International Journal of Medical Research & Review
Permanent URI for this collection
Editor in Chief : Dr. D. Sharad Gedam,
ISSN: 2320–6012(Print)
Frequency: 6 issues a year
Language: English
An Journal of Shishu Mangalam Child Care Centre, Bhopal, India
Open Access Peer-reviewed journal
Web site: https://www.ijmrr.in/ /
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Item Pulmonary and Extrapulmonary Tuberculosis, An Inflammatory Disease misdiagnosed as Cancer(Siddharth Health Research and Social Welfare Society, 2024-06) Gheryani, NA; Elkwafi, RS; Anbaig, A; Berras, Ali RJ; Elmatri, HIntroduction:Tuberculosis is a serious infection associated with a high mortality rate if not treated.The clinical and imaging presentation are usually nonspecific and can mimic malignancy; therefore, extrapulmonary TB should be considered in the differential diagnosis of any suspicious extrapulmonary masses, particularly in immunocompromised patients. Objective:This study aims to analyse 160 cases of pulmonary and extra-pulmonary tuberculosis correlate the pathological features with the clinical data and find the most common differentiation diagnosis of both pulmonary and extrapulmonary tuberculosis.Methodology: A retrospective analysis of 160 cases of pulmonary and extra-pulmonary tuberculosis was performed.The age, gender , site, and symptoms of the lesion were collected, extrapulmonary sites were detected including rare and unusual sites and the differential diagnosis of these lesions was highlighted. The data were plotted in graphs and were analyzed.Result: In our study 63.6% were male and 36.4 were females.The majority of the patients were in the age group of 21-30 years followed by 31- 40 years, cough and hemoptysis were the most common symptoms followed by cervical swelling with 39% and 33% respectively. The most common sites were lung with (39%) and cervical swelling with (33%).The main differential diagnosis for many pulmonary and all extra-pulmonary tuberculosis was malignancy. Conclusion:Tuberculosis is a serious young person's disease that can affect almost every organ and tissue of the body and should be considered in the differential diagnosis of suspicious masses, as tuberculosis is often misdiagnosed as cancer.Item The pattern of Parental Handling in Children with Emotional and Behavioural Disorders - A Cross-Sectional Study(Siddharth Health Research and Social Welfare Society, 2023-04) Raju, R.; Roy, G M.Introduction: This study is to determine patterns of parental handling in children with emotional and behavioural disorders, and to determine the correlation of parental handling patterns to the child’s behavioural and emotional symptom s. Methods: A cross-sectional study was conducted over one year among the parents of children and adolescents aged 4 to 17 years diagnosed with emotional and behavioural disorders and consulting a tertiary care centre in Kerala, South India, for the first time. Results: Most parents showed low care and low control patterns, while a majority of the children were at high risk for clinically significant problems. Approximately 62% of the children were at high risk due to hyperactivity/inattention, 45% for issues with peers, and 33% for poor prosocial behavior. There was a significant negative correlation between the control and conduct symptoms (?=-.232, p=0.020) and between control and hyperactivity (?-.221, p=0.027). A significant positive correlation was observed between emotional symptoms and the educational status of the parent (?=.265, p=0.008), and between peer problems and the age of the child (?=.232, p=0.020). There was also a significant correlation between externalising disorders and control scores. Conclusion: The population was found to predominantly have low care and low control patterns, i.e., less optimal parenting styles. Parental control was found to positively influence conduct symptoms and hyperactivity symptoms. There was no relation between socio-demographic factors and the pattern of parental handling or between parental handling patterns and other emotional and behavioural symptoms in the childItem Prevalence of Major Depressive Disorder among Mothers of Childrenand Adolescents with Attention Deficit Hyperactivity Disorded Attending a Tertiary care Centre(Siddharth Health Research and Social Welfare Society, 2023-06) Sarika, P.; Roy, G M.Introduction:Attention deficit hyperactivity disorder (ADHD) accounts for the majority of referrals to child and adolescent psychiatry services because of the associated poor scholastic performance. Despite the possibility of depressive symptoms in caregivers, there is a paucity of studies on