BACKGROUND A distinct change in human senescence occurs in the face and the most pioneering sign appears in the area surrounding the eyes and nasolabial fold. Each injector learns through experience, where to place the botulinum toxin for desired effects. Aims & Objectives Haematoxylin & Eosin study was performed to understand the histology of the Nasolabial fold (NLF). METHODS Nasolabial folds were identified in 5 formalin-fixed cadavers aged between 55-70 years. Tissue was obtained from three points: one from ala of the nose (A), second from the angle of the mouth (C), and third from the mid-centre of an imaginary line extending from point A to point C (B) bilaterally and then formalin-fixed, paraffin-installed, and stained with haematoxylin and eosin stain. RESULTS Macroscopically, several muscle fibres of different origins were observed to insert directly on the nasolabial fold. On microscopic investigation, muscular fibres were observed to extend from the subcutaneous layer to the dermis, at point A&C and few or no muscle fibres were observed at point B. CONCLUSIONS Microscopical investigation shows muscular fibres extending from the subcutaneous layer to the dermis, at point A&C and few or no muscle fibres were observed at point B. If botulism toxin is injected intradermally adjacent to the ala of nose and angle of mouth it gives a satisfactory result to reduce rhytids.
{"title":"Histochemical Study of Nasolabial Fold in Indian Cadavers","authors":"Rahul Sharma, Pooja Bhadoria, Amarjyoti Chaturvedi","doi":"10.14260/jemds.v12i2.344","DOIUrl":"https://doi.org/10.14260/jemds.v12i2.344","url":null,"abstract":"BACKGROUND \u0000A distinct change in human senescence occurs in the face and the most pioneering sign appears in the area surrounding the eyes and nasolabial fold. Each injector learns through experience, where to place the botulinum toxin for desired effects. \u0000Aims & Objectives \u0000Haematoxylin & Eosin study was performed to understand the histology of the Nasolabial fold (NLF). \u0000METHODS \u0000Nasolabial folds were identified in 5 formalin-fixed cadavers aged between 55-70 years. Tissue was obtained from three points: one from ala of the nose (A), second from the angle of the mouth (C), and third from the mid-centre of an imaginary line extending from point A to point C (B) bilaterally and then formalin-fixed, paraffin-installed, and stained with haematoxylin and eosin stain. \u0000RESULTS \u0000Macroscopically, several muscle fibres of different origins were observed to insert directly on the nasolabial fold. On microscopic investigation, muscular fibres were observed to extend from the subcutaneous layer to the dermis, at point A&C and few or no muscle fibres were observed at point B. \u0000CONCLUSIONS \u0000Microscopical investigation shows muscular fibres extending from the subcutaneous layer to the dermis, at point A&C and few or no muscle fibres were observed at point B. If botulism toxin is injected intradermally adjacent to the ala of nose and angle of mouth it gives a satisfactory result to reduce rhytids.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49078628","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}
BACKGROUND Influenza is viral fever with the main symptoms of the respiratory tract like cough, fever, breathlessness, nasal discharge, sore throat & myalgia. Pandemic 2009 H1N1 influenza A was the virus that presented a significant public health threat on a global scale. This prospective study was undertaken to analyse the prevalence of the influenza virus in patients with a severe acute respiratory infection (SARI) and also to determine the demographic characteristics and seasonal variations. METHODS This was a hospital-based prospective study done in the Department of Microbiology, Silchar Medical College & Hospital, Silchar for 1 year from June 2021 to May 2022. Respiratory specimens were tested for Influenza virus by one step real-time reverse transcription polymerase chain reaction (RT-PCR). RESULTS In real-time PCR, the influenza virus was detected in 6 out of 85 SARI patients (7%). Of 6 total positives, 4(67%) were influenza A and 2(33%) were influenza B. Among 4 influenza A positive cases, 3(75%) were influenza A (H1N1) pdm09 and 1(25%) was seasonal influenza A (H3N2). The highest percentage of positivity (50%) was detected in the age group of 15-29 years. The most common symptoms among the positive influenza cases were fever (100%), cough (88%), and breathlessness (56%). Other associated symptoms were sore throat (63%), nasal discharge (75%), and myalgia (75%). CONCLUSIONS This study clearly shows that influenza is an important cause of severe acute respiratory infection. It also suggests the need for continuous effective surveillance of influenza viruses to detect cases and control outbreaks. Early intervention and proper management of influenza virus cases are required to curb the disease burden.
