MGM Journal of Medical Sciences

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/152473

Editor-in-Chief: Dr Chander P Puri
ISSN: 2347-7946

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.mgmjms.com/

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Now showing 1 - 20 of 365

A case series of sinonasal mucormycosis and actinomycosis infection: a clinicopathological approach
(Wolters Kluwer – Medknow, 2024-12) Gupta, Arushi; Khetrapal, Shaan; Rana, Safia; Jairajpuri, Zeeba Shamim; Khan, Sabina; Jetley, Sujata; Monga, Seema
Background: Mucormycosis is a fast-progressing and life-threatening fungal infection caused by fungi belonging to the order Mucorales. It primarily affects individuals with weakened immune systems or diabetes mellitus (DM). Case Reports: This study includes eight patients aged from 24 to 68 years (six males and two females), all of whom presented to the ear, nose, and throat department with primary complaints of nasal obstruction. Histopathological evaluation of biopsies confirmed mucormycosis, revealing areas of necrosis. After appropriate treatment, all patients showed improvement. Discussion: Histopathological examination is the gold standard for diagnosing fungal infections like mucormycosis and actinomycosis. Hematoxylin and eosin staining typically shows necrotic tissue, a mix of acute and chronic inflammatory cells, and broad, nonseptate fungal hyphae. Conclusion: Mucormycosis is the third most common angioinvasive fungal infection and carries a high mortality rate. Successful management requires early diagnosis, aggressive surgical intervention, and timely antifungal therapy. Additionally, controlling underlying conditions, such as DM, is critical in both preventing and treating this serious infection. This case series underscores the importance of thorough histopathological evaluation and heightened clinical awareness when diagnosing and managing sinonasal infections in immunocompromised patients.
Hymenolepis nana: a case report of an intestinal helminthic infection from Northern India
(Wolters Kluwer – Medknow, 2024-12) Singh, Sangeeta; Sen, Manodeep; Raj, Nikhil; Singh, Riddhi; Agarwal, Jyotsna
Hymenolepis nana (H. nana), known as the dwarf tapeworm, is an intestinal helminth. This report highlights a case of H. nana infection in a young female from Northern India who presented with abdominal pain and achieved a favorable outcome following antiparasitic treatment. An 18-year-old female from a rural community in Kothara village, Baharaich, Uttar Pradesh, India, was diagnosed with H. nana infection. She exhibited mild iron deficiency anemia and granulocytosis but remained largely asymptomatic despite a moderate infection burden. While H. nana infections are often asymptomatic, prompt treatment is essential. Without intervention, the infection can spread within isolated rural populations. Therefore, incorporating H. nana screening into routine evaluations for intestinal parasites and treating even asymptomatic cases is vital to prevent further transmission.
Role of controlled radial expansion balloon bronchoplasty in benign subglottic and tracheal stenosis
(Wolters Kluwer – Medknow, 2024-12) Patra, Jeetendra Kumar; Ray, Chinmaya Sundar; Pattnaik, Manoranjan; Behera, Subrat Kumar
Background: Central airway obstruction can arise from both benign and malignant conditions, as well as from congenital or acquired causes. One common cause of acquired central airway obstruction is post-intubation subglottic and tracheal stenosis. Presentations can vary widely, from asymptomatic cases to symptoms such as difficulty clearing secretions and dyspnea on exertion due to airway narrowing. Critical tracheal or subglottic stenosis may present with stridor. Bronchoscopy is the primary diagnostic tool for assessing the type and severity of stenosis in the subglottic and tracheal regions. Controlled radial expansion (CRE) balloon bronchoplasty is a cost-effective procedure that can be performed either under sedation in a bronchoscopy suite or under general anesthesia in an operating room. This technique provides temporary relief and can be repeated, allowing time for more definitive or complex treatments. Materials and Methods: This case series study was conducted in the Department of Pulmonary Medicine in collaboration with the Department of Ear, Nose, and Throat at SCB Medical College and Hospital, Cuttack, Odisha, India, from January 2018 to July 2021. Six patients with subglottic and tracheal stenosis confirmed via fiber-optic bronchoscopy, all of whom had previously undergone tracheostomy, were included. Balloon bronchoplasty was performed using rigid laryngoscopy under general anesthesia with a CRE balloon (Boston Scientific), an Alliance-II integrated inflation device, a guide wire, and an Alliance inflation syringe. A follow- up fiber-optic bronchoscopy was conducted 1 month later. If an optimal tracheal diameter of 8–10 mm was not achieved, the patient underwent an additional CRE balloon bronchoplasty session. Results: This case series evaluated six patients with subglottic or tracheal stenosis. CRE balloon bronchoplasty was completed in three patients, with no recurrence of stenosis. However, the remaining three patients did not achieve an optimal tracheal lumen with CRE balloon bronchoplasty and were referred for tracheal reconstruction surgery. Discussion: CRE balloon bronchoplasty is an effective treatment for restoring optimal tracheal lumen in simple benign subglottic or tracheal stenosis cases. Patients with more complex stenosis should be considered for earlier referral to tracheal reconstruction surgery. Conclusion: CRE balloon bronchoplasty is a safe, straightforward, efficient, and repeatable procedure for relieving central airway obstruction due to benign subglottic and tracheal stenosis. It can serve as either a standalone treatment or an adjunct to other therapies for managing benign subglottic and tracheal stenosis.
