Pub Date : 2024-07-01DOI: 10.3126/ajms.v15i7.64686
Sayani Chaudhuri, Arnab Chowdhury, Sayak Biswas
Background: Thyroid hormones play a crucial role in major metabolic pathways in the body and dyslipidemia is a major metabolic abnormality seen in thyroid disorders. Cardiovascular diseases (CVDs) are now emerging as the leading cause of morbidity and mortality worldwide and the most important risk factor for CVDs is dyslipidemia. The lipid ratios that have a positive association with CVD risk are atherogenic index of plasma (AIP), Castelli’s risk index (CRI)-I and II, and atherogenic coefficient (AC). Clinically, both an excess and deficiency of thyroid hormones can exacerbate or induce CVDs and lipid ratio can be used as an inexpensive marker for predicting CVD risk. Aims and Objectives: This study aims to evaluate the lipid ratios (AIP, CRI-I, CRI-II, AC) in patients with thyroid dysfunction and compare the results with lipid ratios in euthyroid individuals. This study also aims to find any correlation, if exists, between lipid ratios and serum thyroid-stimulating hormone (TSH) levels in thyroid dysfunction. Materials and Methods: The serum TSH and lipid profile were evaluated in fifty euthyroid, fifty hypothyroid, fifty subclinical hypothyroid, and fifty hyperthyroid patients. The lipid ratios (AIP, CRI-I, CRI-II, AC) were calculated from the lipid profile. Results: The mean lipid ratios were higher in hypothyroid, followed by subclinical hypothyroid cases when compared to euthyroid controls and hyperthyroid patients. A positive correlation was observed between the TSH and lipid ratios in euthyroid, hypothyroid, and subclinical hypothyroid subjects. There was no significant correlation between TSH and lipid ratios in hyperthyroid patients. Conclusion: This study demonstrates that the evaluation of lipid ratios along with TSH can provide an effective screening tool to assess the cardiovascular risk in patients with subclinical and overt hypothyroidism, especially in the absence of imaging techniques in resource-limited centers.
背景：甲状腺激素在体内的主要代谢途径中发挥着至关重要的作用，而血脂异常是甲状腺疾病中的一种主要代谢异常。心血管疾病（CVDs）现已成为全球发病和死亡的主要原因，而血脂异常是心血管疾病最重要的危险因素。与心血管疾病风险呈正相关的血脂比率包括血浆致动脉粥样硬化指数（AIP）、卡斯泰利风险指数（CRI）-I 和 II 以及致动脉粥样硬化系数（AC）。在临床上，甲状腺激素过量和缺乏都会加重或诱发心血管疾病，而血脂比值可作为预测心血管疾病风险的廉价标记物：本研究旨在评估甲状腺功能障碍患者的血脂比率（AIP、CRI-I、CRI-II、AC），并将结果与甲状腺功能正常者的血脂比率进行比较。本研究还旨在发现甲状腺功能障碍患者的血脂比率与血清促甲状腺激素（TSH）水平之间是否存在相关性：对 50 名甲状腺功能正常、50 名甲状腺功能减退、50 名亚临床甲状腺功能减退和 50 名甲状腺功能亢进患者的血清促甲状腺激素和血脂概况进行了评估。根据血脂谱计算血脂比率（AIP、CRI-I、CRI-II、AC）：与甲状腺功能正常的对照组和甲状腺功能亢进症患者相比，甲状腺功能减退症患者的平均血脂比率较高，其次是亚临床甲状腺功能减退症患者。在甲状腺功能亢进症、甲状腺功能减退症和亚临床甲状腺功能减退症患者中，观察到促甲状腺激素和血脂比率之间存在正相关。甲亢患者的促甲状腺激素和血脂比率之间没有明显的相关性：本研究表明，在评估亚临床和显性甲减患者的心血管风险时，血脂比率与促甲状腺激素的评估可作为一种有效的筛查工具，尤其是在资源有限的中心缺乏成像技术的情况下。
