https://www.msjonline.org/index.php/ijrms/issue/feedInternational Journal of Research in Medical Sciences2024-02-28T19:43:31+0530Editormedipeditor@gmail.comOpen Journal Systems<p>International Journal of Research in Medical Sciences (IJRMS) is an open access, international, peer-reviewed general medical journal. The journal's full text is available online at https://www.msjonline.org. The journal allows free access to its contents. International Journal of Research in Medical Sciences is dedicated to publishing research in medical science from all disciplines and therapeutic areas of medical science or practice. The journal has a broad coverage of relevant topics across medical science or practice. International Journal of Research in Medical Sciences (IJRMS) is one of the fastest communication journals and articles are published online within short time after acceptance of manuscripts. 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Bakhamissbakhamis@phcc.gov.qaMaryam Alrashidmalrashid@phcc.gov.qaFatima M. Abdullafabdulla@phcc.gov.qaAlanoud S. Alfehaididr-dawar@live.comDina T. Alawardr-dawar@live.com<p><strong>Background:</strong> The utilization of telephone consultation (TC) has seen a significant increase of up to 86% since the start of the COVID-19 pandemic. In order to bridge the existing knowledge gap by examining the usage and efficacy of telephone or virtual consultations in a clinical setting during the COVID-19 lockdown, the objective of the current review is to gain a comprehensive understanding of the advantages and limitations of TC in the light of physicians and familial perspectives to enlighten future healthcare planning and decision-making.</p> <p><strong>Methods:</strong> The data utilized in this research spanning the period of COVID-19 and other studies related to TC that occurred before the onset of the pandemic were gathered from a variety of reputable sources, such as Pubmed, Pubmed Central, Google Scholar, Research Gate, and Science Direct with the pre-established eligibility criteria and relevant keywords.</p> <p><strong>Results:</strong> Studies revealed that the incorporation of teleconsultation has demonstrated numerous benefits for patients, including effective handling of data, fair accessibility, and adherence to standardized care protocols. Nonetheless, the implementation of TC also presents obstacles such as insufficiently trained staff, technical hurdles like connectivity issues and unreliable internet connections, and the possibility of erroneous diagnoses.</p> <p><strong>Conclusions:</strong> During the COVID-19 phase, TC has proven effective with fewer limitations that can be minimized by training the healthcare staff and overcoming technical issues.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13092Castration resistant prostate cancer: from existing therapies to compounds under investigation2024-01-02T10:45:10+0530Raveena Bajajraveenabajaj2015@gmail.comAnil Pareekanil.pareek@ipca.comIndranil Purkaitindranil.purkait@ipca.com<p>Prostate carcinoma is a highly prevalent biologically and clinically heterogeneous disease. Unfortunately, within 5 years of diagnosis, 10-20% of patients acquire a castration-resistant prostate cancer (CRPC) in spite of multiple surgical and non-surgical therapy choices. The clinical context of CRPC is heterogeneous, encompassing patients with asymptomatic prostate-specific antigen (PSA) elevation following ADT failure and good performance status, as well as those experiencing severe, incapacitating symptoms and a rapidly progressing disease that ultimately results in death. Non-metastatic CRPC (nmCRPC) is a stage of the disease that is transient and is defined by certain criteria that are set within a certain time frame. Most patients with nmCRPC will eventually develop metastatic lesions, which are linked to morbidity and death specific to prostate cancer. Until 2010, the only treatments for patients with metastatic prostate cancer were androgen deprivation therapy and docetaxel. The advent of several hormonal and non-hormonal therapies such as abiraterone acetate, enzalutamide, apalutamide, cabazitaxel, darolutamide, the immunotherapeutic sipuleucel-T has brought about a paradigm shift in management of CRPC patients. These molecules have demonstrated a survival benefit in mCRPC & nmCRPC. For patients with advanced PSMA-positive mCRPC, 177Lu-PSMA-617 radioligand therapy offers a novel and efficacious therapeutic approach. PARPi are sensitive to tumors with gene mutations that impact homologous recombination repair, such as BRCA1 and BRCA2 abnormalities in mCRPC. The goal of this study was to highlight recent developments in CRPC clinical trials as well as guidelines recommendations for CRPC.</p> <p> </p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13135Ceftaroline fosamil in the treatment of methicillin-resistant Staphylococcus aureus2024-01-08T14:40:32+0530Sahad P.Sahad888@gmail.comChandrakala D.chandrakalad017@gmail.comMeghana K.www.meghanakrishnamurthy7@gmail.comMedhini H. Gowdamedhiniharish@gmail.com<p>Ceftaroline fosamil, a cephalosporin approved by the FDA for treating infections caused by methicillin-resistant <em>Staphylococcus aureus</em> (MRSA). <em>Staphylococcus aureus</em>, particularly MRSA strains, poses a significant health risk due to antibiotic resistance. Ceftaroline fosamil is unique in its ability to bind to penicillin-binding protein 2a (PBP2a) found in MRSA, inhibiting bacterial cell wall synthesis and causing bacterial death. The pharmacokinetics of ceftaroline involve rapid conversion to its active form, primarily excretion through the kidneys, and a plasma protein binding rate of approximately 20%. Ceftaroline is effective against complex skin and soft tissue infections (cSSTIs) and community-acquired pneumonia (CAP), especially when MRSA is suspected. However, its efficacy against gram-negative bacteria is limited. The safety profile of ceftaroline fosamil is generally good, with reported adverse events comparable to other comparator agents in clinical trials. It is contraindicated in individuals with hypersensitivity to cephalosporins. Comparative efficacy with other antibiotics like vancomycin and daptomycin is discussed, emphasizing the importance of considering individual patient characteristics and local prevalence of resistant bacteria. The use of ceftaroline fosamil in special populations, such as pediatric and adult patients. While its efficacy in pediatric MRSA infections is explored, the lack of large-scale clinical trials for certain conditions like MRSA bacteremia is acknowledged. Clinical outcomes, including successful treatment of MRSA bacteremia, infective endocarditis, central nervous system infections, and nosocomial pneumonia, are discussed, suggesting ceftaroline fosamil's potential as a valuable therapeutic option. The conclusion underscores its breakthrough status, offering hope in addressing MRSA infections and improving patient outcomes.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13205Exposing Nipah virus: an epidemiological study of another thread in Kerala, South India2024-01-27T21:01:20+0530Kartikay Prakashkartikrajpoot80@gmail.comReetu Yadavshashank6889@gmail.comShashank TiwariRITUARP@GMAIL.COM<p>Bats spread the Nipah virus, which causes severe encephalitis and high mortality. Multiple reports have come from Malaysia, Bangladesh, Singapore, and India. Pteropus fruit bats are known to host the virus. The virus has caused four outbreaks in Kerala in the past quinquennium. Scholars believe the virus is indigenous to the state's bat population. Climate change, resource depletion, deforestation, natural terrain changes, farming, and industrialization all contribute to viral disease outbreaks. In this review, we will discuss the epidemiological background of the previous NiV outbreak. We will also examine the transmission method epidemic prevention and control strategies and possible causes of the outbreak. Four Nipah epidemics have occurred in Kerala in the past five years. Expert investigation suggests that the virus may be endemic in the state’s bat population. Kerala, India, has many bat species. In 2018, research found viral infections in the local fruit bat population. Traditionally, people eat fresh toddy or sap from trees, which can be polluted by bats carrying the Nipah virus. Kerala's healthcare system also closely monitors unexplained fevers for Nipah virus infections. The World Health Organisation and Indian Council of Medical Research found that the entire state is susceptible to Nipah virus infections. The virus is a major cause of encephalitis outbreaks, which have high mortality rates, mostly in Indo-Bangladesh.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13143Effectiveness of polyhexamethylene biguanide dressings vs. platelet-rich plasma in diabetic foot ulcer: a pilot study of case series2024-01-10T23:48:57+0530Roerto Martínez-Mejoradarobmed10@gmail.comJorge A. Rojas-Ortizdrjorgerojasortiz@gmail.comSandra C. López-Romerolororizo@hotmail.comXimena C. Vázquez-Guerraximenacvg@hotmail.comGabriel Garcia Gonzalezgabriel.garciagzz99@gmail.com<p>Diverse treatments, including polyhexamethylene biguanide dressings, have been explored for managing diabetic foot ulcers. Platelet-rich plasma, known for its potential in chronic wound healing, has demonstrated efficacy both in vivo and in vitro, with possible intralesional or topical application. However, research on the production costs of PRP is scarce. This study compares the effectiveness and financial implications of polyhexamethylene biguanide dressings versus Platelet-rich Plasma in the treatment of diabetic foot ulcers. Conducted at the General Hospital of Mexico from July to August 2019, this case series involved 8 patients, split equally between the two treatment groups. Weekly assessments showed consistent reductions in wound size in both groups. By the fourth week, 75% of patients achieved clinical healing. The PHMB group demonstrated a 75.13% reduction in wound size, compared to a 37.38% reduction in the PRP group. However, due to the small sample size, no statistical significance was found between wound size, healing time, and dressing type. This report suggests no clear relationship between treatment, healing duration, and wound diameter. Additionally, PRP did not show a clear financial advantage over PHMB dressings. Randomized control trials with sufficient sample sizes are required to demonstrate overall advantage for each therapy choice.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13142Not an innocent bystander: case series of tranexamic acid induced cortical necrosis 2024-01-10T21:58:32+0530Madhav Handemadhavhande93@gmail.comMohammed F. Khanmohammedfahadkhan92@gmail.comKishore Babudrkishore60@gmail.comVishwanath Siddinivishwanath710@gmail.comSanjay Rampurerampuresanjay@yahoo.co.in<p>Acute cortical necrosis accounts for <2% of all acute kidney injuries. Pregnancy complications, viperine snake bites, haemolytic uremic syndrome, shock, and severe pancreatitis are all linked to it. There are relatively few case reports of acute cortical necrosis secondary to tranexamic acid, which is utilised in the treatment of acute bleeding because of its antifibrinolytic actions. Acute cortical necrosis is very infrequently brought on by medicines. Here, we present a group of three instances, each of which experienced the onset of oligo-anuria soon after receiving tranexamic acid. Cortical necrosis was demonstrated by contrast computed tomography (CT) and renal biopsy. While the third patient had patchy cortical necrosis and had partially recovered renal functions, the other two patients both had total acute cortical necrosis and are still reliant on dialysis. This case series demonstrates the need for clinicians to be cautious while using tranexamic acid and to be aware of the possibility of abrupt renal cortical necrosis following its administration.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13168Gram negative grimness: unveiling prognostic peril of septic pulmonary embolism in a case series 2024-01-16T22:32:52+0530Kavita Chaudhrydrkavitachaudhry@gmail.comShelly Duttashelly.nim.10@gmail.comRajat Bhatiabhatiarajat.1407@gmail.comKeyur Sodvadiyakeyursp11@gmail.com<p>Septic pulmonary embolism (SPE) is a complex condition characterized by the embolization of fibrin-thrombi containing pathogens from an infectious site to pulmonary vasculature, leading to secondary infection. The commonly reported causes are right sided infective endocarditis, septic thrombophlebitis, purulent infections in the skin and soft tissues, pelvic thrombophlebitis, intravascular catheters and liver abscess and the leading organisms implicated are <em>Staphylococcu</em>s and <em>Klebsiella</em>. This case series describes three elderly patients with comorbid illnesses and having gram-negative septicemia secondary to <em>Klebsiella</em>, each with sub segmental septic pulmonary emboli and tries to explores the possibility of association of sub segmental SPE as prognostication marker in gram negative sepsis.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13115Delirium-a letter update2024-01-04T16:50:43+0530Ashutosh Shahashutosh.shah@rfhospital.orgMayur PatelMayur.H.Patel@rfhospital.org<p>Delirium is essentially acute brain failure that results from stressors that surpass the brain's homeostatic reserve. Delirium is caused by a combination of risk factors that are both predisposing and precipitating. Advanced age, frailty, medication exposure or withdrawal, sedation depth, and sepsis are all known risks. Stressors most likely have coordinated rather than independent effects, and the systems they affect are linked rather than separate. Changes in the blood-brain barrier and the central nervous system's de novo synthesis or elaboration of inflammatory mediators account for the pathophysiology of delirium. It also seems that neuro-inflammatory activity contributes to the dysregulation of neurotransmitters.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13211Anomalous origin of the left coronary artery with origin in the right coronary artery from a single coronary ostium associated with multivessel coronary artery disease: case report and literature review2024-01-31T07:41:03+0530Jovany Castro-Laracastrolarajovany@gmail.comSara S. Herrera-Lemussusan.lms.h@gmail.comSandra Sánchez-Cassiodra.cassio@gmail.comManuel A. Vera-Fuentesmanuel_verafuentes@hotmail.comMarco G. Vivas-Baizabalbaizita@hotmail.comErick G. Andrade-Torrestage_azul@hotmail.com<p>The anomalous origin of the coronary arteries is a group of rare congenital heart conditions in which there has been an increase in its diagnosis thanks to more accessible and less invasive imaging techniques such as coronary angiotomography, which allows visualization of the arteries in its entire path in a short exploration interval, with adequate spatial and temporal resolution. The clinical presentation is variable, up to 80% are asymptomatic and the remaining 20% may present arrhythmias, myocardial infarction, heart failure and sudden death. We present the case of a patient with unstable angina in whom an anomalous origin of the left coronary artery (LCA) with origin in the right coronary artery (RCA) from a single coronary ostium associated with multivessel coronary artery disease was diagnosed.