major depressive disorder among mothers of children and adolescents with ADHD in our setting. Objectives:Assessing the prevalence of major depressive disorder and the association of sociodemographic and clinical variables among mothers of children & adolescents with ADHD attending a tertiary care centre. Studying the correlation between the severity of ADHD and maternal depression. Methods: Cross-sectional study on 150 mothers of children and adolescents aged 5-18 years with ADHD attending the Child and Adolescent Psychiatry Clinic of the Govt. Medical College, Thiruvananthapuram. Results:The prevalence of Major Depressive Disorder among mothers belonging to the age group of 30?39 years was found to be 20%. Across age groups, 28.7% of the subjects had minimal depressive symptoms, while 10% each had mild and moderate symptoms. We found a positive correlation between the severity of maternal depression and the child’s ADHD. The association of major depressive disorder with medical comorbidities and having another offspring with ADHD was statistically significant.Conclusion:Owing to the statistically high prevalence of depressive disorders, routine screening for depressive symptoms has to be considered for mothers when their children are diagnosed with ADHD, with the provision for appropriate intervention.Item Lymphocytic colitis: an Important but Underdiagnosed Cause of Chronic Diarrhoea in Adult Nigerians(Siddharth Health Research and Social Welfare Society, 2024-06) Okonkwo, K; Ojo, O; Betiku, OIntroduction : Lymphocytic colitis is an important cause of chronic diarrhoea which is amenable to appropriate treatment which helps to reduce the morbidity and mortality associated with chronic diarrhoea.In Africa unfortunately, there is poor awareness of this treatable cause of chronic diarrhoea on account of a paucity of skilled experts necessary to make a diagnosis and implement effective therapy.Aim :We present the clinical aspects, endoscopic findings and Introduction :Lymphocytic colitis is an important cause of chronic diarrhoea which is amenable to appropriate treatment which helps to reduce the morbidity and mortalit y associated with chronic diarrhoea. In Africa unfortunately, there is poor awareness of this treatable cause o chronic diarrhoea on account of a paucity of skilled experts necessary to make a diagnosis and implement effective therapy. Aim : We present the clinical aspects, endoscopic findings and pathological features of twenty-one Nigerian patients with lymphocytic colitis. A short literature review of the epidemiological, clinical, endoscopic, and pathological features of this important condition is also presented. Materials and Methods : This was a retrospective analysis of the clinical, endoscopic and pathological findings of twenty-one patients who were diagnosed with lymphocytic colitis following colonoscopy in an open-access endoscopy setting in Akure, Ondo State, Nigeria over eighteen months. Results : Twenty-one diagnoses of lymphocytic colitis were made from a pool of one hundred and twenty-two colonosco pies done between December 2021 and May 2023.There were slightly more females diagnosed with an M: F ratio of 3:4 with a mean (SD) age of 52.2 (± 14.3) years. All of the patients had a history of passage of watery diarrhoea while normal colonoscopy findings were present in 87.5%. The mean (SD) time to diagnosis in five of these study subjects was 18.4 ± 9.1 months.These patients had standard medical treatment with good outcomes. Conclusion : In sub-Saharan Africa, lymphocytic diarrhoea is a treatable cause of chronic diarrhoea. It is important to refer patients with chronic diarrhoea to facilities where they can benefit from the expertise of endoscopists and pathologists. pathological features of twenty-one Nigerian patients with lymphocytic colitis.A short literature review of the epidemiological, clinical, endoscopic, and pathological features of this important condition is also presented. Materials and Methods :This was a retrospective analysis of the clinical, endoscopic and pathological findings of tIntroduction : Lymphocytic colitis is an important cause of chronic diarrhoea which is amenable to appropriate treatment which helps to reduce the morbidity and mortality associated with chronic diarrhoea. In Africa unfortunately , there is poor awareness of this treatable cause of chronic diarrhoea on account of a paucity of skilled experts necessary to make a diagnosis and implement effective therapy. Aim : We present the clinical aspects, endoscopic findings and pathological features of twenty-one Nigerian patients with lymphocytic colitis. A short literature