{"title":"A study of the association of lipid ratios with thyroid dysfunction in a tertiary medical college in Eastern India","authors":"Sayani Chaudhuri, Arnab Chowdhury, Sayak Biswas","doi":"10.3126/ajms.v15i7.64686","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.64686","url":null,"abstract":"Background: Thyroid hormones play a crucial role in major metabolic pathways in the body and dyslipidemia is a major metabolic abnormality seen in thyroid disorders. Cardiovascular diseases (CVDs) are now emerging as the leading cause of morbidity and mortality worldwide and the most important risk factor for CVDs is dyslipidemia. The lipid ratios that have a positive association with CVD risk are atherogenic index of plasma (AIP), Castelli’s risk index (CRI)-I and II, and atherogenic coefficient (AC). Clinically, both an excess and deficiency of thyroid hormones can exacerbate or induce CVDs and lipid ratio can be used as an inexpensive marker for predicting CVD risk.\u0000Aims and Objectives: This study aims to evaluate the lipid ratios (AIP, CRI-I, CRI-II, AC) in patients with thyroid dysfunction and compare the results with lipid ratios in euthyroid individuals. This study also aims to find any correlation, if exists, between lipid ratios and serum thyroid-stimulating hormone (TSH) levels in thyroid dysfunction.\u0000Materials and Methods: The serum TSH and lipid profile were evaluated in fifty euthyroid, fifty hypothyroid, fifty subclinical hypothyroid, and fifty hyperthyroid patients. The lipid ratios (AIP, CRI-I, CRI-II, AC) were calculated from the lipid profile.\u0000Results: The mean lipid ratios were higher in hypothyroid, followed by subclinical hypothyroid cases when compared to euthyroid controls and hyperthyroid patients. A positive correlation was observed between the TSH and lipid ratios in euthyroid, hypothyroid, and subclinical hypothyroid subjects. There was no significant correlation between TSH and lipid ratios in hyperthyroid patients.\u0000Conclusion: This study demonstrates that the evaluation of lipid ratios along with TSH can provide an effective screening tool to assess the cardiovascular risk in patients with subclinical and overt hypothyroidism, especially in the absence of imaging techniques in resource-limited centers.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701827","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 : 2024-07-01DOI: 10.3126/ajms.v15i7.66108
Dayanand Paswan, Lipika Adhikari, Sandip Sarkar
Background: Management of non-ST elevation myocardial infarction acute coronary syndrome (NSTEMI ACS) patients is not well defined as that of ST elevation myocardial infarction. The accuracy of results of conventional echocardiography is significantly compromised when imaging is suboptimal, myocardial damage is in small areas, and compensatory hyperkinesias of healthy segment. Aims and Objectives: Duration of early systolic lengthening (DESL) may be employed to identify early myocardial ischemia and thus, may help to prepare treatment strategies for NSTEMI patients. Materials and Methods: A total of 57 patients with NSTEMI ACS attending the cardiology department were included in the study group. Results: More than 80% of patients of NSTEMI have normal or near normal ejection fraction and wall motion score index. In our study, the DESL is prolonged in a significant number of non-ST-elevation acute coronary syndrome patients. Conclusion: As DESL is afterload independent, it is superior to global longitudinal strain in assessing myocardial damage. Several studies including ourselves show that DESL of <50 ms may be the cutoff value to reveal minimal myocardial damage.
