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   2016| May-August  | Volume 30 | Issue 2  
    Online since May 24, 2016

 
 
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ORIGINAL ARTICLES
Patterns of hemoglobinopathies diagnosed by high-performance liquid chromatography in and around Pune (Western Maharashtra, India): A pilot study
Archana Buch, Banyameen Iqbal, Rajiv Bordawekar, Ambuj Jain, Pratik Jariwala, Hetal Rathod
May-August 2016, 30(2):111-115
DOI:10.4103/0972-4958.182921  
Background: Hemoglobinopathies are one of the major public health problems in the state of Maharashtra, India. Their prevalence shows regional and ethnic variations. Pune, now becoming educational and IT hub cater populations from different regions. Aim: To study the pattern of hemoglobinopathies diagnosed by high-performance liquid chromatography (HPLC) in Western Maharashtra, India. Settings and Design: This pilot study was aimed to find the prevalence of hemoglobinopathies in and around Pune (Western Maharashtra, India) and identify the change in the demographic profile Materials and Methods: A total of 3465 cases received from January 2012 to December 2014 for hemoglobin variant analysis at the referral laboratory were studied for hemoglobinopathies. Samples were received from various private hospitals and laboratories in and around Pune. The samples were run on instrument manufactured by Bio-Rad Laboratories based on the principle of HPLC. Based on retention time and proportion of hemoglobin (Hb) variants different hemoglobinopathies were diagnosed and their prevalence were analyzed. Results and Conclusions: Out of total 3465 patients screened for suspected hemoglobinopathies 175 (5.05%) were found positive for abnormal Hbs with maximum number in the age group 20-30 years. We found that a maximum number of patients was of thalassemia trait with a prevalence of 3.7%, followed by double heterozygous states of Sickle cell with beta thalassemia trait, sickle cell trait, and sickle cell disease in decreasing order. Other rare variants such as Hb E disease, Hb D disease, Hb E trait, double heterozygous Hb SD, and Hb SC were also identified. We found more heterozygous states as compared to homozygous states. Prevalence was on the lower side of the normal range. Conclusion: Continuous awareness programs, mass screening of the population especially childbearing age and school going children will help in early detection of heterozygous states. This further helps in preventing severe hemoglobinopathies and reducing the morbidity and mortality.
  7,063 728 -
Prevalence of non-communicable diseases risk factors among college students of Anjarakandy Integrated Campus, Kannur, Kerala, India
Imaad Mohammed Ismail, PP Venugopalan, AK Sarada, Kanniyan Binub
May-August 2016, 30(2):106-110
DOI:10.4103/0972-4958.182911  
Background: India is presently facing a growing burden of noncommunicable diseases (NCDs) due to industrialization, socioeconomic development, urbanization, changing age structure, and changing lifestyles. There is scarcity of data regarding the prevalence of established risk factors of NCDs among college students and hence, this study was undertaken. Aim: To estimate the prevalence of risk factors of NCDs among college students of Anjarakandy Integrated Campus, Kannur, Kerala, India. Settings and Design: It was a cross-sectional study conducted in Anjarakandy Integrated Campus, Kannur, Kerala, India from March 2014 to June 2015. Materials and Methods: The integrated campus has a total of 1,933 students from the medical, dental, engineering, Medical Laboratory Technology (MLT), nursing, and pharmacy colleges who formed the sampling frame. After taking oral consent, a pretested, structured questionnaire was used to collect data on the sociodemographic variables, diet, smoking, alcohol consumption, physical activity, and family history of NCDs. Statistical Analysis: Data entry and analysis were done on Statistical Package for the Social Sciences (SPSS) version 17. Percentages and proportions were used to describe the results. Results: A total of 634 students participated in the study. The prevalence of risk factors of NCDs was as follows: lack of exercise -44.6%, junk food intake of more than 3 times/week -65.9%, extra salt intake -78.5%, daily smoker -2.4%, and alcoholic consumption in the past 30 days -2.5%. On an average, students spend 3 h using their mobile phones and 1 h watching television daily. It was found that 29.8% of the students were undernourished and 9.8% were preobese/obese. A total of 10 students were diagnosed as hypertensive. Conclusion: Lack of exercise, consumption of junk food, and high salt intake were found to be highly prevalent in the study participants. To address the issues, sports should be promoted, especially among women and nutrition education classes should be included in the curriculum.
