Pub Date : 2022-07-01DOI: 10.17727/jmsr.2022/10-21
Lundberg A, L. E., K. L., Wirestam R
Magnetic susceptibility can be assessed by quantitative susceptibility mapping (QSM), based on measured magnetic resonance imaging (MRI) phase data. The QSM reconstruction process is, however, mathematically challenging and still not fully robust. A signal-generating holmium [Ho(III)] aqueous solution with air-equivalent magnetic susceptibility was prepared, and used as a surrounding medium in a water phantom with tubes filled with a solution of gadolinium contrast agent at various concentrations. Extended analyses under controlled conditions were accomplished by simulations of the phantom construction. Without surrounding holmium solution, a gadolinium tube positioned centrally, parallel with B0, showed a susceptibility difference that agreed well with theoretical values, whereas a peripheral parallel tube position showed larger deviation. Orientation perpendicular to B0 resulted in less variation between the internal tube positions. Air-equivalent magnetic susceptibility corresponded to 16.5 mM Ho(III) solution. With surrounding holmium solution, several post-processing steps became challenging. Simulations indicated higher degree of underestimation when the theoretical susceptibility difference increased. Details in the mathematical implementation, for example, background field removal can strongly influence the result. Simulated results were, in part, unexpected, and provided awareness of limitations in the reconstruction technique, mainly related to conditions with large susceptibility differences between compartments.
磁化率可以通过定量磁化率图(QSM)来评估，基于测量的磁共振成像(MRI)相位数据。然而，QSM重建过程在数学上具有挑战性，并且仍然不是完全健壮。制备了一种具有空气等效磁化率的产生信号的钬[Ho(III)]水溶液，并将其用作水幻影的周围介质，水幻影的管中填充了不同浓度的钆造影剂溶液。在控制条件下的扩展分析是通过模拟的幻影结构完成的。在没有周围钬溶液的情况下，与B0平行放置在中心位置的钆管的磁化率差异与理论值吻合较好，而周围平行放置的钆管的磁化率差异较大。垂直于B0的方向导致内部管位置之间的变化较小。空气等效磁化率为16.5 mM Ho(III)溶液。由于周围有钬溶液，几个后处理步骤变得具有挑战性。模拟结果表明，理论敏感性差异越大，低估程度越高。数学实现中的细节，例如，背景场去除会强烈影响结果。在某种程度上，模拟结果是出乎意料的，并提供了对重建技术局限性的认识，主要与室间敏感性差异较大的条件有关。
{"title":"Notes on quantitative susceptibility mapping reconstruction accuracy under challenging conditions: Phantom measurements and simulations","authors":"Lundberg A, L. E., K. L., Wirestam R","doi":"10.17727/jmsr.2022/10-21","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-21","url":null,"abstract":"Magnetic susceptibility can be assessed by quantitative susceptibility mapping (QSM), based on measured magnetic resonance imaging (MRI) phase data. The QSM reconstruction process is, however, mathematically challenging and still not fully robust. A signal-generating holmium [Ho(III)] aqueous solution with air-equivalent magnetic susceptibility was prepared, and used as a surrounding medium in a water phantom with tubes filled with a solution of gadolinium contrast agent at various concentrations. Extended analyses under controlled conditions were accomplished by simulations of the phantom construction. Without surrounding holmium solution, a gadolinium tube positioned centrally, parallel with B0, showed a susceptibility difference that agreed well with theoretical values, whereas a peripheral parallel tube position showed larger deviation. Orientation perpendicular to B0 resulted in less variation between the internal tube positions. Air-equivalent magnetic susceptibility corresponded to 16.5 mM Ho(III) solution. With surrounding holmium solution, several post-processing steps became challenging. Simulations indicated higher degree of underestimation when the theoretical susceptibility difference increased. Details in the mathematical implementation, for example, background field removal can strongly influence the result. Simulated results were, in part, unexpected, and provided awareness of limitations in the reconstruction technique, mainly related to conditions with large susceptibility differences between compartments.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67450546","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 : 2022-07-01DOI: 10.17727/jmsr.2022/10-25
Chakrabarty S, S. S, Maji A, Biswas L, Mandal S
Though adjuvant radiotherapy has an established role in the treatment of carcinoma breast, there is concern regarding irradiation to heart and lung, more on left sided disease. Intensity Modulated Radiation Therapy (IMRT) modulates the intensity of the radiation beams with better accuracy, sparing surrounding normal organs. But it increases integral dose to normal healthy tissues compared to 3-Dimensional Conformal Radiation Therapy (3DCRT). So, our study was aimed at comparing the dosimetry and acute toxicity profile of 3DCRT and IMRT in post-mastectomy patients. In study arm patients received radiotherapy with IMRT and in control arm with 3DCRT, radiation dose being 50 Gy in 25 fractions for 5 weeks for both the arms. We compared the dosimetric data for Planning Target Volume (PTV) and Organ At-risk (OAR) by both techniques along with acute toxicity profile. Dosimetric parameter of PTV coverage V95 and V107 were significantly better in IMRT than 3DCRT (p-value <0.0001). IMRT showed better homogeneity index (0.14 Gy vs 0.26 Gy) and conformity index was also better for IMRT (0.94 Gy vs 0.74 Gy, p-value 0.0028). The mean value of heart V25 in left sided disease was significantly lower in IMRT than 3DCRT (22.59 and 25.64, p value 0.01). V20 of ipsilateral lung was numerically less in IMRT though not significant (31.44 vs 35.3). But low dose volume was significantly more in IMRT, as seen by higher V5 of heart and ipsilateral lung. To conclude, IMRT has better PTV coverage and better sparing of organs at risk with more homogenous and conformal plans than 3DCRT.
