Pub Date : 2023-11-20DOI: 10.4103/jmms.jmms_105_23
Prasenjit Panda, Anupam Kumar, G. Shivaram, Rohit Singh
Regular monitoring of Vitamin B12 (VB12) levels and intake of supplements is crucial since their deficiency may cause serious health conditions including neurological and cardiovascular complications. Medical professionals recommend supplements in the form of oral tablets and parenteral replacement for patients who cannot obtain these nutrients through diet or who are deficient due to other health conditions. This study aimed to compare the efficacy of oral medications and parenteral administrations, especially intramuscular (IM) injections for managing VB12 deficiency. The patients diagnosed with confirmed VB12 deficiency (<211 pg/mL) were divided into two groups. One group received oral tablet (Mecobal 1000 mg); the other received VB12 injection (1000 mg) IM. The blood levels of both the groups were assessed after 6 months. The data were statistically analyzed to compare the efficacy of both routes. The mean age of oral and IM groups was 57 ± 10 years and 53 ± 11 years, respectively. The baseline serum VB12 values for the oral and IM groups were 158 pg/mL and 139 pg/mL, respectively (P = 0.01), and the mean VB12 values after treatment for the oral and IM groups were 301 pg/ml and 1416 pg/ml, respectively (P < 0.0001). The oral group observed a mean change of 143, while the IM group experienced a change of 1277 pg/ml (P < 0.0001). Our findings support the use of parenteral replacement over oral medications for the management of VB12.
{"title":"Management of Vitamin B12 Deficiency: A Comparative Analysis of Intramuscular Injections versus Oral Medications","authors":"Prasenjit Panda, Anupam Kumar, G. Shivaram, Rohit Singh","doi":"10.4103/jmms.jmms_105_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_105_23","url":null,"abstract":"Regular monitoring of Vitamin B12 (VB12) levels and intake of supplements is crucial since their deficiency may cause serious health conditions including neurological and cardiovascular complications. Medical professionals recommend supplements in the form of oral tablets and parenteral replacement for patients who cannot obtain these nutrients through diet or who are deficient due to other health conditions. This study aimed to compare the efficacy of oral medications and parenteral administrations, especially intramuscular (IM) injections for managing VB12 deficiency. The patients diagnosed with confirmed VB12 deficiency (<211 pg/mL) were divided into two groups. One group received oral tablet (Mecobal 1000 mg); the other received VB12 injection (1000 mg) IM. The blood levels of both the groups were assessed after 6 months. The data were statistically analyzed to compare the efficacy of both routes. The mean age of oral and IM groups was 57 ± 10 years and 53 ± 11 years, respectively. The baseline serum VB12 values for the oral and IM groups were 158 pg/mL and 139 pg/mL, respectively (P = 0.01), and the mean VB12 values after treatment for the oral and IM groups were 301 pg/ml and 1416 pg/ml, respectively (P < 0.0001). The oral group observed a mean change of 143, while the IM group experienced a change of 1277 pg/ml (P < 0.0001). Our findings support the use of parenteral replacement over oral medications for the management of VB12.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"77 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256610","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}
Ali Mustajib, Sharma Arunav, Sheik R. Abdul, Harshit Bhargava, Agrawal Sunil
Coronavirus disease 19 (COVID-19) has become a global pandemic; its unparalleled speed of spread has left us all in a worldwide alarming situation. The aim was to study the prevalence of COVID-19 infection in asymptomatic antenatal patients at term and its maternal and fetal outcomes and neonates being followed up till 18 months for developmental assessment. This was a prospective observational study carried out from September 1, 2020, to March 31, 2023. This prospective observational study was conducted on 250 pregnant women attending the antenatal care outpatient department in a Zonal Hospital in Northeastern India expected to undergo delivery in the next 5 days, and all suspected COVID-19 pregnant women were included in the study. Asymptomatic pregnant women not expecting delivery in the next 5 days were excluded. All neonates born to these 250 mothers were followed till 18 months of age and were then assessed for the impact of COVID-19 on the developmental milestones. The prevalence of COVID-19 was calculated in the study population. The Chi-square test was used to compare categorical variables in COVID-19-positive and -negative groups. P <0.05 was considered significant. The prevalence of COVID-19 infection in term pregnancies was found to be 4%. The findings of the study showed no immediate impact on maternal and fetal health from COVID-19 infection. However, on follow-up of these babies (born during the pandemic) at 18 months of age, there was a delay in social and language domains of development in 18.8% of children. Most women were discharged without any significant problems, and there were no signs that COVID-19 had been transmitted vertically. COVID-19 infection was found to have no immediate impact on maternal and neonatal health. However, follow-up at 18 months of babies born during the COVID-19 era revealed a delay in social and language milestones in 18.8% of children. Further multicentric studies with a larger population base need to be done to substantiate this claim.