  3,537 401 1
Prophylactic intravenous ephedrine for prevention of hypotension in cesarean section during spinal anesthesia: A comparative study
Takhelmayum Hemjit Singh, Rupendra Singh Thokchom, Manichandra Sinam, Rakesh Nongthonbam, Maharabam Binarani Devi, Khullem Maniram Singh
May-August 2016, 30(2):116-120
DOI:10.4103/0972-4958.182922  
Background: Spinal anesthesia is the most common preferred technique for cesarean delivery. However, it is associated with hypotension which is detrimental to both the mother and fetus. The study has been undertaken to determine the effect of bolus intravenous ephedrine in ameliorating spinal-induced hypotension. Materials and Methods: Fifty primiparous parturients scheduled for cesarean section were randomly allocated into two groups of 25 patients each: Group 1 (study) and Group 2 (control) to receive either 1 ml of 5 mg bolus intravenous ephedrine or equal volume of normal saline, respectively, just after 10 mg of 0.5% intrathecal bupivacaine. Results: Significant fall in systolic blood pressure from its baseline value occurs at all time intervals in both the groups, except up to the 4 th min in the ephedrine group. The incidences of hypotension between the two groups were 60% and 72% in the ephedrine and control group, respectively (P > 0.05). Conclusion: Prophylactic use of intravenous ephedrine did not significantly decrease the incidence of maternal hypotension.
  2,698 280 2
Prevalence of diabetes in chronic liver disease patient admitted in medicine ward in RIMS Hospital, Imphal
Obang Perme, Yumnam I Singh, Karam R Singh, Bhagyabati S Devi, Aksay Rao, Salam K Singh
May-August 2016, 30(2):84-88
DOI:10.4103/0972-4958.182906  
Context: First study on prevalence of diabetic among chronic liver disease (CLD) patient in Manipur and North-East India as a whole. Aims: To determine the prevalence of diabetes in CLD patient and to correlate the presence of diabetes with clinical features and complications of CLD. Settings and Design: A prospective study was carried out in the Department of Medicine, RIMS, Imphal, from September 2011 to August 2013. Subjects and Methods: Total of 155 cases of CLD who qualify the inclusion criteria was included in analysis. CLD was diagnosed based on history, liver function test, ultrasonography abdomen, and upper gastrointestinal endoscopy. Diabetes diagnosed based on history and who criteria. Statistical Analysis Used: Data obtained from study were analyzed by SPSS Version 16. Results: The prevalence of diabetes was 12.9%. Most common age group was 31-40 years. However, percentage wise diabetes tends to be higher among younger age group 18-30 years groups (27.3%) compared to other age groups. The common clinical findings were ascites (95.5%), pallor (83.8%), and icterus (74.8%). Most common finding among diabetic patient was ascites (95%). Anemia, upper gastrointestinal bleeding, and hepatic encephalopathy (HE) were slightly higher in diabetic group. Conclusions: In this study, prevalence of diabetes was 12.9% among CLD. Complication of CLD was slightly higher among diabetic patient. Presence of diabetes mellitus in patients of CLD post a difficulty in diagnosis as well as management of complications, especially HE.
