Pub Date : 2021-08-31DOI: 10.5005/jp-journals-10057-0162
Vijay B. Gaikwad, Sharayu N Garud, Astha Ganeriwal
Stroke is a “Rapidly developing clinical signs of focal or global disturbances of cerebral functions lasting for more than 24 hours”. 1 One of the most important causes of high morbidity and mortality all over the world is stroke. The diseases of cerebral blood vessels and their related infarcts and hemorrhages occur in the elderly as well as the young. The various abnormalities in lipid profile have been reported in young patients with stroke. Both hypercholesterolemia and hypertriglyceridemia appear to be important risk factors for atherosclerosis. A total of 50 subjects were selected by non-probability convenient sampling method at the tertiary care center. Out of all patients fulfilling the inclusion criteria of the age-group of 15–45 years. Dyslipidemia was seen in 32% [90% CI (22.31–43.53%)] of patients. Cortical venous thrombosis in 9 (18%) [90% CI (10.78–28.50%)] patients all of them were women. All but one was in a postpartum state. There was a single case of antiphospholipid antibody syndrome. Ten percent [90% CI (4.95–19.15%)] and 4% [90% CI (1.33–11.39%)] of patients were found to have rheumatic heart disease and systemic lupus erythematosus, respectively. One of the ischemic and hemorrhagic strokes was undiagnosed [90% CI (0.5–8.8%)]. Dyslipidemia as in elevated LDL and decreased HDL was a common finding. Dyslipidemia was found as the most common etiology for stroke in the young. Diagnostic challenges are to be expected while evaluating these patients.
{"title":"Dyslipidemia: A Cause of Stroke in Young Adults","authors":"Vijay B. Gaikwad, Sharayu N Garud, Astha Ganeriwal","doi":"10.5005/jp-journals-10057-0162","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0162","url":null,"abstract":"Stroke is a “Rapidly developing clinical signs of focal or global disturbances of cerebral functions lasting for more than 24 hours”. 1 One of the most important causes of high morbidity and mortality all over the world is stroke. The diseases of cerebral blood vessels and their related infarcts and hemorrhages occur in the elderly as well as the young. The various abnormalities in lipid profile have been reported in young patients with stroke. Both hypercholesterolemia and hypertriglyceridemia appear to be important risk factors for atherosclerosis. A total of 50 subjects were selected by non-probability convenient sampling method at the tertiary care center. Out of all patients fulfilling the inclusion criteria of the age-group of 15–45 years. Dyslipidemia was seen in 32% [90% CI (22.31–43.53%)] of patients. Cortical venous thrombosis in 9 (18%) [90% CI (10.78–28.50%)] patients all of them were women. All but one was in a postpartum state. There was a single case of antiphospholipid antibody syndrome. Ten percent [90% CI (4.95–19.15%)] and 4% [90% CI (1.33–11.39%)] of patients were found to have rheumatic heart disease and systemic lupus erythematosus, respectively. One of the ischemic and hemorrhagic strokes was undiagnosed [90% CI (0.5–8.8%)]. Dyslipidemia as in elevated LDL and decreased HDL was a common finding. Dyslipidemia was found as the most common etiology for stroke in the young. Diagnostic challenges are to be expected while evaluating these patients.","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80763924","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 : 2021-08-31DOI: 10.5005/jp-journals-10057-0155
P. Rijhwani, Aviral Gupta, Anchin Kalia, C. Mittal, S. Choudhary, M. Sarna, Aakriti Vij
A bstrAct Aim and background: In this study, the role of hematological indices in coronavirus disease 2019 (COVID-19) patients’ prognosis who have visited our hospital has been evaluated. Materials and methods: Clinical profile, disease severity, disease outcome, blood parameters [hemoglobin, white blood cell counts, neutrophil counts, lymphocyte counts, neutrophil:lymphocyte ratio (NLR), lymphocyte:monocyte ratio, platelet counts, eosinophil count, and platelet:lymphocyte ratio (PLR)] were evaluated in patients with confirmed COVID-19 infection. Results: High values of leukocytes, neutrophils, and low value of platelets, eosinophil counts indicated poor prognosis in COVID-19 patients. High NLR, PLR, and low lymphocyte:monocyte ratio also indicated a bad prognosis. Conclusion: Monocyte count, lymphocyte count, eosinophil count, NLR, lymphocyte monocyte ratio, and PLR values can be used in the prognosis of COVID-19 patients.
