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   2017| January-March  | Volume 12 | Issue 1  
    Online since July 25, 2017

 
 
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ORIGINAL ARTICLES
Assessment of maternal and perinatal outcome in postdated pregnancy
Ritika Bhriegu, Manjusha Agrawal, C Hariharan
January-March 2017, 12(1):35-40
DOI:10.4103/jdmimsu.jdmimsu_20_17  
Objective: To study maternal and neonatal outcome in postdated pregnancies. Study Design: Prospective observational study. Results: Of 100 cases 79(79%) cases were under 20 to 25 years, majority cases were primigravida (62%), overall caesarean rate was 34%, Meconium stained liquor with fetal distress was the most common indication for LSCS 8(23.5 %) , fetal distress was the most common fetal complications, rate of NICU admission was 33.33% at 41 weeks 1 day to 42 weeks, rate of induced labour is 71.43% at 41 weeks 1 day to 42 weeks. Conclusion: In our study we concluded that prolonged pregnancy was associated with significant risk of perinatal complications like fetal distress, meconium aspiration syndrome and IUGR. There was significantly increased risk of obstetric complications like oligohydramnios, perineal tear, atonic pph and shoulder dystocia.
  1,876 234 -
A comparative study of cilostazol and pentoxifylline in intermittent claudication in peripheral arterial disease
Kshitij Gupta, Chandrashekhar Mahakalkar, Meghali Kaple, Swati Deshpande, Prateek Ladhha, Niket Jain
January-March 2017, 12(1):11-16
DOI:10.4103/jdmimsu.jdmimsu_13_17  
Aims: A comparative study of Cilostazole and Pentoxifylline on intermittent claudication in patients of peripheral arterial disease. Materials and Methods: A total of 70 patients clinically proven occlusive peripheral arterial disease admitted at wards of General Surgery at Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha. It was prospective study the patients were randomized in two groups in 1:1 ratio. The randomization was done using a random allocation sequence generated by computer program and sequential patient consenting to participate in the study was allocated in the respective treatment arms - Cilostazole and Pentoxyphylline per the allocation sequence. Group I Patients (n=35) were administered Tab. Pentoxifylline 400 mg thrice a day; Group II (n=35), Tab Cilostazol 100 mg twice a day. History, clinical examination, all routine investigation including lipid profile, color Doppler study of lower limb and Angiography of lower limb vessels was performed at the start of the trial. Patients were re-evaluated at the time of enrolment and at 24 weeks for Intermittent Claudication Distance (ICD), Absolute Claudication Distance (ACD), and Ankle Brachial Index (ABI). Results: The group II (Cilostazole Group) showed more rise in intermittent claudication distance and Acute Claudication Distance as compared to Pentoxifylline. There was also statically improvement in ankle brachial index of Group II (Cilostazole Group) as compared to Group I (Pentoxifylline). Conclusion: Thus, the comparative analysis revealed that the efficacy of Cilostazole is more than the Pentoxifylline in increasing the ICD and ACD in patients of occlusive peripheral arterial disease with stable intermittent claudication in patients of peripheral arterial disease.
