International Journal of Scientific Study

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https://imsear.searo.who.int/handle/123456789/157719

Editor-in-Chief: Dr.Swapnil Bumb
ISSN (Print): 2321-6379 (Electronic): 2321-595X

Frequency: Monthly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.ijss-sn.com/

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Now showing 1 - 20 of 780

Saccharomyces boulardii: An Efficient Yeast Probiotic for Pediatric Gut Dysbiosis Management
(International Research Organization for Life & Health Sciences, 2024-08) Reddy, AD; Parija, A; Madhavi, B; Madhav, SV; Shalini, B; Sreenivasulu, M; Venkatswami, P; Reddy, TRK; Gopal, SH.
The human microbiome, comprising diverse microorganisms across body surfaces, profoundly influences host physiology, metabolism, and nutrition. Dysbiosis, an imbalance within gut microbiota, triggers health issues such as inflammation, autoimmune disorders, and obesity. Probiotics, which are live microorganisms known for their health benefits, when used correctly, hold promise for managing dysbiosis. Prebiotics, probiotics, synbiotics, and immunobiotics have demonstrated efficacy in addressing gut dysbiosis. Among these supplements, yeast-based probiotics such as Saccharomyces boulardii CNCM I-745 demonstrate significant benefits over bacterial alternatives. Yeast cells, being larger and more resistant to digestive enzymes and bile than bacterial cells, serve as a barrier against pathogens and possess immunomodulatory properties, enhancing gut health. S. boulardii CNCM I-745, with its unique features such as pathogen binding, immune stimulation, and toxin neutralization without genetic transfer, notably mitigates antibiotic resistance risk. It effectively prevents antibiotic-associated diarrhea and pediatric acute gastroenteritis compared to bacterial probiotics, endorsed by the international guidelines for managing acute diarrhea safely. In addition, oral probiotics may aid microbiota restoration and potentially prevent other diseases.
Exploring the Therapeutic Benefits of Saccharomyces boulardii CNCM I-745: A Potent Probiotic Solution
(International Research Organization for Life & Health Sciences, 2024-08) Kumar, A; Katkuri, DR; Prasad, GS; Ahmed, J; Rao, KSS; Reddy, BS.
Humans and microbes have a close symbiotic relationship, particularly in the gut, where more than 1000 species contribute to its development and maturation. The gut microbiota is essential for normal physiological development, as it supports the maturation and differentiation of the gut mucosa and its immune system. As an infant’s diet evolves, the microbiota becomes more complex, resembling that of an adult by early childhood. Malnutrition can disrupt this balance, leading to dysbiosis, which is characterized by a decrease in beneficial Bifidobacteria and an increase in harmful microbes such as Escherichia coli, Fusobacterium mortiferum, and Streptococcus spp. Dysbiosis is associated with a higher risk of various gastrointestinal diseases (GIDs), including inflammatory bowel disease, irritable bowel syndrome (IBS), and necrotizing enterocolitis. Probiotics play a crucial role in maintaining a balanced gut microbiota, making probiotic-based therapy a promising approach for preventing and treating GIDs. The mechanisms of action of probiotics include competitive adhesion and exclusion of potential pathogens, stimulation of intestinal epithelial cell proliferation, enhancement of the epithelial barrier, and interactions with the enteric nervous system and immune system. Yeasts offer several advantages as probiotics. They are stable in acidic and bile environments and can adhere to human intestinal cells. Saccharomyces boulardii CNCM I 745 is particularly effective in treating multiple gastrointestinal disorders, including traveller’s diarrhea, antibiotic-associated diarrhea (AAD), Clostridium difficile-associated syndrome, IBS, and Crohn’s disease. In addition, S. boulardii can survive the competitive environment of the intestinal tract and is naturally resistant to antibiotics and proteolysis, enhancing its effectiveness as a probiotic.
Evaluation of Peripapillary Retinal Nerve Fiber Layer and Macular Thickness in Myopic Patients by Spectral Domain Optical Coherence Tomography
(International Research Organization for Life & Health Sciences, 2024-12) Hardia, Y; Mehta, S; Gupta, K; Mehta, M.