review of the epidemiological, clinical, endoscopic, and pathological features of this important condition is also presented. Materials and Methods :This was a retrospective analysis of the clinical, endoscopic and pathological findings of twenty-one patients who were diagnosed with lymphocytic colitis following colonoscopy in an open-access endoscopy setting in Akure, Ondo State, Nigeria over eighteen months. Results :Twenty-one diagnoses of lymphocytic colitis were made from a pool of one hundred and twenty-two colonoscopies done between December 2021 and May 2023.There were slightly more females diagnosed with an M: F ratio of 3:4 with a mean (SD) age of 52.2 (± 14.3) years. All of the patients had a history of passage of watery diarrhoea while normal colonoscopy findings were present in 87.5%. The mean (SD) time to diagnosis in five of these study subjects was 18.4 ± 9.1 months. These patients had standard medical treatment with good outcomes. Conclusion : In sub-Saharan Africa, lymphocytic diarrhoea is a treatable cause of chronic diarrhoea. It is important to refer patients with chronic diarrhoea to facilities where they can benefit from the expertise of endoscopists and pathologists.wenty-one patients who were diagnosed with lymphocytic colitis following colonoscopy in an open-access endoscopy setting in Akure, Ondo State, Nigeria over eighteen months. Results :Twenty-one diagnoses of lymphocytic colitis were made from a pool of one hundred and twenty-two colonoscopies done between December 2021 and May 2023. There were slightly more females diagnosed withIntroduction : Lymphocytic colitis is an important cause of chronic diarrhoea which is amenable to appropriate treatment which helps to reduce the morbidity and mortality associated with chronic diarrhoea.In Africa unfortunately , there is poor awareness of this treatable cause of chronic diarrhoea on account of a paucity of skilled experts necessary to make a diagnosis and implement effective therapy. Aim :We present the clinical aspects, endoscopic findings and pathological features of twenty-one Nigerian patients with lymphocytic colitis. A short literature review of the epidemiological, clinical, endoscopic, and pathological features of this important condition is also presented. Materials and Methods :This was a retrospective analysis of the clinical, endoscopic and pathological findings of twenty-one patients who were diagnosed with lymphocytic colitis following colonoscopy in an open-access endoscopy setting in Akure, Ondo State, Nigeria over eighteen months. Results :Twenty-one diagnoses of lymphocytic colitis were made from a pool of one hundred and twenty-two colonosco pies done between December 2021 and May 2023. There were slightly more females diagnosed with an M: F ratio of 3:4 with a mean (SD) age of 52.2 (± 14.3) years. All of the patients had a history of passage of watery diarrhoea while normal colonoscopy findings were present in 87.5%. The mean (SD) time to diagnosis in five of these study subjects was 18.4 ± 9.1 months.These patients had standard medical treatment with good outcomes. Conclusion : In sub-Saharan Africa, lymphocytic diarrhoea is a treatable cause of chronic diarrhoea. It is important to refer patients with chronic diarrhoea to facilities where they can benefit from the expertise of endoscopists and pathologists. an M: F ratio of 3:4 with a mean (SD) age of 52.2 (± 14.3) years. All of the patients had a history of passage of watery diarrhoea while normal colonoscopy findings were present in 87.5%. The mean (SD) time to diagnosis in five of these study subjects was 18.4 ± 9.1 months.These patients had standard medical treatment with good outcomes. Conclusion :In sub-Saharan Africa, lymphocytic diarrhoea is a treatable cause of chronic diarrhoea. It is important to refer patients with chronic diarrhoea to facilities where they can benefit from the expertise of endoscopists and pathologists.Item Effectiveness of an information booklet on Prevention and early detection of Cervical cancer in terms of Knowledge among Female School teachers in Selected Secondary Schools in mairang Town, Meghalaya State.