Paecilomyces keratitis: a case report
(Wolters Kluwer – Medknow, 2024-12) Choudhury, Debapriya Das; Ubale, Milind; Baranwal, Rimjhim; Nanoty, Vaibhavi; Patel, Mayuri
Ocular trauma involving vegetative matter is the most common cause of keratitis in ophthalmic practice in India, with many cases resulting in fungal keratitis or corneal ulceration. Here, we present a case of fungal keratitis due to Paecilomyces lilacinus that was successfully managed with oral and topical antifungal therapy, avoiding surgical intervention. The patient, a female, presented with a corneal abscess, conjunctival congestion, and persistent pain in her right eye after sustaining an ocular injury from vegetative matter. Based on the clinical signs, a provisional diagnosis of fungal keratitis was made, and treatment with 5% natamycin eye drops was initiated. Potassium hydroxide mount findings indicated fungal hyphae, leading to the addition of oral voriconazole due to suspected deuteromycosis. Fungal culture confirmed the presence of P. lilacinus. Gradually, the patient improved with antifungal therapy over a month without surgical intervention.
Analyzing the quality of multiple-choice questions in microbiology for second-year MBBS students
(Wolters Kluwer – Medknow, 2024-12) Singh, Gurjeet; Singh, Raksha; Ananthakrishnan, Nilakantan
Background and Objective: According to the 2023 Graduate Medical Education Regulations by the National Medical Commission for competency-based medical education in the MBBS curriculum, 20% of assessment questions are now multiple-choice questions (MCQs) in formative and summative evaluations. This study aims to evaluate the quality of MCQs in microbiology assessment for second-year MBBS students and compare different methods for calculating the difficulty index, discrimination index (DI), and distractor effectiveness (DE) of the items. Materials and Methods: This study analyzed 20 MCQs, including 20 correct answers (keys) and 60 distractors, from an internal microbiology assessment of 150 students. The items were evaluated for difficulty index (DIF I), Discrimination Index (DI), and Distractor Effectiveness (DE) using three methods: (1) entire group analysis, (2) grouping by the upper third and lower third of students (50 in each), and (3) selecting the top and bottom 27% of students. Results: The difficulty index was calculated using the whole group, upper-third vs. lower-third, and top vs. bottom 27%. Results indicated that the whole group and upper-third/lower-third methods provided similar accuracy, while the top vs. bottom 27% selection method tended to underestimate difficulty levels. The DI, useful for distinguishing between high and low performers, was best calculated using the top and bottom 27% of students, as whole-group analysis was found irrelevant. Two methods were used to measure DE: whole-group and upper-third/lower-third. However, neither approach showed statistically significant differences (P < 0.05). Conclusion: This study highlights the importance of selecting quality MCQs with moderate difficulty, high discriminative power, and effective distractors to accurately differentiate student performance. Findings suggest that using the top and bottom 27% group is more effective than using the upper-third/lower-third group for analysis of the items.
A study of sleep hygiene practices and quality of sleep in health professional students
(Wolters Kluwer – Medknow, 2024-12) Gawade, Neha D.; Isaac, David N.; Khadkikar, Rita M.; Isaac, Catherine D.
