Medical Journal Armed Forces India最新文献

英文中文

Appreciation for the introduction of the Postgraduate Medical Education Regulations, 2023

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2024.07.007

Shruti Vimal

引用次数: 0

Effectiveness of different combinations of phenoxetol and formaldehyde on preservation of histological features in human cadaveric tissues phenoxetol和甲醛不同组合对人体尸体组织组织学特征保存的有效性

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2023.07.001

Femina Sam , Pauline Shanthi , Deepak Vinod Francis

Background

Fixation preserves the tissues in a close to the life-like state by preventing its autolysis and putrefaction. Formalin has long been considered the close to ideal fixative for histological studies. With the awareness of occupational hazards, a few researchers have tried phenoxetol as a secondary preservative which offered comparable histological results to that of formalin. The adoption of phenoxetol as a non-toxic histological fixative of choice for staining purposes will require a process of validation; hence, the study aimed to see the suitability of different proportions of formalin and phenoxetol which can be used as a histological fixative.

Methods

A few tissue sections (lip, ear lobe, muscle, vessels, and adipose tissue) were taken from a single cadaver before routine formalin-based embalming. The tissues were cut into smaller segments and fixed in 10% formalin, 1% phenoxetol, and in different proportions of 10% formalin and 1% phenoxetol. After the set time of fixation, tissue processing was carried out, and the slides were stained using hematoxylin and eosin (H&E) as well as special stains. The histological features of the tissues were assessed by two observers who were blinded to the fixation process.

Results

Most of the tissues preserved in 1% phenoxetol stained sufficiently well compared to other fixatives (formalin, phenoxetol + formalin). As the study was done using a standardized protocol followed for 10% formalin, few combinations did not work well. Still, the tissues fixed in 1% phenoxetol gave excellent results.

Conclusion

We can conclude that for histological studies, 1% phenoxetol can be used as a short-term primary fixative.

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引用次数: 0

An observational study to determine the role of indirect immunofluorescence and ELISA for desmogleins in the diagnosis and monitoring of autoimmune bullous disorders 一项观察性研究，以确定桥粒蛋白的间接免疫荧光和ELISA在自身免疫性大疱性疾病诊断和监测中的作用

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2022.05.007

Veena Kharayat , Biju Vasudevan , K. Lekshmi Priya , Rajesh Verma , Prabal Deb , M.S. Deora

Background

Autoimmune bullous disorder (AIBD) is a diverse group of blistering dermatoses that affects the skin and mucous membrane, characterized by the formation of autoantibodies against the desmosomal glycoproteins and adhesion molecular components of the basement membrane zone. Various immunoassay techniques for serological diagnosis are Direct Immunofluorescence (DIF), Indirect Immunofluorescence (IIF), Enzyme Linked Immunosorbent Assay (ELISA) and immunoblotting. Quantitative ELISA titer can also be used to monitor the disease activity and response to treatment. The aim of this study was to evaluate the role of IIF in diagnosing various AIBDs and the role of ELISA for desmogleins in monitoring disease activity in the pemphigus group of disorders.

Methods

A total of 45 patients with freshly diagnosed AIBD were included in the study. Skin biopsies were done to establish the diagnosis by histopathology and DIF. BIOCHIP-based IIF assay was performed on the sera of the patient. The sensitivity and specificity of the IIF assay were then calculated based on the established diagnosis by Histopathological examination (HPE) and DIF. Quantitative ELISA titer was performed to measure the antibody (anti desmoglein (Dsg) 1 and 3) titre in serum samples of patients with pemphigus at baseline, 1 and 3 months follow-up after initiation of appropriate treatment therapy and results were then compared with disease activity scoring system.

Results

Sensitivity and specificity of IIF for Dsg 1 for the pemphigus group were derived to be 85.7% and 98.2% respectively, while that for Dsg 3 were 100% and 98.7%, respectively. Sensitivity (90–100%) of IIF for Bullous pemphigoid was higher than specificity (85–96%). The ELISA titers of anti Dsg1 and 3 were also observed to fall sequentially so was the disease activity score during the follow-up visits at 1 and 3 months.

Conclusion

Biochip IIF assay can be used as a screening tool for the serological diagnosis of AIBD and quantitative ELISA for monitoring the disease activity and response to treatment.