(Siddharth Health Research and Social Welfare Society, 2023-04) Nongsiej, I.; Devi, Khumukcham AnupamaIntroduction: A pre-experimental study was undertaken with one group pretest posttest design to find the effectiveness of Information booklet on knowledge of female school teachers regarding prevention and early detection of cervical cancer in selected secondary schools, Mairang Town, Meghalaya State.Objectives:The main objectives of the study were to assess the knowledge of female school teachers on prevention and early detection of cervical cancer before and after administering the information booklet and to evaluate the effectiveness of information booklet on prevention and early detection of cervical cancer in terms of gain in knowledge . Material and Methods:The conceptual frame work adopted for the study was based on Health Belief Model. The sample size is 30, non-probability purposive sampling is the sampling technique adopted.The data was collected by using the structured knowledge questionnaire.Result:The findings of the study revealed that the mean posttest knowledge scores (23.17) of the teachers was higher than the pretest knowledge scores (12.83).The obtained mean difference was found to be statistically significant at 0.05 level of significance, as evident from calculated ‘t’(29)= 20.09, there by indicating the effectiv eness of the information booklet regarding prevention and early detection of cervical cancer.Conclusion:The information Booklet on prevention and early detection of cervical cancer was effective for increasing the knowledge.Item Antimicrobial Resistance and its Impact on Public Health(Siddharth Health Research and Social Welfare Society, 2024-06) Mukherjee, KushalAim of the Study: The current study addresses the increasing threat of AMR and its direct impact on global public health.It aims to contribute to the existing knowledge about the key challenges of AMR, bringing attention to the need for further research and creating a combined effort in the battle with antimicrobial resistance.Background & Methods: Antimicrobial resistance (AMR) has been considered one of the key problems that humankind has come across, showing a massive impact on public health globally. The continuous emergence of new microbial strains complicates it further by reducing the efficacy of the available antimicrobial drugs. For the current study, various scientific journals were studied from multiple resources. Furthermore, the websites of policymakers and agencies associated with this cause were studied and referred to.Results & Conclusions:The study has revealed a concerning trend of a steep increase in resistance of pathogens to antimicrobial agents. The major contributing factors which were identified during this study include misuse and overuse in the healthcare sector, inadequate prevention of infections and disease control, overuse in agriculture and the lack of novel antimicrobial agents. Several policies like the “One Health” approach by the Centers for Disease Control and Prevention (CDC) and the United Nations Sustainable Development Goals (SDGs) have been put in place as a means to combat the global public health problem. The study also highlights the need for policymakers, stakeholders and researchers to work in unison to combat the global issue.Item A Case of Refractory Supraventricular Tachycardia in a Newborn(Siddharth Health Research and Social Welfare Society, 2023-02) P.Wali, P.; Khan, A; Parakh, HSupraventricular Tachycardia (SVT) is the most common neonatal dysrhythmia with the incidence being 1 in 100 for children of all ages and 1 in 250 for neonates.The origin of supraventricular tachycardia is either above the bifurcation of the bundle of His or it has mechanisms dependent on the bundle of His. Newborns may present with irritability, poor feeding and tachypnea.The most important clinical sign of SVT is tachycardia sometimes associated with hypotension,heart failure,pallor,or decreased level of consciousness.Diagnosis is done with heart rate continuously remaining ? 220 beats per minute with a QRS < 0.08 seconds.Adenosine is the first-line abortive therapy of choice. Intractable SVTs are treated with amiodarone, esmolol,and procainamide. SVT with Circulatory collapse needs a synchronized DC cardio version.Prognosis of SVT is generally excellent in the absence of structural heart disease.Item Monitoring and Evaluation of Adverse Drug Reaction In Emergency Medicine Department: A Prospective Observational Study(Siddharth Health Research and Social Welfare Society, 2023-04) N. Patel, S.; M. Patel, S.; R. Patel, K.; S. Patel, K.Background: Any deviation from the intended beneficial effect of medication results in a drug-related problem. Adverse drug reactions (ADRs) are negative consequences of drug therapy. It is the fourth to the sixth leading cause of mortality in the United States of America. Aims: To find out the proportion of medical emergency admissions that are secondary to Adverse Drug Reactions(ADRs). Settings and Designs: An observational, prospective study conducted at the Emergency Medicine Department, at Tertiary Care Teaching Hospital for 12 months, daily from 9 am to 5 pm. Materials and Methods: Patients aged ? 