{"title":"A Prospective Study on the Prevalence of Coronavirus Disease 19 Infection in Antenatal Patients at Term and Its Effects on Maternal-fetal Health and on Early Childhood Development","authors":"Ali Mustajib, Sharma Arunav, Sheik R. Abdul, Harshit Bhargava, Agrawal Sunil","doi":"10.4103/jmms.jmms_86_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_86_23","url":null,"abstract":"Coronavirus disease 19 (COVID-19) has become a global pandemic; its unparalleled speed of spread has left us all in a worldwide alarming situation. The aim was to study the prevalence of COVID-19 infection in asymptomatic antenatal patients at term and its maternal and fetal outcomes and neonates being followed up till 18 months for developmental assessment. This was a prospective observational study carried out from September 1, 2020, to March 31, 2023. This prospective observational study was conducted on 250 pregnant women attending the antenatal care outpatient department in a Zonal Hospital in Northeastern India expected to undergo delivery in the next 5 days, and all suspected COVID-19 pregnant women were included in the study. Asymptomatic pregnant women not expecting delivery in the next 5 days were excluded. All neonates born to these 250 mothers were followed till 18 months of age and were then assessed for the impact of COVID-19 on the developmental milestones. The prevalence of COVID-19 was calculated in the study population. The Chi-square test was used to compare categorical variables in COVID-19-positive and -negative groups. P <0.05 was considered significant. The prevalence of COVID-19 infection in term pregnancies was found to be 4%. The findings of the study showed no immediate impact on maternal and fetal health from COVID-19 infection. However, on follow-up of these babies (born during the pandemic) at 18 months of age, there was a delay in social and language domains of development in 18.8% of children. Most women were discharged without any significant problems, and there were no signs that COVID-19 had been transmitted vertically. COVID-19 infection was found to have no immediate impact on maternal and neonatal health. However, follow-up at 18 months of babies born during the COVID-19 era revealed a delay in social and language milestones in 18.8% of children. Further multicentric studies with a larger population base need to be done to substantiate this claim.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"12 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258046","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}
Although H3N2 outbreaks were once rare, they have become more common in recent years. With a significant toll on health-care resources and the ability to cripple any society, the epidemiological significance of this disease is paramount. While most of the previous studies on influenza outbreaks have reported H1N1 disease, there is a scarcity of literature regarding the H3N2 clinicoradiological profile. Hereby, we present the clinicoradiological profile of a series of H3N2 cases from western India. This is a retrospective chart-based review of clinicoradiological profile of a series of cases that were reported to a tertiary care center in western India between February 2023 and March 2023. A total of 10 patients had tested positive for H3N2. All patients had a history of fever lasting an average of 4.7 days, and six had varying degrees of dyspnea. One patient had gastrointestinal symptoms, and six developed tachypnea with hypoxemia requiring oxygen supplementation. One patient with multiple comorbidities required invasive mechanical ventilation and had a complicated course with a superadded bacterial infection. Out of the four patients with radiographic findings, two had atypical pneumonia/acute infective etiology. This study provides valuable insights into the clinical presentation and management of H3N2 infections. The findings highlight the importance of influenza vaccination and early detection of H3N2 infections to prevent severe complications. The successful outcomes of the patients in this study demonstrate the effectiveness of prompt intervention and appropriate treatment in managing H3N2 infections.