</p>2024-02-08T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13131Multiple unilateral craniopathies (Guillain-Alajouanine-Garcin syndrome) resulting from a malignancy of the external auditory canal: a case report2024-01-07T18:55:15+0530Kevin Royce G. Angkevinroyce.ang@gmail.comCeferino L. Riveraeamcneuroresidents@gmail.comFrancis A. Almeloreamcneuroresidents@gmail.com<p>Garcin syndrome (or Gullain-Alajouanine-Garcin syndrome) was first described in the year 1926, as a paralytic unilateral cranial syndrome consisting of multiple cranial nerve palsies, without findings pointing towards increased intracranial pressure or long tract involvement. A 54-year-old female presented to us initially with ptosis and lateral rectus palsy of the right eye, later on, followed by progressive hearing loss on the right ear, right facial hemianesthesia, and progressive ipsilateral facial paralysis. A mass at the external auditory canal was seen during otoscopy, and a biopsy revealed squamous cell carcinoma. Contrast-enhanced neuroimaging also showed an enhancing mass lesion at the right skull base.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13160Cross-leg flap after free flap failure: a case report2024-01-16T01:56:43+0530Arsenio F. A. Azcueteno_htp@hotmail.comJorge L. L. Silvaarsferarazcue@gmail.comRicardo F. Riera arsferarazcue@gmail.com<p>The cross-leg flap is a technique that has been used for a long time to address defects in the distal third of the leg. Currently, the gold standard for these defects is free flap reconstruction. However, the success of microsurgery is not always guaranteed due to a wide range of extrinsic and intrinsic factors. In this study, we present the use of a cross-leg flap as an alternative in the case of free flap failure, performed in the plastic and reconstructive surgery department of the General Hospital of Mexico. The cross-leg flap represents a reliable, simple, and effective alternative when free flaps are not suitable or as a rescue in case of their failure, either due to extrinsic or patient-related causes.</p> <p> </p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13191Endoscopic decompression as management of uncomplicated sigmoid volvulus: case report and literature review2024-01-23T00:40:58+0530Blaz-Zavala R. Agustinagusblazzavala@facmed.unam.mxSanchez-Escobar Alejandraagusblazzavala@facmed.unam.mxEspinosa-Nader Jose Antonioagusblazzavala@facmed.unam.mxDiez-Gonzalez Renataagusblazzavala@facmed.unam.mxReyes-Elizondo César agusblazzavala@facmed.unam.mx<p>Sigmoid volvulus is a cause of intestinal obstruction explained by the twist of the sigmoid over its mesentery. The colon is at risk of ischaemia due to alterations in the irrigation due to rotation of the mesentery and risk of perforation. Surgical management is suggested in complicated cases, but endoscopic management with decompression and detorsion may be suggested in the case of uncomplicated sigmoid volvulus, with risk of recurrence. We present the case of a 49-year-old male with a diagnosis of uncomplicated sigmoid volvulus resolved by decompression with rigid proctosigmoidoscopy and medical management with remission of intestinal occlusion, without surgical intervention. A case and review of the current literature are presented.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13170Presacral tumor, experience of two cases in Mexico and review of the literature 2024-01-17T02:10:11+0530Mauricio Gutierrez A.m.gutierrezalvarez@outlook.comDaniel I. Camacho M.drcamachomauries@gmail.comJorge Leal H.lealrj11@gmail.comKevin J. Fuentes C.kjfuentescalvo@gmail.com<p>Presacral or retrorectal tumors are rare, they can present different histologic strains and they can also be benign or malignant. These tumors represent a challenge for the surgeon due to their location in the presacral space and due to the low incidence and written information. Various surgical approaches have been described. We present the case of two patients who were diagnosed with presacral tumors (hamartoma and schwannoma) and who underwent a posterior approach for the removal of the tumors. There are several approaches for the treatment of presacral tumors, but in our experience, the posterior approach has shown adequate results without recurrence in the medium-term follow-up. The purpose of the manuscript is to document our experience in the management of two patients.</p> <p> </p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13264Anterolateral thigh mega flap for upper limb reconstruction: a case report 2024-02-14T01:17:41+0530Ricardo F. Rierafdz.artis@gmail.comJuan A. U. Vitellyteno_htp@hotmail.comArsenio F. A. Azcueteno_htp@hotmail.comMauricio D. Caciquemau_davila19@hotmail.com<p>The innovative concept of employing "Megaflaps", large free flaps, in particular the anterolateral thigh megaflap, for the reconstruction of large surface defects remains relatively unexplored. Although the theoretical value of "megaflaps" is recognized, their documentation remains limited. Microsurgical free flaps are essential for treating musculotendinous, osseous, and vasculonervous injuries. The appeal of these flaps lies in their minimal donor site morbidity, which offers an alternative approach. Taking advantage of the intricate anatomy of the lateral femoral circumflex artery and its branches facilitates the creation of large surface area flaps.</p> <p> </p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13210Aggressive salivary duct carcinoma with widespread dissemination: a case report2024-01-29T21:10:50+0530Anindita Sahashreyathomasina1996@gmail.comSailendranath Biswasshreyathomasina1996@gmail.comAsish K. Dasshreyathomasina1996@gmail.comShreya Gangulyshreyathomasina1996@gmail.com<p>Salivary duct carcinoma is a rare and aggressive salivary gland malignancy with a poor prognosis. Due to the paucity of literature, very little is known about this neoplasm. We have described such a case in this case report and highlighted the clinical and histopathological features associated with this disease. A sixty-year old male patient reported in the outpatient department of a regional dental college and hospital with a circular firm growth in the mandibular anterior region and mobility of adjacent mandibular teeth. An array of investigations including radiographic, tomographic, ultrasonographic as well as histopathological were performed<strong>. </strong>It was diagnosed as invasive salivary duct carcinoma with distant metastases in the shoulder joint, ribs as well as pelvic bones. Currently, no National Comprehensive Cancer Network guidelines for the specific treatment of salivary duct carcinomas exist. National Comprehensive Cancer Network guidelines recommend complete surgical excision of tumors for major salivary gland tumors without nodal involvement (N0) with or without neck dissection for high-grade and T3/T4 salivary gland tumors.</p> <p> </p>2024-02-08T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13108A case of recurrent achalasia cardia with sigmoid esophagus managed laparoscopically2024-01-02T13:44:28+0530Kanishka Harsh Panalalkpanalal@gmail.comSiddhant Shrotriyakpanalal@gmail.comSuresh Naikkpanalal@gmail.comBahar Kulkarnikpanalal@gmail.com<p>Recurrences of symptoms after the surgery for achalasia cardia are not uncommon. There are several causes of recurrences but the early recurrences are thought to be secondary either to incomplete myotomy or late recurrences due to fibrosis after the myotomy or megaesophagus. A laparoscopic approach is a standard method because of the obvious benefits for the patients. The extent of the myotomy and addition of fundoplication are debatable issue in the management of achalasia cardia but evidence suggests that some kind of fundoplication would be necessary after the complete division of lower esophageal sphincter. We present our experience in a case of recurrent achalasia, secondary to incomplete myotomy managed laparoscopically by extended myotomy and a Dors fundoplication.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13122Ayurvedic management of supraspinatus tendon tear: a case report2024-01-06T16:56:32+0530Mary Rehna K. A.antonymaryrehna@gmail.comP. V. Giridoctorviswagiri@gmail.comT. C. Marikuttydrmarikuttytc@gmail.com<p>The two main causes of rotator-cuff injuries are trauma and degeneration. Modern medical sciences recommend operative reconstruction surgery for ruptured injuries of the rotator cuff. But the outcome of surgery often leads to restrictions on movement. In this case, supraspinatus tendon tears with degenerative causes were satisfactorily managed with ayurvedic conservative management alone. A 68-year-old patient was admitted to the Kayachikitsa inpatient department of Vaidyaratnam ayurveda college, Ollur, on September 21, 2023, with right shoulder pain and restricted shoulder movements. In an MRI, the case was diagnosed as a partial tear of the anterior fibres of the supraspinatus tendon of the rotator cuff with sub-coracoid bursitis of the right shoulder joint. On examination of the right shoulder joint, all shoulder movements were restricted due to pain. Hawkins’s impingement test, Neer’s test, and the painful arc test were found to be positive. She underwent a treatment protocol of Vatavyadhi Chikitsa incorporated with Bhagna Chikitsa. Internal and external medications, along with Upanaham, Abhyanga, Thaila pichu, bandage, and active shoulder exercises, were the treatments followed in this case. After the treatment, patient got relief from pain (VAS scale: 7 to 4) and considerable improvement in range of motion (ROM) for the right shoulder joint. This case study highlighted that within one month, the chronic rotator cuff injury got partial functional restoration (SPADI-56 to 30) by conservative ayurvedic management.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13123Ayurvedic management of pituitary macroadenoma-a case report2024-01-06T14:45:50+0530Anuja K. Vasanthanujavasanth18@gmail.comP. V. Giridoctorviswagiri@gmail.comT. C. Marikuttydrmarikuttytc@gmail.com<p>Pituitary macroadenoma is an infrequently encountered clinical condition, characterized by a non-metastasizing neoplasm situated within the pituitary gland. This case report endeavours to elucidate the efficacy of ayurvedic interventions in achieving symptomatic resolution. A 44-year-old female patient, residing in Thrissur, diagnosed with features suggestive of pituitary macroadenoma, sought admission to Vaidyaratnam ayurveda college hospital for complaints of generalized pain, heaviness of head, impaired peripheral vision in the left eye, and amenorrhea persisting for approximately 7 months. The case was conclusively diagnosed as Pituitary Macroadenoma and meticulously addressed through therapeutic modalities including takradhara, nasyam, and thalapothichil. patient was already prescribed with Caberlin tablets at a dosage of 0.25 mg twice weekly, administered nocturnally. Following 21 days of treatment, notable improvement in the LBNQ-Pituitary score was observed from 60 to 21 accompanied by significant symptomatic alleviation. A specific treatment protocol for the management of pituitary macroadenoma is currently unavailable.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13124Lasuna rasayana in management of parkinsonism-a case report2024-01-06T14:45:41+0530Arathi R.arathi.ram8@gmail.comP. V. GiriArathi.ram8@gmail.com<p>Parkinsonism is a disease with insidious onset and slow progression. It is one of the most common extrapyramidal disorders seen in clinical practice. Parkinsonism can be correlated with Kampavata in Ayurveda based on similar symptomatology. This case presents an intriguing scenario of Parkinsonism, with the patient having undergone allopathic medication for the last two years. Additionally, Ayurvedic treatments and Rasayana therapy have been introduced as complementary measures. The patient underwent Avaranagna and Vatavyadi chikitsa, incorporating practices such as Agni deepanam, Amapachanam, Snehana svedanam, Shodanam, and Rasayana chikitsa for a holistic therapeutic approach. Patients assessment was conducted using modified Hoehn and Yahr scale, Schwab and England ADL scale, Parkinson’s disease composite scale and PDQ 39 scale on the 0<sup>th</sup> day and 42<sup>th</sup> day. Quality of life scale PDQ-39 SI score was improved from 53.25 pre-treatment to 35.79 post treatment. Following 42 days of treatment incorporated with ayurvedic treatment procedures, coupled with Rasayana therapy, demonstrated a notable amelioration of symptoms, a reduction in disability, and an enhancement in the overall quality of life<span style="font-size: 0.875rem;">.</span></p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13126Area postrema syndrome: an atypical presentation of primary Sjogren's2024-01-08T23:16:43+0530Sonam Tanwarsonamtanwar1902@gmail.comRahul Jadhavrahul.jadhav241093@gmail.comJyotsna Oakjyotsnaoak@gmail.comTushar Rauttushar.27r@gmail.com<p>Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune condition characterized by antibodies against serum aquaporin-4 (AQP4), primarily affecting the optic nerves and spinal cord. This case report sheds light on the diagnostic challenges of area postrema syndrome (APS) as the initial manifestation of Sjogren's syndrome, often misidentified due to its diverse symptomatology. APS, seen in 10% of NMOSD cases, manifests as persistent nausea, vomiting, and uncontrollable hiccups. Left untreated, APS can progress to optic neuritis and longitudinally extensive myelitis, emphasizing the need for early intervention with corticosteroid therapy and immunomodulators. NMOSD commonly coexists with other autoimmune diseases like Sjogren's syndrome and systemic lupus erythematosus. Recent evidence also highlights NMOSD's impact on peripheral organs, particularly skeletal muscles, with elevated creatine kinase levels during acute phases. Understanding the relationship between NMOSD and autoimmune diseases is vital for accurate diagnosis and management, especially in cases of seronegative NMOSD and recurrent attacks, emphasizing comprehensive clinical evaluations and a broader diagnostic approach.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13149Reversible blindness in cryptococcal meningitis with human immunodeficiency virus infection2024-01-13T11:32:40+0530Manisha Guptamanishagupta251830@gmail.comAbhishek Kumardrakumarcardio@gmail.comAngad Kumardrabhikumar19@gmail.comVaibhav Mathurdrabhikumar19@gmail.com<p>Ocular complications in cryptococcal meningitis (CM) are commonly attributed to elevated intracranial pressure (ICP). We report a case of reversible vision loss complicating acquired immunodeficiency syndrome (AIDS) related to CM with a normal ICP. The patient had sudden onset painless blindness during the anti-retroviral therapy (ART) and anti-fungal therapy. On evaluation, clinical and radiological findings of optic neuritis were present. While reviewing the literature for causes of blindness in CM, we concluded the cause was optic neuritis due to immune reconstitution inflammatory syndrome (IRIS) because of concomitant ART intake by the patient. We witnessed dramatic visual improvement after the use of systemic corticosteroids. The potential significance of this case report is to highlight the possible role of corticosteroids in the prevention of blindness due to CM.