Background: Chronic sleep deprivation is a prevalent yet treatable condition among young adults and teenagers, often resulting from various sleep disorders that negatively affect overall wellbeing in this age group. Sleep quality refers to an individual’s overall satisfaction with different aspects of their sleep experience, while sleep hygiene encompasses easily modifiable pre-sleep behaviors that support healthy sleep patterns. This study aims to assess health professional students’ sleep quality and hygiene practices and evaluate the correlation between these two factors. Materials and Methods: This prospective, observational, and cross-sectional study involved 320 health professional students who completed a self-administered questionnaire. The Pittsburgh sleep quality index(PSQI) was used to assess sleep quality, while the sleep hygiene index (SHI) was used to evaluate sleep hygiene practices. Data were recorded in Excel and analyzed by a statistician. Results: Of the 320 participants, 74.4% (238 students) exhibited a moderate SHI, 13.4% (43 students) had a fair SHI, 11.6% (37 students) demonstrated excellent sleep hygiene, and 0.6% (2 students) showed poor sleep hygiene. Additionally, 63.8% (204 students) reported poor sleep quality, while 36.3% (116) experienced good sleep quality. Conclusion: Most health professional students followed moderate sleep hygiene practices and reported poor sleep quality. Statistical analysis revealed a significant positive correlation between sleep hygiene and sleep quality, suggesting that improving sleep hygiene practices may lead to better sleep quality.
An investigation of birth preparedness and complication readiness and its implication in reducing childbirth mortality in Nigeria
(Wolters Kluwer – Medknow, 2024-12) Aniekan, Peter Theresa; Aturaka, Samson Olusegun; Eric, Yila; Sanni, Olaniyi Felix; Christiana, Adeforiti Ebiyemi; Augusta, Ozor Nneka; Modupe, Abiola Agatha; Olubukola, Popoola Temitope; Saidi, Modupe Ireti
Background: Maternal mortality poses a significant threat to mothers, their children, and families, prompting pregnant women to seek safe and effective deliveries. Nigeria ranks second globally in maternal mortality rates, highlighting the urgent nature of this issue. To address this, the United Nations supports birth preparedness and complication readiness (BPCR) to lower mortality rates and promote safer childbirth. This study evaluates BPCR practices among antenatal clinic attendees in Nigeria as part of ongoing efforts to reduce maternal and infant mortality. Materials and Methods: A descriptive cross-sectional survey was employed using a structured questionnaire. A total sample of 320 participants was calculated using a population-based random sampling formula, with 40 pregnant women selected from each of the eight clinics in the Iseyin Local Government Area. Data were analyzed using the IBM Statistical Package for the Social Sciences version 25.0 (Chicago, IL, USA), employing descriptive and inferential statistics at a 0.05 significance level. Results were presented through tables and charts. Results: The findings indicated that most respondents (86.8%) demonstrated a strong understanding of BPCR, while 87.8% reported good BPCR practices. A significant relationship (P < 0.05) was also observed between respondents’ knowledge, parity, and BPCR practices. Conclusion: The study highlights that sociodemographic factors, gravidity, parity, and BPCR knowledge significantly influence birth preparedness among pregnant women in Iseyin, Nigeria. Younger, first-time mothers and those with greater BPCR knowledge showed better preparedness. While most participants practiced essential BPCR measures, challenges such as unsafe abortions, limited antenatal care, and poverty still contribute to perinatal mortality. Addressing these gaps through targeted education and resource access could further reduce childbirth-related mortality.
A study of acute transfusion reactions at a tertiary care center: a retrospective analysis
(Wolters Kluwer – Medknow, 2024-12) Dey, Damayanti R.; Dhote, Shweta W.; Lad, Subhangi Y.; Gupta, Sonal S.
