Pub Date : 2020-07-01DOI: 10.4103/mjmsr.mjmsr_1_20
N. Dias, B. Kishore, D. Sukumar
Background: Severity scoring systems are important parameters in assessing the severity of a disease aiding in categorization of disease and its prompt treatment. However, reliability of these scoring systems and inter-observer variation is a concern. In the recent years, there has been a lot of debate on reliability of Psoriasis Area and Severity Index (PASI) scoring as there is a wide range of difference in the scoring when assessed by each observer. We conducted this study to assess the inter-observer variation of PASI scoring observed in out-patient department of Dermatology at a tertiary care hospital. Methods: Total of 35 patients clinically presenting with chronic plaque type psoriasis, irrespective of disease duration and treatment taken were enrolled in the study. PASI scoring was assessed by 3 different observers (2st year, 3nd year postgraduate residents and clinical staff) independently on each patient and reliability was determined by intra-class coefficient. (ICC). Results: Our study showed an excellent reproducibility of PASI score when an inter-observer variation was performed. Most of the parameters showed an agreement of >0.9 (ICC) which was statistically significant (<0.001). However it was noted that “erythema” in head, upper limbs and lower limbs was in less agreement with ICC when compared to other parameters, yet excellent. Mean PASI score was 10.96, 10.78 and 10.47 among observer 1, 2 and 3 respectively. Conclusion: Our study concludes that PASI is a reproducible and reliable clinical tool with less inter-observer variation if done by trained qualified observers to assess the severity of chronic plaque type psoriasis although its application gets tedious and difficult in busy dermatology clinics. Limitation: A small sample size.
背景:严重程度评分系统是评估疾病严重程度的重要参数，有助于疾病的分类和及时治疗。然而，这些评分系统的可靠性和观察者之间的差异是一个问题。近年来，对于银屑病面积及严重程度指数(Psoriasis Area and Severity Index, PASI)评分的可靠性存在很多争论，因为每个观察者对PASI评分的评估存在很大的差异。我们进行了这项研究，以评估在三级护理医院皮肤科门诊观察到的PASI评分的观察者间差异。方法:35例临床表现为慢性斑块型银屑病的患者，不论病程和治疗方法。PASI评分由3个不同的观察者(第21年，第3年研究生住院医师和临床工作人员)对每个患者独立评估，可靠性由班级内系数确定。(ICC)。结果:我们的研究表明，当观察者之间发生变化时，PASI评分的可重复性很好。大部分参数的一致性为>.9 (ICC)，具有统计学意义(<0.001)。然而，值得注意的是，与其他参数相比，头部、上肢和下肢的“红斑”与ICC的一致性较差，但仍很好。观察者1、观察者2、观察者3的平均PASI评分分别为10.96、10.78、10.47。结论:PASI是一种可重复可靠的临床工具，如果由训练有素的合格观察员来评估慢性斑块型银屑病的严重程度，观察者之间的差异较小，尽管在繁忙的皮肤科诊所中应用它是繁琐和困难的。局限性:样本量小。
{"title":"Interobserver variation of psoriasis area and severity index in a clinical setting","authors":"N. Dias, B. Kishore, D. Sukumar","doi":"10.4103/mjmsr.mjmsr_1_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_1_20","url":null,"abstract":"Background: Severity scoring systems are important parameters in assessing the severity of a disease aiding in categorization of disease and its prompt treatment. However, reliability of these scoring systems and inter-observer variation is a concern. In the recent years, there has been a lot of debate on reliability of Psoriasis Area and Severity Index (PASI) scoring as there is a wide range of difference in the scoring when assessed by each observer. We conducted this study to assess the inter-observer variation of PASI scoring observed in out-patient department of Dermatology at a tertiary care hospital. Methods: Total of 35 patients clinically presenting with chronic plaque type psoriasis, irrespective of disease duration and treatment taken were enrolled in the study. PASI scoring was assessed by 3 different observers (2st year, 3nd year postgraduate residents and clinical staff) independently on each patient and reliability was determined by intra-class coefficient. (ICC). Results: Our study showed an excellent reproducibility of PASI score when an inter-observer variation was performed. Most of the parameters showed an agreement of >0.9 (ICC) which was statistically significant (<0.001). However it was noted that “erythema” in head, upper limbs and lower limbs was in less agreement with ICC when compared to other parameters, yet excellent. Mean PASI score was 10.96, 10.78 and 10.47 among observer 1, 2 and 3 respectively. Conclusion: Our study concludes that PASI is a reproducible and reliable clinical tool with less inter-observer variation if done by trained qualified observers to assess the severity of chronic plaque type psoriasis although its application gets tedious and difficult in busy dermatology clinics. Limitation: A small sample size.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45970445","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 : 2020-07-01DOI: 10.4103/mjmsr.mjmsr_32_20
J. Jyothsna, Prema D' Cunha, Chethana Bolanthakodi