Background: Myopia is a prevalent refractive error characterized by light focusing in front of the retina, with projections indicating that nearly 50% of the global population could be affected by 2050. Myopia-related changes in retinal structure, especially in the retinal nerve fiber layer (RNFL) and macula, are observable with Optical Coherence Tomography (OCT). This study aimed to assess RNFL and macular thickness variations across different grades of myopia (mild, moderate, and high) using spectral domain OCT. Materials and Methodology: This prospective, observational study was conducted at the Ruxmaniben Deepchand Gardi Medical College, Ujjain, Madhya Pradesh, with a sample of 96 patients aged ?15 years diagnosed with axial myopia. Participants were categorized into three groups based on spherical equivalent: Low (?1D–
Role of Magnetic Resonance Enteroclysis in the Assessment of Pathologies of Small Bowel
(International Research Organization for Life & Health Sciences, 2024-08) Thirukoveluri, R.
background: Examination of the gastrointestinal (GI) tract for both anatomy and pathology is essential in diagnosing GI diseases. Traditional radiology has historically played a pivotal role, alongside endoscopy which remains primary despite limitations. However, non-invasive cross-sectional imaging modalities such as ultrasound (US), computed tomography (CT), positron-emission tomography (PET), and magnetic resonance imaging (MRI) have revolutionized GI tract assessment. These modalities offer enhanced resolution, 3D imaging, and contrast enhancement, with multimodal approaches such as PET-CT and PET-MRI improving sensitivity and specificity in tissue pathology studies. US, due to its affordability, non- invasiveness, and high diagnostic accuracy, has gained prominence in GI disease diagnosis, particularly with Doppler and contrast-enhanced US providing critical blood flow data. Magnetic resonance enteroclysis (MRE) has emerged as a standard imaging test for evaluating small-bowel (SB) pathologies, necessitating standardized practices in indications, interpretation, and methodology. MRE accurately assesses intraluminal, parietal, and extraluminal aspects of the SB, distinguishing between neoplastic and non-neoplastic diseases. This study aims to present the MRE technique, interpret imaging findings, and compare them with final diagnoses, emphasizing its role and advantages in diagnosing SB pathologies through rigorous methodological steps. Objective: This study evaluates the role of MRE in diagnosing SB pathologies, including inflammatory bowel diseases (IBD) and their extraluminal complications and extraintestinal manifestations. It focuses on assessing disease activity, treatment response, and distinguishing inflammatory from fibrotic strictures in conditions such as Crohn’s disease (CD) and ulcerative colitis (UC). Materials and Methods: A retrospective and prospective study conducted over 5 years starting from May 2019 to July 2024 (5 years) at the Department of Radiology, Sri Ramachandra Institute of Higher Education and Research, involved 34 patients with various SB pathologies undergoing MRE. Clinical and histopathological evaluations were compared with MRE findings. Statistical analysis determined the sensitivity and specificity of MRE as a diagnostic tool. Results: The study showed a slight male predominance among patients, with ages ranging from 1 to 80 years, most commonly affected between 21 and 40 years. Common symptoms included abdominal pain, vomiting, weight loss, and diarrhea. MRE identified bowel wall thickening, strictures, fat stranding, fistulas, lymph node enlargement, and ascites, with CD being the most prevalent diagnosis. Histopathological examination confirmed IBD in the majority as well as other pathologies such as tuberculosis and validating MRE diagnoses. Conclusion: MRE proves effective in diagnosing a wide range of GI pathologies, particularly inflammatory small-bowel disorders such as CD and UC. Its comprehensive imaging capabilities provide crucial insights for precise diagnosis and treatment planning, making it a preferred first-line imaging technique due to its non-invasiveness and absence of radiation exposure.
Nonsurgical Management of Ranula with Intralesional Sclerotherapy with 3% Sodium Tetradecyl Sulfate in Pediatric Patients
(International Research Organization for Life & Health Sciences, 2024-12) Mahajan, N; Kotwal, B; Kaul, B; Gupta, A; Mahajan, P; Shah, SG.
