International Journal of Applied and Basic Medical Research最新文献

Pigmented purpuric dermatoses (PPDs) comprise a collection of disorders characterized by many petechial hemorrhages due to underlying capillaritis. Specific clinical characteristics facilitate the categorization of PPD into different variants, with Schamberg's disease being the most frequently encountered. Treatment may not always yield positive results, and recurrences are common. We report the case of a 38-year-old male patient who presented with numerous reddish lesions on his lower and upper limbs, as well as his trunk. He exhibited purpuric eruptions and brownish discolorations that were diffusely spread across these areas. A biopsy indicated Schamberg's disease. The patient was treated with oral anti-inflammatory drugs. After 3 months of follow-up, there was significant improvement in the existing lesions, and no new lesions had developed.

The global incidence of placenta accreta spectrum is increasing rapidly, mirroring the trend of increased cesarean delivery. We report a case series of four patients diagnosed with placenta percreta who presented to a single unit of the department of obstetrics and gynecology at a tertiary care center in North India from March 2024 to May 2024 with a pathologically proven diagnosis. In all cases, a hysterectomy was the outcome. We have included cases with prenatal diagnoses in this case series. For appropriate planning, a prenatal diagnosis of placenta percreta is necessary, as the multidisciplinary team's approach is particularly beneficial. After DJ stenting, elective surgery was scheduled in one of the four instances.

Introduction: Human Milk Banking (HMB) has emerged as an effective strategy to provide pasteurized Donor Human Milk (DHM) when a mother's own milk is unavailable or insufficient. This study assessed newborn feeding practices and awareness and attitude toward human milk donation among postnatal mothers.

Materials and methods: A cross-sectional study was conducted for 3 months among 206 mothers admitted to postnatal wards under a tertiary care institute of Kolkata. The mothers were selected by systematic random sampling, and face-to-face interviews were conducted using an interview schedule, which also included an observation checklist to assess the newborn feeding practices. Descriptive and inferential statistics were employed as applicable.

Results: The mean age of study participants was 25.1 (±2.9) years. Almost 92.1% of mothers fed their newborns with breast milk. Around 63% were unaware that DHM is the best alternative for preterm infants when mothers' own milk is unavailable. Nearly half (49%) reportedly had low awareness, while 42% had unfavorable attitude toward human milk donation. Only 32% were aware of an established HMB in the study setting. Mothers' education had statistically significant associations with newborn feeding practices and awareness of human milk donation, respectively.

Conclusion: Almost half of the mothers had low awareness and unfavorable attitude toward human milk donation. Increased awareness campaigns, workshops are needed to be conducted to generate more awareness regarding milk donation and HMB.

Introduction: More than half of Indian rural women (pregnant and non-pregnant) are anemic. Limited evidence exists on the effectiveness and tolerability of ferric carboxymaltose (FCM) in Indian rural and tribal women.

Aims and objectives: The primary objective was to assess the effectiveness of intravenous (IV) infusion of FCM in iron deficiency anemia (IDA) in rural and tribal women. Secondary objectives included evaluating changes in hematological parameters from baseline and assessing tolerability.

Materials and methods: A prospective, open-label, observational, real-world, single-center study was conducted at Getwell Multispecialty Hospital, Manchar, Pune. Female patients with IDA (Pregnant: Hb 6 to <11 g/dL, non-pregnant: Hb: 6 to <12 g/dl) were recruited. FCM was administered as an IV infusion, and patients were followed up at 6 weeks. Change in Hb, other haematological parameters from baseline were assessed. Adverse effects related to FCM were monitored.

Results: Fifty-five patients completed the study; 7.27% were pregnant and 92.73% were nonpregnant. A significant increase in Hb of 3.64 g/dL was recorded at 6 weeks. All pregnant women achieved the target Hb of 11 g/dL, whereas 58.82% of nonpregnant women reached 12 g/dL; there was a significant increase in hematocrit, mean corpuscular volume, mean corpuscular hemoglobin (MCH), and MCH concentration (P < 0.05 for all) as compared to baseline. FCM infusion was well tolerated.

Conclusions: FCM IV infusion significantly increased Hb levels and other hematological parameters at 6 weeks. FCM appears to be an effective and well-tolerated treatment for IDA in pregnant and non-pregnant women in rural and tribal area.