虽然辅助放疗在乳腺癌的治疗中有一定的作用，但对心脏和肺部的放疗，尤其是对左侧疾病的放疗存在担忧。强度调制放射治疗(IMRT)以更好的准确性调节辐射束的强度，不影响周围的正常器官。但与三维适形放射治疗(3DCRT)相比，它增加了对正常健康组织的总剂量。因此，我们的研究旨在比较3DCRT和IMRT对乳房切除术后患者的剂量学和急性毒性。研究组采用IMRT放射治疗，对照组采用3DCRT放射治疗，两组放射剂量均为50 Gy，分25次，持续5周。我们比较了计划靶体积(PTV)和危险器官(OAR)两种技术的剂量学数据以及急性毒性谱。IMRT中PTV覆盖的剂量学参数V95、V107明显优于3DCRT (p值<0.0001)。IMRT表现出更好的均匀性指数(0.14 Gy vs 0.26 Gy)和一致性指数(0.94 Gy vs 0.74 Gy, p值为0.0028)。左侧病变IMRT组心脏V25均值明显低于3DCRT组(22.59、25.64,p值0.01)。同侧肺V20在IMRT中数值较低，但无统计学意义(31.44 vs 35.3)。但在IMRT中，低剂量体积明显增加，表现为心脏和同侧肺V5增高。综上所述，与3DCRT相比，IMRT具有更好的PTV覆盖和更好的保留危险器官的能力，且方案更加均匀和适形。
{"title":"Prospective study to compare the dose distribution and acute toxicity of three-dimentional conformal radiation therapy with intensity-modulated radiation therapy for post-mastectomy radiotherapy in carcinoma breast","authors":"Chakrabarty S, S. S, Maji A, Biswas L, Mandal S","doi":"10.17727/jmsr.2022/10-25","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-25","url":null,"abstract":"Though adjuvant radiotherapy has an established role in the treatment of carcinoma breast, there is concern regarding irradiation to heart and lung, more on left sided disease. Intensity Modulated Radiation Therapy (IMRT) modulates the intensity of the radiation beams with better accuracy, sparing surrounding normal organs. But it increases integral dose to normal healthy tissues compared to 3-Dimensional Conformal Radiation Therapy (3DCRT). So, our study was aimed at comparing the dosimetry and acute toxicity profile of 3DCRT and IMRT in post-mastectomy patients. In study arm patients received radiotherapy with IMRT and in control arm with 3DCRT, radiation dose being 50 Gy in 25 fractions for 5 weeks for both the arms. We compared the dosimetric data for Planning Target Volume (PTV) and Organ At-risk (OAR) by both techniques along with acute toxicity profile. Dosimetric parameter of PTV coverage V95 and V107 were significantly better in IMRT than 3DCRT (p-value <0.0001). IMRT showed better homogeneity index (0.14 Gy vs 0.26 Gy) and conformity index was also better for IMRT (0.94 Gy vs 0.74 Gy, p-value 0.0028). The mean value of heart V25 in left sided disease was significantly lower in IMRT than 3DCRT (22.59 and 25.64, p value 0.01). V20 of ipsilateral lung was numerically less in IMRT though not significant (31.44 vs 35.3). But low dose volume was significantly more in IMRT, as seen by higher V5 of heart and ipsilateral lung. To conclude, IMRT has better PTV coverage and better sparing of organs at risk with more homogenous and conformal plans than 3DCRT.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41947413","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 : 2022-07-01DOI: 10.17727/jmsr.2022/10-22