Background: Clinical quality dashboards equip hospitals with a simple method for maintaining and monitoring clinical quality indicators. The maternity dashboard. provides an opportunity to integrate managerial, organizational, and clinical audits to improve quality of care. It has four broad categories: clinical activity, workforce, clinical outcome, and complaints/risk incidents. It can be used to benchmark activity and monitor performance against the standards agreed locally for the maternity unit on a monthly basis. Aim: The aim of this study was to design and implement a maternity dashboard to improve maternal and child health care. Settings and Design: This was a retrospective observational study conducted at a tertiary care hospital. Materials and Methods: Data were collected manually from outpatient department, labor ward, neonatal intensive care unit registers, and electronic records from June 2018 to May 2019 in a tertiary care hospital. Goals for each of the parameters were set, as well as upper and lower thresholds, and the data were analyzed. A suggested approach is to use the traffic light system, such as “green,” “amber,” and “red.” All the parameters after analyzing were noted on the dashboard. Results: During the study period of 1 year, there were 3750 deliveries. Auditing was done for various clinical activity indicators along with clinical outcome (both maternal and neonatal) and triaged using traffic light colors on a monthly basis. Conclusions: Maternity dashboard facilitates targeted quality improvement initiatives. They help in comparing current performance against expected standards and hence helpful in driving changes toward optimum maternal and child health.
{"title":"Measure what you treasure! – A maternity dashboard","authors":"J. Jyothsna, Prema D' Cunha, Chethana Bolanthakodi","doi":"10.4103/mjmsr.mjmsr_32_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_32_20","url":null,"abstract":"Background: Clinical quality dashboards equip hospitals with a simple method for maintaining and monitoring clinical quality indicators. The maternity dashboard. provides an opportunity to integrate managerial, organizational, and clinical audits to improve quality of care. It has four broad categories: clinical activity, workforce, clinical outcome, and complaints/risk incidents. It can be used to benchmark activity and monitor performance against the standards agreed locally for the maternity unit on a monthly basis. Aim: The aim of this study was to design and implement a maternity dashboard to improve maternal and child health care. Settings and Design: This was a retrospective observational study conducted at a tertiary care hospital. Materials and Methods: Data were collected manually from outpatient department, labor ward, neonatal intensive care unit registers, and electronic records from June 2018 to May 2019 in a tertiary care hospital. Goals for each of the parameters were set, as well as upper and lower thresholds, and the data were analyzed. A suggested approach is to use the traffic light system, such as “green,” “amber,” and “red.” All the parameters after analyzing were noted on the dashboard. Results: During the study period of 1 year, there were 3750 deliveries. Auditing was done for various clinical activity indicators along with clinical outcome (both maternal and neonatal) and triaged using traffic light colors on a monthly basis. Conclusions: Maternity dashboard facilitates targeted quality improvement initiatives. They help in comparing current performance against expected standards and hence helpful in driving changes toward optimum maternal and child health.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42288779","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 : 2020-07-01DOI: 10.4103/mjmsr.mjmsr_39_20
E. Robinson, C. Wekhe
Laryngocele is a rare anomalous air-filled dilatation of the saccule of the larynx with unclear etiology. The patient in our case presented with a complaint of a painless anterior neck swelling which moved and increased in size on coughing, swallowing, and straining. Physical examination revealed a compressible swelling measuring approximately 2 cm in the widest diameter in the anterior aspect of the neck with normal overlying skin. It was nontender, soft, cystic, fluctuant, and mobile. The advent of magnetic resonance imaging (MRI) has made its diagnosis easier than the use of laryngoscope. The finding revealed multiple, nonenhancing, oval-shaped but lobulated masses in both infrahyoid visceral spaces involving the paraglottic space with an extralaryngeal component. They hypo to isointense on T1-weighted and hyperintense on T2-weighted and short tau inversion recovery images and measured 3.71 cm × 3.06 cm in the right and 1.27 cm × 1.04 cm in the left (right bigger than left). Hence, a diagnosis of bilateral laryngocele was made. In the index report, MRI being a noninvasive imaging modality using radiofrequency with brilliant soft-tissue contrast and spatial resolution was used to diagnose the lesion. The paucity of literature and information with regard to bilateral laryngocele in our environment and the role of MRI have informed this report.