背景：非 ST 段抬高型心肌梗死急性冠状动脉综合征（NSTEMI ACS）患者的管理与 ST 段抬高型心肌梗死的管理不同。当成像效果不理想、心肌损伤范围较小以及健康节段出现代偿性高运动时，传统超声心动图结果的准确性就会大打折扣。目的和目标：早期收缩期延长持续时间（DESL）可用于识别早期心肌缺血，从而帮助制定 NSTEMI 患者的治疗策略：研究组共纳入了57名在心内科就诊的NSTEMI ACS患者：80%以上的NSTEMI患者射血分数和室壁运动评分指数正常或接近正常。在我们的研究中，大量非 ST 段抬高型急性冠脉综合征患者的 DESL 延长：结论：DESL不受后负荷影响，因此在评估心肌损伤方面优于整体纵向应变。包括我们自己在内的多项研究表明，DESL<50 ms可能是显示最小心肌损伤的临界值。
{"title":"A study to observe the association of left ventricular ejection fraction and wall motion score index with duration of early systolic lengthening in patients with non-ST-elevation acute coronary syndrome","authors":"Dayanand Paswan, Lipika Adhikari, Sandip Sarkar","doi":"10.3126/ajms.v15i7.66108","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.66108","url":null,"abstract":"Background: Management of non-ST elevation myocardial infarction acute coronary syndrome (NSTEMI ACS) patients is not well defined as that of ST elevation myocardial infarction. The accuracy of results of conventional echocardiography is significantly compromised when imaging is suboptimal, myocardial damage is in small areas, and compensatory hyperkinesias of healthy segment.\u0000 Aims and Objectives: Duration of early systolic lengthening (DESL) may be employed to identify early myocardial ischemia and thus, may help to prepare treatment strategies for NSTEMI patients.\u0000Materials and Methods: A total of 57 patients with NSTEMI ACS attending the cardiology department were included in the study group.\u0000Results: More than 80% of patients of NSTEMI have normal or near normal ejection fraction and wall motion score index. In our study, the DESL is prolonged in a significant number of non-ST-elevation acute coronary syndrome patients.\u0000Conclusion: As DESL is afterload independent, it is superior to global longitudinal strain in assessing myocardial damage. Several studies including ourselves show that DESL of <50 ms may be the cutoff value to reveal minimal myocardial damage.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712471","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: Hydropneumothorax is an abnormal presence of air and fluid in the pleural space. It is a common presentation in the Indian scenario. However, there is a scarcity of studies from Eastern India. Aims and Objectives: The study aimed to evaluate the clinical and radiological presentation, etiological factors, treatment modalities, and outcome of patients of hydropneumothorax. Materials and Methods: Descriptive, observational, cross-sectional study conducted in a tertiary care hospital for 1 year. Adult patients of both genders presenting with a diagnosis of hydropneumothorax were studied. Detailed history and clinical examination were recorded. Chest X-ray, blood, pleural fluid, sputum investigations, and computed tomography (CT) thorax were done. An intercostal drainage (ICD) tube was inserted and the duration of ICD stay was noted. Results: Thirty-six patients were studied. The mean age of presentation is 40.8±14.8 (Mean±SD) years with male predominance. Breathlessness and cough were the most common symptoms (86.1%). Right-sided hydropneumothorax was more common (52.7%). All patients had exudative pleural fluid. Cavity (38.9%) was the most commonly associated radiological finding in CT thorax. Tuberculosis (TB) was the most common etiology (61.1%), followed by acute bacterial infection (36.1%), and malignancy (2.7%). All patients have undergone ICD insertion. About 61.11% of patients had an ICD stay of less or equal to 15 days. Conclusion: Pleural fluid analysis is essential in establishing the etiological diagnosis of hydropneumothorax. TB is the common etiology. ICD insertion along with appropriate chemotherapy are essential components of management.
{"title":"A study on clinicoradiological profile of patients with hydropneumothorax in a tertiary care hospital in Eastern India","authors":"Falguni Mandi, Pranab Mandal, Agnishwar Mukherjee, Aparup Dhua, Pinaki Maiti","doi":"10.3126/ajms.v15i7.62580","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.62580","url":null,"abstract":"Background: Hydropneumothorax is an abnormal presence of air and fluid in the pleural space. It is a common presentation in the Indian scenario. However, there is a scarcity of studies from Eastern India.\u0000Aims and Objectives: The study aimed to evaluate the clinical and radiological presentation, etiological factors, treatment modalities, and outcome of patients of hydropneumothorax.\u0000Materials and Methods: Descriptive, observational, cross-sectional study conducted in a tertiary care hospital for 1 year. Adult patients of both genders presenting with a diagnosis of hydropneumothorax were studied. Detailed history and clinical examination were recorded. Chest X-ray, blood, pleural fluid, sputum investigations, and computed tomography (CT) thorax were done. An intercostal drainage (ICD) tube was inserted and the duration of ICD stay was noted.