{"title":"A Clinicoradiological Profile of H3N2 Outbreak in Western India","authors":"P. Harikrishnan, Suraj Gautam Duche, Rohit Vashisht, Yogendra Mishra, Abhinav Kumar, Samir Samadarshi","doi":"10.4103/jmms.jmms_85_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_85_23","url":null,"abstract":"Although H3N2 outbreaks were once rare, they have become more common in recent years. With a significant toll on health-care resources and the ability to cripple any society, the epidemiological significance of this disease is paramount. While most of the previous studies on influenza outbreaks have reported H1N1 disease, there is a scarcity of literature regarding the H3N2 clinicoradiological profile. Hereby, we present the clinicoradiological profile of a series of H3N2 cases from western India. This is a retrospective chart-based review of clinicoradiological profile of a series of cases that were reported to a tertiary care center in western India between February 2023 and March 2023. A total of 10 patients had tested positive for H3N2. All patients had a history of fever lasting an average of 4.7 days, and six had varying degrees of dyspnea. One patient had gastrointestinal symptoms, and six developed tachypnea with hypoxemia requiring oxygen supplementation. One patient with multiple comorbidities required invasive mechanical ventilation and had a complicated course with a superadded bacterial infection. Out of the four patients with radiographic findings, two had atypical pneumonia/acute infective etiology. This study provides valuable insights into the clinical presentation and management of H3N2 infections. The findings highlight the importance of influenza vaccination and early detection of H3N2 infections to prevent severe complications. The successful outcomes of the patients in this study demonstrate the effectiveness of prompt intervention and appropriate treatment in managing H3N2 infections.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"32 6","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257717","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 : 2023-11-20DOI: 10.4103/jmms.jmms_130_23
B. Madhu, Brototi Biswas, Dhivya Karegam, Arun Kumar Yadav
Environmental factors such as temperature, precipitation, and various other pollutants in the air like nitrogen dioxide (NO2), CO2, etc., have been studied for sustenance and transmission of Coronavirus disease-19 (COVID-19). Studies from India are lacking about the distribution of COVID-19 cases according to air pollutants and meteorological factors. Hence, the present study was conducted to study the relationship between COVID-19 and environmental factors with the objectives of Cluster mapping of the COVID-19 cases district-wise for the state of Maharashtra. The air pollution variables NO2 column density (mol/m2), sulfur dioxide column density (mol/m2), Aerosol absorbing index (Ai), Carbon monoxide (CO) column density (mol/m2), and Ozone column density (mol/m2) were extracted from Sentinel-5P datasets available in Google Earth Engine (GEE) (https://code.earthengine.google.com/). The meteorological variables precipitation (m), temperature (t), and humidity (k) were extracted from the European Environmental Agency 5-Land reanalysis dataset in GEE, which provides data at a resolution of 1113.2 m. The preprocessing and retrieval of data were carried out in GEE. These values were correlated with daily cases, density, and other demographic factors. The study identified a cluster of cases in few districts of Maharashtra. These districts were Pune, Ahmednagar, Mumbai, Nashik, and Nagpur. Population density and NO2 were important factors in most of the monthly data. The present study used data available on public platforms to assess the association between COVID-19 and environmental factors. The study found that various environmental factors such as NO2, CO, and Ai may be associated with increase cases of COVID-19 in the district. However, ecological bias may be kept in mind.