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13151Spinal anaesthesia for emergency cesarean section in neurofibromatosis for an antepartum haemorrhage: a case report2024-01-13T12:50:06+0530Gunmeet Kourgunmeet8@gmail.comShivani Sharmagunmeet8@gmail.comDeeksha Sharmagunmeet8@gmail.comGurbir Singhgunmeet8@gmail.com<p>Neurofibromatosis 1 (NF1) is an autosomal dominant disease and is usually diagnosed during childhood. Neurofibromatosis are group of genetic disorders that cause tumors to form, which can develop anywhere in the nervous system including brain, spinal cord and nerves. It poses a great challenge to the anaesthesiologist as it may have difficult airway, fibrosis in lungs and neuromas in spinal cord. Due to the involvement of CNS, regional anaesthesia in type 2 neurofibromatosis without careful preoperative examination can be extremely dangerous. Regional anaesthesia on the other hand could be useful in type 1 neurofibromatosis because CNS involvement is rare. This was a case report of management in a 24-year-old pregnant female with undiagnosed neurofibromatosis for an emergency cesarean section for antepartum haemorrhage and IUD under spinal anaesthesia. Although general anaesthesia is the safer option in neurofibromatosis patients, spinal anaesthesia can be a safe procedure in neurofibromatosis patients but special precautions should be taken to avoid neurological injury and uneventful anaesthesia.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13154Anesthetic management in a challenging case of primary pulmonary synovial sarcoma2024-01-14T18:03:59+0530Pooja Singhdr.pooja26887@gmail.comAnkur Vermaanksaquarian@gmail.comShubhashish Biswasshubhashishbiswas79@gmail.comTarun Tyagityagitarun30@gmail.comSurender Kumar Dabassurenderdabas318@yahoo.co.in<p>Primary pulmonary synovial sarcoma is a very rare tumor. This tumor accounts for less than 0.5% of all lung neoplasia. While synovial sarcomas are commonly reported from periarticular tissues, they are often found in lung or thorax as a metastasis from an extrapulmonary primary. However, rarely they arise primarily from lung tissue. We report a case of primary pulmonary synovial sarcoma which was indenting the right side of the heart. He was managed with neoadjuvant chemotherapy followed by surgical resection. The anesthetic management was challenging. The focus was kept on stringent invasive as well as non-invasive monitoring of cardiac and respiratory parameters. The surgery was uneventful and the patient made a successful recovery.</p> <p> </p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13158A case report of severe hypertriglyceridemia induced acute pancreatitis managed with continuous insulin infusion2024-01-15T22:11:18+0530Joseph Thomasjosephthomas3094@gmail.com<p>31-year-old male, chronic alcoholic presented to the emergency room with epigastric pain, nausea and vomiting. On examination he was febrile, had abdominal distention with tenderness in the epigastric region. His lipase was elevated and computed tomography of abdomen showed evidence of acute pancreatitis. His past history was significant for chronic myeloid leukemia on imatinib and poorly controlled type 2 diabetes mellitus. Laboratory studies revealed elevated triglyceride levels (5254 mg/dl) and uncontrolled blood sugars (HbA1c-10.77%). Due to the severity of his pancreatitis presentation, he was admitted to the intensive care unit. He received aggressive intravenous fluid hydration and was started on continuous insulin infusion. He improved significantly with insulin therapy. His triglyceride levels decreased from 5254 mg/dl to 1891 mg/dl after 48 hours of initiating insulin therapy, by fifth day of admission triglycerides were below 500 mg/dl and was clinically better. He was discharged with a basal dose of insulin and fenofibrates. Intravenous insulin infusion is an effective, affordable, and accessible therapy for acute pancreatitis due to severe hypertriglyceridemia.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13249Rapunzel syndrome and gastric Peutz Jeghers (hamartomatous) polyps: case report2024-02-10T19:56:21+0530M. D. Gaikwadmohdamir8898@gmail.comMohd Amir Choudharydrmurharigaikwad@gmail.comBibi Zainab Shaikhbibizainabshaikh@gmail.com<p>Rapunzel syndrome is an extremely rare complication of a trichobezoar. These females have a history of trichophagia and trichotillomania. Peutz Jeghers syndrome (PJS) is an uncommon autosomal dominant syndrome with a variable to high penetrance that leads to the development of the polyps within the gastrointestinal mucosa. This case report of a 25-year-old deaf and dumb female presented with pain and lump in upper abdomen, vomiting, nausea, loss of appetite, loss of weight. An exploratory laparotomy with anterior gastrotomy was performed and a giant trichobezoar with tail extending into the duodenum was removed. There were multiple polyps in the lower stomach excised. Histopathology reports showed Peutz Jeghers (hamartomatous polyps). She recovered well and was discharged on the 10<sup>th</sup> day. Patient was advised regular follow up.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13111Clinical and biological markers for predicting acute respiratory distress syndrome in sepsis patients: a systematic review and meta-analysis2024-01-03T06:15:34+0530Gede Ari Mahendra Mardaningratarimahendra28@gmail.comPutu Andrikaarimahendra28@gmail.comIsabella Soerjanto Putriarimahendra28@gmail.comI. Putu Hendri Aryadiarimahendra28@gmail.com<p>Sepsis is a serious condition that occurs when a person's immune system responds excessively to an infection, causing an inflammatory reaction that damages the body's organs. One of the complications that can occur in sepsis patients is acute respiratory distress syndrome (ARDS). Sepsis and ARDS are conditions with high mortality rates, so it is important to prevent them. This study aims to determine clinical and biological markers that can be used as a reference in predicting ARDS in sepsis patients, so that prevention efforts can be carried out quickly and precisely. We performed a search in two databases (PubMed and Cochrane) for articles published between January 1, 2013 and September 30, 2023 that reported markers or predictors of ARDS in sepsis patients. Eleven studies out of the 360 articles identified, met the inclusion criteria for this review. APACHE II score (MD 0.36; 95% CI=0.15-0.56), sequential organ failure assessment score (SOFA) score (Mean difference (MD)=0.50; 95% CI=0.04-0.97), CRP (MD=0.75; 95% CI=0.46-1.04), SP-D (MD=0.70; 95% CI=0.51-0.90), and serum receptor for advanced glycation end-products (sRAGE) (MD=0.72; 95% CI=0.59-0.84) have a significant influence on the incidence of ARDS in sepsis patients. Overall, the findings of a meta-analysis that included 11 studies involving 6,623 patients showed that the APACHE II score, SOFA score, CRP, SP-D, and sRAGE showed statistically significant values.</p> <p><strong> </strong></p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13166Effect of an acute bout strength training on executive function among college students: a pilot study2024-01-16T19:51:21+0530Priyaben A. Janijanipriya01@gmail.comNeha Verma nidhiverma4@gmail.com<p class="abstract" style="margin-bottom: 0cm;"><span lang="EN-US">Executive functions are built such as reasoning, problem solving and planning. Even mild form of executive dysfunction might hamper everyday activities depending on the work and situation, which requires various cognitive domains. Strength exercises are able to increase the anti-inflammatory balance with an increase in cognition and better physical performance. Aim of the study was to evaluate the acute bout effect of strength training on executive function among college students. 10 participants were divided into control and intervention group for experimental study performed at SPB physiotherapy college. Consent was taken from the participants. Only one session of 30 minutes was performed by intervention group. Intervention group performed 10 repetitions of 12 exercise per set and 2 sets per session. Warm up and cool down was performed by participants. Pre and post measures of trail making test B was recorded as outcome measure for executive function. Trail making test score was significantly improved immediately after strength training with p value <0.05 suggesting improvement in executive function. The study concluded that Strength training has greater immediate impact on executive function among college students</span></p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13265Prevalence and patterns of thyroid dyfunction in chronic kidney disease patients in a tertiary hospital in southern Nigeria2024-02-14T05:54:46+0530Victoria E. Gombaevoougreen@yahoo.comChioma Unachukwuchiomaunachukwu@yahoo.comSunny Chinenyesunnychinenye@gmail.com<p><strong>Background:</strong> Several studies have identified that a decline in renal function as occurs in chronic kidney disease (CKD) is associated with thyroid dysfunction among other endocrine disorders. The prevalence and pattern of thyroid dysfunction in CKD patients in our environment is however not known. This study aimed to determine the prevalence and pattern of thyroid dysfunction in dialysis naïve CKD patients in a tertiary hospital in Southern Nigeria.</p> <p><strong>Methods:</strong> This was a cross sectional study involving 100 participants with established CKD and 100 age and sex matched healthy controls. Relevant data were collected using an interviewer based questionnaire. Samples collected from the participants were assayed for fT3, fT4, TSH and serum creatinine. Analyses was done using version 25 of the SPSS software at a 95% confidence interval and a p value of <0.05 was considered statistically significant.</p> <p><strong>Results:</strong> There were 93 males and 107 females with mean ages of 46.3±15.9 and 45.7±14.9 years for the CKD and control participants respectively (p=0.7587). The prevalence of thyroid dysfunction was 45% in the CKD group and 4% in the control group. Sick euthyroid syndrome was the commonest form of thyroid dysfunction (23%), followed by subclinical hypothyroidism (14%). Thyroid dysfunction increased with increasing severity of CKD but this was not statistically significant.</p> <p><strong>Conclusions:</strong> Thyroid dysfunction is highly prevalent in dialysis naive CKD patients. Further studies need to be carried out to determine risk factors and evaluate the impact of treatment in these patients following which a guideline for screening and management can be developed.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13199Characteristics of cataract patients who underwent cataract surgery in H. L. Manambai Abdulkadir hospital Sumbawa2024-01-25T18:17:25+0530Anak A. D. Paramitadiyanandaparamita@gmail.comAloysius A. Wibowoaloysiusangga.wibowo@gmail.comEka B. P. Warnerinebaywarnerin89@gmail.com<p><strong>Background:</strong> Cataract is a clouding of the natural intraocular crystalline lens that can cause decrease in vision and may lead to blindness. Worldwide, cataracts are number one cause of preventable blindness. Cataract surgery is the most effective intervention regardless of its etiology. The purpose of this study was to obtain characteristics of cataract patients who underwent cataract surgery in H. L. Manambai Abdulkadir hospital Sumbawa based on cataract types, sex, age, comorbidities, initial visual acuity, and surgery methods.</p> <p><strong>Methods:</strong> A quantitative study at H. L. Manambai Abdulkadir hospital Sumbawa. Consecutive, non-random sampling technique was used to recruit participants. This study enrolled 317 cataract patients who underwent cataract surgery.</p> <p><strong>Results:</strong> Of the 317 patients, 172 (54.26%) were men, 301 (94.95%) senile cataract, 141 (44.48%) bilateral case, 210 (66.25%) initial visual acuity <3/60, 43 (13.56%) with diabetes mellitus. Two hundred and seventy eight (88.54%) underwent phacoemulsification surgery, with 303 (95.58%) experienced visual acuity improvement.</p> <p><strong>Conclusions:</strong> Most of cataracts patients who underwent cataract surgery were men, most surgery were done by phacoemulsification method. Senile cataract and bilateral case are the most common case. Patients had visual acuity improvement after cataract surgery.</p> <p> </p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13195Emerging antibiotic resistance: a modern-day horseman of the apocalypse2024-01-23T23:03:47+0530Juan José Gómez-Piñadrjgomezp@gmail.comVanessa Castro Lunadrjgomezp@gmail.comNatalia León Alfarodrjgomezp@gmail.comAbraham Gilberto Medina Reyesdrjgomezp@gmail.comCitlalli Piña Pérezdrjgomezp@gmail.comNallely Puebla Valdésdrjgomezp@gmail.comArturo Olvera Acevedo drjgomezp@gmail.com<p><strong>Background:</strong> Antimicrobial resistance (AMR) has emerged as a global public health crisis, posing a significant threat to the effectiveness of antimicrobial agents. Mexico, faces a daunting challenge in tackling the rising prevalence of AMR. The misuse and overuse of antimicrobial drugs, inadequate infection control practices, and a lack of awareness among healthcare providers and the general public have all contributed to the rapid spread of resistant pathogens in the country. We aimed to determine the prevalence of antimicrobial resistance in patients hospitalized from January 2018 to December 2019</p> <p><strong>Methods:</strong> In this study, we analyzed blood, urine, wound, expectoration, and secretion cultures from January 2018 to December 2019 to assess antimicrobial resistance in our unit. We collected patient data, evaluated isolates using EUCAST and CLSI breakpoint tables, and excluded intrinsically resistant antibiotics. A circus plot graph was created to compare resistance profiles between the two years. SPSS version 25 and R Studio software were used for statistical analysis and visualization.</p> <p><strong>Results:</strong> AMR increased across diverse organisms (2018-2019), notable rises in <em>A. xylosoxidans</em> (cefuroxime, ciprofloxacin), <em>A. baumannii</em> (piperacillin/tazobactam, ceftazidime), <em>E. coli</em> (ampicillin/sulbactam), <em>K. pneumoniae</em> (ceftazidime), <em>P. aeruginosa</em> (cefuroxime) were observed. Enterococcus faecalis displayed lowest resistance to nitrofurantoin/tobramycin, but highest to fosfomycin. <em>Escherichia coli</em> showed significant resistance to aztreonam, ampicillin/sulbactam, trimethoprim/sulfamethoxazole. <em>Pseudomonas aeruginosa</em> exhibited concerning levels of resistance to ceftriaxone, ampicillin/sulbactam, ceftazidime.</p> <p><strong>Conclusions:</strong> AMR in our unit raise concerns for empiric therapy and infection control. Emerging resistance in key pathogens demands enhanced surveillance, rapid response, and robust infection control strategies, including meticulous hygiene, disinfection, antimicrobial stewardship, and resistance monitoring. Continuous optimization is crucial to combat this escalating public health threat in Mexico.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13165Changing trends in cardiovascular risk factors among adults in southern Nigeria2024-01-16T18:39:14+0530Chibuike E. Nwaforeze.nwafor@uniport.edu.ngJulius Edeogujedeogu@yahoo.co.ukStanley O. Rosemaryfinerose531@gmail.comBlessing Chinaza Enyichukwublessechukwu@gmail.comJovita Agbamorojovitaagbamoro360@gmail.com<p><strong>Background:</strong> Globally, cardiovascular diseases (CVDs) cause 17.9 million deaths yearly. In nations like Nigeria, diabetes, hypertension, and obesity, coupled with modifiable behaviors such as physical inactivity, unhealthy diet, smoking, and alcohol use, are rising. This study focused on assessing the evolving prevalence and distribution of CVD risk factors among adults in southern Nigeria.</p> <p><strong>Methods:</strong> This cross-sectional study, conducted in Port Harcourt, Rivers state, was part of world heart day celebrations over three years (September 2019-September 2023). 309 adults participated, undergoing screening for blood pressure, fasting blood glucose, lipid profile, and body mass index calculated from weight and height measurements.