{"title":"Role of Hematological Indices in COVID-19 Patient's Prognosis","authors":"P. Rijhwani, Aviral Gupta, Anchin Kalia, C. Mittal, S. Choudhary, M. Sarna, Aakriti Vij","doi":"10.5005/jp-journals-10057-0155","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0155","url":null,"abstract":"A bstrAct Aim and background: In this study, the role of hematological indices in coronavirus disease 2019 (COVID-19) patients’ prognosis who have visited our hospital has been evaluated. Materials and methods: Clinical profile, disease severity, disease outcome, blood parameters [hemoglobin, white blood cell counts, neutrophil counts, lymphocyte counts, neutrophil:lymphocyte ratio (NLR), lymphocyte:monocyte ratio, platelet counts, eosinophil count, and platelet:lymphocyte ratio (PLR)] were evaluated in patients with confirmed COVID-19 infection. Results: High values of leukocytes, neutrophils, and low value of platelets, eosinophil counts indicated poor prognosis in COVID-19 patients. High NLR, PLR, and low lymphocyte:monocyte ratio also indicated a bad prognosis. Conclusion: Monocyte count, lymphocyte count, eosinophil count, NLR, lymphocyte monocyte ratio, and PLR values can be used in the prognosis of COVID-19 patients.","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86462411","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 : 2021-08-31DOI: 10.5005/jp-journals-10057-0146
Sarvesh Maheshwari, B. Sharma, M. Misra
Background: There are two standardized techniques for the laparoendoscopic repair of inguinal hernia, i.e., transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP); however, both are associated with a steep learning curve. The objective of the present study was to define the learning curve of a laparoendoscopic inguinal hernia repair for both TEP repair and TAPP repair. Material and methods: In this prospective study, 85 patients with inguinal hernia posted for laparoendoscopic inguinal hernia repair using either TEP or TAPP were included to assess the learning curve. The learning curve was assessed for junior surgeon (otherwise experienced laparoscopic surgeon not performing laparoendoscopic groin hernia repair) under the direct supervision of senior surgeon (regularly performing laparoendoscopic groin hernia repair). The study period was between January 2018 and June 2019. A comparison was done based on patient demographics, details of operative procedure [TEP or TAPP, operative time, intraoperative difficulty, peritoneal laceration (TEP), vascular injury, conversion from TEP to TAPP, and/or open hernia repair] postoperative hospital stay, intraoperative complications, conversion rate, hospital stay in days, and postoperative complications. Results: Out of 85, 50 patients were operated by the senior surgeon (TAPP was done in 38 cases and TEP was done in 12) and 35 by the junior surgeon (TAPP was done in 14 cases and TEP in 20 and 1 case, i.e., 1.2% was converted from laparoscopic to open). There were 103 groin hernias in 85 patients in the study. Indirect, direct, and combined hernias were present in 39, 28, and 36, respectively. In our study, there was less prevalence of direct hernia, i.e., 32.8% out of which 38 and 62% were operated by the senior and junior surgeons, respectively, whereas 45.6% were indirect hernia out of which 40 and 60% were operated by the senior and junior surgeons, that shows its high prevalence. 17.6%, i.e., 15 cases were found to be bilateral hernia out of which 73.33% were operated by the senior surgeon while 82.4%, i.e., 70 cases were unilateral hernia out of which 60% were operated by the junior surgeon, statistically not significant ( p = 0.44). The patients operated by the senior surgeon had higher mean age, i.e., 53 ± 17.43 years as compared to the junior surgeon, i.e., 46 ± 14.22 years ( p value = 0.043) with statistically significant. Mean operating time by the senior surgeon was 49 ± 4.63 minutes, and 62 ± 4.20 minutes for the junior surgeon with a p value of 0.0005, statistically highly significant. 25.33% of patients had intraoperative complications and 24.13% of patients had a peritoneal injury. The surgeries done by the junior surgeon had 30% of peritoneal injury while it was 21.05% for the senior surgeon in the TEP procedure, statistically not significant ( p = 0.56). Twenty percent of patients had postoperative complications out of which urinary retention was maximum, i.e., in 8 (9.4%) sta
