Acta Medica International

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/157542

Chief Editor: Prof. S. K. Jain
ISSN (Print): 2349-0578 (Online): 2349-0896

Frequency: Biannual

Language: English

Open Access Peer-reviewed journal

Web site: www.actamedicainternational.com

Browse

Now showing 1 - 20 of 359

A Study of Different Cytological Typing of Primary Bronchogenic Carcinoma and their Different Diagnostic Methods with Special Reference to Ultrasonography-guided Fine-needle Aspiration Cytology
(Wolters Kluwer – Medknow, 2025-04) Pal, Amitava; Banerjee, Saikat; Chaudhuri, Arunabha Datta; Karmakar, Debasish
Introduction: Lung cancer is a leading cause of cancer?related deaths worldwide and one of the most common cancers in both men and women. Despite its increasing incidence, knowledge about its morbidity and mortality in our country remains limited. Materials and Methods: This study analyzed 142 patients with confirmed primary lung cancer, focusing on demographic, clinical, and radiological parameters. Various diagnostic methods were employed to obtain histological or cytological diagnoses, with special emphasis on Ultrasonography (USG)?guided fine?needle aspiration cytology (FNAC) for peripheral lung lesions. Results: The male?to?female ratio was 4.68:1, with most patients aged 51–60 years (31.69%). Common symptoms included cough, chest pain, and breathlessness, while superior vena cava obstruction was seen in 10.56% of cases. Squamous cell carcinoma (SCC) was the most frequent histological type (46.48%). Clubbing, pallor, and pleural effusion were common clinical findings. Radiologically, mass lesions (74.65%) were the most common presentation, with central lesions in 53.52% and mediastinal lymphadenopathy in 61.97%. Diagnostic modalities included fiber?optic bronchoscopy, lymph node FNAC, image?guided FNAC, tru?cut biopsy, and pleural biopsy. Conclusion: Men aged 51–60 years are at higher risk for lung cancer, with SCC being the predominant type. Mass lesions with mediastinal lymphadenopathy, cough, chest pain, and breathlessness are common presentations, often accompanied by clubbing, pallor, or pleural effusion. USG?guided FNAC is a safe, cost?effective, and accurate diagnostic technique for peripheral lung cancers, providing reliable results without radiation exposure.
Correlation between Mean Corpuscular Hemoglobin, Mean Corpuscular Hemoglobin Concentration, and Fetal Hemoglobin Levels in Sickle Cell Anemia Patients of Saurashtra Region in Gujarat
(Wolters Kluwer – Medknow, 2025-04) Trivedi, Dhara P.; Mehta, Deval; Narayanan, Punithan; Bhimani, Pragati Kantibhai; Saradva, Nidhi; Ladani, Kruti; Gohil, Pruthvi
Introduction: Sickle cell anemia (SCA) is a genetic disorder characterized by abnormal hemoglobin S production. Fetal hemoglobin (HbF) levels and complete blood count (CBC) parameters are crucial in evaluating SCA. This study investigates the correlations between mean corpuscular hemoglobin (MCH), MCH concentration (MCHC), and HbF levels in SCA patients. Materials and Methods: A retrospective, observational study was conducted using data from 68 SCA patients. The study included patients with HbSS genotype, aged over 1 year, who had complete CBC and high?performance liquid chromatography data available between January 1, 2023, and January 1, 2024. Patients with incomplete data, pregnancy, recent blood transfusions, and concurrent conditions affecting blood parameters were excluded. Pearson’s correlation analysis was performed to assess relationships between HbF, MCH, and MCHC. Results: The analysis revealed significant correlations among the studied parameters. A positive correlation was observed between HbF and MCH (r = 0.243, P = 0.046). A stronger positive correlation was found between HbF and MCHC (r = 0.328, P = 0.006). The strongest correlation was observed between MCH and MCHC (r = 0.571, P < 0.001). Conclusion: The study demonstrates significant positive correlations between HbF levels and both MCH and MCHC in SCA patients. These findings suggest that elevated HbF levels may influence red blood cell indices, potentially reflecting compensatory mechanisms in SCA. The relationships observed could have implications for understanding disease severity variability and treatment responses in SCA patients.