  1,813 225 -
Effect of music therapy in patients with moderate-to-severe traumatic brain injury
Bobba Ushasree Reddy, P Phanisree, M Priyanka, D Kavitha, S Indira, Prashant Bhandarkar, Veda Dhruthy Samudrala, Amit Agrawal
January-March 2017, 12(1):51-54
DOI:10.4103/jdmimsu.jdmimsu_23_17  
Introduction: Following traumatic brain injury (TBI), there are different innovative approaches to improve or enhance the recovery of brain. Musical therapy has shown promising results in better improvement of TBI patients. Such studies from our country are meager. The present study investigates the effect of musical therapy on TBI patients who have undergone brain surgery. Methodology: It is a prospective study conducted at Tertiary Hospital at Nellore. Moderate-to-severe brain injury patients who have undergone neurosurgery were selected. Three Indian classical ragas were selected and given as follows; Hindola in the morning, Todi in the afternoon, and Kalyani in the evening. The mp3 music was given over earphones at specific time for 30 min duration throughout a week. Vitals parameters such as heart rate, systolic blood pressure (SBP), respiratory rate, pupillary movement, and motor activity of patients were documented before and after music therapy. The SPSS version 20.0 software was used for statistical analysis. Results: Ten selected patients were undergone through predefined session for three times a day with consecutive 7 days. Mean age of the patients was 48.5 (23–71 years) and majority (90%) were male. Two hundred and ten responses of each, like this for ten patients, heart rate changes were observed in 77% with mean change of 0.92 units. On average, 5.20 units heart rate was decreased and 6.20 units increased after music therapy. Changes in SBP were observed in 63%with mean change of 1.36 units. About 9.10 units were lower and 10.95 units were higher after therapy. Nearly 64% responses of patients were changed for respiratory rate, with mean change of 0.13 units. On an average of 3.00 units, respiratory rate was decreased, and 4.22 units increased after musical therapy. Conclusion: The present study reports that musical therapy for TBI patients after neurosurgery has an important role in changing the vitals parameters such as respiratory rate, heart rate, and SBP. Detail prospective studies with larger number of patients are required to get in-depth knowledge on effect of musical therapy.
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A comparative study of scalpel versus surgical diathermy skin incisions in clean and clean-contaminated effective abdominal surgeries in AVBRH, Wardha, Maharashtra, India
Noopur Priya, YR Lamture, Luv Luthra
January-March 2017, 12(1):21-25
DOI:10.4103/jdmimsu.jdmimsu_15_17  
Aim: To study the safety and efficacy of diathermy as a modality to give skin incisions. Study Design: Observational study conducted in department of surgery at AVBRH, over 2 years from 2013 to 2015. Material and Methods: 100 cases were studied. In 50 cases incision was given by scalpel and in 50 incisions was given by diathermy. Primary outcome variable was the incisional blood loss, calculated by measuring the weight of swabs used exclusively during incision until complete hemostasis was achieved. Secondary outcome variables were incision time, operative time, pain verbal rating scale (VRS), wound healing, and wound complications. Incision time was defined as the time from the beginning of skin incision until subcutaneous fat arrived, with complete haemostasis; it was expressed in s/cm2. Severity of pain was defined using VRS. Results: we reported shorter time for skin incision, lesser blood loss during surgery and lesser wound complication in cases of diathermy incision, and has more significant pain reduction as compared to scalpel group. Conclusion: The findings of the present study shows that diathermy seems to provide some benefit with respect to postoperative wound pain and has obvious safety advantages to the surgical team compared with scalpel.
  1,271 136 1
Laparoscopic approach to adnexal mass in adolescents: A retrospective analysis
Kavitha D Yogini, Devi Balasubramaniam, Chinnusamy Palanivelu, Amrutha Kakollu
January-March 2017, 12(1):55-60
DOI:10.4103/jdmimsu.jdmimsu_26_17  
Background: Adnexal masses result from benign or malignant lesions of ovarian, tubal and paratubal origin as well as pregnancy related causes such as mullerian anomalies, infectious causes and ectopic pregnancy. The current study aimed to evaluate the preoperative diagnosis, surgical procedure and histopathological findings of adolescent girls who underwent laparoscopic surgery for adnexal mass in our hospital. Materials and Methods: A retrospective chart review of patients with adnexal mass was conducted over a period of one year from Jan 2014-2015. Overall 96 patients were included in the study after reviewing clinical records. In all the patients' malignancy was excluded by preoperative imaging with sonography, CT or MRI and tumor marker study. Results: Laparoscopy was the operative approach for all 96 patients. None resulted in malignant histology. Majority of the adnexal masses were simple cyst (28%), 11.4% were dermoid cyst, 2% were endometriotic cyst. One patient had tubal ectopic, 3 patients had Koch's abdomen and pelvis. Among them one 13 year old girl underwent rudimentary horn excision who presented as a para tubal mass with acute abdomen. Almost half of the patients (68.7%) presented with acute abdomen of which 41.6% were adnexal torsion. All adnexal masses were resected laparoscopically and the outcome was uneventful in all the patients. Conclusion: Laparoscopy is regarded as an appropriate surgical method for benign adnexal masses which was safe and effective even for giant ovarian cyst in well selected cases as most of the pelvic adnexal masses seen in adolescents and young girls are of benign nature.