{"title":"Learning Curve in Laparoscopic Inguinal Hernia Repair","authors":"Sarvesh Maheshwari, B. Sharma, M. Misra","doi":"10.5005/jp-journals-10057-0146","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0146","url":null,"abstract":"Background: There are two standardized techniques for the laparoendoscopic repair of inguinal hernia, i.e., transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP); however, both are associated with a steep learning curve. The objective of the present study was to define the learning curve of a laparoendoscopic inguinal hernia repair for both TEP repair and TAPP repair. Material and methods: In this prospective study, 85 patients with inguinal hernia posted for laparoendoscopic inguinal hernia repair using either TEP or TAPP were included to assess the learning curve. The learning curve was assessed for junior surgeon (otherwise experienced laparoscopic surgeon not performing laparoendoscopic groin hernia repair) under the direct supervision of senior surgeon (regularly performing laparoendoscopic groin hernia repair). The study period was between January 2018 and June 2019. A comparison was done based on patient demographics, details of operative procedure [TEP or TAPP, operative time, intraoperative difficulty, peritoneal laceration (TEP), vascular injury, conversion from TEP to TAPP, and/or open hernia repair] postoperative hospital stay, intraoperative complications, conversion rate, hospital stay in days, and postoperative complications. Results: Out of 85, 50 patients were operated by the senior surgeon (TAPP was done in 38 cases and TEP was done in 12) and 35 by the junior surgeon (TAPP was done in 14 cases and TEP in 20 and 1 case, i.e., 1.2% was converted from laparoscopic to open). There were 103 groin hernias in 85 patients in the study. Indirect, direct, and combined hernias were present in 39, 28, and 36, respectively. In our study, there was less prevalence of direct hernia, i.e., 32.8% out of which 38 and 62% were operated by the senior and junior surgeons, respectively, whereas 45.6% were indirect hernia out of which 40 and 60% were operated by the senior and junior surgeons, that shows its high prevalence. 17.6%, i.e., 15 cases were found to be bilateral hernia out of which 73.33% were operated by the senior surgeon while 82.4%, i.e., 70 cases were unilateral hernia out of which 60% were operated by the junior surgeon, statistically not significant ( p = 0.44). The patients operated by the senior surgeon had higher mean age, i.e., 53 ± 17.43 years as compared to the junior surgeon, i.e., 46 ± 14.22 years ( p value = 0.043) with statistically significant. Mean operating time by the senior surgeon was 49 ± 4.63 minutes, and 62 ± 4.20 minutes for the junior surgeon with a p value of 0.0005, statistically highly significant. 25.33% of patients had intraoperative complications and 24.13% of patients had a peritoneal injury. The surgeries done by the junior surgeon had 30% of peritoneal injury while it was 21.05% for the senior surgeon in the TEP procedure, statistically not significant ( p = 0.56). Twenty percent of patients had postoperative complications out of which urinary retention was maximum, i.e., in 8 (9.4%) sta","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86442532","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 : 2021-08-31DOI: 10.5005/jp-journals-10057-0142
P. Gupta, Kishor C. Singh, G. Devpura
Introduction: Incidence of skin manifestations in diabetes mellitus (DM) varies from 11.3 to 70.6% and may manifest once the primary disease has already developed, but may also occur coincidently with its onset or may even precede DM in some of the cases. Our study is an attempt to analyze the pattern of various types of skin manifestations seen in DM. Aims and objectives: To study and analyze the various skin manifestations in patients of DM. Materials and methods: Two hundred patients of DM were enrolled. A detailed history was taken, investigations like preprandial and postprandial capillary plasma glucose and HbA1c were done. Diabetes was considered controlled when preprandial capillary plasma glucose 3.9–7.2 mmol/L (70–130 mg/dL), postprandial capillary plasma glucose < 180 mg/dL, and HbA1c < 7.0%. Results: Infections were the commonest skin manifestation present in a total of 81% of patients (56% fungal, 19% bacterial, and 6% viral) followed by conditions associated with DM present in 67% of patients (skin tag 33% was the commonest). Miscellaneous skin conditions were present in 62% of patients (discoloration of nails was the commonest 11%). Conclusion: Various skin manifestations may appear early and remain undetected till DM is diagnosed. The majority of patients do not take regular treatment and follow dietary restrictions in early diabetes leading to a persistent hyperglycemic state which predisposes to infections and other skin manifestations. The presence of easily visible skin manifestations can heighten the suspicion for early diagnosis of DM and thus, may very well be taken as a clinical marker of DM.