Expression of Human Epidermal Growth Factor Receptor (HER2/neu) and Proliferative Marker Ki-67 in Nonneoplastic, Preneoplastic, Neoplastic Lesions of Gallbladder and Its Association with Clinicopathological Parameters
(Wolters Kluwer – Medknow, 2025-04) Yadav, Kiran; Arora, Deepti; Awasthi, Seema; Chaudhary, Nikhil
Introduction: Globally, gallbladder carcinoma (GBC) ranks sixth among gastrointestinal tract tumors. Gallbladder cancer is difficult to diagnose. Nevertheless, there is a rising trend of gallbladder cancer; even then, chronic cholecystitis persists commonly among gallbladder lesions nursing various epithelial alterations, ultimately resulting in carcinoma. The current research is performed to evaluate the expression of HER2/neu (human epidermal growth factor receptor 2), Ki?67 in nonneoplastic, preneoplastic, neoplastic gallbladder lesions and to assess the association of expression of HER2/neu, Ki?67 with clinicopathological parameters in gallbladder lesions. Materials and Methods: A total of 76 cases were included in the study, out of which 19 cases were considered under neoplastic group (malignant as well as preneoplastic) and 57 cases (nonneoplastic) were considered under control group. Immunohistochemical staining results of HER2/neu and Ki?67 were evaluated. The correlation was noted among both groups. Statistical analysis was assessed utilizing MS Excel 2021 and SPSS V 25.0 software. The Chi?square test was utilized for evaluating association among variables. P <0.05 was considered statistically significant. A case–control hospital?based study was conducted from March 2022 to July 2024 (For 2 years). The ethical clearance was obtained with IEC number TMU/ IEC/2024?25/007/12. Results: Positive HER2/neu expression (+2, +3) was noted in 26.3% (5/19) of malignant cases (neoplastic group), whereas the expression was completely absent in the nonneoplastic group (P < 0.05). Ki?67 labeling index (?20%) expression was noted in 57.8% (11/19) of the neoplastic group (P < 0.05), while it was completely absent in the nonneoplastic group. Conclusions: HER2/neu and Ki?67 were overexpressed in neoplastic cases as compared with the control group. Moreover, HER2/neu can act as potential target therapeutic modality in GBC cases.
Assessment of Functional Status and Mental Health in Post-COVID-19 Patients in a Dedicated COVID-19 Hospital in Maharashtra: A Cross-sectional Study
(Wolters Kluwer – Medknow, 2025-04) Bharadwaj, Gauri; Sankhe, Lalit; Bharadwaj, Shubhendra
Introduction: The COVID?19 pandemic has resulted in prolonged health challenges for many survivors, often termed long COVID?19. These challenges include persistent physical symptoms such as fatigue and breathlessness, alongside mental health issues such as depression, anxiety, and stress. Materials and Methods: A cross?sectional study was conducted among 114 post?COVID?19 patients admitted to a dedicated COVID?19 hospital in Mumbai. Functional limitations were evaluated using the Post?COVID?19 Functional Status scale, while the Depression, Anxiety, and Stress Scale measured mental health outcomes. Data analysis was done using Chi?square tests and multiple linear regressions to explore the relationship between functional and mental health metrics. Results: The study found that 16.7% of patients had no functional limitations, while 42.1% experienced minimal limitations. Severe functional limitations were reported by 13.2% of patients. Mental health analysis showed that 23.68% had mild?to?severe depression, with anxiety and stress affecting 21.1% and 14.04%, respectively. Regression analysis revealed significant associations between functional limitations and mental health, with depression (P < 0.001) having the most substantial impact, followed by anxiety and stress. Conclusion: Post?COVID?19 patients in Maharashtra face significant functional and psychological challenges, with depression being the most influential factor in delaying recovery. These findings highlight the need for integrated physical and mental health interventions in post?COVID?19 care.