  2,665 238 -
The assessment of effects of yoga on pulmonary functions in asthmatic patients: A randomized controlled study
Shruti Agnihotri, Surya Kant, Santosh Kumar, Ranjit Kishore Mishra, Satyendra Kumar Mishra
May-August 2016, 30(2):98-102
DOI:10.4103/0972-4958.182909  
Background and Objective: Asthma is a serious health problem throughout the world, affecting people of all ages. It is a chronic inflammatory respiratory disorder. There are a few short-term studies with least number of the patients showing the impact of yoga on forced expiratory volume during the first second of the forced breath (FEV 1 ) and peak expiratory flow rate (PEFR). To assess the efficacy of yoga on pulmonary functions in asthma patients. Setting and Design: It was a randomized controlled trial, conducted at a tertiary-care teaching hospital in Lucknow, UP, India. Materials and Methods: The study was carried out in mild-to-moderate persistent asthma (FEV 1 > 60%) patients aged between 12 years and 60 years. The patients were recruited from the Department of Pulmonary Medicine and were randomly divided into two groups as follows: "the case group" and "the control group." Their spirometric assessments were done at the baseline, third month, and sixth month. Statistical Analysis Used: The statistical analysis was done by using GraphPad inStat version 3.05 software Inc., year 2000 (Version. 3.05 GraphPad software, Inc., California, USA). Results and Conclusion: No significant changes were found in spirometric variables in "the control group" during the course of the study. In contrast, "the yoga group" got significantly better improvement in spirometric variables. The result shows that yoga can be an adjuvant therapy along with standard medical treatment for the better management of asthma.
  2,416 280 2
Anticonvulsant effect of Portulaca oleracea in experimental animal models
Mayanglambam Medhabati Devi, Leisangthem Tarinita Devi, Nameirakpam Meena Devi, Khomdram Krishna Pramodini Devi, Akham Subhalakshmi Devi
May-August 2016, 30(2):94-97
DOI:10.4103/0972-4958.182908  
Background: Portulaca oleracea, locally known as Leipak-kundo, which belongs to portulacaceae family is an annual succulent prostrate herb with 15-30 cm long stem, fleshy leaves, and flowers. The plant is used for the treatment of gonorrhea, gum and teeth complaints, scurvy and liver diseases. The constituents of the plant are flavonoids, alkaloids, omega-3 fatty acid, and antioxidants. P. oleracea has been reported to possess hypoglycemic, anti-ulcer, muscle relaxant, analgesic, and anti-inflammatory properties. Materials and Methods: The anticonvulsant effect of the aqueous extract of P. oleracea leaves (200, 400, and 600 mg/kg, p.o.) was studied against seizures induced by maximal electroshock (MES) and pentylentetrazol (PTZ) in albino mice. Results: The aqueous extract of P. oleracea leaves decreased the duration of hind limb tonic extension phase and recovery time in MES model. It also decreased the time of onset and duration of clonic convulsion induced by PTZ. The aqueous extract of P. oleracea leaves exhibited significant anticonvulsant effect against MES and PTZ-induced seizures. Conclusion: The aqueous extract of P. oleracea leaves (200, 400, and 600 mg/kg) produced significant anticonvulsant effect against MES and PTZ-induced seizures in mice. The aqueous extract of P. oleracea may be potentiating the GABAergic transmission in the central nervous system.
  2,398 183 -
Incremental yield of second sputum smear examination for diagnosis of tuberculosis patients at a tertiary care teaching hospital in Puducherry, India
Ramesh Chand Chauhan, Anil Jacob Purty, Abel Samuel, Zile Singh
May-August 2016, 30(2):89-93
DOI:10.4103/0972-4958.182907  
Background and Objectives: The Revised National Tuberculosis Control Programme (RNTCP) guidelines recommend two sputum smear examinations for the diagnosis of tuberculosis (TB). This does not reduce the patient's inconvenience and laboratory workload. So, the present study was conducted to assess the contribution of second sputum smear examination for the diagnosis of TB. Materials and Methods: A retrospective record review of TB laboratory registers at a tertiary care medical college hospital in Puducherry, India was conducted from April 2009 to December 2012. Results: A total of 2,917 patients were recorded in the RNTCP laboratory registers during the study period. Of these, 2,869 (98.4%) patients had given sputum samples for diagnosis and 48 (1.6%) were follow-up cases on TB treatment. Among 2,869 TB suspects, 397 (13.8%) were acid-fast bacilli (AFB)-positive although 616 (21.5%) failed to submit their second sputum samples. Further, among 2,253 (78.5%) TB suspects who submitted two sputum samples, 361 (16.0%) were AFB-positive. Of these, 98.3%, 98.6%, and 96.9% were positive on the first, second, and both sputum smear examinations, respectively. The additional yield of the second sputum smear was 1.7%. Conclusions: The incremental yield of second smear examination is low; this indicates that single sputum smear examination is enough for the diagnosis of TB in tertiary health care settings.