{"title":"Prevalence of Influenza Virus in Patients with Severe Acute Respiratory Infections (SARI)","authors":"Debadatta Dhar Chanda, Chhandasree Biswas, Supriya Upadhyay","doi":"10.14260/jemds.v12i2.340","DOIUrl":"https://doi.org/10.14260/jemds.v12i2.340","url":null,"abstract":"BACKGROUND \u0000Influenza is viral fever with the main symptoms of the respiratory tract like cough, fever, breathlessness, nasal discharge, sore throat & myalgia. Pandemic 2009 H1N1 influenza A was the virus that presented a significant public health threat on a global scale. This prospective study was undertaken to analyse the prevalence of the influenza virus in patients with a severe acute respiratory infection (SARI) and also to determine the demographic characteristics and seasonal variations. \u0000METHODS \u0000This was a hospital-based prospective study done in the Department of Microbiology, Silchar Medical College & Hospital, Silchar for 1 year from June 2021 to May 2022. Respiratory specimens were tested for Influenza virus by one step real-time reverse transcription polymerase chain reaction (RT-PCR). \u0000RESULTS \u0000In real-time PCR, the influenza virus was detected in 6 out of 85 SARI patients (7%). Of 6 total positives, 4(67%) were influenza A and 2(33%) were influenza B. Among 4 influenza A positive cases, 3(75%) were influenza A (H1N1) pdm09 and 1(25%) was seasonal influenza A (H3N2). The highest percentage of positivity (50%) was detected in the age group of 15-29 years. The most common symptoms among the positive influenza cases were fever (100%), cough (88%), and breathlessness (56%). Other associated symptoms were sore throat (63%), nasal discharge (75%), and myalgia (75%). \u0000CONCLUSIONS \u0000This study clearly shows that influenza is an important cause of severe acute respiratory infection. It also suggests the need for continuous effective surveillance of influenza viruses to detect cases and control outbreaks. Early intervention and proper management of influenza virus cases are required to curb the disease burden.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46015920","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 : 2023-02-28DOI: 10.14260/jemds.v12i2.342
Anvar Sadath, Nisha Rajmohan, Vismaya Raj Mohan
Pregnancy in a patient with large ventricular septal defect (VSD) with severe pulmonary hypertension (PAH) increases the risk of mortality severalfold. This when combined with single ventricle physiology forms a rare and deadly combination. A 26-year-old female presented for elective LSCS at 35 weeks gestation. She had a large VSD with severe PAH with a single ventricle physiology. We report the successful conduct of a caesarean section in this patient under graded epidural anaesthesia.
{"title":"Anaesthesia for Caesarean Section in a Patient with Large Ventricular Septal Defect with Pulmonary Hypertension with Single Ventricle Physiology","authors":"Anvar Sadath, Nisha Rajmohan, Vismaya Raj Mohan","doi":"10.14260/jemds.v12i2.342","DOIUrl":"https://doi.org/10.14260/jemds.v12i2.342","url":null,"abstract":"Pregnancy in a patient with large ventricular septal defect (VSD) with severe pulmonary hypertension (PAH) increases the risk of mortality severalfold. This when combined with single ventricle physiology forms a rare and deadly combination. A 26-year-old female presented for elective LSCS at 35 weeks gestation. She had a large VSD with severe PAH with a single ventricle physiology. We report the successful conduct of a caesarean section in this patient under graded epidural anaesthesia.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43991449","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 : 2023-02-28DOI: 10.14260/jemds.v12i2.338
Türkay Kölüş, Mehmet Şahbaz, Uğur Köklü
BACKGROUND Dental treatment objects produced with 3D resin printers barely polymerize after fabrication. They need post-curing and an extra polymerization oven is required. Present study is aimed to determine the effectiveness of dental curing lights for post-curing of objects produced with a 3D resin printer. METHODS Samples were produced with Alias Sharp & Rigid Model 3D Printing Resin in Photon Mono X 3D resin printer. The control set samples were cured with UV light for 2 min in Wash & Cure Plus device. T-20, T-40 and T-60 set samples were exposed to VALO Cordless curing light for 20, 40 and 60 seconds respectively. The hardness was measured with the Shore D Durometer. Then, the samples were subjected to compression. For statistical analysis, one way analysis of variance (ANOVA) and Tukey test was used. RESULTS The set cured with VALO Cordless for 20 seconds showed the highest strength. Compressive strength decreased with prolongation of the curing time. All experimental sets showed significantly higher hardness than the control set. Hardness increased gradually in the 20 and 40 second sets, but the difference between the 40 and 60 second sets was not significant. Also, color change was observed in the experimental sets samples. CONCLUSIONS Dental curing lights are effective in post-curing 3D printer resins.