Background: Blood transfusion refers to the therapeutic use of blood products, and while often lifesaving, it carries a variety of potential complications. Ensuring access to safe and sufficient blood is a critical component of healthcare, leading to the development of hemovigilance. Hemovigilance is essential for improving patient safety by learning from errors and implementing system-wide changes to prevent their recurrence. A comprehensive assessment of adverse events is the primary goal of hemovigilance. Aim: To assess the frequency and types of acute transfusion reactions (ATRs). Objectives: (1) To examine the types of ATRs related to the specific blood components transfused. (2) To analyze ATRs based on different clinical parameters. Materials and Methods: A retrospective analysis was conducted over 3 years, evaluating all transfusion reactions reported to the Department of Immunohematology and Blood Transfusion at Mahatma Gandhi Mission College and Hospital, Navi Mumbai. Reactions were assessed according to the institution’s established protocol. Statistical analysis was performed using IBM Statistical Package for the Social Sciences version 20, with significance at P < 0.05. Results: During the study period, 22,188 blood component units were issued, of which 38 (0.174%) resulted in an ATR. Febrile non-hemolytic transfusion reactions (FNHTR) accounted for 31 cases (81.58%), allergic transfusion reactions for six cases (15.79%), and one case (2.63%) involved an immunologic hemolytic transfusion reaction caused by alloantibodies. Among the reported ATRs, 37 (97.36%) were associated with packed red cells (PRC), while 1 (2.64%) occurred with fresh frozen plasma (FFP). Conclusion: FNHTR was the most common ATR, followed by allergic reactions. These findings highlight the importance of continuous monitoring and strict adherence to standard protocols in blood transfusion practices to enhance patient safety.
A study of the histopathological spectrum of thyroid neoplasms in a tertiary health care center
(Wolters Kluwer – Medknow, 2024-12) Siddiqui, Rabia Parveen; Bhaskar, Vanita; Swami, Kavita; Pandey, Varsha; Chandrakar, Anubhav; Mangrulkar, Kasturi
Background: Thyroid gland lesions are common and can result from systemic conditions such as Graves’ disease or localized abnormalities like nodular enlargement or tumors. Thyroid malignancies are the most prevalent endocrine cancers, accounting for approximately 92% of all endocrine malignancies. This study aims to explore the spectrum of thyroid neoplasms in a tertiary healthcare center. Aims and Objectives: The primary objective of this study was to examine the histopathological spectrum of thyroid neoplasms in a tertiary healthcare center. Additionally, the study aims to assess the frequency of various thyroid neoplasms across different age groups and genders and to identify any associated nonneoplastic thyroid lesions that occur alongside thyroid neoplasms. Materials and Methods: This observational descriptive cross-sectional study was conducted in the Department of Pathology, Pt. Jawahar Lal Nehru Memorial Medical College, Raipur, Chhattisgarh, India, over 50 months from January 2020 to March 2024. A total of 71 cases meeting the inclusion criteria were analyzed. Results: Of the 71 thyroid specimens examined, 12 cases (16.9%) were benign, whereas 59 cases (83.09%) were malignant. The study demonstrated a significant female predominance with a female-to-male ratio of 9.1:1 (64 females and 7 males). Most cases were observed in the 21–30 years age group, with a mean age of 32.3 years. Papillary carcinoma was identified as the most common malignant lesion, accounting for 35 cases (52.1%), whereas follicular adenoma was the most common benign lesion, accounting for 9 cases (12.7%). Conclusion: Accurate diagnosis of thyroid malignancies requires a combination of clinical history, radiological imaging, thyroid function tests, and thorough histopathological examination. Early and proper diagnosis facilitates more effective treatment decisions, standardized management protocols, and improved patient outcomes.
Harnessing nanotechnology for enhanced epilepsy management
(Wolters Kluwer – Medknow, 2024-12) Manasa, V.; Ruby, J. Joysa; Gogoi, Himadri Priya; Vignesh, S.; Anjaneya, P. H.; Akhil
Epilepsy, a condition characterized by unprovoked, recurrent seizures, currently has no cure, with treatments ranging from medications to treatment modalities such as antiepileptic drugs (AEDs) and vagus nerve stimulation, as well as ketogenic diet and surgical procedures. Recent advancements in nanotechnology have introduced groundbreaking approaches to epilepsy treatment, including targeted drug delivery, diagnostics, and therapeutic interventions. Nanocarrier systems—such as nanoparticles, micelles, and liposomes—enhance drug specificity for brain delivery, improving the therapeutic efficacy and reducing off-target toxicity. New developments in nanocarrier systems for AEDs, including phenytoin, phenobarbital, carbamazepine, and valproate, demonstrate increased brain penetration, solubility, and controlled drug release, offering promising benefits in epilepsy management. Nanotechnology also advances diagnostic capabilities with nano-sensitive devices such as enhanced electroencephalography and biomarker technologies, enabling more personalized monitoring and treatment. Prospects include nanodroplet drug delivery, neural repair with nanomaterials, and highly individualized epilepsy therapies. These innovations could significantly improve traditional treatments, patient outcomes, and quality of life, underscoring the importance of collaboration among healthcare providers, scientists, and technologists to maximize their potential. Efforts have been made to present epilepsy and its management graphically.