  2,375 172 1
The acute effect of erythropoietin on mean corpuscular hemoglobin concentration levels during hypoxia - reoxygenation injury in rats
Constantinos Tsompos, Constantinos Panoulis, Konstantinos Toutouzas, George Zografos, Apostolos Papalois
May-August 2016, 30(2):79-83
DOI:10.4103/0972-4958.182905  
Background: The aim of this experimental study was to examine the effect of erythropoietin on rat model and particularly in an hypoxia reoxygenation (HR) protocol. The effect of that molecule was studied hematologically using mean corpuscular hemoglobin concentration (MCHC) levels. Materials and Methods: 40 rats of mean weight 247.7 g were used in the study. MCHC levels were measured at 60 min (groups A and C) and at 120 min (groups B and D) of reoxygenation. Erythropoietin (Epo) was administered only in groups C and D. Results: Epo administration significantly increased the MCHC levels by 1.73% +0.50% (P = 0.006). Reoxygenation time non-significantly increased the MCHC levels by 0.17%+0.56% (P = 0.7555). However, erythropoietin administration and reoxygenation time together produced a significant combined effect in increasing the MCHC levels by 0.89% +0.31% (P = 0.0061). Conclusion: Erythropoietin administration whether it interacted or not with reoxygenation time has significant increasing short - term effects on recovery pathophysiology of MCHC levels.
  2,376 144 -
CASE REPORT
Acrylic gingival veneer prosthesis: A case report
Nitai Debnath, Renu Gupta, Rajesh Singh Nongthombam, Preety Chandran
May-August 2016, 30(2):121-123
DOI:10.4103/0972-4958.182923  
Periodontal disease may lead to gingival recession causing elongated clinical crown height and formation of black triangle in the interproximal area. Acrylic gingival prosthesis is a noninvasive, economical restorative procedure to artificially replace the lost gingival tissue. This artificial prosthesis overcomes the pitfall of extensive surgical corrective procedure. This article aims to describe a clinical case with advanced gingival recession with diastema between the upper anterior teeth, which was esthetically rehabilitated with acrylic gingival veneer prosthesis.
  2,224 213 -
GUEST EDITORIAL
Teaching medical ethics in India
Brogen Singh Akoijam
May-August 2016, 30(2):73-74
DOI:10.4103/0972-4958.182903  
  2,044 292 -
CASE REPORTS
Cysticercosis: Presenting as a swelling of sternocleidomastoid muscle
Komal Sawaimul, Banyameen Mohamad Iqbal, Tushar Kambale
May-August 2016, 30(2):124-125
DOI:10.4103/0972-4958.182924  
Cysticercosis presenting as neck swelling is an uncommon disease caused by Cysticercus cellulosae which is the larval form of the tapeworm Taenia solium. Human beings are the only definitive host. They harbor the adult tapeworm. Both humans and pigs can act as intermediate hosts and contain the larvae or cysticerci. We report a case of a 40-year-old female patient who presented to our hospital with a solitary swelling in the anterior triangle of the neck for the last 6 years. On excision and hist opathologic examination, it revealed a multilayered, lamellated cyst wall with a single invaginated scolex containing rostellum and hooklets giving a diagnosis of cysticercosis.