{"title":"An observational study to determine the role of indirect immunofluorescence and ELISA for desmogleins in the diagnosis and monitoring of autoimmune bullous disorders","authors":"Veena Kharayat , Biju Vasudevan , K. Lekshmi Priya , Rajesh Verma , Prabal Deb , M.S. Deora","doi":"10.1016/j.mjafi.2022.05.007","DOIUrl":"10.1016/j.mjafi.2022.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune bullous disorder (AIBD) is a diverse group of blistering dermatoses that affects the skin and mucous membrane, characterized by the formation of autoantibodies against the desmosomal glycoproteins and adhesion molecular components of the basement membrane zone. Various immunoassay techniques for serological diagnosis are Direct Immunofluorescence (DIF), Indirect Immunofluorescence (IIF), Enzyme Linked Immunosorbent Assay (ELISA) and immunoblotting. Quantitative ELISA titer can also be used to monitor the disease activity and response to treatment. The aim of this study was to evaluate the role of IIF in diagnosing various AIBDs and the role of ELISA for desmogleins in monitoring disease activity in the pemphigus group of disorders.</div></div><div><h3>Methods</h3><div>A total of 45 patients with freshly diagnosed AIBD were included in the study. Skin biopsies were done to establish the diagnosis by histopathology and DIF. BIOCHIP-based IIF assay was performed on the sera of the patient. The sensitivity and specificity of the IIF assay were then calculated based on the established diagnosis by Histopathological examination (HPE) and DIF. Quantitative ELISA titer was performed to measure the antibody (anti desmoglein (Dsg) 1 and 3) titre in serum samples of patients with pemphigus at baseline, 1 and 3 months follow-up after initiation of appropriate treatment therapy and results were then compared with disease activity scoring system.</div></div><div><h3>Results</h3><div>Sensitivity and specificity of IIF for Dsg 1 for the pemphigus group were derived to be 85.7% and 98.2% respectively, while that for Dsg 3 were 100% and 98.7%, respectively. Sensitivity (90–100%) of IIF for Bullous pemphigoid was higher than specificity (85–96%). The ELISA titers of anti Dsg1 and 3 were also observed to fall sequentially so was the disease activity score during the follow-up visits at 1 and 3 months.</div></div><div><h3>Conclusion</h3><div>Biochip IIF assay can be used as a screening tool for the serological diagnosis of AIBD and quantitative ELISA for monitoring the disease activity and response to treatment.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"81 1","pages":"Pages 80-89"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42866352","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}

引用次数: 0

Real world experience on patterns of usage and toxicity profile of immunotherapy drugs in Indian patients: A prospective observational study 印度患者免疫治疗药物使用模式和毒性概况的真实世界经验:一项前瞻性观察研究

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2023.07.007

M.R. Kaushik , Amul Kapoor , H.P. Singh , P. Suresh , Deepak Mulajkar , Anvesh Rathore , Rajesh Nair , D.S. Nihanthy , Aarty Mehrotra , Amol Patel

Background

Immune checkpoint inhibitors (ICIs) are now considered revolutionary agents in the treatment of various cancers. Prospective data are limited on the patterns of usage and toxicity profile of these drugs. We planned this study for addressing the same in Indian patients.

Methods

This prospective study was conducted over a period of 2 years. All patients who were treated with Nivolumab, pembrolizumab, atezolizumab, and durvalumab were included. Immune-related adverse events were recorded. Toxicities were graded and number of patients experiencing dose limiting toxicities was recorded.

Results

A total of 53 patients received one of the above four agents. Majority of patients were less than 60 years of age. Carcinoma lung was the most frequent malignancy followed by renal cell carcinoma, Hodgkin's Lymphoma, Urinary Bladder cancers, Malignant Melanoma, and Recurrent/Metastatic Head and neck cancer. Nivolumab was used in most of the study population followed by pembrolizumab. Majority of agents were used in second line. The frequency of all grade adverse events for fatigue, anemia, pneumonitis, skin rash, dyspnea, diarrhea, and hypothyroidism were (in %) 73.58, 62.26, 16.9, 11.32, 9.43, 9.43, and 7.55, respectively. No grade 5 toxicity was observed. None of the grade 3 or 4 toxicities led to treatment discontinuation. Statistically, no difference was found for all grade toxicities among ICI drugs and among the various lines of use.

