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   Table of Contents - Current issue
April-June 2018
Volume 13 | Issue 2
Page Nos. 79-117

Online since Friday, November 23, 2018

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The study of carotid intima-media thickness in prediabetes and its correlation with cardiovascular risk factors p. 79
Hirday Pal Singh Bhinder, TK Kamble
Background: Metabolic syndrome, insulin resistance, so-called prediabetes (impaired glucose tolerance and impaired fasting glucose), and overt type 2 diabetes are all associated to more extensive and even premature atherosclerosis both in the coronary and the carotid arteries. They are all found to be associated with cardiovascular risk factors. Carotid intima-media thickness (CIMT) is considered surrogate marker of atherosclerosis. Early and cheap method of detecting atherosclerosis rules out the burden of cardiovascular disease in society. Materials and Methods: This was a prospective case–control study of CIMT in patients having prediabetes. A total of 100 patients of prediabetes and equal number of age- and sex-matched controls were enrolled. Bilateral assessment of IMT was done in common carotid artery. Statistical analysis was done using descriptive statistics and inferential statistics, using Chi-square test, odd's ratio, Pearson's correlation coefficient and multiple regression analysis. The software used in this analysis was SPSS version 17.0 and GraphPad Prism version 5.0. P <0.05 was considered as a level of statistical significance. Results: About 56% of cases were male and 44% were females, and in controls, 58% were male and 42% were female. Mean age of cases was 45.06 ± 13.08 and that of controls was 44.15 ± 13.64. Mean value of CIMT for cases (0.79 ± 0.06 mm) was higher than for controls (0.72 ± 0.02 mm). The difference between the two groups was found to be statistically significant (P < 0.05, S). Conclusion: Mean CIMT was higher in prediabetes group in comparison to controls; however, in both groups, CIMT was not in the abnormal range. Body mass index and waist-hip ratio were significantly higher in prediabetes as compared to controls. Systolic and diastolic blood pressures were significantly higher in prediabetes as compared to controls. Total cholesterol, low-density lipoprotein (LDL), triglyceride (TG), and very LDL were significantly higher in prediabetes, and high-density lipoprotein (HDL) was significantly lower in prediabetes as compared to controls. According to this model, among cases, serum Tg and age were found to be responsible for the maximum variability of CIMT.
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A comparative study of serum lipid profile of women with preeclampsia and normotensive pregnancy p. 83
Shreya Yadav, Manjusha Agrawal, Chela Hariharan, Deepika Dewani, Kavita Vadera, Nilay Krishna
Introduction: Preeclampsia is associated with substantial risks for the fetus and the mother. Women with preeclampsia have a significant difference in lipid parameters compared to normal pregnancy. The association of serum lipid profile with gestational proteinuric hypertension is highly suggested to reflect a new diagnostic tool. Materials and Methods: The present study is a prospective case–control comparative study done over a period of 2 years, i.e., from October 2015 to July 2017. The study takes into account 100 normotensive pregnant women (control group) and 100 pre-eclamptic women (study group) in their third trimester of pregnancy. Serum total cholesterol (TC), triglycerides (TGs), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-C (HDL-C), and very LDL-C (VLDL-C) were estimated in both groups. Aims: The study aims to analyze the lipid profile in normotensive pregnant patients, to analyze the lipid profile in pregnancy-induced hypertension patients, and to investigate the alteration in lipid profile in both groups. Results: There was a significant rise in serum TC, TGs, LDL-C, VLDL-C, and a significant decrease in HDL-C in the study group as compared to controls. Conclusion: Altered lipid profile also has a potential role in the genesis of endothelial dysfunction and expression of preeclampsia. Early detection of these lipid parameters may help pregnant patients by preventing maternal and fetal complications in preeclampsia and is going to aid in better management of preeclampsia.
