Journal of Krishna Institute of Medical Sciences University

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https://imsear.searo.who.int/handle/123456789/151354

Editor in Chief: Dr. Asha K. Pratinidhi
ISSN: 2231-4261

Frequency: Half yearly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.jkimsu.com/index.html

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Assessment of the relationship between urinary iodine level and thyroid dysfunction among children in south India: A case-control study.
(Dr. M. V. Ghorpade, 2024-09) Sivaraj, V; Sarojini, S; Suyambunathan, AV; Pichandi, S; Kanniyappan, D; Kanakasabapathi, R.
Background: A universal salt iodization program was implemented in India to eradicate Iodine Deficiency Disorders (IDD) in children. Iodine deficiency is eliminated but excess iodine in children could lead to complications in the thyroid gland. Aim and Objectives: To assess urinary iodine levels and thyroid dysfunction among children. Material and Methods: One hundred children between the ages of 6 to 12 years with thyroid dysfunctions and 100 age- and gender-matched healthy children were enrolled in the case-control groups respectively. All subjects were measured for urinary iodine, thyroid profile, anti-microsomal antibody, and anti-thyroglobulin antibody levels. Goiter grading and Fine Needle Aspiration Cytology (FNAC) were performed. Results: Elevated levels of urinary iodine were found in 77% of the case population. Hypothyroidism (66%), hyperthyroidism (11%), and benign goiter (23%) thyroid complications were observed in the case group. FNAC and autoantibody reports confirmed 66% of autoimmune thyroiditis found in the case group. Conclusion: Higher levels of urinary iodine excretion suggest the consumption of excess iodine intake in children. An elevated level of autoantibodies with iodine excess may lead to thyroid complications such as thyroiditis, thyrotoxicosis, and benign goiter in children. So, a continuous supply of iodized salt should be monitored carefully.
Investigation of some anaerobic bacteria in the sputum of cystic fibrosis patients and healthy people in Tehran, Iran.
(Dr. M. V. Ghorpade, 2024-09) Hamayeli, H; Abdi-Ali, A; Attaran, B; Shafiei, M; Modaresi, M.
Background: In Cystic Fibrosis (CF) patients, increased mucus secretion and accumulation due to genetic defect leads to decreased oxygen levels and colonization of anaerobic bacteria. Aim and Objectives: In addition to investigating the difference in the prevalence of anaerobic bacteria in the sputum samples of CF patients and healthy populations, this study evaluated the relationship of demographic factors with anaerobic bacteria and CF disease. Material and Methods: Anaerobic bacteria were investigated in sputum samples of CF patients (50 people) and healthy individuals (18 people) in Tehran, Iran by molecular method in 2021-2022. The prevalence of common anaerobic bacteria in CF patients was investigated by Polymerase Chain Reaction (PCR). Results: The relationship between Bifidobacterium and Prevotella in both of healthy and CF groups, as well as the disease and Bifidobacterium (p = 0.0437) and disease and Prevotella (p = 0.0514), were significant. The results of Spearman's correlation also showed an inverse relationship between age and gender (men) with disease and a direct relationship between antibiotic use and disease. Conclusions: The abundance of potentially beneficial species of Bifidobacterium and Prevotella was lower in CF than in healthy people. The role of anaerobic bacteria in the lungs of CF patients is different according to the bacterial genus and species.
Prospective observational study to compare subclavian vein collapsibility index with inferior vena cava collapsibility index in predicting hypotension after induction of general anaesthesia.
(Dr. M. V. Ghorpade, 2024-09) Patil, MC; Kola, HP; Kalal, RH.