K. M, S. S., Patil A, M. J., Yadav Pk, Jayalakshmi S, Varalakshmi Ea, Kaul S, S. M.
Background: Traditionally rheumatic heart disease with mitral stenosis and atrial fibrillation has been the common mechanism of cardioembolic strokes in India. However, with the increase in life span and higher detection and development of cardiac diseases, the frequency and etiologic spectrum of cardioembolic stroke in an Indian hospital may be changing. Methods: The case records of patients admitted in the year 2020 were analyzed for the presence of risk factors and identified stroke mechanisms. Results: Among 538 patients of ischemic strokes, cardioembolic source was identified in 156 (29.8%) patients. Five major cardiac sources of embolism were identified: Coronary artery disease (with acute or remote myocardial infarction) 56/156 (35.89%), non valvular atrial fibrillation, 34/156(21.79%), post cardiac intervention 28/156 (17.94%), left atrial cardiomyopathy 20/156 (12.8%), and rheumatic heart disease 13/156 (8.3%). Conclusion: Coronary artery disease, non valvular atrial fibrillation, post intervention stroke and left atrial cardiomyopathy are emerging as common causes of cardioembolic strokes. Rheumatic heart disease continues to be an important but less frequent cause of cardioembolic strokes.
{"title":"Etiological spectrum of cardioembolic strokes in a tertiary care hospital of India: Analysis of one year data","authors":"K. M, S. S., Patil A, M. J., Yadav Pk, Jayalakshmi S, Varalakshmi Ea, Kaul S, S. M.","doi":"10.17727/jmsr.2022/10-22","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-22","url":null,"abstract":"Background: Traditionally rheumatic heart disease with mitral stenosis and atrial fibrillation has been the common mechanism of cardioembolic strokes in India. However, with the increase in life span and higher detection and development of cardiac diseases, the frequency and etiologic spectrum of cardioembolic stroke in an Indian hospital may be changing. Methods: The case records of patients admitted in the year 2020 were analyzed for the presence of risk factors and identified stroke mechanisms. Results: Among 538 patients of ischemic strokes, cardioembolic source was identified in 156 (29.8%) patients. Five major cardiac sources of embolism were identified: Coronary artery disease (with acute or remote myocardial infarction) 56/156 (35.89%), non valvular atrial fibrillation, 34/156(21.79%), post cardiac intervention 28/156 (17.94%), left atrial cardiomyopathy 20/156 (12.8%), and rheumatic heart disease 13/156 (8.3%). Conclusion: Coronary artery disease, non valvular atrial fibrillation, post intervention stroke and left atrial cardiomyopathy are emerging as common causes of cardioembolic strokes. Rheumatic heart disease continues to be an important but less frequent cause of cardioembolic strokes.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44544305","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 : 2022-07-01DOI: 10.17727/jmsr.2022/10-27
Srinivasa Kh, Maganty V, Kumar Kk, Babu Gs
Background: Surface ablation methods as a method of refractive surgery is making a comeback considering its safety, efficacy and the ease of doing the surgery. Various techniques of epithelial debridement in photorefractive keratectomy were described, like mechanical debridement, using 20% alcohol, using excimer laser or using a rotating brush. This study compares two methods of epithelial removal, namely alcohol assisted and excimer laser assisted in patients undergoing photorefractive keratectomy. Material and methods: A prospective, randomized, interventional study in a tertiary care centre. A total of 50 patients were enrolled, after subjecting them to various test including a detailed history, ocular examination and pentacam. The patients selected were then divided into 2 groups using a randomization software, and the surgery was performed on the de novo eyes. Analysis was done using descriptive statistics namely mean, standard deviation, percentage. Student t test and chi square test was used for the analysis of the data, wherever applicable. Results: The baseline best corrected visual acuity was 0.03 ± 0.0 in the alcohol assisted photorefractive keratectomy group and 0.03 ± 0.08 in the excimer laser assisted epithelial removal photorefractive keratectomy group. At the end of 6 months, all the patients had a visual acuity of 0.00 on logmar scale. Corneal haze noticed on post-operative day one was 0.98 ± 0.09 in the alcohol assisted photorefractive keratectomy group and 0.94 ± 0.1 in the excimer laser assisted group. No corneal haze was found at the end of one week. Pain scale analysis showed that it was 3.08 ± 0.80 in the alcohol assisted photorefractive keratectomy group and 2.9 ± 0.1 in the excimer laser assisted epithelial removal photorefractive keratectomy group which was not statistically significant. There was no pain at the end of one week. Conclusion: Various modes of epithelium removal have evolved over time. The two methods of epithelial removal here have similar outcomes in visual outcome, corneal haze and pain, with a good safety margin.
