International Journal of Research in Medical Sciences

Editor: Dr. Bhaven Kataria

ISSN: 2320-6071 Online : 2320-6012

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.msjonline.org/index.php >

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Now showing 1 - 20 of 2814
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    Clinical and socio-demographic profile of substance abusing persons seeking treatment at a teaching hospital in Garhwal hills of Uttarakhand
    (Medip Academy, 2020-10) Singh, Prem; Rathi, Harsh
    Background: The substance abuse is gradually becoming one of the major public health issues of present day India. Many factors influence the pattern of substance abuse, including age, sex, educational level, social support, cultural factors, availability of drugs and the presence of cognitive or psychiatric problems. This study was planned to find out the clinical and socio-demographic profile of substance abusing persons.Methods: The study was conducted in the Out-patient facility of the Department of Psychiatry, Veer Chandra Singh Garhwali Government Institute Of Medical Science and Research, Srinagar (Uttarakhand), starting from 23 September 2015. One hundred consecutive treatment seeking subjects fulfilling International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), criteria for Mental and behavioural disorders due to psychoactive substance use were included in the study. All the participants were required to sign an informed consent approved by the institutional ethical committee before being enrolled in the study. All the subjects included in the study were administered a self-structured proforma to elicit the clinical and socio-demographic variables.Results: One hundred patients consisting of 95 men (95%) and 05 women (05%) were included. The average age of the sample was 39.68 years (SD=11.97). As for the socio-demographic variables other than age, 87% of the patients were married, 62% patients were living in nuclear families and 66% belonged to the rural areas. 79% patients were educated up to high school and above and only 06% were illiterate. Alcohol was the most frequently abused substance seen in 78% patients followed by tobacco smoking in 58% of the study subjects. Peer Pressure was cited as the most common reason for the initiation of substance abuse by 75 (75%) patients.Conclusions: Alcohol was the most commonly abused substance. Substance abuse was higher in married, educated males from rural areas living in nuclear families.
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    Evaluation of maternal and perinatal morbidity and mortality in eclampsia by early termination of pregnancy
    (Medip Academy, 2020-10) Mondal, Suresh C.; Lahiri, Sandip
     Background: Eclampsia is one of the leading causes of maternal mortality in India.Methods: A prospective observational study was done on 200 pregnant women admitted with antepartum eclampsia in Malda Medical College from 1 April 2017 to 30 October 2019. Group A included patients who delivered through vaginal route within 10 to 12 hrs of eclampsia by stabilisation of patients while Group B included subjects who underwent early caesarean section for uncontrolled convulsions or poor Bishop score. Maternal and perinatal outcomes were compared between the groups. Data was recorded in a pretested performa and was analyzed using appropriate statistical methods with SPSS.Results: Caesarean section (group B) was done in 130 cases (65%) while vaginal delivery (group A) was done in 65 cases (37.5%). Group A had higher maternal mortality (10.7%) in comparison to group B (4.6%) which was statistically not significant (p=0.1075). There were 32 neonatal deaths (24.6%) and 11 still births (8.46%) in group A while there were 12 neonatal deaths (18.46%) and 3 still births (4.61%) in group B. There was a statistically significant difference (p<0.0001) between the groups with respect to total perinatal deaths.Conclusions: Antenatal and intranatal eclampsia should be managed by early termination of pregnancy preferably with Caesarean section. Early presentation and timely decision to terminate pregnancy will improve the maternal and perinatal outcome.
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    A study on scrape smear cytology in oral leukoplakia in a tertiary health care centre of southern Assam
    (Medip Academy, 2020-10) Ullah, Sania S.; Deka, Manoj K.; Khakhlari, Nitumani
    Background: Oral cavity is susceptible to countless changes with advancing, environmental, and lifestyle related habits and factors. Oral mucosal lesions especially related to chewing and smoking of tobacco have led to the increased incidence and prevalence of potentially malignant and malignant disorders worldwide. Oral leukoplakia has been a very frequent finding in patients coming to our department and with an increasing rise of oral squamous cell carcinoma in the region, the study was conducted.Methods: Patients referred to our section from various department with white oral lesion. Scrapping smears were prepared. Stained with MGG and PAP stain. Study period: January 2019 to May 2020.Results: Total number of patients with white oral lesion were 83. Out of these 65 were male and 18 were female. Most of the patients had addiction to betel nut and leaf with tobacco and few had history of intake of bidi for several years.Conclusions: The study reveals that most of the oral leukoplakia cases is attributed to smoking, betel nut and lime intake. Exfoliative cytology of oral mucosa serves to be an easy, convenient and reproducible technique for early diagnosis of premalignant condition. Biopsy can be used as an adjunct in cases showing atypia and mixed type of keratosis.
