International Journal of Contemporary Medical Research

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https://imsear.searo.who.int/handle/123456789/158083

Editor-in-Chief: Dr. Devanand Gupta ISSN: 2393-915X Frequency: Quarterly Language: Half yearly Open Access Peer-reviewed journal Web site: https://www.ijcmr.com/

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Insights of a Spontaneous Rupture of Pancreatic Pseudocyst into Sub- Capsular Spleen : A Rare Occurrence - Case Report Vijaya Kamble1, Arya Agnihotri2
(International Society for Contemporary Medical Research, 2024-08) Kamble, Vijaya; Agnihotri, Arya
Introduction: This Case report highlights the radiological features of a unique complication of pancreatitis, presenting as Ruptured Pseudocyst into subcapsular spleen. Although rare, recognizing and addressing these complications can significantly improve patient prognosis and prevent life- threatening systemic issues. Case report: A man in his fifties arrived at the emergency room complaining of intense stomach discomfort, fever, chills, and rigors. Computed tomography study revealed well defined collection of approximate volume~ 600 to 700 cc surrounding the spleen in the subscapular region with peripheral wall enhancement and few incomplete loculations on post contrast study. Another lesion in the pancreatic tail of size ~ 34 X 16 X 13 mm in antero-posterior, transverse and cranio-caudal diameter respectively was noticed in close contact with splenic hilum.Impression of acute on chronic pancreatitis with inflammatory pancreatic cyst in the tail of the pancreas with possibility of pancreatic cyst rupture into the subcapsular spleen was considered. Percutaneous drainage of the perisplenic subcapsular collection was done. Patient showed good recovery. The biochemical findings showed high levels of amylase and lipase.These findings confirmed that it was the ruptured Pseudocyst in close proximity to tail of pancreas into subcapsular spleen. Conclusion: In this case, anatomical proximity of pancreatic tail pseudocyst to splenic hilum allowed us to make this diagnosis of ruptured pseudocyst into subcapsular spleen. It is important to recognize and report such complications. By reporting this, patient抯 prognosis is improved. Also critically grave systemic issues can be prevented.
Thyroid Spectrum Disease in Patients with Type 2 Diabetes Mellitus
(International Society for Contemporary Medical Research, 2024-08) Shah, Bhagwan Babu; Daha, Sunil Kumar; BK, Mukesh; Lamichhane, Binita
Introduction: There is a complex underlying relation between diabetes mellitus and thyroid dysfunction. This is attributable to an array of complex intertwining biochemical, genetic and hormonal malfunctions mirroring this patho-physiological association. Autoimmunity has been implicated to be the major cause of thyroid-dysfunction associated diabetes mellitus. Hence, the current study aimed to establish the prevalence of thyroid dysfunction in type 2 diabetes mellitus. Materials and Methods: The current study was carried out on 100 type 2 diabetes mellitus patients attending department of Internal Medicine, National Medical College, Birgunj from July 2018 to July 2019. After obtaining informed consent, socio-demographic, clinical and anthropometric data was collected as per a structured proforma. Also, blood was collected from each patient to obtain fasting blood sugar, post prandial blood sugar, Glycated hemoglobin, triiodothyronine, and thyroxine and thyrotropin levels. Statistical analysis was done as per standard protocol. Result: The mean Body Mass Index of our patients was 24.88 (SD�26) kg/m2 and body mass index was significantly associated with thyroid dysfunction (p value=.043).Thyroid dysfunction was present in 31% of patients. Also, thyroid dysfunction was significantly associated with fasting blood sugar, post prandial blood sugar and HbA1c levels. Conclusion: Thyroid dysfunction has a high prevalence in type 2 diabetes mellitus. Hence, all type 2 diabetes mellitus must undergo screening for thyroid dysfunction for optimal patient management.