{"title":"Can We Use Our Dental Curing Lights to Polymerize Objects Produced with 3D Resin Printer?","authors":"Türkay Kölüş, Mehmet Şahbaz, Uğur Köklü","doi":"10.14260/jemds.v12i2.338","DOIUrl":"https://doi.org/10.14260/jemds.v12i2.338","url":null,"abstract":"BACKGROUND \u0000Dental treatment objects produced with 3D resin printers barely polymerize after fabrication. They need post-curing and an extra polymerization oven is required. Present study is aimed to determine the effectiveness of dental curing lights for post-curing of objects produced with a 3D resin printer. \u0000METHODS \u0000Samples were produced with Alias Sharp & Rigid Model 3D Printing Resin in Photon Mono X 3D resin printer. The control set samples were cured with UV light for 2 min in Wash & Cure Plus device. T-20, T-40 and T-60 set samples were exposed to VALO Cordless curing light for 20, 40 and 60 seconds respectively. The hardness was measured with the Shore D Durometer. Then, the samples were subjected to compression. For statistical analysis, one way analysis of variance (ANOVA) and Tukey test was used. \u0000RESULTS \u0000The set cured with VALO Cordless for 20 seconds showed the highest strength. Compressive strength decreased with prolongation of the curing time. All experimental sets showed significantly higher hardness than the control set. Hardness increased gradually in the 20 and 40 second sets, but the difference between the 40 and 60 second sets was not significant. Also, color change was observed in the experimental sets samples. \u0000CONCLUSIONS \u0000Dental curing lights are effective in post-curing 3D printer resins.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48365484","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}
BACKGROUND Stress is a physiological response to psychological and physical demands. Cortisol is a stress hormone that is released in increasing quantities as pregnancy progresses. Stress is a cumulative effect of changing life events with failure of coping reflex that leads to chronic stress which repeatedly activates hypothalamic–pituitary-adrenal (HPA) axis without relaxation response, to release excess cortisol. Duration of stress and its sites of action lead to decrease in lactation. In this study, we wanted to determine the relationship between stress and levels of maternal serum cortisol before and after the delivery and assess the relation between stress and milk output in the first week of post-partum period. METHODS A cross-sectional study was carried out among 96 pregnant women, using HOLMES-RAHE STRESS SCALE: categorized into mild, moderate, and severe stressed. Serum cortisol levels are assessed using electrochemiluminescence immunoassay before and after delivery. Postnatal mothers were advised to breastfeed their newborns ten times a day after delivery and the baby's weight is measured using the baby-test weighing method using digital weighing machine at regular intervals for seven days. Mean serum cortisol levels were computed and compared with milk production. RESULTS 48.9 % pregnant women were mildly, 29.1 % were moderately and 21.8 % severely stressed. Serum cortisol levels were significantly high (p < 0.05) in moderately and severely stressed women with significant reduction in milk volume when compared to mildly stressed women. CONCLUSIONS Findings of this study indicates that moderate and severe stressful events reduce lactation in post-natal women. More research is needed to understand relationship between stress, other maternal factors, and their impact on breastfeeding outcomes.