Background: Ranula is a term for mucocele occurring on the floor of the mouth after trauma or obstruction to components of the salivary gland. Surgical method was the only choice of treatment for ranula. However, there are certain limitations of surgical approach. Alternatively, intralesional sclerotherapy with 3% sodium tetradecyl sulfate is newer, simpler and non-invasive treatment procedure. Objective: The objective is to analyze the effect of 3% sodium tetradecyl sulfate (STS) on ranula and to evaluate whether sclerotherapy can be a potent alternative to other surgical treatment modalities. Materials and Methods: This study was carried out among children aged between 7 and 14 years with the chief complaint of swelling in the floor of mouth causing functional impairment and pain in some cases. Surface local anesthesia was applied over the lesion. STS 3% was injected under aseptic conditions with an insulin syringe and this was subsequently repeated on weekly intervals till complete regression. Follow-up was done after every 1, 3, 6 months, and 1 year interval to check for any recurrence. Results: After the first injection of 0.5–1 mL of 3% STS, we observed a complete clinical disappearance of lesion in 9 (31%) cases, a moderate response in 13 (44.9%), and no response in 7 (24.1%) children. Four weeks after the first injection, regression of lesion was observed in all the cases. Conclusion: Sclerotherapy with 3% STS is minimally invasive, safe, and effective treatment of different oral lesions and may be the method of choice in pediatric populations.
Stereotactic Radiosurgery in Brain Metastases at a Tertiary Cancer Center in Kashmir: A Novel Experience
(International Research Organization for Life & Health Sciences, 2024-12) Mustafa, SA; Nabi, MG; Shafi, S; Bhat, MA.
Background and Objective: With improvised cancer care the incidence of brain metastases is increasing worldwide. Traditionally whole brain radiotherapy, corticosteroids, and surgery have been the mainstay of treatment. Stereotactic radiosurgery (SRS) has evolved as a promising modality in the management of brain metastases, either alone or in combination with other modalities. We share our experience of SRS in brain metastases at a tertiary cancer center in Kashmir, India. Materials and Methods: One hundred and twenty patients with radiologically or histologically documented brain metastases were addressed for their demographic profile of which 37 were analyzed with respect to their clinico-dosimetric profile. Results: Thirty-seven patients received SRS, predominantly hypofractionated schedule. The majority were males with underlying lung cancer. Conclusion: The present analysis, besides highlighting the increasing trend of incidence of brain metastasis also suggests the feasibility of linear accelerator (LINAC)-based SRS in brain metastases owing to the wide availability of LINAC-based radiotherapy machines, ease of execution, and non-operative alternative.
Serum Aminotransferase Level among Non- Alcoholic Fatty Liver Disease/Metabolism- Associated Steatotic Liver Disease Patients of North East India
(International Research Organization for Life & Health Sciences, 2024-12) Bhaumik, R; Bhat, SA; Bhaumik, P.
Introduction: Non alcoholic fatty liver disease or Metabolism associated steatotic liver disease is emerging as an increasingly common liver disease worldwide, especially in association with obesity, diabetes and metabolic syndrome. Aim of the Study: This study aims at assessing serum aminotransferase enzymes: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) Methods: The study was conducted in 628 patients with NAFLD diagnosed by abdominal ultrasonography. The patients were categorized into three grades based on the extent of liver fat accumulation. The patients were divided into Grade I (mild fat accumulation of 5-33%), Grade II (moderate fat accumulation of 34-66%), and Grade III (severe fat accumulation of more than 66%). Result : the work conducted showed that serum AST and ALT concentrations rose in proportion to the severity of NAFLD. In Grade I, the mean AST was 35.06 U/L and mean ALT was 39.17 U/L, while in Grade III the levels increased to 248.00 U/L of AST and 286.00 U/L of ALT, which shows severe liver inflammation. Further it was observed that, aminotransferase alterations were higher amongst male patients in all grades while the female patients’ results were relatively low. Discussion: Aminotransferase levels was normal in many grade I patients arguing the fact that normal AST and ALT levels may not effectively rule out early NAFLD. It reflects that though aminotransferase level may not increase in early NAFLD, but in later stage aminotransferase level increases invariably and requiring further noninvasive diagnostic evaluation. Conclusion: Aminotransferase level may vary in different area or community and standardization and validation is very much required . Though aminotransferase is single independent marker of inflammation of liver but confirmation by other associated non invasive marker is required.
