Pub Date : 2024-03-15DOI: 10.18231/j.pjms.2024.003
Lakshmi Jyothi T, M. Wajid, Saranya M, Shazia Naaz, Vivek Hada, Usha Rani, S. Suravaram, Ariyanachi K
Case-based learning (CBL) is an interactive student-centred exploration of real-life situations. It has been used in addition to didactic lectures (DL) in the medical curriculum for strengthening the students' critical thinking, clinical reasoning, and better understanding of the disease and its management. 100 students were divided into 2 groups. Group A was exposed to CBL first and didactic lectures later and Group B were exposed to didactic lectures and then to CBL, with pre and post tests conducted with questionnaire each time. 91% of the students were satisfied with the newer teaching learning method and 94% of the students felt the teaching method must be student centric. CBL revealed improvised learning among the students and enhanced their communication skills and long term memory, while with didactic lectures, the students seemed not too keen on applying and implementing the topics.
{"title":"Impact of case-based learning approach in clinical microbiology on second-year students: A prospective observational study","authors":"Lakshmi Jyothi T, M. Wajid, Saranya M, Shazia Naaz, Vivek Hada, Usha Rani, S. Suravaram, Ariyanachi K","doi":"10.18231/j.pjms.2024.003","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.003","url":null,"abstract":"Case-based learning (CBL) is an interactive student-centred exploration of real-life situations. It has been used in addition to didactic lectures (DL) in the medical curriculum for strengthening the students' critical thinking, clinical reasoning, and better understanding of the disease and its management. 100 students were divided into 2 groups. Group A was exposed to CBL first and didactic lectures later and Group B were exposed to didactic lectures and then to CBL, with pre and post tests conducted with questionnaire each time. 91% of the students were satisfied with the newer teaching learning method and 94% of the students felt the teaching method must be student centric. CBL revealed improvised learning among the students and enhanced their communication skills and long term memory, while with didactic lectures, the students seemed not too keen on applying and implementing the topics.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"77 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238170","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.043
Ashok Bhat
To evaluate and compare quality of life in pre dialysis (CKD stage4) and patients with End stage renal disease (ESRD) on maintenance hemodialysis and to analyze the correlation of sociodemographic, clinical and laboratory parameters with quality of lifeThis was a cross-sectional study in which 100 pre dialysis(CKD stage4) and 100 ESRD patients on maintenance hemodialysis were enrolled. SF 36 questionnaire was used to assess quality of life. Quality of life was compared between the two groups and the correlation of quality of life with sociodemographic ,clinical and laboratory parameters was assessed.Pre dialysis group had better SF 36 scores than patients on hemodialysis (64.93±13.05 vs. 59.55±13.29 p=0.004). Erythropoietin use, higher albumin and more frequent dialysis emerged as independent predictors of better quality of life.Perceived quality of life was worse for patients on hemodialysis when compared to pre dialysis patients. Use of erythropoietin, higher albumin levels, and more frequent dialysis were independent predictors of better quality of life.