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    Estimation of interleukin-17 levels in gingival crevicular fluid from healthy individuals, chronic gingivitis and chronic periodontitis patients using enzyme linked immunosorbent assay
    (Medip Academy, 2020-10) Nainee, Neha; Sanikop, Sheetal; Jha, Abhilasha
    Background: Chronic Periodontitis (CP) is an infectious disease resulting in inflammation of supporting tissues of the teeth. A number of pro-inflammatory cytokines are formed against periodontopathogenic microorganisms. Interleukin-17 (IL-17) is a pro-inflammatory cytokine, implicated in numerous inflammatory and autoimmune conditions.Methods: A total of 25 periodontally healthy subjects (Group 1), 25 patients with gingivitis (Group 2) and 25 patients with CP (Group 3) were included for the study based on clinical examination. Gingival index, probing pocket depth and clinical attachment loss were recorded in all subjects.Results: The levels of IL-17 increased from healthy to gingivitis to periodontitis patients. A positive correlation was found with the IL-17 and the clinical parameters like gingival index, probing pocket depth and clinical attachment loss.Conclusions: There is a strong association between the levels of IL-17 with periodontal disease as well as with its severity and its possible use as a biomarker for inflammatory periodontal disease.
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    Association of ocular biometric parameters with diabetic retinopathy
    (Medip Academy, 2020-10) Utaal, Shubhneek Kaur Dhillon; Chopra, Rupali; Batra, Nitin
    Background: To study the association of ocular biometric parameters {Spherical equivalent (SE), Axial length (AL), Anterior chamber depth (ACD) and Corneal curvature (CC)} with diabetic retinopathy (DR) in subjects with Type 2 diabetes mellitus (DM).Methods: This prospective observational study was conducted in the Outpatient Department of Ophthalmology of a tertiary care teaching hospital in North India. The study included 100 subjects having various grades of DR as cases and 100 diabetics without DR as controls. The SE was assessed using objective autorefraction, while AL, CC and ACD were measured using the NIDEK AL SCAN.  International Clinical Diabetic Retinopathy Disease Severity Scale was used for grading of DR.Results: A total of 181 eyes in the study group and 200 eyes in the control group were analysed.  Progressive decrease in the mean AL was observed with the increasing severity of DR (p=0.017). Deeper ACD had a negative correlation with severity of DR (p=0.037). No statistically significant difference was observed for AL and ACD with the incidence of DR (p=0.147 and p=0.091 respectively). Likewise, there was no significant relation of DR with SE or CC.Conclusions: Longer AL and deep ACD were protective against progression to the severe forms of DR. However, there was no correlation of AL and ACD with the incidence of DR. The SE and CC were not found to be significant determinants for either development or severity of DR.
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    Predisposing factors and outcome of uterine rupture in Jos, North-central Nigeria
    (Medip Academy, 2020-09) Kahansim, Makshwar L.; Nyango, Dalyop D.; Oyebode, Tinuade A.; Egbodo, Christopher O.; Anyaka, Charles U.; Pam, Victor C.