Conclusion

Nivolumab was the commonest drug used in our cohort. Most of ICIs were used in second-line setting. Toxicities are in line with the published literature.

{"title":"Real world experience on patterns of usage and toxicity profile of immunotherapy drugs in Indian patients: A prospective observational study","authors":"M.R. Kaushik , Amul Kapoor , H.P. Singh , P. Suresh , Deepak Mulajkar , Anvesh Rathore , Rajesh Nair , D.S. Nihanthy , Aarty Mehrotra , Amol Patel","doi":"10.1016/j.mjafi.2023.07.007","DOIUrl":"10.1016/j.mjafi.2023.07.007","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) are now considered revolutionary agents in the treatment of various cancers. Prospective data are limited on the patterns of usage and toxicity profile of these drugs. We planned this study for addressing the same in Indian patients.</div></div><div><h3>Methods</h3><div>This prospective study was conducted over a period of 2 years. All patients who were treated with Nivolumab, pembrolizumab, atezolizumab, and durvalumab were included. Immune-related adverse events were recorded. Toxicities were graded and number of patients experiencing dose limiting toxicities was recorded.</div></div><div><h3>Results</h3><div>A total of 53 patients received one of the above four agents. Majority of patients were less than 60 years of age. Carcinoma lung was the most frequent malignancy followed by renal cell carcinoma, Hodgkin's Lymphoma, Urinary Bladder cancers, Malignant Melanoma, and Recurrent/Metastatic Head and neck cancer. Nivolumab was used in most of the study population followed by pembrolizumab. Majority of agents were used in second line. The frequency of all grade adverse events for fatigue, anemia, pneumonitis, skin rash, dyspnea, diarrhea, and hypothyroidism were (in %) 73.58, 62.26, 16.9, 11.32, 9.43, 9.43, and 7.55, respectively. No grade 5 toxicity was observed. None of the grade 3 or 4 toxicities led to treatment discontinuation. Statistically, no difference was found for all grade toxicities among ICI drugs and among the various lines of use.</div></div><div><h3>Conclusion</h3><div>Nivolumab was the commonest drug used in our cohort. Most of ICIs were used in second-line setting. Toxicities are in line with the published literature.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"81 1","pages":"Pages 39-45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135254919","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}

引用次数: 0

Analysis of factors influencing length of stay in the emergency department in public hospital, Padang, Indonesia 印度尼西亚巴东公立医院急诊科住院时间影响因素分析

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2023.11.009

Fitri Mailani , Tiurmaida Simandalahi , Aisyah Purnama Sari

Background

Extending the time patients spend in the emergency department (ED) not only diminishes the quality of care but also heightens the potential for harm and adversely impacts patient satisfaction. However, there exists a dearth of accessible information regarding the length of stay (LOS) in emergency departments and the factors associated with it in Indonesia. This study aims to analyze the factors that influence the LOS of patients in the emergency department of a public hospital in Padang, Indonesia.

Methods

This research design is a cross-sectional approach. The sample was patients who visited the ED in a tertiary public hospital in Padang (n = 328). The data collected from the medical records included length of stay, mode of arrival, case type, triage scale, diagnostic examination, specialist consultation needs, and needs for admission. Data analysis was performed using the chi-square statistical test and binary logistic regression.

Results

The percentage of patients with LOS > 6 h in the emergency department was 29 %. There was a significant relationship between the triage scale, diagnostic tests, and the need for hospitalization with LOS (p < 0.05). The results of the multivariate analysis showed that the case type and the need for admission to hospitalization influence 12.4 % of LOS in ED.

Conclusion

This study enriches our comprehension of the variables exerting the most substantial impact on the average duration of stay in the emergency department of a hospital in Indonesia. The findings will assist policymakers in crafting enduring strategies to optimize patient flow in the emergency department.