评估和比较透析前（CKD4 期）和接受维持性血液透析的终末期肾病（ESRD）患者的生活质量，分析社会人口学、临床和实验室参数与生活质量的相关性 这是一项横断面研究，共招募了 100 名透析前（CKD4 期）和 100 名接受维持性血液透析的终末期肾病患者。采用 SF 36 问卷评估生活质量。两组患者的生活质量进行了比较，并评估了生活质量与社会人口学、临床和实验室参数的相关性。透析前组患者的 SF 36 评分优于血液透析患者（64.93±13.05 vs. 59.55±13.29 p=0.004）。与透析前患者相比，血液透析患者的感知生活质量更差。使用促红细胞生成素、白蛋白水平较高和透析次数较多是提高生活质量的独立预测因素。
{"title":"Comparison of quality of life in hemodialysis and pre dialysis patients: A cross sectional study","authors":"Ashok Bhat","doi":"10.18231/j.pjms.2024.043","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.043","url":null,"abstract":"To evaluate and compare quality of life in pre dialysis (CKD stage4) and patients with End stage renal disease (ESRD) on maintenance hemodialysis and to analyze the correlation of sociodemographic, clinical and laboratory parameters with quality of lifeThis was a cross-sectional study in which 100 pre dialysis(CKD stage4) and 100 ESRD patients on maintenance hemodialysis were enrolled. SF 36 questionnaire was used to assess quality of life. Quality of life was compared between the two groups and the correlation of quality of life with sociodemographic ,clinical and laboratory parameters was assessed.Pre dialysis group had better SF 36 scores than patients on hemodialysis (64.93±13.05 vs. 59.55±13.29 p=0.004). Erythropoietin use, higher albumin and more frequent dialysis emerged as independent predictors of better quality of life.Perceived quality of life was worse for patients on hemodialysis when compared to pre dialysis patients. Use of erythropoietin, higher albumin levels, and more frequent dialysis were independent predictors of better quality of life.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"4 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239001","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}
India has a high suicide rate and a large proportion of these suicides occur through poisoning. Poisoning by Hair dye has been increasing and constitutes a large proportion of the poisoning cases. The principle toxic constituent of Hair dye poisoning is Paraphenylenediamine (PPD).Present study was done by analyzing the demographic profile, clinical presentation, biochemical profile, life saving interventions and mortality in cases of PPD poisoning. This study was conducted on 80 cases. Angioedema, pain in oral cavity, dark coloured urine, oro-facial edema were main clinical features. Raised TLC count, elevated liver enzymes (sgpt, sgot), elevated serum creatinine, hypocalcemia, elevated bilirubin, low haemoglobin.Paraphenylene diamine poisoning is developing now days due to easy obtainability and low cheap price. It is more common in poor, illiterate, married females of younger age group living in rural areas. Aggressive treatment and Tracheostomy can save life of Patients.
{"title":"A retrospective study of clinical profile of para-phenylenediamene poisoning (hair dye poisoning) in cases admitted in medical college","authors":"Neha Ahuja, Kanwal Kamboj, Amrita Sinha, Nilam Nigam","doi":"10.18231/j.pjms.2024.031","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.031","url":null,"abstract":"India has a high suicide rate and a large proportion of these suicides occur through poisoning. Poisoning by Hair dye has been increasing and constitutes a large proportion of the poisoning cases. The principle toxic constituent of Hair dye poisoning is Paraphenylenediamine (PPD).Present study was done by analyzing the demographic profile, clinical presentation, biochemical profile, life saving interventions and mortality in cases of PPD poisoning. This study was conducted on 80 cases. Angioedema, pain in oral cavity, dark coloured urine, oro-facial edema were main clinical features. Raised TLC count, elevated liver enzymes (sgpt, sgot), elevated serum creatinine, hypocalcemia, elevated bilirubin, low haemoglobin.Paraphenylene diamine poisoning is developing now days due to easy obtainability and low cheap price. It is more common in poor, illiterate, married females of younger age group living in rural areas. Aggressive treatment and Tracheostomy can save life of Patients.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"86 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239670","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.004
Supriya P Savant, Vinay Naik, Jyothi B. Lingegowda
Breast cancer is steadily increasing worldwide. This study is based on application of recently proposed International Academy of cytology (IAC) Yokohama categorisation system of Breast cytology from C1 to C5. (C1-Insufficient material, C2-Benign, C3- Atypical, C4-Suspicious & C5-Malignant). We aim to categorize the breast lesions based on the above-mentioned categorization scheme (IAC, Yokohama 2016) along with histopathological correlation (wherever possible). This was a retrospective observational study conducted from January 2018 to December 2021 in the Department of Pathology of a tertiary care hospital involving coastal population. Ethical clearance was taken from institutional reviw committee. All patients with palpable breast lumps who had undergone FNAC were included in the study. Patient details and data were collected from the case records maintained in Department of Pathology. All quantitative parameters were described through descriptive statistics. Total scores were computed for all the risk factors. Sensitivity, specificity, Positive Predictive Value, Negative Predictive Value calculated. Risk of malignancy(ROM) was calculated for each category. A total 200 patients, with age group ranging from 17 - 67 years with breast lesions were included in the study. C1 lesions were found in 5 cases, C2 in 152 cases, C3 in 11 cases, C4 in 4 cases, and C5 in 28 cases. Cytohistological correlation obtained in 94 cases with concordance noted in 89 cases and discordance in 5 cases. Breast FNAC cytology categorization according to IAC Yokohama system increases accuracy of diagnosis and helps clinician in appropriate patient management.