{"title":"Study of Effect of Stress on Lactation in Postnatal Women","authors":"Tatapudi Susmitha Madhuri, Moravineni Usha Rani, Paidi Sirisha","doi":"10.14260/jemds.v12i1.323","DOIUrl":"https://doi.org/10.14260/jemds.v12i1.323","url":null,"abstract":"BACKGROUND \u0000Stress is a physiological response to psychological and physical demands. Cortisol is a stress hormone that is released in increasing quantities as pregnancy progresses. Stress is a cumulative effect of changing life events with failure of coping reflex that leads to chronic stress which repeatedly activates hypothalamic–pituitary-adrenal (HPA) axis without relaxation response, to release excess cortisol. Duration of stress and its sites of action lead to decrease in lactation. In this study, we wanted to determine the relationship between stress and levels of maternal serum cortisol before and after the delivery and assess the relation between stress and milk output in the first week of post-partum period. \u0000METHODS \u0000A cross-sectional study was carried out among 96 pregnant women, using HOLMES-RAHE STRESS SCALE: categorized into mild, moderate, and severe stressed. Serum cortisol levels are assessed using electrochemiluminescence immunoassay before and after delivery. Postnatal mothers were advised to breastfeed their newborns ten times a day after delivery and the baby's weight is measured using the baby-test weighing method using digital weighing machine at regular intervals for seven days. Mean serum cortisol levels were computed and compared with milk production. \u0000RESULTS \u000048.9 % pregnant women were mildly, 29.1 % were moderately and 21.8 % severely stressed. Serum cortisol levels were significantly high (p < 0.05) in moderately and severely stressed women with significant reduction in milk volume when compared to mildly stressed women. \u0000CONCLUSIONS \u0000Findings of this study indicates that moderate and severe stressful events reduce lactation in post-natal women. More research is needed to understand relationship between stress, other maternal factors, and their impact on breastfeeding outcomes.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48525709","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 : 2023-01-31DOI: 10.14260/jemds.v12i1.324
Khawaja Bilal Waheed, Jawad Nasser, Raghad Hamdi Alsaidalani, Zubair Ahmed
Tracheobronchomegaly or Mounier-Kuhn syndrome is a rare condition affecting the airways and is characterized by dilatation of the trachea and major bronchi secondary to atrophic or absent elastic fibres of the cartilage and thinning of the muscles.[1] The abnormally enlarged flaccid portions of the bronchial tree collapse and fail to maintain patency during expiration and coughing, predisposing the patient to stagnation of contents and recurrent lower respiratory tract infections, emphysema, bronchiectasis and chronic pulmonary suppuration.[2] The diagnosis is usually made on basis of specific radiographic features,[3] particularly on computed tomography (CT) scan. We report a case of a 69-year-old man who presented with recurrent lower respiratory tract infections and was found to have tracheobronchomegaly as an underlying primary airway abnormality on imaging and bronchoscopy that was initially undiagnosed.
{"title":"Tracheobronchomegaly (Mounier-Kuhn Syndrome) in Old Age - A Case Report","authors":"Khawaja Bilal Waheed, Jawad Nasser, Raghad Hamdi Alsaidalani, Zubair Ahmed","doi":"10.14260/jemds.v12i1.324","DOIUrl":"https://doi.org/10.14260/jemds.v12i1.324","url":null,"abstract":"Tracheobronchomegaly or Mounier-Kuhn syndrome is a rare condition affecting the airways and is characterized by dilatation of the trachea and major bronchi secondary to atrophic or absent elastic fibres of the cartilage and thinning of the muscles.[1] The abnormally enlarged flaccid portions of the bronchial tree collapse and fail to maintain patency during expiration and coughing, predisposing the patient to stagnation of contents and recurrent lower respiratory tract infections, emphysema, bronchiectasis and chronic pulmonary suppuration.[2] The diagnosis is usually made on basis of specific radiographic features,[3] particularly on computed tomography (CT) scan. We report a case of a 69-year-old man who presented with recurrent lower respiratory tract infections and was found to have tracheobronchomegaly as an underlying primary airway abnormality on imaging and bronchoscopy that was initially undiagnosed.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45848757","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 : 2023-01-31DOI: 10.14260/jemds.v12i1.319
Asja Begovac, Mirela Mačkić-Đurović, Aganović-Mušinović