  2,173 111 -
ORIGINAL ARTICLES
Small group tutorials in physiology - Undergraduate students' perspectives in a Northeast Indian Medical Institute
Jayshree Phurailatpam
May-August 2016, 30(2):75-78
DOI:10.4103/0972-4958.182904  
Background: Students consider physiology as a dry, difficult, and vast discipline to be mastered in too short period. Small group tutorials (SGTs) per se are "extra efforts" in the curriculum, conducted every week for assessing the effectiveness of lectures on knowledge delivery, and in part, a formative assessment for the student. At present, tutorials consume a considerable 60 h in an academic term which may be utilized otherwise for the students, if not beneficial. Aims: To highlight the perspective of undergraduate students with special regards to SGTs and to identify modifiable/amendable areas, if any in the current form of SGTs, which may likely improve teaching-learning process of physiology in a North Eastern Medical Institute, Imphal. Materials and Methods: Anonymous feedback questionnaires from 95 students in 1 st year MBBS were obtained after exposure to existing tutorials in physiology and analyzed accordingly. Results and Conclusions: Students perceive the present form of the tutorial as one that benefits them in many positive ways in improving their understanding and knowledge of physiology. However, insufficient interaction time as well as tutor's attitude during tutorials attracted negative responses. They expressed strongly against the tendency of the teachers to re-enforce the importance of memorization as the ultimate way to learn and 95% of them wanted more tutorials as they found that it drives them toward more study covering more topics which increase their self-confidence and can assess their own level of knowledge so that they can improvise accordingly in time.
  1,861 171 -
Endoscope-assisted single burr hole drainage and irrigation of chronic subdural hematoma (SDH): A retrospective analysis
Vyas Khongbantabam, Khaidem Mani Singh, Supriya Laifangbam, Takhellambam Arun Singh
May-August 2016, 30(2):103-105
DOI:10.4103/0972-4958.182910  
Background: Chronic subdural hematoma (SDH) is usually associated with mild trivial head trauma in the elderly population. Its treatment varies from multiple burr hole, irrigation, twist drill, and craniotomy for membranectomy. Objectives: 1) To describe the operative procedure of single burr hole, drainage, and irrigation assisted by an endoscope in the management of patients with chronic SDH and 2) to present its favorable outcome. Materials and Methods: Seventy-two patients were managed by endoscope-assisted single burr hole, drainage, and irrigation during the period from July 2008 to August 2013. All patients were given local anesthesia. Retrospective data at the times of admission, discharge, and at follow-up at 3 weeks and 6 weeks were analyzed. Results: The mean age of the patients was 65 years and males outnumbered females. Average operation time was 30 min. All patients were discharged at Markwalder's grade 0 within 3-4 days of admission. There were 1.38% cases of seizures but no cases with recurrences or mortality. On follow-up, 86.11% and 100% cases of full brain expansion were achieved at 3 and 6 weeks, respectively. Conclusion: Endoscope-assisted single burr hole drainage and irrigation of chronic SDH is simple, safe, and patient friendly. The short duration of this surgery performed in the elderly patients under local anesthesia is its biggest advantage.
  1,792 138 -
LETTERS TO EDITOR
A case of community-acquired multi-drug resistant Acinetobacter lwoffii bacteremia
Rudrajit Paul, Jayanti Ray, Sagnik Mondal, Jayati Mondal
May-August 2016, 30(2):128-129
DOI:10.4103/0972-4958.182926  
  1,742 125 -
Alarming global estimates of herpes simplex virus 1: A lot needs to be done from the public health dimension
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
May-August 2016, 30(2):126-127
DOI:10.4103/0972-4958.182925  
  1,567 87 -
Friendly vaccination: Responding effectively to the vaccine associated iatrogenic pain on a global scale

May-August 2016, 30(2):130-131
DOI:10.4103/0972-4958.182927  
  1,321 84 -
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