{"title":"FNAC as preoperative diagnostic tool for neoplastic and non-neoplastic breast lesions with special reference to IAC standardised reporting in Coastal population - A teaching hospital experience","authors":"Supriya P Savant, Vinay Naik, Jyothi B. Lingegowda","doi":"10.18231/j.pjms.2024.004","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.004","url":null,"abstract":"Breast cancer is steadily increasing worldwide. This study is based on application of recently proposed International Academy of cytology (IAC) Yokohama categorisation system of Breast cytology from C1 to C5. (C1-Insufficient material, C2-Benign, C3- Atypical, C4-Suspicious & C5-Malignant). We aim to categorize the breast lesions based on the above-mentioned categorization scheme (IAC, Yokohama 2016) along with histopathological correlation (wherever possible). This was a retrospective observational study conducted from January 2018 to December 2021 in the Department of Pathology of a tertiary care hospital involving coastal population. Ethical clearance was taken from institutional reviw committee. All patients with palpable breast lumps who had undergone FNAC were included in the study. Patient details and data were collected from the case records maintained in Department of Pathology. All quantitative parameters were described through descriptive statistics. Total scores were computed for all the risk factors. Sensitivity, specificity, Positive Predictive Value, Negative Predictive Value calculated. Risk of malignancy(ROM) was calculated for each category. A total 200 patients, with age group ranging from 17 - 67 years with breast lesions were included in the study. C1 lesions were found in 5 cases, C2 in 152 cases, C3 in 11 cases, C4 in 4 cases, and C5 in 28 cases. Cytohistological correlation obtained in 94 cases with concordance noted in 89 cases and discordance in 5 cases. Breast FNAC cytology categorization according to IAC Yokohama system increases accuracy of diagnosis and helps clinician in appropriate patient management.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"96 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239742","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.015
Nidhi Goel, Ved Prakash, K. R. Giri, Amol Dehade
: Overactive bladder is chronic debilitating condition, with physical, psychological, and economical consequences. Urinary vesicle tissue contains muscarinic receptors, M3 is principal mediator of detrusor contraction. Muscarinic receptor antagonists, comprises traditional pharmacological treatment. But due to non-selective inhibition, these agents, probably been related with safety and tolerability concerns. Drugs particular inhibiting sM3 receptor (Darifenacin) have potential to present effective relief while reducing side effects concerned with blockade of M1, M2 and M5 receptors. Duloxetine is Serotonin and nor-epinephrine reuptake inhibitor, leading increased concentration of 5-HT and NE in synaptic cleft, increases stimulation of pudendal motor neurons, thus increasing resting tone and contraction of urethral sphincter.: In present prospective, randomized, parallel group, comparative open label study with 60 OAB patients the combination therapy of Duloxetine with Darifenacin was equated with monotherapy using Darifenacin. The outcome thus analyzed using three different OAB-questionnaires and was statistically compared. : We demonstrated that addition of Duloxetine has shown better result outcome in symptoms as well as quality of life, though the difference of OAB-V8, OABss mean score was non-significant, but for OAB-qSF the reduction (percentage change) in mean score was more in treatment group II as compare to group I (w6:13.82±3.17% vs 12.13±3.24% & W12 29.99±5.40% Vs 25.56±5.17%) , and was statistically significant.(p<0.05).: Duloxetine has synergistic effect to Darifenacin, its ability to increase bladder capacity may be the reason for the improvement OAB symptoms, promising in controlling and treating symptoms either alone or in combination with anti-cholinergic drugs.
