Pub Date : 2023-04-01DOI: 10.4103/jdmimsu.jdmimsu_359_22
Gunjan Tahilramani, Deepali Barapatre, S. Mishra, S. Bhasmey, R. Chowdhary
Aim and Objectives: The stresses transferred from the implant to the surrounding bone greatly influence the clinical outcome of the implant-supported prosthesis. The role of implant-supported prostheses made from zirconia and polyether ether ketone (PEEK) material in transferring stresses is not much known. The purpose of the finite element analysis study was to evaluate stress distribution in an implant-supported fixed dental prosthesis (FDP) using two different framework materials. Materials and Methods: Two three-dimensional models of implant-supported FDPs were designed using ANSYS software, with implants in right maxillary central incisor and canine regions supporting a three-unit fixed partial denture. Model 1 was made using zirconia as a framework material and model 2 using PEEK as a framework material. A static load of 100 N was applied in two directions, i.e., vertically and obliquely at an angle of 30° along the long axis of the implant. The von Mises stress analysis was done to find stresses generated in implants and the prosthesis, and the maximum and minimum principal stress analyses were used to find the stress generated in the bone. Results: Under both the loading conditions, maximum stress concentration was observed in the connector region of model 1 (zirconia group) compared to model 2 (PEEK group); 6.28 MPa versus 2.17 MPa in vertical loading and 8.85 MPa versus 2.69 MPa in oblique loading, respectively. The stresses generated in bone were nearly similar in both models. Conclusion: The framework material does affect the load-bearing capacity of the prosthesis. Stresses observed with PEEK as framework material were lesser compared to zirconia. Therefore, PEEK can be considered a suitable framework material for implant-supported FDPs.
{"title":"Stress distribution in implant-supported fixed dental prosthesis (Pontic Design) using two different framework materials: A finite element analysis","authors":"Gunjan Tahilramani, Deepali Barapatre, S. Mishra, S. Bhasmey, R. Chowdhary","doi":"10.4103/jdmimsu.jdmimsu_359_22","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_359_22","url":null,"abstract":"Aim and Objectives: The stresses transferred from the implant to the surrounding bone greatly influence the clinical outcome of the implant-supported prosthesis. The role of implant-supported prostheses made from zirconia and polyether ether ketone (PEEK) material in transferring stresses is not much known. The purpose of the finite element analysis study was to evaluate stress distribution in an implant-supported fixed dental prosthesis (FDP) using two different framework materials. Materials and Methods: Two three-dimensional models of implant-supported FDPs were designed using ANSYS software, with implants in right maxillary central incisor and canine regions supporting a three-unit fixed partial denture. Model 1 was made using zirconia as a framework material and model 2 using PEEK as a framework material. A static load of 100 N was applied in two directions, i.e., vertically and obliquely at an angle of 30° along the long axis of the implant. The von Mises stress analysis was done to find stresses generated in implants and the prosthesis, and the maximum and minimum principal stress analyses were used to find the stress generated in the bone. Results: Under both the loading conditions, maximum stress concentration was observed in the connector region of model 1 (zirconia group) compared to model 2 (PEEK group); 6.28 MPa versus 2.17 MPa in vertical loading and 8.85 MPa versus 2.69 MPa in oblique loading, respectively. The stresses generated in bone were nearly similar in both models. Conclusion: The framework material does affect the load-bearing capacity of the prosthesis. Stresses observed with PEEK as framework material were lesser compared to zirconia. Therefore, PEEK can be considered a suitable framework material for implant-supported FDPs.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"239 - 243"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42569816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/jdmimsu.jdmimsu_25_22
A. Harrison, N. Rao, Ankitha Hebbar, P. Pavithra
Context: Hemophagocytic lymphohistiocytosis (HLH) is a hyperactive, but ineffective immune response releasing proinflammatory cytokines, culminating in multiorgan failure and death. Clinical mimickers, lack of gold standard tests, equivocal diagnostic criteria, and limited literature delay the diagnosis. After a comprehensive literature review, we surmise that this is the largest study in India involving 14 patients. Settings and Design: This was a retrospective observational study. Subjects and Methods: Out of 11,272 bone marrow (BM) examinations in 5 years and 3 months, hemophagocytosis was observed in 133 aspirates. Clinical details of these were reviewed. Results: Fourteen patients fulfilling HLH-2004 criteria were included in the study. Infection associated HLH was seen in 71.4% patients. Malignancy and autoimmune disease were seen in 14.2% patients each. Fever was the most common presentation. Splenomegaly was seen in only 21.4% cases. Cytopaenia was present in all patients. Hypertriglyceridaemia was seen in 85.7% patients. Hyperferritinaemia was seen in 92.8% patients. Hemophagocytosis was seen in all patients. Conclusions: HLH should be suspected in cases with cytopaenia and hyperinflammatory markers. Early BM examination, clubbed with appropriate investigations, points to the diagnosis. Newer diagnostic modalities are available however, not much is known about their efficacy. More research in this field will immensely contribute to timely initiation of therapy and improved outcome of HLH.