Clinical case series on presentations of krait bite envenomation
(Wolters Kluwer – Medknow, 2024-12) Yakub, Shireen Faruque; Ghodke, Babita; Puvvadu, Lakshmi Monika; Nirmal, Apoorva; Patil, Ravi
Neurotoxicity is the most peculiar feature of krait envenomation. A patient presenting to the emergency room with complaints of snakebite followed by acute neuromuscular weakness and progressive respiratory involvement should ring a bell for neurotoxic snakebite. The progression of symptoms, muscle involvement and weakness, respiratory worsening, and recuperating post administration of antivenom and acetylcholinesterase inhibitors can vary widely. Delays in diagnosis and administration of treatment are linked to increased mortality rates. In this report, we present cases of krait envenomation, highlighting differences in their management based on each patient’s presentation. All three cases were confirmed krait bites—in two cases, the bystanders had killed and brought the snake to the emergency room, where it was identified as a krait on arrival. Meanwhile, in the third case—based on symptoms, treatment was initiated, and krait was identified a couple of hours later.
Investigating the utilization of biomaterials and bioengineering methods in developing functional cardiac tissue for heart repair
(Wolters Kluwer – Medknow, 2024-12) Elsaka, Omar
It has become increasingly apparent that cardiac tissue engineering applications can be employed to repair heart injuries. The primary purpose of the present research is to examine the use of biomaterials and bioengineering methods to create functioning cardiac tissue. Techniques for tissue maturation, scaffold design, cell sources, and biomaterial selection are important subjects. The proper growth of functioning heart tissue is dependent upon these factors. The assessment emphasizes further research and development areas and discusses the field’s challenges and potential solutions. In conclusion, this article highlights the significant advancements in cardiac tissue engineering. Regardless of its challenges, the medical discipline of cardiology has left tremendous prospects for heart repair in future generations. In this significant progress in this critically important area of regenerative medicine, biomaterials, bioengineering research, and innovation are necessary.
Polymeric hydrogel nanoparticles in drug delivery and bioprinting technologies: a review
(Wolters Kluwer – Medknow, 2024-12) Ghosh, Prasanta Kumar
Multiple kinds of hydrogel polymers, natural and synthetic, are known. Self-assembly and aggregation are their inherent properties. The diverse applications of hydrogel polymers, encompassing natural and synthetic varieties known for their water-swelling capabilities and biocompatibility, have been explored and summarized. Hydrogels are pivotal in medicine, particularly in drug delivery systems, and emerging three-dimensional (3D) bioprinting technologies. Integrating nanoparticles into hydrogels enhances their functionality for targeted drug release and as components of bioinks used in bioprinting aimed at priming and replicating tissue and organ structures. Natural hydrogel polymers are favored for their biocompatibility characteristics in bioinks, while synthetic polymers and nanoparticles contribute to stronger mechanical properties and increased versatility. This study highlights the importance of the nanoparticle-based hydrogel polymer-entrapped drug substances for efficient use in tissue- specific delivery systems. It emphasizes the critical role of bioink development in advancing synthetic organ fabrication via the 3D bioprinting technology.
A large submucosal pedunculated fundal fibroid presenting as a vaginal mass: a rare case report
(Wolters Kluwer – Medknow, 2024-12) Dasila, Priyank Singh; Shah, Maitri; Thamke, Pratima
This study reports the clinical outcomes of a 47-year-old female, para 1, living 1, abortion 1, with a previous lower segment cesarean section, who presented with a history of vaginal spotting and weight loss over 6 months. Both ultrasonography and magnetic resonance imaging indicated a mass originating from the lower uterus and cervix, likely of neoplastic origin. Upon vaginal and speculum examination, a soft, round cystic mass was detected, filling the vaginal cavity, making cervical evaluation impossible. However, histopathology and fluid cytology confirmed the mass as benign. An exploratory laparotomy revealed a large submucosal pedunculated fibroid originating from the fundus and extending into the vaginal cavity. The fibroid was removed, and a hysterectomy was performed. This case highlights a rare presentation of a submucosal fibroid as a vaginal mass. It underscores the importance for gynecologists to recognize this complication to avoid delays in diagnosis and prevent unnecessary morbidity and mortality.