18, who have given written informed consent were included and patients not able to give willing consent and women presented with pregnancy were excluded from the study. The data was recorded in the case record form, The causality assessment was performed using the WHO causality assessment scale. To determine the ADR severity, the Modified Hartwig and Siegel scale was used. Statistical Analysis: The statistical evaluation was done with the help of Statistical Package for Social Science (SPSS) version 21.0 manufactured by IBM (demo version) and Microsoft Excel 2016. p< 0.05 was considered statistically significant. Results: Elderly patients were having a higher incidence of ADRs. Among all drug groups, the highest incidence was antimicrobials and drugs acting on blood. The majority of patients either recovered or were in a recovery phase. Most of the ADRs were not preventable.Conclusions:Reporting ADRs systematically allows appropriate analysis and intervention which will improve the patient,s safety. Many ADRs could be preventable by avoiding certain drug/drug combinations, hospitalization, dose- dependent side effects, appropriate individual dosing and applying for the Antimicrobial Stewardship Programme.Item Randomized, Standard Controlled Study Evaluating the Efficacy and Safety of Habb-e Habbe-e-Wajaal Mafasil in Managing Cervical Spondylosis(Siddharth Health Research and Social Welfare Society, 2023-04) Husain, S.; Ahmad Rather, S.; Ahmad Bhat, S.Background and Objectives: Cervical Spondylosis is a degenerative disease of intervertebral discsand adjacent vertebral bodies of the cervical region due to wear and tear changes. Neck pain,radiculopathy, and stiffness comprise the prime features of cervical spondylosis demandingimmediate attention and respite. Despite the advancement in pharmacological, nonpharmacological and surgical interventions, the management remains unsatisfactory due to high cost, adverse effectsand unusual eventualities. Hence a clinical trial was done to evaluate the efficacy of herbal formulation, Habb-e-Waja‘al-Maf?s?il (HWM), in managing cervical spondylosis (Waja‘al-‘Unuq).Methods: The study is an open-labelled, randomized and standard controlled trial. Sixty diagnosedpatients of age group 20 to 70 years were randomly allocated, using a computer-generated chart, inthe test group (n=30) receiving HWM (6gm), and the control group (n=30) receiving ibuprofen1200mg/day, orally in divided doses. The severity score of clinical symptoms and signs; pain,stiffness, swelling, restriction of movement and radiological findings were analyzed at baseline and30 days. Results: Both HWM and ibuprofen significantly reduced the severity score of pain,stiffness, swelling, and restriction of movement (p=<0.001) associated with cervical spondylosis after completion of the treatment protocol. However, no change was observed in radiological findingsin either group (p=1). In comparison to the control group, no significant result was noticed in thetest group statistically (p=>0.05), except for “restriction of movement” (p=<0.05). Conclusion:The herbal formulation, HWM, is equally effective as conventional treatment in managing cervicalspondylosis. Therefore, HWM can be prescribed as a safe and cost-effective alternative treatment for cervical spondylosis.Item The Intersection of LGBTQ+ Mental Health and the Rise of Same-Sex Marriage: Understanding Current Trends and Implications forLGBTQ+Rights and Societ(Siddharth Health Research and Social Welfare Society, 2024-04) Devi, KA; Singh, Sk; Devi, TSThe mental health of LGBTQ+ individuals is often marred by societal stigma and discrimination. However, recent strides in LGBTQ+ rights, particularly the legalization of same-sex marriage, present promising prospects.This article examines the intersection of LGBTQ+ mental health and same-sex marriage, emphasizing the positive effects on well-being.Legal recognition of same-sex marriage is associated with improved mental health outcomes, including reduced rates of depression and anxiety, heightened social support, and enhanced self-esteem. Moreover, it fosters societal acceptance, diminishes internalized stigma, and promotes positive parenting experiences within LGBTQ+ families.Additionally ,same-sex marriage yields economic advantages, such as financial stability and increased workplace productivity among LGBTQ+ individuals. Despite these advancements, disparities persist, with many countries yet to legalize same-se x marriage and LGBTQ+ individuals facing ongoing discrimination.Continuous advocacy efforts are vital to