</p> <p><strong>Results:</strong> Over three years, 309 subjects (mean age 46.63±12.03) were studied, with 53.40% females and 46.28% males. Most cardiovascular risk factors occurred in the 41-50 age group. Hypertension rose from 65.63% (2019) to 75.29% (2023), dipping to 64.79% (2022). Obesity decreased from 29.69% (2019) to 24.71% (2023), rising to 30.99% (2022). Diabetes increased from 23.44% (2019) to 27.59% (2023), decreasing to 19.71% (2022). Total cholesterol rose from 1.56% (2019) to 2.9% (2023). High LDL increased from 3.12% (2019) to 12.7% (2023). Low HDL and high TRIG decreased from 2019 to 2023.</p> <p><strong>Conclusions:</strong> From 2019 to 2023, cardiovascular risk factors like hypertension, obesity, diabetes, and dyslipidemia increased, with a slight fluctuation in 2022. Heightened awareness and preventive measures against adult CVD risk factors are imperative. National education on risk factors is vital for individuals to monitor their blood pressure, weight, cholesterol, and blood sugar levels.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13162Relationship between inter-arm blood pressure differences and predicted future cardiovascular risk in hypertensive patients2024-01-16T11:10:43+0530Abu S. M. O. Faroquekariul@hotmail.comPrabir K. Dassayemrobin84@gmail.comAsish Deysayemrobin84@gmail.comM. Sawkat Hossansayemrobin84@gmail.comEvana Ibrahimsayemrobin84@gmail.comSayem B. Latifsayemrobin84@gmail.com<p><strong>Background:</strong> Hypertension stands as a widely recognized significant risk factor for cardiovascular disease. In clinical practice, it is advisable to measure blood pressure (BP) in both arms. The increasing attention on inter-arm blood pressure difference (IABPD) stems from its association with cardiovascular disease. This study aimed to assess the relationship between inter-arm blood pressure differences and predicted future cardiovascular risk in hypertensive patients.</p> <p><strong>Methods:</strong> This cross-sectional study was conducted at the department of cardiology, Chittagong Medical College Hospital from July 2020 to June 2021. The study included 428 cases of previously or newly diagnosed hypertension, selected through convenient sampling. Data analysis was conducted using Microsoft Office tools and statistical package for the social sciences (SPSS) version 23.0.</p> <p><strong>Results:</strong> In this study, 8.2% of patients exhibited noteworthy systolic IAD, and 2.3% demonstrated notable diastolic IAD. Median 10-year cardiovascular risk, assessed by Framingham and ASCVD calculators, was 21% and 11% respectively. A positive correlation was observed between sIAD and 10-year cardiovascular risk (p=0.003) and sIAD and 10-year ASCVD risk (p=0.041). Patients with significant sIAD had a higher incidence of ischemic heart disease compared to those without (p=0.041). Multiple regression analysis revealed a significant correlation between 10-year Framingham cardiovascular risk and sIAD (p=0.003).</p> <p><strong>Conclusions:</strong> A significant difference in systolic blood pressure between arms is linked to a higher 10-year cardiovascular risk and the presence of cardiovascular disease in well-managed hypertensive patients. So, monitoring sIAD could be an additional factor in predicting future cardiovascular events in patients receiving hypertension treatment.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13136A cross-sectional Study on lifestyle factors influencing gastritis and dyspepsia among international students’ faculty of medical university2024-01-08T19:16:51+0530Lemeshevskaya Zoya Petrovnasathishadeshan666@gmail.comL. R. Sathisha Deshan Liyanagesathishadeshan666@gmail.comGrishma Rajendrakumar Patelsathishadeshan666@gmail.comMohamed Rilwan Maryamsathishadeshan666@gmail.com<p><strong>Background:</strong> Gastritis is the syndrome associated with the inflammation of the stomach epithelium. Age, dietary pattern, health issues, level of stress, the existence of any other gastrointestinal symptoms, smoking, use of alcohol, and use of over-the-counter medication were considered extraneous variables. The purpose of this study was to determine the lifestyle characteristics that predispose to gastritis among the international students of Grodno State Medical University, Belarus and the results were closely and meticulously analyzed.</p> <p><strong>Methods:</strong> A descriptive survey strategy was used to evaluate the variables associated with gastritis. A simple random approach was chosen for this research. Data was collected with the help of a questionnaire in the format of an online Google form and recorded. Responses from 211 respondents mostly aged 18 to 29 years old were collected. The survey focused on gastritis and its connection to lifestyle factors like smoking, stress, and eating patterns.</p> <p><strong>Results:</strong> The frequency value for the consumption of processed food was the highest above all with regards to dietary habits in this study followed by consumption of fibrous food, having carbonated drinks, frequency of having coffee/tea per day, and general stress level with their daily workload as well as evidently due to consumption of spicy food.</p> <p><strong>Conclusions:</strong> This study demonstrates that the incidence of gastritis among the respondents was multifactorial.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13109Examining folic acid intake: a cross-sectional study of pregnancy-related practices2024-01-02T18:32:06+0530Muhammad M. Khanmohdmominashraf@gmail.comMuhammad Saadsaadarain299@gmail.comMuhammad R. Syedrayyanyounus@gmail.comFarina F. Siddiquisiddiquifarinafatima@gmail.comAisha R. Siddiqui254dr.rehman@gmail.comMaisam A. Rajputmaisamali99@zoho.comNoor-us-Sahar SiddiquiNoorussahar212@gmail.comIfrah SanaullahIfrahsana12@gmail.comLaraib GulLaraibmummal123@gmail.comMuhammad Ahmadmuhammadahmad4812@gmail.com<p><strong>Background:</strong> Folic acid supplementation during the periconceptional period is critical in preventing neural tube defects (NTDs) in the developing fetus. In Pakistan, a profound lack of awareness is seen regarding preventable pregnancy-related illnesses and the consequential high maternal and fetal mortality and morbidity rates. However, data from the surveys in the region of Sindh lacks inquiries regarding the baseline characteristics of the surveyed participants. Therefore, this study endeavoured to address this gap.</p> <p><strong>Methods:</strong> Between October 2022 and April 2023, a cross-sectional study was conducted at two major tertiary care hospitals in Hyderabad and Jamshoro, Pakistan. A total of 374 participants, chosen by non-probability consecutive sampling, comprised the sample size. The association of demographic variables and knowledge, attitude, and practice of consumption of folic acid during pregnancy was determined using the χ<sup>2</sup> test. A p value of less than 0.5 was considered statistically significant.</p> <p><strong>Results:</strong> The mean age of the participants was 26.4±5.7 years. A total of 199 (53.20%) participants were literate, compared to 175 (46.79%) participants who were illiterate. Literate women fared better than illiterate women in all the metrics with a p-value of <0.001 and a Pearson correlation coefficient (r) of >0.7. Moreover, folic acid was consumed by only 38% of pregnant women during the periconceptional period.</p> <p><strong>Conclusions:</strong> A substantial lack of knowledge regarding folic acid was found in the surveyed sample, significantly more marked in the illiterate faction. Additionally, the practice was rather unsatisfactory. However, the attitude remained encouraging.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13082Prevalence of Bombay phenotype among Bangladeshi ‘O’ blood group population2023-12-23T19:28:13+0530Sheikh Saiful Islam Shaheenshaheen.islammjps@gmail.comAyesha Khatundrskshaheen@yahoo.comAtiar Rahmandrskshaheen@yahoo.comFarah Anjum Soniadrskshaheen@yahoo.comJannatul Fedousdrskshaheen@yahoo.com<p><strong>Background:</strong> The Bombay blood group, a rare type often confused with ‘O’, poses a critical transfusion risk, requiring specific compatibility with Bombay (Oh) blood. With a lack of data in Bangladesh, this study aimed to establish a comprehensive database for the rare Bombay phenotype, crucial for transfusion safety. Objective was to determine the frequency prevalence of Bombay phenotype among ‘O’ blood group individuals.</p> <p><strong>Methods:</strong> A cross-sectional study conducted at Bangabandhu Sheikh Mujib Medical University from January 2020 to June 2021 involved, aseptic collection of 3 ml venous blood sample, with forward and reverse blood grouping revealing a ‘O’ phenotype. Utilizing anti-H lectin resolved discrepancies and confirmed the absence of ‘H’ antigen in individuals with Bombay blood groups. Blood samples of Bombay phenotype individuals showed the following reactions: anti-A (-), anti-B (-), anti-AB (-), anti-H (-), A cells 4+, B cells 4+, O cells 4+.</p> <p><strong>Results:</strong> Among 10,000 individuals with apparent blood group ‘O’, 99.97% were identified as ‘O’ blood type, while only 0.03% exhibited the rare Bombay blood group. ABO and Rh-D blood group frequencies varied over the study period, with B +ve at the highest (28.31%) and AB -ve at the lowest (0.21% to 0.23%). Overall, O +ve had the highest frequency (97.29%), and Bombay blood group was rare, with ‘O’ dominating at 99.97%.</p> <p><strong>Conclusions:</strong> The study identified a 0.03% prevalence of the Bombay phenotype. Due to its potential confusion with ‘O’ blood group, transfusing ‘O’ blood to Bombay individuals carries a substantial risk of severe hemolytic reactions, including fatal consequences.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13059Antenatal care at rivers state university teaching hospital, southern Nigeria: who and when?2023-12-16T05:02:35+0530Esther Ijeoma Nonye-Enyidahhernsi@yahoo.comAltraide Basil O. A.hernsi@yahoo.comAwopola I. Jumbohernsi@yahoo.comNonyenim Solomon Enyidahhernsi@yahoo.comKasso Terhemenhernsi@yahoo.com<p><strong>Background:</strong> Antenatal care prepares pregnant women physically and psychologically for birth and parenthood. It also prevents, detects and manages health problems affecting mothers and their babies. Objectives were to identify and characterise those attending antenatal care at RSUTH and when they register for antenatal care.</p> <p><strong>Methods:</strong> A retrospective study conducted from 1<sup>st</sup> January, 2015-31<sup>st</sup> December, 2020 at ANC of RSUTH. Records of 9990 pregnant women who booked for antenatal care were retrieved and reviewed. Socio-demographic characteristics and gestational age at booking were studied. Data was analyzed using SPSS version 23.0. P value <0.05 was statistically significant.</p> <p><strong>Results:</strong> During the study period, 9990 pregnant women booked for antenatal care. Most (23.3%) registered in 2016. Mean age at booking was 31.4±4.7 years. Highest age group (62.4%) was 30-39 years. Modal parity was para 0 and majority (37.5%) were para 2-4. Mean gestational age at booking was 20.5±7.5 weeks. More than 70% had tertiary education and 67.9% were traders and civil servants. More than 97% were married and 58.3% registered in their second trimester. When gestational age at booking was compared with the various socio-demographic parameters, those with the differences statistically significant and associated with late booking were educational level, age, parity, occupation and employment status.</p> <p><strong>Conclusions:</strong> Most women at booking were in their thirties, second trimester, married, multiparous, working class and had tertiary level of education. Most socio-demographic parameters showed statistically significant differences when compared with the gestational age at booking.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13025Association of liver function tests with severity of disease in patients with COVID-192023-12-04T02:23:56+0530Serkan Ipekserkanipek@hotmail.comSule Ayse Gelgecsulegelgecc@gmail.comGamze Turkerdrgamzeturker@gmail.comSerra Aydin Catakliserraydin@hotmail.com<p><strong>Background:</strong> We aimed to investigate the association of liver function tests with disease severity at admission and during hospitalization in patients with coronavirus disease 2019 (COVID-19).</p> <p><strong>Methods: </strong>Blood tests of patients who were hospitalized due to COVID-19 were retrospectively analyzed. Liver tests included serum aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, total bilirubin, and albumin. Besides these, C-reactive protein and ferritin were also analyzed in the study. Levels of these tests at admission and peak levels during hospitalization were then recorded. Severe COVID-19 infection was defined as the reason for ICU admission. Both the associations of the levels of liver tests at admission and peak levels during hospitalization with severe disease were evaluated.</p> <p><strong>Results: </strong>The study included a total of 602 patients, and 127 (21.1%) of the patients were hospitalized in the ICU. In our study, only albumin level abnormality was significantly associated with severe disease in COVID-19 patients at admission. However, during hospitalization, a significant association was found between severe disease and abnormal AST, ALT, GGT, T.BIL, albumin, and ferritin levels. During hospitalization, it was also observed that the rates of severe disease cases increased as AST, ALT, GGT, and T.BIL levels increased.</p> <p><strong>Conclusions: </strong>Abnormal liver function tests may be a predictor for severe disease in patients with COVID-19. It is therefore important to monitor liver function tests in hospitalized patients.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13009Evaluating the toxicity of capecitabine-cisplatin versus gemcitabine-cisplatin regimens for palliative chemotherapy in advanced biliary tract carcinoma2023-11-30T11:47:03+0530Tariq Hasankariul@hotmail.comS. M. Rahid Sarwarkariul@hotmail.comFatema Sarkarkariul@hotmail.comIshrat Jahankariul@hotmail.comM. Shabnam Mostarikariul@hotmail.com<p><strong>Background: </strong>Advanced biliary tract carcinoma is a malignancy associated with poor prognosis and limited treatment options. This study aimed to compare the treatment effects in terms of toxicities of Capecitabine-Cisplatin and Gemcitabine-Cisplatin regimens as palliative chemotherapy for ABTC in Bangladesh.</p> <p><strong>Methods: </strong>This quasi-experimental study was conducted at the Department of Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, involving 78 patients with histopathologically confirmed ABTC (AJCC Stage IV). Participants were divided into two groups: Arm-A received Capecitabine-Cisplatin, and Arm-B received Gemcitabine-Cisplatin. Treatment response, hematological and non-hematological toxicities were assessed and compared between the two groups.</p> <p><strong>Results: </strong>No significant differences in baseline demographic and clinical characteristics were observed between the two groups. Arm-A demonstrated a higher rate of partial response in the final assessment (51.28% vs. 41.03%, p=0.029). Acute hematological toxicities were more frequent in Arm-B, with a higher incidence of Grade 2 and 3 anemia, neutropenia, and leukopenia (p<0.05). Non-hematological toxicities were comparable, except for Hand-Foot Syndrome, which was significantly higher in Arm-A (p=0.03).