{"title":"The role of magnetic resonance imaging in the diagnosis of bilateral laryngocele","authors":"E. Robinson, C. Wekhe","doi":"10.4103/mjmsr.mjmsr_39_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_39_20","url":null,"abstract":"Laryngocele is a rare anomalous air-filled dilatation of the saccule of the larynx with unclear etiology. The patient in our case presented with a complaint of a painless anterior neck swelling which moved and increased in size on coughing, swallowing, and straining. Physical examination revealed a compressible swelling measuring approximately 2 cm in the widest diameter in the anterior aspect of the neck with normal overlying skin. It was nontender, soft, cystic, fluctuant, and mobile. The advent of magnetic resonance imaging (MRI) has made its diagnosis easier than the use of laryngoscope. The finding revealed multiple, nonenhancing, oval-shaped but lobulated masses in both infrahyoid visceral spaces involving the paraglottic space with an extralaryngeal component. They hypo to isointense on T1-weighted and hyperintense on T2-weighted and short tau inversion recovery images and measured 3.71 cm × 3.06 cm in the right and 1.27 cm × 1.04 cm in the left (right bigger than left). Hence, a diagnosis of bilateral laryngocele was made. In the index report, MRI being a noninvasive imaging modality using radiofrequency with brilliant soft-tissue contrast and spatial resolution was used to diagnose the lesion. The paucity of literature and information with regard to bilateral laryngocele in our environment and the role of MRI have informed this report.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46016851","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 : 2020-07-01DOI: 10.4103/mjmsr.mjmsr_37_20
Nishant Lohia, Manoj Prashar, S. Harish, Sankalp Singh, Anand Subramananiam, S. Viswanath, R. Ranjan, G. Trivedi
Anorectal melanoma is a very rare and aggressive mucosal melanocytic malignancy, accounting for 1% of all anorectal cancers. There have only been a few cases reported. Surgical resection remains the mainstay of treatment. No definitive management strategies exist because of the absence of randomized trials. We here report a case series on four cases of anorectal melanoma. All four cases underwent abdominoperineal resection (APR) and nodal dissection. Two out of four cases received adjuvant temozolomide (TMZ), one case received adjuvant doublet chemotherapy with TMZ and cisplatin, and the fourth case succumbed to nononcological disease before he could be subjected to adjuvant chemotherapy. In the first and third case, nodal dissection was limited to pelvic nodes only. However, in the second case, extensive nodal dissection in the form of bilateral pelvic and inguinal lymph nodal dissection and para-aortic lymph nodal dissection was performed. The fourth case also was subjected to extensive nodal dissection in form of bilateral pelvic and para-aortic lymph node dissection. The first patient however became metastatic at the end of first cycle of adjuvant TMZ and succumbed to his illness post 3 months of surgery. The second patient could complete all six cycles of adjuvant TMZ, and after 1 year of completion of adjuvant TMZ, he presented with skeletal and brain metastases. He also received palliative whole-brain radiotherapy for brain metastases. He finally succumbed to his disease 18 months after surgery. The third case completed all six cycles of adjuvant TMZ and is still alive with disease-free interval of around 1 year. The fourth case succumbed to nononcological death around 1 month after surgery.