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引用次数: 0

Vexatious and euphemistic affairs in retractions of scientific publications: A pilot study 科学出版物撤回中令人烦恼的委婉事件:一项初步研究

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2023.07.005

Jyotindu Debnath , Debjyoti Debnath , Seema Patrikar

Background

An increasing number of retractions have been published in the recent past which may be conforming to the large number publications being added on a daily basis. Concerns have been flagged time and again regarding comprehensiveness and utility of retraction notices.

Methods

Retraction notices published in PubMed in Jan 23 were analyzed for journal, publisher, article, country affiliation of authors, month of publication, who raised concern, main and additional reason for retraction, completeness of retraction notice, editors/authors requesting for retraction, agreement between authors and editors, and the number of citations received.

Results

A total of 295 retraction notices published in PubMed in Jan 2023 by 110 journals (which included 24 publishers and 9 standalone journals) were analyzed. Sixty-four percent of journals published single retraction notice. The highest number of retractions by a single journal was 70. Only 31% of retraction notices gave complete details. Editors requested for retraction in 88% cases. Eighty-four percent of the articles received at least one citation. In 71% of cases, it is not known who raised the concern. Reasons for retraction were compromised peer review (37%), plagiarism (20%), image manipulation (13%), data reliability (8%), authorship dispute (6%), methodology issues (4%), and so on. Twenty-seven percent of cases had more than one reason. Plagiarism of figures constituted 84% of total plagiarism cases. Fifty-eight of 59 plagiarism cases were described indirectly despite clear evidence. Authors and editors agreed for retraction in 25% of cases, and no information was available in 36% cases.

Conclusion

A substantial number of retraction notices are incomplete, vague, and euphemistic. Plagiarism of figures/images is an emerging threat.

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引用次数: 0

Video bronchoscopic electrocautery fulguration of endobronchial carcinoids: Case series from an Indian tertiary care center 支气管内膜类癌的视频支气管镜电灼术：来自印度三级医疗中心的病例系列

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2023.03.007

Manu Chopra , Priyanka Singh , Shafin Babu PS , A. Bandopadhyay , Priyanka Mishra , Yadvendra Singh Sirohi , Shivinder Singh

Carcinoid tumors are slow-growing tumors noticed in the tracheobronchial tree and pulmonary parenchyma. Generally, these tumors are slow growing with minimum risk of distant metastasis, but the atypical type of carcinoids has greater malignant potential with lower survival rates. The primary and most effective treatment for all pulmonary carcinoid tumors is surgical resection if no contraindications to surgery exist. Compared to surgical resection, bronchoscopic management is minimally invasive and parenchyma sparing. The present case series describes six patients, all young males, diagnosed with typical (n = 4) and atypical (n = 2) carcinoids, and managed with electrocautery fulguration carried out through video bronchoscope. Three cases were suggested pneumonectomy, while the other three cases were suggested for lobectomy by the Hospital Tumour Board. After the electrocautery fulguration procedure, the procedures of lobectomy or pneumonectomy were successfully prevented in all the cases, thereby saving these young males from life-threatening surgeries and permanent disabilities that would have affected their health and career. This is one of its kind case series that shows the importance of bronchoscopic management in carcinoid cases, from developing countries that can help in preserving the lungs.

{"title":"Video bronchoscopic electrocautery fulguration of endobronchial carcinoids: Case series from an Indian tertiary care center","authors":"Manu Chopra , Priyanka Singh , Shafin Babu PS , A. Bandopadhyay , Priyanka Mishra , Yadvendra Singh Sirohi , Shivinder Singh","doi":"10.1016/j.mjafi.2023.03.007","DOIUrl":"10.1016/j.mjafi.2023.03.007","url":null,"abstract":"<div><div>Carcinoid tumors are slow-growing tumors noticed in the tracheobronchial tree and pulmonary parenchyma. Generally, these tumors are slow growing with minimum risk of distant metastasis, but the atypical type of carcinoids has greater malignant potential with lower survival rates. The primary and most effective treatment for all pulmonary carcinoid tumors is surgical resection if no contraindications to surgery exist. Compared to surgical resection, bronchoscopic management is minimally invasive and parenchyma sparing. The present case series describes six patients, all young males, diagnosed with typical (n = 4) and atypical (n = 2) carcinoids, and managed with electrocautery fulguration carried out through video bronchoscope. Three cases were suggested pneumonectomy, while the other three cases were suggested for lobectomy by the Hospital Tumour Board. After the electrocautery fulguration procedure, the procedures of lobectomy or pneumonectomy were successfully prevented in all the cases, thereby saving these young males from life-threatening surgeries and permanent disabilities that would have affected their health and career. This is one of its kind case series that shows the importance of bronchoscopic management in carcinoid cases, from developing countries that can help in preserving the lungs.</div></div>","PeriodicalId":39387,"journal":{"name":"Medical Journal Armed Forces India","volume":"81 1","pages":"Pages 90-94"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48069024","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}