Assessment of Severity of Acute Pancreatitis Using Modified Computed Tomography Severity Index and Revised Atlanta Classification and Their Association with Clinical Outcome Parameters
(Wolters Kluwer – Medknow, 2025-04) Jain, Swasti; Malhotra, Ankur; Chandak, Shruti; Arora, Deepti; Taneja, Aman
Introduction: Acute pancreatitis (AP) is a serious gastrointestinal condition with significant morbidity and mortality. It can lead to various complications and is commonly diagnosed using laboratory tests and contrast?enhanced computed tomography (CT) scans. This study evaluates the efficacy of the Modified CT Severity Index (MCTSI) and the neutrophil?to?lymphocyte ratio (NLR) in predicting the severity of AP compared to the Revised Atlanta Classification (RAC). In addition, we will also assess concordance of MCTSI and RAC with NLR.Materials and Methods: After approval from IEC, this prospective observational study, conducted over18 months at Teerthanker Mahaveer Medical College Hospital, Moradabad, Uttar Pradesh, included 65 adult patients clinically diagnosed with AP. All participants satisfying the inclusion criteria were enrolled after taking a written informed consent and they underwent standard laboratory tests (including a complete blood count) and radiological evaluation (including CT scan performed using 128?slice scanner Ingenuity CT, Philips Healthcare) during their hospital stay. The primary outcome measures were the sensitivity, specificity, and accuracy of NLR and MCTSI, as well as their alignment with the RAC for assessing AP severity. Results: In this study of 65 patients with clinically diagnosed AP, the mean age was 38.82 ± 15.82 years with a range of 15–85 years of age, with a male predominance (61.5%) and male to female ratio of 1.6:1. The study evaluated the effectiveness of MCTSI, NLR, and RAC methods for predicting the severity of AP. Severe AP cases, as classified by all methods, were associated with higher rates of surgical intervention(up to 45.5%), infection (up to 66.7%), persistent organ failure (up to 100%), mortality (up to 36.4%), and longer hospital stays (mean of up to 20.21 days), highlighting the need for accurate severity assessment in managing AP. The sensitivity, specificity, and accuracy of NLR were 67%, 90.9%, and 76%, respectively, while MCTSI had sensitivity of 95%, specificity of 13.6%, and accuracy of 62%. NLR showed a high area under the curve(0.855) compared to MCTSI (0.645). NLR was found to be a viable alternative for predicting severity, especially in resource?limited settings. Conclusion: The Modified Computed Tomography Severity Index (MCTSI) is a well?established tool for assessing the severity of AP, demonstrating ease of calculation and a close correlation with clinical outcomes. Our study confirmed that MCTSI has superior predictive ability for moderately severe and severe cases, showing high sensitivity and positive predictive value. It aligns well with the RAC, with both scoring systems significantly correlating with clinical outcomes such as the need for surgical intervention, infection, organ failure, mortality, and hospital stay duration. More adverse outcomes were observed in moderate and severe grades compared to mild cases. Additionally, NLR which is a novel parameter demonstrates strong concordance with RAC in assessing moderate?to?severe AP and offers a cost?effective alternative to MCTSI and traditional radiological methods. It can effectively predict disease severity and guide early diagnosis and treatment, particularly in settings with limited resources.
Sonographic Determination of Thyroid Gland Volume among Apparently Healthy School-aged Children in Northern Nigeria
(Wolters Kluwer – Medknow, 2025-04) Aminu, Abubakar A; Ramalan, Mansur A; Mansur, Yahuza; Yau, Anas; Mansur, Umar; Shuaibu, Abdullahi; Ogochukwu, Nwadike Sharonrose; Nasiru, Habiba Muhammad
Introduction: The establishment of normative thyroid volumes for school?aged children is pivotal for accurate assessments of thyroid health, especially in regions impacted by iodine?related interventions. This study aimed to determine the normal thyroid gland volume in apparently healthy school?aged children within Kano metropolis using ultrasonography. Materials and Methods: A cross?sectional and prospective study enrolled 276 randomly selected school children. Ultrasonography, facilitated by a 7.5 MHz linear probe?equipped machine, assessed thyroid volume alongside the collection of demographic data (age, height, and weight). Statistical analysis employed the Statistical Package for the Social Sciences (SPSS) version 21, with significance set at P < 0.05. Results: The findings revealed a total thyroid gland volume (TTGV) of 1.9 ± 0.5 cm3, with no statistically significant gender?based differences observed. Interestingly, the mean right lobe volume (1.1 ± 0.3 cm3) was significantly larger than the left lobe volume (0.9 ± 0.3 cm3) with P = 0.001. Furthermore, positive correlations were noted between overall thyroid gland volume and factors such as age, height, weight, and body surface area. Conclusion: This study establishes the normative thyroid gland volume for school?aged children in the Kano metropolis, emphasizing the correlation primarily with age. These findings serve as a vital reference for accurate thyroid assessments in this population. The identified correlations between thyroid volume and demographic factors underscore the importance of considering these variables in thyroid health evaluations.