{"title":"Distribution of COVID-19 Cases According to Environmental Pollutants and Meteorological Factors in Districts of Maharashtra","authors":"B. Madhu, Brototi Biswas, Dhivya Karegam, Arun Kumar Yadav","doi":"10.4103/jmms.jmms_130_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_130_23","url":null,"abstract":"Environmental factors such as temperature, precipitation, and various other pollutants in the air like nitrogen dioxide (NO2), CO2, etc., have been studied for sustenance and transmission of Coronavirus disease-19 (COVID-19). Studies from India are lacking about the distribution of COVID-19 cases according to air pollutants and meteorological factors. Hence, the present study was conducted to study the relationship between COVID-19 and environmental factors with the objectives of Cluster mapping of the COVID-19 cases district-wise for the state of Maharashtra. The air pollution variables NO2 column density (mol/m2), sulfur dioxide column density (mol/m2), Aerosol absorbing index (Ai), Carbon monoxide (CO) column density (mol/m2), and Ozone column density (mol/m2) were extracted from Sentinel-5P datasets available in Google Earth Engine (GEE) (https://code.earthengine.google.com/). The meteorological variables precipitation (m), temperature (t), and humidity (k) were extracted from the European Environmental Agency 5-Land reanalysis dataset in GEE, which provides data at a resolution of 1113.2 m. The preprocessing and retrieval of data were carried out in GEE. These values were correlated with daily cases, density, and other demographic factors. The study identified a cluster of cases in few districts of Maharashtra. These districts were Pune, Ahmednagar, Mumbai, Nashik, and Nagpur. Population density and NO2 were important factors in most of the monthly data. The present study used data available on public platforms to assess the association between COVID-19 and environmental factors. The study found that various environmental factors such as NO2, CO, and Ai may be associated with increase cases of COVID-19 in the district. However, ecological bias may be kept in mind.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"262 3-4","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257211","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}
Metaverse, the disruptive digital technology, has demonstrated significant effectiveness in the fields of preventive and cognitive therapy, diagnostics, surgical interventions and rehabilitation. Virtual Reality (VR), a part of Metaverse, integrates imaging data and input from users and deliver a 3D graphical output which can be visualised through a wearable headset. Augmented reality (AR) on the other hand, can control the presence of the user in the real world. A review was undertaken of peer-reviewed literature on the emerging evidence on the applications of AR and VR in healthcare. Research studies carried out to identify effectiveness of AR and VR technologies were included. AR & VR have been effective in rehabilitation of patients of Autism Spectrum Disorders and Mild Cognitive Impairment by improving motor skills, social skills and various cognitive indices like task learning and attention. In the surgical field, AR head mounted device (HMD) can provide three-dimensional, patient specific anatomic information during surgery. It minimises surgical complications and improves patient satisfaction. AR is of particular interest in complicated spinal surgeries and orthopaedic manoeuvres which require high level of surgical skill. AR has also been used successfully in different types of robotic surgeries as well. In several countries AR technology have been used in basic medical and advanced surgical training. Major challenges in implementing AR and VR in the field of health care persist in the domains of cyber security, ethical issues and cost effectiveness. VR and AR technology can maximise patient outcomes and rapidly develop satisfactory patient management in fields of cognitive research and surgical interventions. More clinical trials with immersive digital technologies are required. Ethical and cyber security challenges are present but there are ways to overcome them. It is our duty as physicians to participate in the development of these innovations to ensure virtual health reality benefits for our patients in real-world setting.
Metaverse是一项颠覆性的数字技术，在预防和认知治疗、诊断、外科干预和康复等领域都取得了显著成效。虚拟现实（VR）是 Metaverse 的一部分，它整合了成像数据和用户输入的信息，并提供三维图形输出，可通过可穿戴头戴式设备进行可视化。另一方面，增强现实（AR）可以控制用户在现实世界中的存在。 我们对同行评审的文献进行了审查，以了解 AR 和 VR 在医疗保健领域应用的新证据。其中包括为确定 AR 和 VR 技术的有效性而开展的研究。 AR 和 VR 能够提高自闭症谱系障碍和轻度认知障碍患者的运动技能、社交技能以及各种认知指标（如任务学习和注意力），对其康复非常有效。在外科领域，AR 头戴式设备（HMD）可以在手术过程中提供三维的、针对病人的解剖信息。它能最大限度地减少手术并发症，提高患者满意度。在需要高水平手术技能的复杂脊柱手术和矫形手术中，AR 尤其受到关注。AR 也已成功应用于不同类型的机器人手术。在一些国家，AR 技术已被用于基础医学和高级外科培训。在医疗保健领域应用 AR 和 VR 的主要挑战仍然存在于网络安全、伦理问题和成本效益等领域。 在认知研究和外科干预领域，VR 和 AR 技术可以最大限度地提高病人的治疗效果，并迅速发展令人满意的病人管理。需要利用沉浸式数字技术开展更多临床试验。伦理和网络安全方面的挑战是存在的，但有办法可以克服。作为医生，我们有责任参与这些创新技术的开发，以确保虚拟健康现实技术在现实世界中为患者带来益处。
