Objective: Suicide is an unrecognised and underestimated epidemic of high complexity and accounts for premature loss of at least 1 million lives worldwide, leaving behind irreparable loss and backlash to family, friends and society. This study was carried out with the aim of analysing the clinical presentation, modes of deliberate self-harm (DSH), demographic and biochemical features with outcomes of patients presenting with DSH and admitted through the emergency unit of the medicine department to a tertiary care teaching hospital in South India. Materials and Methods: The clinical presentation, demographic details, psychiatric evaluation and blood investigations of patients admitted with a history of DSH during the study (2020–2021) were analysed, with special emphasis on serum cholesterol, C-reactive protein (CRP) and thyroid-stimulating hormone (TSH). Results: In this study, of the 508 patients studied, the most common mode of self-harm was poisoning by drug overdose (32.28%) followed by plant toxin poisoning and rodenticide ingestion-finding different from other studies of South India during this COVID pandemic. Values of TSH, serum cholesterol, CRP and haematogram were normal in majority of patients. All the patients underwent psychiatry evaluation in which substance abuse, adjustment disorders and personality disorders were the most common diagnosis reached. Conclusions: Clinical profile and methods of DSH have marked regional variation necessitating the need to create a regional database. Serum cholesterol, CRP and TSH are subject to genotypic and regional variations and thus are not reliable as biomarkers of suicidal ideation.
{"title":"Profile and in-hospital outcomes of deliberate self-harmed patients in a tertiary care centre","authors":"J. John, K. Rashmi, R. Jayachandran","doi":"10.4103/cmrp.cmrp_33_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_33_22","url":null,"abstract":"Objective: Suicide is an unrecognised and underestimated epidemic of high complexity and accounts for premature loss of at least 1 million lives worldwide, leaving behind irreparable loss and backlash to family, friends and society. This study was carried out with the aim of analysing the clinical presentation, modes of deliberate self-harm (DSH), demographic and biochemical features with outcomes of patients presenting with DSH and admitted through the emergency unit of the medicine department to a tertiary care teaching hospital in South India. Materials and Methods: The clinical presentation, demographic details, psychiatric evaluation and blood investigations of patients admitted with a history of DSH during the study (2020–2021) were analysed, with special emphasis on serum cholesterol, C-reactive protein (CRP) and thyroid-stimulating hormone (TSH). Results: In this study, of the 508 patients studied, the most common mode of self-harm was poisoning by drug overdose (32.28%) followed by plant toxin poisoning and rodenticide ingestion-finding different from other studies of South India during this COVID pandemic. Values of TSH, serum cholesterol, CRP and haematogram were normal in majority of patients. All the patients underwent psychiatry evaluation in which substance abuse, adjustment disorders and personality disorders were the most common diagnosis reached. Conclusions: Clinical profile and methods of DSH have marked regional variation necessitating the need to create a regional database. Serum cholesterol, CRP and TSH are subject to genotypic and regional variations and thus are not reliable as biomarkers of suicidal ideation.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78755217","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: Adverse drug reactions (ADRs) are a rapidly growing universal problem that has a significant impact on users worldwide. They are the cause of significant disability and mortality and are expected to be associated with an economic burden on the health-care system. Aims: To promote patient safety from pharmaceutical products. Materials and Methods: A prospective, observational evaluation of the ADRs collected during spontaneous pharmacovigilance reporting over a period of 18 months in various hospital departments. During the study period, 214 individual case safety reports (ICSR) were reported. Results: The 214 reports that were identified, a slightly higher percentage of ADRs in females 105 (50.93%) was observed as compared to males 109 (49.07%), 73 (34.1%) serious and 141 (65.9%) non serious ADRs. In serious ADRs, the male patients were 35 (33.3%) and females were 38 (34.9%) including 6 (2.8%) deaths. The largest number of reports was associated with antimicrobials 41% followed by non-steroidal anti-inflammatory drugs − 21.1%, antidiabetic − 10.9%. The most commonly implicated organ system was skin − 46.62% followed by gastrointestinal reactions − 18.05%, blood and metabolic disorder − 11.65%, central nervous system − 6.77%, liver − 6.02% and cardiovascular system (3.38%). The outcomes were recorded as recovering (45.8%), recovered (26.2%), continuing (19.2%) and unknown (6.1%) at the time of processing ICSR through vigiflow database. The causality of more than half of ADRs were recorded as possible (59.8%) followed by probable (24.8%), certain (15%) and unlikely (0.5%). Conclusion: Limited ADR is permissible in normal clinical trials setting; hence, spontaneous adverse reaction reporting systems need to be developed, which may improve rational drug prescribing habits to obtain maximum benefits meanwhile minimizing the risk of health from undesirable effects of drugs.
