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   Table of Contents - Current issue
Coverpage
July-September 2018
Volume 13 | Issue 3
Page Nos. 119-162

Online since Thursday, January 17, 2019

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ORIGINAL ARTICLES  

To observe the proportion of amblyopia among children presenting in a rural hospital in Central India p. 119
Sachin Daigavane, Madhumita Prasad
DOI:10.4103/jdmimsu.jdmimsu_50_18  
Objectives: • To screen the children attending the ophthalmology OPD • To know the profile and cause of amblyopia. Materials and Methods: A Cross-sectional study was conducted between August 2017 to February 2018. Children aged 5-20 years were recruited in the study. Children <5 years due to resistance to examination and poor communication were excluded. Visual Acuity and pen light ophthalmic examination were performed for 300 children. Mean age range was 8-12 years. 250 children were from rural areas and 50 from urban areas. Children were subjected to full ophthalmic examination including slit lamp and fundus examination in addition to cycloplegic refraction. Children having vision <6/12 without organic lesion were included in the study. Results: 13 children had amblyopia. The main cause was anisometropia 7 (53%), followed by strabismus 3 (23%), isometropia 2 (15%), and finally deprivation 1 (8%) 7 unilateral and 6 bilateral cases were observed. Conclusion: There is lack of awareness of parents because of illiteracy and ignorance. It is mandatory to improve the facility for checkup and frequent eye screening for refractive errors and strabismus examination and corneal blind and cataract for school children. This Study emphasizes need for time to time eye screening for school children. Amblyopia can have devastating psychosocial and economical fall outs.
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Immunohistochemical evaluation of expression pattern of p53, p63, and p73 in epithelial dysplasia p. 122
Deepali Prakash Mohite, Alka H Hande, Rolly Gupta, Minal S Chaudhary, Prakash M Mohite, Swati Patil, Madhuri Gawande
DOI:10.4103/jdmimsu.jdmimsu_64_18  
Objective: The objective of this study was to evaluate the expression pattern of p53, p63, and p73 in different grades of epithelial dysplasia through immunohistochemical (IHC). Materials and Methods: 30 cases of epithelial dysplasia and 10 samples of normal buccal mucosa were included in the study. The cases with epithelial dysplasia were classified as mild, moderate and severe. Immunohistochemical staining was carried out using monoclonal mouse anti-human antibody against p53, p63, and rabbit polyclonal antibody against p73. Labelling index was calculated. The numbers of positively stained nuclei were expressed as a percentage of the total number counted for individual layer and in complete epithelium. The number of cells positive for p63 protein immunoexpression was higher than that for p53. Significant difference in positivity was observed with respect to p53 and p63 amongst all the grades of dysplasia. In severe dysplasia, significantly higher expression of p63 was observed. Expression of p53 was significantly higher in severe dysplasia than mild dysplasia and normal tissue. p73 was observed to be non significant amongst all grades of dysplasia and in normal tissue. Significant positive correlation was noted between p63 and p53 in severe dysplasia. Study Design: Thirty cases of epithelial dysplasia and 10 samples of normal buccal mucosa were included in the study. The cases with epithelial dysplasia were classified as mild, moderate, and severe. IHC staining was carried out using monoclonal mouse anti-human antibody against p53, p63, and rabbit polyclonal antibody against p73. Labeling index was calculated. The numbers of positively stained nuclei were expressed as a percentage of the total number counted for the individual layer and in the complete epithelium. The number of cells positive for p63 protein immunoexpression was higher than that for p53. Significant difference in positivity was observed with respect to p53 and p63 among all the grades of dysplasia. In severe dysplasia, significantly higher expression of p63 was observed. Expression of p53 was significantly higher in severe dysplasia than mild dysplasia and normal tissue. p73 was observed to be nonsignificant among all grades of dysplasia and in normal tissue. Significant positive correlation was noted between p63 and p53 in severe dysplasia. Results and Conclusion: Our results indicate that increase in the severity of dysplasia correlates with increase in expression of p53 and p63. Increased immunoexpression of p53 and p63 may help in identifying those cases of epithelial dysplasia which can transform into carcinomas. p53 alongwith p63 is a better indicator of progression of dysplasia toward malignancy rather than p53/p63 alone. This can serve as a useful prognostic indicator and also an indicator of treatment outcome.
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Local infiltration anaesthesia for lateral internal anal sphincterotomy; a safe and effective alternative to regional or general anaesthesia p. 130
D Kishan, Gayatri Priyanka Gadiraju
DOI:10.4103/jdmimsu.jdmimsu_46_18  
Background: Chronic fissure in ano is one of the most common anal disorders in all age groups which causes significant distress to the patient even though the disease is benign in nature. Several treatment options are available ranging from medical to surgical of which surgical division of sphincter, lateral internal anal sphincterotomy, is one the most common surgical procedures done to relieve anal sphincter spasm and aid healing of fissure. Most commonly, surgery for fissure in ano is performed under regional or general anesthesia due to severe pain associated with disease. Patient acceptance is also low as the perianal area is very sensitive to pain which may be aggravated by patient positioning during surgery. Materials and Methods: This is a prospective study was done in Osmania General Hospital over a period of 3 years in patients who were treated in our unit with acute and chronic fissure in ano. All patients were counseled regarding disease and treatment options. Informed and written consent was obtained from all patients willing to undergo sphincterotomy under local anesthesia. These patients include females and males >15 years of age and also patients having medical comorbid conditions, such as chronic obstructive pulmonary disease, uncontrolled diabetes, and others in whom surgery under regional or general anesthesia was deferred or contraindicated due to high risk. Results: All lateral internal anal sphincterotomies were performed under local anesthesia. There was significant pain relief following surgery. Intraoperative complications related to administration and drug, and surgery were negligible, and the duration of surgery was very less compared to regional or general anesthesia cases. Patient acceptance was also very good as local anesthesia provided good pain relief during and after surgery and fissure healing rates were high with less complications and no recurrences. Conclusion: Local infiltrative anesthesia is a very effective and safe form of anesthesia for lateral anal sphincterotomy for acute and chronic fissure in ano in terms of minimal complications, ease of giving anesthesia, and cost-effective as no extensive pre-operative preparation and investigations are required. It can also be safely administered in all age group, and also in patients with medical comorbid conditions which precludes administration of spinal or general anesthesia.