Evaluation of Serum Adenosine Deaminase Levels as Diagnostic Marker in Pulmonary and Extra Pulmonary Tuberculosis Cases
(International Society for Contemporary Medical Research, 2024-07) Omar, Asia; Tabrez, Md. Shams; Singh, Sude Kumar; Kumar, Ajit; Singh, Shankar Dayal; Nafe, Abu
Introduction: There is growing interest in developing biochemical tests that measure the body's metabolic reaction in tuberculosis (TB) infection. Both pulmonary and extrapulmonary TB can be diagnosed using these tests, which seems to be an appealing approach. Adenosine deaminase (ADA), an enzyme involved in purine breakdown, is present in T lymphocytes . It has been shown that tuberculosis leads to elevation in the T lymphocytes and eventually causes an elevation in ADA activity. Aim: To evaluate the diagnostic potential of serum ADA concentration in detecting pulmonary and extra pulmonary tuberculosis cases. Methods and Materials: For this study, 336 patients in a variety of age groups who were admitted were chosen. In this investigation, 112 patients of pulmonary tuberculosis were considered. This study comprised 112 cases of extra- pulmonary TB in total. This study comprised 112 control volunteers who were matched for age and sex. 46 of them served as healthy controls for this study; they had a normal skiagram chest, no previous history of pulmonary or extrapulmonary tuberculosis, and no other chronic illnesses. This study includes 66 diseased controls with empyema, pneumonia, and cancer were included. ADA was calculated using a commercial ADA-MTB kit produced by Tulip Diagnostics (P) Ltd.'s MICROXPRESS division. Results: Mean Serum ADA concentration was 45.78�33 IU/L, 27.31�21 IU/L and 14.43� 1.84 in pulmonary TB participants, diseased controls and healthy controls respectively. Mean Serum ADA concentration was 44.74�12 IU/L, 29.95�64 IU/L and 14.42 �86 in extra pulmonary TB participants, diseased controls and healthy controls respectively. It was observed that serum ADA was significantly greater in pulmonary TB and extra pulmonary TB study participants as compared to disease controls and healthy controls. (p<0.05). The overall accuracy was 95.32% in detecting pulmonary tuberculosis. The overall accuracy was 94.16% in detecting pulmonary tuberculosis. Fischer exact revealed statistically significant diagnostic ability of serum ADA concentration in identification of pulmonary TB and extra pulmonary TB. Conclusion: Serum ADA concentration can be important diagnostic tool in identification of pulmonary TB and extra pulmonary TB.
Teachers� Impediments on Reporting Child Abuse - A Cross Sectional Study
(International Society for Contemporary Medical Research, 2024-08) Kumar, Ajay; Kaul, Shalan; Kour, Sukhbir; Mahajan, Nanika; Malik, Azhar; Singh, Rachna Dhani
Introduction: The available evidence suggests that the severity of child abuse has the propensity to propagate and harm child抯 overall development, so its early detection and intervention is critical in preventing victim from suffering severe abuse. The teachers of primary school have excellent opportunity among all the professionals to notice and act promptly in response to child abuse and neglect (CAN). Material and method: A descriptive cross- sectional survey was conducted among the Primary school teachers of Jammu City, J&K, India. A Structured Close Ended Questionnaire in two Languages (English & Hindi) comprising of ten questions was used. Results: Teachers have a positive attitude toward this great problem and consider reporting CAN as their moral responsibility but face certain barriers in performing their duties. Conclusion: There is need for formulating proper reporting guidelines of CAN for the teachers. There should be proper training programmes and continuing education programmes for the teachers for their knowledge and reporting about CAN at various levels including college curriculum.
Evaluation of the Effect of Non-Surgical Periodontal Treatment on Circulating Serum High Sensitivity Capsule Reactive Protein, Interleukin 6 and Homocysteine Levels in Otherwise Healthy Subjects - A Case-Control Study
(International Society for Contemporary Medical Research, 2024-09) Sharma, Shivani; Nagar, Rahul; Kumar, Mukesh; Tyagi, Sumit; Nagar, Avani
Background: Periodontal disease has been associated with many chronic inflammatory systemic diseases and high levels of inflammatory markers in the blood. This study was conducted to compare the chronic inflammatory markers; serum high sensitivity-capsule reactive protein, interleukin 6 and homocysteine in control individuals and in patients with periodontal disease. Also, the effect of periodontal treatment was observed on these inflammatory disease markers 3 months post therapy. Methods: This case-control study involved 25 (age- and sex-matched) subjects with chronic periodontitis and healthy controls each. Patients were systemically healthy and did not use any medication. Periodontal and systemic parameter assessments included Oral Hygiene Index, Plaque index, Gingival index, probing depth, clinical attachment level, hematologic parameters as well as the following inflammatory markers: interleukin (IL)-6, high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy). Results: Significant reduction in Oral hygiene Index, Plaque Index, Gingival Index, probing depth, clinical attachment level were found 3 months post scaling. While comparing IL-6 (pg/ ml), Capsule Reactive Protein (mg/dL), Serum homocysteine (?mol/L) levels among subjects of chronic periodontitis group pre and post treatment, significant results were obtained. Conclusion: Increase in periodontal inflammation is accompanied by an increase in the levels of inflammatory markers i.e C Reactive protein, IL-6 and Hcy levels. Increase in these markers have been associated with risk of systemic diseases. Non-surgical periodontal therapy causes significant reduction in periodontal inflammation as well as the levels of these inflammatory markers.