BACKGROUND Azoospermia (the absence of sperm in the semen) significantly amounts to infertility in men (15 % of infertile men). Since genetics plays a huge part in its origin, genetic testing needs to be considered as an important part of early diagnostics when evaluating azoospermic patients. The aim of our study was to determine the genetic cause of azoospermia, to analyze karyograms and the possible presence of Y chromosome microdeletion. METHODS The study included 20 men diagnosed with azoospermia. The oldest male was 50 and the youngest was 24 years old. They were sent for analysis of karyotype and microdeletions of the Y chromosome (AZF region) to the Center for Genetics of the Faculty of Medicine. RESULTS The results of the cytogenetic analysis showed 3/20 (15 %) of abnormal karyotypes. Three patients were identified with two different translocations that were not previously reported. Two brothers were identified with the same translocation between the short arm of chromosome 8 and the long arm of chromosome 17 [46, XY, t(8;17)(p23;q11)], after both of them had failed in-vitro fertilization (IVF). The third patient with chromosomal translocation between the short arm of chromosome 4 and the long arm of chromosome 11 [46, XY, t(4;11)(p16;q13)]. Molecular genetic analysis showed no Y chromosome microdeletion in any of these three cases. However, from the rest of the group, only one patient had Y chromosome microdeletion in the AZFc region (one of the most common causes of genetic azoospermia). His karyotype was normal. CONCLUSIONS Our study confirms that cytogenetic and molecular genetic analysis plays an important role in identifying the cause of azoospermia. Genetic counseling should be provided when these abnormalities are identified before making any future medical decisions.
{"title":"Cytogenetic Analysis in Patients with Azoospermia","authors":"Asja Begovac, Mirela Mačkić-Đurović, Aganović-Mušinović","doi":"10.14260/jemds.v12i1.319","DOIUrl":"https://doi.org/10.14260/jemds.v12i1.319","url":null,"abstract":"BACKGROUND \u0000Azoospermia (the absence of sperm in the semen) significantly amounts to infertility in men (15 % of infertile men). Since genetics plays a huge part in its origin, genetic testing needs to be considered as an important part of early diagnostics when evaluating azoospermic patients. The aim of our study was to determine the genetic cause of azoospermia, to analyze karyograms and the possible presence of Y chromosome microdeletion. \u0000METHODS \u0000The study included 20 men diagnosed with azoospermia. The oldest male was 50 and the youngest was 24 years old. They were sent for analysis of karyotype and microdeletions of the Y chromosome (AZF region) to the Center for Genetics of the Faculty of Medicine. \u0000RESULTS \u0000The results of the cytogenetic analysis showed 3/20 (15 %) of abnormal karyotypes. Three patients were identified with two different translocations that were not previously reported. Two brothers were identified with the same translocation between the short arm of chromosome 8 and the long arm of chromosome 17 [46, XY, t(8;17)(p23;q11)], after both of them had failed in-vitro fertilization (IVF). The third patient with chromosomal translocation between the short arm of chromosome 4 and the long arm of chromosome 11 [46, XY, t(4;11)(p16;q13)]. Molecular genetic analysis showed no Y chromosome microdeletion in any of these three cases. However, from the rest of the group, only one patient had Y chromosome microdeletion in the AZFc region (one of the most common causes of genetic azoospermia). His karyotype was normal. \u0000CONCLUSIONS \u0000Our study confirms that cytogenetic and molecular genetic analysis plays an important role in identifying the cause of azoospermia. Genetic counseling should be provided when these abnormalities are identified before making any future medical decisions.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48893995","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}
BACKGROUND In this study, we wanted to evaluate the effect of negative pressure wound therapy on diabetic foot ulcers. METHODS This was a hospital based prospective comparative study, conducted among 40 patients who came for treatment of diabetic foot ulcers to the Department of General Surgery, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, over a period of 2 years from September 2019 to September 2021, after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. RESULTS The increase in amount of granulation tissue negative pressure wound therapy (NPWT) and saline-soaked gauzed dressing (SSGD groups were found to be statistically significant. Mean change (increase in granulation tissue in NPWT & SSGD groups) from day 0 to day 42 were 78.083 % and 66.103 % respectively. Whereas in NPWT and SSGD groups, the size of ulcer was decreased which was statistically significant. Mean decrease in ulcer size in NPWT & SSGD groups from day 0 to day 42 were 52 cm sq and 29.15 cm sq respectively. The mean duration of stay in hospital in NPWT & SSGD groups were 29.35 + 4.51 days and 32.75 + 4.75 days with p value of 0.02, which is statistically significant. Among patients with NPWT, response was present in 95 % (19) patients and among patients with SSGD, response was present in 85 % (17) patients. The association between the groups was found to be statistically not significant. CONCLUSIONS Length of stay was shorter in the NPWT group when compared with that of SSGD group. Rate of granulation tissue formation was faster in NPWT group when compared to SSGD group. Reduction in ulcer size was significantly better in the NPWT group. Patient compliance and satisfaction was better in NPWT group. Lesser number of changes of dressings were needed in the NPWT group. It could be concluded that negative pressure wound therapy helps in faster healing, better, safe, and convenient as compared to saline soaked gauzed dressing in the treatment of diabetic foot ulcers.