ensure equal rights and protections for the LGBTQ+ community globall.Item Path to a Peaceful Death: Coping with Terminal Illness(Siddharth Health Research and Social Welfare Society, 2024-04) Anupama Devi, K; Soniya Devi, T; Kumar Singh, STerminal illness can cause immense suffering, both physical and emotional, for patients and their families.However, with appropriate care and support, patients can experience a peaceful death.This article reviews the literature on peaceful death from terminal illness, including the psychological, emotional, and physical factors that contribute to a peaceful death.The article highlights the importance of early palliative care and psychological interventions in improving the quality of life and reducing suffering for patients with terminal illnesses.The role of emotional support and legacy - making in enhancing the well-being of patients is also discussed.The article concludes by stressing the need for continued efforts to improve end-of -life care for patients with terminal illnesses.Item Expert opinion on the clinical approach of using sodium glucose cotransporter-2 inhibitors for managing diabetic patients with cardiovascular and renal complications in Indian settings(Siddharth Health Research and Social Welfare Society, 2024-02) Manjula, S; Krishna, Kumar MObjective:To evaluate the prescription practice of sodium-glucose co-transporter -2 (SGLT2) inhibitors with a special focus on dapagliflozin to treat cardiac and renal disorders in obese Indian diabetic patients.Methods: A cross-sectional, questionnaire-based study was conducted to collect the perspectives of physicians with expertise in treating diabetic obese patients with cardiac and renal disorders in endocrinology across India between June 2022 and December 2022. Descriptive statistics were used to summarize the characteristics of the study by employing frequencies and percentages.Results:Among the 1,446 survey participants, 80% of them indicated that young diabetic patients with obesity, and obese patients with cardio-renal complications may require SGLT2 inhibitors.Furthermore, patients aged between 41-50 and 51-60 years also required SGLT2 inhibitors for diabetes management accord ing to 57% and 27% of the respondents.The majority of the respondents (91.29% and 90.53%) recommended dapagliflozin as the best SGLT2 inhibitor for treating patients with chronic kidney disease and heart failure.Additionally , about 59% and 66% of the experts indicated that patients would experience an average weight loss of 2-3 kilograms and an average blood pressure reduction of 3-6 mm Hg after 12 weeks of treatment with dapagliflozin, respectively.Conclusion:Experts recommend the use of SGLT2 inhibitors for the treatment of young diabetic patients with obesity and obese subjects with cardiorenal complications.Dapagliflozin monotherapy was preferred for patients with chronic kidney disease and heart failure. Furthermore, experts highly recommend the combinations of dapagliflozin + metformin and DPP4 inhibitors + metformin + dapagliflozin for effective diabetes management.Item Kartagener's syndrome with Dextrocardia - A case report(Siddharth Health Research and Social Welfare Society, 2024-04) Kushwaha, A; Sinwal, A; Singh, I; Upadhayay, K; Bhardwaj, M; Baby, SOne rare variant of immotile cilia syndrome is known as Kartagener's syndrome.The sinus, eustachian tube, middle ear, and respiratory tract cilia are all impacted by Kartagener's syndrome.These cilia's inability or improper movement causes persistent issues with the ear and sinuses.Some individuals with dextrocardia may not experience any symptoms, while others may have heart-related issues or other associated health problems. Diagnosis typically involves imaging studies such as X-rays, echocardiograms, or CT scans to visualize the position of the heart and other organs.Treatment depends on the presence of any associated heart defects or health issues. In many cases, individuals with dextrocardia can lead normal, healthy lives with proper medical management. Close collaboration between patients and healthcare providers is essential for individuals with dextrocardia to track their heart health and general wellness.If needed, regular check-ups and appropriate medical interventions can help manage any potential complications associated with this condition.Individuals with dextrocardia need to work closely with healthcare professionals to monitor their heart health and overall well-being.If needed, regular check-ups and appropriate medical interventions can help manage any potential complications associated with this condition.Item The Double Trouble: Caudal