Accelerating Healing: The Impact of Negative Pressure Wound Therapy on Diabetic Foot Ulcers
(International Society for Contemporary Medical Research, 2024-09) Swarnaakshari, S.; Meitei, Lourembam Romen; Sharma, B. Bobby; Jaleshwar, Laishram; Deepak, Minjur Ilango; Sharma, M. Birkumar; Singh, Th. Suraj
Diabetic foot ulcers, a prevalent global health issue, often necessitate hospitalization due to prolonged healing times and complications. This study aimed to compare the efficacy of Negative Pressure Wound Therapy (NPWT) with Standard Moist Wound Therapy (SMWT) in treating diabetic foot ulcers. Conducted over two years at the Regional Institute of Medical Sciences, Imphal, the study enrolled 40 patients with chronic diabetic foot ulcers. The NPWT group, receiving continuous sub-atmospheric pressure via a vacuum pump, demonstrated superior outcomes compared to the SMWT group. Specifically, the NPWT group achieved 97.25% granulation tissue formation within three weeks, compared to 83% in the SMWT group, and had a significantly reduced hospital stay duration (mean 12.6 days vs. 38.3 days). Additionally, NPWT led to better glycaemic control and improved renal function. These results suggest that NPWT enhances wound healing, reduces hospital stay, and is a cost- effective alternative to traditional wound management. The study supports the use of NPWT as a recommended treatment for diabetic foot ulcers in hospital settings.
Endobronchial Ultrasound Elastography in the Evaluation of Mediastinal and Hilar Lymph Nodes
(International Society for Contemporary Medical Research, 2024-06) Reza, Maqsumi; Prakash, Ved; Nivedita; Firdaus, Huma; Kazmi, Syed Ahmad Hussain; Gautam, Vikram.
Introduction: Endobronchial ultrasound (EBUS) elastography is an imaging procedure for describing the elasticity of intrathoracic lesions and provides important additional diagnostic information. Objective: The purpose of this study was to compare the elastographic patterns of lymph nodes with the outcomes from endobronchial ultrasound- guided transbronchial needle aspiration in order to assess the usefulness of endobronchial ultrasound elastography for mediastinal and hilar lymph nodes. Material and methods: A total of 52 lymph nodes were examined. Endoscopic ultrasound processor and a convex probe endobronchial ultrasonography were utilized to evaluate elastographic patterns that were categorized according to color distribution as follows: Type 1, which consists primarily of non-blue colors (green, yellow, and red); Type 2, which consists partly blue, partly non-blue (green, yellow and red); and Type 3, which consists of predominantly blue colors. The ultimate pathologic outcomes of the endobronchial ultrasound- guided transbronchial needle aspiration were compared to the elastographic patterns. Results: On pathological evaluation of the lymph nodes, 11 were found to be benign and 41 were malignant. The lymph nodes that were classified as Type 1 on endobronchial ultrasound elastography were benign in 8/8 (100%); for Type 2 lymph nodes, 3/9 (33.3%) were benign and 6/9 (66.6%) were malignant; Type 3 lymph nodes were benign in 3/35 (8.5%) and malignant in 32/35 (91.4%). In classifying Type 1 as 慴enign� and Type 3 as 憁alignant,� the sensitivity, specificity, positive predictive value and negative predictive values were 85.3%, 81.8%, 94.59%, and 60%, respectively. Conclusions: It is possible to predict nodal metastases during endobronchial ultrasound-guided transbronchial needle aspiration using the noninvasive endobronchial ultrasound elastography of mediastinal and hilar lymph nodes.