Background: With the adoption of competency-based medical education (CBME) by the National Medical Commission of India in 2019, assessment methods such as objective structured clinical/practical examination (OSCE/OSPE) have gained importance for objectively evaluating clinical and practical competencies. However, the success of such methods largely depends on effective faculty training and subsequent transfer of training (TOT) to the workplace.

Aim and objectives: This study aimed to evaluate the immediate and long-term TOT among medical faculty following a structured OSCE/OSPE workshop and subsequent implementation in respective departments. The objectives included to design and conduct the training workshop on OSCE/OSPE and to assess knowledge retention, skill application, and impact on student learning using Kirkpatrick's four-level evaluation model.

Materials and methods: A prospective, interventional study was conducted over 3 years at a medical college with an annual intake of 150 MBBS students. The first phase involved training 29 faculty members across 16 departments through a 1-day OSCE/OSPE workshop. The second phase involved implementation in respective departments. Data were collected from trained faculty, peer faculty and students using reflective writing, self-efficacy questionnaires, Likert-scale feedback, and open-ended responses. Quantitative data were analyzed in terms of medians, percentages and satisfaction indices and represented in graphs, whereas qualitative data were transcribed and thematic analysis was conducted.

Results: A total of 29 trained faculty, 53 peer faculty, and 410 students participated in the study. Following the OSCE/OSPE workshop, 94% of departments implemented it in their workplace. Faculty showed significant improvement in knowledge, confidence, and self-efficacy, with satisfaction indices ranging from 80% to 90%. Peer faculty validated the effective application and teamwork of trained faculty. Students found OSCE/OSPE more structured, equitable, and less stressful, with improved confidence and skill retention. The study demonstrated successful TOT at all levels of Kirkpatrick's model, with sustained implementation across 3 years and regular practice thereafter, indicating strong institutional integration and impact.

Conclusions: OSCE/OSPE-based assessment was perceived positively by faculty, peers, and students, reinforcing its value in CBME. Continuous follow-up and institutional commitment are essential for long-term success. The study provides strong evidence that well-structured faculty training, followed by support and evaluation, facilitates effective and sustainable TOT.

Introduction: Vitamin D (VD) deficiency has become a global epidemic in the past 2 decades. Cardiac troponin is a specific biomarker for detecting myocardial injury, particularly in the context of myocardial infarction (MI), where elevated levels are indicative of myocardial necrosis. This study aimed to investigate the relationship between VD levels and troponin values in patients admitted to the Intensive Care Unit under suspicion of acute coronary syndrome, including comparisons with patients ultimately not diagnosed with ACS.

Materials and methods: This cross-sectional study included a group of 69 patients who were hospitalized in the Intensive Care Unit of the Hospital under suspicion of acute coronary syndrome. The control consisted of patients without ACS. The content of VD-(25[OH]D) in blood plasma was measured by enzyme-linked immunosorbent assay during June-August 2024. Blood samples were taken in tubes with ethylenediaminetetraacetic acid anticoagulant. The tubes without anticoagulant were used for collecting blood for VD, fibrinogen, D-dimer, and lipid parameter measurement.

Results: A statistically significant difference in total cholesterol levels was observed between patients with angina pectoris and those with MI (P < 0.05). Pearson correlation analysis also demonstrated a moderate negative correlation between VD levels and troponin values in patients diagnosed with MI (P < 0.05), indicating that lower VD concentrations may be associated with greater myocardial injury.

Conclusions: Based on the data obtained, the medical community is inclined to believe that correction of VD deficiency has great prognostic significance. Further clinical and experimental studies are needed to study in more detail the mechanisms of the negative effects of VD deficiency on the cardiovascular system.

Background: Intracranial aneurysms pose significant challenges due to their potential to rupture, leading to subarachnoid hemorrhage (SAH) with severe neurological consequences. Endovascular treatment has emerged as a minimally invasive alternative to surgical clipping, offering distinct advantages in terms of morbidity and recovery. This study aims to compare the clinical profiles, treatment outcomes, and prognostic factors between microsurgical clipping and endovascular treatment in the management of intracranial aneurysms.

Materials and methods: This study analyzed 103 patients treated for intracranial aneurysms at a tertiary care institution in North India between January 2018 and December 2023. Of these, 53 underwent microsurgical clipping and 50 underwent endovascular treatment. Data on demographics, clinical presentations, aneurysm characteristics, and treatment details were meticulously collected. Immediate and long-term outcomes, including neurological status and complications, were assessed. Statistical analyses, including Chi-square tests and t-tests, were used to identify significant predictors of poor outcomes.