{"title":"Hemophagocytic lymphohistiocytosis: A study of 14 cases","authors":"A. Harrison, N. Rao, Ankitha Hebbar, P. Pavithra","doi":"10.4103/jdmimsu.jdmimsu_25_22","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_25_22","url":null,"abstract":"Context: Hemophagocytic lymphohistiocytosis (HLH) is a hyperactive, but ineffective immune response releasing proinflammatory cytokines, culminating in multiorgan failure and death. Clinical mimickers, lack of gold standard tests, equivocal diagnostic criteria, and limited literature delay the diagnosis. After a comprehensive literature review, we surmise that this is the largest study in India involving 14 patients. Settings and Design: This was a retrospective observational study. Subjects and Methods: Out of 11,272 bone marrow (BM) examinations in 5 years and 3 months, hemophagocytosis was observed in 133 aspirates. Clinical details of these were reviewed. Results: Fourteen patients fulfilling HLH-2004 criteria were included in the study. Infection associated HLH was seen in 71.4% patients. Malignancy and autoimmune disease were seen in 14.2% patients each. Fever was the most common presentation. Splenomegaly was seen in only 21.4% cases. Cytopaenia was present in all patients. Hypertriglyceridaemia was seen in 85.7% patients. Hyperferritinaemia was seen in 92.8% patients. Hemophagocytosis was seen in all patients. Conclusions: HLH should be suspected in cases with cytopaenia and hyperinflammatory markers. Early BM examination, clubbed with appropriate investigations, points to the diagnosis. Newer diagnostic modalities are available however, not much is known about their efficacy. More research in this field will immensely contribute to timely initiation of therapy and improved outcome of HLH.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"249 - 254"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41900995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/jdmimsu.jdmimsu_310_22
Divit Shah, D. Talwar, S. Sushanth Kumar, S. Acharya
Platelets are non-nucleated blood cells that are essential for maintaining hemostasis. While platelet activation and increased platelet numbers (thrombocytosis) are associated with a higher risk of thrombotic events, low platelet counts (thrombocytopenia) and a variety of platelet function abnormalities are associated with a higher risk of bleeding. Platelets and their activation state have been proven in recent years to influence innate and adaptive immune responses, and low platelet counts have been identified as a surrogate indicator for poor prognosis in septic patients. Platelet activation frequently occurs in conjunction with viral infections. Viruses, on the other hand, can interact directly with platelets and megakaryocytes, modulating their function. All these factors contribute to platelet activation, which leads to increased platelet consumption and elimination, as well as thrombocytopenia, which is common during viral infection Platelets and their secreted products have been demonstrated to suppress infection and aid virus persistence in the presence of certain viruses, making platelets a double-edged sword during viral infections. In this review we have highlighted about what is currently known about platelet interactions with various types of viruses, virus effects on platelet activation, as well as platelet-mediated regulation of innate and adaptive immune responses.