Background: Intraoperative hypotension leads to many postoperative complications which can be avoidable. In contrast with inferior vena cava, subclavian vein collapsibility index is found to be a better predictor of intravascular volume status. Aim and Objectives: To compare subclavian vein/infraclavicular axillary vein collapsibility index with inferior vena cava collapsibility index (during spontaneous breathing or deep inspiration) in predicting hypotension after induction of general anesthesia. Material and Methods: In this study, 70 ASA I and II healthy individuals were enrolled. Using ultrasonography, diameters of subclavian vein and inferior venacava during one respiratory cycle were recorded and their collapsibility indices were calculated. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Arterial Pressure (MAP) were noted at every 2 minutes interval after induction of general anesthesia. Intraoperative blood pressure measurements were correlated with the collapsibility indices of great veins to predict intraoperative hypotension. Results: MAP at 2, 4, 6 and 8 minutes showed insignificant correlation with the inferior vena cava collapsibility index on spontaneous breathing with values of 'p' being 0.63, 0.98, 0.93 and 0.65, respectively. MAP at 2, 4, 6 and 8 minutes showed insignificant correlation with the inferior vena cava collapsibility index on deep inspiration with values of 'p' being 0.78, 0.20, 0.17 and 0.20, respectively. MAP at 2, 4, 6 and 8 minutes showed very significant correlation with the subclavian vein's collapsibility index on spontaneous breathing with values of 'p' being 0.48, 0.20, 0.17 and 0.20, respectively. MAP at 2, 4, 6 and 8 minutes showed very significant correlation with the subclavian vein's collapsibility index on deep inspiration with values of 'p' being 0.0010, 0.0020, 0.0007 and 0.0012, respectively. Conclusion: Subclavian vein collapsibility index on spontaneous breathing and deep inspiration had highly substantial association with the MAP, as compared to inferior vena cava collapsibility indices.
Assessing the diagnostic accuracy of radiological and histological findings in the diagnosis of non-alcoholic fatty liver diseases stages among patients in a tertiary hospital.
(Dr. M. V. Ghorpade, 2024-09) Ekpe, EL; Emanghe, U; Ekpe, EL; Obiora, IC; Yemiode, I; Akinmola, OO.
Background: Early screening, detection, and early intervention are life-saving modalities to lessen the impact and burden of non-communicable diseases. Aim and Objectives: To evaluate the diagnostic strength of ultrasound in the diagnosis of Non-alcoholic Fatty Liver Disease (NAFLD) stages. Material and Methods: Participants were recruited from patients with fatty liver who underwent liver biopsy and baseline ultrasound at the University of Calabar Teaching Hospital between January 2023 and December 2023. Ultrasonographic findings were correlated with the histological findings of liver biopsy which was considered the gold standard for the diagnosis of NAFLD. Results: One hundred and nine participants were recruited and participated in this study, of which 62 (56.9%) were females and 47(43.1%) were males, with the highest age bracket presenting at 56-65 years. The female-to-male ratio was 1:1.4 and their mean age was 55.5 ± 12.8 years (age range was 18-70 years). The ultrasonographic findings were correlated with histological data (considered as the gold standard). The sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were evaluated. The ultrasonography had a sensitivity of 90.4% (95% Confidence Interval (CI): 83.6-93.6) and a specificity of 72.5% (95% CI: 68.7-79.8). The PPV and NPV were 74.7% and 65.6% respectively. The area under the curve was 84.5%. The positive likelihood ratio was 1.5 (95 CI: 1.21-1.90), and the negative likelihood ratio was 0.30 (0.17-0.54). Conclusion: Ultrasound findings were highly significant and useful in detecting advanced or late-stage steatosis in patients with fatty liver. In the future, as technology advances, it is hoped that the need for liver biopsy may not be necessary as hi-tech radiological involvement may help patients with fatty liver without the involvement of any invasive procedure.
Evaluation of resistance rates of Enterobacterales to beta-lactam drugs and interpretation of their minimum inhibitory concentrations relative to clinical breakpoints.
(Dr. M. V. Ghorpade, 2024-09) Uma, BM; Naik, N; Rama, NK.