Filling the Void between the Existing Dental Education in Par with Dental Students and Dental Sign Language for Effective Clinical Practise
(International Society for Contemporary Medical Research, 2024-10) BS, Chandrashekar; Khatua, Preetam Kumar; L, Suchitha; Jacob, Anieta Merin; P, Shibu
Introduction: Across the dental colleges, one thing that the students are taught is the idea of 4 handed dentistry, behavioural dentistry with differently abled patients and ergonomics. However, if there is something that the pandemic has taught us it is that, no matter how hard we try to make the system more efficient we lack the basic structural foundation to establish it properly because the building foundation/ budding dentists of tomorrow have no idea or enthusiasm to embrace the newer mode of practices. Aim: Aim of the study is to assess the perception of dental students and patients regarding the usage of hand signals during dental procedure. Materials & Methods: A total of 110 dental students were taken and randomly divided into groups of 2 ; Group A and Group B, consisting 55 students each. Also,a questionnaire study was undertaken among the dental students and patients. A test of 10 marks is conducted and a cross � sectional questionnaire was followed for both the groups and responses was compared. Again, a cross � sectional questionnaire was conducted among 110 patients seeking treatment in various departments of our hospital after demonstrating and using hand signals for communication during treatment. The questionnaire constituted questions based on difficulty in communication and attitude toward hand-sign usage. The data were subjected to Pearson抯 Chi-square statistical analysis. Result: Better scores were achieved by students of Group � B who were given physical and verbal training about the hand signals and a greater acceptance was seen by them as compared to the students of Group � A. Majority of the patients preferred the usage of hand signals over interrupted talking for reducing their fear and anxiety during a treatment procedure. They also agreed to the point that these hand signals can improve dentist杙atient rapport. Conclusion: Hence training should be given to all the students in their curriculum regarding hand signals for them to inculcate a better communication with the patient as well as providing a good experience to the patient while treatment. Hand signals can provide a unique way to understand patient抯 discomfort and respond immediately to their discomfort. This can help patients to gain confidence on their dentists and they would approach the same dentist for further treatment requirements.
A Case Report on Reticulated Pattern Sebaceoma in a Young Female
(International Society for Contemporary Medical Research, 2024-10) Salim, Nazia; Biligi, Dayananda S
Sebaceoma is a rare benign adnexal neoplasm that is composed of predominantly of immature sebocytes with occasional mature sebocytes. Muir Torre syndrome has been linked to sebaceomas. Usually seen in older individuals, as a single flesh-coloured papule on the head and neck region. This case study describes a female patient, aged 32, who presented with recurring tumor on her left upper eyelid. Microscopic examination showed features favouring Sebaceoma - Reticulated pattern. Although sebaceoma usually has an indolent clinical course, it is an uncommon condition that seldom affects young people.
A Study of Thyroid Profile Status and its Correlation with Lipid Profile in a Tertiary Care Centre
(International Society for Contemporary Medical Research, 2024-07) Ashwani; Kumar, Ashwini; Gupta, Anurodh; MK, Sibin
Introduction: The thyroid hormone, which has varying effects on cell metabolism in various organs, is a crucial component of healthy homeostasis. It was discovered that thyroid hormones, which are classified as catabolic hormones, control several metabolic processes, such as lipid synthesis, mobilization, and breakdown. Aim: To study thyroid profile status and its correlation with lipid profile in a tertiary care centre Material and methods: It is a Cross-sectional study. All the above samples were taken from the outpatient department (OPD). 5 ml of venous blood was collected in yellow topped vacutainer. Analysis of all the analytes Total Cholesterol, Triglycerides and HDL Cholesterol was made using a fully automated Biochemistry analyzer (Siemens Dimension EXL 200) LDL Cholesterol was calculated based on the Friedewald formula. Serum T3, T4, and TSH were analyzed using VIDAS. Two sets were tabulated, in one set when TSH value was less than 5uIU/mL, and in the second set the value of TSH was more than 5uIU/mL. Correlation of TSH value at both the set were done. Results: Spearman test is used. Compare the TSH value at both levels, 0-5 and 5.1-10.5uIU/mL, to serum total cholesterol and serum triglyceride, we found that there was no significant correlation between the two. Conclusion: It is not necessary that alteration in the thyroid hormones will affect the levels of serum total cholesterol and serum triglyceride in the body.