{"title":"Clinical outcomes after alcohol assisted photorefractive keratectomy versus excimer laser assisted epithelial removal photorefractive keratectomy","authors":"Srinivasa Kh, Maganty V, Kumar Kk, Babu Gs","doi":"10.17727/jmsr.2022/10-27","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-27","url":null,"abstract":"Background: Surface ablation methods as a method of refractive surgery is making a comeback considering its safety, efficacy and the ease of doing the surgery. Various techniques of epithelial debridement in photorefractive keratectomy were described, like mechanical debridement, using 20% alcohol, using excimer laser or using a rotating brush. This study compares two methods of epithelial removal, namely alcohol assisted and excimer laser assisted in patients undergoing photorefractive keratectomy. Material and methods: A prospective, randomized, interventional study in a tertiary care centre. A total of 50 patients were enrolled, after subjecting them to various test including a detailed history, ocular examination and pentacam. The patients selected were then divided into 2 groups using a randomization software, and the surgery was performed on the de novo eyes. Analysis was done using descriptive statistics namely mean, standard deviation, percentage. Student t test and chi square test was used for the analysis of the data, wherever applicable. Results: The baseline best corrected visual acuity was 0.03 ± 0.0 in the alcohol assisted photorefractive keratectomy group and 0.03 ± 0.08 in the excimer laser assisted epithelial removal photorefractive keratectomy group. At the end of 6 months, all the patients had a visual acuity of 0.00 on logmar scale. Corneal haze noticed on post-operative day one was 0.98 ± 0.09 in the alcohol assisted photorefractive keratectomy group and 0.94 ± 0.1 in the excimer laser assisted group. No corneal haze was found at the end of one week. Pain scale analysis showed that it was 3.08 ± 0.80 in the alcohol assisted photorefractive keratectomy group and 2.9 ± 0.1 in the excimer laser assisted epithelial removal photorefractive keratectomy group which was not statistically significant. There was no pain at the end of one week. Conclusion: Various modes of epithelium removal have evolved over time. The two methods of epithelial removal here have similar outcomes in visual outcome, corneal haze and pain, with a good safety margin.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41856324","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 : 2022-07-01DOI: 10.17727/jmsr.2022/10-31
Dasari G, Rao Vvln, Satyanarayana Kvv, V. B
Pyogenic granuloma is an acquired vascular proliferative lesion with associated inflammation, affecting the skin and mucous membranes more frequently. Ocular pyogenic granulomas are rare, involving adnexa, conjunctiva, and cornea. Eyelid pyogenic granuloma is uncommon, associated with chalazion, lid surgeries, lacrimal sac procedures, trauma, predisposing cutaneous lesions, congenital capillary malformations, and idiopathic. We report a case of a 40-year-old male patient who attended our outpatient department with right eye upper lid painless growth, gradually increasing in size in the last two months. The differential diagnosis was burst chalazion, capillary haemangioma, molluscum contagiosum, pilomatricoma, basal cell carcinoma, squamous cell carcinoma, and Kaposi's sarcoma. The lesion was surgically excised, and histopathological examination confirmed the diagnosis. There was no recurrence. This present case illustrates the importance of considering benign inflammatory causes in the differential diagnosis of eyelid mass lesions to avoid unnecessarily aggressive intervention.