Background: Beta lactam group of antibiotics are one among the most widely used against enterobacterales. There has been an escalation of resistance among cephalosporins, and carbapenems in the recent days. Evaluation of resistance rates and careful selection of drugs based on Minimum Inhibitory Concentration (MIC) aids in effective therapy of infections caused by these resistant strains. Aim and Objectives: To determine the resistance rates of beta lactam antibiotics among enterobacterales, to analyse the relative extent of resistance and susceptibility based on their MIC, relative to their breakpoints, and also to determine MIC 50 and 90. Material and Methods: Study was conducted in a tertiary care hospital in rural Bengaluru from June 2022 to May 2023. A total of 733 clinical isolates from all samples were included in the study. Identification and antimicrobial susceptibility testing was done by VITEK-2 Compact automated system. Results: Based on analysis of MIC among urine samples, resistance rates of 88% for ampicillin, 71% for cefixime and 69% for ceftriaxone was seen. Among other samples 71%,61% and 57% resistance was seen to cefuroxime, ceftriaxone and amoxclav respectively. Least resistance was seen to meropenem (13%) cefoperazone sulbactam (17%) and imipenem (19%). Cefoperazone sulbactam and carbapenems had better susceptibility with MIC 50 less than the susceptible breakpoint. MIC 90 of piperacillin tazobactum and ceftazidime were well above the resistant breakpoint. Conclusion: Understanding the MIC and analysis of susceptibility and resistance of antibiotics will help in rational selection of antibiotics, which may serve as an aid in abating the development of resistant strains. It would be prudent to spare the drugs with MIC 90 above the resistant breakpoint from being included in the empirical panel and should be watchful while using third generation cephalosporins for uncomplicated infections.
A case of schwannoma in breast: A rare site.
(Dr. M. V. Ghorpade, 2024-12) Jawalkar, S; Patil, V; Raj, SS.
Schwannomas are slow growing, benign tumors that develop from Schwann cells of peripheral nerve sheath. Breast schwannomas are exceedingly rare, comprising only 2.6% of all schwannomas. This report describes the case of a woman aged 22, who developed a firm, mobile lump in the right breast, initially diagnosed as fibroadenoma. After excision, histopathology study revealed a well-encapsulated, pale white tumor, microscopically portraying interlacing fascicles of spindle-shaped cells, characteristic Verocay bodies and S100 protein immunopositivity, confirming the diagnosis of schwannoma. This case emphasizes the necessity of factoring breast schwannoma in the diagnostic possibilities of palpable breast masses and the necessity of histopathological confirmation following imaging studies.
Case series of Pityriasis lichenoides in the post-COVID era: Clinical features and response to erythromycin monotherapy.
(Dr. M. V. Ghorpade, 2024-12) Eddula, VR; Chinni, SS; C Sravana, D; Kumar, MA; Chaudhuri, S; Sneha, KH.
Pityriasis Lichenoides (PL) is a rare dermatological condition marked by erythematous papules and plaques, presenting in acute and chronic forms. The COVID-19 pandemic has seen a surge in PL cases, potentially linked to post-viral immune dysregulation, highlighting a novel aspect of post-COVID dermatological manifestations. This article presents a case series of PL patients diagnosed in the post-COVID era, detailing their clinical features and treatment responses. Notably, all patients in this series responded favorably to erythromycin monotherapy. The cases revealed that erythema, scaling, and pruritus were common symptoms, which significantly improved with erythromycin. This consistent positive response underscores erythromycin's potential as a first-line therapeutic option for PL, especially when considering the emerging pattern of post-viral dermatological conditions. The findings suggest that erythromycin may modulate the immune response altered by COVID-19, providing symptomatic relief and disease resolution. These observations pave the way for further research into the mechanisms of PL in the context of post-viral immune dysregulation and reinforce the need for heightened awareness among clinicians of the possible dermatological sequelae of COVID-19.
Role of stratification of immunohistochemistry markers in primary lung carcinomas: experience in a south Indian tertiary care center.