:膀胱过度活动症是一种使人衰弱的慢性疾病，会对身体、心理和经济造成影响。尿囊组织中含有毒蕈碱受体，M3 是导致逼尿肌收缩的主要介质。毒蕈碱受体拮抗剂是传统的药物治疗方法。但由于这些药物具有非选择性抑制作用，因此可能存在安全性和耐受性方面的问题。抑制 sM3 受体的药物（达非那新）有可能在有效缓解症状的同时，减少因阻断 M1、M2 和 M5 受体而产生的副作用。度洛西汀是羟色胺和去甲肾上腺素再摄取抑制剂，可增加突触间隙中 5-HT 和 NE 的浓度，增加对阴部运动神经元的刺激，从而增强尿道括约肌的静息张力和收缩。 在本项前瞻性、随机、平行组、开放标签对比研究中，60 名 OAB 患者接受了度洛西汀和达非那新的联合治疗，与使用达非那新的单一疗法进行了比较。研究结果通过三种不同的 OAB 问卷进行了分析和统计比较。 研究结果表明：虽然 OAB-V8、OABss 平均得分的差异不显著，但治疗组 II 与治疗组 I 相比，OAB-qSF 平均得分的降低（百分比变化）更大（w6:13.82±3.17% Vs 12.13±3.24% & W12 29.99±5.40% Vs 25.56±5.17%），且具有统计学意义（P<0.05）：度洛西汀与达非那新具有协同作用，其增加膀胱容量的能力可能是改善 OAB 症状的原因，无论是单独使用还是与抗胆碱能药物联合使用，都有望控制和治疗症状。
{"title":"A study evaluating and comparing the effectiveness of combination therapy – Duloxetine with darifenacin versus darifenacin as monotherapy on perception of symptoms, quality and standard of life in patients suffering with overactive bladder (OAB)","authors":"Nidhi Goel, Ved Prakash, K. R. Giri, Amol Dehade","doi":"10.18231/j.pjms.2024.015","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.015","url":null,"abstract":": Overactive bladder is chronic debilitating condition, with physical, psychological, and economical consequences. Urinary vesicle tissue contains muscarinic receptors, M3 is principal mediator of detrusor contraction. Muscarinic receptor antagonists, comprises traditional pharmacological treatment. But due to non-selective inhibition, these agents, probably been related with safety and tolerability concerns. Drugs particular inhibiting sM3 receptor (Darifenacin) have potential to present effective relief while reducing side effects concerned with blockade of M1, M2 and M5 receptors. Duloxetine is Serotonin and nor-epinephrine reuptake inhibitor, leading increased concentration of 5-HT and NE in synaptic cleft, increases stimulation of pudendal motor neurons, thus increasing resting tone and contraction of urethral sphincter.: In present prospective, randomized, parallel group, comparative open label study with 60 OAB patients the combination therapy of Duloxetine with Darifenacin was equated with monotherapy using Darifenacin. The outcome thus analyzed using three different OAB-questionnaires and was statistically compared. : We demonstrated that addition of Duloxetine has shown better result outcome in symptoms as well as quality of life, though the difference of OAB-V8, OABss mean score was non-significant, but for OAB-qSF the reduction (percentage change) in mean score was more in treatment group II as compare to group I (w6:13.82±3.17% vs 12.13±3.24% & W12 29.99±5.40% Vs 25.56±5.17%) , and was statistically significant.(p<0.05).: Duloxetine has synergistic effect to Darifenacin, its ability to increase bladder capacity may be the reason for the improvement OAB symptoms, promising in controlling and treating symptoms either alone or in combination with anti-cholinergic drugs.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"22 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240409","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.053
Saikat Sau, Lina Mukherjee, Sourav Sau
Non ischemic dilated cardiomyopathy is an important cause of heart failure and cardiovascular mortality. Numerous pharmacologic therapies have been applied from the ancient era for treatment. Some of them have shown improve morbidity. From various literatures it was concluded that combination therapy with H-ISDN in addition to conventional medicines are very effective in black population group. In our study we have tried to establish the efficacy of fixed dose drug combination (Hydralazine + Isosorbide dinitrate) to alleviation of heart failure symptoms and mortality benefit if any. : Patient in NYHA 3 or ambulatory class 4 were included in study. Total two hundred populations were included in the prospective study. One hundred patients were treated by conventional optimum medications for heart failure including ACE inhibitors, ARBs. One hundred patients were given ISDN+Hydralazine (fixed dose) in addition to conventional medicines.: Mean age of study and controlled group was 62.5 years and 61.4 years respectively. Base line mean ejection fraction in control group was 33% and study group was 33%. After a mean one and half year follow up 61% of patient population achieved NYHA 2 in case group and 53% in control group. We assess the NT pro BNP level in both group of population at baseline and every six month interval. There is significant reduction in BNP level in study patients. 72% achieved below baseline cut off value for the age in control. In control population 51% achieved the estimated BNP value cut off for age. : Significant scope remains to improve the outcome for these patients through research related to use of H-ISDN in heart failure patients.