Effect of Two Different Temperatures on Resistance to Cyclic Fatigue of Hyflex EDM TruNatomy and ProTaper Next Files: An In Vitro Study
(International Research Organization for Life & Health Sciences, 2024-08) Purushothama, R; Rakshith, VR; Samrat, MR; Balaji, DR; Yalamanchili, S; Meghana, K.
Introduction: One of the important aspects in success of endodontic treatment is root canal instrumentation. Nickel-titanium rotary instruments drastically improved the root canal preparation technique. However, the major disadvantage of these instruments is their unexpected fracture. Intracanal temperature plays an important role in the cyclic fatigue resistance. This study was conducted to compare the effect of two different temperatures on resistance to cyclic fatigue of HyFlex EDM, TruNatomy, and ProTaper Next files. Methods: A total of 30 endobloc and 30 continuous rotary files from each system (n = 10) (GROUP 1: HyFlex EDM, GROUP 2: TruNatomy, GROUP 3: ProTaper Next) were used for the study. Samples were further divided into two subgroups (n = 5) and tested at room temperature and at stimulated intracanal temperature (45–50°C). A digital thermometer was used to measure the temperature of the water. The number of cycles to fracture was calculated. Length of fractured segments was measured using a digital caliper. The fractured files were examined under a scanning electron microscope to determine morphological characteristics. Data were analyzed using I Kruskal–Wallis test, post hoc Mann–Whitney test, and Wilcoxon sign test. Results: At both temperatures, HyFlex EDM files showed the highest number of cycles to fracture compared with ProTaper Next and TruNatomy files (P < 0.05). There was no significant difference in fractured segment length at intracanal stimulated temperature whereas TruNatomy showed higher fracture segment length at room temperature. Conclusion: Within the limitations of this in vitro study, it can be concluded that HyFlex EDM showed the highest cyclic fatigue resistance both in the room and stimulated intracanal temperature compared to TruNatomy and ProTaper Next. There was increase length of fracture segment of TruNatomy at room temperature. Scanning electron microscope analysis showed the presence of morphological changes in the fractured files.
Evaluation of Retinal Nerve Fiber Layer Thickness in Patients having Pseudoexfoliation Syndrome
(International Research Organization for Life & Health Sciences, 2024-08) Shahid, M; Gupta, R; Hassan, A.
Background: Pseudoexfoliation syndrome (PEX) is a systemic disorder and is characterized by a progressive chronic deposition and accumulation of extracellular grayish-white material in several organs including the eye. PEX can lead to a variety of intraocular problems that affect the eyes, particularly the lens and the trabecular meshwork. PEX also leads to structural changes in the retinal nerve fiber layer (RNFL) that can be detected by optical coherence tomography (OCT). Aims and Objectives: The aims and objectives of the study are to compare mean RNFL thickness in patients having PEX with normal age-matched controls using spectral domain OCT (SD-OCT). Materials and Methods: This case–control study was conducted at the Department of Ophthalmology, ASCOMS, Jammu, for 6 months on 88 eyes divided into two groups of 44 subjects each (Group A – subjects with PEX and normal intraocular pressure [IOP] and Group B – subjects with no evidence of ocular pathologies). Complete history and comprehensive ophthalmic examination were carried out in each subject. Statistical analysis of the data was done using the Statistical Packages for the Social Sciences version 19.0. Results: In both groups, the majority of the participants were in the age group 61–70 years old, and male patients outnumbered female patients in both groups. There was no significant difference in IOP in both groups. Statistically significant differences were detected between the two groups for mean average RNFL thickness (P = 0.019) and mean RNFL thickness in the inferior quadrant (P = 0.014). Conclusion: The patients having PEX with normal IOP and other visual fields have thin RNFL as compared to healthy age- matched controls.
Accuracy and Correlations of Cervical Cytology: Cervical Pap Smears Screening and Detection of Abnormal Cytology in Southern Indian Population in Tertiary Centre of Karwar Institute of Medical Sciences, Karwar, Karnataka
(International Research Organization for Life & Health Sciences, 2024-12) Rampada, SP; Vijay, PM; Biyani, A.