{"title":"A Tertiary Care Hospital-based Study of Various Skin Manifestations in Diabetes Mellitus Patients: Skin as a Clinical Marker of Diabetes Mellitus","authors":"P. Gupta, Kishor C. Singh, G. Devpura","doi":"10.5005/jp-journals-10057-0142","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0142","url":null,"abstract":"Introduction: Incidence of skin manifestations in diabetes mellitus (DM) varies from 11.3 to 70.6% and may manifest once the primary disease has already developed, but may also occur coincidently with its onset or may even precede DM in some of the cases. Our study is an attempt to analyze the pattern of various types of skin manifestations seen in DM. Aims and objectives: To study and analyze the various skin manifestations in patients of DM. Materials and methods: Two hundred patients of DM were enrolled. A detailed history was taken, investigations like preprandial and postprandial capillary plasma glucose and HbA1c were done. Diabetes was considered controlled when preprandial capillary plasma glucose 3.9–7.2 mmol/L (70–130 mg/dL), postprandial capillary plasma glucose < 180 mg/dL, and HbA1c < 7.0%. Results: Infections were the commonest skin manifestation present in a total of 81% of patients (56% fungal, 19% bacterial, and 6% viral) followed by conditions associated with DM present in 67% of patients (skin tag 33% was the commonest). Miscellaneous skin conditions were present in 62% of patients (discoloration of nails was the commonest 11%). Conclusion: Various skin manifestations may appear early and remain undetected till DM is diagnosed. The majority of patients do not take regular treatment and follow dietary restrictions in early diabetes leading to a persistent hyperglycemic state which predisposes to infections and other skin manifestations. The presence of easily visible skin manifestations can heighten the suspicion for early diagnosis of DM and thus, may very well be taken as a clinical marker of DM.","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89645885","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 : 2021-08-31DOI: 10.5005/jp-journals-10057-0157
Mukesh Jain, P. Rijhwani, Arpit Pareek, D. P. Bansal, R. Jat, P. Agarwal, A. Tyag
Background and aim: The normal level of serum uric acid (SUA) is generally 6.5–7 mg/dL for males and 6–6.5 mg/dL for females. The prevalence of hypertension and complications has rapidly increased worldwide, leading to significantly increased morbidity and mortality. Serum uric acid is one of the emerging recognized laboratory markers for cardiovascular diseases (CVD) in recent years. Thus, we conducted the present study to assess whether there exists an association of SUA with CVD in hypertensive patients. Materials and methods: This case–control study was conducted in 75 hypertensive patients with 25 cases having cardiovascular disease and 50 hypertensive control attending the OPD and IPD of the Department of General Medicine, Mahatma Gandhi Medical College, Jaipur. Results: In this study, mean uric acid in CVD patient was 5.89 + 1.66 mg/dL and in controls, it is 4.31 + 1.07 mg/dL. This difference was a statistically significant ( p value < 0.001) negative correlation between uric acid and ejection fraction. It shows with the increment of uric acid levels ejection fraction decreases proportionately. As the severity of cardiovascular disease increases, uric acid levels also increase. Conclusion: According to our study, it seems that UA is a real risk factor for the development of CVD. We have shown that serum uric acid levels are negatively associated with ejection fraction. Under these conditions of reduced ejection fraction, serum uric acid is an independent risk factor for CVD, respectively, in individuals with hypertension.