{"title":"Efficacy of Isosorbide dinitrate and Hydralazine combination in non ischemic dilated cardiomyopathy in a tribal based population at a tertiary care hospital","authors":"Saikat Sau, Lina Mukherjee, Sourav Sau","doi":"10.18231/j.pjms.2024.053","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.053","url":null,"abstract":"Non ischemic dilated cardiomyopathy is an important cause of heart failure and cardiovascular mortality. Numerous pharmacologic therapies have been applied from the ancient era for treatment. Some of them have shown improve morbidity. From various literatures it was concluded that combination therapy with H-ISDN in addition to conventional medicines are very effective in black population group. In our study we have tried to establish the efficacy of fixed dose drug combination (Hydralazine + Isosorbide dinitrate) to alleviation of heart failure symptoms and mortality benefit if any. : Patient in NYHA 3 or ambulatory class 4 were included in study. Total two hundred populations were included in the prospective study. One hundred patients were treated by conventional optimum medications for heart failure including ACE inhibitors, ARBs. One hundred patients were given ISDN+Hydralazine (fixed dose) in addition to conventional medicines.: Mean age of study and controlled group was 62.5 years and 61.4 years respectively. Base line mean ejection fraction in control group was 33% and study group was 33%. After a mean one and half year follow up 61% of patient population achieved NYHA 2 in case group and 53% in control group. We assess the NT pro BNP level in both group of population at baseline and every six month interval. There is significant reduction in BNP level in study patients. 72% achieved below baseline cut off value for the age in control. In control population 51% achieved the estimated BNP value cut off for age. : Significant scope remains to improve the outcome for these patients through research related to use of H-ISDN in heart failure patients.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"11 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240926","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.001
Sourav Das, Tiasa Sinha
This article is to spread awareness among Indian women regarding vaginal contraceptive ring use. Since the introduction of hormonal contraceptives, combined oral pills (COCs) have become the method of choice for many women. Although COCs have improved significantly, they have got some disadvantages. This has prompted development of non-oral hormonal contraceptive methods. One of them is combined contraceptive vaginal ring (CCVR). Most studies found out that CCVR was associated with good cycle control and was not associated with vaginal or cervical abnormalities. Treatment related adverse effects like headache, leucorrhoea, nausea, etc and systemic side effects are minimal. Most women found the ring easy to insert, easy to remove and were satisfied with ring usage. So it can be concluded that CCVR is an effective contraceptive with good cycle control that is well tolerated. It is associated with high user and partner acceptability and minimal local and systemic effects. Therefore gynaecologists and policy makers should give more emphasis on its routine use.