\u0000Results: Thirty-six patients were studied. The mean age of presentation is 40.8±14.8 (Mean±SD) years with male predominance. Breathlessness and cough were the most common symptoms (86.1%). Right-sided hydropneumothorax was more common (52.7%). All patients had exudative pleural fluid. Cavity (38.9%) was the most commonly associated radiological finding in CT thorax. Tuberculosis (TB) was the most common etiology (61.1%), followed by acute bacterial infection (36.1%), and malignancy (2.7%). All patients have undergone ICD insertion. About 61.11% of patients had an ICD stay of less or equal to 15 days.\u0000Conclusion: Pleural fluid analysis is essential in establishing the etiological diagnosis of hydropneumothorax. TB is the common etiology. ICD insertion along with appropriate chemotherapy are essential components of management.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690408","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 : 2024-07-01DOI: 10.3126/ajms.v15i7.64922
Kapil Deb Lahiri, Amit Kumar Gupta, Utpal Kumar Biswas
Background: Elevated oxidized low-density lipoprotein (Ox-LDL) was significantly associated with the atherosclerotic cardiovascular disease as well as retinal vascular diseases but there were no studies to show the reference range of Ox-LDL levels in any Indian population. Aims and Objectives: The aim of this study was to formulate the reference intervals of Ox-LDL cholesterol in a population of West Bengal. Materials and Methods: Ox-LDL levels of 434 apparently healthy individuals were estimated based on the history, clinical examination, and laboratory investigations. Statistical analysis was performed using the statistical package for the social sciences software. Results: The reference range of Ox-LDL levels for all ages was 34.1±4.9 mol/L in healthy male and 34.5±4.5 mol/L in healthy female. The 2.5th and 97.5th percentile values of Ox-LDL level in the reference population were 27 (0.90 CI = 26.4–27.6) and 42 (0.90 CI = 41.4–42.6), respectively. Conclusions: Reference intervals for Ox-LDL may help clinicians to predict the future risk for coronary heart disease and retinal vascular disease by taking medical decision limits and also open up the scope for further research for other laboratories to formulate their own reference interval of Ox-LDL.
背景：氧化型低密度脂蛋白（Ox-LDL）升高与动脉粥样硬化性心血管疾病和视网膜血管疾病密切相关，但没有任何研究显示印度人群中 Ox-LDL 水平的参考范围：本研究的目的是制定西孟加拉邦人群中Ox-LDL胆固醇的参考区间：根据病史、临床检查和实验室检查结果估算了 434 名表面健康者的 Ox-LDL 水平。使用社会科学统计软件包进行统计分析：所有年龄段健康男性的 Ox-LDL 水平参考范围为 34.1±4.9 mol/L，健康女性为 34.5±4.5 mol/L。参考人群中Ox-LDL水平的2.5百分位数和97.5百分位数分别为27（0.90 CI = 26.4-27.6）和42（0.90 CI = 41.4-42.6）：Ox-LDL的参考区间有助于临床医生通过医疗决策限值来预测未来冠心病和视网膜血管疾病的风险，同时也为其他实验室制定自己的Ox-LDL参考区间开辟了进一步研究的空间。
{"title":"Establishment of reference intervals of oxidized low-density lipoprotein cholesterol in a population of West Bengal","authors":"Kapil Deb Lahiri, Amit Kumar Gupta, Utpal Kumar Biswas","doi":"10.3126/ajms.v15i7.64922","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.64922","url":null,"abstract":"Background: Elevated oxidized low-density lipoprotein (Ox-LDL) was significantly associated with the atherosclerotic cardiovascular disease as well as retinal vascular diseases but there were no studies to show the reference range of Ox-LDL levels in any Indian population.\u0000Aims and Objectives: The aim of this study was to formulate the reference intervals of Ox-LDL cholesterol in a population of West Bengal.\u0000Materials and Methods: Ox-LDL levels of 434 apparently healthy individuals were estimated based on the history, clinical examination, and laboratory investigations. Statistical analysis was performed using the statistical package for the social sciences software.\u0000Results: The reference range of Ox-LDL levels for all ages was 34.1±4.9 mol/L in healthy male and 34.5±4.5 mol/L in healthy female. The 2.5th and 97.5th percentile values of Ox-LDL level in the reference population were 27 (0.90 CI = 26.4–27.6) and 42 (0.90 CI = 41.4–42.6), respectively.\u0000Conclusions: Reference intervals for Ox-LDL may help clinicians to predict the future risk for coronary heart disease and retinal vascular disease by taking medical decision limits and also open up the scope for further research for other laboratories to formulate their own reference interval of Ox-LDL.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691736","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 : 2024-07-01DOI: 10.3126/ajms.v15i7.65202
Samuel George, Karthick Raj A