{"title":"Platelet indices: Is it a reliable biomarker in viral infections?","authors":"Divit Shah, D. Talwar, S. Sushanth Kumar, S. Acharya","doi":"10.4103/jdmimsu.jdmimsu_310_22","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_310_22","url":null,"abstract":"Platelets are non-nucleated blood cells that are essential for maintaining hemostasis. While platelet activation and increased platelet numbers (thrombocytosis) are associated with a higher risk of thrombotic events, low platelet counts (thrombocytopenia) and a variety of platelet function abnormalities are associated with a higher risk of bleeding. Platelets and their activation state have been proven in recent years to influence innate and adaptive immune responses, and low platelet counts have been identified as a surrogate indicator for poor prognosis in septic patients. Platelet activation frequently occurs in conjunction with viral infections. Viruses, on the other hand, can interact directly with platelets and megakaryocytes, modulating their function. All these factors contribute to platelet activation, which leads to increased platelet consumption and elimination, as well as thrombocytopenia, which is common during viral infection Platelets and their secreted products have been demonstrated to suppress infection and aid virus persistence in the presence of certain viruses, making platelets a double-edged sword during viral infections. In this review we have highlighted about what is currently known about platelet interactions with various types of viruses, virus effects on platelet activation, as well as platelet-mediated regulation of innate and adaptive immune responses.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"322 - 326"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41569554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/jdmimsu.jdmimsu_93_23
M. Deshmukh, Pranali S Fokmare, Gaurav Mishra
In the educational system, evaluation of the student's intelligence and clinical skill in the examination is an important factor. Because of this students', clinical skills are evaluated. Traditional long-case practical examinations are used for this in medical courses students, but every aspect is not covered by the examiner. Moreover, it can be different for every student. Objective structured long examination record (OSLER) is a questionnaire containing 10 items that cover all the domains of the evaluation in the practical long-case examination. This review aimed to see the efficacy of this OSLER in examining the students in different medical courses. Articles were searched on database sources, i.e., Google Scholar and PubMed, using searched words. Articles that meet the criteria were included in this study. This showed that OSLER is used in medical courses examination and is a useful tool to score the students in the practical examinations.
{"title":"A review on the efficacy of structured long examinations used in assessing students in different medical courses","authors":"M. Deshmukh, Pranali S Fokmare, Gaurav Mishra","doi":"10.4103/jdmimsu.jdmimsu_93_23","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_93_23","url":null,"abstract":"In the educational system, evaluation of the student's intelligence and clinical skill in the examination is an important factor. Because of this students', clinical skills are evaluated. Traditional long-case practical examinations are used for this in medical courses students, but every aspect is not covered by the examiner. Moreover, it can be different for every student. Objective structured long examination record (OSLER) is a questionnaire containing 10 items that cover all the domains of the evaluation in the practical long-case examination. This review aimed to see the efficacy of this OSLER in examining the students in different medical courses. Articles were searched on database sources, i.e., Google Scholar and PubMed, using searched words. Articles that meet the criteria were included in this study. This showed that OSLER is used in medical courses examination and is a useful tool to score the students in the practical examinations.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"318 - 321"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45586956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/jdmimsu.jdmimsu_294_21
Gaurav Mishra, A. Dhok, Rohankumar Singh, P. Patwa
Background: Evaluation is a systematic determination of a subject's merit, worth, and significance, using criteria governed by a set of standards. It can assist an organization, program, project, or any other intervention or initiative to assess any aim, reliable concept/proposal, or any alternative, to help in decision-making; or to ascertain the degree of achievement or value in regard to the aim and objectives and results of any such action that has been completed. Materials and Methods: In a sample of 30 with a break up of 19 learners and 11 faculty, a standard curriculum questionnaire (Annexure-II) for ascertaining the “Relevance, Efficiency, Effectiveness, Impact and Sustainability” vide Danish International Development Agency guidelines generated by Development Assessment Committee of Organization for Economic Cooperation and Development the educational process in MD Radiodiagnosis and Diploma in Medical Radiodiagnosis (DMRD) educational program was given to the participating learners and members of the teaching staff to evaluate the “process” of the said educational programs. The participants will be divided into three groups, namely Group-1 (Neutral Opinion), Group-2 (Agreeing and Strongly Agreeing Opinion) and Group-3 (Disagreeing and Strongly Disagreeing opinion). Further, the participants will be required to rate their satisfaction level on a rating scale of 10. Results: Response evaluation of MD Radiodiagnosis group showed significantly higher level of satisfaction in terms of relevance, effectiveness, and efficiency of the curriculum. Response evaluation of DMRD group showed similar results. In comparison of both groups, the level of satisfaction with respect to MD Radiodiagnosis program quantitatively was greater as compared to DMRD program. Conclusion: The evaluation and the obtained results therein were with reference to “process” of the academic program namely MD Radiodiagnosis and DMRD respectively. The evaluation of “product” part could not be included in the study.