Prevalence of Red Cell Alloantibodies Among Cohort of Healthy Blood Donors in a Tertiary Care Hospital � A Step Towards Blood Safety
(International Society for Contemporary Medical Research, 2024-09) Ghotra, Bableen Kaur; Gupta, Sonia; Kumar, Rajesh
Background: Red cell antibody screening should be an imperative element in assuring transfusion safety. The aim of the study is to screen healthy donors for clinically significant alloantibodies to prevent risk of adverse reactions in transfusion recipients. Methods: This prospective cohort study was carried out for a period of one year. Antibody screening of all blood donors was performed as a routine on an automated immunohaematology platform using Immucor Capture R-ready screen (pooled O cells) Galileo Neo (Immucor Inc. Norcross GA, USA). Positive screen was further investigated to identify specificity by 3 cell and 11 cell panel. Results: Red cell alloantibodies screening was conducted on 26,772 blood samples of healthy donors of which 26,129 (94.9%) were male and 4 (5.1%) were female. The donors were screened from both indoor (blood centre) 79.7% and outdoor collection (camp) 20.3%. 79 (0.3%), were found to be positive for antibody screening. Mean age of donors showing positive screen was 35.14�67 years (20-60 years). Mean weight of the donor was 81.59�.19. On antibody identification 48 (61%) had alloantibodies, 4 (5.1%) warm autoantibodies while 27 (34.2%) were inconclusive. The most common alloantibody identified was Anti M 28 (35.4%), Anti P1 5 (6.3%) followed by Anti E 3 (3.8%). The result showed a high prevalence of RBC alloantibodies in females than males (0.6% / 0.2%). Conclusion: Type and Screen protocol should be followed for detection of alloantibodies against red cells antigens which adds as an additional layer of safe blood transfusion.
Comparison of Perioperative Bleeding in Transurethral Resection of Prostate for Benign Prostatic Hyperplasia with and without Preoperative Dutasteride
(International Society for Contemporary Medical Research, 2024-06) Tiwari, Jonesh; BK, Mukesh; Bhatta, Om Prakash; Daha, Sunil Kumar
Introduction: Benign Prostate Hyperplasia (BPH) is characterized by increased proliferation of stromal and acinar cells around the urethra, prolonged by increased gland angiogenesis. The increased vascularity can result in massive bleeding during and after TURP. 5 alpha-reductase inhibitor treatment has been reported to reduce this bleeding. There is conflict regarding use of Dutasteride before surgery to decrease intraoperative blood loss. This study aims to compare the perioperative bleeding in TURP with and without two weeks of preoperative treatment with dutasteride in patients with BPH. Material and Methods: This is a Single-center, Randomized Controlled Open-label Trial done at Department of Urology and Renal Transplant Unit-II, Mayo Hospital Lahore, Pakistan, from February 17, 2018, to February 17, 2019. Patients fulfilling the inclusion criteria of age over 55, unresponsive to medical therapy, and an enlarged prostate (40-70 grams) with an absolute indication for surgery. Group A received a tablet of dutasteride 0.5 mg once a day. Group B did not receive dutasteride two weeks before transurethral resection of the prostate for BPH. Patients were followed up after 24 hours of surgery in which hematocrit levels were estimated. Blood loss was calculated by recording pre-operative and post-operative (after 24 hours) hematocrit levels. Results: 64 patients were randomized into two groups, i.e., Group A (TURP with dutasteride) and Group B (TURP without dutasteride). The mean age was 66.4�5 years in group A and 66.5�2 years in group B. The mean blood loss was 158.3�1.1 ml in group a patients and 311.5�0.7 ml in group B, with a p-value of 0.000054, which is statistically significant. Conclusions: Patients on dutasteride have less perioperative bleeding during transurethral resection of the prostate for BPH than controls.