{"title":"Study of Correlation of Serum Uric Acid Level and Cardiovascular Diseases and Its Severity: An Observational Case–Control Study","authors":"Mukesh Jain, P. Rijhwani, Arpit Pareek, D. P. Bansal, R. Jat, P. Agarwal, A. Tyag","doi":"10.5005/jp-journals-10057-0157","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0157","url":null,"abstract":"Background and aim: The normal level of serum uric acid (SUA) is generally 6.5–7 mg/dL for males and 6–6.5 mg/dL for females. The prevalence of hypertension and complications has rapidly increased worldwide, leading to significantly increased morbidity and mortality. Serum uric acid is one of the emerging recognized laboratory markers for cardiovascular diseases (CVD) in recent years. Thus, we conducted the present study to assess whether there exists an association of SUA with CVD in hypertensive patients. Materials and methods: This case–control study was conducted in 75 hypertensive patients with 25 cases having cardiovascular disease and 50 hypertensive control attending the OPD and IPD of the Department of General Medicine, Mahatma Gandhi Medical College, Jaipur. Results: In this study, mean uric acid in CVD patient was 5.89 + 1.66 mg/dL and in controls, it is 4.31 + 1.07 mg/dL. This difference was a statistically significant ( p value < 0.001) negative correlation between uric acid and ejection fraction. It shows with the increment of uric acid levels ejection fraction decreases proportionately. As the severity of cardiovascular disease increases, uric acid levels also increase. Conclusion: According to our study, it seems that UA is a real risk factor for the development of CVD. We have shown that serum uric acid levels are negatively associated with ejection fraction. Under these conditions of reduced ejection fraction, serum uric acid is an independent risk factor for CVD, respectively, in individuals with hypertension.","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81100718","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 : 2021-08-31DOI: 10.5005/jp-journals-10057-0149
Dinesh Yadav, Ashish Jain, P. Rijhwani, Anchin Kalia, Manu Jain, A. Tyagi
Mucormycosis is a fungal infection, caused by fungi of the order Mucorales of subphylum Mucoromycotina. It is an aggressive, life-threatening infection that is common in immunocompromised patients and diabetics. COVID-19 infection and its treatment renders the patient severely immunocompromised and can increase the risk of such secondary infections. Here, we present a case of a 62-year-old man, a known case of diabetes who was recently diagnosed as COVID-19 positive. He then complained of left eye swelling and pain, with chemosis while being on steroids and remdesivir for the COVID-19 pneumonia. He was later diagnosed with orbital cellulitis, with a possible fungal infection which was later confirmed microbiologically. The patient was started on liposomal amphotericin B and high-grade antibiotics for orbital cellulitis. The patient later succumbed to sepsis-related complications. We conclude that prompt identification of symptoms and early initiation of therapy is necessary to have a better outcome in such cases, also this case can help us be more vigilant in diabetic patients with COVID-19, in whom therapeutic agents like steroids and monoclonal antibodies should be given at lowest recommended doses.
{"title":"Mucormycosis: A Deadly Complication of COVID-19 and Diabetes","authors":"Dinesh Yadav, Ashish Jain, P. Rijhwani, Anchin Kalia, Manu Jain, A. Tyagi","doi":"10.5005/jp-journals-10057-0149","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0149","url":null,"abstract":"Mucormycosis is a fungal infection, caused by fungi of the order Mucorales of subphylum Mucoromycotina. It is an aggressive, life-threatening infection that is common in immunocompromised patients and diabetics. COVID-19 infection and its treatment renders the patient severely immunocompromised and can increase the risk of such secondary infections. Here, we present a case of a 62-year-old man, a known case of diabetes who was recently diagnosed as COVID-19 positive. He then complained of left eye swelling and pain, with chemosis while being on steroids and remdesivir for the COVID-19 pneumonia. He was later diagnosed with orbital cellulitis, with a possible fungal infection which was later confirmed microbiologically. The patient was started on liposomal amphotericin B and high-grade antibiotics for orbital cellulitis. The patient later succumbed to sepsis-related complications. We conclude that prompt identification of symptoms and early initiation of therapy is necessary to have a better outcome in such cases, also this case can help us be more vigilant in diabetic patients with COVID-19, in whom therapeutic agents like steroids and monoclonal antibodies should be given at lowest recommended doses.","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89583507","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 : 2021-08-31DOI: 10.5005/jp-journals-10057-0148
P. Gupta, B. Gupta, G. Devpura
Ab s t r Ac t Background: Magnesium is the second most abundant intracellular cation in the body and recently there has been an emerging interest in its major role played in various physiological and disease states of the body. Its deficiency is being correlated with pathogenesis, glycemic control, and various complications occurring in patients of diabetes mellitus (DM) in many studies. Aim and objective: To estimate serum magnesium levels in diabetic patients and correlating it with pathogenesis, duration of diabetes, poor glycemic control, and various complications in our tertiary care hospital patients. Materials and methods: This is a case-control, prospective study comprising 120 diabetic patients diagnosed as per recommended criteria of ADA and were evaluated at NIMS Medical College, Jaipur, Rajasthan. Keeping serum magnesium value threshold of 1.6 mg/dL, all patients were divided into two groups; hypomagnesemic(s) and normomagnesemic(s). Twenty-five healthy age-matched controls were also enrolled and compared. Results: We observed 120 patients (52.5% males and 47.5% females), with age ranges between 36 years and 78 years; however, 60% of patients were in the range of 40–65 years. Mean serum values in hypomagnesemic, normomagnesemic, and healthy controls were detected in the range 1.54 ± 0.43, 1.81 ± 0.56, and 2.12 ± 0.67, respectively. 60.8% of diabetic patients had one or more diabetic complications; more in hypomagnesemic (83.3%) compared with normomagnesemic (51.9%). Microvascular complications were the most common. A single case of neuromuscular weakness was also detected. Conclusion: Hypomagnesemia is common in patients of type 2 DM (T2DM) and has a negative correlation with its incidence, duration of disease, poor glycemic control, and various complications of DM. The therapeutic potential of serum magnesium is worth exploring via large clinical trials. Since replenishment of serum magnesium is a simple clinical entity, thus, it will be prudent to measure serum magnesium in each diabetic patient and replenish it accordingly.