{"title":"Indian women should be encouraged to use combined contraceptive vaginal ring","authors":"Sourav Das, Tiasa Sinha","doi":"10.18231/j.pjms.2024.001","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.001","url":null,"abstract":"This article is to spread awareness among Indian women regarding vaginal contraceptive ring use. Since the introduction of hormonal contraceptives, combined oral pills (COCs) have become the method of choice for many women. Although COCs have improved significantly, they have got some disadvantages. This has prompted development of non-oral hormonal contraceptive methods. One of them is combined contraceptive vaginal ring (CCVR). Most studies found out that CCVR was associated with good cycle control and was not associated with vaginal or cervical abnormalities. Treatment related adverse effects like headache, leucorrhoea, nausea, etc and systemic side effects are minimal. Most women found the ring easy to insert, easy to remove and were satisfied with ring usage. So it can be concluded that CCVR is an effective contraceptive with good cycle control that is well tolerated. It is associated with high user and partner acceptability and minimal local and systemic effects. Therefore gynaecologists and policy makers should give more emphasis on its routine use.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"8 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237365","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.040
Huma Firdaus, Shadan Sadaf, Rajendra Kumar Saini, Mohammad Shameem
Obese patients have low levels of serum 25-hydroxy vitamin D due to feedback inhibition of hepatic synthesis of the metabolite by increased circulating 1,25(OH) vitamin D. Obese individuals have more physical activity which limits their exposure to sunlight resulting in lower levels of 25(OH)D. Sleep fragmentation in OSA leads to daytime drowsiness, fatigue and hence decreased outdoor activity contributing to the same. Hence, OSA aggravates obesity and obesity aggravates OSA creating a vicious cycle and together contribute to the depletion of serum vitamin D level.Patients attending the special clinic of sleep were included in the study and were screened using STOP-BANG scoring system for OSA Patients with score of >2 were included in the study and further underwent polysomnography test. Among the study population, cases had an apnea-hypopnea index (AHI) > 5 in polysomnography and controls had AHI <5. Controls were further matched for age, sex and BMI with cases. Vitamin D Level was tested in both cases and controls for comparison using arterial blood sample.Total ninety-three patients were included in the study, out of whom 59 were cases which formed the OSA group, had mean age of 48.02 ±8.435 years, mean body mass index (BMI) 33.73 ±7.48 kg/m2, mean neck circumference 37.8 cm ±5.08 Mean vitamin D level in the case and control was 21.02 ± 7.27 and 24.48 ± 6.92 respectively with a p value < 0.05, with a negative correlation of AHI with serum vitamin D level (p< 0.001, r = −0.286).Different mechanisms play a role in OSA patients affecting. This study shows inverse relationship between vitamin D level and AHI (apnea-hypopnea index) which was statistically significant and vitamin D level was higher in controls than cases. Thus it can be said that 25(OH)D levels and OSAS are related, but it is difficult to establish a direct causal association between them.
肥胖患者的血清 25- 羟基维生素 D 水平较低，这是由于循环中 1,25（OH）维生素 D 的增加对肝脏合成代谢物的反馈抑制作用所致。OSA 中的睡眠碎片会导致白天嗜睡、疲劳，从而减少户外活动，这也是导致 OSA 的原因之一。因此，OSA 会加重肥胖，而肥胖又会加重 OSA，从而形成恶性循环，共同导致血清维生素 D 水平下降。在研究人群中，病例的多导睡眠图中呼吸暂停-低通气指数（AHI）大于 5，对照组的 AHI 小于 5。对照组在年龄、性别和体重指数方面与病例进一步匹配。研究共纳入 93 名患者，其中 59 人为 OSA 组病例，平均年龄（48.02 ± 8.435）岁，平均体重指数（BMI）（33.73 ± 7.病例和对照组的平均维生素 D 水平分别为 21.02 ± 7.27 和 24.48 ± 6.92，P 值 < 0.05，AHI 与血清维生素 D 水平呈负相关（P < 0.001，r = -0.286）。本研究显示，维生素 D 水平与 AHI（呼吸暂停-通气指数）呈反向关系，具有统计学意义，且对照组的维生素 D 水平高于病例。因此可以说，25（OH）D 水平与 OSAS 有关，但很难确定两者之间的直接因果关系。