{"title":"Pharmacovigilance study of spontaneous adverse drug reaction in a tertiary care centre","authors":"Wazid Ali, Smita Manjavkar, Imran Kazmi, Shamim Khan","doi":"10.4103/cmrp.cmrp_7_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_7_22","url":null,"abstract":"Background: Adverse drug reactions (ADRs) are a rapidly growing universal problem that has a significant impact on users worldwide. They are the cause of significant disability and mortality and are expected to be associated with an economic burden on the health-care system. Aims: To promote patient safety from pharmaceutical products. Materials and Methods: A prospective, observational evaluation of the ADRs collected during spontaneous pharmacovigilance reporting over a period of 18 months in various hospital departments. During the study period, 214 individual case safety reports (ICSR) were reported. Results: The 214 reports that were identified, a slightly higher percentage of ADRs in females 105 (50.93%) was observed as compared to males 109 (49.07%), 73 (34.1%) serious and 141 (65.9%) non serious ADRs. In serious ADRs, the male patients were 35 (33.3%) and females were 38 (34.9%) including 6 (2.8%) deaths. The largest number of reports was associated with antimicrobials 41% followed by non-steroidal anti-inflammatory drugs − 21.1%, antidiabetic − 10.9%. The most commonly implicated organ system was skin − 46.62% followed by gastrointestinal reactions − 18.05%, blood and metabolic disorder − 11.65%, central nervous system − 6.77%, liver − 6.02% and cardiovascular system (3.38%). The outcomes were recorded as recovering (45.8%), recovered (26.2%), continuing (19.2%) and unknown (6.1%) at the time of processing ICSR through vigiflow database. The causality of more than half of ADRs were recorded as possible (59.8%) followed by probable (24.8%), certain (15%) and unlikely (0.5%). Conclusion: Limited ADR is permissible in normal clinical trials setting; hence, spontaneous adverse reaction reporting systems need to be developed, which may improve rational drug prescribing habits to obtain maximum benefits meanwhile minimizing the risk of health from undesirable effects of drugs.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75696581","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}
Synchronous tumours of the female genital tract are rare, accounting for approximately 1%–2% of all gynaecological malignancies involving simultaneous independent primary malignancies. Synchronous tumours in the ovary and endometrium are the most common combination. We report on a 58-year-old postmenopausal woman who presented with bleeding per vaginum for 1.5 months with no prior menstrual complaints. On per vaginal examination, a mass was felt in the pelvis. Ultrasonography revealed a mass of 8 cm × 9 cm in size filling the entire uterine cavity. Contrast enhanced computed tomography showed a multilobate mass in the pelvis, replacing the whole uterus and cervix, with heterogeneous enhancement and internal necrosis. Bilateral ovaries were not visualised separately. The radiological impression suggested an endometrial carcinoma. Wertheim's hysterectomy was subsequently performed. On microscopic examination, the uterine mass revealed a malignant mixed Müllerian tumour (carcinosarcoma) of the endometrium, along with a high-grade serous carcinoma of the left ovary and left fallopian tube. The right fallopian tube showed adenocarcinoma in situ. The patient had an unusual past history of multiple system comorbidities, a few of which were continuing and for which she was receiving medical treatment.
{"title":"Synchronous primary malignancies and pre-cancers affecting entire hysterectomy specimen: A report of an unfortunate case","authors":"S. Bharti, Iffat Jamal, Pritanjali Singh","doi":"10.4103/cmrp.cmrp_94_21","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_94_21","url":null,"abstract":"Synchronous tumours of the female genital tract are rare, accounting for approximately 1%–2% of all gynaecological malignancies involving simultaneous independent primary malignancies. Synchronous tumours in the ovary and endometrium are the most common combination. We report on a 58-year-old postmenopausal woman who presented with bleeding per vaginum for 1.5 months with no prior menstrual complaints. On per vaginal examination, a mass was felt in the pelvis. Ultrasonography revealed a mass of 8 cm × 9 cm in size filling the entire uterine cavity. Contrast enhanced computed tomography showed a multilobate mass in the pelvis, replacing the whole uterus and cervix, with heterogeneous enhancement and internal necrosis. Bilateral ovaries were not visualised separately. The radiological impression suggested an endometrial carcinoma. Wertheim's hysterectomy was subsequently performed. On microscopic examination, the uterine mass revealed a malignant mixed Müllerian tumour (carcinosarcoma) of the endometrium, along with a high-grade serous carcinoma of the left ovary and left fallopian tube. The right fallopian tube showed adenocarcinoma in situ. The patient had an unusual past history of multiple system comorbidities, a few of which were continuing and for which she was receiving medical treatment.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88305569","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}
{"title":"Do checklist-based box system interventions improve post-natal care service utilisation?","authors":"M. Taywade, Debkumar Pal, D. Sahu","doi":"10.4103/cmrp.cmrp_38_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_38_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86058555","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}
{"title":"Challenges in Medical Education - Let's talk about solutions","authors":"H. Gupta","doi":"10.4103/cmrp.cmrp_39_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_39_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85649669","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}
Aplastic anaemia can develop due to various viral infections. However, SARS-CoV-2 infection evolving into aplastic anaemia is rarely seen. Here, we present a case of a 6-year-old boy who presented with epistaxis and rashes all over the body after recovery from COVID-19. Peripheral blood smear examination revealed pancytopenia with neutropenia and also reticulocytopenia. Bone marrow biopsy showed a hypoplastic marrow (cellularity of 10%), leading to a diagnosis of aplastic anaemia.