{"title":"Evaluation of educational program of doctor of medicine (MD - Radiology) and diploma in medical radio-diagnosis in jawaharlal nehru medical college, a constituent unit of datta meghe institute of medical sciences (Deemed to be University), Sawangi (Meghe), Wardha","authors":"Gaurav Mishra, A. Dhok, Rohankumar Singh, P. Patwa","doi":"10.4103/jdmimsu.jdmimsu_294_21","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_294_21","url":null,"abstract":"Background: Evaluation is a systematic determination of a subject's merit, worth, and significance, using criteria governed by a set of standards. It can assist an organization, program, project, or any other intervention or initiative to assess any aim, reliable concept/proposal, or any alternative, to help in decision-making; or to ascertain the degree of achievement or value in regard to the aim and objectives and results of any such action that has been completed. Materials and Methods: In a sample of 30 with a break up of 19 learners and 11 faculty, a standard curriculum questionnaire (Annexure-II) for ascertaining the “Relevance, Efficiency, Effectiveness, Impact and Sustainability” vide Danish International Development Agency guidelines generated by Development Assessment Committee of Organization for Economic Cooperation and Development the educational process in MD Radiodiagnosis and Diploma in Medical Radiodiagnosis (DMRD) educational program was given to the participating learners and members of the teaching staff to evaluate the “process” of the said educational programs. The participants will be divided into three groups, namely Group-1 (Neutral Opinion), Group-2 (Agreeing and Strongly Agreeing Opinion) and Group-3 (Disagreeing and Strongly Disagreeing opinion). Further, the participants will be required to rate their satisfaction level on a rating scale of 10. Results: Response evaluation of MD Radiodiagnosis group showed significantly higher level of satisfaction in terms of relevance, effectiveness, and efficiency of the curriculum. Response evaluation of DMRD group showed similar results. In comparison of both groups, the level of satisfaction with respect to MD Radiodiagnosis program quantitatively was greater as compared to DMRD program. Conclusion: The evaluation and the obtained results therein were with reference to “process” of the academic program namely MD Radiodiagnosis and DMRD respectively. The evaluation of “product” part could not be included in the study.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"271 - 276"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48221374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/jdmimsu.jdmimsu_191_22
H. Barboza, Fatima Dsilva, M. Moosaba, A. Lobo
Background: The perioperative phase includes a variety of procedures that aim to prepare the patient, physically and psychologically and prevent postoperative complications, thereby reducing the length of hospital stay. Objectives: This study includes the application of various measures to encourage active involvement and prompt participation of the patients in the enhanced recovery. Materials and Methods: A quasi-experimental design was used to evaluate the effectiveness of interventions on enhanced recovery among patients undergoing abdominal surgery at a tertiary care hospital, Mangaluru. Patients undergoing abdominal surgery between 20 to 60 years were selected as participants. Results: The majority of the participants (40%) belonged to the category of normal Body Mass Index (BMI) of 18.5-24.9 Kg/m2 in the experimental group and control group as per BMI categories for Asian populations. There was a significant difference in vital capacity scores between the experimental and control groups (P<0.05) on postoperative days 2 and 3. Thus it proved that deep breathing exercises are effective in improving pulmonary functions. In the experimental group, 60% received oral feed within 6 hours of surgery. The comparison of length of postoperative hospital stays in the experimental and control groups showed a significant difference between the groups (p<0.05) and the average postoperative hospital stay was 4 days in the experimental group. Conclusion: The enhanced surgery recovery protocol provides a faster recovery rate and fewer postoperative complications. These multimodal interventions are useful in routine practice for the optimal perioperative care for patients undergoing open abdominal surgery.