Duplication Syndrome-A rare case series with a review of literature(Siddharth Health Research and Social Welfare Society, 2024-04) Datta, D; Saha, S; Dakshit, D; Maity, A; Bansal, R; Basu, NCaudal duplication syndrome (CDS) is a very rare disease entity with prevalence of less than 1 per 100,000 at birth.It includes a broad range of abnormalities and clinical symptoms , from single or partial duplication of the gastrointestinal, genitourinary and distal neural tube system organs to total duplication.There have been several ideas proposed to explain the complicated yet symmetrical abnormalities and the wide range of clinical manifestations of caudal duplication syndrome.In this case series, we present two confirmed cases of Caudal Duplication Syndrome in our institute.The management for this syndrome is individualized and may include surgical intervention to fuse or excise the duplicated organs.Item Lymph node metastasis after neoadjuvant chemotherapy(Siddharth Health Research and Social Welfare Society, 2023-02) Dutta, P.; Wadhawan, G.Neoadjuvant therapy refers to the systemic treatment of breast cancer prior to definitive surgical from size reduction before conservation therapy. Response to neoadjuvant chemotherapy is evaluated by the change in tumor size from pretreatment clinical and or radiologic measurement to post-treatment status. The spectrum of response to neoadjuvant chemotherapy varies from complete response, partial response, to non-response. This concept is the same in breast tumors as well as axillary lymph nodes. The presented case is a known case of Triple Negative Invasive Ductal carcinoma with Axillary involvement Right Breast since November 2020 and had undergone NeoadjuvantChemotherapy till February 2021,followed by surgical intervention in October 2022.Item The role of lactate to guide resuscitation- A Clinician’s perspective(Siddharth Health Research and Social Welfare Society, 2023-12) Chowdhury, DMeasured lactate levels have been long considered to be a marker for the critical nature of the patient undergoing resuscitation. Serial measurement of the lactate levels has been shown to improve with the patient’s clinical condition. However, the lactate level should only be used as adjunct to the ensuing resuscitation whilst appreciating that there may be a delayed rise in lactate levels as the perfusion status improves.In the context of sepsis, an absolute increased level of lactate untreated has been associated with increased morbidity and mortality and forms part of the initial management of the ‘Sepsis Six campaign’.In the context trauma, lactate is also noted to be a vital parameter that guides the resuscitation effort highlighting the improvement in the anaerobic metabolism as oxygen delivery is improved to the end organs.This article aims to explore some of the concerns that emergency and critical care clinicians have a raised lactate.Item Pharmacological Therapy approaches for the treatment of Knee Osteoarthritis(Siddharth Health Research and Social Welfare Society, 2024-02) Hofmann, M; Studers, P; Jakovicka, DTo date, no effective treatment has been able to modify the pathological progression of osteoarthritis (OA).Current therapy can be broadly categorized into pharmacological and non-pharmacological approaches before considering surgical interventions. Non-pharmacological methods address lifestyle modifications, weight reduction and physical therapy, all aiming at alleviating mechanical stress on the affected joint.In this article, we focused on pharmacological treatment options, that primarily target pain reduction by reducing joint inflammation or restoring the altered synovial environment to a normal state.In this literature review , the main focus is on approved conservative therapies and examined emerging conservative strategies. Evaluating their advantages and limitations.Item The general skeletal features of Multicentric Carpotarsal Osteolysis:what the radiologist needs to know(Siddharth Health Research and Social Welfare Society, 2023-12) Albahkali, S; Alsaiady, MPurpose of review:Radiographic imaging is the first investigational step in detecting Multicentric carporarsal osteolysis, and the radiologist must be aware then familiar with the radiological features in order both to reach a prompt diagnosis and then to classify the patient’s condition at this important time for considering early management. Here we review the literature on this topic. Recent Findings: Patients with multicentric carpotarsal osteolysis (MCTO) are frequently diagnosed with juvenile idiopathic arthritis (JIA). Initially, their symptoms are arthritic and include pain, swelling