{"title":"A study to see association between vitamin d level and obstructive sleep apnea","authors":"Huma Firdaus, Shadan Sadaf, Rajendra Kumar Saini, Mohammad Shameem","doi":"10.18231/j.pjms.2024.040","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.040","url":null,"abstract":"Obese patients have low levels of serum 25-hydroxy vitamin D due to feedback inhibition of hepatic synthesis of the metabolite by increased circulating 1,25(OH) vitamin D. Obese individuals have more physical activity which limits their exposure to sunlight resulting in lower levels of 25(OH)D. Sleep fragmentation in OSA leads to daytime drowsiness, fatigue and hence decreased outdoor activity contributing to the same. Hence, OSA aggravates obesity and obesity aggravates OSA creating a vicious cycle and together contribute to the depletion of serum vitamin D level.Patients attending the special clinic of sleep were included in the study and were screened using STOP-BANG scoring system for OSA Patients with score of >2 were included in the study and further underwent polysomnography test. Among the study population, cases had an apnea-hypopnea index (AHI) > 5 in polysomnography and controls had AHI <5. Controls were further matched for age, sex and BMI with cases. Vitamin D Level was tested in both cases and controls for comparison using arterial blood sample.Total ninety-three patients were included in the study, out of whom 59 were cases which formed the OSA group, had mean age of 48.02 ±8.435 years, mean body mass index (BMI) 33.73 ±7.48 kg/m2, mean neck circumference 37.8 cm ±5.08 Mean vitamin D level in the case and control was 21.02 ± 7.27 and 24.48 ± 6.92 respectively with a p value < 0.05, with a negative correlation of AHI with serum vitamin D level (p< 0.001, r = −0.286).Different mechanisms play a role in OSA patients affecting. This study shows inverse relationship between vitamin D level and AHI (apnea-hypopnea index) which was statistically significant and vitamin D level was higher in controls than cases. Thus it can be said that 25(OH)D levels and OSAS are related, but it is difficult to establish a direct causal association between them.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"65 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237390","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}
Scrub typhus is a leading cause of acute undifferentiated febrile illness in India. Overlapping clinical presentation and very low incidence of characteristic eschar makes serology the main stay of diagnosis. IgM ELISA is the most common test performed in tertiary care centres along with rapid diagnostic tests (RDT) and Weil Felix with varying sensitivity and specificityThe present study was conducted to compare the RDT’s and Weil Felix with IgM ELISA and analyse the demographic and clinical profile of scrub positive patientsSerum samples from clinically suspected scrub typhus patients admitted in a tertiary care hospital were tested by Weil Felix, RDT and IgM ELISA. Scrub typhus was confirmed in 38 of the 100 clinically suspected patients by IgM ELISA. Fever was the most common presenting symptom with significant proportion of patients being exposed to vegetation (p=0.0001).Sensitivity of Weil Felix and RDT was 42.1% and 84.2% respectively. Acute Kidney injury was the most common complication and mortality rate was 7.9%.Weil Felix is not a reliable test for scrub typhus diagnosis due to low sensitivity. Results of positive RDT’s can used for early initiation of specific treatment and IgM ELISA can be used as a confirmatory test in highly suspected cases.