Background: Peripheral nerve blockade is a crucial component of comprehensive anesthetic care, providing effective analgesia with fewer side effects than opioids and other oral analgesics. Aims and Objectives: This study investigated the effectiveness of a magnesium adjuvant in an ultrasound-guided supraclavicular brachial plexus block to determine the minimum dose required for the desired effects. Materials and Methods: This prospective, double-blind, and randomized controlled study included 90 patients scheduled for elective upper limb orthosurgery at GTMCH. The 90 patients were divided into three groups: A, B, and C. Each group received 21.5 mL of the test drug, with A receiving ropivacaine and normal saline, B receiving ropivacaine and magnesium, and C receiving ropivacaine and magnesium. Results: There was a significant difference in Group A between the onset of sensory and motor blockade in Groups B and C. There was a significant difference in Group A between the duration of sensory and motor blockade in Groups B and C, but no significant difference was observed between Groups B and C. The visual analog scale score varied from 0 to 6 in Group A and from 0 to 5 in Groups B and C. It was found to be significant only from the 7th to 10th h. There was a significant difference in Group A between Groups B and C in 1st rescue analgesia post-operatively and the number of rescue injections in the first 24 h, but no significant differences was observed between Groups B and C. Conclusion: Both 100 and 150 mg magnesium sulfate with 0.5% ropivacaine in supraclavicular blocks prolonged the blockade duration and reduced analgesic needs.
背景：周围神经阻滞是综合麻醉护理的重要组成部分，与阿片类药物和其他口服镇痛药相比，它能提供有效的镇痛，且副作用较少。目的和目标：本研究调查了镁辅助剂的有效性：本研究调查了镁辅助剂在超声引导下锁骨上臂丛神经阻滞中的有效性，以确定达到预期效果所需的最小剂量：这项前瞻性、双盲、随机对照研究纳入了 90 名计划在 GTMCH 进行上肢矫形手术的患者。这 90 名患者被分为 A、B 和 C 三组：A 组接受罗哌卡因和生理盐水，B 组接受罗哌卡因和镁，C 组接受罗哌卡因和镁：A 组的感觉和运动阻滞起始时间与 B 组和 C 组有显著差异，A 组的感觉和运动阻滞持续时间与 B 组和 C 组有显著差异，但 B 组和 C 组之间无显著差异。A 组与 B 组和 C 组在术后第一次镇痛抢救和头 24 小时内的抢救注射次数上有显著差异，但 B 组和 C 组之间没有观察到显著差异：结论：在锁骨上阻滞术中使用 100 毫克和 150 毫克硫酸镁与 0.5% 罗哌卡因都能延长阻滞时间并减少镇痛需求。
{"title":"Evaluation of varying doses of magnesium as an adjuvant to ropivacaine in supraclavicular brachial plexus block","authors":"Samuel George, Karthick Raj A","doi":"10.3126/ajms.v15i7.65202","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.65202","url":null,"abstract":"Background: Peripheral nerve blockade is a crucial component of comprehensive anesthetic care, providing effective analgesia with fewer side effects than opioids and other oral analgesics.\u0000 Aims and Objectives: This study investigated the effectiveness of a magnesium adjuvant in an ultrasound-guided supraclavicular brachial plexus block to determine the minimum dose required for the desired effects.\u0000Materials and Methods: This prospective, double-blind, and randomized controlled study included 90 patients scheduled for elective upper limb orthosurgery at GTMCH. The 90 patients were divided into three groups: A, B, and C. Each group received 21.5 mL of the test drug, with A receiving ropivacaine and normal saline, B receiving ropivacaine and magnesium, and C receiving ropivacaine and magnesium.\u0000Results: There was a significant difference in Group A between the onset of sensory and motor blockade in Groups B and C. There was a significant difference in Group A between the duration of sensory and motor blockade in Groups B and C, but no significant difference was observed between Groups B and C. The visual analog scale score varied from 0 to 6 in Group A and from 0 to 5 in Groups B and C. It was found to be significant only from the 7th to 10th h. There was a significant difference in Group A between Groups B and C in 1st rescue analgesia post-operatively and the number of rescue injections in the first 24 h, but no significant differences was observed between Groups B and C.\u0000Conclusion: Both 100 and 150 mg magnesium sulfate with 0.5% ropivacaine in supraclavicular blocks prolonged the blockade duration and reduced analgesic needs.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695574","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 : 2024-07-01DOI: 10.3126/ajms.v15i7.64751
Venipriya Sigamani, Viswesh Kathavarayan, Lalithambigai Chellamuthu, Ravichandran Kandasamy, H. Prasanth
Background: The prevalence of myopia in the 5–15-year age group in India has been 7.5% over the past four decades. While ocular growth and physical growth occur simultaneously during early life, the existence of a common regulatory system for both is still debated. Aims and Objectives: This study aims to analyze the ocular biometry and anthropometric values of young myopes and emmetropes aged 18–25 years. Materials and Methods: This case–control study involved a sample size of 86 participants. Corneal curvature was measured using keratometry, while A-scan ultrasonography was utilized to measure axial length, lens thickness, anterior chamber depth, and vitreous chamber depth. Results: The results indicated that there were no significant differences in ocular