{"title":"Effect of Negative Pressure Wound Therapy on Diabetic Foot Ulcers","authors":"Prerana Raju Gudimetla, Swarnadeepu Shabasu, Akshay Duppelly, Yadagiri Rao Jeripotula","doi":"10.14260/jemds.v12i1.318","DOIUrl":"https://doi.org/10.14260/jemds.v12i1.318","url":null,"abstract":"BACKGROUND \u0000In this study, we wanted to evaluate the effect of negative pressure wound therapy on diabetic foot ulcers. \u0000METHODS \u0000This was a hospital based prospective comparative study, conducted among 40 patients who came for treatment of diabetic foot ulcers to the Department of General Surgery, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, over a period of 2 years from September 2019 to September 2021, after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. \u0000RESULTS \u0000The increase in amount of granulation tissue negative pressure wound therapy (NPWT) and saline-soaked gauzed dressing (SSGD groups were found to be statistically significant. Mean change (increase in granulation tissue in NPWT & SSGD groups) from day 0 to day 42 were 78.083 % and 66.103 % respectively. Whereas in NPWT and SSGD groups, the size of ulcer was decreased which was statistically significant. Mean decrease in ulcer size in NPWT & SSGD groups from day 0 to day 42 were 52 cm sq and 29.15 cm sq respectively. The mean duration of stay in hospital in NPWT & SSGD groups were 29.35 + 4.51 days and 32.75 + 4.75 days with p value of 0.02, which is statistically significant. Among patients with NPWT, response was present in 95 % (19) patients and among patients with SSGD, response was present in 85 % (17) patients. The association between the groups was found to be statistically not significant. \u0000CONCLUSIONS \u0000Length of stay was shorter in the NPWT group when compared with that of SSGD group. Rate of granulation tissue formation was faster in NPWT group when compared to SSGD group. Reduction in ulcer size was significantly better in the NPWT group. Patient compliance and satisfaction was better in NPWT group. Lesser number of changes of dressings were needed in the NPWT group. It could be concluded that negative pressure wound therapy helps in faster healing, better, safe, and convenient as compared to saline soaked gauzed dressing in the treatment of diabetic foot ulcers.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42370492","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}
BACKGROUND In pregnant women, thyroid disorders are common endocrine problems and due to non-specific symptoms and hyper-metabolic state of pregnancy they are often neglected. To know the prevalence of thyroid disorders in pregnant women and their maternal and foetal outcome was the purpose of this study. METHODS This was an observational study which was conducted from 15th November 2021 to 15th May 2022 in the Department of Obstetrics and Gynaecology, Srinivas Medical College, Mukka, (Mangalore). Registration of one fifty pregnant women attending antenatal clinic in first trimester was done. Detailed history and examination was done. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) level evaluation was done apart from routine antenatal investigations. RESULTS Among 150 pregnant women, the prevalence of thyroid disorders is 14 (9.31 %). Subclinical hypothyroidism 9 (6 %) was the most common thyroid disorder observed. Maternal anaemia and eclampsia was most common complication 3 each (33.33 %). 1 (11 %) was antepartum haemorrhage. Thyroid disorder occurred during the 2nd trimester 58.33 %; 25 % and 16.66 % in 1st and 3rd trimester. Most commonly observed foetal birth weight in this study were between 2 - 2.5 kgs 7 (77.77 %). Most common foetal complication observed were foetal growth restriction (five) with spontaneous abortion and intra uterine foetal demise (IUFD) (one each) was noted. Out of all thyroid disorders associated with pregnancy, subclinical hypothyroidism is the most frequently noted. Patients with subclinical hypothyroidism remain asymptomatic when not treated, but had bad obstetric and neonatal outcome, although less severe than overt hypothyroidism cases. CONCLUSIONS Timely screening of pregnant women is required during pregnancy for the prevention of pregnancy which helps in the early diagnosis and management of complications related to maternal and foetus due to thyroid disorders.