{"title":"Pyogenic granuloma of eyelid: A literature review and case report","authors":"Dasari G, Rao Vvln, Satyanarayana Kvv, V. B","doi":"10.17727/jmsr.2022/10-31","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-31","url":null,"abstract":"Pyogenic granuloma is an acquired vascular proliferative lesion with associated inflammation, affecting the skin and mucous membranes more frequently. Ocular pyogenic granulomas are rare, involving adnexa, conjunctiva, and cornea. Eyelid pyogenic granuloma is uncommon, associated with chalazion, lid surgeries, lacrimal sac procedures, trauma, predisposing cutaneous lesions, congenital capillary malformations, and idiopathic. We report a case of a 40-year-old male patient who attended our outpatient department with right eye upper lid painless growth, gradually increasing in size in the last two months. The differential diagnosis was burst chalazion, capillary haemangioma, molluscum contagiosum, pilomatricoma, basal cell carcinoma, squamous cell carcinoma, and Kaposi's sarcoma. The lesion was surgically excised, and histopathological examination confirmed the diagnosis. There was no recurrence. This present case illustrates the importance of considering benign inflammatory causes in the differential diagnosis of eyelid mass lesions to avoid unnecessarily aggressive intervention.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42260315","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 : 2022-07-01DOI: 10.17727/jmsr.2022/10-26
Hanan M, Kutty Ckk, S. P, J. Mb
Background: Weekly cisplatin at 40mg/m2 is the most common regimen followed in our institution. However, patients receiving cisplatin can experience high-frequency hearing loss due to its expansive toxicity profile, a side effect known as ototoxicity. The dearth of information on the extent and severity of cisplatin-associated ototoxicity prevents implementing a context-specific audiological monitoring program. The study aimed to determine the extent and severity of cisplatin ototoxicity in patients receiving concurrent chemoradiation in carcinoma cervix. Methods: Otoscopic examinations and audiological investigations were undertaken at regular intervals in patients undergoing concurrent chemoradiation for carcinoma cervix with single-agent cisplatin in the Department of Radiation Oncology, with the aid of the Department of ENT. All the audiological investigations were provided free of cost. Sixty-six patients who met the inclusion criteria were sent for audiological evaluation before the start of chemotherapy, immediately after chemotherapy completion and after one month following chemotherapy. Results: The study found that cisplatin was associated with high frequency, predominantly bilateral sensorineural hearing loss. Among 66 patients, seven patients (11%) developed cisplatin-induced hearing loss. However, most of the patients developed mild and minimal hearing loss. Conclusion: The study concluded that patients receiving concurrent chemoradiation for carcinoma cervix with cisplatin developed predominantly bilateral, high-frequency sensorineural hearing loss. However, most patients developed minimal or mild hearing loss.
{"title":"Cisplatin-induced ototoxicity in patients receiving concurrent chemoradiation in carcinoma cervix","authors":"Hanan M, Kutty Ckk, S. P, J. Mb","doi":"10.17727/jmsr.2022/10-26","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-26","url":null,"abstract":"Background: Weekly cisplatin at 40mg/m2 is the most common regimen followed in our institution. However, patients receiving cisplatin can experience high-frequency hearing loss due to its expansive toxicity profile, a side effect known as ototoxicity. The dearth of information on the extent and severity of cisplatin-associated ototoxicity prevents implementing a context-specific audiological monitoring program. The study aimed to determine the extent and severity of cisplatin ototoxicity in patients receiving concurrent chemoradiation in carcinoma cervix. Methods: Otoscopic examinations and audiological investigations were undertaken at regular intervals in patients undergoing concurrent chemoradiation for carcinoma cervix with single-agent cisplatin in the Department of Radiation Oncology, with the aid of the Department of ENT. All the audiological investigations were provided free of cost. Sixty-six patients who met the inclusion criteria were sent for audiological evaluation before the start of chemotherapy, immediately after chemotherapy completion and after one month following chemotherapy. Results: The study found that cisplatin was associated with high frequency, predominantly bilateral sensorineural hearing loss. Among 66 patients, seven patients (11%) developed cisplatin-induced hearing loss. However, most of the patients developed mild and minimal hearing loss. Conclusion: The study concluded that patients receiving concurrent chemoradiation for carcinoma cervix with cisplatin developed predominantly bilateral, high-frequency sensorineural hearing loss. However, most patients developed minimal or mild hearing loss.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47545215","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 : 2022-07-01DOI: 10.17727/jmsr.2022/10-23
Manjunath Hg, Nisha Ba, Greeshma Nm, H. Kv
Background: The discontinuation or weaning from mechanical ventilation is an important clinical issue which is associated with lot of complications and patient discomfort. So we need a reliable and feasible method for early, safe and effective liberation of patients from mechanical ventilation. The objectives of our study are to determine sensitivity and specificity of rapid sequence breathing index (RSBI) and ultrasonography (USG) guided diaphragmatic thickness fraction (DFT) as weaning indices and to compare their effectiveness. Methods: The study was carried out on mechanical ventilated patients, when they were considered ready for weaning and the underlying disease is stable or resolving. The measurements of RSBI and DFT using USG were carried out. Weaning was taken as successful if the patients could maintain spontaneous breathing at least 48hrs after extubating, otherwise weaning was classified as failed. Results: RSBI and DTF group showed no statistically significant difference in extubation of mechanically ventilated patients in the intensive care unit (ICU). RSBI showed sensitivity of 96%, specificity of 74.4%, positive predictive value of 88.2%, negative predictive value of 80.5%, and accuracy of 87.2%, and DTF showed sensitivity of 96%, specificity of 69.7%, positive predictive value of 82.4%, negative predictive value of 78.9% and accuracy of 81.9%. Conclusion: In our study since there was only one reintubation in each of the groups, that is failure of weaning of one case each in RSBI and DTF groups, both RSBI and DTF has the same sensitivity of 96%, RSBI has better specificity of 74.4% than DTF of 69.7%, RSBI having a better accuracy of 87.2% than DRF which has an accuracy of 81.9%. We conclude that both the methods are equally effective when used as weaning indices for extubation of mechanically ventilated patients.