{"title":"Evaluation of serological tests in the diagnosis of scrub typhus","authors":"Mvnl Ram Mohan, Shiva Prasad Jamakayala, Subhada K, Talasila Sudha, Teja V.D, U. Pamidimukkala","doi":"10.18231/j.pjms.2024.042","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.042","url":null,"abstract":"Scrub typhus is a leading cause of acute undifferentiated febrile illness in India. Overlapping clinical presentation and very low incidence of characteristic eschar makes serology the main stay of diagnosis. IgM ELISA is the most common test performed in tertiary care centres along with rapid diagnostic tests (RDT) and Weil Felix with varying sensitivity and specificityThe present study was conducted to compare the RDT’s and Weil Felix with IgM ELISA and analyse the demographic and clinical profile of scrub positive patientsSerum samples from clinically suspected scrub typhus patients admitted in a tertiary care hospital were tested by Weil Felix, RDT and IgM ELISA. Scrub typhus was confirmed in 38 of the 100 clinically suspected patients by IgM ELISA. Fever was the most common presenting symptom with significant proportion of patients being exposed to vegetation (p=0.0001).Sensitivity of Weil Felix and RDT was 42.1% and 84.2% respectively. Acute Kidney injury was the most common complication and mortality rate was 7.9%.Weil Felix is not a reliable test for scrub typhus diagnosis due to low sensitivity. Results of positive RDT’s can used for early initiation of specific treatment and IgM ELISA can be used as a confirmatory test in highly suspected cases.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"69 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237555","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 : 2024-03-15DOI: 10.18231/j.pjms.2024.017
A. Dhok, N. Shinde, Simran Rathi, Kajal Mitra
To assess how COVID-19 pneumonia differs from other pneumonias in terms of the chest computed tomography features.In this study we included 170 clinically diagnosed cases pneumonia referred to department of radio diagnosis subjected to HRCT thorax which include out patients and in patients out of which 127 patients tested RT-PCR positive for Covid 19 pneumonia for a total duration of 1 year. (March 2020 to March 2021). The parenchymal abnormalities including Ground glass opacities (GGO), ground glass opacities with interlobular septal thickening (crazy paving), GGO with consolidation, consolidation, pulmonary nodules, tree in bud appearances, bronchiolar wall thickening, interlobular septal thickening , halo sign, reverse halo sign, cavitation and pleural effusion and were observed and categorized along with determination of pattern of distribution on chest CT.127 patients who tested positive for COVID 19 and 43 patients with other pneumonia (such as community-acquired pneumonia) were visited, and CT scans were analysed to determine the presence and distribution of the disease pattern.Patients with COVID 19 pneumonia primarily have peripheral-based lesions (90%), whereas patients with other pneumonias primarily have mixed patterns (70%)—a difference that is statistically different (p 0.05).Statistics show that COVID 19 had higher bilateral involvement than other pneumonia (p<0.05). In COVID-19 pneumonia, GGOs, GGOs with interlobular septal thickening (crazy paving), and GGOs with consolidation with peripheral and basal predominance in bilateral lung parenchyma are the most common imaging patterns and findings. These findings will help us distinguish COVID-19 pneumonia from other causes of pneumonia. There is less evidence of tree in bud, pure consolidation, cavitation, and bronchiolar wall thickening.
{"title":"HRCT chest: A valuable tool to differentiate other pneumonias from covid-19 pneumonia","authors":"A. Dhok, N. Shinde, Simran Rathi, Kajal Mitra","doi":"10.18231/j.pjms.2024.017","DOIUrl":"https://doi.org/10.18231/j.pjms.2024.017","url":null,"abstract":"To assess how COVID-19 pneumonia differs from other pneumonias in terms of the chest computed tomography features.In this study we included 170 clinically diagnosed cases pneumonia referred to department of radio diagnosis subjected to HRCT thorax which include out patients and in patients out of which 127 patients tested RT-PCR positive for Covid 19 pneumonia for a total duration of 1 year. (March 2020 to March 2021). The parenchymal abnormalities including Ground glass opacities (GGO), ground glass opacities with interlobular septal thickening (crazy paving), GGO with consolidation, consolidation, pulmonary nodules, tree in bud appearances, bronchiolar wall thickening, interlobular septal thickening , halo sign, reverse halo sign, cavitation and pleural effusion and were observed and categorized along with determination of pattern of distribution on chest CT.127 patients who tested positive for COVID 19 and 43 patients with other pneumonia (such as community-acquired pneumonia) were visited, and CT scans were analysed to determine the presence and distribution of the disease pattern.Patients with COVID 19 pneumonia primarily have peripheral-based lesions (90%), whereas patients with other pneumonias primarily have mixed patterns (70%)—a difference that is statistically different (p 0.05).Statistics show that COVID 19 had higher bilateral involvement than other pneumonia (p<0.05). In COVID-19 pneumonia, GGOs, GGOs with interlobular septal thickening (crazy paving), and GGOs with consolidation with peripheral and basal predominance in bilateral lung parenchyma are the most common imaging patterns and findings. These findings will help us distinguish COVID-19 pneumonia from other causes of pneumonia. There is less evidence of tree in bud, pure consolidation, cavitation, and bronchiolar wall thickening.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"65 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238416","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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