{"title":"Transition toward Technological Transformation: Challenges of Implementing Virtual Reality and Augmented Reality in the Health Sector","authors":"Sougat Ray, Shabeena Tawar, Neha Singh, Gurpreet Singh","doi":"10.4103/jmms.jmms_89_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_89_23","url":null,"abstract":"Metaverse, the disruptive digital technology, has demonstrated significant effectiveness in the fields of preventive and cognitive therapy, diagnostics, surgical interventions and rehabilitation. Virtual Reality (VR), a part of Metaverse, integrates imaging data and input from users and deliver a 3D graphical output which can be visualised through a wearable headset. Augmented reality (AR) on the other hand, can control the presence of the user in the real world. A review was undertaken of peer-reviewed literature on the emerging evidence on the applications of AR and VR in healthcare. Research studies carried out to identify effectiveness of AR and VR technologies were included. AR & VR have been effective in rehabilitation of patients of Autism Spectrum Disorders and Mild Cognitive Impairment by improving motor skills, social skills and various cognitive indices like task learning and attention. In the surgical field, AR head mounted device (HMD) can provide three-dimensional, patient specific anatomic information during surgery. It minimises surgical complications and improves patient satisfaction. AR is of particular interest in complicated spinal surgeries and orthopaedic manoeuvres which require high level of surgical skill. AR has also been used successfully in different types of robotic surgeries as well. In several countries AR technology have been used in basic medical and advanced surgical training. Major challenges in implementing AR and VR in the field of health care persist in the domains of cyber security, ethical issues and cost effectiveness. VR and AR technology can maximise patient outcomes and rapidly develop satisfactory patient management in fields of cognitive research and surgical interventions. More clinical trials with immersive digital technologies are required. Ethical and cyber security challenges are present but there are ways to overcome them. It is our duty as physicians to participate in the development of these innovations to ensure virtual health reality benefits for our patients in real-world setting.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"154 3","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257592","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 : 2023-11-20DOI: 10.4103/jmms.jmms_136_23
Pramila Menon
{"title":"Urgency of Breastfeeding Promotion in Climate Crisis","authors":"Pramila Menon","doi":"10.4103/jmms.jmms_136_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_136_23","url":null,"abstract":"","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"18 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258042","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}
Worldwide, stroke is the most common cause of death after coronary artery disease (CAD). The risk factor stratification and prognostication of stroke patients are vital in planning and allocating health-care resources. We conducted a prospective, comparative observational study. Fifty age- and sex-matched cases each of ischemic stroke (IS) and intracerebral hemorrhage (ICH) stroke were enrolled, and baseline demographic, risk factor profile, Glasgow Coma Scale, modified Rankin scale (mRS), and Barthel Index (BI) were recorded, and the cases were followed up for 90 days or till death. We looked at the risk factors associated with IS and ICH and functional outcome of IS vis-à-vis ICH using mRS and BI at 90 days postenrollment. We also compared the mortality of IS vis-à-vis ICH. The presence of hypertension (100% vs. 88%) and smoking (50% vs. 26%) was significantly higher in ICH (P < 0.05). The presence of diabetes mellitus (40% vs. 18%) and CAD (12% vs. 2%) was significantly more in IS cases (P < 0.05). Consumption of alcohol was more prevalent in ICH patients compared to IS patients (30% vs. 24%). Based on mRS and BI at 90 days, ICH cases had significantly poorer functional outcome compared to IS cases (P < 0.0001). Mortality of IS cases (4%) was also significantly less compared to ICH cases (30%). A combination of hypertension, smoking, and history of alcohol consumption had a higher predilection for the occurrence of ICH, whereas a combination of hypertension, diabetes mellitus, and CAD favored the occurrence of IS. The functional outcome of cases of ICH 90 days poststroke was significantly poorer compared to IS cases. The most important factors for poor outcome of ICH cases were more stroke severity at baseline compared to IS cases and the presence of intraventricular hemorrhages in some cases. Mortality was also found to be more in patients with ICH compared to IS.