{"title":"A Hospital-based Prospective Study of Hypomagnesemia in Type 2 Diabetes Mellitus Patients","authors":"P. Gupta, B. Gupta, G. Devpura","doi":"10.5005/jp-journals-10057-0148","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0148","url":null,"abstract":"Ab s t r Ac t Background: Magnesium is the second most abundant intracellular cation in the body and recently there has been an emerging interest in its major role played in various physiological and disease states of the body. Its deficiency is being correlated with pathogenesis, glycemic control, and various complications occurring in patients of diabetes mellitus (DM) in many studies. Aim and objective: To estimate serum magnesium levels in diabetic patients and correlating it with pathogenesis, duration of diabetes, poor glycemic control, and various complications in our tertiary care hospital patients. Materials and methods: This is a case-control, prospective study comprising 120 diabetic patients diagnosed as per recommended criteria of ADA and were evaluated at NIMS Medical College, Jaipur, Rajasthan. Keeping serum magnesium value threshold of 1.6 mg/dL, all patients were divided into two groups; hypomagnesemic(s) and normomagnesemic(s). Twenty-five healthy age-matched controls were also enrolled and compared. Results: We observed 120 patients (52.5% males and 47.5% females), with age ranges between 36 years and 78 years; however, 60% of patients were in the range of 40–65 years. Mean serum values in hypomagnesemic, normomagnesemic, and healthy controls were detected in the range 1.54 ± 0.43, 1.81 ± 0.56, and 2.12 ± 0.67, respectively. 60.8% of diabetic patients had one or more diabetic complications; more in hypomagnesemic (83.3%) compared with normomagnesemic (51.9%). Microvascular complications were the most common. A single case of neuromuscular weakness was also detected. Conclusion: Hypomagnesemia is common in patients of type 2 DM (T2DM) and has a negative correlation with its incidence, duration of disease, poor glycemic control, and various complications of DM. The therapeutic potential of serum magnesium is worth exploring via large clinical trials. Since replenishment of serum magnesium is a simple clinical entity, thus, it will be prudent to measure serum magnesium in each diabetic patient and replenish it accordingly.","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79986456","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 : 2021-08-31DOI: 10.5005/jp-journals-10057-0160
Siddharth Mankar, Vijay K Gaikwad, Astha Ganeriwal
Introduction: 2D echo is a non-invasive, rapid, investigation that enables us to visualize the heart directly in real-time using ultrasound and can help in such situations in diagnosing AMI by detecting any regional wall motion abnormality. The diagnosis of ST-elevation in myocardial infarction (STEMI) is usually based on patient’s history and ECG findings, but it should be taken into account that patients may present with atypical symptoms, also it takes cardiac enzymes some time to elevate above the normal range after the onset of chest pain. Materials and methods: A total of 100 diagnosed patients with the first episode of acute ST-elevation myocardial infarction who reported in the emergency were included in the study and who have given written informed consent. On admission, patients with typical or atypical ischemic symptoms and ECG changes of ST-segment elevation of > 0.1 mV (1 mm) in leads 2, 3, avF, V4, V5, V6, 1, and avL, and in leads V2, V3 > 0.2 mV (2 mm) in males > 40 years, > 0.25 mV in males 0.15 mV in females, in 2 contiguous leads were diagnosed as acute STEMI. Observation and results: In our study, mechanical complications of AMI were detected on 2D echo, of which, mitral regurgitation was found in 23 patients (23%), the ventricular septal rupture was found in 3 patients (3%), ventricular free wall rupture in 2%, papillary muscle rupture in 11%, pericardial effusion was found in 13%, and LV clot was found in 11% patients. Conclusion: Acute myocardial infarction is seen more commonly in the age-group of 61–70 years and it is more common among males. Killip classification of patients has prognostic value and helps in accessing the severity of myocardial infarction. Mechanical complications of AMI can be detected by 2D echo and can aid accordingly in treatment.