  1,143 142 -
Clinical profile and management of primary open-angle glaucoma patients above 40 years: A rural hospital-based study
Praveen Tidake, Surabhi Sharma
January-March 2017, 12(1):1-6
DOI:10.4103/jdmimsu.jdmimsu_18_17  
Aim: The aim was to do appropriate screening of the patients of primary open angle glaucoma (POAG) visiting ophthalmology OPD in AVBRH, Sawangi(Meghe) and to compare Visual Acuity(VA), Intraocular Pressure(IOP) retinal nerve fiber layer (RNFL) thickness measurements using optical coherence tomography (OCT) and visual field defects(VFD) with age and sex. Materials and Methods: In this cross-sectional, observational, clinical study ,100 eyes of 50 patients with POAG above 40 years of age were examined. They underwent investigations like visual acuity, intra ocular pressure, fundus examination, gonioscopy, optical coherence tomography (OCT) of optic disc examination and perimetry. Only patients who had intraocular pressure (IOP) greater than 21 mmHg were enrolled into the study. Results: A total of 100 eyes of 50 patients were examined. Mean age of 50 patients was 54.22±13.28 (25-82 yrs), out of which, were 54% were females and 46% were males. At presentation,34% had blurring of vision and 16% had eye pain or photophobia. The mean IOP was 27.49±5.50 mmHg, and the mean CDR was 0.65±0.1. Conclusion: Visual Acuity(VA),Intraocular Pressure(IOP) retinal nerve fiber layer (RNFL) thickness measurements using optical coherence tomography (OCT) and visual field defects(VFD) are correlated to each other and show a correlation with age but not with gender.
  1,101 125 -
Birth preparedness and complication readiness among rural pregnant women: A cross-sectional study in Udupi, Southern India
Jayata Gurung, Varalakshmi Chandrasekaran, Sameer Phadnis, VS Binu
January-March 2017, 12(1):70-74
DOI:10.4103/jdmimsu.jdmimsu_2_16  
Introduction: As per the WHO estimates in 2013, about 289,000 women died of complications related to pregnancy or childbirth. The present study aimed at assessing the status of birth preparedness (BP) and complication readiness (CR) among rural pregnant women and its correlates in coastal Karnataka in Southern India. Methods: This cross-sectional study was conducted in Udupi taluk. In all, 305 pregnant women in the second and third trimesters of pregnancy were interviewed. Two-stage cluster sampling was used to select 320 women. To achieve this sample size, of 16 clusters using simple random sampling, 20 pregnant women in the second and third trimesters were selected from each village with the help of lay health workers in the community. Results: Among 305 pregnant women, 157 pregnant women (51.47%) were prepared to face birth. The factors associated with preparedness were awareness about expected date of delivery (odds ratio [OR] = 2.48, 95% confidence interval [CI]: 1.15–5.35) and at least one danger sign during delivery (OR = 2.88, 95% CI: 1.28–6.51). The identification of skilled birth attendant and arrangement for transportation were high at 99% and 100%. However, only about 42.3% of the respondents had identified a health facility for an emergency. Conclusion: The low preparedness level may be due to inadequate maternal knowledge on BP/CR practices as a result of inadequate information being provided to pregnant women. This study places emphasis on the need to plan and implement training programs for the health-care providers (ASHA, auxiliary nurse midwife's, staff nurse) on the components of BP/CR.