{"title":"Primary anorectal melanoma: Multimodality management in a series of four cases and review of literature","authors":"Nishant Lohia, Manoj Prashar, S. Harish, Sankalp Singh, Anand Subramananiam, S. Viswanath, R. Ranjan, G. Trivedi","doi":"10.4103/mjmsr.mjmsr_37_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_37_20","url":null,"abstract":"Anorectal melanoma is a very rare and aggressive mucosal melanocytic malignancy, accounting for 1% of all anorectal cancers. There have only been a few cases reported. Surgical resection remains the mainstay of treatment. No definitive management strategies exist because of the absence of randomized trials. We here report a case series on four cases of anorectal melanoma. All four cases underwent abdominoperineal resection (APR) and nodal dissection. Two out of four cases received adjuvant temozolomide (TMZ), one case received adjuvant doublet chemotherapy with TMZ and cisplatin, and the fourth case succumbed to nononcological disease before he could be subjected to adjuvant chemotherapy. In the first and third case, nodal dissection was limited to pelvic nodes only. However, in the second case, extensive nodal dissection in the form of bilateral pelvic and inguinal lymph nodal dissection and para-aortic lymph nodal dissection was performed. The fourth case also was subjected to extensive nodal dissection in form of bilateral pelvic and para-aortic lymph node dissection. The first patient however became metastatic at the end of first cycle of adjuvant TMZ and succumbed to his illness post 3 months of surgery. The second patient could complete all six cycles of adjuvant TMZ, and after 1 year of completion of adjuvant TMZ, he presented with skeletal and brain metastases. He also received palliative whole-brain radiotherapy for brain metastases. He finally succumbed to his disease 18 months after surgery. The third case completed all six cycles of adjuvant TMZ and is still alive with disease-free interval of around 1 year. The fourth case succumbed to nononcological death around 1 month after surgery.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43853459","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 : 2020-07-01DOI: 10.4103/mjmsr.mjmsr_10_20
D. Patnana, Bhavana Chopparapu, Swathi Dulla, L. Kutikuppala
Background: Fast food generally refers to food that people intend to consume quickly either on- or off-site. Junk foods are foods that contain little or no proteins, vitamins, or minerals but are rich in salt, sugar, and fats and are high in energy (calories). Excess consumption of fast food has been linked with a variety of health problems including obesity and type II diabetes. Fast foods tend to contain high trans-fat levels which tend to raise amounts of low-density lipoprotein in the human body leading to ill effects on health. Aim: The aim of this study was to know the knowledge, attitude, and practice of medical, paramedical, and dental students toward consumption of fast foods. Materials and Methods: This study is carried out at Konaseema Institute of Medical Sciences and Research Foundation for 2 months among 658 students from medical, dental, and paramedical courses. Students were asked to fill a self-administered questionnaire, and acquisition of data from those filled questionnaires was done. Data entry and assessment were done in MS Excel and depicted as required. Results: Six hundred and fifty-eight students of medical, dental, Bachelor of Physiotherapy (BPT), and nursing courses participated in this study, out of which 421 (64%) are MBBS, 165 (25%) are BDS, 39 (6%) are BPT, and 33 (5%) are nursing students. Conclusion: Hygienic practices should be maintained at fast-food outlets and restaurants. A law postulating to label nutritional information for unpacked foods before serving should be implemented.
{"title":"A study on knowledge, attitude, and practice of medical, paramedical, and dental students of a tertiary care institution toward consumption of fast foods","authors":"D. Patnana, Bhavana Chopparapu, Swathi Dulla, L. Kutikuppala","doi":"10.4103/mjmsr.mjmsr_10_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_10_20","url":null,"abstract":"Background: Fast food generally refers to food that people intend to consume quickly either on- or off-site. Junk foods are foods that contain little or no proteins, vitamins, or minerals but are rich in salt, sugar, and fats and are high in energy (calories). Excess consumption of fast food has been linked with a variety of health problems including obesity and type II diabetes. Fast foods tend to contain high trans-fat levels which tend to raise amounts of low-density lipoprotein in the human body leading to ill effects on health. Aim: The aim of this study was to know the knowledge, attitude, and practice of medical, paramedical, and dental students toward consumption of fast foods. Materials and Methods: This study is carried out at Konaseema Institute of Medical Sciences and Research Foundation for 2 months among 658 students from medical, dental, and paramedical courses. Students were asked to fill a self-administered questionnaire, and acquisition of data from those filled questionnaires was done. Data entry and assessment were done in MS Excel and depicted as required. Results: Six hundred and fifty-eight students of medical, dental, Bachelor of Physiotherapy (BPT), and nursing courses participated in this study, out of which 421 (64%) are MBBS, 165 (25%) are BDS, 39 (6%) are BPT, and 33 (5%) are nursing students. Conclusion: Hygienic practices should be maintained at fast-food outlets and restaurants. A law postulating to label nutritional information for unpacked foods before serving should be implemented.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48830783","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 : 2020-07-01DOI: 10.4103/mjmsr.mjmsr_2_20
S. Garg, Arpita Jain, U. Sharma, Vatsal Thakral
Ovarian hyperstimulation syndrome (OHSS) is a disorder that usually occurs with ovulation induction. It is rare in pregnant women and only a very few cases have been reported in spontaneous unstimulated conceptions. We report a case of spontaneous OHSS with primary hypothyroidism in a 19-year-old primigravida, where the imaging and laboratory findings confirmed the diagnosis of “Van Wyk–Grumbach syndrome” with pregnancy. This rare event in pregnancy needs attention, as early institution of thyroid hormone replacement therapy results in resolution of cysts and avoids unnecessary evaluation and surgical misadventures.