    Background: Uterine rupture has continued to be an obstetric catastrophe with tragic maternal and foetal outcomes particularly in Nigeria.Methods: an institutional, cross sectional retrospective study was carried out at Jos University Teaching Hospital, North-Central Nigeria. Case files of mothers with uterine rupture managed at the hospital from 1 January 2011 to 31 December 2019 were retrieved and included in the study. Data extracted from case files included maternal age, parity, gestational age, booking status, presence of uterine scar, obstetric interventions prior to rupture, site of rupture, type of surgery, units of blood transfused, intensive care unit admission and duration of hospital stay and maternal or foetal death.Results: the incidence of uterine rupture was 1 in 497 deliveries (0.2%). The mean age of the patients was 30.1±5.1years. About 75% of the patients were para 1-4. Seventeen (70.8%) patients were unbooked while fourteen (58.3%) had unscarred uterine rupture. Eight out of 14(57.1%) patients with unscarred uterus had uterotonics for induction or augmentation of labour. Fourteen (58.3%) patients had rupture involving anterior lower uterine segment. Over half of the patients had uterine repair only (58.3%), 29.2% had uterine repair with bilateral tubal ligation while 12.5% had subtotal hysterectomy. Twenty-two (91.7%) required blood transfusion, five patients had 5 or more units of blood transfused. The perinatal mortality was 69.6%, there was no maternal death.Conclusions: the major predisposing factors to uterine rupture in our facility were lack of antenatal care, presence of previous caesarean section scar and injudicious use of uterotonics.
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    Study the role of hepcidin in diagnosis of iron deficiency anemia in young females of northern India
    (Medip Academy, 2020-10) Shaveta; Bansal, Sanjiv Kumar; Patel, Seema
    Background: Iron deficiency is one of the most common nutritional disorder. Maintenance of body iron status is an integral part of healthcare in young female of reproductive age group. Thereby early detection could lead to early intervention and reduce its comorbidity.  Indeed, an ideal screening test should be capable of identifying iron deficiency long before developing anemia. Henceforth, the present study was aimed to determine utility of serum hepcidin in iron deficiency and to access the baseline value of hepcidin in young female.Methods: This sectional study was conducted in the Department of biochemistry SGT Medical College Hospital and Research Institute, Budhera, Gurugram. It included non-pregnant female students of age 18-25 years with normal RBC indices and hemoglobin >12 gm%. Estimation of serum hepcidin-25 was by ELISA.Results: The reference range of hepcidin established in this study was 12.14-139.89 ng/ml for females with the mean being 42.4±29.13 ng/ml. It showed higher discriminating power in evaluating iron status in young healthy women (AUC 0.984) with best combination of diagnostic sensitivity (95.7%) and specificity (93.2%) at a cut off of >15.7 ng/ml. Serum hepcidin identified 17% of young healthy females with normal hemoglobin to have functional or storage iron deficiency.Conclusions: The prevention of iron deficiency anemia remains insufficient worldwide especially among underprivileged women and children Therefore, estimation of serum hepcidin may be considered as a valuable tool in assessing iron status in young healthy female population who are the prime target group for iron supplements to reduce comorbidity associated with iron deficiency and anemia.
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    Knowledge, attitude and practices towards COVID-19 pandemic in the community: a cross-sectional web-based survey in India
    (Medip Academy, 2020-10) Shukla, Shruti; Deotale, Prerana
    Background: Coronavirus disease is a current new virulent disease rising its transmission and fatality with each passing day globally. People’s observance of the prevention measures is essential for controlling the spread of COVID-19, which is affected by their knowledge, attitude, and practices (KAP) towards COVID-19. The aim of this study was to assess knowledge, attitude, and practices towards COVID-19 in the community in India.Methods: Present descriptive cross-sectional study was a web-based survey carried out between 15th July and 19th July 2020 among 570 participants in Maharashtra, India. A 30-item questionnaire distributed among the public using Google forms through social media networks.Results: 97.4% participants knew contact with the infected person as a mode of transmission for COVID-19. Common symptoms of COVID-19 reported were difficulty in breathing (96.3%), fever (90.7%), cough (88.9%), sore throat (82.8%), etc. The majority of participants (>90%) had correct knowledge about preventive measures to stop the spread of COVID-19. Around 80% had a positive attitude that India will win the battle against the disease. More than 90% were practicing appropriate preventive measures while going out.Conclusions: Majority of the Indian population demonstrated good knowledge, positive attitude, and good practices regarding the COVID-19 pandemic.