Introduction: Cervical carcinoma in women is the 3rd most prevalent cancer of the world. It is also considered as 2nd most common carcinoma in reproductive age group. Cervical Pap smears is used as prediagnosis for early screening and detection of the diseases. Objective: 1. Screening of cervical PAP smears, 2. Evaluation of the Pre malignant lesions. 3. Study of spectrum of changes seen in cervical PAP smears with ages. Methodology: This was a prospective study done from September 2022 – September 2023.Cervical pap smears were sent from OBG department for routine screening which were stained and prepared for cytological evaluation with reporting based on Bethesda system of reporting cervical cytology. Results:In the present study, total 357 cases were analyzed with most common age group were between 41-50 years old with most common cases were of asymptomatic routine 119(33%), followed by WDPV 57cases (16%) and abdominal pain 33 cases (9%). 234 smears (65%) belong to NILM, 63 smears (17%) Inflammatory changes and 31 smears (8.68%) of atrophic related changes. Conclusion: This study concludes that premalignant and malignant lesions were less prevalent in our institution. Among all cases, WDPV and abdominal painwere most common symptoms among the visiting patients in the Hospital with most smears were of NILM, Inflammatory and atrophic related changes been reported.
Radiology Education: The Role of Social Media in Learning and Collaboration
(International Research Organization for Life & Health Sciences, 2024-08) Bodapati, S.
In recent years, the integration of social media platforms into medical education has significantly transformed the landscape of learning and collaboration in various medical specialties, and radiology is no exception. This review article inspects the multifaceted role of social media in revolutionizing radiology education while examining its impact on knowledge dissemination, professional networking, skill development, and academic collaboration. By examining the current practices, this article aims to discuss the transformative impact of social media in radiological education: its advantages, challenges, and future prospects.
Correlation of Clinical Parameters, Lipid Profile and Carotid and Vertebral Arteries Plaque as Detected by Doppler Ultrasound in Ischemic Stroke
(International Research Organization for Life & Health Sciences, 2024-11) Chakrabarti, B; Paul, A; Dhaliwal, MS; Paul, UK.
Background: A stroke is caused by a disruption in blood flow to the brain, either from ischemia (blockage) or hemorrhage (rupture), and is a medical emergency. This study focuses on assessing carotid arteries using color Doppler sonography to evaluate stenosis and correlate cerebrovascular accidents with carotid artery status, clinical parameters, and lipid profiles. Methods: It is a cross-sectional observational study that investigates the correlation between clinical parameters, lipid profile, and carotid and vertebral artery plaque in patients with ischemic stroke, using Doppler ultrasound amongst 65 patients. Results: Out of 65 patients studied a significant portion of the study group (72.3%) were aged 51–70, with a male predominance (66.2%). Risk factors such as hypertension (47.7%), diabetes (43.1%), and dyslipidemia (41.5%) were prevalent. Doppler ultrasound findings revealed that most patients had peak systolic velocities between 125 and 200 cm/s (47.7%) and stenosis in the 50–70% range (47.7%). Hypoechoic plaques were more common than hyperechoic plaques, with hypoechoic plaques predominantly associated with 50–70% stenosis. Conclusion: The study concludes that early detection and management of risk factors, along with carotid Doppler ultrasound, are critical in preventing ischemic stroke in high-risk patients. Carotid sonography, especially in individuals over 50 years with significant risk factors, is recommended for early diagnosis and intervention.
Clinical Profile, Etiology, and Outcome of Pediatric Patients with Stroke: A Tertiary Care Hospital-based Study
(International Research Organization for Life & Health Sciences, 2024-11) Sharma, S; Parihar, A; Katoch, GS; Wani, KA.