</p> <p><strong>Conclusions: </strong>The Capecitabine-Cisplatin regimen exhibited a different toxicity profile compared to the Gemcitabine-Cisplatin regimen for palliative chemotherapy in advanced biliary tract carcinoma. While both regimens were generally well-tolerated, the Capecitabine-Cisplatin regimen demonstrated lower incidences of hematological toxicities. These findings emphasize the importance of considering toxicity profiles when selecting treatment options for patients with advanced biliary tract carcinoma.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13187Evaluation of adaptive capabilities of students of different nationalities: cross sectional study2024-01-20T23:00:12+0530Mohotti Gedara Weerakoon Mudiyanselage Varsha Priyadarshanivarshweerakoon@gmail.comPoorna Gayan Wattaladeniyagayan.wattaladeniya@gmail.comKarnialiuk Dzmitryzmicerka@tut.byShailesh Anbalaganshaileshanbalagan@gmail.comOwini Kalna MunasingheOwinimunasinghe1997@gmail.com<p><strong>Background:</strong> The autonomic nervous system actively regulates the body's reactions to various external and internal factors, ensuring physiological balance in a person. Advances in information technology now allow for a dependable and non-intrusive examination of this system through an in-depth analysis of heart rate variability. This approach is not only a recognized instrument in cardiac studies but is also growing in its utilization for numerous clinical purposes. This overview details the foundational theories and practical uses of this evolving method. The purpose of the study is to study the adaptive reserves and indicators of autonomic regulation in students of different nationalities.</p> <p><strong>Methods:</strong> We conducted a cross sectional study of 110 students studying in Grodno State Medical University using photoplethysmography method via an app “Pulse HRV”during the period of December 2022- February 2023. The students were grouped into three groups: Group 1 being Southeast Asian students, Group 2 being Nigerian students and Group 3 being Belarussian students.</p> <p><strong>Results:</strong> As a result of the analysis, it was found that AP in group 2 was significantly different from groups 1 and 3. At the same time endurance coefficient was above norm in all groups, which indicated a weakening of the cardiovascular system, while in students from group 2 it was significantly less than in groups 1 and 3.</p> <p><strong>Conclusions:</strong> Students from Nigeria have significantly higher adaptive reserves than students from Belarus and Southeast Asia, which may be due to the prevalence of increased tone of the parasympathetic nervous system.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13247An epidemiological trend in surgical management of pelvis and acetabulum fractures at Indira Gandhi Institute of Medical Sciences level-1 trauma centre in Patna: a retrospective study2024-02-09T20:33:04+0530Rishabh Kumardrrishabh2005@gmail.comAshutosh Kumardr.ashutoshkrsmriti@gmail.comAnand Shankardrshanka@gmail.comRakesh Kumardr.rakesh.pmch04@gmail.com<p><strong>Background:</strong> Pelvic and acetabular fractures, principally resulting from high-energy trauma like motor vehicle accidents, are challenging orthopedic injuries that can lead to significant morbidity and functional impairment. Understanding their epidemiology, treatment, and outcomes is crucial for improving patient care.</p> <p><strong>Methods:</strong> This retrospective cohort study involving 34 patients who underwent surgery for pelvic and acetabular fractures from April 2021 to September 2023. Data on patient demographics, injury mechanisms, fracture types, surgical approaches, and post-operative outcomes were collected and analyzed.</p> <p><strong>Results:</strong> The study group comprised predominantly males (67%) with mean age of 35 years. Road traffic accidents were the leading cause of injuries (95%). The most common fracture types were the posterior wall of the acetabulum (10%) and type II anteroposterior compression fractures (10%). Related injuries included long bone fractures (62.5%) and posterior hip dislocation (33.33%). Surgical treatment primarily involved open reduction and internal fixation with various approaches. Postoperative complications included sciatic nerve palsy (4.17%), venous thromboembolism (20.83%), and wound infections (12.5%), but both post-operative mortality and heterotopic ossification were absent.</p> <p><strong>Conclusions:</strong> The study highlights the prevalence of pelvic and acetabular fractures due to road traffic accidents and the complexity of their surgical management. The associated injuries and postoperative complications underscore the need for specialized orthopedic care.</p>2024-02-20T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13182Knowledge, attitude and practice on dengue among residents of tribal hostel in Bilaspur: a cross-sectional study2024-01-19T17:11:06+0530Vivek Sharmadrvivek81@gmail.comNasarin Parveennasparveen02@gmail.comDarwin Deissuzadeissuza@gmail.com<p><strong>Background:</strong> In the present era, vector-born disease accounts for 17% of the estimated global burden of all infectious diseases. One such deadly vector-borne disease is dengue. Dengue, dengue hemorrhagic fever, and dengue shock syndrome are major international public health concerns; 2.5 billion people live in high-risk dengue areas with 50 million dengue infections worldwide annually. Aim of the research was to conduct cross-sectional knowledge, attitude and practice (KAP) study of dengue among residents of tribal hostel in Bilaspur, Chhattisgarh (C.G).</p> <p><strong>Methods:</strong> A community-based cross-sectional study was conducted among 150 students residing at a tribal hostel of Bilaspur.</p> <p><strong>Results:</strong> The study showed that 95% of the participants had previously heard about dengue. Only 34.3% of the respondents were aware that dengue is a contagious disease, and only 48.6% knew that the disease is caused by the bite of mosquito. Almost 52% were aware of the exact source of disease transmission.</p> <p><strong>Conclusions:</strong> When it came to basic knowledge about dengue, the majority of the respondents answered positively. However, there were large lacunae present within the specific knowledge of dengue such as, whether dengue is contagious, or about the biting and breeding time and site, respectively, of the mosquito.</p> <p> </p>2024-02-14T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13217Prescribing patterns in patients with chronic liver and kidney disease in a tertiary care hospital 2024-02-01T19:17:08+0530Pratichhya Mathemapratichhyamathema215@gmail.comDinesh R. Neupanegranzzz.neupane2054@gmail.comSafal K. Shresthasafalkumarshrestha836@gmail.com<p><strong>Background:</strong> Liver diseases are major cause of mortality and morbidity worldwide. It is the 12th leading cause of death liver diseases can be classified as acute if the onset of symptom does not exceed six months or chronic if symptoms persist beyond this period. According to the recently available World Health Organization. The aim of study is to facilitate rational use of medicines.</p> <p><strong>Methods:</strong> This study is a prospective, observational, single center study which include patients aged ≥18 years, diagnosis of liver diseases with or without co-morbidities and is conducted at out-patient of Medicine department, Rajindra Medical College and Hospital, Patiala.</p> <p><strong>Results:</strong> In this study, total of 97 prescriptions of patients with liver disease were analyzed. Out of 97 patients, the majority of patients were male. In ALD, males were 32 (78%) whereas female were 9 (22%) while in CLD males were 47 (84%) and females were 9 (16%).While observing the LFT profile of patients with ALD common tests were observed which includes total bilirubin (1.82±2.42), SGOT (96.81±117.49) and SGPT (94.78±142.94) and in patients with CLD common tests were observed which includes total bilirubin (2.50±3.63), SGOT (67.50±43.04), SGPT (47.10±33.12), blood urea (46.92±24.14) and alkaline phosphatase (147.02±63.14).</p> <p><strong>Conclusions:</strong> The study interprets the prescribing pattern of drugs used in patients with ALD and CLD and observed that vitamins and minerals and antibiotics were the most prescribed in order to avoid further complications followed by hepatoprotective agents, antiulcer drugs, antihypertensives and laxatives.</p> <p> </p>2024-02-14T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13121Sex difference effects of acute starvation on excitatory and inhibitory synapses on dopamine neurons2024-01-05T17:05:59+0530Shazia Haque Arshadshaziahaque2@gmail.comAjay Kumar Singhdarashajaysingh@gmail.comDayanand Prasaddnproh@gmail.comSarbil Kumarisarbil.binod@gmail.com<p><strong>Background:</strong> The aim of this study is to assess the influence of acute fasting on synaptic properties in the ventral tegmental area (VTA) with regards to the sex-dependent differences by use of male and female mice. The study aimed to unravel the intricate interplay between fasting, synaptic plasticity, and behavioural changes to enhance our understanding of the underlying mechanisms.</p> <p><strong>Methods:</strong> This study carried out at a tertiary care centre, employed a 16-hour overnight fasting protocol in female rodents and male rodents to examine the effects on physiological parameters, feeding behaviour, and neuronal attributes in the VTA. Various assays, including measurements of blood glucose, ketones, corticosterone (CORT) levels, locomotor activity, and electrophysiological recordings of synaptic currents, were conducted to assess the physiological and synaptic responses to acute fasting.</p> <p><strong>Results:</strong> The study found that acute fasting induced significant metabolic changes, including body mass decrease by about 10%. Altered food-seeking behaviour was evident, with male mice exhibiting a pronounced increase. Moreover, neuronal attributes in the midbrain or VTA showed gender-dependent responses: males displayed substantial 20% increase in the frequency of mEPSC onto the dopaminergic neurons in the midbrain post fasting, while females exhibited a 13% elevation in CORT levels, accompanied by a transient period of depression at stimulatory synapses onto dopaminergic neurons which was mediated by endocannabinoids. Notably, no significant changes were observed at restraining synapses in rodents of both genders. These findings highlight the nuanced influence of short-term fasting/starvation on the VTA's synaptic plasticity, emphasizing sex-specific responses and providing valuable insights into potential mechanisms influencing gender differences in neuropsychiatric conditions.</p> <p><strong>Conclusions:</strong> The study reveals that acute fasting induces sex-specific synaptic changes in the VTA, shedding light on the intricate relationship between metabolism, food-seeking behaviour, and neural plasticity. These findings emphasize the importance of considering gender-specific responses in studies exploring the neurobiological effects of fasting and their relevance to mental health.</p>2024-02-08T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13271A micro bacteriological culture assessment of the histopathological alterations in liver and bile in gallstone disease2024-02-15T19:43:23+0530Pradeep Jaiswalpradeep.jaiswal43@yahoo.comRajeev Ranjanrajeevdmch3059@gmail.comRinku Kumaririnku7770@gmail.comKaushalendra Kumarkumar.kaushalendra89@gmail.comRia Rajgariadrria2020@gmail.comPawan Kumar Jhajhapawankumar426@gmail.com<p><strong>Background:</strong> The present investigation aims to evaluate both the intensity and occurrence of hepatic impairment in patients afflicted with gallstone disease, examining the involvement of bacteria in the progression of these alterations.</p> <p><strong>Methods:</strong> This prospective observational investigation was carried out on 189 patients scheduled for open or laparoscopic cholecystectomy at IGIMS in Patna, Bihar, India. In all the patients, laboratory and radiological investigations were performed. A healthy section of the liver border near the gallbladder fossa was chosen and grasped with non-traumatic forceps. Approximately 1 cm of the liver edge was excised using scissors and forwarded for histopathological analysis.</p> <p><strong>Results:</strong> An examination of 189 liver biopsy specimens revealed that 87 (46%) patients showed no abnormalities, while 102 patients (54%) exhibited one or more changes. Upon analysing the liver biopsy samples from the control cohort (41 patients) during autopsy, 37% of the cases were identified to display hepatic lipidosis, while 48% of the cases showed lymphocytic invasion. Importantly, no cases of acute inflammatory changes were detected in the control cohort. Microbiological analysis was conducted on 96 patients, of which 33 (34%) showed positive cultures, with one or more microorganisms isolated from either the biliary tract or liver. Among these, 74% (24 cases) originated from the bile or gallbladder, while 26% (9 cases) were isolated from the liver.</p> <p><strong>Conclusions:</strong> Gallstone disease induces significant liver histological changes, notably more prevalent in patients with prolonged symptoms. The present study clearly identifies this and underscores the importance of timely diagnosis and intervention for the effective management of this disease.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13273Seroma formation after modified radical mastectomy: analysing risk factors and incidence2024-02-15T19:52:56+0530Chandrakala Kumaridrchandrakala22srishti@gmail.comN. P. Naraindrn.narain@rediff.com<p><strong>Background:</strong> Breast cancer is a prevalent form that affects women and is a leading cause of death among women. The development of seroma is a frequent complication that can arise after breast cancer surgery, and its underlying mechanisms are still not fully understood. Consequently, data was collected to analyze the occurrence and factors that contribute to the development of seroma in patients. We aimed to enhance our comprehension and ultimately discover methods to mitigate it.</p> <p><strong>Methods:</strong> A prospective group research study was conducted on a sample of 86 female patients who underwent mastectomy from August 2020 to August 2023. This study was carried out as part of the senior residency program at Nalanda Medical College and Hospital in Patna, Bihar, India. Patients who develop seroma within four weeks of surgery are usually recommended to undergo, specifically ultrasonography, and radiological evaluation to determine the size.</p> <p><strong>Results: </strong>27 out of 86 patients (31%) were found to have seroma. Several factors are closely linked to the development of seroma. Factors that may contribute to increased risk The minimum age at which seroma production occurs following MRM ≥56 or older, having a BMI of 26.50 or higher, a tumour measuring 4 cm or larger undergoing the removal of more than 12 lymph nodes, and having a level 3 axillary dissection.</p> <p><strong>Conclusions:</strong> After surgery, a certain group of people in the study experienced seroma formation within four weeks. These individuals had undergone MRM. Age, BMI, tumour size, level 3 axillary dissection, the removal of more than 12 lymph nodes during surgery, and the occurrence of seroma after MRM were found to be positively correlated. There was no observed connection between seroma production and a range of factors, such as neoadjuvant chemotherapy, the timing of drain removal, shoulder workouts, and the use of breast bandages.