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    Impact of coronavirus on pregnant females in India: an observational study
    (Medip Academy, 2020-10) Garg, Megha; Jain, Madhu; Jain, Shuchi
    Background: Coronavirus (COVID-19) has emerged as a rampant pandemic and the entire world is struggling against it. The entire nations are trying to device measure like national lockdowns, diverting resources towards fighting coronavirus, extensive media coverage, closing of elective services in hospitals. All this has influences the masses to a deep level. Coronavirus not only is morbid for the sick, but also the healthy pregnant females seeking health care and impacted them more mentally than physically.Methods: In this study 103 pregnant females from the entire nation of India were made to answer a well thought and made questionnaire which aimed at assessing the mental state and impact of coronavirus on the pregnant females.Results: Majority of the females answered that they felt anxious and were undergoing stress due to the coronavirus. They fear impending doom for the child and also are struggling a lot to seek apt healthcare for themselves and their children because of the ongoing pandemic.Conclusions: Coronavirus has not only affected people who are directly affected with the virus, but also who are still not affected but are mentally stressed because of it. National lockdown and alteration in the healthcare services are also stress- inducing for the pregnant females.
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    Relationship of serum vitamin D with hepatic fibrosis in patients with chronic hepatitis C
    (Medip Academy, 2020-10) Behera, Manas Kumar; Swain, Surendra Nath; Abhilash, V. B.; Shukla, Sunit Kumar; Dixit, Vinod Kumar
    Background: Serum vitamin D concentration is proposed to have an important role on outcome in patients with chronic hepatitis C virus (HCV) infection. A few studies have shown an inverse association of vitamin D level with stage of fibrosis. The aim of the present study was to verify whether serum vitamin D level is an independent predictor of significant hepatic fibrosis.Methods: Seventy-two treatment naive chronic HCV subjects and 40 healthy age and sex matched controls were included in the study. A serum vitamin D level was assessed in both HCV subjects and controls, and liver biopsy was performed in all HCV subjects to assess for stage of fibrosis.Results: Serum vitamin D levels were significantly lower HCV patients in comparison to age and sex matched controls (18.04±6.92 versus 21.53±8.2, p<0.01). Most common genotype in HCV patients was genotype 3 (62.5%) and blood transfusion was the most common mode of transmission (28%) followed by intravenous drug user (IVDU) (17%). The HCV patients with vitamin D level <20 ng/ml had higher metavir score as compared to vitamin D≥20 ng/ml (1.67±0.66 versus 2.5±0.67, p<0.001). Both univariate and multivariate analysis performed using logistic regression revealed that vitamin D<20 ng/dl is a significant negative predictor of liver fibrosis (p<0.05).Conclusions: Chronic HCV patients had significantly lower vitamin D levels as compared to healthy controls. Serum vitamin D was a negative predictor of stage of fibrosis in patients with chronic hepatitis C.
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    Correlation between peak expiratory flow rate and pectoralis muscle length
    (Medip Academy, 2020-10) Subramanian, Visalakshi H.; Chennakeshawaran, Aruna; Kumar, Vijay Krishna
    Background: Peak expiratory flow rate (PEFR) is a measure of the maximum speed of exhalation after a deep inspiration. The peak expiratory flow is measured by a device named peak flow meter. This study concentrates on the correlation of the PEFR with the pectoral muscle length.Methods: It is a cross sectional study of 30 convenient samples based on gender distribution where the PEFR and pectoralis muscle length were measured in the subjects.Results: Statistical analysis shows that there is a significant correlation between right pectoralis major general muscle length and PEFR (p=0.030), left pectoralis major general muscle length and PEFR (p=0.014), right pectoralis major clavicular end muscle length with PEFR (p=0.010).Conclusions: There is a significant correlation between peak expiratory flow and pectoralis muscle length.
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    Soft tissue neoplasms: a clinicopathological study
    (Medip Academy, 2020-10) K. T., Athulya Krishna Kumar; S., Ariya
    Background: The current WHO classification has categorized soft tissue tumours into benign, malignant and so-called intermediate neoplasms. Soft tissue sarcoma comprises <1% of adult cancers. The aim of the study was to clinically correlate soft tissue neoplasms and study the histomorphological features of various malignant soft tissue tumors.Methods: This was a retrospective study conducted in a tertiary care hospital in Mangalore, India from January 2019 to June 2020. Clinical details of all cases of soft tissue neoplasms retrieved from the medical records of our institution. Data collected included age, gender, presenting symptoms, site and size of soft tissue neoplasms and clinical diagnosis. Pathological diagnosis of these tumours was made and details recorded.Results: A total of 113 cases of soft tissue neoplasms were collected. 94.4% benign and 18.6 %. malignant tumours were present. 77% cases presented with swelling whereas 23% presented with pain. Majority of benign soft tissue tumours were located in the trunk (36.9%) and the most common type was lipomas (66.38%). Malignant soft tissue tumours showed male to female ratio of 1.33:1. Most predilection was noted for the extremities (42.8%) and leiomyosarcomas were the most common type (38%).Conclusions: The incidence of malignant soft tissue tumours is rare. Majority of the cases were noted in the extremities. Leiomyosarcoma was the most common type, in our study. Lipomas were the most common benign soft tissue tumours, and majority of the benign tumours were located in the trunk.