biometry and anthropometric values between the case and control groups, except for corneal thickness and axial length. The mean corneal thickness was found to be 549.64 μm in the case group and 566.05 μm in the control group, while the mean axial length was 24.70 mm in the case group and 23.41 mm in the control group. An increase in height was correlated with longer axial length in myopes. Conclusion: There was no difference in anthropometry and ocular biometry in emmetropes and myopes in the age group of 18–25 years of age. Myopes tend to have thinner corneas, which should be taken into consideration before performing refractive surgeries. The presence of thin corneas in individuals with myopia can result in inaccurately low measurements of intraocular pressure, potentially hampering the early detection of glaucoma within this high-risk demographic.
{"title":"Ocular biometry and anthropometric measurements in young myopes – A case–control study","authors":"Venipriya Sigamani, Viswesh Kathavarayan, Lalithambigai Chellamuthu, Ravichandran Kandasamy, H. Prasanth","doi":"10.3126/ajms.v15i7.64751","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.64751","url":null,"abstract":"Background: The prevalence of myopia in the 5–15-year age group in India has been 7.5% over the past four decades. While ocular growth and physical growth occur simultaneously during early life, the existence of a common regulatory system for both is still debated.\u0000Aims and Objectives: This study aims to analyze the ocular biometry and anthropometric values of young myopes and emmetropes aged 18–25 years.\u0000Materials and Methods: This case–control study involved a sample size of 86 participants. Corneal curvature was measured using keratometry, while A-scan ultrasonography was utilized to measure axial length, lens thickness, anterior chamber depth, and vitreous chamber depth.\u0000Results: The results indicated that there were no significant differences in ocular biometry and anthropometric values between the case and control groups, except for corneal thickness and axial length. The mean corneal thickness was found to be 549.64 μm in the case group and 566.05 μm in the control group, while the mean axial length was 24.70 mm in the case group and 23.41 mm in the control group. An increase in height was correlated with longer axial length in myopes.\u0000Conclusion: There was no difference in anthropometry and ocular biometry in emmetropes and myopes in the age group of 18–25 years of age. Myopes tend to have thinner corneas, which should be taken into consideration before performing refractive surgeries. The presence of thin corneas in individuals with myopia can result in inaccurately low measurements of intraocular pressure, potentially hampering the early detection of glaucoma within this high-risk demographic.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700361","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 : 2024-07-01DOI: 10.3126/ajms.v15i7.65172
Rethinesh Kumar T, Jabapriya B, Angappan P
Background: Head-and-neck squamous cell carcinoma (HNSCC) is a major cancer in India with a poor prognosis. Novel antineoplastic agents, such as selective cyclooxygenase-2 inhibitors such as celecoxib, have shown antitumor, anti-angiogenesis, and radiosensitizing effects, improving radiotherapy response in many cancers. Aims and Objectives: This study aimed to determine the efficacy and safety of low-dose celecoxib combined with concurrent chemoradiation in Locally Advanced HNSCC. Materials and Methods: A double-arm prospective randomized control study was conducted, in which 103 eligible locally advanced HNSCC patients were randomized to concurrent chemoradiotherapy 66 Gy/2 Gy/33 fractions/61/2 weeks along with Inj Cisplatin 40 mg/m2 weekly either with celecoxib 100 mg twice daily (Study Arm – 62) or placebo (Control Arm – 41). Tumor response was evaluated using response evaluation criteria in solid tumors criteria 1.1 and acute toxicities based on the radiation therapy oncology group and common terminology criteria for adverse events criteria 5.0. Results: On analysis using the Chi-square test, the complete response rate was 65.6% in the study arm compared to 44.7% in the control arm, with P=0.0441 (significant at P<0.05). The incidence of acute dermatitis and mucositis (grade ≥3) in the study and control arms was 29.3% versus 23.6%, with P=0.544 and 40% versus 37% with a P=0.782 (insignificant at P<0.05), respectively. The patients in both arms were followed up to assess late toxicities, locoregional control rate, disease-free survival, and overall survival. Conclusion: Adding low-dose daily celecoxib to concurrent chemoradiation with weekly cisplatin in locally advanced HNSCC significantly improved the clinical response rates with acceptable treatment-related toxicities.