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13300Role of histopathological and microbiological investigations for a definitive diagnosis of benign sinonasal masses: a tertiary care institute study2024-02-20T20:12:57+0530Arvinder Singh Maanmaanarvinder@yahoo.comRuchika BhagatRuchikabhagat62@gmail.comNavneetdrnavneet2130@gmail.com<p><strong>Background:</strong> This research aimed to study the clinical presentation of various sino nasal masses (SNM), to study the importance of Histopathological and microbiological investigations in making diagnosis of SNM and to study the correlation between clinical, radiological, histopathological, and microbiological findings of SNM.</p> <p><strong>Methods:</strong> In the present study 50 patients attending the ENT outpatient department with clinical evidence of nasal mass were selected based on inclusion and exclusion criteria. Patients were examined clinically and radiologically followed by surgical intervention. Histopathological and microbiological examination was done to make a definitive diagnosis.</p> <p><strong>Results:</strong> Majority of cases were from 21-40 years age group (66%) with male preponderance. Nasal obstruction was most common symptom 45 (90%) followed by nasal discharge 43(86%). On histopathology highest incidence was of inflammatory polyps 22 (44%) followed by allergic polyps 14(28%) and non-invasive fungal sinusitis (NIFS) 11 (22%) respectively. Microscopically in KOH, fungal elements, yeast and hyphae were seen in total 11 (22%) cases and with SDA, <em>Aspergillus niger</em> was seen in 7 (14%) cases, <em>Candida albicans</em> in 3 (6%) and both in 1 (2%) case. Correlation of provisional diagnosis with HPE was found to be highly significant.</p> <p><strong>Conclusions:</strong> It was observed that histopathological and microbiological examination is irreplaceable as both are the “GOLD STANDARD” for making a definitive diagnosis.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13246An evaluation of effectiveness of Ilizarov external fixation in treating infected non-union tibial fractures: a prospective observational study2024-02-09T20:25:31+0530Ashutosh Kumardr.ashutoshkrsmriti@gmail.comRishabh Kumardrrishabh2005@gmail.comAnand Shankardrshanka@gmail.comRakesh Kumardr.rakesh.pmch04@gmail.com<p><strong>Background:</strong> Infected non-union tibial fractures pose significant challenges in orthopedic care. Ilizarov external fixation has emerged as a promising treatment option for such complex fractures. The purpose of this research is to evaluate the efficacy and safety of Ilizarov fixation in non-union, infected tibial fractures.</p> <p><strong>Methods:</strong> A prospective observational study was conducted on 30 patients at Indira Gandhi Institute of Medical Sciences. Inclusion criteria involved patients aged 20-65 with clinical and radiological signs of infection and non-union of the tibia. Data on patient demographics, injury details, treatment history, and outcomes were collected. Ilizarov fixation was performed, and patients were followed up.</p> <p><strong>Results:</strong> The study cohort, primarily males (80%), with mean age of 35.75 years, displayed a high incidence of type III compound injuries (63.33%). Monofocal and bifocal osteosynthesis effectively reduced limb shortening, with an overall average residual shortening of 1.8 cm. Bony outcomes were favorable, with 16 cases achieving excellence. Functional outcomes were also promising. Complications included stiffness, infections, and deformities.</p> <p><strong>Conclusions:</strong> Ilizarov external fixation demonstrates potential in managing infected non-union tibial fractures, offering favorable bony and functional outcomes. However, post-operative complications require vigilant management. Further research is needed to validate and optimize this approach.</p>2024-02-20T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13081Understanding motivators and barriers for yoga practice in obese and non-obese individuals2023-12-23T13:09:22+0530Shirley Tellesoffice@prft.co.inShivam K. Guptashivam.gupta@patanjali.res.inSachin K. Sharmasachin.sharma@patanjali.res.in<p><strong>Background:</strong> Yoga is a comprehensive lifestyle intervention which has been used for weight management by overweight and obese. Yoga is also used as therapy for various other ailments by both obese and non-obese individuals. However, the motivators and barriers of yoga in obese persons compared to non-obese has not been reported.</p> <p><strong>Methods:</strong> The present cross-sectional comparative control trial included 200 participants of both sexes aged between 13 and 80 years. Of these, 102 were obese and 98 were non-obese. Data were analyzed using Chi-square test.</p> <p><strong>Results:</strong> The most common motivators for yoga were: reducing symptoms of illness (35% for obese versus 21.73% for non-obese), pain relief, (21% for obese versus 10.86% for non-obese) and lifestyle changes (9% for obese versus 10.86% for non-obese). The most common barriers for yoga were: no time (29.54% for obese versus 42.25% for non-obese), physical incapability of practicing yoga (18.18% for obese versus 16.9% for non-obese) and tiredness (15.9%) for obese and no interest/motivation (15.49%) for non-obese.</p> <p><strong>Conclusions:</strong> The motivators to yoga for obese are comparable to non-obese with obese use yoga more frequently for “reducing symptoms of illness”. Also, the barriers to yoga are comparable to obese with normal weight for “no time”.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13089Study of epidemiology and management of liver abscess in Jammu region2023-12-26T12:25:16+0530Javaid Iqbal Gulshandjigq2222@gmail.comShahzada Faisal Manzoordjigq222@gmail.com<p><strong>Background:</strong> Liver abscess is a common medical condition with different causes and variable morbidity and mortality in different parts of the world, this study has looked into epidemiology, pattern of disease gender and age of affected patients and associated factors.</p> <p><strong>Methods:</strong> This prospective study was conducted at a government medical college over a period of one year from August 2022 up to July 2023. Data of patients managed at our centre was collected, analysed and interpreted on MS Excel.</p> <p><strong>Results:</strong> The majority of affected patients were male (77.5%). 30 to 40 years age group was the most commonly affected, most of the patients presented with complaints of pain abdomen (85%). Amoebic abscess was present in 71.25% of patients. The right lobe of the liver was involved most commonly (67.5%). Conservative management was successful in 56.25% of patients. Alcohol intake was present in 43.75% of patients, complications were pleural effusion, portal vein thrombosis, necrotizing colitis and gastrointestinal bleeding.</p> <p><strong>Conclusions:</strong> In the present era of modern medical science, diagnosis of liver abscesses has become easy through radiological and serological tests, and treatment modalities from minimally invasive to conservative have proved successful in the treatment of liver abscesses. Antibiotics remain the primary course of treatment for both amoebic liver abscess (ALA) and pyogenic liver abscess (PLA), unless there is persistent fever, a substantial abscess cavity, or complications that require surgical intervention. However, challenges persist in combating antibiotic resistance, stemming from incomplete and over-the-counter misuse of available medications. Special concerns include associated comorbidities, delayed medical consultation, and treatment-seeking behavior, as well as the misuse of unhealthy substances or alcohol.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13093Prevalence of diabetes distress and its psychosocial determinants among Indian population with type II diabetes2023-12-28T16:43:20+0530Suraj Purushottamandrsuraj.p@bhaktivedantahospital.comAmeya Joshiameyaable@gmail.comDhaval Dalaldrdalal.rns@gmail.comMohd Fahaadmohdfahad1990@gmail.comNamrata Raoraonamrata24@hotmail.comShivanjali Goredrshivanjali.g@shareyourcare.comRia Vijayria.v@bhaktivedantahospital.com<p><strong>Background:</strong> Diabetes distress (DD) refers to the negative emotional or affective experience resulting from the challenge of living with the demands of diabetes, regardless of the type of diabetes. In addition to the chronic treatment of diabetes, patients with type 2 diabetes mellitus (T2DM) often experience psychosocial difficulties which can go unnoticed. Hence, it is necessary to identify DD at an early stage to prevent its effect on the patients’ long-term self-care and management plan. This study was conducted to assess the prevalence of DD and its psychosocial determinants among T2DM at a tertiary care centre.</p> <p><strong>Methods:</strong> This was a cross sectional, observational study which included patients of either gender, who were between 18-65 years of age with T2DM for more than 3 months to 12 years. DD was assessed using the diabetes distress scale (DDS17) scale. In addition, association between the level of DD with the sociodemographic and clinical characteristics of the patients was assessed.</p> <p><strong>Results:</strong> The prevalence of DD in type II diabetic patients in suburban population was found to be 17.69%. The psychosocial determinants which influence DD were found to be age, treatment modality, hypothyroidism, hypertension, and smoking.</p> <p><strong>Conclusions:</strong> This study signifies the importance of identifying DD by the primary care physician which often remain unrecognized in clinical practice and to implement the interventions at early stages to improve the quality of life of diabetic patients.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13098Efficacy and safety of apremilast versus dapsone versus colchicine in recurrent aphthous stomatitis: a three arm double blinded comparative study2023-12-30T20:06:09+0530Dinesh Kumar Yadavdineshyadav084@gmail.comAakanksha Aroraakarora357@gmail.comAshish Yadavashishy.2770@gmail.com<p><strong>Background:</strong> Recurrent aphthous stomatitis (RAS) is often considered as an incurable ailment. Therefore, an effective management option is required for controlling the symptoms and severity of RAS. We aimed to conduct a study to compare the effectiveness and safety profile of apremilast, dapsone and colchicine in management of RAS.</p> <p><strong>Methods:</strong> This three-arm double blinded comparative study included 60 cases of recurrent aphthous stomatitis (RAS). Twenty patients each were randomly allocated in three groups: group A (apremilast), group B (dapsone) and group C (colchicine).</p> <p><strong>Results:</strong> At the end of 6 weeks, the complete response was seen in 6 (30%) patients in group A as compared to 2 (10%) and 4 (20%) patients in group B and C (p >0.05). At the end of 12 weeks, response rate became statistically significant (p=0.003) with complete response in 14 (70%) of patients. Median time to recurrence, defined as oral ulcer after loss of complete response, was significantly increased to 4.3 weeks in group A as compared to group B and C. The most commonly encountered side effects were gastrointestinal in all three groups. None of the adverse effects resulted in discontinuation of treatment, hospitalization or death in any patient.</p> <p><strong>Conclusions:</strong> Although, traditional therapies like dapsone and colchicine have been commonly used in clinical practice, apremilast yielded a rapid and maintained improvement of RAS.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13103Clinical characteristics and associated factors of cerebral palsy in pediatric population: a tertiary care centre clinicoepidemiological study2024-01-01T13:24:54+0530Naveen Kumarnaveenkumar09061992@gmail.comRenu Agrawaltippy1234@rediffmai.comG. S. Tanwardrgstanwar@gmail.comSrishti Agrawalagrawal.srishti22@gmail.com<p><strong>Background:</strong> Although, a highly prevalent disease, the etiology of cerebral palsy is still poorly understood thereby eluding a definitive prevention strategy. Our study aimed to evaluate the etiological, clinical and prognostic factors associated with cerebral palsy in children of western Rajasthan.</p> <p><strong>Methods:</strong> All cases of non-progressive neurological disorder in the age group of 6 months to 14 years were enrolled in the present study. Detailed assessment, CNS examination and related neuroimaging were performed. Statistical analysis was done by standard statistical methods.</p> <p><strong>Results:</strong> Maximum number of patients in current study were in the age group of 1-3 years. In our study according to sex, 40 (66.67%) were males and 20 (33.33) were females. Most of the patient in the present study were spastic quadriplegic type (40%) followed by spastic diplegia in 20% cases. As per gross motor function classification system (GMFCS) grading, maximum number of cases were 16 (26.67%) from grade 4. The most common sequelae in cerebral palsy were speech delay in 49 (81.66%) patients. Cortical atrophy was the most commonly (71.73%) seen abnormality on neuroimaging with CT-scan.</p> <p><strong>Conclusions:</strong> Cerebral palsy is a non-progressive CNS disorder which has a major physical as well as psychological effects on the children as well as their families. The present study highlights the importance of understanding epidemiological and etiological aspects of the disease in Indian scenario.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13105Impact of adverse drug reaction on quality of life in drug resistant tuberculosis2024-01-11T19:04:12+0530Siddharth Chatterjeesristig92@gmail.comArvind Pandeysiddharth_3006@yahoo.com<p><strong>Background:</strong> India has largest population of drug resistant tuberculosis, the treatment of which is long and full of adverse drug reactions. Despite the ongoing research in clinical and pharmacological aspects, quality of life in drug-resistant tuberculosis remains less explored. This study aims to study the quality of life in drug-resistant tuberculosis patients before and after treatment of the adverse drug reactions.</p> <p><strong>Methods:</strong> This hospital based cross-sectional study done in the at tertiary care center in Surat, from January 2019 to February 2020, enrolling patients above 18 years, with multi-drug/ extensively drug resistant tuberculosis, who suffered > 1 adverse drug reaction after commencing treatment. SF-36 was administered at start of treatment and after treatment of first adverse drug reaction, and scores compared. Paired Student T Test was used for comparison of pre - post scores. p -value < 0.05 is considered statistically significant.</p> <p><strong>Results:</strong> Among the 120 patients studied, majority (87.5%) were had pulmonary tuberculosis. 92.5% and 7.2% were multi-drug resistant and extensively drug resistant respectively. A significant improvement in QOL scores was seen in all 3 domains post treatment of adverse drug reaction- physical domain: After vs. Before: 55.2±6.8 vs. 25.2±4.2; (p-value < 0.0001), mental domain: After vs. Before: 66.8±6.7 vs. 39.4±2.1; (p-value < 0.0001) and social domain After vs. Before: 65.4±5.5 vs. 39.7±2.0; p-value < 0.0001).</p> <p><strong>Conclusions:</strong> Drug-resistant tuberculosis along with its associated adverse drug reactions greatly impacts the quality of life in all domains. However, prevention and effective treatment of such adverse effects, especially in systematic protocolised manner can do wonders in improving the life of these patients.