(Dr. M. V. Ghorpade, 2024-12) Prabhu, S; Mathews, A; Nair, S; Rao, ACK; Mony, R; Kattoor, J.
Background: Accurate subtyping of lung carcinomas is essential owing to therapeutic implications. Aim and Objectives: To assess the role of immunohistochemical markers in the classification of primary lung carcinomas in resource-poor setting. Material and Methods: This was a 6-month retrospective study from January 2019 to June 2019 carried out in a tertiary care cancer centre. Biopsy confirmed cases of lung carcinoma were retrieved. Immunohistochemistry (IHC), wherever performed, was reviewed and the cases were typed. IHC markers were used in a tiered manner comprising TTF-1, Napsin A, p40, p63, Synaptophysin and Chromogranin A. CD56, Cytokeratin 7 (CK7), Pancytokeratin (CK) were performed in selective cases. Results: Two hundred and sixty-four (264) cases of primary lung carcinomas comprising of seven lobectomies and 257 small biopsies were studied. Prior to IHC, the distribution of cases was as follows: Small Cell Carcinoma (SCLC) (6.8%, n=18), non-small Cell Lung Carcinoma (non-SCLC) (89.4%, n=236) further divided into Adenocarcinoma (ADC) (35.9%, n=95), Squamous Cell Carcinoma (SCC) (19.8%, n=52) and non-SCLC, unclassifiable (33.7%, n=89). Non-SCLC, unclassifiable after use of IHC was non-SCLC favoring ADC (20%, n=53), non-SCLC favoring SCC (7.9%, n=21). One case of non-SCLC (adenocarcinoma) with SCLC (0.4%) on biopsy; one case of non-SCLC on biopsy showed both squamous and adenocarcinoma components (0.3%, n=1). Two cases were of adenosquamous (1.1%, n=2) and three cases of large cell neuroendocrine carcinomas (n=3,1.1%). Salivary gland type tumors comprised 6 (2.2%) cases. Eight cases (3%) could not be reclassified despite adequate IHC, and hence were retained in non-SCLC, NOS category. Conclusion: IHC panel of TTF-1, Napsin A, p40, p63, Synaptophysin, Chromogranin A, CK, CK7 used judiciously and in tiered manner aids in accurately subtyping most primary lung carcinomas.
Biological activity produced by ruthenium chloride on perfusion pressure, left ventricular pressure and heart failure using an isolated rat heart model.
(Dr. M. V. Ghorpade, 2024-09) Lauro, FV; Marcela, RN; Magdalena, AR; Maria, LR; Emilio, AS; Virginia, MA.
Background: Several drugs have been used to treat heart failure, including digoxin, spironolactone, captopril, and valsartan; however, some of these drugs can produce different secondary effects. Aim and Objectives: The aim of this investigation was to evaluate the biological activity of ruthenium chloride on perfusion pressure, left ventricular pressure and heart failure. Material and Methods: Effects produced by ruthenium chloride (0.001 to 100 nM) on perfusion pressure was evaluated using an isolated rat heart model. Besides, the biological activity of ruthenium chloride (1 to 100 nM) on Left Ventricular Pressure (LVP) was determined in the absence or presence of nifedipine, indomethacin, prazosin, and WB-4101 at a dose of 1 nM. Finally, biological activity of ruthenium chloride (1 to 100 nM) against heart failure was evaluated using an ischemia/reperfusion injury model. Results: The results showed that ruthenium chloride increased the perfusion pressure from 1 to 100 nM; ruthenium chloride increased LVP in a dose- dependent manner, whose effect was inhibited by prazosin and WB-4101; and the ruthenium derivative significantly decreased the infarct area (p = 0.05) compared with the control conditions. Conclusion: These data suggest that ruthenium chloride may act as ? -adrenoreceptor activator and could be a good agent to treat heart failure.
Morphological variations of acromion process in rotator cuff tear using magnetic resonance imaging.