Correlation of Adenosine Deaminase Activity with Glycated Hemoglobin Levels in Type II Diabetes Mellitus
(International Society for Contemporary Medical Research, 2024-06) Siddiqui, Azra; Siddiqui, Aqeelah Mohammed; Siddiqui, Mohammed Abdul Mujeeb; Devi, M. Uma
Introduction: Diabetes mellitus is not a single disease entity but rather a group of metabolic disorders characterized by hyperglycemia which results from defects in insulin secretion, insulin action or most commonly both. The chronic hyperglycemia and attendant metabolic dysregulation may be associated with secondary damage in multiple organ systems, especially the kidneys, eyes, nerves and blood vessels. Materials and methods: The present study includes 90 subjects, of which 60 were cases of type 2 DM from Department of Endocrinology, Osmania General Hospital. Investigations were performed at the Department of Biochemistry, Osmania Medical College/ Osmania General Hospital; Hyderabad and results were analyzed. Results: A total of 90 patients were recruited for the study which included 30 Type II Diabetes mellitus patients with glycated hemoglobin ? 7 %, 30 Type II Diabetes mellitus with glycated hemoglobin < 7% and 30 healthy individuals as controls. The following parameters were analyzed.1. Fasting plasma glucose, 2.Glycated hemoglobin (HbA1C), 3.Serum Adenosine deaminase, 4. Serum uric acid The data was analyzed using Graph Pad Prism software version 7.0. Descriptive results are expressed as mean and SD of various parameters in different groups. Conclusions: There is clear cut elevation of serum ADA in Type 2 Diabetes mellitus. But due to short half life and diurnal variations of ADA, to establish ADA as a routine diagnostic and prognostic marker in the laboratory, substantial number of samples have to be analyzed in larger and more elaborate studies.
Submuscular Plating vs Flexible Intramedullary Nailing in the Management of Paediatric Femoral Shaft Fractures
(International Journal of Contemporary Medical Research, 2023-02) Haq, Inam Ul; Sultan, Asif; Rashid, Shafat
Introduction: The aim of this study was to compare the outcome in terms of patient characteristics, intraoperative blood loss, operative time, length of hospital stay and complications after insertion and removal of submuscular plates (SMPs) and flexible nails (FNs) for pediatric femoral shaft fractures. Material and methods: 40 children between the age of 6 to 14 years of age who underwent treatment with SMPs (n=22) and FNs (n=18) from 2018 to 2020. Results: insertion of FNs was associated with shorter operative time (mean= 61.2 minutes) and less blood loss (mean=92 ml) compared to SMPs. The FNs group had a shorter length of hospital stay (mean 4.9 days) compared with SMPs (mean=8.6 days). Removal of FNs was also associated with shorter operative time and less blood loss compared to SMPs. Two patients treated with SMPs and one patient treated with FNs developed surgical site infections. Two patients treated with SMPs and three treated with FNs developed implant irritation that resolved with removal. Two patients treated with SMPs and one treated with FNs developed knee stiffness requiring aggressive physiotherapy protocol. One patient treated with FNs developed burisitis at nail insertion site. No other complications occurred. Conclusion: When compared with SMPs, FNs are associated with less operative time, decreased blood loss and less duration of hospital stay in patients with femur fractures.
Multi-dimensional Problem Scoring in the Continuing Management of Elderly Patients
(International Journal of Contemporary Medical Research, 2023-02) Chandrasekhar, G. Mohan; Rao, Nallapu Samson Sanjeeva
Introduction: Usual diagnosis in hospitalised elderly addresses mainly their physical ailment. However, there is a need to also take into account various other issues like the psychological status, financial status, ability of activities of daily living, family support which will help plan continuing care at the home after discharge. This study aims to look at various aspects in the care of an elderly person and to make a multi-dimensional problem identification structure for them before discharge. Method and materials: This descriptive study done over 3 months at the NRI Medical College General Hospital involved 120 inpatients (equal males & females) aged above 65 years. After taking an informed consent, a predetermined instrument covering 10 different dimensions i.e. physical, mental, emotional, spiritual, nutritional, family support, social, occupational, financial, and home environment was administered. A total of 40 responses were assigned appropriate scores, the minimum being 40 for those doing well and maximum being 105 indicating severity in all dimensions. The collected data was entered in Microsoft Excel and presented in tables and graphs. Important findings were subjected to tests of significance like Chi square and Z tests at 5% LOS. Results: The prepared scoring instrument showed a Cronbach's Alpha value of 0.78 which indicates internal consistency and an acceptable level of reliability. The mean score was 71 (range 50 – 95, Standard deviation 10.7). High scores show an inverse relationship to the financial situation of the patient (Chi square 32.4, p value < 0.0001). When the purpose in life for the elderly was weak, the score was higher (Chi square 53.7, p value < 0.00001). Discussion: The study indicates the need for a problem scoring system which looks at all aspects of an elderly person’s life i.e. psychological, emotional, social etc. in addition to the physical diagnosis. Elderly patients living alone, widowed or financially weak are prone to neglect and depression. Patients who feel lonely or have a poor will to live are also at risk. Conclusion: A multi-dimensional problem identification system for elderly hospitalised patients can yield a comprehensive understanding of the patient’s real life circumstances and help make better post discharge care plans.