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13106Effect of screentime in college students during the COVID-19 online classes on their neck posture and postural control: an observational study2024-01-02T12:29:11+0530Chaitra Bhat P.chaitraphysio07@gmail.comRajina Sajirajinasaji2017@gmail.comRiyas Basheer K. B.riyas2423@gmail.com<p><strong>Background:</strong> Corona virus which is the source of severe acute pulmonary syndrome causes an airway tract contamination (COVID 19). Prolonged sitting for online classes in the college students leads to the enlarged postural deviation, increased low back pain. Prolonged static contraction of skeletal muscles of the cervical region, lower back leads to impaired flow of blood to the muscle groups together with edema and accumulation of waste metabolites will trigger the muscle spasm.</p> <p><strong>Methods:</strong> Total 30 college students aged between 18-25 years who attended the online classes during COVID-19 were included in this study by using a questionnaire. The outcome measures used were the measurement of CV angle, SEBT and BBS. The postural control was estimated by using star excursion balance test and Berg balance scale.</p> <p><strong>Results:</strong> Using Karl Pearson’s correlation coefficient, a positive correlation was observed between CV angle and BBS (r = 0.82). Between BMI and CV angle there exists a statistically significant negative correlation (r = -0.564).</p> <p><strong>Conclusions:</strong> This study proved that there exists a forward neck posture in the students who attended the online classes during the COVID-19 pandemic and that also affected their postural control.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13110Study of automated hematology analyzer’s scatterplot patterns in white blood cell disorders2024-01-02T23:47:31+0530Tanvi Tailortan_93tail@hotmail.comToral Jivanidrtoraljivani@gmail.comAmi Jagirdardrtoraljivani@gmail.comShilpa Pateldrtoraljivani@gmail.com<p><strong>Background:</strong> Automated hematology analyzers produce scattergrams that can be used as screening tool for various hematological conditions and efficiently shorten turnaround times. Aim was to study scattergram patterns of various while blood cell disorders and assess their efficacy compared to a peripheral blood smear for diagnosis of various disorders.</p> <p><strong>Methods:</strong> Scattergram findings generated by UniCel® DxH 800 automated hematology analyzer, a 5-part differential analyzer. The graphic displays have been compiled over a period of 3 months from blood samples received for CBC. Samples that the counter flagged as abnormal for white blood cell were chosen. Based on the scatterplots, a preliminary diagnosis was formed. It was compared with the peripheral blood smear (PBS) findings which were taken as the gold standard.</p> <p><strong>Results:</strong> The scatterplots showed unique patterns for various disorders on the basis of location, shape, size, density of the cells and their clustering. The scattergram analyser showed 90% sensitivity and 88% specificity for diagnosing hematological disorders. A 97-100% accuracy rate was reported showing excellent correlation between PBS result and WBC parameter result in cell counter analyzers.</p> <p><strong>Conclusions:</strong> Not all cases of haematological malignancy exhibit cytopenias or cytosis at initial presentation. Therefore, these scatter plots offer helpful information that prompts a hematopathologist to suspiciously screen the peripheral smear in cases with normal counts. Scattergram analysis suspects a diagnosis earlier than peripheral smear examination. Given their strong correlation with a variety of WBC disorders and confirmed by PBS, WBC scatterplots can be used as a screening tool.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13113Correlation of ultrasonography and fine needle aspiration cytology in diagnosis of hepatic space occupying lesions at Bankura Sammilani Medical College and Hospital2024-01-03T23:19:43+0530Shubhankar Poddarjhaashutosh240@gmail.comApurba Ghoshjhaashutosh240@gmail.comJha Ashutoshkumar Lalankumarjhaashutosh240@gmail.comBibekananda Chinajhaashutosh240@gmail.com<p><strong>Background:</strong> USG can differentiate various types of liver lesions based on their echo features and vascularity on CD then FNAC can be done only for those selected patients who needs further evaluation. Thus, patients with benign lesions based on USG and color Doppler, will be exempted from invasive, painful and time-consuming procedure of FNAC.</p> <p><strong>Methods:</strong> It was an evaluation study of a diagnostic test and was cross sectional in design.</p> <p><strong>Results:</strong> A total of 100 patients with focal hepatic lesions were included in our study group, with 47 cases diagnosed as abscesses, 2 cases were diagnosed as adenoma, 1 case was diagnosed as hepatic cyst, 1 case was diagnosed as cholangiocarcinoma, 22 cases were diagnosed as HCC and 21 cases were diagnosed as metastasis on FNAC. In diagnosis of abscess by USG, sensitivity was 87.23%, specificity was 93.33%, PPV was 93.18%, NPV was 87.5%, diagnostic accuracy was 90.21%. In diagnosis of HCC by USG, sensitivity was 63.64%, specificity was 84.28%, PPV was 56%, NPV was 88.05%, diagnostic accuracy was 79.34%. In diagnosis of metastasis by USG, sensitivity was 52.38%, specificity was 85.91%, PPV was 52.38, NPV was 85.91%, diagnostic accuracy was78.26%.</p> <p><strong>Conclusions:</strong> Our study showed more than 75% diagnostic accuracy in diagnosing the commonest focal liver lesions like abscess, hepatocellular carcinoma and metastatic lesions, by USG as compared to FNAC diagnosis which was considered as confirmatory in our institution.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13117Comparison of outcomes of acute kidney injury in elderly and non-elderly hospitalized patients in a tertiary care hospital in India: a prospective observational study2024-01-04T22:33:03+0530Devada Sindhukdevadasindhu@gmail.comGaurav Shekhar Sharmashekhargaurav2012@gmail.comMinakshi Dharminakshi.dhar@rediffmail.comRanjeeta Kumarirkaiims2012@gmail.comSharon Kandarisharon.nephro@aiimsrishikesh.edu.inSandeep Sainisandeep.nephro@aiimsrishikesh.edu.inDipesh K. DhootDoctordd1986@gmail.comChandrashekhar Cheluvaiahchandrasekar260@gmail.comHimadri Koleydrhimadri.50@gmail.com<p><strong>Background:</strong> The prevalence of acute kidney injury (AKI) progressively increases with age. A higher rate of dialysis dependency and mortality is observed in elderly with AKI. Here we have studied the comparison of clinical features, outcomes of AKI between elderly (age ³60 years) and non-elderly AKI patients and their risk factors for mortality.</p> <p><strong>Methods:</strong> This prospective observational study enrolled 100 patients with AKI, with elderly and non-elderly in a 1:1 ratio for comparison, from September 2021 to January 2023 at AIIMS Rishikesh in India. Detailed history, clinical examination, relevant laboratory and radiological investigations were done to evaluate for the cause of AKI. Etiological causes, complications of AKI, and in-hospital outcomes were observed. They were given standard treatment and dialysis as per standard indications. We analysed the mortality risk of these groups using the Cox proportional hazards model.</p> <p><strong>Results:</strong> The in-hospital mortality rates among these two groups were non-significant (p=0.29). A significantly higher number of patients with non-elderly AKI were HD-dependent at discharge (p=0.027). Elderly patients had significantly lesser complications like uremic encephalopathy and fluid overload compared to non-elderly. There was a significant association between mortality and female gender, intensive care unit (ICU) admissions, hospital-acquired AKI, pre-renal/renal causes, chronic obstructive pulmonary disease (COPD) as comorbidity, multiple organ dysfunction syndrome (MODS), mechanical ventilation requirement, vasopressor support requirement, need for hemodialysis and prolonged ICU stay.</p> <p><strong>Conclusions:</strong> Elderly patients with AKI do not experience worse mortality outcomes than non-elderly patients with AKI. Therefore, elderly patients should not be denied timely treatment, solely based on their age.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13118Sonomammographic and sonoelastographic evaluation of benign and malignant breast lesions and its correlation with fine needle aspiration cytology2024-01-07T17:18:06+0530Khushboo Gourgourkhushboo19@gmail.comRikta Mallikdr.riktamallick@gmail.comAnisha Mondalmailbox.anisha97@gmail.comAbhishek Mondalabhishekmondal592@gmail.com<p><strong>Background:</strong> Breast cancer affects 25.8% of women worldwide. Mammography and ultrasound have sensitivity, but invasive breast biopsies and aggressive biopsies are essential. Sonoelastography is a non-invasive imaging method that can measure tissue stiffness related to different pathologic conditions, such as cancer. Objective is to assess the diagnostic accuracy of sonomammography and sonoelastography in diagnosing breast lesions as benign or malignant in correlation with fine needle aspiration cytology (FNAC) as gold standard.</p> <p><strong>Methods:</strong> This study was conducted on 52 female patients with breast mass and sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), kappa and p value of conventional gray scale ultrasound and ultrasonography (USG) elastography were calculated and compared with that of FNAC. Ultrasound was performed using grayscale and elastography mode on GE LOGIQ P9 ultrasound equipment with a 7-12 MHz linear-array transducer. All cases with breast lesions identified on ultrasound elastography underwent FNAC.</p> <p><strong>Results:</strong> The sensitivity, specificity, PPV, NPV of sonoelastography were 78.5, 94.7, 84.6, 92.3 with kappa 0.75 and p value <0.0001. Similarly, sensitivity and specificity for strain ratio were 85.7 and 97.4, and that for size ratio were 85.7 and 100 respectively. These results are comparable to or better than results for conventional ultrasound.</p> <p><strong>Conclusions:</strong> Breast elastography makes it easier to classify BIRADS 3 category lesions which are benign but still confused as malignant on conventional USG. BIRADS category 3 and 4 lesions with benign findings on sonoelastography can be downgraded to category 2 and 3 respectively thus reducing the number of false positive malignancy cases and biopsy.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13120Expert opinion on the clinical use and benefits of liposomal iron in the treatment of anemia in Indian settings2024-01-05T16:53:57+0530Manjula S.drmanjulas@gmail.comKrishna Kumar M.drmanjulas@gmail.com<p><strong>Background:</strong> Several studies have reported the effectiveness and safety of liposomal iron in increasing hemoglobin levels and correcting anemia. However, there was a dearth of information regarding the prescription pattern of physicians regarding its use and advantages in the actual practice. The present survey-based study aims at gathering clinicians' perspectives regarding the clinical use and benefits of liposomal iron in the treatment of anemia in Indian settings.</p> <p><strong>Methods:</strong> This cross-sectional study used a 19-item questionnaire to gather insights from specialists across different Indian settings regarding their perspectives on anemia and liposomal iron.</p> <p><strong>Results: </strong>Out of 124 participants, 77% opined that liposomal iron was highly bioavailable, achieves much higher plasma iron concentration, and bypasses the extremely restrictive, normal intestinal barriers. Oral liposomal iron was preferred by 77% of clinicians for the rapid increase in hemoglobin level and 99% of clinicians reported improved patient compliance with liposomal iron therapy for anemia. According to 50% of clinicians, oral liposomal iron was effective in non-hemodialysis dependent chronic kidney diseases and 87% of clinicians reported that patients without CKD needed oral liposomal iron. Half of the respondents reported a significant increase in Hb with liposomal iron in both dialysis and non-dialysis patients.</p> <p><strong>Conclusions: </strong>The survey participants reported that liposomal iron treatment for anemia was beneficial in treating both CKD and non-CKD patients. The survey findings have corroborated the advantages of liposomal iron for treating anemia such as increased bioavailability, rapid and effective increase in Hb level, better patient compliance and tolerability, decreased side effects, cost-effectiveness, and flexible dosing.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13127Profile of adverse events in plateletpheresis and plasmapheresis donors in a tertiary care hospital of North India2024-01-06T23:17:56+0530Harnoor S. Bhardwajdr.hsb03@gmail.comRajni Bassirajniajata@yahoo.comKanchan Bhardwajdrkanchan_bhardwaj@yahoo.com<p><strong>Background</strong>: Apheresis procedures are usually well tolerated. Adverse events (AEs) associated with the use of cell separators can be due to delivery of the anticoagulant, vasovagal, allergy, venous access or machines malfunction. Aim was to study the profile of adverse events of plateletpheresis and plasmapheresis donors.</p> <p><strong>Methods: </strong>Plateletpheresis and plasmapheresis procedures enrolled for donors during 2017-2018 were done after taking informed and written consent by using Trima Accel and MCS+cell separator. Donor related AEs were categorised according to severity, site and etiology. Non-donor related (NDR) AEs were kit, technique, or equipment related.</p> <p><strong>Results:</strong> 2859 procedures were done, 2836 (99.19%) plateletpheresis and 23 (0.8%) plasmapheresis. All 145 (5.07%) AEs were seen in plateletpheresis. Majority of AEs, 130 (4.54%) were DR. 15 (0.52%) were NDR. Commonest DR AEs was citrate related (CR) 76 (2.6%), followed by vasovagal reaction (VVR) in 31 (1.08%) and vascular injury in 23 (0.8%). Majority of the AEs were mild in 124 (4.33%), only 6 (0.20%) were moderate. 107 (3.74%) AEs were (VI) systemic, while 23 (0.80%) were local. In local AEs, hematomas were more common. First time donors had more AEs, 62/1234 (5.02%) as compared to the repeat donors 68/1625 (4.18%). CR AEs were more in repeat donors, 46 (2.8%) as compared to first time donors, 30 (2.43%). VVRs and VIs were more in first time as compared to the repeat donors. NDR AEs were 15 (0.52%).</p> <p><strong>Conclusions:</strong> Donor vigilance, trained technical personnel and specialists’ supervision are vital for donor safety hence affecting apheresis donor pool.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13137Relationship between body mass index, liver enzymes and high-sensitivity C-reactive protein in type 2 diabetes mellitus patients2024-01-09T13:20:15+0530Sukhmanjot Kaursandhu.sk.30399@gmail.comRitu Sharmars.gcm1977@gmail.comSukhraj Kaursukhrajkaur2005@yahoo.co.in<p><strong>Background:</strong> Obesity is a frequent co-morbid condition associated with excessive increase in weight. It is one of the most important modifiable risk factors in the pathogenesis of type 2 diabetes mellitus (T2DM). Obesity may be associated with liver disease and the progression of hepatic dysfunction. Also, highly sensitive C-reactive protein (hsCRP), which is elevated in inflammatory situations, can be produced by monocyte-derived macrophages in adipose tissue may also disrupt liver functions.</p> <p><strong>Methods:</strong> A case control study with 50 patients of T2DM and 50 age and sex matched individuals were taken to serve as controls.