  1,067 158 -
Visual inspection of cervix with acetic acid: An alternative to cytology and colposcopy in early screening of cervical cancer in low-resource setup
Shalini Manisha, Neelajkumar Bagde, Dipti Shrivastava
January-March 2017, 12(1):32-34
DOI:10.4103/jdmimsu.jdmimsu_19_17  
Introduction: Cervical cancer is an emotive disease, with multiple connotations. Cervical cancer is major health problem worldwide. Cervical malignancy is the commonest malignancy amongst Indian women. The life time estimated risk of cervical cancer is 2-4%. In Indian women, Cervical malignancy accounts for 26.1- 43.8% of all cancers. Cancer cervix is a preventable and curable disease provided, it is diagnosed early by screening tests and appropriate measures are taken. Aim and Objectives: 1)To compare the efficacy of Visual Inspection with Acetic acid, cytology(Pap smear) and colposcopy in detection of cervical intraepithelial lesions. 2) To assess the role of Visual Inspection with Acetic acid as an alternative to cytology (Pap smear), in screening for cervical cancer in low resource set- up. Material and Method: 200Women in 30-50 years age group who attended the gynecology department OPD, at Acharya Vinobha Bhave Rural Hospital, Sawangi (Meghe), Wardha for routine check up. Results: In the present study, the sensitivity of Pap smear came to be 90.48% and Specificity came out to be 81.40%.The sensitivity of VIA in detecting cervical cancer was 95.24% and the Specificity was 44.19%. The sensitivity of colposcopy in detecting cervical cancer was 90.48% and the Specificity was 67.44%. Conclusion: VIA as compared to Pap smear(cytology) and colposcopy can be a better screening test due to its high sensitivity, simple administration and low cost.
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Heterogeneous group discussion to improve reliability and validity of data tool: A global mental health assessment tool – Primary care version study
Vaishali D Tendolkar, Prakasha Behere, Zahir Quazi, Abhai Gaidhane
January-March 2017, 12(1):45-50
DOI:10.4103/jdmimsu.jdmimsu_22_17  
Background: Mental illness constructs are not universal and are likely to be burdened with ethnocentric conceptualization. Different terminology is used to refer to the same aspects of the translation process, making it harder to achieve clarity. Heterogenous focus group discussion is particularly suited for obtaining several perspectives about the same topic. The benefits of heterogenous focus group discussion include gaining insights into people's shared understandings of a concept and the ways in which individuals are influenced by others in a group situation. Objectives: 1) To find out reliability of GMHAT/PC Marathi. 2. To assess the validity of the GMHAT/PC Marathi for the diagnosis of psychiatric illness. Research Design: cross sectional study Sample: Persons aged 15 yrs and above, reporting to psychiatry units. Sample size: 500. Material: Global Mental Health Assessment Tool – Primary care Marathi. Result: The Cronbach's alpha coefficient estimated to 0.854 with the reliability coefficient of r=0.921. The 'k' value is 0.744 which indicates that the tool has good diagnostic accuracy. The overall sensitivity of the tool was found to be 96.51% (CI = 94.21% to 98.08%) (Assumed sensitivity = 90%). The estimated specificity of the tool is 74.75% (CI =65.02% to 82.94%). Conclusion: GMHAT/PC -Marathi is a valid, quick and comprehensive assessment and diagnoses of mental disorders for Marathi speaking people. GMHAT/PC- Marathi in psychiatric settings appears to have very good sensitivity and specificity. The mean duration of the interview was around 13.4 minutes which makes it feasible for routine use in the outpatient departments.
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Diagnostic role of magnetic resonance imaging in rotator cuff pathologies
Gaurav Kumar, Suresh V Phatak, Bhushan Lakhkar, Sanjay Kumar Yadaw
January-March 2017, 12(1):7-10
DOI:10.4103/jdmimsu.jdmimsu_11_17  
Aims and objectives: 1. To study the rotator cuff pathologies and association of rotator cuff pathologies with acromion morphology and biceps (long head) pathologies. Material and Methods: 100 patients clinically suspected of rotator cuff pathologies were evaluated using 1.5 tesla MRI for the rotator cuff tendon tears/tendinosis and associated acromion morphology and biceps tendon(long head) pathologies. Results : The average age of the patients was 41.73±16.55 years with male dominance (84%).Out the 100 patients, supraspinatus was the most common pathological tendon with 81% cases showing abnormalities. The rotator cuff tears were more common in the later age groups and tendinosis more common in the early age groups. Partial tears of rotator cuff were more common than complete tears.58% cases showed partial tears in supraspinatus as compared to 14% cases of complete tears. Articular surface tears were most common partial tears seen in 46.5% cases.Variation in the acromion morphology Biceps(long head) pathologies showed positive correlation with the rotator cuff pathologies Conclusion: MRI is a valuable modality to diagnose and characterise the rotator cuff and associated pathologies.