Teleconsultation Services by Medical Students during the Second Wave of the COVID-19 Pandemic in India
(Wolters Kluwer – Medknow, 2025-04) Dkhar, Sabira Aalia; Quansar, Ruqia; Malik, Tazean Zahoor; Khan, S. Mohammad Salim; Haq, Inaamul; Noorani, Qazi Imran Abid
Introduction: Teleconsultation refers to interactions between a clinician and a patient providing diagnostic or therapeutic advice through electronic means. Teleconsultations effectively guide the patient’s diagnosis and treatment, minimizing the risk of disease transmission. It plays an important role when a person is not able to move out from their residence for fear of contracting the virus or is suspected of having the disease. Materials and Methods: We conducted an online survey?based study during July–August 2021 in medical students (Bachelor of Medicine, Bachelor of Surgery) of different medical colleges in India. Using Google Forms, the questionnaire was circulated to participants. Statistical analysis was done using SPSS (ver. 22). The determination of association was achieved using logistic regression for statistically significant variables (P < 0.05) on initial analysis. Results: Out of 386 students, only 98 (25.4%) had been part of teleconsultations for patients during the second wave of the COVID?19 pandemic (April–May 2021) in India. The student’s age, gender, designation, whether they received any training for teleconsultation, whether they felt they helped COVID?19 patients, and whether their studies were affected were significantly associated with the overall experience of the student. Conclusion: The provision of deployment of medical students and interns for teleconsultation services would reduce the burden of patients in hospitals as mild COVID?19 cases could be provided treatment using telemedicine facilities.
Sorting Out the Perception of Medical Teachers Regarding Family Adoption Program: A Qualitative Inquiry
(Wolters Kluwer – Medknow, 2025-04) Mukhopadhyay, Diptakanti; Bandyopadhyay, Kajari; Ray, Soumalya
Introduction: The family adoption program (FAP) was launched by National Medical Commission in 2022. This study aimed to explore the perception of medical educators regarding FAP implementation in West Bengal in terms of strengths, weaknesses, opportunities, and challenges. Materials and Methods: A descriptive, cross?sectional study was conducted among the teachers of Community Medicine in the state of West Bengal from December 2023 to March 2024 using free?listing and pile?sorting methods. Fifty teachers of different tiers from different government medical colleges of West Bengal were selected through stratified purposive sampling. Collected data were analyzed using visual Anthropac software. Results: The response rate was 90% (45/50). The mean (standard deviation) and median (interquartile range) age of the respondents were 45.7 (6.4) years and 45.0 (8.0) years, respectively. Community?oriented medical education and nurturing clinical and communication skills were perceived as the major strengths. In contrast, constraints in human resources, logistics, as well as improper curricular planning were the major weakness of FAP. Bolstering community?oriented medical education through enhanced participation in primary health care was the major opportunity. In contrast, the overall sustainability of the program in the face of resource constraints and lack of motivation of stakeholders was perceived as a major challenge. Conclusion: The FAP envisaged an avenue for community?based medical education grounded in the principles of primary healthcare. Efficient handling of issues pertaining to resource constraints, curricular planning, and motivation of all stakeholders will be important for the sustainability of the program.
Risk Prediction of Bladder Carcinomas in Atypical Urine Specimens by Redefining Diagnostic Cytomorphological Criteria
(Wolters Kluwer – Medknow, 2025-04) Shukla, P; Ojha, T.
Introduction: Urine cytology in bladder tumors is challenging due to the lack of definite cytomorphological criteria in categorizing atypical cases. The study aims to re?evaluate atypia in the light of three definitive cytological parameters (high N/C ratio, hyperchromasia, and irregular nuclear contours) and correlate with the follow?up histopathology and cytopathology with an attempt to redefine the morphological features that would aid in distinguishing reactive atypia from malignancy. Materials and Methods: A retrospective analysis of 56 atypical urine specimens was performed considering three definitive cytomorphological parameters. All cases were classified into the following categories: atypical urothelial cells (AUCs)?favor reactive, AUCs?not otherwise specified (AUC?NOS), AUCs?favor neoplastic (AUC?FN), urothelial carcinoma (UC), and negative for malignancy (NEM). The cases reviewed were correlated with follow?up histopathology and cystoscopy. The sensitivity and specificity of urine cytology were then assessed. Results: Out of 56 cases, 20 cases (35.7%) were positive on urine cytology (AUC?FN/UC), and amongst them, 16 cases (80%) showed positive follow?up. Among the AUC?NOS category, 71% of the cases showed positive follow?up. The sensitivity and specificity of urine cytology in atypical cases were 89.8% and 87.5%, respectively. Conclusions: Urine cytology can be potentially useful in predicting the risk of bladder carcinomas when definite cytomorphological features are analyzed stringently. Moreover, urine cytology in conjunction with cystoscopy can increase the detection rate of malignancy with greater accuracy.