{"title":"Thyroid Disorders in Pregnancy and Their Maternal and Foetal Outcome in Tertiary Care Centre","authors":"Vasani Asha Kuvarji, Tahseen Fathima, Susham S Shetty, Chandaa Vinodkumar Jakkannavar, Sangeetha K, Radha Nair, Nisarg Sutaria, Pramukh Hegde","doi":"10.14260/jemds.v12i1.321","DOIUrl":"https://doi.org/10.14260/jemds.v12i1.321","url":null,"abstract":"BACKGROUND \u0000In pregnant women, thyroid disorders are common endocrine problems and due to non-specific symptoms and hyper-metabolic state of pregnancy they are often neglected. To know the prevalence of thyroid disorders in pregnant women and their maternal and foetal outcome was the purpose of this study. \u0000METHODS \u0000This was an observational study which was conducted from 15th November 2021 to 15th May 2022 in the Department of Obstetrics and Gynaecology, Srinivas Medical College, Mukka, (Mangalore). Registration of one fifty pregnant women attending antenatal clinic in first trimester was done. Detailed history and examination was done. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) level evaluation was done apart from routine antenatal investigations. \u0000RESULTS \u0000Among 150 pregnant women, the prevalence of thyroid disorders is 14 (9.31 %). Subclinical hypothyroidism 9 (6 %) was the most common thyroid disorder observed. Maternal anaemia and eclampsia was most common complication 3 each (33.33 %). 1 (11 %) was antepartum haemorrhage. Thyroid disorder occurred during the 2nd trimester 58.33 %; 25 % and 16.66 % in 1st and 3rd trimester. Most commonly observed foetal birth weight in this study were between 2 - 2.5 kgs 7 (77.77 %). Most common foetal complication observed were foetal growth restriction (five) with spontaneous abortion and intra uterine foetal demise (IUFD) (one each) was noted. Out of all thyroid disorders associated with pregnancy, subclinical hypothyroidism is the most frequently noted. Patients with subclinical hypothyroidism remain asymptomatic when not treated, but had bad obstetric and neonatal outcome, although less severe than overt hypothyroidism cases. \u0000CONCLUSIONS \u0000Timely screening of pregnant women is required during pregnancy for the prevention of pregnancy which helps in the early diagnosis and management of complications related to maternal and foetus due to thyroid disorders.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41379232","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}
BACKGROUND Concurrent chemoradiation (CCRT) is the standard of care for locally advanced head and neck squamous cell carcinoma (LAHNSCC). In settings with considerable waiting period for radiation, institutional protocols advocate induction chemotherapy before CCRT. This study aimed to assess the outcome of concurrent chemoradiation after induction of chemotherapy among patients with LAHNSCC attending a tertiary care radiotherapy center in Kerala, India. METHODS Patients with non-metastatic LAHNSCC (stage 111 and 1V) with good performance score of 0-1 who received induction chemotherapy (with docetaxel 75mg/m2and cisplatin 75 mg/m2, day 1 and 5-fluorouracil 750 mg/m2, day 1 and 2 as infusion every 3 weeks for 3 cycles) followed by CCRT (with concurrent cisplatin 40 mg/m2 weekly) were selected for the study. CCRT was administered only to those patients who showed more than 30 % response to induction chemotherapy. They were followed up for 24 months. The primary end point was the clinical response assessed by ENT evaluation 8 weeks after the completion of CCRT. RESULTS 117 patients with LAHNSCC were enrolled. Four patients (3.4 %) dropped out after induction therapy. Out of 113 patients who initiated concurrent chemo radiation, two patients (1.7 %) dropped out while on CCRT, two patients (1.7 %) were intolerant to CCRT and two patients (1.7 %) left soon after CCRT. 107 patients were available for follow up after treatment completion. Acute toxicities were