To Determine the Role of Color Doppler Ultrasonography (CDUS) as a Routine Investigational Method for Diagnosis of Scrotal Pathologies
(International Journal of Contemporary Medical Research, 2023-02) Haq, Ahatsham ul; Sharma, Sumit; Kumar, Akshit; Sharma, Rajesh; Sodhi, Amitoj Singh
Introduction: Colour Doppler ultrasonography (CDUS) is an important tool for diagnosis of scrotal diseases because of its ability to depict anatomy and perfusion in real time. Diagnosis of scrotal diseases has always been a challenge for the clinician due to non-specific signs and symptoms. The causes of scrotal swelling are broadly classified as neoplastic and non-neoplastic. This distinction between these is important because the plan for the management differ in each cause .Ultrasonography plays a major role in distinguishing neoplastic and nonneoplastic scrotal pathologies. To determine the role of color Doppler ultrasonography as a routine investigational method for diagnosis of scrotal pathologies. Materials and Methods: This prospective observational study (case series) was carried out over a period of 12 months on 50 patients in the age range of 0 to 80 years, presenting with scrotal swellings and pain. After adequate history and examination, B mode and CDUS was performed. The CDUS findings were compared with final outcome, based on course and outcome of the disease, fine needle aspiration cytology results and operative findings. Results: In our study the final diagnoses were acute epididymitis or epididymo-orchitis (7), hydrocele (6), varicocele (7), testicular malignancy (5), orchitis (1), testicular torsion (1), hematocele (3), spermatocele (2) and others. Conclusion: Color Doppler ultrasonography is an excellent method for evaluating patients with scrotal pathologies. It aids in diagnosing testicular tumors and reduces the number of unnecessary explorations. It is especially important in conditions like testicular torsion where immediate diagnosis is required.
Ultrasonographic Evaluation of First Trimester Vaginal Bleeding
(International Journal of Contemporary Medical Research, 2023-02) Puri, Jigyasa; Sodhi, Amitoj, Singh; Hamdani, Hanna; Sharma, Rajesh; Haq, Ahatsham ul
Introduction: Vaginal bleeding after confirmation with a positive pregnancy test requires further assessment in order to identify normal or abnormal development of the pregnancy or a pathological condition that requires intervention. To evaluate the role of ultrasonography in patients with bleeding in the first trimester of pregnancy and to correlate ultrasonographic findings with clinical diagnosis thus helping the treating obstetrician in deciding the management protocol. Materials and methods: The study included all the patients (inpatient and outpatient) with history of vaginal bleeding in the first trimester of pregnancy, referred from the Department of Obstetrics and Gynaecology. 158 patients presenting with bleeding in the first trimester of pregnancy were enrolled for the study. Results: In our study fetal cardiac activity with closed internal os on USG was seen in 45 patients.38 patients showed heterogenous thickened endometrium, no fetal cardiac activity was seen in 27 patients, intrauterine gestational sac without yolk sac or fetal node was seen in 17 patients. Sonographic features suggestive of ectopic pregnancy were present in 19 patients. 6 patients had homogenous apposed endometrium. USG showed echogenic mass with cystic areas in 6 patients. Conclusion: The common causes of bleeding during first trimester of pregnancy include abortions, ectopic pregnancy and molar pregnancy. Ultrasound is a non-invasive, nonionizing and easily available method of investigation that helps in the differentiation of causes of first trimester vaginal bleeding.