引用次数: 0

Sochureki, the different saw- scaled viper: Challenges are many! Sochureki，与众不同的锯鳞毒蛇：挑战是多方面的！

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2023.11.004

Sudeep Prakash , Asturkar Vikram , A.W. Kashif , Soumitra Khare

Snake bite is a major cause of mortality in the Indian subcontinent. The condition is fraught with the problem of under reporting. Most bites in India are caused by the “Big 4 species,” based on this, the anti–snake venom (ASV) is also sourced from these species only. It has been observed that the venom of snakes from different regions respond differently to it, as is sourced mainly from snakes of southern region of India. We present a case of a saw-scaled viper (SSV) bite, where the patient had unusual presentation of thrombotic microangiopathy (TMA) along with venom-induced consumption coagulopathy (VICC). The patient was resistant to ASV and finally succumbed. The snake was identified as Echis carinatus sochureki (a subspecies of SSV). This case highlights that VICC is the commonest presentation in a SSV bite, rather than disseminated intravascular coagulation (DIC). The organ failure in such bites is due to rare coexistence of TMA (especially in an E carinatus sochureki bite) and should not be attributed to DIC. It also identifies that the polyvalent ASV produced in India is not effective against E carinatus sochureki bite.

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引用次数: 0

New variant/ subspecies of plasmodium in Northeastern India 印度东北部疟原虫的新变异体/亚种

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2022.10.010

Mahima Lall, Naveen Grover, Himmat Singh Pawar, Naseem Ahmed, Kuldeep Singh, Amit P. Sharma, Nitin Damsadekar, Tukaram C. Ahirawadagi

引用次数: 0

Enamel renal gingival syndrome in Indian scenario: A systematic review

Q2 Medicine

Medical Journal Armed Forces India

Pub Date : 2025-01-01 DOI: 10.1016/j.mjafi.2024.09.003

Rahul Koul , Dempsy Chengappa , Devashish , Sanjeev Datana , S.S. Chopra

Background

Enamel renal gingival syndrome (ERS) is a genetic disorder caused by mutations in the FAM20A gene located on long arm of chromosome 17. It is characterized by presence of intra-oral features like hypoplastic type of amelogenesis imperfecta, fibromatosis of gingiva and nephrocalcinosis in addition to delayed eruption. The oral phenotype is evident in childhood, whereas the renal involvement is clinically silent at this age and requires further investigation for detection at later age. Gingival hyperplasia typically accompanies other features of the syndrome but is more variable, ranging from discrete to severe.

Methods

The present review aimed to analyze ERS in Indian population through a comprehensive literature analysis to emphasize the main findings of the syndrome. Present study is a systematic analysis of scientific literature conducted using four databases namely PubMed, Biomed, Cochrane, DOAJ in May 2024. The systematic review was registered in PROSPERO with registration number - CRD42024511916.

Result

A total of 14 articles as per inclusion criteria laid down for the present review were obtained, including data from 18 patients. Gender equivalence was observed among participants, with ages ranging from 09 to 32 years old. The syndrome has shown a genetic pattern, with consanguinity present in eight patients (47%) and a positive familial history in nine patients (52%). Laboratory findings observed mainly included hypocalciuria and hypophosphaturia (16.6%), hypocitraturia (11.1%), 24-h increased fractional excretion of calcium and magnesium and altered serum creatinine (16.6%).

Conclusion

Many times, it could be a dentist who may be the first person to encounter and diagnose such a condition. Enhanced cooperation between medical and dental professionals will result in improved understanding of this condition and enable more efficient and effective treatment of individuals suffering from it.

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引用次数: 0

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