Clinical and Epidemiological Profile of Musculoskeletal Disabled Patients Visiting the Physical Medicine and Rehabilitation Department: A Retrospective Study
(Wolters Kluwer – Medknow, 2025-04) Kumar, Deepak; Biswas, Labani; Kumari, Kusum; Bhadauria, Mamta Shukla; Chellamuthu, Vasanth; Kalyani, Vasantha; Varshney, Saurabh
Introduction: Globally, 3.8% of adults have severe disabilities and 19.4% have moderate?to?severe disabilities. Individuals with impairments frequently endure unbearable pain and hefty weights, which poses unique challenges for their families. This study’s primary goal was to identify the clinical and epidemiological traits of musculoskeletal disability patients who visited the physical medicine and rehabilitation (PMR) outpatient department (OPD). Materials and Methods: This retrospective study was conducted in the PMR Department of All India Institute of Medical Sciences, Deoghar, Jharkhand. The study aimed to assess and describe the pattern and profile of patients seeking treatment in PMR OPD, based on 4 years of records (2021–2024). During this time, 2174 patients in total visited PMR OPD. The Institutional Ethical Committee granted ethical approval. Results: The mean age of the 2174 patients who visited the PMR OPD was 43.48 years. The majority of patients in the PMR department were female (51%) and underwent occupational therapy and physical therapy (87%). The majority of them had disorders of the upper and lower limbs (each 36%). Most patients (66%) in the PMR department travelled 50 km or less to get to the OPD. Only 9% of patients went more than 100 km, while 25% of patients travelled between 51 and 100 km to receive PMR OPD care. Conclusions: Physical constraints can have a major impact on people’s daily activities, social participation, and overall quality of life, and no research was done to assess clinical and epidemiological features of musculoskeletal patients in the tribal areas of Jharkhand.
Interim Analysis of Outcome in Postoperative Cases of Squamous Cell Cancer of Oral Cavity Receiving Adjuvant Radiotherapy/Radiochemotherapy: An Observational Descriptive Study
(Wolters Kluwer – Medknow, 2025-04) Singh, Rashmi; Kumari, Vinita; Kushwaha, Ajit Kumar
Introduction: Squamous cell carcinoma of the oral cavity and lip is the most common type of head?and?neck cancer in India. Various tumor and treatment?related factors influence locoregional control. We aim to assess the impact of these prognostic factors on 2?year disease?free survival (DFS) in postoperative cases of cancer in the oral cavity. We present the interim analysis of our study. Materials and Methods: This was a prospective observational descriptive study conducted in the radiation oncology department. An interim analysis was performed at a minimum of 6 months following radiotherapy or sooner if an event occurred. Patients received either postoperative radiotherapy or chemoradiotherapy, depending on the presence of risk factors. We documented histopathological parameters and treatment?related factors. To evaluate the impact of risk factors on survival, we applied the log?rank test and Cox regression analysis. P ? 0.05 was considered statistically significant. Results: A total of 22 patients were included in this interim analysis. The median DFS was 5.6 months. Kaplan–Meier survival analysis revealed that DFS was significantly poorer in patients with a higher pathological nodal (pN) stage (P = 0.000), those with positive lymphovascular invasion (LVI+) compared to those with negative LVI (142.62 ± 47.07 days vs. 253.61 ± 10.5 days; P = 0.004), and those with positive extranodal extension (ENE+) compared to patients without ENE (90 ± 40.41 days vs. 254.32 ± 9.54 days; P = 0.000). In univariate analysis using Cox regression, higher pN status (hazard ratio [HR]: 4.802; confidence interval [CI]: 1.236–13.482; P = 0.021) and LVI+ (HR: 15; CI: 1.39–177.72; P = 0.029) were found to be associated with poor survival outcomes. Conclusions: In this interim analysis, DFS was significantly impacted by high nodal burden, ENE+, and the presence of LVI. Other pathological prognostic factors and treatment?related factors did not significantly affect DFS.
Is this Acute Manifestation of Adrenal Crisis?
(Wolters Kluwer – Medknow, 2025-04) Nwaneri, Chukwuemeka
Adrenal crisis is a life threatening complication of both primary and secondary adrenocortical insufficiency. The diagnosis of adrenal crisis requires a high index of suspicion, such as circulatory collapse, refractory hypotension, and metabolic acidosis. The clinical features are because of both mineralocorticoid and glucocorticoid deficiencies. The primary and initial treatment is intravenous cortisol therapy, and saline (sometimes glucose). Case presentation was used in this 43 year old woman who presented with dizziness, anorexia, vomiting, generalized weakness, and lethargy. She had a history of recent tuberculosis infection and was commenced on antituberculosis therapy, rifampicin. Her biochemical profile was suggestive of impending adrenal crisis. Her chest X ray and computed tomography were grossly normal. The patient recovered completely and was discharged home with the resolution of her deranged metabolic and electrolyte derangements. Appropriate specialist care is vital in patients with adrenal crisis, coupled with initial aggressive fluid resuscitation and acid base balance and good intensive care.