{"title":"SARS-CoV-2 infection evolving into aplastic anaemia: An unusual presentation of COVID-19 in the paediatric age group","authors":"Akanksha Bhatia, Vijay Kumar, A. Yadav","doi":"10.4103/cmrp.cmrp_55_21","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_55_21","url":null,"abstract":"Aplastic anaemia can develop due to various viral infections. However, SARS-CoV-2 infection evolving into aplastic anaemia is rarely seen. Here, we present a case of a 6-year-old boy who presented with epistaxis and rashes all over the body after recovery from COVID-19. Peripheral blood smear examination revealed pancytopenia with neutropenia and also reticulocytopenia. Bone marrow biopsy showed a hypoplastic marrow (cellularity of 10%), leading to a diagnosis of aplastic anaemia.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87029384","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}
Aim: To study the role of magnesium and gamma- glutamyl transferases in alcoholic liver disease. Objectives: (1) To estimate serum magnesium and serum glutamyl-transferases (GGT) in alcoholic liver disease. (2) To estimate liver enzymes Alanine Transaminases (ALT), Aspartate Transaminases (AST), Alkaline Phosphatase (ALP), and Total protein and Albumin in alcoholic liver disease. (3) To correlate serum magnesium with all liver enzymes. (4) To correlate serum GGT with all liver enzymes. Materials and Methods: All liver enzymes, serum magnesium, serum GGT, total protein and albumin were estimated in 50 alcoholic liver disease patients and 50 normal subjects on Trivitron Dirui autoanalyzer. Results: Significant difference was found between mean values of cases and controls in Mg, GGT, AST, ALT, Alkaline phosphatase, and Albumin (P<0.05). Positive correlation was found between Mg with GGT, ALT, Total proteins and Albumin. This indicates that the higher(lower) values of Mg are associated with higher(lower) values of GGT, ALT, Total proteins, and Albumin. But the result were not statistically significant.(P >0.05). Conclusion: Chronic alcoholic liver disease significantly elevates Gamma-glutamyl transferase. Hypomagnesemia is also seen in alcoholic liver disease. Gamma-glutamyltransferase has a significant relation with magnesium levels in alcoholic liver disease.
{"title":"To study the role of magnesium and Gamma- glutamyl transferases in alcoholic liver disease","authors":"K. Gaikwad, S. Selkar, S. Agrawal","doi":"10.4103/cmrp.cmrp_63_21","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_63_21","url":null,"abstract":"Aim: To study the role of magnesium and gamma- glutamyl transferases in alcoholic liver disease. Objectives: (1) To estimate serum magnesium and serum glutamyl-transferases (GGT) in alcoholic liver disease. (2) To estimate liver enzymes Alanine Transaminases (ALT), Aspartate Transaminases (AST), Alkaline Phosphatase (ALP), and Total protein and Albumin in alcoholic liver disease. (3) To correlate serum magnesium with all liver enzymes. (4) To correlate serum GGT with all liver enzymes. Materials and Methods: All liver enzymes, serum magnesium, serum GGT, total protein and albumin were estimated in 50 alcoholic liver disease patients and 50 normal subjects on Trivitron Dirui autoanalyzer. Results: Significant difference was found between mean values of cases and controls in Mg, GGT, AST, ALT, Alkaline phosphatase, and Albumin (P<0.05). Positive correlation was found between Mg with GGT, ALT, Total proteins and Albumin. This indicates that the higher(lower) values of Mg are associated with higher(lower) values of GGT, ALT, Total proteins, and Albumin. But the result were not statistically significant.(P >0.05). Conclusion: Chronic alcoholic liver disease significantly elevates Gamma-glutamyl transferase. Hypomagnesemia is also seen in alcoholic liver disease. Gamma-glutamyltransferase has a significant relation with magnesium levels in alcoholic liver disease.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81389542","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}
{"title":"Understanding suicide: A biopsychosocial framework","authors":"Soumya Tandon","doi":"10.4103/cmrp.cmrp_48_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_48_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84412180","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}
{"title":"Need for COVID-19 vaccination in children","authors":"Shyam Kukreja","doi":"10.4103/cmrp.cmrp_24_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_24_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81685359","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}
{"title":"Three-Dimensional (3D) scanning applications for COVID-19 pandemic","authors":"Abid Haleem, M. Javaid","doi":"10.4103/cmrp.cmrp_72_20","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_72_20","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80284126","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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