在全球范围内，中风是继冠状动脉疾病（CAD）之后最常见的死亡原因。对脑卒中患者进行危险因素分层和预后评估对于规划和分配医疗资源至关重要。 我们进行了一项前瞻性对比观察研究。入组 50 例年龄和性别匹配的缺血性脑卒中（IS）和脑内出血（ICH）病例，记录基线人口统计学、危险因素概况、格拉斯哥昏迷量表、改良 Rankin 量表（mRS）和 Barthel 指数（BI），并随访 90 天或直至死亡。我们研究了与 IS 和 ICH 相关的风险因素，并使用 mRS 和 BI 对入院后 90 天的 IS 和 ICH 的功能结果进行了比较。我们还比较了 IS 和 ICH 的死亡率。 高血压（100% 对 88%）和吸烟（50% 对 26%）明显高于 ICH（P < 0.05）。IS病例中患糖尿病（40%对18%）和CAD（12%对2%）的比例明显更高（P < 0.05）。与 IS 患者相比，ICH 患者饮酒的比例更高（30% 对 24%）。根据 90 天后的 mRS 和 BI，ICH 患者的功能预后明显差于 IS 患者（P < 0.0001）。IS病例的死亡率（4%）也明显低于ICH病例（30%）。 合并高血压、吸烟和饮酒史者更倾向于发生 ICH，而合并高血压、糖尿病和 CAD 者更倾向于发生 IS。卒中后90天的ICH病例的功能预后明显差于IS病例。导致 ICH 病例预后不佳的最重要因素是基线时中风严重程度高于 IS 病例，以及部分病例存在脑室内出血。此外，ICH 患者的死亡率也高于 IS 患者。
{"title":"Risk Factors and Functional Outcome of Ischemic Stroke Vis-à-vis Hemorrhagic Stroke at a Tertiary Care Hospital in North India","authors":"Anirban Gupta, Arindam Mukherjee, Aditya Gupta, Tirulapati Padmavathi Shashikala, Satish Barki, Brig Pawan Dhull","doi":"10.4103/jmms.jmms_131_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_131_23","url":null,"abstract":"Worldwide, stroke is the most common cause of death after coronary artery disease (CAD). The risk factor stratification and prognostication of stroke patients are vital in planning and allocating health-care resources. We conducted a prospective, comparative observational study. Fifty age- and sex-matched cases each of ischemic stroke (IS) and intracerebral hemorrhage (ICH) stroke were enrolled, and baseline demographic, risk factor profile, Glasgow Coma Scale, modified Rankin scale (mRS), and Barthel Index (BI) were recorded, and the cases were followed up for 90 days or till death. We looked at the risk factors associated with IS and ICH and functional outcome of IS vis-à-vis ICH using mRS and BI at 90 days postenrollment. We also compared the mortality of IS vis-à-vis ICH. The presence of hypertension (100% vs. 88%) and smoking (50% vs. 26%) was significantly higher in ICH (P < 0.05). The presence of diabetes mellitus (40% vs. 18%) and CAD (12% vs. 2%) was significantly more in IS cases (P < 0.05). Consumption of alcohol was more prevalent in ICH patients compared to IS patients (30% vs. 24%). Based on mRS and BI at 90 days, ICH cases had significantly poorer functional outcome compared to IS cases (P < 0.0001). Mortality of IS cases (4%) was also significantly less compared to ICH cases (30%). A combination of hypertension, smoking, and history of alcohol consumption had a higher predilection for the occurrence of ICH, whereas a combination of hypertension, diabetes mellitus, and CAD favored the occurrence of IS. The functional outcome of cases of ICH 90 days poststroke was significantly poorer compared to IS cases. The most important factors for poor outcome of ICH cases were more stroke severity at baseline compared to IS cases and the presence of intraventricular hemorrhages in some cases. Mortality was also found to be more in patients with ICH compared to IS.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"51 9","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258520","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 : 2023-11-20DOI: 10.4103/jmms.jmms_106_23
M. Al-Mendalawi
{"title":"Sonographic Evaluation of Carotid Intima-media Thickness and Carotid Plaques in Coronary Artery Disease Patients","authors":"M. Al-Mendalawi","doi":"10.4103/jmms.jmms_106_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_106_23","url":null,"abstract":"","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"26 6","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139255838","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}
Admiral Anupam NM Kapur, V. S. J. Rao, M. K. Tangri, Reema Kumar Bhatt, Hrishikesh Magdum