(Dr. M. V. Ghorpade, 2024-12) Goshi, RC; Vijay, C; Patil, V; Chaithra, N; Anupama.
Background: The acromion is one of the markers on the posterior shoulder. The pathophysiology of Rotator Cuff Tear (RCT) seems to be related with the shape of the acromion, which is often evaluated by its characteristics. Aims and Objectives: To use magnetic resonance imaging to determine the morphological features of the acromion connected with RCT. When remedying patients with rotator cuff disease and shoulder impingement syndrome, orthopaedicians must have a thorough understanding of the structure and configuration of the acromion. To detect the RCT with respect to morphology and type of acromion. The objective was to know the incidence and type of RCT with respect to morphology and type of acromion. Material and Methods: This study, which involved 48 patients with RCT, either partial- or full-thickness, was conducted at JSS Medical College and Hospital. In our retrospective analysis, we examined the acromial type, Acromial Thickness (AT), Lateral Acromial Angle (LAA), Acromio-Humeral Distance (AHD), Critical Shoulder Angle (CSA), and Acromial Index (AI) in 48 cases of RCT. Results: The age of our participants ranged from 20 to 76 years, with mean of 40.40 years and standard deviation of 14.35 years, suggesting considerable variability in age across the study sample. AI varied between 0.11 and 0.84, with a mean of 0.58 and a standard deviation of 0.16. AT varied from 0.36 to 1.47, with a mean of 0.72 and a standard deviation of 0.19. LAA varied from 52.46 to 95.26 degrees, with a mean of 77.04 degrees and a standard deviation of 8.19 degrees. AHD varied from 0.34 to 1.24 cm, with a mean of 0.81 cm and a standard deviation of 0.18 cm. CSA varied from 10.73 to 42.82 degrees with a mean of 32.82 degrees and a standard deviation of 5.55 degrees. Conclusion: In our study, in the context of RCTs, there was no correlation between the three acromial shapes and sex, regardless of the muscle that was injured. However, we identified a significantly higher incidence of full-thickness supraspinatus tears in the right shoulders of men aged 40–60 years with type 2 acromia.
Testicular cholesterol granuloma: A diagnostic surprise in an uncommon site.
(Dr. M. V. Ghorpade, 2024-12) Nerune, SM; Chavan, DK; Kalla, Y; Das, SK.
This case report outlines an unusual presentation of a cholesterol granuloma in the testis, an uncommon site of such a pathology. A male in his fifties, with chronic left groin swelling, was initially suspected to have a pyocele or scrotal abscess based on preliminary investigations. The swelling's longstanding nature and ultrasonography findings led to orchidectomy, with a significant evacuation of pus. However, histopathological examination revealed testicular cholesterol granuloma characterized by distinct features. This case emphasizes the significance of a comprehensive differential diagnosis for enduring swellings and emphasizes the pivotal role of histopathological examination in confirming rare presentations.
Assessment of metabolic risk among the Rotterdam’s polycystic ovary syndrome phenotypes in Bangalore.
(Dr. M. V. Ghorpade, 2024-12) Anand, C; Singh, R; Narayana, S.
Background: Polycystic Ovary Syndrome (PCOS) is characterized by a variety of complex manifestations with an unclear underlying cause. This condition is consistently linked to an increased cardio-metabolic risk. It is essential to evaluate this risk at the phenotype level to identify the most vulnerable subgroup within the PCOS population. Aim and Objectives: To phenotype the PCOS patients as per the standard Rotterdam's criteria and to assess the metabolic syndrome markers in those phenotypes. Material and Methods: A total of seven hundred participants (n=700) were assessed and categorized based on the Rotterdam criteria. Clinical, radiological, and biochemical assessments were conducted and analyzed statistically. Chi-square and two-way ANOVA tests were conducted using SPSS version 19 statistical software. The results indicated that phenotype A was the most prevalent, comprising 83.2% (583) of the cases, followed by phenotype C at 8% (56), phenotype D at 5.55% (39), and phenotype B at 3.1% (22). Notably, phenotype B, while being the least prevalent, exhibited the highest metabolic risk. This phenotype was significantly associated with increased levels of hirsutism, postprandial hyperinsulinemia, impaired glucose tolerance, and hormonal imbalances. Additionally, although not statistically significant, there was a higher occurrence of family history of metabolic syndrome, elevated waist circumference (greater than 35 inches), obesity, stress, and dyslipidemia associated with this phenotype. Conclusion: The highest metabolic risk was observed in phenotype B, which was characterized by a combination of hyperandrogenism and irregular menstruation in the absence of polycystic ovaries.