Expression of Her2/Neu, VEGF, and Ki-67 in Epithelial Ovarian Carcinomas: An Experience from a Tertiary Care Center, West Bengal, India
(International Journal of Contemporary Medical Research, 2024-02) Bhattacharyya, Palas; Das, Rama; Lath, Abhisek; Guha, Debasish
Introduction: Ovarian carcinomas is still maintaining pivotal role among gynecological malignancy regarding cancer death in women. This study aims to observe expression pattern of VEGF, Her2/Neu and Ki-67 in lieu of targeted therapy for ovarian carcinoma. Materials and Methods: It was retrospective observational study carried out for last 3 years (2020-2022). A total of 160 cases of Ovarian tumors were received from different departments. The specimens were processed, histopathological sections were examined under Hematoxylin and Eosin stain, Immunohistochemical stains like VEGF, Her2/Neu and Ki-67. Evaluation was done by trained and independent pathologists. Correlation of Histological type, grade, age group. FIGO stage with expression of VEGF, Her2/Neu, and Ki-67 done. Results: Out of 160 specimens of histological examination proved 143 EOC- serous type constituted maximum (53.1 %) number. Among them (63.7%) were high grade and most of the cases belonged to 41.3% (59/143) in FIGO stage I in our study. Grade 3+ HER2/neu immunostaining was identified in 22.37% cases and had significantly correlated with tumor grade (?2 = 19.7981 with Yates correction; P <0.00001) and FIGO Staging (p=0.00024). Among High grade EOC, High proliferation index (HPI) was 19.5% for Ki-67. we could observe significant statistical association of Ki-67 HPI and tumor differentiation. Moreover, significant correlations was found between the high-grade EOC and HPI of Ki-67/Her2- neu co-expression (p<0.05). Though significant association was found between tumor grade and VEGF expression (?2 = 11.1041; P = .000861) but no correlation were in VEGF/Her-2/neu HPI and the degree of tumor differentiation (chi-square, p>0.05). Conclusion: Role of Her2/Neu and Ki-67 expression and their association should be considered in the progression and tumor grade and stage of EOC.
Management of Periarthritis of Shoulder Joint by Supra-scapular Nerve Block
(International Journal of Contemporary Medical Research, 2024-01) Chowdhary, Bashir Mohammed; Bhat, Mudasir Ahmad
Periarthritis is a chronic, inflammatory disorder of the shoulder and surrounding soft tissues, caused by injury, leading to pain and lack of use. Various therapeutic methods and surgical treatments have been introduced for shoulder periarthritis. This observational study was carried out on 16 patients clinically and radiologically diagnosed with periarthritis of shoulder to assess the efficacy of SSNB in the treatment of periarthritis of the shoulder. In this study the mean abduction increased and reached from 72.3° ± 3.10° to 116.3°± 4.8° at the follow-up of 12-weeks. Mean flexion, mean internal rotation and mean external rotation shows an improvement of 41.50, 19.8° and 23.50 respectively at 12-weeks follow-up. The mean VAS score was 7.25 ± 0.9, which shows a significant reduction at different time intervals. In this study we conclude that supra-scapular nerve block (SSNB) is an effective method for controlling pain and accelerating recovery of shoulder motion in patients with periarthritis of shoulder.
Study to Determine the Common Substances that Caused Deaths due to Ingestion brought for autopsy in Tertiary Care Hospital, Hyderabad, Telangana, India
(International Journal of Contemporary Medical Research, 2023-12) Siddiqui, Mohammed Abdul Mujeeb; Siddiqui, Zahraa Mohammed; Siddiqui, Azra; Parvathi, Katkuri
Backgound: This study was conducted to know the common substances that caused deaths by ingestion, brought for autopsy to Osmania General Hospital, Hyderabad, Telangana State, India for a period three years. The cases of deaths due to poisoning were selected from the autopsies conducted and analyzed for the most commonly ingested substance. Material and methods: The samples were collected for three consecutive years from January 2012 to December 2014. The contents of the stomach were examined grossly and the samples were collected in three containers during autopsy for each individual case. Portion of stomach and its contents, portions of liver, kidney, blood and body fluids were collected labeled and sent to the State Forensic Science Laboratory for analysis of unknown poison. The reports were analyzed. The data collected was arranged according to age, sex and substances detected. Results: A total of 1196 cases of poisoning in three years were studied. Most of the deaths occurred, were due the ingestion of Organophosphates. It is the commonest insecticide used by farmers in fields. The common age group involved is between 21 years to 30 years ingesting organophosphates. In the deaths due to poisonings, men are predominantly involved compared to women. Conclusion: In the study it was concluded that the ingestion of poisonous substance organophosphate is usually intentional and is used to commit suicide. In children it is mostly accidental. Poison can also be used as homicide to kill a person

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