Navigating the digital dilemma: the impact of Internet addiction on social interaction among nursing students
(Wolters Kluwer – Medknow, 2024-12) Sharma, Mudita R.; Gupta, Manisha; Shiju, Dolly John; Pareek, Shatrughan
Background: With 4.57 billion people actively using the Internet worldwide, concerns about Internet addiction disorder (IAD) and its effects on daily life have become increasingly significant. This study investigates the intricate relationship between Internet addiction and face-to-face communication, focusing on how excessive online engagement influences traditional social interactions. It examines the association between Internet addiction and social interaction among nursing students in today’s digitally driven world. Materials and Methods: A quantitative research design was adopted, and data were collected from 128 nursing students using convenience sampling. The Internet Addiction Test (IAT) was employed to assess the severity of Internet addiction, whereas face-to-face social interactions were evaluated using a customized questionnaire. Results: The findings revealed a moderate level of Internet addiction among participants, with a mean IAT score of 45.7. A negative correlation (?0.32) was identified between IAT scores and the quality of face-to-face interactions, indicating that higher Internet addiction levels are associated with reduced interaction quality. Regression analysis further confirmed a significant negative correlation (?0.23) between IAT scores and the quality of social interactions. Although daily hours spent online demonstrated a positive but nonsignificant relationship (0.11) with interaction quality, a negative correlation (?0.17) was observed between the frequency of social media use and the quality of face-to-face interactions. Conclusion: This study underscores the significant impact of Internet addiction on face-to-face social interactions among nursing students. It emphasizes the need for targeted strategies to balance the benefits of digital connectivity with the preservation of meaningful interpersonal communication, providing valuable insights for future research and intervention.
Nanotechnology in cancer: advancements in treatment and detection—a review
(Wolters Kluwer – Medknow, 2024-12) Parthasarathi, Abhirami K.; Karabsanawar, Someshwar S.; Acharya, Prajnashree
Cancer, characterized by the rapid growth of abnormal cells capable of invading surrounding tissues and metastasis, is a leading cause of mortality worldwide. Conventional treatments such as chemotherapy and immunotherapy often encounter challenges such as limited specificity, drug resistance, and significant side effects. Nanotechnology offers promising advancements in both cancer treatment and diagnosis. Nanoparticles (NPs) represent a breakthrough in cancer treatment because they target tumors precisely, improve drug delivery, and enhance imaging techniques. These nanoscale materials have the potential to reduce side effects and overcome drug resistance, thus boosting the therapeutic effectiveness. Additionally, NPs play a critical role in early cancer detection and metastasis imaging. This review examines how nanotechnology enhances cancer cell eradication, supports immunotherapy, and advances drug delivery systems. Ongoing research in nanoparticle production and multifunctional nano-platforms highlights the potential of nanomedicine to transform cancer therapy, paving the way for personalized and highly effective treatment approaches.
A rare case of a migrated foreign body found in and around the urinary bladder and urethra
(Wolters Kluwer – Medknow, 2024-12) Yelikar, Aditya
Common causes of intravesical or intraurethral foreign bodies include iatrogenic injuries, self-insertion, sexual abuse, assault, and migration from adjacent sites. A 64-year-old man had been presented with a 1-year history of intermittent urinary dribbling, accompanied by painful urination (dysuria), occasional blood in the urine (hematuria), and lower urinary tract symptoms. Initially, we performed cystolithotripsy to free a guide wire encased in tissue. However, the wire remained lodged in the urinary bladder, prompting us to conduct a laparoscopic cystolithotomy for complete removal. It is possible that the guide wire either slipped into the femoral vein and was subsequently forgotten, later migrating to the urinary bladder, or that it was used to railroad a Foley catheter, which slipped into the bladder and was left behind. Foreign bodies in the urinary bladder are relatively common and should be considered when symptoms and test results are inconsistent. When endoscopic removal is not feasible, laparoscopic removal is an effective minimally invasive option.