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Oral treatment of urinary tract infection: Could the answer lie in a sachet? p. 135
Simit Kumar, Maitreyi Bandyopadhyay, Abhishek Sengupta, Manas Kumar Bandyopadhyay, Prabir Kumar Mukhopadhyay, Mitali Chatterjee
DOI:10.4103/jdmimsu.jdmimsu_96_17  
Introduction: Fosfomycin trometamol is a phosphonic acid derivative, which acts primarily by interfering with bacterial peptidoglycan synthesis with broad spectrum of activity against agents causing urinary tract infections (UTIs) with good antibiofilm activity and limited reports of resistance. There are limited studies from India regarding the efficacy of the drug, so the study was conducted to determine the in vitro efficacy of fosfomycin. Materials and Methods: Two hundred and thirty nonrepetitive urinary isolates over a period of 4 months were included in the study. Antibiotic susceptibility and extended-spectrum β-lactamase (ESBL) detection following the Clinical and Laboratory Standards Institute guidelines were performed. Results: One hundred and seventy (73.91%) out of the 230 urinary isolates were sensitive to fosfomycin in our study with equivalent efficacy among outdoor and indoor patients. Among the Gram-positive isolates, 34 (60.71%) out of 56 isolates were sensitive to fosfomycin. Among the Gram-negative isolates, 136 (78.16%) out of 174 were sensitive to fosfomycin which was higher than other commonly used drugs for UTI. ESBL production did not affect the overall susceptibility to the drug. Conclusion: The convenience of a single-dose regimen, broad range of activity proven in vitro and in vivo, and minimal propensity for promoting resistant pathogens make fosfomycin an attractive regimen for the treatment of complicated and uncomplicated community- and hospital-acquired UTIs. This study also reveals an alarming finding of high level of resistance among Klebsiella spp., which could well turn out to be a limiting factor in the clinical usefulness of this drug, which warrants further clinical studies regarding the drug in India.
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Analysis of diadochokinesis in persons with Parkinson's disease Highly accessed article p. 140
Santosh Kumar, Puranjit Kar, Deepak Singh, Mukesh Sharma
DOI:10.4103/jdmimsu.jdmimsu_66_18  
Background: Parkinson's disease (PD) is a chronic and progressive disorder of movements of body parts which affect muscles of face, mouth, and throat. This can lead to affect the speech production in various aspects such as changes in voice, difficulty in forming sounds, and slow speech rate. Diadochokinetic (DDK) rate is the most common measures to see the speech production in persons with PD. Methods: This study was carried out on seven persons with PD with the control of medications and compared with the age- and gender-matched control group. Speech sample of DDK (alternating motion rate and sequential motion rate) was recorded in quiet environment. All the participants were instructed to produce syllable with rapid rate in a single breath. PRAAT software was used for the analysis of speech rate. Result and Conclusion: DDK rate was lower in PD group compared to control group. This could be due to limited muscle control and movements of lips and tongue.
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Physical growth pattern among adolescents from Satara District: Using sitting height, leg length, and other anthropometric measurements p. 143
Supriya Satish Patil, Satish R Patil, Prakash M Durgawale
DOI:10.4103/jdmimsu.jdmimsu_56_18  
Background: Adolescent is a transitional phase between childhood and adulthood. Apart from height and weight other anthropometric measurements such as sitting height and leg length are also useful in assessment of physical growth pattern. Aims and Objectives: The objectives of this study is to develop mean and standard deviation (SD) for sitting height, leg length, biacromial diameter, bicristal diameter etc., and to compare them with the national Indian council of medical research standard and other study reference values. Materials and Methods: Cross-sectional school-based study was carried out in Satara district. Data were analyzed using SPSS software version 20 for windows. Results: During 10–15 years of age, sitting height increased by 12.10 and 8.44 cm for boys and girls, respectively. The peak sitting height velocity was observed at 13–14 years in boys and 12–13 years in girls. During 10–15 years of age leg length was increased by 14.86 and 10.58 cm for boys and girls, respectively. Thus, both boys and girls have more increase in leg length as compared to sitting height. There is proportionately more increase in shoulder width than the hip width in case of boys whereas girls showed a more increase in hip width. Conclusions: As there are very less studies regarding other anthropometric measurements such as sitting height, leg length, and biacromial diameter it is necessary to carry out regional and national studies to develop standard/reference values for these anthropometric measurements.
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Health status of inmates in an open prison: A cross-sectional study in Eastern India p. 150
Arijit Kundu, Lipilekha Patnaik, Trilochan Sahu, Surjeet Sahoo, Sandeep Kumar Panigrahi
DOI:10.4103/jdmimsu.jdmimsu_98_17  
Background: The physical and mental health among prisoners is worse than the general population as their health is usually ignored. Objectives: The main objectives of this study is (1). To assess the physical, mental, and social well-being of the inmates of an open prison. (2). To find out the association of duration of stay in open prison with psychiatric well-being and depression among them. Subjects and Methods: It was a cross-sectional study conducted from June to October 2016 among the prisoners of an open prison. A total of 71 inmates out of 86 were included after taking necessary permission and consent. Data were collected by the semi-structured questionnaire, including the personal data sheet, General Health Questionnaire-12, and Hamilton Rating Scale for Depression and Anxiety. Mean and standard deviation, proportions, and correlation were used to analyze the data. Results: This jail was meant only for males. Mean age of the participants was 46 ± 10.99 years. Among the inmates, 23.9% were current smokers. Among them, 46.5% had mild depression and 2.8% had moderate depression. There was statistically significant negative correlation between the duration of stay in open prison with psychiatric well-being (r = −0.318; P = 0.007) and with depression (r = −0.307; P = 0.010). Nearly 87.3% of the participants said that open prison is better than the conventional prison. Conclusion: Thus, it may be said that open prison is a better place for maintaining a healthy lifestyle among the inmates. Periodic psychiatric check-up and counseling should be more strengthened for the betterment of inmates.
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CASE REPORTS Top