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A study of prevalence and determinants of irritable bowel syndrome in an urban slum community in Mumbai p. 87
Shashikant Narayan Nagaonkar, Vijaykumar Sukhdev Singh, Digambar Tulshiram Kangule, Snehashree Sadhanala
Context: Prevalence of irritable bowel syndrome (IBS) in Indian community according to studies varies from 10% to 20%. Only 20% seek medical care which is just a tip of an iceberg. Early detection is needed as it affects the quality of life markedly. Magnitude is not known in slums of Mumbai due to scarcity of studies. Aims: The aim of the study was to study epidemiological factors related to IBS in an urban slum population. Settings and Design: This study design was a cross-sectional and conducted in urban slum. Subjects and Methods: The study was conducted among the slum population by systematic random sampling with a predesigned, pretested, semi-structured questionnaire as a study tool. Statistical Analysis Used: Statistical analysis used Excel and SPSS software packages. Results: The prevalence of IBS was 12.27%, of which 56% were males and 44% were females. Majority were aged between 25 and 44 years (66%) and married (64%). Most common symptoms were relief of pain after bowel movement (68%), change in frequency of stools (65%) with 51.52% showing diarrhea-predominant subtype, and only 15.15% had visited a gastroenterologist. Psychiatric disorders, sexual dysfunction, and pelvic pain each at P < 0.01 and decreased quality of life (P < 0.01) had shown a significant association with IBS. Conclusions: Psychiatric disorders, sexual function, work absenteeism, pelvic pain, and gastroesophageal reflux diseases were significantly associated with IBS, while sex, marital status, religion, and socioeconomic status were not.
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Nasal carriage of Staphylococcus aureus among undergraduate medical students: Prevalence and antibiogram including methicillin resistance, inducible clindamycin resistance, and high-level mupirocin resistance p. 91
Ruhi Munjal, Gargi Mudey
Background: Treatment of infections caused by Staphylococcus aureus has become more problematic since the development of methicillin-resistant S. aureus (MRSA). Medical students carrying S. aureus can be a potential source of infection to the patients. The anterior nares have been shown to be the main reservoir of S. aureus in both children and adults. Hence, the study was carried out to find out the prevalence of nasal carriage of S. aureus and its antimicrobial resistance pattern in undergraduate medical students. Materials and Methods: Nasal swabs of undergraduate medical students were collected aseptically and cultured using standard microbiological methods. Antibiotic susceptibility was done by disc diffusion method as per the CLSI guidelines. Results: The prevalence of S. aureus nasal carriage was 16%. The prevalence of MRSA and inducible clindamycin resistance was 5% and 3.5%, respectively. No isolate showed high-level mupirocin resistance. Interpretation and Conclusions: Nasal carriage of S. aureus is a major threat for public health and required surveillance.
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Internet addiction and its correlates among undergraduate college students in Udupi Taluk, Karnataka p. 95
Binita Sharma, Lena Ashok, Varalakshmi Chandrasekaran, Ashma Monteiro
Background: Due to the rapid expansion of technology, internet has become the most vital part of human life and youth are found to be more dependent on it for various purposes. Aim: This study aims to estimate the prevalence of internet addiction and identify its associated factors among undergraduate college students. Materials and Methods: A cross-sectional study design was adopted. A total of 1304 college students were included through convenient sampling. A self-administered questionnaire was used which consisted of a semi-structured pro forma on sociodemographic profile, characteristics of internet usage, Young's Internet addiction test and depression, anxiety and stress test. Descriptive statistics were reported, and Chi-square test was used to assess the relationship between expected outcomes. Results: Out of the total 1304 participants, 716 (54.9%) were females and 588 (45.1%) were females. The mean age of the participants was 19.16 years. The prevalence of internet addiction was found to be 44% and it was significantly associated with factors such as gender, father's occupation, mother's education, availability of personal gadgets, use of smartphone, exposure to internet at young age; and with increase in internet addiction, there was subsequent increase in the level of depression, anxiety, and stress. Conclusion: Although internet technology is considered the most effective tool and one is compelled to use it for various purposes, however, every individual should be able to recognize the point where internet starts to overrule one's life and further hinders other activities of daily living.