{"title":"Early Diagnosis of Complications of ST-elevation Myocardial Infarction with 2D Echocardiography","authors":"Siddharth Mankar, Vijay K Gaikwad, Astha Ganeriwal","doi":"10.5005/jp-journals-10057-0160","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0160","url":null,"abstract":"Introduction: 2D echo is a non-invasive, rapid, investigation that enables us to visualize the heart directly in real-time using ultrasound and can help in such situations in diagnosing AMI by detecting any regional wall motion abnormality. The diagnosis of ST-elevation in myocardial infarction (STEMI) is usually based on patient’s history and ECG findings, but it should be taken into account that patients may present with atypical symptoms, also it takes cardiac enzymes some time to elevate above the normal range after the onset of chest pain. Materials and methods: A total of 100 diagnosed patients with the first episode of acute ST-elevation myocardial infarction who reported in the emergency were included in the study and who have given written informed consent. On admission, patients with typical or atypical ischemic symptoms and ECG changes of ST-segment elevation of > 0.1 mV (1 mm) in leads 2, 3, avF, V4, V5, V6, 1, and avL, and in leads V2, V3 > 0.2 mV (2 mm) in males > 40 years, > 0.25 mV in males 0.15 mV in females, in 2 contiguous leads were diagnosed as acute STEMI. Observation and results: In our study, mechanical complications of AMI were detected on 2D echo, of which, mitral regurgitation was found in 23 patients (23%), the ventricular septal rupture was found in 3 patients (3%), ventricular free wall rupture in 2%, papillary muscle rupture in 11%, pericardial effusion was found in 13%, and LV clot was found in 11% patients. Conclusion: Acute myocardial infarction is seen more commonly in the age-group of 61–70 years and it is more common among males. Killip classification of patients has prognostic value and helps in accessing the severity of myocardial infarction. Mechanical complications of AMI can be detected by 2D echo and can aid accordingly in treatment.","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"65 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91499416","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 : 2021-08-31DOI: 10.5005/jp-journals-10057-0161
N. Arora, Yashraj Jain, Vaishnavi Gupta, Sushil Mokashi, Chiranjibi Panda
In today’s world, there is more reliance on technologically advanced systems and artificial intelligence (AI) to shoulder the work-related commitments of individuals, corporate giants, government, or businesses. Artificial intelligence refers to the human-like intelligence exhibited by a computer, robot, or other machines (www.ibm.com). Many high-tech advancements in the field of healthcare are all due to improvements and evolutions in AI. Moreover, an AI-powered chatbot swiftly responds to all the queries; reducing the lag time and other hindrances. They have become real-time healthcare assistants, bringing about revolutions in the healthcare industry. The future belongs to AI-enabled technologies and henceforth, leading to an increased importance of the introduction of this kind of technology in the public health sector also. An important constituent in the public health sector is a maternal issue like breastfeeding. There are several challenges, doubts, hesitations, and skepticism that new mothers face while breastfeeding their kids. Along with facing postpartum depression, several new or first-time mothers have limited knowledge about breastfeeding. This paper focuses on the usage of AI-enabled chatbots that educates first-time mothers regarding anxiety, stress, postpartum depression, and lactation patterns. The paper gives an insight into the adoption behavior of new mothers using chatbots related to breastfeeding counseling. The authors have gone thru 85 peer-reviewed papers published between the years 2002 and 2020 and found this research to be one of its kinds in this sphere. The study includes the population of new mothers from the city of Amritsar and Jaipur, India, and gives solutions with respect to problems and doubts pertaining to breastfeeding the newborn.