Enhancing the esthetics with all-ceramic prosthesis p. 155
Abhilash U Dudhekar, Sharayu Vinod Nimonkar, Vikram Murlidhar Belkhode, Anjali Borle, Rajiv Bhola
DOI:10.4103/jdmimsu.jdmimsu_78_18  
All-ceramic restorations are widely and successfully used for a fixed dental prosthesis. The properties such as biocompatibility, high strength, and superior esthetic have made this veneering material popular among the dental practitioners and patients. This case report describes the enhancement of esthetics by replacing missing anterior teeth with a zirconia-based all-ceramic prosthesis.
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Massive intracerebral and intraventricular hemorrhage following ventriculoperitoneal shunt p. 158
V Anil Kumar, Yashawant Sandeep, Amit Agrawal
DOI:10.4103/jdmimsu.jdmimsu_15_18  
Post-ventriculoperitoneal (VP) shunt placement intracerebral hemorrhage is a rare complication and carries a high mortality. In the present article, we describe a case of a 22-year-old male who underwent VP shunt placement and developed massive intracerebral hemorrhage with intraventricular extension and review the relevant literature to understand the underlying causative pathophysiology.
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COMMUNICATION Top

Magnetic resonance imaging mishaps: A brief review p. 160
Shakeel Santerbennur Khazi, Shishir Ram Shetty, Sesha Manchala Reddy, Venkata Ramana Vannala, Raghavendra Manjunath Shetty, Praveen Shetty
DOI:10.4103/jdmimsu.jdmimsu_63_18  
Imaging and laboratory test are vital components for accurate diagnosis of any medical condition. In the current scenario, computerized tomography and magnetic resonance imaging (MRI) have dominated the field of imaging. Although much is spoken and written about the radiation hazards of computerized tomography, safety aspect of MRI hardly receives any importance. A recent accident involving a diagnostic MRI unit in Mumbai highlights the importance of safety aspects being neglected in MRI. The authors of this article have made an attempt to highlight the facts about MRI-related fatal accidents and briefly review the safety protocol and procedures.
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LETTER TO EDITOR Top

Global prevention and containment of gender-based violence p. 162
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
DOI:10.4103/jdmimsu.jdmimsu_11_16  
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