  934 110 -
CASE SERIES
Evaluation of effectiveness of subepithelial connective tissue graft in combination with coronally positioned flap in the treatment of isolated gingival recession in esthetic areas by using surgical microscope
Priyanka G Jaiswal, Sneha S Puri, Manohar L Bhongade
January-March 2017, 12(1):79-84
DOI:10.4103/jdmimsu.jdmimsu_27_17  
Objectives: When maximum precision is required in performing periodontal surgery to satisfy particular esthetic demands, a surgical microscope that enhances complete visualization of the operative field may represent a useful tool. The aim of this case series was to assess clinical outcome of isolated gingival recession treated by using subepithelial connective tissue graft (SCTG) in combination with coronally positioned flap (CPF) in esthetic areas by using surgical microscope. Study Design: A total of 3 cases of isolated gingival recession (Class I and II) located on mandibular incisors were treated by using SCTG in combination with CPF with the aid of a surgical microscope. Gingival recession, probing pocket depth, clinical attachment loss, and width of keratinized gingiva were recorded at baseline, before surgery and at 6 months following surgery. Results: Prior to surgery, there were 2 mm gingival recession (REC), 3 mm clinical attachment loss (CAL) with PPD of 1 mm in two cases while one case had 3 mm gingival recession, 4 mm clinical attachment loss with PPD of 1 mm. 6 months post surgery, 2 cases showed 2 mm reduction of gingival recession indicating 100% root coverage while one case showed 80% of root coverage (2 mm reduction of gingival recession). Conclusion: In the present case report, qualitative aesthetic evaluation of the treated cases showed better searing and marginal profile. This could be due to an atraumatic surgical approach and excellent visualization of the operative field by using surgical microscope. Microsurgery enhances normal vision through magnification and favorable lightening which would lead to an improvement in cosmetic results and patient comfort level.
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ORIGINAL ARTICLES
The study of ovulatory pattern following use of clomiphene citrate and anastrozole in infertile women with ovulatory dysfunction: A comparative study
Meenal Gupta, S Samal, Deepti Shrivastava, Neelaj Bagde, Nalini Mishra, Sandeep Gupta
January-March 2017, 12(1):17-20
DOI:10.4103/jdmimsu.jdmimsu_14_17  
Objective: To determine an efficacy of Anastrozole compared with clomiphene citrate to induce follicular growth and ovulation in infertile women with ovulatory dysfunction. Study Design: Comparative prospective study setting: The study was carried out in the department of Obstetrics and Gynaecology at AVBRH, Sawangi, Wardha. Patient(s): The study comprised a total of 100 infertile women (cycles) with ovulatory dysfunction. Intervention(s): Patient received anastrozole (1 mg /d;50 patient , 87 cycles) and CC (50 mg /d ;50 patient, 74 cycles) for 5 days , starting on day3 of mense. Result(s): In 1st treatment cycle the ovulation rates for anastrozole at 1 mg was 32% (n=50) ,compared with 54% (n=50) for Clomiphene citrate at 50 mg/d. in up to 3 cycles of treatment, cumulative ovulation rate was 59.4% with CC and 43.6% with anastrozole. Conclusion(s): CC 50 mg exerts a stronger stimulatory effect on follicular growth compared with 1 mg of anastrozole . Anastrozole was associated with significantly fewer mature and growing follicle and thicker endometrium.
  907 73 -
Noncompliance in psychosis
Siddharth Kalucha, KK Mishra, Sachin Ratan Gedam
January-March 2017, 12(1):61-65
DOI:10.4103/jdmimsu.jdmimsu_28_17  
Introduction: Compliance broadly means the degree to which a person's behaviour, is constant with taking the drugs prescribed, life style changes advised, keeping with appointment date. Psychosis by its very nature impairs patient's judgement and insight so it's very natural that chances of non-compliance in psychosis is high. Jim Rosack explained the phenomenon of adherence to medication in terms of refill rate. Aim and Objective: The study was aimed at assessing reasons for drug non-compliance among patients receiving neuroleptic medications. Objective to study socio-demographics variables of these non-compliant psychiatric patients. Material and Method: 180 consecutive non-compliant psychotic patients were interviewed using ROMI scale and soico-demographic proforma. Results: Most common reason for drug non-compliance was denial of illness, financial obstacles, side effects of medications, stigma of mental illness among others as accessed by ROMI scale. Age at onset of mental illness was significantly associated with mean scores for non-compliance of ROMI scale. Conclusion: psychosis has high chances of drug non-compliance. These are patient related, illness related and doctor related. This issues like denial of illness or financial obstacles need to be dealt with judiciously to improve compliance and quality of life.