{"title":"Assessment on Adoption Behavior of First-time Mothers on the Usage of Chatbots for Breastfeeding Consultation","authors":"N. Arora, Yashraj Jain, Vaishnavi Gupta, Sushil Mokashi, Chiranjibi Panda","doi":"10.5005/jp-journals-10057-0161","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0161","url":null,"abstract":"In today’s world, there is more reliance on technologically advanced systems and artificial intelligence (AI) to shoulder the work-related commitments of individuals, corporate giants, government, or businesses. Artificial intelligence refers to the human-like intelligence exhibited by a computer, robot, or other machines (www.ibm.com). Many high-tech advancements in the field of healthcare are all due to improvements and evolutions in AI. Moreover, an AI-powered chatbot swiftly responds to all the queries; reducing the lag time and other hindrances. They have become real-time healthcare assistants, bringing about revolutions in the healthcare industry. The future belongs to AI-enabled technologies and henceforth, leading to an increased importance of the introduction of this kind of technology in the public health sector also. An important constituent in the public health sector is a maternal issue like breastfeeding. There are several challenges, doubts, hesitations, and skepticism that new mothers face while breastfeeding their kids. Along with facing postpartum depression, several new or first-time mothers have limited knowledge about breastfeeding. This paper focuses on the usage of AI-enabled chatbots that educates first-time mothers regarding anxiety, stress, postpartum depression, and lactation patterns. The paper gives an insight into the adoption behavior of new mothers using chatbots related to breastfeeding counseling. The authors have gone thru 85 peer-reviewed papers published between the years 2002 and 2020 and found this research to be one of its kinds in this sphere. The study includes the population of new mothers from the city of Amritsar and Jaipur, India, and gives solutions with respect to problems and doubts pertaining to breastfeeding the newborn.","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81146578","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 : 2021-08-31DOI: 10.5005/jp-journals-10057-0147
Neha Bagri, R. Misra
Aim and objective: We report a rare case of the canal of Nuck hernia containing part of the uterus and both ovaries as its contents. The aim is to build up the awareness of this condition by reviewing the ultrasound and MRI imaging findings and identification of prolapsed ovary with correct knowledge of the entity and focused analysis. Background: The patent canal of Nuck is one of the rare developmental entities in females. Hernia of the canal of Nuck is an extension of the peritoneal fold through the inguinal canal up to the labia majora. Defective obliteration of this peritoneal fold leads to herniation of abdominal content into the inguinal canal. Case description: An exceptionally rare case of a 5-month-old female child who presented to us with a palpable, non-tender, left labial mass. Ultrasound and MRI were performed showing the contents of herniating sac as uterine fundus and bilateral ovaries along with minimal free fluid. The infant was managed conservatively and kept under follow-up. Conclusion: Incidence of both ovary and uterus as contents of hernia is very rare. Furthermore, early and correct identification of the herniated ovary prevents an uncalled-for surgery. Clinical significance: It is very important to be familiar with this entity, especially in cases of ovarian hernia due to the risk of associated complications like incarceration and torsion.
{"title":"A Rare Case Report of Out of the Ordinary Canal of Nuck Hernia Encompassing Pelvic Structures, Showing up as a Labial Mass","authors":"Neha Bagri, R. Misra","doi":"10.5005/jp-journals-10057-0147","DOIUrl":"https://doi.org/10.5005/jp-journals-10057-0147","url":null,"abstract":"Aim and objective: We report a rare case of the canal of Nuck hernia containing part of the uterus and both ovaries as its contents. The aim is to build up the awareness of this condition by reviewing the ultrasound and MRI imaging findings and identification of prolapsed ovary with correct knowledge of the entity and focused analysis. Background: The patent canal of Nuck is one of the rare developmental entities in females. Hernia of the canal of Nuck is an extension of the peritoneal fold through the inguinal canal up to the labia majora. Defective obliteration of this peritoneal fold leads to herniation of abdominal content into the inguinal canal. Case description: An exceptionally rare case of a 5-month-old female child who presented to us with a palpable, non-tender, left labial mass. Ultrasound and MRI were performed showing the contents of herniating sac as uterine fundus and bilateral ovaries along with minimal free fluid. The infant was managed conservatively and kept under follow-up. Conclusion: Incidence of both ovary and uterus as contents of hernia is very rare. Furthermore, early and correct identification of the herniated ovary prevents an uncalled-for surgery. Clinical significance: It is very important to be familiar with this entity, especially in cases of ovarian hernia due to the risk of associated complications like incarceration and torsion.","PeriodicalId":16223,"journal":{"name":"Journal of Mahatma Gandhi University of Medical Sciences and Technology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83784658","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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