Aims: This study aims to compare the effectiveness, induction to abortion interval, blood loss, and side effect profile between administration of intraamniotic prostaglandin F2 alpha (PGF2a) with a combination of mifepristone and misoprostol for medical termination of pregnancy in mid-trimester. Prospective observational study. The study was conducted by dividing the women with indicated mid-trimester abortions into two groups of 20 women each. Group-I received Tablet Mifepristone 200 mg orally on day 1 and then after 48 h, Tablet Misoprostol 400 mg given per vaginally every 4 h till abortion was completed or a maximum of 5 doses whichever was earlier. Group-II received a single injection of PGF2a (250 mg) intra-amniotically under ultrasonography guidance. Group comparisons were made using t-test/Mann–Whitney U-test for normally/nonnormally distributed continuous data, respectively, and Chi-square test for categorical variables. SPSS version 23 was used for analysis. P < 0.05 was taken as the cut-off for statistical significance. The success rate was 100% in both the groups. There was a significant difference in the mean induction to abortion interval between Group-I, the mean being 12.92 ± 2.68 h compared to Group-II being 33.08 ± 6.35 h (P < 0.001). Group-I had a mean blood loss of 221 ± 55.15 mL, significantly more than Group-II 160 ± 25.13 mL (P < 0.001). Twenty-five percent of the Group-I woman had retained products of conception with none in Group-II (P = 0.029). The pain score was better in Group II (pain score 4.4 vs. 5.7, P < 0.001). Fewer women developed chills in Group II compared to Group I (0% vs. 50%, P < 0.001). PGF2a is equally effective as a combination of Mifepristone and Misoprostol in mid-trimester abortion. Although it has a longer induction to abortion interval, it appears to be better with respect to the completeness of evacuation, lesser blood loss, and better patient tolerance.
{"title":"To Study the Efficacy of Intraamniotic Prostaglandin F2 Alpha versus Mifepristone and Misoprostol Combination for Mid-trimester Medical Termination of Pregnancy","authors":"Admiral Anupam NM Kapur, V. S. J. Rao, M. K. Tangri, Reema Kumar Bhatt, Hrishikesh Magdum","doi":"10.4103/jmms.jmms_78_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_78_23","url":null,"abstract":"Aims: This study aims to compare the effectiveness, induction to abortion interval, blood loss, and side effect profile between administration of intraamniotic prostaglandin F2 alpha (PGF2a) with a combination of mifepristone and misoprostol for medical termination of pregnancy in mid-trimester. Prospective observational study. The study was conducted by dividing the women with indicated mid-trimester abortions into two groups of 20 women each. Group-I received Tablet Mifepristone 200 mg orally on day 1 and then after 48 h, Tablet Misoprostol 400 mg given per vaginally every 4 h till abortion was completed or a maximum of 5 doses whichever was earlier. Group-II received a single injection of PGF2a (250 mg) intra-amniotically under ultrasonography guidance. Group comparisons were made using t-test/Mann–Whitney U-test for normally/nonnormally distributed continuous data, respectively, and Chi-square test for categorical variables. SPSS version 23 was used for analysis. P < 0.05 was taken as the cut-off for statistical significance. The success rate was 100% in both the groups. There was a significant difference in the mean induction to abortion interval between Group-I, the mean being 12.92 ± 2.68 h compared to Group-II being 33.08 ± 6.35 h (P < 0.001). Group-I had a mean blood loss of 221 ± 55.15 mL, significantly more than Group-II 160 ± 25.13 mL (P < 0.001). Twenty-five percent of the Group-I woman had retained products of conception with none in Group-II (P = 0.029). The pain score was better in Group II (pain score 4.4 vs. 5.7, P < 0.001). Fewer women developed chills in Group II compared to Group I (0% vs. 50%, P < 0.001). PGF2a is equally effective as a combination of Mifepristone and Misoprostol in mid-trimester abortion. Although it has a longer induction to abortion interval, it appears to be better with respect to the completeness of evacuation, lesser blood loss, and better patient tolerance.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"59 12","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256607","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 : 2023-11-20DOI: 10.4103/jmms.jmms_115_23
Atul Gupta, Poonam Raj