Introduction: Stroke constitutes a significant health problem in pediatric population. The reported incidence of childhood stroke has risen to 2–6 per 100,000 children per year in the past 10 years. The estimates from North America report an incidence of 2.5–2.7 cases per 100,000 children per year, while in France, the incidence is reported to be 13 cases per 100,000 children per year. There is no population-based published data about the incidence or prevalence of pediatric stroke in India. Objective: The objective is to study the clinical profile, etiology, and outcome of pediatric patients with stroke admitted to our hospital. Material and Methods: This was a prospective observational, single-center study designed to study the clinical profile, etiology, and outcome of pediatric stroke patients in Kashmir conducted in the Postgraduate Department of Pediatrics, GMC Srinagar. All children aged 6 months to 18 years of age were included in the study. Children aged <6 months or >18 years and children with a history of head injury were excluded from the study. All included children were evaluated clinically and necessary investigations were done after taking proper informed consent. The present study was conducted over 1 year. On examination, general physical examination and neurological examination were done. The presence of edema, jaundice, cyanosis, lymphadenopathy, petechial hemorrhage, purpura, bruit, cardiac findings, and hepatosplenomegaly was noted. Admission vital parameters (heart rate, blood pressure, and respiratory rate), consciousness as assessed by the Glasgow Coma Scale (GCS), and focal neurological deficit (monoplegia, hemiplegia, quadriplegia, aphasia, visual field defect, cranial nerve palsy, and sensory abnormalities) were noted. Neuroimaging (either CT or MRI) of the brain was performed for each patient. The location and arterial territory of infarction were noted. Results: It was a prospective hospital-based observational study conducted over a period of 1 year. A total of 38 patients were enrolled in the study. There were 21 males and 17 females in our study. The mean age of presentation in our study was 6.43 years. Majority of patients in our study were in the age group of 6 months–4 years (50%). Seizures (focal + generalized) were the most common presenting feature in our study. Consciousness was impaired in most patients in our study. The most common infectious cause of stroke was meningoencephalitis followed by neurotuberculosis. Hemiparesis was the most common neurological deficit. MCA was the most common territory involved on arterial ischemic stroke. The most common type of stroke was found to be arterial ischemic stroke. Conclusion: The current study has provided valuable information into the pediatric strokes clinical profile, etiology, and outcome. This study further strengthens the observation that AIS is the most common type of stroke in children at all ages, followed by CSVT and hemorrhagic variety. The study further confirms that MCA is the most common territory involved. Thereby, the presentation of stroke more or less is same in different parts of the world. However, there is a difference in etiology which may be due to underlying genetic and environmental factors. Survivors have high morbidity and moderate-to-severe neurologic deficits are common.
Light at the End of the Tunnel- A Rare Case of Neuromelioidosis and its Imaging Findings
(International Research Organization for Life & Health Sciences, 2024-11) Rakshith, V; Chandrasekaran, A; Manokaran, RK.
Melioidosis, caused by Burkholderia pseudomallei, is a rare but serious infection with a wide spectrum of clinical manifestations, including central nervous system (CNS) involvement. Neuromelioidosis, which affects the CNS, is uncommon but carries a poor prognosis and high mortality. Here is a case of a 16-year-old girl who presented with fever, hemiparesis, and neurological deficits. Following a magnetic resonance imaging (MRI) brain, a close differential of demyelination versus infection was considered. Despite initial steroid treatment for presumed demyelination, her condition worsened. Her serial MRI brain scans showed progressively characteristic lesions, the rare “tunnel sign,” which along with the clinical picture raised suspicion of an infectious etiology such as Melioidosis. Tissue sampling confirmed the diagnosis. This led to the initiation of targeted antibiotics (meropenem and co-trimoxazole) with the patient improving considerably and the follow-up MRI showing significant regression of lesions. This case highlights the diagnostic challenges of neuromelioidosis, a condition often confused with other CNS infections or autoimmune conditions. Imaging features, particularly the tunnel sign when present, along with microbiological confirmation, are crucial for diagnosis. Timely administration of appropriate antibiotics can significantly improve outcomes. This case report underscores the importance of early recognition and treatment of neuromelioidosis, especially in endemic regions.
Assessing The Potential Value of KI-67 in Predicting the Therapeutic Response to Neoadjuvant Chemotherapy in Breast Cancer Patients in Indian Population and to Determine the Best Ki-67 Cutoff Value that Increases the Prediction Accuracy in Making Treatment Decisions
(International Research Organization for Life & Health Sciences, 2024-12) Naz, A; Sarkar, DK; Basu, S; Das, AK; Roy, PK.