{"title":"Ovarian hyperstimulation syndrome following natural conception","authors":"S. Garg, Arpita Jain, U. Sharma, Vatsal Thakral","doi":"10.4103/mjmsr.mjmsr_2_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_2_20","url":null,"abstract":"Ovarian hyperstimulation syndrome (OHSS) is a disorder that usually occurs with ovulation induction. It is rare in pregnant women and only a very few cases have been reported in spontaneous unstimulated conceptions. We report a case of spontaneous OHSS with primary hypothyroidism in a 19-year-old primigravida, where the imaging and laboratory findings confirmed the diagnosis of “Van Wyk–Grumbach syndrome” with pregnancy. This rare event in pregnancy needs attention, as early institution of thyroid hormone replacement therapy results in resolution of cysts and avoids unnecessary evaluation and surgical misadventures.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47323351","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 : 2020-07-01DOI: 10.4103/mjmsr.mjmsr_35_20
D. Fonseca, S. Arya, K. Raju
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal (GI) tract and comprise <2.2% of all GI tumors. The incidence of endometrial cancer in India is 1.2%. Among synchronous cancers, female genital tract tumors, mostly endometrioid/ovarian carcinomas, constitute 5% of GIST patients. We describe an unusual case with synchronous occurrence of GIST of the stomach with high-grade serous carcinoma (HGSC) of the endometrium, which was proven by histopathological examination and further confirmed by immunohistochemistry. This is the first case published so far of a patient with synchronous occurrence of low-risk GIST of the stomach with HGSC of the endometrium. The main objective of the study is to present a unique case because we have not found any reports for coexistence of the described neoplasm as in our patient, and we hope that it will be valuable in future investigations about the genesis, diagnosis, and treatment of these types of tumors.
{"title":"An unusual occurrence of synchronous gastrointestinal stromal tumor and high-grade serous carcinoma of the endometrium - A rare combination","authors":"D. Fonseca, S. Arya, K. Raju","doi":"10.4103/mjmsr.mjmsr_35_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_35_20","url":null,"abstract":"Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal (GI) tract and comprise <2.2% of all GI tumors. The incidence of endometrial cancer in India is 1.2%. Among synchronous cancers, female genital tract tumors, mostly endometrioid/ovarian carcinomas, constitute 5% of GIST patients. We describe an unusual case with synchronous occurrence of GIST of the stomach with high-grade serous carcinoma (HGSC) of the endometrium, which was proven by histopathological examination and further confirmed by immunohistochemistry. This is the first case published so far of a patient with synchronous occurrence of low-risk GIST of the stomach with HGSC of the endometrium. The main objective of the study is to present a unique case because we have not found any reports for coexistence of the described neoplasm as in our patient, and we hope that it will be valuable in future investigations about the genesis, diagnosis, and treatment of these types of tumors.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48634153","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 : 2020-01-01DOI: 10.4103/mjmsr.mjmsr_25_20
S. Shrivastava, P. Shrivastava
Insufficient physical activity has been regarded as one among the potential risk factors for the development of non-communicable diseases and the associated complications, including mortality. The World Health Organization has recommended for at least 60 minutes of physical activity per day for adolescents. In the global mission to improve the levels of physical activity and to reduce the percentage of insufficient physical activity by 10% by 2025, there is an immense need to formulate effective strategies and programs for the benefit of adolescents. At the same time, it is extremely important to implement multi-sectoral actions, which will then offer varied chances for adolescents and youths to be physically active. In conclusion, physical activity is an important aspect to ensure optimal health and wellbeing in all age-groups. It is the need of the hour that nations and communities should implement measures to enhance the number of opportunities available for adolescents to be physically active.