{"title":"Effectiveness of multimodal care interventions on enhanced recovery among the patients undergoing abdominal surgery","authors":"H. Barboza, Fatima Dsilva, M. Moosaba, A. Lobo","doi":"10.4103/jdmimsu.jdmimsu_191_22","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_191_22","url":null,"abstract":"Background: The perioperative phase includes a variety of procedures that aim to prepare the patient, physically and psychologically and prevent postoperative complications, thereby reducing the length of hospital stay. Objectives: This study includes the application of various measures to encourage active involvement and prompt participation of the patients in the enhanced recovery. Materials and Methods: A quasi-experimental design was used to evaluate the effectiveness of interventions on enhanced recovery among patients undergoing abdominal surgery at a tertiary care hospital, Mangaluru. Patients undergoing abdominal surgery between 20 to 60 years were selected as participants. Results: The majority of the participants (40%) belonged to the category of normal Body Mass Index (BMI) of 18.5-24.9 Kg/m2 in the experimental group and control group as per BMI categories for Asian populations. There was a significant difference in vital capacity scores between the experimental and control groups (P<0.05) on postoperative days 2 and 3. Thus it proved that deep breathing exercises are effective in improving pulmonary functions. In the experimental group, 60% received oral feed within 6 hours of surgery. The comparison of length of postoperative hospital stays in the experimental and control groups showed a significant difference between the groups (p<0.05) and the average postoperative hospital stay was 4 days in the experimental group. Conclusion: The enhanced surgery recovery protocol provides a faster recovery rate and fewer postoperative complications. These multimodal interventions are useful in routine practice for the optimal perioperative care for patients undergoing open abdominal surgery.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"244 - 248"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48919944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/jdmimsu.jdmimsu_634_22
V. Pawar, A. Sontakke, S. Pawar
Context: Today, the world is in search of potential biomarkers for assessing the severity and prognosis of coronavirus disease-2019 (COVID-19) disease with its different clinical presentations. Aim: The aim of this study was to assess the roles of C-reactive protein (CRP), lactate dehydrogenase (LDH), procalcitonin (PCT), and methemoglobin (Met-Hb) in the clinical outcome of COVID-19 patients. Settings and Design: This observational cross-sectional study was conducted in COVID-19 cases admitted in the intensive care unit (ICU) of a tertiary care hospital from June 2021 to October 2021. Subjects and Methods: For all selected patients, estimation of CRP, LDH, PCT, and Met-Hb levels was done on the 2nd–3rd days of hospital admission, and definitive outcomes were included sequentially. Results: Out of 495 ICU admissions, 69 patients were evaluated in the end. Out of which, 27 patients died during the hospital stay. The mean Met-Hb, LDH, PCT, and CRP levels in nonsurvivors were significantly high. In multivariate bivariate regression analysis, age (odds ratio [OR]–1.06; 95% confidence interval [CI]: 1.01–1.13; P = 0.021), LDH (OR–1.006; 95% CI: 1.001–1.010; P = 0.013), and CRP (OR–1.03; 95% CI: 1.002–1.6; P = 0.047) were independently associated with nonsurvival of the patients. The receiver operating characteristic curve showed a cutoff value of 684 U/L for LDH which predicted mortality due to COVID-19 disease with 66.7% sensitivity and 70.4% specificity. For CRP, a cutoff value of 28.3 mg/L predicted mortality with 73.8% sensitivity and 59.3% specificity. Conclusions: In conclusion, higher levels of LDH and CRP were related to mortality due to COVID-19 disease. Slightly raised values of Met-Hb in nonsurvivors suggest nonresponding hypoxia. The research in this context may open new options in the treatment of COVID-19 disease.
{"title":"Methemoglobin and inflammatory markers in the context of mortality in COVID-19 disease","authors":"V. Pawar, A. Sontakke, S. Pawar","doi":"10.4103/jdmimsu.jdmimsu_634_22","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_634_22","url":null,"abstract":"Context: Today, the world is in search of potential biomarkers for assessing the severity and prognosis of coronavirus disease-2019 (COVID-19) disease with its different clinical presentations. Aim: The aim of this study was to assess the roles of C-reactive protein (CRP), lactate dehydrogenase (LDH), procalcitonin (PCT), and methemoglobin (Met-Hb) in the clinical outcome of COVID-19 patients. Settings and Design: This observational cross-sectional study was conducted