A review of gut microbiota as a therapeutic approach for Parkinson’s disease
(Wolters Kluwer – Medknow, 2024-12) Ghosh, Debosree; Ghosh, Suvendu; Sharma, Madhurima; Datta, Sutapa
Parkinson’s disease (PD) is a neurodegenerative disorder that affects the brain–gut axis, manifesting through both motor dysfunction and nonmotor symptoms. While several factors contribute to PD, the precise cause remains unknown. Research studies suggest that an altered gut microbiota (GM) plays a key role in PD pathophysiology. Gut dysbiosis compromises the integrity of the intestinal epithelium, increasing gastrointestinal permeability. This, in turn, activates the innate immune system, leading to systemic inflammation, whereas the adaptive immune system responds to bacterial proteins through cross-reactivity with human antigens. The altered GM promotes the accumulation of alpha-synuclein fibrils in the intestinal neural plexus, which are then transported to the central nervous system, driving the core pathological process of PD. This review focuses on the connection between gut dysbiosis, PD pathology, and current microbial-based therapeutic interventions. Furthermore, research into innovative approaches to modulate the GM and reinforce gut epithelial integrity is crucial to halting or slowing PD progression.
Perinatal mortality and its associated factors in selected tertiary care hospital of Belagavi, Karnataka, India
(Wolters Kluwer – Medknow, 2024-12) Kole, Uma; Raddi, Sudha
Background: In many low- and middle-income countries, stillbirths are generally defined as those occurring after 28 weeks of gestation, whereas in some high-income countries, the threshold is set at 20 completed weeks of gestation. The stillbirth rate is acknowledged as a sensitive indicator of healthcare quality and equity. All provinces have demonstrated accelerated progress in reducing stillbirths. Materials and Methods: This study aimed to identify the risk factors associated with perinatal mortality among 3508 mothers who delivered at selected tertiary care hospitals in Belagavi, Karnataka, India. Using consecutive sampling, mothers from labor rooms and maternity wards were surveyed via the Maternal and Newborn Health Registry. Results: The perinatal mortality rate observed in this study was 36.48/1000 live births. Among the mothers, 78.9% were anemic, 11.86% experienced antepartum hemorrhage (APH), and 79.7% had hypertensive disorders during pregnancy. Additionally, 13.8% of neonates suffered from birth asphyxia, 6.1% presented with hypothermia, and 21.1% of births were preterm, with gestational ages ranging from 28 weeks and 6 days to 36 weeks and 6 days. Conclusion: The study conducted at tertiary care facilities revealed that most stillbirths were preventable and primarily linked to conditions such as APH, maternal hypertension, labor hypoxia, and low birth weight. Many of these deaths could be avoided through skilled obstetric care, which includes prenatal and intrapartum screening for specific conditions, fetal heart rate monitoring during labor, and timely interventions, often involving cesarean delivery. There is an urgent need for a global classification system and perinatal mortality audits to understand the causes better and enhance prevention efforts.
Correlation between cystoscopy findings and symptom severity in painful bladder syndrome
(Wolters Kluwer – Medknow, 2024-12) Palnitkar, Devdatt Purushottam; Patankar, Prakash; Patankar, Suresh
Background: Painful bladder syndrome (PBS) is characterized by persistent pelvic discomfort and urinary symptoms. Cystoscopy is frequently utilized to investigate bladder abnormalities in patients with PBS, particularly those presenting with persistent hematuria, refractory symptoms, or suspected bladder pathology. Objective: We aimed to evaluate the relationship between cystoscopy findings and symptom severity in patients with PBS. Materials and Methods: The study included 22 patients who underwent cystoscopy for PBS. Indications for the procedure included persistent hematuria, unrelenting symptoms, and suspected bladder pathology. Based on visual assessment, the cystoscopic findings were classified into three categories: normal, mild, and severe. Symptom severity was evaluated using a standardized symptom score questionnaire administered before treatment. Results: Of the 22 patients, 6 had normal cystoscopy findings, 14 exhibited mild changes, and 2 demonstrated severe changes. Symptom severity scores varied across the group, with no clear correlation between the severity of symptoms and cystoscopic findings. Notably, patients with severe symptoms often had normal or only mild changes on cystoscopy. Conclusion: No significant correlation was found between symptom severity and cystoscopy findings in PBS patients. This discrepancy may stem from the subjective nature of symptom scoring, the multifactorial origins of PBS symptoms, and the potential influence of functional disorders. Further research is warranted to identify additional factors influencing symptom severity in PBS.

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