{"title":"Comparison of rapid shallow breathing index versus ultrasonographic guided diaphragmatic thickness fraction as weaning indices on mechanically ventilated patients","authors":"Manjunath Hg, Nisha Ba, Greeshma Nm, H. Kv","doi":"10.17727/jmsr.2022/10-23","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-23","url":null,"abstract":"Background: The discontinuation or weaning from mechanical ventilation is an important clinical issue which is associated with lot of complications and patient discomfort. So we need a reliable and feasible method for early, safe and effective liberation of patients from mechanical ventilation. The objectives of our study are to determine sensitivity and specificity of rapid sequence breathing index (RSBI) and ultrasonography (USG) guided diaphragmatic thickness fraction (DFT) as weaning indices and to compare their effectiveness. Methods: The study was carried out on mechanical ventilated patients, when they were considered ready for weaning and the underlying disease is stable or resolving. The measurements of RSBI and DFT using USG were carried out. Weaning was taken as successful if the patients could maintain spontaneous breathing at least 48hrs after extubating, otherwise weaning was classified as failed. Results: RSBI and DTF group showed no statistically significant difference in extubation of mechanically ventilated patients in the intensive care unit (ICU). RSBI showed sensitivity of 96%, specificity of 74.4%, positive predictive value of 88.2%, negative predictive value of 80.5%, and accuracy of 87.2%, and DTF showed sensitivity of 96%, specificity of 69.7%, positive predictive value of 82.4%, negative predictive value of 78.9% and accuracy of 81.9%. Conclusion: In our study since there was only one reintubation in each of the groups, that is failure of weaning of one case each in RSBI and DTF groups, both RSBI and DTF has the same sensitivity of 96%, RSBI has better specificity of 74.4% than DTF of 69.7%, RSBI having a better accuracy of 87.2% than DRF which has an accuracy of 81.9%. We conclude that both the methods are equally effective when used as weaning indices for extubation of mechanically ventilated patients.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44942420","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 : 2022-07-01DOI: 10.17727/jmsr.2022/10-28
Jisha M, Kannan D, Koti S, Polavarapu R, Arunpandiyan V
Background: Epidural administration of local anaesthetic provides effective pain relief. Commonly used epidural local anaesthetics are bupivacaine and ropivacaine. Most studies compared these drugs along with an opioid or any other adjuvants like clonidine, dexmedetomidine etc. Our aim was to compare the analgesic efficacy and safety of continuous infusion of epidural ropivacaine and bupivacaine without any adjuvants in postoperative patients. Materials and methods: A prospective randomized clinical study was conducted in a tertiary care hospital in 60 patients between the age groups of 20-years and 60-years undergoing elective lower limb orthopaedic procedures. Total patients were divided into two groups (A and B) of 30 each. Continuous epidural infusion was started with 6ml per hour of 0.125% bupivacaine in Group A and 6ml per hour of 0.2% ropivacaine in Group B postoperatively. After the commencement of epidural infusions, heart rate, blood pressure, Visual Analogue Score (VAS) and supplementary analgesic requirement were monitored postoperatively for 48 hrs. Results: Our observations showed no significant difference in haemodynamic parameters like heart rate and blood pressure. VAS showed a statistically significant difference with higher mean VAS score in Group B patients at one hour (p value = 0.0126), 12 hrs (p value = 0.031) and 24 hrs (p value = 0.0421) as compared to Group A. Add on analgesic requirement was also higher for Group B patients. Conclusions: Both bupivacaine and ropivacaine can be used effectively for postoperative analgesia but bupivacaine has a superior analgesic efficacy than ropivacaine with similar safety profile.