Objective: To assess the potential value of Ki-67 in predicting the therapeutic response to neoadjuvant chemotherapy in breast cancer patients in the Indian population and to determine the best Ki-67 cutoff value that increases the prediction accuracy in making treatment decisions. Materials and Methods: This is a prospective observational study where breast cancer patients who underwent MRM/BCS surgery after neoadjuvant chemotherapy at SSKM and IPGMER Hospital between January 2024 and September 2024 in 50 patients. The clinical and pathologic characteristics of all patients were obtained from the hospital medical records. The clinical and pathological response to chemotherapy was determined. Result: As a result of the analysis from this study, clinical and pathological responses to NST were significantly improved when Ki-67 levels were high >17% (P = 0.05). Furthermore, a better rate of pathological complete response (pCR) was significantly associated with tumor size <5 cm (P = 0.02), and vascular invasion when positive (P = 0.023). Conclusion: Clinical and pathological responses to NST were significantly improved when Ki-67 levels were high >17. Furthermore, a better rate of pCR was significantly associated with tumor size <5 cm, and vascular invasion when positive. Our analysis showed that a Ki-67 cutoff >17% predicted a better pCR rate.
Comparative Evaluation of Sugammadex versus Neostigmine for Reversal of Neuromuscular Blockade in Patients Undergoing Cholecystectomy under General Anesthesia
(International Research Organization for Life & Health Sciences, 2024-11) Sharma, A; Chatrath, V; Marwah, D; Kamboj, A; Gupta, M; Arora, A.
Background and Aims: Muscle relaxation is the vital element of general anesthesia. It is attained using neuromuscular blocking agents (NMBAs). After surgery, full restoration of patient’s muscle strength is essential to ensure safe post-operative recovery. The reversal of non-depolarizing NMBAs is achieved using acetylcholinesterase inhibitors or gamma-cyclodextrins. The present study was done to compare Sugammadex and neostigmine for the reversal of vecuronium-induced neuromuscular blockade in patients undergoing cholecystectomy under general anesthesia. Materials and Methods: This prospective randomized double-blinded study was conducted in Guru Nanak Dev Hospital attached to Government Medical College, Amritsar, after taking written informed consent from patients in their vernacular language and approval from the Institutional Ethics Committee. This study was conducted on 60 patients, aged 18–60 years, American Society of Anesthesiologists Grade I and II, scheduled to undergo elective cholecystectomy under general anesthesia. The patients were randomly divided into two groups with 30 patients in each group. At the end of the surgery, when train-of- four (TOF) count reached 2, Group S patients received Sugammadex 2 mg/kg intravenously, and Group N patients received neostigmine 50 mcg/kg and glycopyrrolate 10 mcg/kg combination intravenously to reverse vecuronium induced neuromuscular blockade. Results: The mean time from the study drug administration (at appearance of second twitch T2 after last dose of vecuronium) to tracheal extubation, that is, TOF ratio 0.9 was significantly faster in Sugammadex compared to neostigmine with 2.84 ± 0.592 min (mean ± standard deviation) in Group S and 14.168 ± 2.351 min in Group N. Furthermore, the mean time from study drug administration to operating room discharge ready was 8.92 ± 4.264 min in Group S, and it was 25.064 ± 10.208 min in Group N. Post-operative residual paralysis was not seen in any patient in both the groups. Conclusion: Sugammadex is faster than neostigmine-glycopyrrolate combination in reversing vecuronium-induced neuromuscular blockade. Sugammadex is safe and well tolerated. The incidence of drug-related side effects (post-operative nausea vomiting, post-operative urinary retention) was slightly lower in the Sugammadex group as compared to neostigmine group (10% and 26.6%, respectively).
A Study on Clinical Profile of Children with Fever more than 5-day Duration in a Tertiary Care Hospital in Tirupati
(International Research Organization for Life & Health Sciences, 2024-11) Babu, AC; Kumar, PM; Manohar, B.