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    Evaluating substance use in an urbanizing town of mid hills of Northern India
    (Medip Academy, 2020-10) Singh, Ajay K; Verma, Kushel; Guleria, Amit; Puri, Shalini; Sharma, Ankit; Sharma, Vaishali
    Background: Substance use is emerging as a major cause of morbidity and mortality across the world. Solan, a fast urbanizing town of India has witnessed mushrooming of industries and educational institutes. A surge in the persons booked under the Narcotic Drug and Psychoactive Substance Act 1985 led us to look into the determinants of the substance use in this region.Methods: We undertook a cross sectional study of one year secondary data analysis of 750 substance users screened at the de-addiction centre of Solan Hospital. The data mining was done by the cluster analysis technique. SPSS 16 and STATA 13 software were employed.Results: Mean age of users was 31 years with dominance of males (89.20 %), two third of total users were married, 75% were unemployed, 42% had upper school level education. About 60 and 38% were using cannabis and chitta (a synthetic opioid) respectively. Only 2% were consuming tobacco and alcohol. 62% of substance users had the fear of legal action and 44% had no family history of substance use. 39% had only single parent, 54% had started substance use under peer pressure and duration of use varied between 6 to 24 months.  Alcohol and cannabis were used more in urban and rural areas respectively. 63 and 70% had family history and experience of peer pressure respectively.Conclusions: Cluster analysis has generated substance specific socio-demographic determinants of substance use which would help in planning appropriate substance use alleviation strategies.
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    A study of percutaneous injuries amongst health care workers in a tertiary care hospital
    (Medip Academy, 2020-10) Jacob, Aswin Geo; Deodhar, Divya; John, Mary
    Background: Percutaneous injuries (PCI) pose a significant risk of occupational transmission of blood borne pathogens to health care workers (HCWs). Their incidence is considerably higher than current estimates, and hence a low injury rate should not be interpreted as a non-existent problem.Methods: This prospective observational study was conducted over a period of 1 year at a tertiary care teaching hospital in northern India. As soon as the HCW sustains a PCI, they were instructed to report to the emergency department where note was made of all the details in the post exposure reporting form.Results: The incidence of PCI in this study was found to be 4.3%. PCIs were reported maximum among nursing staff (63.41%) compared to doctors (36.58%). Majority of PCIs were reported within 1 hour of sustaining the injury (57.1%). Needle stick injury was the commonest injury sustained by HCWs (84.5%). 91.46% of HCWs were fully immunized against hepatitis B.Conclusions: Preventing PCI is an essential part of infection control program in a hospital. Stress must be laid for mandatory reporting of all PCI irrespective of the source.