Cord Blood Bilirubin as a Predictor of Neonatal Hyperbilirubinemia
(Wolters Kluwer – Medknow, 2024-09) Beg, Saman; Firdaus, Uzma; Ali, Syed Manazir
Introduction: In the 1st week of life, hyperbilirubinemia is the most common clinical condition in newborns that has to be evaluated and treated. It is also a prominent cause of readmission to the hospital. Some newborns experience noticeable, potentially dangerous bilirubin levels, which can directly increase the risk of severe brain damage, despite it being a benign, postnatal, transitory phenomenon. The current investigation looked at the relationship between cord blood bilirubin levels and the predictability of pathological jaundice. Materials and Methods: Cord blood bilirubin was estimated at birth. Bilirubin estimation was done at 48 h, 72 h, and 5–7 days of life using a trans?bilirubinometer. The study was approved by the Institutional Ethical Committee. Results: Significant hyperbilirubinemia was found in 3.7% of the neonates. A statistically significant correlation was found between cord blood bilirubin and the development of significant hyperbilirubinemia at 48 h of life. Gender, gestational age, birth weight, and use of Oxytocin have no correlation with cord bilirubin or the subsequent development of jaundice. A cord blood value of >2 mg/dL has a high negative predictive value (98%), sensitivity (83%), specificity (41%), and positive predictive value (5.3%) in predicting the future development of future pathological jaundice. Conclusions: A high negative predictive value in our study suggests that healthy term babies with cord bilirubin ?2 mg/dL can be discharged early with assurance to parents. Babies with cord blood bilirubin >2 mg/dL should be followed more frequently.
Assessment of Antibiotics Adherence and Investigating the Targeted Interventions to Dwindle the Antibiotics Nonadherence
(Wolters Kluwer – Medknow, 2024-09) Kothandan, Dhivya; Keshavini, S.; Jagadheeshwari, M.; Ramya, V. G. Sapthami; Backkiyashree, D.; Pratibha, N.; Sophia, B. Vincy Santhana; Ramya, A.
Introduction: Antibiotic resistance is a pressing global health concern, exacerbated by antibiotic nonadherence and misuse. Understanding the knowledge, attitude, and practice (KAP) regarding antibiotics among the general population is crucial for effective interventions. This study aims to assess antibiotic adherence behavior among adults in the Chennai population and validate potential interventions to improve adherence. Materials and Methods: This cross?sectional study was conducted in and around Thoraipakkam, Chennai, over 6 months. Data were collected using a specially designed form covering demographics, medication adherence, KAP related to antibiotics. Statistical analysis was performed using SPSS version 23. Results: Among 250 participants, the majority (64%) was nonadherent to antibiotics, with significant associations found between adherence and gender, education, and medication purchase practices. Knowledge scores indicated that 39% had good knowledge of antibiotic use. Attitudes were varied, with 56% holding positive attitudes toward antibiotics. Practices also varied, with 52% exhibiting good antibiotic use practices. Validation of potential interventions showed high acceptance rates among participants, indicating the effectiveness of targeted interventions in improving adherence. Conclusion: This study highlights the prevalence of antibiotic nonadherence and identifies factors associated with it among adults in Chennai. It underscores the importance of targeted interventions to improve adherence and mitigate antibiotic resistance.
Determinants of Survival in Cancer Rectum: Our Experience at a Tertiary Care Center
(Wolters Kluwer – Medknow, 2024-09) Singh, Rashmi; Kumar, Anup; Verma, Manika; Raina, Payal
Introduction: As per GLOBOCON 2018, colorectal cancer is the seventh leading cancer in India. Our primary aim was to look for various clinical, radiological, and pathological factors in the cancer rectum and their impact on overall survival (OS) and disease?free survival (DFS) at our tertiary care center. Materials and Methods: Nineteen patients’ clinical and treatment details were compiled from the physical records stored in the department. Calculation of median survival (MS), mean OS, and DFS was done using the Kaplan–Meier method, and the Log? rank test was applied. Results: Bleeding per rectum (84.2%), increased serum carcinoembryonic antigen (63.2%), Grade 2 adenocarcinoma (95%), ulceroinfiltrating type (57.89%), and tumor length >5 cm (73.68%), and stage III (57.89%) were most common observation. Fifteen patients underwent upfront surgery, among them 66.6% of cases had ?12 lymph node removal. 40% (6 / 15) of patients had either proximal (n = 1), distal (n = 2), or CRM positive (n = 3) (3 / 6). The MS was 45 months, and increased mean OS, as well as DFS, was observed in patients having younger age, female sex, stage II, N0, ulcer?infiltrating tumor, tumor length <5 cm, negative margin, abdominoperineal resection, LN resected <12 but P value were nonsignificant. Conclusions: We observed that increased nodal burden, margin positivity, and advanced T in histopathology are associated with locoregional and distant failure.