{"title":"Efficacy and safety of low-dose celecoxib with chemoradiation in locally advanced head-and-neck squamous cell carcinoma","authors":"Rethinesh Kumar T, Jabapriya B, Angappan P","doi":"10.3126/ajms.v15i7.65172","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.65172","url":null,"abstract":"Background: Head-and-neck squamous cell carcinoma (HNSCC) is a major cancer in India with a poor prognosis. Novel antineoplastic agents, such as selective cyclooxygenase-2 inhibitors such as celecoxib, have shown antitumor, anti-angiogenesis, and radiosensitizing effects, improving radiotherapy response in many cancers.\u0000Aims and Objectives: This study aimed to determine the efficacy and safety of low-dose celecoxib combined with concurrent chemoradiation in Locally Advanced HNSCC.\u0000Materials and Methods: A double-arm prospective randomized control study was conducted, in which 103 eligible locally advanced HNSCC patients were randomized to concurrent chemoradiotherapy 66 Gy/2 Gy/33 fractions/61/2 weeks along with Inj Cisplatin 40 mg/m2 weekly either with celecoxib 100 mg twice daily (Study Arm – 62) or placebo (Control Arm – 41). Tumor response was evaluated using response evaluation criteria in solid tumors criteria 1.1 and acute toxicities based on the radiation therapy oncology group and common terminology criteria for adverse events criteria 5.0.\u0000Results: On analysis using the Chi-square test, the complete response rate was 65.6% in the study arm compared to 44.7% in the control arm, with P=0.0441 (significant at P<0.05). The incidence of acute dermatitis and mucositis (grade ≥3) in the study and control arms was 29.3% versus 23.6%, with P=0.544 and 40% versus 37% with a P=0.782 (insignificant at P<0.05), respectively. The patients in both arms were followed up to assess late toxicities, locoregional control rate, disease-free survival, and overall survival.\u0000Conclusion: Adding low-dose daily celecoxib to concurrent chemoradiation with weekly cisplatin in locally advanced HNSCC significantly improved the clinical response rates with acceptable treatment-related toxicities.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689248","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 : 2024-07-01DOI: 10.3126/ajms.v15i7.65776
Senior Resident Manojit Sarkar, Dr. Rahul Dasgupta-https, Dr. Pintu Mudi-https, Dr. Nilima Shejole-https, Dr. Amit Ray-https
Bowel obstruction is known to be caused by intussusception, which is far more common in pediatric patients. The majority of people with adult intussusception require a predisposing cause, which might be a benign lesion, a malignant lesion, or an irregularity of the intestinal wall such as inflammatory bowel disease. Adult intussusception is a very rare condition. We present the case of a patient presenting with upper abdominal pain, nausea, vomiting, and weakness. The patient had ongoing mild intermittent abdominal pain for months which was investigated with an upper gastrointestinal endoscopy that showed gastritis. There were features of peritonism on clinical examination and this was associated with raised inflammatory markers. A contrast-enhanced multidetector computed tomography (MDCT) scan showed a long-segment telescoping of the ileum into the cecum with ascending colon with proximal bowel distension suggesting bowel obstruction: Ileocolic intussusception. The patient underwent emergency surgical resection with a double-barrel stoma. Histopathology assessment did not identify a causative factor for the intussusception. An uncommon instance of adult idiopathic enteroenteric intussusception is presented here. The diagnosis can be established with the use of the clinical history of chronic intermittent abdominal pain, entire abdomen ultrasonography, and abdomen MDCT. In patients who are unstable and exhibit indications of peritonitis, surgery remains the only choice, even though a more cautious strategy is outlined in the literature. Adult intussusception is a rare and challenging diagnosis to make. Individuals suffering from intussusception may experience prolonged bouts of sporadic abdominal pain that intensify suddenly as a result of acute obstruction. The most helpful investigative technique for confirming the intussusception diagnosis is CT.