Results: The mean age was 52.43 years for the clipping group and 54.42 years for the endovascular treatment group, with no significant difference (P = 0.951). The most common clinical presentations were headache and altered sensorium, with similar frequencies in both groups. Anterior communicating artery aneurysms were the most common location in both cohorts. The mean duration of operation was significantly longer for clipping (120.5 ± 30.6 min) compared to endovascular treatment (68.53 ± 25.23 min, P < 0.001). Postoperative complications were higher in the clipping group, including vasospasm (22.6% vs. 38.0%, P = 0.090) and cerebral infarcts (22.6% vs. 20.0%, P = 0.741). Endovascular treatment patients had a shorter hospital stay (18.30 ± 9.40 days vs. 27.55 ± 22.43 days, P = 0.162).

Conclusion: Both endovascular treatment and microsurgical clipping are effective treatment modalities for intracranial aneurysms, each with distinct advantages. Endovascular treatment offers a less invasive approach with shorter hospital stays and potentially better long-term outcomes. Microsurgical clipping provides durable aneurysm occlusion and remains critical for complex aneurysms. The choice of treatment should be individualized based on aneurysm characteristics, patient condition, and available expertise.

Background: Pregabalin is being used as preemptive analgesic for better postoperative pain management. This present study was aimed at comparing effectiveness and safety of 75 mg and 150 mg of oral pregabalin given as premedication 1 h before the surgery.

Materials and methods: This was prospective, randomized, and double-blinded placebo controlled study in which 90 patients were enrolled and randomized into three groups of 30 patients each. Groups P75 (given 75 mg pregabalin), P150 (given 150 mg pregabalin) and C (given placebo drug). Postoperative pain and sedation assessment were done. Adverse effects such as somnolence, dizziness, nausea, and vomiting were noted.

Results: Pain was lowest in P150 group than P75 and control group at 2 h. The duration of analgesia was highest in the P150 group followed by the P75 group with the control group showing the shortest duration. A significant difference was observed in total tramadol consumption (P < 0.001) in three groups. Sedation scores were the highest in P150 followed by P75 and C (P < 0.001) during the 1^st h. Somnolence was the highest in P150 group which was statistically significant. Difference in other side effects such as dizziness, nausea, vomiting, headache, and dryness of mouth was not statistically significant.

Conclusion: Pregabalin is a safe drug and has good analgesic effect. Although the analgesic effectiveness of higher dose, i.e., 150 mg was better, adverse effect in terms of sedation was more. Hence, we suggest pregabalin 75 mg to be used preoperatively as it has demonstrated to have good analgesic effectiveness.

Background: Various materials are available to plug screw access hole (SAH) in a screw retained implant prosthesis. Bacterial contamination of this plugging material and its subsequent leakage can contribute to inflammation of peri-implant area.

Aim: The present study aimed to evaluate bacterial contamination of cotton (Co), polytetrafluoroethylene (PTFE), and cotton dipped in 1% chlorhexidine (Co1%CHX) as SAH plugging material.

Materials and methods: Forty implant sites were included in the study. After prosthetic restorations, cotton was used as the primary SAH plugging material in all implant sites. Next month, implant sites were randomly divided into subgroups Co1%CHX and PTFE and given respective plugging material after retrieving the cotton pellet, which was subjected for microbial assay the same day. On the next visit, respective plugging material was retrieved and sent for microbial analysis. SAH was re-plugged with the respective plugging material. Peri-implant sulcular fluid (PISF) was collected from respective sites and stored at - 80°C. After 3 months of the last visit, patients were recalled for the collection of PISF, stored suitably. All the PISF samples were analyzed for interleukin-6 (IL-6) levels via sandwich enzyme-linked immunosorbent assay.

Results and conclusion: Bacterial contamination of cotton was highest and statistically significant when compared with both PTFE and Co1%CHX for both aerobic and anaerobic bacteria. Co1%CHX with fewer positive samples and lower bacterial counts was found to be a better plugging material than PTFE. However, the leakage from SAH for both PTFE and Co1%CHX was insufficient to cause any significant increase in IL-6 levels in PISF of patients after 3 months.