Introduction: In children, fever is generally a sign of infection. Fever due to other causes including malignancy is rare. The prognosis for the most common forms of pediatric infections is usually excellent, but this is not the case for some bacterial infections and malignancies. Aims and Objectives: (1) Aims: To study the clinical profile of children with fever more than 5-day duration in children 1 month to 12 years of age. (2) Objectives: To document the clinical profile of children with fever more than 5-day duration. To document the outcome of children with fever more than 5-day duration. Materials and Methods: Study design: Prospective study. Setting: In-patients from a tertiary care hospital. Participants: 106 (mean age: 5.9 years) children between 1 month and 12 years with fever more than 5 days duration (fever – axillary temperature >99°F and oral temperature >100°F). Results: Among 106 children (57 males and 49 females), 83% had a fever for 6–10 days, 44.4% had vomiting, 41.5% had chills/rigors, 25.5% needed oxygen supplementation, 55.7% needed intravenous fluids, 30.2% had hospital stay >10 days, 59.4% had intensive care unit stay, 32.1% were diagnosed as scrub typhus/spotted fever; 91.5% improved, 3.8% died. Conclusion: Children with prolonged fever had overall better outcomes when brought earlier to the hospital setting. Most of the cases (91.5%) recovered without complications. Early and proper work-up and intervention improve the outcome in prolonged fevers.
Hemorrhage in the Pancreas
(International Research Organization for Life & Health Sciences, 2024-08) Kapur, A; Ramachandran, R; Jeyakumar, A; Rajeswaran, R; Sivaramakrishna, B.
Acute pancreatitis is a disease characterized by pancreatic inflammation associated with several etiological factors. There are two types of acute pancreatitis: Acute edematous pancreatitis and acute necrotizing pancreatitis. Hemorrhagic pancreatitis is a known complication of both of them. It is characterized by necrosis of the pancreatic parenchyma, destruction of small blood vessels, interstitial hemorrhage, and significant pancreatic and peri-pancreatic inflammatory reaction associated with a high mortality rate. The incidence of Hemorrhagic Pancreatitis during pregnancy is low, but associated with a high maternal and fetal mortality rate. The highest incidence is seen in the third trimester/early postpartum period. Here, we are presenting two interesting cases of hemorrhagic pancreatitis which presented with apparently benign signs and symptoms.
Diclofenac Topical Gel for the Management of Osteoarthritis and Joint Pain: Real Therapeutic Effect or Just Psychological Effect
(International Research Organization for Life & Health Sciences, 2024-12) Chinnaswami, K; Hegde, A; Davis, D; Raffic, M; Srampickal, GM; Kumar, SS; George, MJ.
Diclofenac topical gel is an effective treatment for osteoarthritis (OA) and joint pain due to its enhanced skin penetration and therapeutic benefits. The gel formulation provides a higher flux, allowing better penetration and absorption into underlying tissues than other formulations such as solutions or patches. Upon application, diclofenac reaches therapeutic levels in deeper tissues, including synovial fluid, which helps alleviate pain and inflammation while reducing systemic side effects, which are a major concern for OA patients with comorbid conditions. The sustained release mechanism of the gel maintains therapeutic levels over time, contributing to prolonged pain relief. In addition, combination formulations incorporating penetration enhancers or active ingredients can further boost the efficacy of diclofenac gel. Moreover, diclofenac gel demonstrates therapeutic benefits, with measurable pain relief and anti-inflammatory effects, making it a preferred choice of clinicians. However, topical counterirritants provide a paradoxical pain-relieving effect and caution is needed as topical analgesics with counterirritants, such as capsaicin, can cause severe skin injuries, including chemical burns.
Choosing the Right Non-Steroidal Anti-Inflammatory Drug: A Critical Determinant for Analgesia in Osteoarthritis Management
(International Research Organization for Life & Health Sciences, 2024-12) Kumar, A; Mishra, AK; Gupta, SK; Tripathi, P; Singhal, A; Gupta, P; Agarwal, AK.
Osteoarthritis (OA) management has evolved from focusing solely on symptomatic relief to a more patient-centered approach that addresses the underlying pathophysiology of the disease. This review examines the role of non-steroidal anti-inflammatory drugs (NSAIDs) in OA, with a particular focus on their effects on the synovial membrane. In OA, the synovium undergoes pathological changes due to inflammation, and diclofenac is known to concentrate in synovial fluid at higher levels than plasma. This accumulation is crucial, as the synovial fluid is the primary site for pain and inflammation relief, suggesting that higher absorption at this site results in longer-lasting pharmacological effects. Choosing the appropriate NSAID for OA requires balancing effective pain relief, improved patient outcomes, and enhanced quality of life while minimizing gastrointestinal, cardiac, and renal side effects.

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