{"title":"Improving physical activity among adolescents through multisectoral actions: World Health Organization","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/mjmsr.mjmsr_25_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_25_20","url":null,"abstract":"Insufficient physical activity has been regarded as one among the potential risk factors for the development of non-communicable diseases and the associated complications, including mortality. The World Health Organization has recommended for at least 60 minutes of physical activity per day for adolescents. In the global mission to improve the levels of physical activity and to reduce the percentage of insufficient physical activity by 10% by 2025, there is an immense need to formulate effective strategies and programs for the benefit of adolescents. At the same time, it is extremely important to implement multi-sectoral actions, which will then offer varied chances for adolescents and youths to be physically active. In conclusion, physical activity is an important aspect to ensure optimal health and wellbeing in all age-groups. It is the need of the hour that nations and communities should implement measures to enhance the number of opportunities available for adolescents to be physically active.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44427947","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 : 2020-01-01DOI: 10.4103/mjmsr.mjmsr_31_20
S. Shrivastava, P. Shrivastava
The corona virus disease-2019 (COVID-19) pandemic has been reported among all the age-groups, with severity being highest among elderly people and those with some pre-existing illnesses. The available evidence has not suggested that a person living with HIV (PLHIV) has a higher risk of acquisition of infection or the development of serious complications if they do get infected with COVID-19, provided their immune system is not compromised. Amidst dealing with this COVID-19 emergency, it is quite possible that delivery of essential health services, including those required for PLHIV will be temporarily interrupted. In these times of emergency, we should aim for reducing the number of visits to the ART center and inform them about the disease. In conclusion, the COVID-19 pandemic is bound to impact the delivery of essential services for PLHIVs and thus it is our utmost responsibility to improve the resilience of the health system to ensure that appropriate strategies are adopted to ensure the uninterrupted supply of the essential services are offered to these vulnerable population groups.
{"title":"Corona virus disease-2019 pandemic: Ensuring delivery of essential HIV services","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/mjmsr.mjmsr_31_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_31_20","url":null,"abstract":"The corona virus disease-2019 (COVID-19) pandemic has been reported among all the age-groups, with severity being highest among elderly people and those with some pre-existing illnesses. The available evidence has not suggested that a person living with HIV (PLHIV) has a higher risk of acquisition of infection or the development of serious complications if they do get infected with COVID-19, provided their immune system is not compromised. Amidst dealing with this COVID-19 emergency, it is quite possible that delivery of essential health services, including those required for PLHIV will be temporarily interrupted. In these times of emergency, we should aim for reducing the number of visits to the ART center and inform them about the disease. In conclusion, the COVID-19 pandemic is bound to impact the delivery of essential services for PLHIVs and thus it is our utmost responsibility to improve the resilience of the health system to ensure that appropriate strategies are adopted to ensure the uninterrupted supply of the essential services are offered to these vulnerable population groups.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44598917","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 : 2020-01-01DOI: 10.4103/mjmsr.mjmsr_27_20
U. Ghosh, D. Mohapatra, N. Sahoo
Genital stromal tumors are a rare and unique subset of soft-tissue tumors encountered in the vulvovaginal and inguinoscrotal region and this group includes fibroepithelial stromal polyp, superficial (cervicovaginal) myofibroblastoma, cellular angiofibroma, mammary-type myofibroblastoma, angiomyofibroblastoma, superficial angiomyxoma, and deep/aggressive angiomyxoma. The relative rarity and overlapping histomorphological and immunohistochemical features result in a diagnostic difficulty for the pathologists. Herein, we describe two cases of soft-tissue tumors in the vulvovaginal region presenting as polypoidal mass with detailed histopathology and immunohistochemical workup.
{"title":"Vulvovaginal fibroepithelial stromal polyp with myxoid stroma: A diagnostic dilemma on histology – Report of two cases","authors":"U. Ghosh, D. Mohapatra, N. Sahoo","doi":"10.4103/mjmsr.mjmsr_27_20","DOIUrl":"https://doi.org/10.4103/mjmsr.mjmsr_27_20","url":null,"abstract":"Genital stromal tumors are a rare and unique subset of soft-tissue tumors encountered in the vulvovaginal and inguinoscrotal region and this group includes fibroepithelial stromal polyp, superficial (cervicovaginal) myofibroblastoma, cellular angiofibroma, mammary-type myofibroblastoma, angiomyofibroblastoma, superficial angiomyxoma, and deep/aggressive angiomyxoma. The relative rarity and overlapping histomorphological and immunohistochemical features result in a diagnostic difficulty for the pathologists. Herein, we describe two cases of soft-tissue tumors in the vulvovaginal region presenting as polypoidal mass with detailed histopathology and immunohistochemical workup.","PeriodicalId":19108,"journal":{"name":"Muller Journal of Medical Sciences and Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49249612","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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