Utility of new reticulocyte parameters such as reticulocyte hemoglobin and new erythrocyte parameters in detection of subclinical stage of iron deficiency in pregnancy.
(Dr. M. V. Ghorpade, 2024-12) Sahithya, H; Arakeri, SU.
Background: Deficiency of iron is the most common cause of anemia in pregnancy. It may cause various morbidities in pregnancy. Hemoglobin estimation is the routine investigation employed in antenatal screening where 11g/dl is taken as a cut-off for diagnosis of anemia. With the advancement of technology, new reticulocyte and erythrocyte parameters, such as the percentage hypochromic red blood cells and the percentage Microcytic Red Blood Cells (Micro-R), can assess iron status. Hence, in the present study, utility of these parameters was evaluated to determine the subclinical stage of iron deficit in pregnancy. Aim and Objectives: To assess utility of newer reticulocyte and erythrocyte parameters by comparing them with serum iron for detecting subclinical deficiency of iron in pregnancy. Material and Methods: Hospital-based, observational study was done on blood samples of non-anemic females of first-trimester pregnancy presenting to the obstetrics and gynecology department for the first time. Unpaired t-test and receiver operating characteristic analysis were done to check the relative efficiency. Results: Reticulocyte Hemoglobin (Ret- He) showed a sensitivity of 98.0% and specificity of 97.0% at the optimal value of 32.25. The area under the curve for Ret-He indicated it as a discriminator of deficiency of iron with a p-value < 0.001. Micro-R percentage at a cut-off of 1.55 showed sensitivity and specificity of 76.9% and 69.9%, respectively, and was statistically significant. Conclusion: Ret-He can be an alternative hematological investigation for detecting subclinical deficiency of iron in females during pregnancy.
Investigating inter-thalamic adhesion in cadavers: Anatomical insights and radiological correlations.
(Dr. M. V. Ghorpade, 2024-12) Dnyanesh, S; Bhimalli, SM; Mali, R; Patil, A; Dnyanesh, K.
Background: The significance of Inter Thalamic Adhesion (ITA) has often been minimized due to its inconsistent presence and seemingly negligible functional relevance. Recent technological advancements in neuroimaging, however, have reignited interest in this anatomical feature, suggesting that its potential may be more complex than previously understood. Aim and Objectives: To determine the prevalence, morphology, and dimensions of the ITA in brains of people from North Karnataka. Material and Methods: A total of 100 brains (including 50 cadaveric specimens and 50 MRI scans) were examined in the midsagittal plane to detect the presence or absence of ITAs, as well as their location on the lateral wall of the third ventricle and their size. Results: The ITA was present in 90% of the samples. Out of the total sample, 38 brains were from female individuals, with an ITA absence observed in only 2 cases (5.2%). In the male group, comprising 62 brains, 8 individuals (12.9%) lacked an ITA. Oval shape was the most common (52 cases), followed by elliptical (33 cases) shape. The majority of ITAs (54 cases) were primarily located in the anterosuperior quadrant, often extending into the posterosuperior quadrant. Individuals younger than 50 years old exhibited significantly larger horizontal (p = 0.001) and vertical diameter (p = 0.002) measurements compared to those aged 50 and above. Conclusion: The absence and duplication of the ITA are quite frequent occurrences in brains of North Karnataka people. Evidence from morphometric data supports the concept that ITA's size changes with age. Future research should continue to explore the ITA's functional roles and its implications for neurological health and disease.