{"title":"A prospective randomised trial comparing the analgesic efficacy of postoperative infusion of epidural bupivacaine and ropivacaine in orthopaedic surgeries","authors":"Jisha M, Kannan D, Koti S, Polavarapu R, Arunpandiyan V","doi":"10.17727/jmsr.2022/10-28","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-28","url":null,"abstract":"Background: Epidural administration of local anaesthetic provides effective pain relief. Commonly used epidural local anaesthetics are bupivacaine and ropivacaine. Most studies compared these drugs along with an opioid or any other adjuvants like clonidine, dexmedetomidine etc. Our aim was to compare the analgesic efficacy and safety of continuous infusion of epidural ropivacaine and bupivacaine without any adjuvants in postoperative patients. Materials and methods: A prospective randomized clinical study was conducted in a tertiary care hospital in 60 patients between the age groups of 20-years and 60-years undergoing elective lower limb orthopaedic procedures. Total patients were divided into two groups (A and B) of 30 each. Continuous epidural infusion was started with 6ml per hour of 0.125% bupivacaine in Group A and 6ml per hour of 0.2% ropivacaine in Group B postoperatively. After the commencement of epidural infusions, heart rate, blood pressure, Visual Analogue Score (VAS) and supplementary analgesic requirement were monitored postoperatively for 48 hrs. Results: Our observations showed no significant difference in haemodynamic parameters like heart rate and blood pressure. VAS showed a statistically significant difference with higher mean VAS score in Group B patients at one hour (p value = 0.0126), 12 hrs (p value = 0.031) and 24 hrs (p value = 0.0421) as compared to Group A. Add on analgesic requirement was also higher for Group B patients. Conclusions: Both bupivacaine and ropivacaine can be used effectively for postoperative analgesia but bupivacaine has a superior analgesic efficacy than ropivacaine with similar safety profile.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49464325","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 : 2022-07-01DOI: 10.17727/jmsr.2022/10-30
P. T, K. A, Arya Rk
Background: Diabetes mellitus is a major public health problem with multiple medical complications. Microvascular complications of diabetes including diabetic retinopathy, depend on the duration and severity of hyperglycemia. There is a paucity of data about the relationship among diabetic retinopathy, microalbuminuria and HbA1c in newly diagnosed type 2 diabetes mellitus (T2DM) patients. The study was conducted on the prevalence of diabetic retinopathy and its association with microalbuminuria and HbA1c among newly diagnosed T2DM patients. Material and method: It was a hospital-based, cross-sectional study conducted at a tertiary care hospital in Rajasthan. After obtaining written informed consent, data were collected from 150 newly diagnosed T2DM patients. Data were analysed using SPSS 20.0. Categorical variables were presented as proportion and continuous variables were presented as mean (SD). Chi square test and one way ANOVA tests were used for bivariate analysis. Results: The mean (SD) age of patients was 50.43 (12.73) years. About 52.7% (n=79) patients were male. About 30% (n=45) of newly diagnosed T2DM patients had microalbuminuria. Thirty patients (20%) had diabetic retinopathy (DR). About 8% (n=12) participants had mild DR, 10.7% (n=16) had moderate to severe DR and 1.3 (n=2) % had proliferative DR. Microalbuminuria was found significantly associated with HbA1c (P<0.01). Diabetic retinopathy and its severity were also found significantly associated with HbA1c (P<0.01). Conclusion: In newly diagnosed T2DM patients, HbA1c and microalbuminuria are associated with the presence of retinopathy. If follow up studies support these results, periodic ophthalmologic monitoring may be beneficial for those newly diagnosed with T2DM.
{"title":"Prevalence of retinopathy in newly diagnosed type 2 diabetes mellitus patients and its association with microalbuminuria and HbA1c: A cross sectional study from Rajasthan","authors":"P. T, K. A, Arya Rk","doi":"10.17727/jmsr.2022/10-30","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-30","url":null,"abstract":"Background: Diabetes mellitus is a major public health problem with multiple medical complications. Microvascular complications of diabetes including diabetic retinopathy, depend on the duration and severity of hyperglycemia. There is a paucity of data about the relationship among diabetic retinopathy, microalbuminuria and HbA1c in newly diagnosed type 2 diabetes mellitus (T2DM) patients. The study was conducted on the prevalence of diabetic retinopathy and its association with microalbuminuria and HbA1c among newly diagnosed T2DM patients. Material and method: It was a hospital-based, cross-sectional study conducted at a tertiary care hospital in Rajasthan. After obtaining written informed consent, data were collected from 150 newly diagnosed T2DM patients. Data were analysed using SPSS 