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    Evaluation of coronary microcirculation by myocardial contrast echocardiography in patients of ST elevation myocardial infarction
    (Medip Academy, 2020-10) Singh, Avijit; Tripathi, Vishwa Deepak; Patel, Pushpraj
    Background: No reflow phenomenon observed during catheter intervention has been associated with poor cardiovascular outcomes. Assessment of filling defect by myocardial contrast echocardiography (MCE) correlates with no reflow. Limited studies are available for the same. This study was designed to look for impact of type of therapy for revascularization (whether percutaneous coronary intervention or thrombolysis) and its evaluation by MCE and follow up echocardiography parameters.Methods: Total 50 consecutive patients of ST-elevation myocardial infarction (STEMI) were taken study including recent STEMI (within 7 days). After all routine investigations patient underwent coronary angiography and percutaneous coronary intervention (PCI) procedure. Following completion of procedure, thrombolysis in myocardial infarction (TIMI) flow, TIMI frame count, and myocardial blush grade were calculated and noted. Post revascularization contrast echocardiography was done after patient stabilization. Findings were correlated with cath-lab parameters applying appropriate statistical tests. Follow up was planned after 30 days.Results: 50 consecutive patients admitted with acute myocardial infarction (MI) or recent MI (0-7 day) who underwent primary PCI - 82% (n=41) or thrombolysed with various thrombolytic agents - 18% (n=9). Mean age of the study group was 55.02±12.65 years. There was significant association in between TIMI 3 flow and absence of filling defect in MCE (p=0.03), but no significant association found in between revascularization therapy (Either PCI or Thrombolysis) and filling defect in MCE (p=0.08).Conclusions: Our study found good correlation between myocardial contrast score with angiographically measured TIMI flow and improved echocardiographic findings on follow up.
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    Staphylococcus aureus still the commonest culprit
    (Medip Academy, 2020-10) Kumar, Saurabh; Faisal, Yousuf; Chaudhary, Rajib Ratan; Sarda, Mukund Shyam
    Background: Sepsis is still one of the most leading cause of death in world. 19 million sepsis (formerly severe sepsis) cases and 5 million sepsis-related deaths are estimated to occur annually. Sepsis is also one of the most common cause of patients getting critically ill and getting admission in intensive care unit. The main focus of this study is to identify the culture isolate from the critically ill patients and to check for the antibiotic sensitivity and resistance and identify if the report has changed the course of treatment and outcome of the patients. Critical illness is a life-threatening multisystem process that can result in significant morbidity or mortality. Critically ill patients are those who have dysfunction or failure of one or more organs/system and depend on survival from advanced instruments of monitoring and therapy. The aim of the study was to identify the causative organism causing sepsis in critically ill patients.Methods: It will be multi central retrospective study which included patients of critical illness of Rohilkhand Medical college, Bareilly, Uttar Pradesh and Varun Arjun Medical college, Shahjanpur, A total of 468 patients were taken for the analysis during period of from August 2018 to November 2019 among of which 324 samples came positive. Samples were taken on day one of the patient’s presentation to the hospital and were analysed in BD BACTEC culture medium. Patient’s data were taken from records available at both the hospitals. Sensitivity was performed using disk diffusion method and the results were compared with the records of patients.Results: Among of samples taken that is 324; 194 were male and 130 were female. Maximum patients which were tested positive for Staphylococcus aureus (n=198). Others included Streptococcus pneumococcus (n=25), Escherichia coli (n=50), Klebsiella oxytoca (n=13), Klebsiella pneumoniae (n=15), Pseudomonas aeruginosa (n=20), and Acinetobacter (n=3). In retrospective analysis of the patients of all 324 cases treatment in approximately 148 patients was changed due to change in the sensitivity of antibiotics.Conclusions: Staphylococcus still dominates the sepsis. It is advisable to add an antibiotic with gram negative if patients count does not improve in first 24 hour.
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    Cyto-histological correlation in diagnosis of gastrointestinal lesions- a prospective study in a tertiary care institute
    (Medip Academy, 2020-10) Aggarwal, Swati; Mardi, Kavita; Sood, Shivani; Kaushal, Vijay; Sharma, Brij; Sood, Pranav
    Background: Gastrointestinal tract is involved by a large number of inflammatory, infectious and neoplastic diseases. There is a worldwide rising incidence of GIT lesions especially neoplasms.Methods: This study was planned to correlate endoscopic and colonoscopic brush cytology with histopathology of gastrointestinal lesions and to determine the spectrum of gastrointestinal lesions in patients subjected to endoscopic brushings and biopsy.Results: Sensitivity of upper GI brush cytology was 95.15% and specificity 90.41%. Sensitivity of colonoscopic brush cytology was 100% and specificity 86.79%. The accuracy of brush cytology came out to be 92.45% in upper GIT and 92.22% in lower GIT.Conclusions: Brush cytology is a non-invasive and cost-effective method to retrieve epithelial cells from a much larger surface area of the mucosa, thus allowing thorough sampling and increasing the diagnostic yield.