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Impact of an educational intervention in improving the body mass index and waist–hip ratio among first-year MBBS students p. 100
Arvind Kumar Pandey, Sushma R Kotian, Anne D Souza, Kavitha Vishal, Raviraj V Acharya, K Annapoorna, Sneha Guruprasad Kalthur
Background: Unhealthy lifestyle practices and physical inactivity may lead to overweight, obesity, and other noncommunicable diseases. For an undergraduate medical student, the 1st year is a dynamic transitional period of development and growth. An educational intervention if planned at this crucial stage may help to improve the health status of the students. The present study was therefore designed to evaluate the impact of a multidisciplinary educational intervention in improving the body mass index (BMI) and waist–hip ratio among the undergraduate medical students. Materials and Methods: Hundred and seventy-seven 1st-year undergraduate medical students (74 males and 103 females) participated in the study. A multidisciplinary educational intervention was provided to promote a healthy lifestyle. The parameters such as BMI and waist–hip ratio were measured both in the baseline and 3 months after the educational intervention. The BMI calculated was used to categorize the student population into four groups: normal, overweight, obese, and underweight. Results: After the educational intervention, a significant difference was observed in the BMI, the hip circumference, and the waist/hip ratio (<0.001). The waist circumference although showed a decrease, the finding, however, was not significant statistically. Further, the obesity among the student population also observed a marked reduction. The comparison of the parameters among the male and the female students did not show any statistical difference. Conclusion: A multidisciplinary educational intervention on healthy lifestyle practices aids to enhance the health status of an individual by improving the BMI and waist/hip ratio. It would further contribute to a medical student's role in promoting a healthy lifestyle.
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Uncommon presentation of inflammatory gingival enlargement: Resolution by means of nonsurgical periodontal therapy only p. 104
Bindu Suresh Singh, Priyanka Ganesh Jaiswal, Prasad Vijay Dhadse, Ankita Arun Agrawal, Vikas Vilas Pakhare
Gingival enlargement is caused by gingival inflammation, fibrous overgrowth, or combination of both, leading to adverse consequences, such as difficulty in plaque control, mastication, altered speech, and esthetic and psychological problems. A 19-year-old male reported with the chief complaint of difficulty in mastication due to swelling of the gingiva for the past 6 months that bled profusely on slight provocation. The lesion gradually increased in size and similar lesions developed in other areas of the jaw, leading to unusual generalized massive gingival enlargement. Within a month of nonsurgical therapy which included supragingival and subgingival scaling, followed by oral hygiene instructions, enlargement reduced significantly. Complete resolution of the inflammatory gingival enlargement was observed after 3 months of nonsurgical therapy without any surgical intervention. Therefore, it will not be an exaggeration to say that scaling is still the gold standard treatment modality in the treatment of plaque-induced gingival enlargement.
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Brain stem arteriovenous malformations: Was preoperative diagnosis possible in this case? p. 108
Amit Agrawal
Arteriovenous malformations (AVMs) involving brain stem in children are uncommon. These lesions usually present as hemorrhage as the first manifestation. When these lesions present both clinically and radiologically as a mass lesion without hemorrhage, it is very difficult to make a preoperative diagnosis of AVM as in the present case. With sophisticated imaging modalities, it may be possible to suspect this diagnosis; however, with limited facilities still, it will be difficult to approach these lesions as in present case.
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Cotyledonoid dissecting leiomyoma of the uterus p. 111
Arti Gupta Tuli, Sunita Goyal
This is a rare case of Cotyledonoid Dissecting Leiomyoma (CDL) in a 50 year old lady. She was evaluated for heavy menstrual bleeding and congestive dysmenorrhea. Her ultrasonogram pelvis and MRI pelvis revealed a large cystic space occupying lesion in pelvis situated in pouch of douglas measuring 7x4 cm with peripherally arranged hemorrhagic cyst, largest measuring 3.3X2.7 cm likely to be of left ovarian origin. She was taken up for Laparoscopy proceed laparotomy which revealed normal uterus with bilateral fallopian tubes and ovaries. A 10x10 cm exophytic, fleshy, serosal, polypoidal mass originating from posterolateral wall of uterus giving an impression of malignancy was noted. Total abdominal hysterectomy with bilateral salpino-oopherectomy was done and specimen sent for histopathological examination. HPE report showed it to be CDL which was benign.
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Intracranial ossified metaplastic meningioma: Unusual cause of headache p. 114
Venkatraman Indiran
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Role of carcinoma-associated fibroblasts in “anoikis resistance” for oral squamous cell carcinoma: Need of the hour p. 116
Anjali P Ganjre
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