20.0. Categorical variables were presented as proportion and continuous variables were presented as mean (SD). Chi square test and one way ANOVA tests were used for bivariate analysis. Results: The mean (SD) age of patients was 50.43 (12.73) years. About 52.7% (n=79) patients were male. About 30% (n=45) of newly diagnosed T2DM patients had microalbuminuria. Thirty patients (20%) had diabetic retinopathy (DR). About 8% (n=12) participants had mild DR, 10.7% (n=16) had moderate to severe DR and 1.3 (n=2) % had proliferative DR. Microalbuminuria was found significantly associated with HbA1c (P<0.01). Diabetic retinopathy and its severity were also found significantly associated with HbA1c (P<0.01). Conclusion: In newly diagnosed T2DM patients, HbA1c and microalbuminuria are associated with the presence of retinopathy. If follow up studies support these results, periodic ophthalmologic monitoring may be beneficial for those newly diagnosed with T2DM.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42954702","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 : 2022-07-01DOI: 10.17727/jmsr.2022/10-29
Mali Nh, A. K, Rakshitha Hb, S. M
Background: Hypertension is a major health issue in India and it has led to increasing incidences of target organ damage including hypertensive retinopathy (HR). Many factors like platelet activation show influence in levels of HR. Mean platelet volume (MPV) being an indicator of platelet activation can help in predicting the severity of HR. The present study was planned to find a correlation of levels of MPV with the severity of HR. Methodology: Data of 100 cases of hypertensive retinopathy aged 31 to 80 years diagnosed by direct and indirect ophthalmoscopic examination in the outpatient department of ophthalmology was recorded and reviewed. Complete clinical and demographic data (age, gender, weight, body mass index and socioeconomic status) was noted. Mean platelet volume was obtained from fully automated haematology analyser Horiba medical Yumizen H550. Results: The mean age (years ± standard deviation) of cases with grade 1 HR was 59.448±11.642, grade 2 HR was 56.166±10.0377 and grade 3 HR was 58±19.37. The mean value of MPV in the study population for grade 1 HR was 8.55±0.576, for grade 2 HR was 9.17±0.8224, for grade 3 was 9.6±1.5594. The comparison between grades of HR and levels of MPV was done by one way analysis of variance. Conclusion: We established a significant relationship between mean platelet volume and severity grades of hypertensive retinopathy. MPV a cheap and easily available biomarker can be used for predicting severity in hypertensive retinopathy.
背景：高血压是印度的一个主要健康问题，它导致靶器官损伤的发生率增加，包括高血压视网膜病变（HR）。血小板活化等许多因素都会影响HR水平。作为血小板活化指标的平均血小板体积（MPV）有助于预测HR的严重程度。本研究旨在寻找MPV水平与HR严重程度的相关性。方法：对100例31～80岁的高血压视网膜病变患者在眼科门诊通过直接和间接检眼镜检查确诊的资料进行回顾性分析。注意到完整的临床和人口统计数据（年龄、性别、体重、体重指数和社会经济状况）。平均血小板体积由全自动血液学分析仪Horiba medical Yumizen H550获得。结果：1级HR患者的平均年龄（年±标准差）为59.448±11.642，2级HR为56.166±10.0377，3级HR为58±19.37。研究人群中1级HR的MPV平均值为8.55±0.576，2级HR为9.17±0.8224，3级为9.6±1.5594。HR等级与MPV水平的比较采用单因素方差分析。结论：我们建立了平均血小板体积与高血压视网膜病变严重程度之间的显著关系。MPV是一种廉价且易于获得的生物标志物，可用于预测高血压视网膜病变的严重程度。
{"title":"Relationship of mean platelet volume in predicting severity in hypertensive retinopathy – A cross sectional study","authors":"Mali Nh, A. K, Rakshitha Hb, S. M","doi":"10.17727/jmsr.2022/10-29","DOIUrl":"https://doi.org/10.17727/jmsr.2022/10-29","url":null,"abstract":"Background: Hypertension is a major health issue in India and it has led to increasing incidences of target organ damage including hypertensive retinopathy (HR). Many factors like platelet activation show influence in levels of HR. Mean platelet volume (MPV) being an indicator of platelet activation can help in predicting the severity of HR. The present study was planned to find a correlation of levels of MPV with the severity of HR. Methodology: Data of 100 cases of hypertensive retinopathy aged 31 to 80 years diagnosed by direct and indirect ophthalmoscopic examination in the outpatient department of ophthalmology was recorded and reviewed. Complete clinical and demographic data (age, gender, weight, body mass index and socioeconomic status) was noted. Mean platelet volume was obtained from fully automated haematology analyser Horiba medical Yumizen H550. Results: The mean age (years ± standard deviation) of cases with grade 1 HR was 59.448±11.642, grade 2 HR was 56.166±10.0377 and grade 3 HR was 58±19.37. The mean value of MPV in the study population for grade 1 HR was 8.55±0.576, for grade 2 HR was 9.17±0.8224, for grade 3 was 9.6±1.5594. The comparison between grades of HR and levels of MPV was done by one way analysis of variance. Conclusion: We established a significant relationship between mean platelet volume and severity grades of hypertensive retinopathy. MPV a cheap and easily available biomarker can be used for predicting severity in hypertensive retinopathy.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46341652","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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