Isoniazid-induced Tenosynovitis: A Rare Case Report
(Wolters Kluwer – Medknow, 2024-09) Jain, Piyush Kumar; Nirala, Pradeep; Maqusood, Mazher; Mishra, Ravi Shankar; Kumar, Abhishek; Sindwani, Pooja; Nath, Ravindra
The presentation of pain and numbness in flexor tendons of wrist in a patient on anti?tuberculosis treatment (ATT) with isoniazid should raise a suspicion for possible tenosynovitis. Commonly, tenosynovitis affects the wrist, hand, and fingers, although it can occur in any tendon sheath in the body. This is a case report illustrates the occurrence of tenosynovitis in a 60?year?old female subsequent to the initiation of anti?tubercular therapy (ATT) containing isoniazid (INH). The patient presented 2 weeks, without a history of trauma. Clinical examination and diagnostic work?up confirmed tenosynovitis, ruling out other causes of musculoskeletal symptoms. Although rare, INH?induced tenosynovitis should be considered, especially in patients with normal uric acid and rheumatoid arthritis factor levels. Regular monitoring for musculoskeletal side effects during ATT is crucial for timely detection and management. The objective of this case report is to highlight the rare occurrence of INH?induced tenosynovitis and emphasize the importance of its early detection and treatment.
Correlations between Placental Thickness and Neonatal Outcomes: A Detailed Analysis at 32 and 36 Weeks
(Wolters Kluwer – Medknow, 2024-09) Agrawal, Alka; Shukla, Prachi; Yonati, Vivek; Ahlawat, Sapna; Meena, Rinku; Ahlawat, Deepak; Patel, Neelesh
Introduction: The placenta helps in supporting the developing fetus by providing essential metabolic, immunological, endocrine, respiratory and nutritional functions. During pregnancy, the placenta grows in size to adequately support the needs of the developing fetus. Abnormalities in placental thickness (PT) can serve as an indicator of potential complications during pregnancy. Utilizing ultrasound technology to assess the thickness of the placenta throughout pregnancy, aiming to identify potential connections with fetal well?being, as well as other relevant factors. In addition, the objective is to establish reference charts for PT during 32 and 36weeks of gestation. Materials and Methods: An observational study at a Medical College and Hospital in India, from February 2023–2024, that included 400 patients. The thickness of the placenta was measured at 32 and 36 weeks in women who were referred for antenatal scans. Out of the 400 participants, 25 gave birth before reaching 36 weeks, while the remaining 375 were monitored until they reached 36 weeks. The thickness was categorized into three groups: Normal (10th–90th percentile), thin (<10th percentile), and thick (>90th percentile). The outcomes of the newborns were evaluated after delivery and statistical analysis was conducted using ANOVA to calculate descriptive measures such as the mean and standard deviation. Results: Among the 400 patients at 32 weeks, PT measurements had varied from 25 to 40 mm, with a PT (mean) of approximately 31 mm ± 3.13 mm. At 36 weeks, among the 375 patients, PT ranged from 27 to 44 mm and a mean PT of approximately 35.2 mm ± 3.27 mm. The correlation of PT and the fetal birth weight was noticeable, with a stronger correlation observed at 36 weeks (r = 0.432) compared to 32 weeks (r = 0.316). Conclusion: The overall thickness of the placenta at 32 and 36 weeks is closely related to the stage of pregnancy and can provide valuable insights into the overall wellness of the newborn. It is important to measure PT along with biometric parameters during ultrasound examinations for pregnant women. In addition, we observed the interaction of different factors, including body mass index and parity.
Correlation of Iron Deficiency Status with Thyroid Profile among Subclinical and Overt Hypothyroidism Patients Attending a Tertiary Care Hospital in Puducherry, India: A Cross-sectional Study
(Wolters Kluwer – Medknow, 2024-09) Sylus, Angel Mercy; Priyatharshini, M.; Muraliswaran, P.; Lavanya, M.