and stiffness.Among the many published studies, some are case reports that describe the phenotypical manifestations with a brief discussion of the radiographic findings and subsequently of the genetic analysis which eventually leads to a definitive diagnosis.Some patients develop end- stage renal failure, and a delay in identifying this condition can lead to unfavorable progression of the disease.In addition, we found reports of joint inflammation based on imaging and pain relief with antirheumatics for osteolysis and bone destruction. Various studies discuss the radiological findings, including the disappearance of the carpal and tarsal bones.Others describe the genetic mutations, including MAFB, that are associated with the condition, and its possible management through the use of therapeutic drugs.A very recent description of serial radiographs taken from a young age suggests that dysfunctional bone formation can play a role in the skeletal phenotype of MCTO.Summary:The unique features of clinical presentation, atypical radiological findings, failure to obtain remission with medical treatment and consanguinity, should guide clinicians towards the diagnosis of this condition.We summarize the X-ray findings which are highly specific and can therefore differentiate with confidence between this condition and others. Further performance of gene.Item 4Dimensional XStrain Echocardiography assessment of Left Bundle Branch Cardiomyopathy in an elderly male: A case report(Siddharth Health Research and Social Welfare Society, 2024-02) Mehrotra, A; Shaban, M; Shakya, ULeft bundle branch block (LBBB) is generally associated with a poorer prognosis in comparison to normal intraventricular conduction. LBBB may be the first manifestation of a more diffuse myocardial disease.The typical surface ECG feature of LBBB is a prolongation of QRS above 0.11s in combination with a delay of the intrinsic deflection in leads V5 and V6 of more than 60 ms and no septal q waves in leads I, V5, and V6 due to the abnormal septal activation from right to left. LBBB may induce abnormalities in left ventricular performance due to abnormal asynchronous contraction patterns. Asynchronous electrical activation of the ventricles causes regional differences in workload which may lead to asymmetric hypertrophy and left ventricular dilatation, especially due to increased wall mass in late-activated regions, which may aggravate preexisting left ventricular pumping performance or even induce it.Item Dengue Serotypes In Manipur –Findings From A Retrospective Analytical Study In A Tertiary Care Hospital(Siddharth Health Research and Social Welfare Society, 2023-12) Anand Singh, L; Suson, T; Geeta, Chanu C; Ranjana, Devi K; Rebachandra, Singh HObjectives:As a part of an ongoing research programme on vector-borne viral diseases especially Dengue, a retrospective analytical study on the occurrence and distribution of Dengue virus serotype(s) in the state of Manipur – a small state situated in the northeastern region of the Indian subcontinent was carried out at Viral Research & Diagnostic Laboratory (VRDL), Department of Microbiology, Regional Institute of Medical Sciences (RIMS), Imphal which is a tertiary care hospital.Materials & Methods:A total of 914 blood samples from clinically dengue-suspected patients were screened for the presence of Dengue infection by adopting the ELISA (IgM) technique during the period from 01/06/2022 to 02/12/2022. Further, anti-Dengue IgM antibody-positive samples having high Optical Density (OD) value(s) were selected and subjected to RT PCR to determine the serotype(s) of the Dengue virus.Results:Of the 914 blood samples examined for the presence of Dengue infection, 111 (12.14%) were found positive for anti- Dengue IgM antibody indicating acute infection of Dengue virus.Of the positive patients, there were 56 (50.45%) males and 55 (49.54%) females.Predominant clinical features observed among the Dengue-confirmed patients included – fever (74%), headache (19%), arthralgia / joint pain (9%), myalgia (6%) and vomiting (6%) respectively.The study revealed that while the circulation of three (03) Dengue virus serotypes, namely DENV – 1, DENV – 2 & DENV – 3 were observed in the Tengnoupal district,the circulation of two Dengue virus serotypes i.e., DENV – 1 & DENV – 2 was evident in Imphal West & Bishnupur districts respectively.The present study also reveals the occurrence of Dengue virus serotype – 1 (DENV - 1) in Churachandpur district. Conclusion:The present study reveals the circulation/distribution of three Dengue virus serotypes namely, DENV – 1, DENV – 2 and DENV – 3 among the studied samples.