in COVID-19 cases admitted in the intensive care unit (ICU) of a tertiary care hospital from June 2021 to October 2021. Subjects and Methods: For all selected patients, estimation of CRP, LDH, PCT, and Met-Hb levels was done on the 2nd–3rd days of hospital admission, and definitive outcomes were included sequentially. Results: Out of 495 ICU admissions, 69 patients were evaluated in the end. Out of which, 27 patients died during the hospital stay. The mean Met-Hb, LDH, PCT, and CRP levels in nonsurvivors were significantly high. In multivariate bivariate regression analysis, age (odds ratio [OR]–1.06; 95% confidence interval [CI]: 1.01–1.13; P = 0.021), LDH (OR–1.006; 95% CI: 1.001–1.010; P = 0.013), and CRP (OR–1.03; 95% CI: 1.002–1.6; P = 0.047) were independently associated with nonsurvival of the patients. The receiver operating characteristic curve showed a cutoff value of 684 U/L for LDH which predicted mortality due to COVID-19 disease with 66.7% sensitivity and 70.4% specificity. For CRP, a cutoff value of 28.3 mg/L predicted mortality with 73.8% sensitivity and 59.3% specificity. Conclusions: In conclusion, higher levels of LDH and CRP were related to mortality due to COVID-19 disease. Slightly raised values of Met-Hb in nonsurvivors suggest nonresponding hypoxia. The research in this context may open new options in the treatment of COVID-19 disease.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"223 - 227"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47731198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/jdmimsu.jdmimsu_628_22
Somadatta Das, Abhipsa Anjeela, R. Padhy, B. Pradhan
Coronavirus disease-2019 (COVID-19) has quickly spread worldwide, suffering countless people from its severe acute respiratory syndrome and lowering the economic status of almost every nation. A pivotal factor in determining the severity of the current pandemic situation in society was the emergence of the current pandemic, the risk factors associated with the mental state of children with COVID-19 infection, and the immunology and behavior of the children. The treatment of hypoxic children (oxygen saturation below 92%) and the elderly involves oxygen therapy; with the availability of facilities such as continuous positive airway pressure therapy, a nasal cannula with a high flow rate, or a ventilatory tube may be necessary for children and the adult population. Multisystem inflammatory syndrome in children, a newly identified COVID-19-related condition/disease, has also been identified and is now termed omicron.
{"title":"Impact on COVID-19 Pandemic in Children's Mental Health and Current Emergency Care – A Narrative Review","authors":"Somadatta Das, Abhipsa Anjeela, R. Padhy, B. Pradhan","doi":"10.4103/jdmimsu.jdmimsu_628_22","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_628_22","url":null,"abstract":"Coronavirus disease-2019 (COVID-19) has quickly spread worldwide, suffering countless people from its severe acute respiratory syndrome and lowering the economic status of almost every nation. A pivotal factor in determining the severity of the current pandemic situation in society was the emergence of the current pandemic, the risk factors associated with the mental state of children with COVID-19 infection, and the immunology and behavior of the children. The treatment of hypoxic children (oxygen saturation below 92%) and the elderly involves oxygen therapy; with the availability of facilities such as continuous positive airway pressure therapy, a nasal cannula with a high flow rate, or a ventilatory tube may be necessary for children and the adult population. Multisystem inflammatory syndrome in children, a newly identified COVID-19-related condition/disease, has also been identified and is now termed omicron.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"311 - 317"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44377062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/jdmimsu.jdmimsu_423_22
S. Jaura, P. Tiwari, Navneet Singh, H. Kaur
Posterior sternoclavicular joint dislocation (PSCJD) is rare. It is usually due to contact sports or trauma and is often associated with multiple life-threatening complications. We report a case of a Kabaddi player (an Indian contact sport) who was pushed by an opponent and fell on his right shoulder. The patient complained of right shoulder pain and visible deformity over the right sternal area. After initial X-rays, the right posterior dislocation of the sternoclavicular joint was confirmed with computed tomography scan. After the attempts of closed reduction failed, open reduction and internal fixation were done with a double loop of No. 5 ethibond sutures. Excellent results can be achieved in PSCJD using open reduction and reconstruction techniques with double-stranded 5.0 ethibond nonabsorbable sutures.