noticed in 9 (7.7 %) while on induction treatment. Mucositis occurred in 1 (0.9 %), haematological toxicities in 4 (3.4 %), gastrointestinal toxicities in 2 (1.7 %) and fatigue and malaise in 2 (1.7 %). In patients who underwent concurrent chemo radiation, 53 (49.03 %) had acute mucosal, skin, GIT and haematological toxicities. On treatment completion, 82 patients (70.1 %) had complete response, 24 (20.5 %) had partial response and one (0.9 %) had stable disease. During the follow up period of 24 months, locoregional failure (relapse) was noted in 15 patients (12.8 %) while 61 patients (52.1 %) remained disease free. Organ preservation rate was 53.4 % for laryngeal primaries. 4 patients (3.4 %) developed distant metastases during the follow up. CONCLUSIONS Induction chemotherapy with docetaxel containing regime followed by concurrent chemoradiation was associated with good clinical response and acceptable toxicity profile.
{"title":"Outcome of Concurrent Chemoradiation after Induction Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma - A Prospective Study among Patients Attending a Tertiary Care Center in Kerala, India","authors":"Preeya Vasanthakumary, Binitha Tresa Thomas, Devi Mohan","doi":"10.14260/jemds.v12i1.322","DOIUrl":"https://doi.org/10.14260/jemds.v12i1.322","url":null,"abstract":"BACKGROUND \u0000Concurrent chemoradiation (CCRT) is the standard of care for locally advanced head and neck squamous cell carcinoma (LAHNSCC). In settings with considerable waiting period for radiation, institutional protocols advocate induction chemotherapy before CCRT. This study aimed to assess the outcome of concurrent chemoradiation after induction of chemotherapy among patients with LAHNSCC attending a tertiary care radiotherapy center in Kerala, India. \u0000METHODS \u0000Patients with non-metastatic LAHNSCC (stage 111 and 1V) with good performance score of 0-1 who received induction chemotherapy (with docetaxel 75mg/m2and cisplatin 75 mg/m2, day 1 and 5-fluorouracil 750 mg/m2, day 1 and 2 as infusion every 3 weeks for 3 cycles) followed by CCRT (with concurrent cisplatin 40 mg/m2 weekly) were selected for the study. CCRT was administered only to those patients who showed more than 30 % response to induction chemotherapy. They were followed up for 24 months. The primary end point was the clinical response assessed by ENT evaluation 8 weeks after the completion of CCRT. \u0000RESULTS \u0000117 patients with LAHNSCC were enrolled. Four patients (3.4 %) dropped out after induction therapy. Out of 113 patients who initiated concurrent chemo radiation, two patients (1.7 %) dropped out while on CCRT, two patients (1.7 %) were intolerant to CCRT and two patients (1.7 %) left soon after CCRT. 107 patients were available for follow up after treatment completion. Acute toxicities were noticed in 9 (7.7 %) while on induction treatment. Mucositis occurred in 1 (0.9 %), haematological toxicities in 4 (3.4 %), gastrointestinal toxicities in 2 (1.7 %) and fatigue and malaise in 2 (1.7 %). In patients who underwent concurrent chemo radiation, 53 (49.03 %) had acute mucosal, skin, GIT and haematological toxicities. On treatment completion, 82 patients (70.1 %) had complete response, 24 (20.5 %) had partial response and one (0.9 %) had stable disease. During the follow up period of 24 months, locoregional failure (relapse) was noted in 15 patients (12.8 %) while 61 patients (52.1 %) remained disease free. Organ preservation rate was 53.4 % for laryngeal primaries. 4 patients (3.4 %) developed distant metastases during the follow up. \u0000CONCLUSIONS \u0000Induction chemotherapy with docetaxel containing regime followed by concurrent chemoradiation was associated with good clinical response and acceptable toxicity profile.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44070826","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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