Anaesthetic considerations in a rare presentation of transposition of great arteries in adulthood with an unusual association of severe valvular aortic stenosis.
(Dr. M. V. Ghorpade, 2024-12) Gayathri, R; Basantwani, S.
Transposition of the Great Arteries (TGA) with Intact Ventricular Septum (IVS) is incompatible with life due to systemic circulation of deoxygenated blood. It usually presents in the neonatal period with cyanosis and an arterial switch operation is done within 3 weeks of life. We present a case of TGA with IVS and severe valvular Aortic Stenosis (AS) presenting for the first time in adulthood. The occurrence of valvular AS with dextro-TGA is a rarity and the anaesthetic considerations in such a case have not been reported. The patient survived till adulthood due to the presence of a large atrial septal defect. Worsening of AS leading to heart failure led to the delayed presentation. Understanding the circulatory pathway and pathophysiology of congenital heart disease before and after surgical correction is essential in managing heart failure peri-operatively. Discussing the anaesthetic considerations in such a case is paramount due to multiple unusual circulatory abnormalities.
Glioblastoma multiforme: A rare case of GBM.
(Dr. M. V. Ghorpade, 2024-12) Varghese, AP; Luharia, A; Uke, A; Luharia, M; Mishra, G; Shrungare, S; Rahul, N.
The most rapid and severe primary brain tumor in adults is Glioblastoma Multiforme (GBM), which is known for its rapid development and high invasiveness. GBM is still associated with a dismal prognosis, even with advancements in multiple treatment modalities like chemotherapy, radiotherapy, and surgical resection. The typical survival following diagnosis is only 12 to 15 months. GBM is incredibly heterogeneous due to its complicated genetic and molecular causes, which makes effective therapy very challenging. Three key molecular pathways associated with the pathophysiology of GBM include PI3K/AKT/mTOR, Rb signaling, and the p53 tumor suppressor. There are promising prospects to improve clinical outcomes with new treatment techniques that target these pathways in addition to innovative strategies like immunotherapy and personalized medicine. This research investigates characteristic approaches to GBM management which includes post op adjuvant radiotherapy with concurrent temozolomide followed by adjuvant chemotherapy for 6 to 12 cycles.
Tale of a pseudocyst of pancreas with page kidney: A rare case report.
(Dr. M. V. Ghorpade, 2024-12) Gandhi, MS; Shilpa, MD; Vajja, N.
Page kidney, a rare clinical phenomenon, involves hypertension arising in a previously normotensive individual, typically caused by external compression of the renal parenchyma. Common etiologies include subcapsular hematomas or urinomas. We report an unusual case of a 35-year-old male with a history of chronic alcoholism who developed a pancreatic pseudocyst leading to Page kidney and secondary hypertension. This combination of conditions is exceptionally rare.
Evaluation of asprosin levels in growth hormone-deficient children.
(Dr. M. V. Ghorpade, 2024-12) Safaa, EA; Marwa, AH; Omar, YS; Karam, G; Isam, NS.
Background: Growth Hormone Deficiency (GHD) in children is a rare endocrine condition characterized by a low GH secretion that minimizes the secretion of growth factors such as Insulin-Like Growth Factor-I (IGF-I). Asprosin (ASP), a novel adipokine predominantly secreted by white adipose tissue, plays a crucial role in the liver's production of glucose. Elevated levels of ASP are observed in metabolic diseases. Aim and Objectives: This study aimed to assess the levels of ASP in pediatric patients with GHD. Material and Methods: This research included 40 subjects (children) with GHD and 50 healthy control subjects, with measurements conducted using ELISA kits for ASP. Results: We found the levels of ASP to be significantly higher in the patient group (mean 5.7, range 2.28-17.79 ng/ml) compared to the control group (mean 4.1, range 3.12-5.21 ng/ml) (p < 0.001). Conclusion: This finding suggests a potential link between GHD and altered ASP secretion. Elevated levels of ASP in GHD patients may contribute to metabolic dysregulation, insulin resistance, and other associated complications.