Military troops deployed in high altitude areas (HAAs) may suffer from illnesses peculiar to the terrain which are usually due to hypoxia. The physiological dynamics at high altitude (HA) are different from those in the plains and hence environmental factors play an important role at HA. The effect, if any, of hemodynamic changes in terms of raised hemoglobin (Hb) levels in HA on otological disorders is not very well researched and needs to be explored further. This study was undertaken to study the clinical manifestations, if any, of the hemodynamic alterations in the inner ear and their correlation with the Hb levels after 1 year deployment at HA. A longitudinal descriptive study was conducted over 1 year duration at a Military Hospital located at HAA on 99 soldiers who were <40 years of age with no history of prior ear complaints/ear surgery and with normal pure tone audiometry (PTA) thresholds and Hb levels at initial evaluation. Each soldier underwent PTA and Hb estimation twice: initially, at the time of induction, and later after completion of 1 year deployment at HAA. Statistical analysis was done using simple paired t-test. On data analysis, no hearing loss was found in any participant of the study cohort at frequencies 500 Hz and 1 kHz in either ear on second evaluation. At 2 kHz, for left ear, the mean Hb level for the group with hearing thresholds greater than 25 dB was 17.07 g% with a standard deviation of 0.66, and for right ear, it was 16.95 g% with standard deviation of 0.64. At 4 kHz, the mean Hb level was 16.50 g% and 16.49 g% for hearing thresholds below and up to 25 dB for left and right ear, respectively. It was 16.99 g% and 16.96 g% for hearing thresholds above 25 dB. The results were statistically significant for both right and left ear at 4 kHz. A statistically significant deterioration of hearing thresholds for 4 kHz frequency with corresponding increase in Hb levels was observed in our study. Hb levels can therefore be used as a marker to ensure no further exposure to other risk factors like loud noise exposure, further deployment at higher altitudes to prevent deterioration, and progression of hearing loss.
{"title":"Raised Hematocrit at High Altitude: Its Relation to Sensorineural Hearing Loss","authors":"Atul Gupta, Poonam Raj","doi":"10.4103/jmms.jmms_115_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_115_23","url":null,"abstract":"Military troops deployed in high altitude areas (HAAs) may suffer from illnesses peculiar to the terrain which are usually due to hypoxia. The physiological dynamics at high altitude (HA) are different from those in the plains and hence environmental factors play an important role at HA. The effect, if any, of hemodynamic changes in terms of raised hemoglobin (Hb) levels in HA on otological disorders is not very well researched and needs to be explored further. This study was undertaken to study the clinical manifestations, if any, of the hemodynamic alterations in the inner ear and their correlation with the Hb levels after 1 year deployment at HA. A longitudinal descriptive study was conducted over 1 year duration at a Military Hospital located at HAA on 99 soldiers who were <40 years of age with no history of prior ear complaints/ear surgery and with normal pure tone audiometry (PTA) thresholds and Hb levels at initial evaluation. Each soldier underwent PTA and Hb estimation twice: initially, at the time of induction, and later after completion of 1 year deployment at HAA. Statistical analysis was done using simple paired t-test. On data analysis, no hearing loss was found in any participant of the study cohort at frequencies 500 Hz and 1 kHz in either ear on second evaluation. At 2 kHz, for left ear, the mean Hb level for the group with hearing thresholds greater than 25 dB was 17.07 g% with a standard deviation of 0.66, and for right ear, it was 16.95 g% with standard deviation of 0.64. At 4 kHz, the mean Hb level was 16.50 g% and 16.49 g% for hearing thresholds below and up to 25 dB for left and right ear, respectively. It was 16.99 g% and 16.96 g% for hearing thresholds above 25 dB. The results were statistically significant for both right and left ear at 4 kHz. A statistically significant deterioration of hearing thresholds for 4 kHz frequency with corresponding increase in Hb levels was observed in our study. Hb levels can therefore be used as a marker to ensure no further exposure to other risk factors like loud noise exposure, further deployment at higher altitudes to prevent deterioration, and progression of hearing loss.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"16 12","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139257692","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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