Introduction: Hypothyroidism and iron deficiency are both highly prevalent disorders that share certain similar clinical presentations, implying the possibility for their coexistence. Hence, the objectives of this study were to evaluate serum iron indices and thyroid function tests in subclinical and overt hypothyroidism compared to healthy controls and to investigate the relationship between iron indices and thyroid function in subclinical and overt hypothyroidism. Materials and Methods: This hospital?based cross?sectional study included 154 participants, aged between 25–60 years, grouped as 46 subclinical hypothyroid patients, 58 overt hypothyroid patients, and 50 healthy controls. Their serum thyroid function and iron indices, namely ferritin, iron, total iron?binding capacity (TIBC), and transferrin saturation (TSAT), were estimated and compared between the groups. Results: The mean age of participants was 37.76 ± 7.13 years. Serum ferritin, iron, and TSAT were significantly lower, while TIBC was higher, in both the subclinical and overt hypothyroid groups compared to healthy subjects. In subclinical and overt hypothyroidism, thyroid?stimulating hormone showed a significant negative correlation with ferritin, iron, and TSAT, but positively correlated with TIBC. Free thyroxine correlated positively with ferritin, iron, and TSAT in both the hypothyroid groups but correlated negatively with TIBC in overt hypothyroidism only. Free triiodothyronine showed a positive correlation with ferritin in overt hypothyroidism. Conclusion: The study results suggest that iron deficiency correlates with thyroid function in both subclinical and overt hypothyroidism, demonstrated by decline in ferritin, iron, and TSAT with an increase in TIBC. It implies the likely coexistence of iron deficiency with subclinical and overt hypothyroidism and emphasizes the necessity for early assessment of iron status in patients with thyroid hypofunction to ensure appropriate management.
Sonographic Determination of Gallbladder Dimension among Apparently Healthy School-aged Children in Kano Metropolis
(Wolters Kluwer – Medknow, 2024-09) Abubakar, Abubakar Aminu; Yahuza, Mansur; Mansur, Ramalan; Yau, Anas; Maikusa, Bara’atu Sani
Introduction: The present study was carried out to sonographically evaluate gallbladder dimensions among healthy school?aged children, thus setting up normal ranges that can be used in clinical settings. The study aimed to establish normal gallbladder dimensions in apparently healthy school?aged children within the Kano metropolis using ultrasonography. Materials and Methods: A prospective cross?sectional study of 276 healthy school?age children comprising 156 males and 120 were recruited randomly. Gallbladder length (GBL), width, height, volume, and wall thickness were recorded. The subject’s demographic information was also obtained. Data were analyzed using the SPSS version 23. Statistical significance was considered at P < 0.05. Results: Statistical analysis highlighted mean gallbladder dimensions: length (5.31 ± 0.65 cm), width (1.57 ± 0.52 cm), height (1.68 ± 0.48 cm), volume (7.31 ± 2.72 cm3), and wall thickness (2.59 ± 0.48 mm). While no significant differences were found between male and female gallbladder width and volume, notable distinctions were observed in GBL, height, and wall thickness between genders. Correlation analyses revealed significant associations between gallbladder dimensions (length, width, and volume) and demographic parameters such as age, height, weight, body mass index (BMI), body surface area, and gallbladder wall thickness (GBWT). Interestingly, gallbladder height showed no significant correlation with height, weight, or BMI, while GBWT exhibited correlations with various demographic factors. Conclusion: This research successfully established reference ranges for gallbladder dimensions in healthy school?aged children, underlining gender?specific disparities in certain measurements.
A Prospective Observational Study to Determine Perinatal Outcome of Second Twin According to Mode of Delivery in a Tertiary Care Hospital
(Wolters Kluwer – Medknow, 2024-09) Patel, Hetal; Seth, Shelley; Roy, Poulomi; Ghosh, Chiranjit; Dasgupta, Shyamal; Das, Pallabi; Choudhuri, Shrabana; Kumari, Jyoti; Saha, Debopriya; Alam, Md Mehebub
Introduction: The mode of delivery in twin pregnancy is a challenging decision for an obstetrician as the outcome of the 2nd twin is significantly affected by that. Materials and Methods: The prospective comparative observational study was conducted for the time span of March 2021–August 2022 in a tertiary care hospital in East India. Forty?four pregnant women with twin pregnancy with gestation age >32 weeks who underwent vaginal delivery (VD) were compared with 44 pregnant with twin pregnancy who underwent cesarean section (CS). Maternal socioeconomic and obstetric parameters were noted, and the perinatal outcome of the 2nd twin was observed and compared between both elective CS and VD groups. Results: Perinatal outcome of 2nd twin through CS showed significantly better Apgar score at 1 min and at 5 min. Umbilical artery pH > 7.2 was found more in the CS group than in the VD group. Intertwin delivery interval of ?10 min was found to be significantly associated with low Apgar score. Conclusion: The strict vigilance during follow?up of the patient in the antenatal period and proper assessment of maternal and fetal state during VD might improve the outcome of the 2nd twin to prevent unnecessary CS and its complications following it.

Browse

Recent Submissions