  810 76 -
Clinical profile of lung cancer at Acharya Vinoba Bhave Rural Hospital
Tarushi Sharma, Babaji Ghewade, Ulhas Jadhav, Swapnil Chaudhari
January-March 2017, 12(1):41-44
DOI:10.4103/jdmimsu.jdmimsu_21_17  
Background: Lung cancer has been the most common cancer in the world for several decades. It is probably one of the most important life threatening conditions responsible for the death of millions of people in today's world. An increasing incidence of lung cancer has also been observed in India. The objective of the present project was to study the clinical profile of lung cancer in histopathologically diagnosed lung cancer patients in AVBRH, Sawangi (Meghe), Wardha. Study Design: The study was conducted at Acharya Vinobha Bhave Rural Hospital, Sawangi (Meghe) in indoor patients of Lung Cancer. This was an observational study which included 62 patients in total who were admitted in AVBRH. A structured standard proforma was used for recording the history, clinical signs, radiological & histopathological findings of patients. Results: Out of the total 62 patients, 59.68% were males and 40.32% were females. Most of the patients presented with cough as chief complaint along with breathlessness, chest pain, fever and loss of weight/appetite were other common symptoms. Majority of males were smokers. On Chest X-ray, right lung was the most commonly involved and right lower lobe was the most common area involved. Adenocarcinoma was the most common subtype found in 51.61% of patients and small cell carcinoma was second most common found in 24.19% of patients. Majority of patients (51.61%) presented in stage 4 of lung cancer. Conclusion: The study shows that smoking is strongly associated with lung cancer. Cough was the most common symptom while presence of mass and right sided effusion were the most common findings in chest x-ray. Adenocarcinoma predominated both in males and females. Most of patients presented in late stages (Stage 3b and 4) thus leading to poor survival rates and poor prognosis among them.
  757 74 -
Association of socioeconomic risk factor with patients delay in presentation of oral squamous cell carcinoma
Vidya K Lohe, Rahul R Bhowate, Ravikant V Sune, Swapnil C Mohod
January-March 2017, 12(1):75-78
DOI:10.4103/jdmimsu.jdmimsu_29_17  
Background: Delayed reporting is a common problem in patients with low socioeconomic group and may be responsible for advanced stage disease. Aim: To evaluate association of socioeconomic risk factor with patients delay in presentation of Oral Squamous Cell Carcinoma (OSCC). Material and Methods: Thorough case history of 120 histopathologically confirmed OSCC patients was taken and were categorized according to TNM staging. Their SES was assessed by Aggarwal OP et al (2005) scale. Patients delay in presentation was calculated by measuring the time between the onset of the first symptoms of OSCC and the first consultation with primary health care provider. Association of socioeconomic status (SES) with patients delay in presentation was sought. Observations and Results: Out of 120 OSCC patients, there were 04 (3.33%) patients from stage II, 31(25.83%) from stage III, 85 (70.83%) from stage IV. Thirteen (10.80%) patients reported within 3 months of onset of the first symptoms, 14 (11.66%) patients reported upto 3 months, 72 (60.00%) reported between 3-6 months, 20 (16.66%) between 6-9 months and 14 (11.66%) between 9-12 months. Association of clinical staging and patient delay was sought by subjecting to chi square test, and the x2 value was 43.80, P = 0.0001, suggesting statistically significant difference. An association of clinical staging, SES and period of patient's first presentation was also carried out and data subjected to chi square test which was statistically significant in all the subgroups of SES. Conclusion: From this study, it can be concluded that there is significant association of socioeconomic status with patients delay in presentation of oral squamous cell carcinoma
  730 79 -
Prospective, longitudinal, and quantitative analysis of pattern of voice quality in male patients of early-stage vocal cord cancer treated with radical radiation therapy
Chaitali Manohar Waghmare
January-March 2017, 12(1):66-69
DOI:10.4103/jdmimsu.jdmimsu_3_16  