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    Clinicopathological study of premalignant and malignant lesions of cervix along with apoptotic index and Ki-67 expression
    (Medip Academy, 2020-10) Atla, Bhagyalakshmi; Prasad, Uma; Samantra, Saraswathi; Botta, Venkata Satya Kartheek; Dasari, Naresh; Changala, Glen Christopher
    Background: Cervical cancer is known to have a good response to radiotherapy. The response and prognosis are dependent on the level of apoptosis. Pap smear and histopathology are cost-effective methods in diagnosing premalignant and malignant lesions of cervix but not accurate in classifying and estimating the progression of the disease, especially in premalignant lesions. Therefore this study was undertaken to know the role of Ki-67 expression and apoptotic index in classifying accurately the premalignant lesions for better management.Methods: The study included 540 cases diagnosed histologically as cervical intraepithelial neoplasia or carcinoma. The apoptotic index is calculated for all the 540 cases using light microscopy on Haematoxylin and Eosin stained sections. Ki-67 immunohistochemical staining was done for 100 cervical biopsies. Ki-67 expression was graded and the Ki-67 labelling index was calculated. Statistical evaluation was done using the unpaired t-test.Results: The Apoptotic index increased with increasing grade of dysplasia. There is a significant difference in the mean apoptotic index between premalignant and malignant lesions of the cervix. The ki-67 index increased with increasing grade of dysplasia. There is a significant difference in the mean Ki-67 index between premalignant and malignant lesions of the cervix.Conclusions: Apoptotic index and proliferative indices have been found useful in distinguishing between premalignant and malignant lesions of the cervix and gives an idea about the proliferative activity of the tumour for better management of the patient and to determine prognosis.
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    The beneficial role of N-acetylcysteine as an adjunctive drug in treatment of COVID-19 patients in a tertiary care hospital in India: an observational study
    (Medip Academy, 2020-10) Bhattacharya, Raja; Mondal, Maitry; Naiya, Subhendu Bikash; Lyngdoh, Lamsaka; Mukherjee, Rishav; Singh, Prabhat K.
    Background: N-acetyl cysteine, a mucolytic agent, demonstrates free radical scavenging and anti-inflammatory properties, and prevents endothelial dysfunction by inhibition of NF-KB and formation of no adducts. This has a potential role to tackle cytokine storms, endothelial dysfunction and prothrombotic state observed in COVID-19 manifestations like ARDS and Multi organ dysfunction.Methods: Institution based descriptive cross sectional study, 164 patients from laboratory confirmed RT PCR positive COVID-19 patients, in the study period from 27th May 2020 to 10th August 2020, were assessed, in medical college Kolkata, a dedicated COVID-19 care facility.Results: It was observed that moderate-severe patients who received N-acetyl cysteine along with standard therapy had average hospital stay duration of 12 days, higher rate of discharge, average duration of oxygen therapy of 8 days, less number of deaths and reduced transfer to critical care facilities.Conclusions: N-acetyl cysteine can be considered as an adjunctive therapy with standard protocol driven care, due to its beneficial anti-inflammatory and free radical scavenging properties.
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    A case control study of serum vitamin D levels in alopecia areata
    (Medip Academy, 2020-10) Naidu, Bobbili Tarun Kesava; Baddireddy, Kavya
    Background: Alopecia areata is an autoimmune disorder of anagen hair follicle leading to distressing and relapsing non-scarring hair loss. Vitamin D is an immunomodulator and plays a role in regulating normal hair cycle. Recent evidence suggests inconsistent association between vitamin D deficiency and alopecia areata.Methods: This case control study included 70 newly diagnosed cases of alopecia areata and 70 healthy controls. Competitive chemiluminescence immunoassay was used to determine and compare the serum vitamin D (25‑hydroxyvitamin D) levels between these groups. Also, the serum vitamin D levels correlation with severity of the disease was studied. ANOVA test and student t test were used for the statistical analysis.Results: Serum Vitamin D levels were significantly decreased in alopecia areata patients than in controls (p<0.05). There was no stastically significant relationship between serum 25-OH Vitamin D levels and severity of the disease (p=0.06).Conclusions: Prevalence of serum 25 (OH) deficiency was significantly higher in alopecia areata group. However no significant relation was found with disease severity.