</p> <p><strong>Results:</strong> The body mass index (BMI) and waist circumference were increased in T2DM patients as compared to controls. However, the variations in liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum alkaline phosphatase (ALP) and hsCRP were increased in individuals of normal BMI as compared with individuals of overweight BMI.</p> <p><strong>Conclusions:</strong> Individuals with normal Body mass index had an increased risk of developing T2DM along with progression of hepatic dysfunction. No associations were observed between chronic low-grade inflammation and BMI and with pathogenesis of obesity-related insulin resistance.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13153A study on the symptoms, sleep quality and cognitive function of the women during menopause2024-01-13T22:21:16+0530Fiza S. H.fizash2000@gmail.comManaswi N.fizash2000@gamil.comPavithra Premanfizash2000@gamil.comGopika Harifizash2000@gamil.comPavan Kalyanfizash2000@gamil.comTesmi Sajanfizash2000@gamil.com<p><strong>Background:</strong> Menopause is the time that marks the end of your menstrual cycle. It is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. The primary objective of the study was to evaluate the pattern of symptoms among women during menopause. The secondary objective was to assess the sleep quality and cognitive function of the women during menopause and to create awareness and educate rural women regarding menopause.</p> <p><strong>Methods:</strong> A cross-sectional observational study was carried out in and around B. G. Nagar, Nagamangala, Mandya for 6 months.</p> <p><strong>Results:</strong> A total of 504 women were enrolled in the study. Out of 504, 224 (44.4%) participants come under perimenopause, 117 (23.31%) participants come under perimenopause and 163 (33.34%) participants comes under post menopause. After filling out the questionnaire it was observed that there was a decline in cognitive function of postmenopausal women along with poor sleep quality. When the age group of the participants was compared with the different symptoms of menopause a significant relation was found between the age category of the participants and the somatic symptoms. A significant relation was found between the sexual activity and with the somatic symptoms (p=0.00**), psychological symptoms (p=0.00**) and urogenital symptoms (p=0.00**) of the participants.</p> <p><strong>Conclusions:</strong> As women passes from premenopausal to perimenopause to post menopause menopausal symptoms were increased. The menopausal transition and postmenopausal years are associated with significant symptoms.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13173Assessment of bacteriological profile and wound infection in open and laparoscopic gall bladder surgery2024-01-17T20:03:19+0530Faizan Rajamubashir.gani72@gmail.comMubashir Ganimubashir.gani72@gmail.comMir Fazil Illahimubashir.gani72@gmail.comAjaz Ahmad Rathermubashir.gani72@gmail.com<p><strong>Background: </strong>Cholecystectomy is one of the most frequent types of abdominal surgery performed in the world. Generally, there is minimal risk of serious postoperative complications. One of the complications is Surgical Site Infection, which can be caused by bile leakage and intraoperative contamination.</p> <p><strong>Methods</strong>: This prospective study was conducted in department of General Surgery, SKIMS medical college Srinagar, from June 2020 to July 2023 comprising of 100 patients. All patients undergoing the procedure were observed for wound infection.</p> <p><strong>Results:</strong> A total of 100 patients were studied with female to male ratio of 2:3. The mean age was 50.24±12.25 with 54% elderly patients. The average hospital stay was 4.02±07. 88% subjects belonged to ASA II Category with Hypertension and hyperthyroidism as common comorbidity. 11 patients got wound infection including 9 from open cholecystectomy and 02 from laparoscopic cholecystectomy with most patients belonging to elderly age group. Wound culture was positive in 9 out of 11 subjects of open cholecystectomy. E. coli was seen to be a major causal bacterial agent. Bile culture was positive in 8 patients. Both genders were almost equally affected by wound infection. Meropenem, Ceftriaxone, Gentamicin and Amikacin showed the highest number of antibiotic sensitivities tested in case of wound cultures.</p> <p><strong>Conclusions</strong>: The prevalence of positive wound culture in uncomplicated laparoscopic cholecystectomy is low as compared to open procedure. Elderly age, co-morbid patients, patients who had history of jaundice, recent history of cholecystitis were at higher risk of wound infections.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13174A retrospective study on the surgical management and outcome of congenital diaphragmatic hernia in neonates2024-01-17T22:26:05+0530Javaid Iqbal Gulshandjigq2222@gmail.comSanjay Rainadjigq222@gmail.comA. Hamid Wanidjigq222@gmail.com<p><strong>Background:</strong> Congenital diaphragmatic hernia is a developmental disorder in the anatomy of the diaphragm, which can range from the presence of a thin sac to the frank absence of part of the diaphragm. It results in protrusion of abdominal contents in the chest. CDH once considered as a surgical emergency is no longer a valid dictum. But definitive management of CDH is the surgical correction of defect. Study the demographics, presentation, diagnosis, and surgical outcomes of congenital diaphragmatic hernia (CDH) repair without significant associated congenital anomalies at a tertiary care institute.</p> <p><strong>Methods:</strong> This was a retrospective study over 3 years from January 2021 to December 2023. Data was collected and noted from the medical records department. Patient’s clinical data in terms of demography, presentation, radiology, preoperative condition, timing of surgery after admission, intra-operative findings and post-operative course (including postoperative complications, duration of NICU stay, the incidence of sepsis, and need of inotropes), etc.</p> <p><strong>Results:</strong> Most patients were male (85%). Among the total cohort, 70% were born outside the tertiary care institute and were referred from peripheral hospitals. Respiratory distress was the predominant complaint (85%). Congenital diaphragmatic hernia (CDH) was incidentally discovered in 5% of neonates. The majority of patients (70%) underwent surgical intervention between the 3rd postnatal day and up to one week. Left-sided herniation was observed in 90% of cases. An identifiable hernial sac was found in 18% of patients, with part or the entirety of the stomach being the most frequently encountered herniated viscera.</p> <p><strong>Conclusions:</strong> Congenital diaphragmatic hernia (CDH) presents as a significant congenital anomaly in the pediatric surgery domain. Hidden mortality in case of CDH leads to underreporting of the actual incidence of the condition. The success of surgical intervention depends on a myriad of factors, encompassing patient-specific attributes and surgical methodologies. However, instances devoid of overt congenital anomalies and featuring stable preoperative physiological parameters typically yield satisfactory surgical outcomes, with favorable results.</p> <p> </p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13184Association of genetic and epigenetic modification in MTHFR gene with coronary artery disease patients in North Indian population2024-01-19T22:35:39+0530Alka Ramtekealka_ramteke@yahoo.comAmita Yadavdramita.md@gmail.comAmol Parshram Anbhuledoctoramol2009@yahoo.co.inAnju Bansaldranjubansal@gmail.comSandeep Bansaldrsbansal200@yahoo.com<p><strong>Background:</strong> Methylene tetra hydro folate reductase (MTHFR) gene polymorphism C677T (rs180113) and DNA methylation in promoter region of MTHFR gene may contribute to the development of coronary artery disease however the results have been inconsistent across studies with different populations, so the aim of our study is to explore the association of polymorphism in MTHFR gene and methylation in promoter region with coronary artery disease (CAD) and other risk factor (lipid profile, homocysteine, vitamin B<sub>12</sub> and folic acid levels) leading to CAD in of north Indian population.</p> <p><strong>Methods:</strong> Total 100 CAD patients and 100 healthy controls were enrolled in the study. Genotyping of rs1801133 SNP (C677T) is done by PCR-RFLP and DNA methylation study in promoter region by methylation specific PCR. Lipid profile analysis by automated chemistry analyzers, serum homocysteine, folic acid and vitamin B<sub>12</sub> was assayed by ELISA.</p> <p><strong>Results:</strong> As per our finding the T allele (OR=3.03, 95% CI=1.74-5.27) and hyper methylation in promoter region of MTHFR increases the odds of coronary artery disease, (OR=3.05, 95% CI=1.7-5.6). Study participants with CT and TT genotype had significantly higher homocysteine (Hcy) (p=0.001), lower folic acid level (p=0.0), and HDL levels (p<0.0001) than those with CC genotype. The study subjects with hyper methylated promoter region have a significantly high homocystenemia levels (p=0.001).</p> <p><strong>Conclusions:</strong> The TT genotype of the MTHFR C677T gene polymorphism and hyper methylation in promoter region of MTHFR, is associated with CAD and can be useful in identification of new biomarkers, development of preventive and therapeutic strategies for CAD.</p> <p> </p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13188Effect on haemodynamic parameters following spinal anaesthesia in sitting versus left lateral position for lower segment caesarean section: a comparative study2024-01-22T18:13:39+0530Noorjahannoorjahanmiss@gmail.comMaharabam Binaranibina.maharabam@gmail.comDhayanithy M.drdhaya8004@gmail.comSophia Koyusophia.koyu@gmail.comLippi Lollenlollenlippi@gmail.comVigneshwaravibhava K.vkvibhava@gmail.com<p><strong>Background:</strong> The percentage of caesarean deliveries carried out under spinal anaesthesia has greatly increased over the last 20 years. However, hypotension remains the most common complication of spinal anaesthesia.</p> <p><strong>Methods:</strong> The study groups divided into two, named group S and group L. The total sample size was 76, 38 patients in each group. All the patients were given 2 ml of hyperbaric bupivacaine (0.5%) in L<sub>3-4</sub> midline intrathecal space in sitting position in group S, and in left lateral position in group L.</p> <p><strong>Results:</strong> The comparison of heart rate showed that there was less heart rate fluctuation in group S. Statistically significant difference in mean systolic and diastolic blood pressure was seen between the groups during 2<sup>nd</sup> to 6<sup>th</sup> minutes, with more stability in group S. The mean MAP was found to be statistically significant in between 2 to 6 minutes and after 25 minutes. The mean onset time of hypotension in the group S was 17.07±7.98 minutes and that in the group L was 11.54±4.66 minutes.</p> <p><strong>Conclusions:</strong> There were no significant differences in the time to reach sensory block level T6, degree of motor blockade (Bromage scale), neonatal outcome and complications in between the two groups. However onset of spinal anaesthesia is faster in the lateral position. Similarly hypotension is more in the left lateral position. The insignificant difference in block height could be because of adjustments in table position.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/12875Case series to study the clinical features, risk factors, prognostic factors, and to assess the different management modalities of EPN and its outcomes2023-10-18T22:29:01+0530Udit Jainudit.jain24@gmail.comYashwanth Kumar Gaddamyashwanthkumar2@gmail.comSreedhar Dayapulesreedh2003@gmail.comDinesh Kumar Ravi dineshkumarraavi@gmail.com<p><strong>Background:</strong> Emphysematous pyelonephritis is an acute necrotising infection of the kidney, often associated with high rate of renal loss and mortality. EPN mostly present with triad of fever, flank pain and nausea. The diagnostic tool of choice is CT KUB. <em>E. coli</em> is the most common pathogen.</p> <p><strong>Methods:</strong> It was prospective study done on 52 patients who were diagnosed to have EPN from department of nephrology and urology in Narayana Medical College, Nellore from March 2022 to January 2024. The diagnosis of EPN was confirmed by plain CT KUB scan.</p> <p><strong>Results:</strong> Among 52 patients 48 patients had diabetes mellitus (DM). left kidney involved in 28 patients and right kidney involved in 16 patients and bilateral kidney involvement in 8. Fever (92%), flank pain (88%) are the most common presentation in patients. Shock during initial presentation was seen in 19.5% of patients. <em>E. coli</em> growth was seen in 26.9% cases. 8 patients were treated conservatively with antibiotics according to culture and sensitivity. 32 patients required double J stenting, 7 patients required percutaneous nephrostomy. Nephrectomy was done in 5 patients. Mortality rate in our study was zero.</p> <p><strong>Conclusions:</strong> Nephrectomy should be promptly attempted for patients not responding to conservative methods. Pre-existing CKD status, shock at presentation and altered sensorium are the factors determining the prognosis and management.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Scienceshttps://www.msjonline.org/index.php/ijrms/article/view/13272Effect of photo-biomodulation therapy in decreasing postoperative pain after surgical removal of third molars compared to other treatment therapies: a systematic review2024-02-15T20:04:15+0530Shreya Gangulyshreyathomasina1996@gmail.comAsish K. Dasadasmds@gmail.comSubhasish Burmansbhsshburman@gmail.comAbhijit Majidr.abhijitmajiomfs@gmail.comAbhishek Khatuaabhishekkhatua@gmail.com<p>Post-operative pain, discomfort, and trismus are common postoperative complications after surgical extraction of third molars. Various therapeutic approaches like prescribing analgesic drugs, corticosteroids, and Non-steroidal anti-inflammatory drugs are followed to reduce these complications. Photo-biomodulation therapy (PBMT) utilizes a monochromatic light source that shows effects in all phases of inflammation by reducing edema, redness, heat, and pain. In vivo studies were searched to evaluate postoperative pain levels in patients who underwent photo-biomodulation therapy following extraction of impacted third molars. A comprehensive search was done from January 2023 to July 2023 in PubMed electronic databases. In addition, a manual search of the references mentioned in the studies and gray literature was done. The literature search yielded a total of 157 studies through a search in the electronic database PubMed. Among all the studies, 51 duplicate records were removed. Ninety-seven studies were removed after screening of titles and abstracts. A total of 9 studies were included for full-text reading. Five studies were included (one randomized single-blind study, two randomized double-blind split-mouth studies, and two randomized clinical trials) in the review. Four out of five studies that were included in this review demonstrated a positive impact of PBMT on reducing pain, especially during the post-operative period compared to other non-surgical treatment protocols. Photo-biomodulation therapy demonstrated an overall positive impact on reducing postoperative complications like edema and trismus.</p>2024-02-28T00:00:00+0530Copyright (c) 2024 International Journal of Research in Medical Sciences