Objective: An improvement in the voice quality after radiotherapy (RT) in early-stage vocal cord cancer (ESVCC) is well documented in the literature. The purpose of this study was to assess whether the voice quality ever reaches to normal and to evaluate pattern of change in voice quality over a period of 2 years in patients of ESVCC treated with radical RT. Materials and Methods: Newly diagnosed and histopathology proven patients of ESVCC treated with radical RT were screened. Voice analysis was done before treatment and during each follow-up after RT. Voice parameters of 19 healthy volunteers were used as control. Eighteen male patients for whom voice analysis was done over the period of 2 years were studied. All patients were educated to maintain vocal hygiene. Results: The study cohort of 18 male patients was comprised 11 patients of stage T1N0M0 and 7 patients of stage T2N0M0. All patients were free of disease till the time of the last follow-up. The minimum intensity improved significantly 2–6 months after RT, decreased a little 9–12 months after, and was sustained till 2 years of follow-up. The average frequency also improved significantly 2–6 months after RT, but the values were less than normal; it improved thereafter and remains sustained till 2 years of follow-up. The harmonics-to-noise ratio was persistently high till 1 year of follow-up, started improving thereafter. Maximum phonation time improved significantly 2–6 months after treatment, deteriorated thereafter, and started improving after 1 year of follow-up. Perturbation parameters were worse till 9–12 months post-RT and improved thereafter. Conclusion: The intensity and frequency improved earlier while the perturbation parameters took longer time to recover. However, voice after RT does not return to normal. Regular vocal rehabilitation exercises, during and after RT, may help to improve voice quality.
  694 54 -
Clinical study, evaluation, and management of cases of intracranial tumors admitted at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe)
Parag Jaipuriya, Meenakshi Yeola (Pate), Sandeep Iratwar, Chandrashekhar C Mahakalkar, Abhijeet Chandankhede
January-March 2017, 12(1):26-31
DOI:10.4103/jdmimsu.jdmimsu_17_17  
Background: The introduction of modern neuro-imaging techniques, as well as various environmental factors, has been changing the incidence and the proportions of the types of clinically diagnosed intracranial tumours. Common presenting symptoms include headache, seizures, and altered mental status. Radiological investigations like MRI and CT helps in defining the extent and type of tumour, histopathology is often required to confirm the diagnosis. Treatment depends on the histology diagnosis which may be surgical resection, radiation therapy or chemotherapy. The aim of this study was to assess the clinical presentation, radiological evaluation and outcome after primary management of cases of intracranial tumours in central India. Materials and Methods: 62 cases of primary intracranial tumours who were admitted at AVBRH (Acharya Vinoba Bhave Rural Hospital), Sawangi(Meghe), Wardha were studied between August 2013 to August 2015. Results: The age group most frequently affected was 41-60 years (51.61%), mean age was 46.62±13.79 years. Astrocytomas (50%) were the most common intracranial tumour. Males (53.23%) were more frequently affected than females (46.77%) with male to female ratio as 1.13:1. Headache (48.38%) was the most common presenting symptom followed by vomiting (45.16%). Cerebral lobe (45.16%) was the most commonly affected site followed by convexity (16.12%).The sensitivity of CT scan and MRI scan were 83.33% and 87.71% respectively. All cases were surgically treated. 87.09% patients improved, 9.67% patients deteriorated and mortality was 3.23%. Conclusion: There seems to be an apparent increase in registration of brain tumours in recent years, which may well reflect the changing awareness and improved diagnostic facilities. The study shows highest frequency of tumours in the middle age group. The most common presenting symptom is headache followed by vomiting and neurological deficit. CT and MRI are useful modalities in diagnosing the intracranial tumours. Histopathology is still the gold standard for diagnosing the intracranial tumours and its types. Surgical treatment forms one of the main modality of treatment . Most of the cases show improvement after surgical management.
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