a replacement
To Determine the Previlance of Fungal Infection Among Patient with Sputum Negative Old Treated Pulmonary Tuberculosis
(JK Science, 2020-04) Kishan, Jai; Yadav, Ajit; Singhal, Sameer
A descriptive study was conducted in the Department of Respiratory Medicine in a tertiary care center ofAmbala. Aim of the study was to determine the prevalence of fungal infection among patient presents withsputum negative old treated pulmonary tuberculosis. The study was carried out among 39 post treated casesof Pulmonary Tuberculosis, whose sputum or bronchial wash showed isolation of Aspergillus. Demographicdetails and clinical findings were noted. Data collected were entered into Excel spreadsheet and quantitativedata were expressed as number and percentage. The presentation of pulmonary aspergillosis in treated casesof pulmonary TB varies from aspergilloma (51.3%) to chronic necrotizing pulmonary aspergillosis (38.4%) toallergic bronchopulmonary aspergillosis (10.3%). Hemoptysis (79.5%) of varying severity was the mostcommon symptom. Most of the patients were farmers by occupation. The most common species wereAspergillus fumigatus; others were Aspergillus flavus, Aspergillus niger and Aspergillus terrus in 23.2%,20.5%, and 12.8 %, respectively. Here we conclude that Aspergillus fumigatus was the most frequentlyisolated species in our region and aspergilloma was the commonest pulmonary manifestation as post-TBsequel.

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