{"title":"Reconstruction of posterior dislocation of the sternoclavicular joint with nonabsorbable No. 5 ethibond sutures","authors":"S. Jaura, P. Tiwari, Navneet Singh, H. Kaur","doi":"10.4103/jdmimsu.jdmimsu_423_22","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_423_22","url":null,"abstract":"Posterior sternoclavicular joint dislocation (PSCJD) is rare. It is usually due to contact sports or trauma and is often associated with multiple life-threatening complications. We report a case of a Kabaddi player (an Indian contact sport) who was pushed by an opponent and fell on his right shoulder. The patient complained of right shoulder pain and visible deformity over the right sternal area. After initial X-rays, the right posterior dislocation of the sternoclavicular joint was confirmed with computed tomography scan. After the attempts of closed reduction failed, open reduction and internal fixation were done with a double loop of No. 5 ethibond sutures. Excellent results can be achieved in PSCJD using open reduction and reconstruction techniques with double-stranded 5.0 ethibond nonabsorbable sutures.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"100 - 103"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44934499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/jdmimsu.jdmimsu_216_22
K. Tejanand, M. Kamath, M. Gopalakrishnan, B. Harish
Context: Transesophageal echocardiography (TOE) has been widely used intraoperatively in cardiovascular surgeries. Its influence on perioperative decision-making in both surgical and pharmacological planning has been well recognized. A study was undertaken to establish the fact that the routine use of TOE not only reduces the complications of Coronary artery bypass grafting procedures, but also helps in better surgical decision-making. Aims: To compare the regional wall motion abnormality (RWMA) using TOE at pre and postgrafting Off-pump coronary artery bypass (OPCAB) procedure. Settings and Design: The study design involves institutional setting and observational study. Subjects and Methods: Seventy-two adult patients undergoing elective OPCAB procedures were included between January 2019 and June 2020. RWMA and ejection fraction (EF) were assessed before grafting and postgrafting using intraoperative TOE (IOTOE) to quantify the improvement of wall motion, if no improvement then the need for graft revision or additional grafting was suggested. Statistical Analysis Used: Quantitative outcomes were compared using paired t-tests. SPSS 20.0 was used to analyze the data collected. P < 0.05 was considered to be statistically significant. Results: Sixty-five (90%) patients had RWMA and EF improvement after the grafting and 3 (4%) patients had improvement after graft revision as suggested by IOTOE. So, 68 (94%) patients out of 72 had good surgical outcomes. The comparison between pre and postgrafting EF showed a statistically significant difference i.e., P < 0.05. Conclusions: IOTOE can be used routinely as a definitive mandatory monitoring tool to help in appropriate intra-operative surgical decision-making in patients undergoing OPCAB to enable better surgical outcomes and thereby reduce the morbidity and mortality associated with the procedure.
{"title":"Assessment of regional wall motion abnormality using transesophageal echocardiography in patient undergoing off pump coronary artery bypass grafting – An observational study","authors":"K. Tejanand, M. Kamath, M. Gopalakrishnan, B. Harish","doi":"10.4103/jdmimsu.jdmimsu_216_22","DOIUrl":"https://doi.org/10.4103/jdmimsu.jdmimsu_216_22","url":null,"abstract":"Context: Transesophageal echocardiography (TOE) has been widely used intraoperatively in cardiovascular surgeries. Its influence on perioperative decision-making in both surgical and pharmacological planning has been well recognized. A study was undertaken to establish the fact that the routine use of TOE not only reduces the complications of Coronary artery bypass grafting procedures, but also helps in better surgical decision-making. Aims: To compare the regional wall motion abnormality (RWMA) using TOE at pre and postgrafting Off-pump coronary artery bypass (OPCAB) procedure. Settings and Design: The study design involves institutional setting and observational study. Subjects and Methods: Seventy-two adult patients undergoing elective OPCAB procedures were included between January 2019 and June 2020. RWMA and ejection fraction (EF) were assessed before grafting and postgrafting using intraoperative TOE (IOTOE) to quantify the improvement of wall motion, if no improvement then the need for graft revision or additional grafting was suggested. Statistical Analysis Used: Quantitative outcomes were compared using paired t-tests. SPSS 20.0 was used to analyze the data collected. P < 0.05 was considered to be statistically significant. Results: Sixty-five (90%) patients had RWMA and EF improvement after the grafting and 3 (4%) patients had improvement after graft revision as suggested by IOTOE. So, 68 (94%) patients out of 72 had good surgical outcomes. The comparison between pre and postgrafting EF showed a statistically significant difference i.e., P < 0.05. Conclusions: IOTOE can be used routinely as a definitive mandatory monitoring tool to help in appropriate intra-operative surgical decision-making in patients undergoing OPCAB to enable better surgical outcomes and thereby reduce the morbidity and mortality associated with the procedure.","PeriodicalId":15592,"journal":{"name":"Journal of Datta Meghe Institute of Medical Sciences University","volume":"18 1","pages":"50 - 57"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43027050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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