COVID-19 CT score and oxygen saturation level on pulse oximetry: Do they correlate?
(Dr. M. V. Ghorpade, 2024-12) Indiran, V; Anantha Eashwar, VM; Nisarga, BV; Aishwarya, PM.
Background: Computed Tomography (CT) scan of Chest was widely used in India during COVID-19 pandemic irrespective of oxygen saturation level of the patients because of wide spread CT availability and prevalence of happy hypoxia in the COVID-19 patients. Aim and Objectives: The aim of our study was to determine the correlation between the COVID-19 CT score and oxygen saturation level on pulse oximetry in patients with Reverse Transcriptase- Polymerase Chain Reaction (RT-PCR) positive status with or without fever. Material and Methods: Those patients attending the fever clinic of our institution with suspicion of COVID-19 and were subjected to CT chest were the primary study population. Of these patients, those with positive RT -PCR status and underwent CT chest (with positive CT- severity score) and had an oxygen saturation (SpO ) level value on pulse oximetry were included in the study.2 Results: About 45.02% of the study participants had oxygen saturation below 94% and 55 % of the patients had oxygen saturation above 94%. Those with a lower saturation (<94) had higher CT mean scores in both CT25 and CT40 scoring systems. In the CT25 group, almost half of the study participants (51.1%) of those with saturation < 94% had CT scores th between 6-15 (moderate category). Almost 3/4 of the study participants (72%) of those with SpO > 94% had CT2 scores between 6-15 (moderate category). There was a statistically significant association (p < 0.5) between oxygen saturation, gender, mortality and CT25 scores. In the CT40 group, there was a statistically significant association (p < 0.05) between CT40 scores and oxygen saturation, diabetes, hypertension and mortality. Almost 84% of those having SpO less than 94% had a CT score above 19 (severe category). Almost half (48%) of those with SpO > 94, had2 2 a CT score above 19 (severe category). Conclusions: The oxygen saturation level alone cannot be an exclusive factor in deciding whether to consider a chest CT-scan imaging, as a lot of patients with normal SpO had significantly higher2 CT-severity scores. Individuals with hypoxia have considerably higher CT severity showing substantial inverse association and the higher CT-severity score has important therapeutic and prognostic implications.
Prevalence of hypertension and determinants of treatment-seeking behavior among the adult population of Nagaon district, Assam.
(Dr. M. V. Ghorpade, 2024-12) Das, NK; Sahoo, H.
Background: Hypertension is a serious health condition that significantly increases the risk of cardiovascular diseases. Around the world, hypertension is a major cause of premature death. The prevalence of non-communicable diseases, especially hypertension, is continuously increasing among adult Indians. There is an urgent need to raise awareness and conduct screening among the population to prevent any damage caused by this disease. Aim and Objectives: The present study attempted to look at the prevalence and awareness of hypertension among the tea tribe community of Nagaon district of Assam. Material and Methods: A community-based cross-sectional study was conducted among 384 adult population living in three villages of Kaliabor subdivision of Nagaon district, Assam. Results: The prevalence of hypertension in the study area was found to be 25.52%. The prevalence of hypertension was found to be higher in men than in women. The burden of hypertension was found to be common in the elderly age group. High blood pressure was more common in people who consumed alcohol, had excessive salt in meal, and smoked bidis or cigarettes, and all of these risk factors were statistically associated with high blood pressure. There was also a lack of community awareness on the issue as most of the people found to have high blood pressure were not previously aware of their condition. Conclusion: The high prevalence of hypertension shows serious health threats in the study population. Therefore, it is recommended that more initiatives should be taken by the health department like organizing health awareness camps, screening programs to detect hypertension and community participation and involvement is also needed for hypertension intervention.

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