{"title":"An unusual case of longest intussusceptum without any pathological lead point in an adult: A rare case report from a peripheral tertiary care institute of Eastern India","authors":"Senior Resident Manojit Sarkar, Dr. Rahul Dasgupta-https, Dr. Pintu Mudi-https, Dr. Nilima Shejole-https, Dr. Amit Ray-https","doi":"10.3126/ajms.v15i7.65776","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.65776","url":null,"abstract":"Bowel obstruction is known to be caused by intussusception, which is far more common in pediatric patients. The majority of people with adult intussusception require a predisposing cause, which might be a benign lesion, a malignant lesion, or an irregularity of the intestinal wall such as inflammatory bowel disease. Adult intussusception is a very rare condition. We present the case of a patient presenting with upper abdominal pain, nausea, vomiting, and weakness. The patient had ongoing mild intermittent abdominal pain for months which was investigated with an upper gastrointestinal endoscopy that showed gastritis. There were features of peritonism on clinical examination and this was associated with raised inflammatory markers. A contrast-enhanced multidetector computed tomography (MDCT) scan showed a long-segment telescoping of the ileum into the cecum with ascending colon with proximal bowel distension suggesting bowel obstruction: Ileocolic intussusception. The patient underwent emergency surgical resection with a double-barrel stoma. Histopathology assessment did not identify a causative factor for the intussusception. An uncommon instance of adult idiopathic enteroenteric intussusception is presented here. The diagnosis can be established with the use of the clinical history of chronic intermittent abdominal pain, entire abdomen ultrasonography, and abdomen MDCT. In patients who are unstable and exhibit indications of peritonitis, surgery remains the only choice, even though a more cautious strategy is outlined in the literature. Adult intussusception is a rare and challenging diagnosis to make. Individuals suffering from intussusception may experience prolonged bouts of sporadic abdominal pain that intensify suddenly as a result of acute obstruction. The most helpful investigative technique for confirming the intussusception diagnosis is CT.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701234","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 : 2024-07-01DOI: 10.3126/ajms.v15i7.64838
Lincy Raj C, Poornima RT, Malawadi BN
Background: Clinical laboratories function to deliver accurate, reliable, and timely reported results which are used in decision-making, diagnosis, and monitoring. Sigma metrics help to assess analytic methodologies and provide benchmarks for laboratories to design protocols for internal quality control (IQC), address poor assay performance, and assess the efficiency of existing laboratory processes. Thus, this study was undertaken to estimate the coefficient of variation (CV%), bias%, and total allowable error (TEa) of quality control (QC) samples using EM 200, to compare the TEa using Clinical Laboratories Improvement Act (CLIA) guidelines, and to analyze the sigma metrics of level 1 QC samples. Aims and Objectives: The aims and objectives of the study are to estimate the CV%, Bias%, TEa of QC samples using EM 200, to compare the TEa using CLIA guidelines, and to analyze the sigma metrics of level 1 QC samples. Materials and Methods: A cross-sectional study was carried out in the Central Biochemistry Lab, Karwar Institute of Medical Sciences, Karwar. IQC data level 1 of 15 analytes was analyzed using EM200 for 3 months. CV% is calculated from internal quality data, whereas bias% is obtained from an external quality assurance program. Sigma metrics were calculated using bias% and CV%. TEa was calculated and compared with CLIA guidelines. Results: We have < 3 sigma values (unstable, unacceptable) for urea, creatinine, BID, serum glutamic oxaloacetic transaminase, serum glutamate pyruvate transaminase (SGPT), protein, cholesterol, calcium, 3–6 (ideal) for glucose, uric acid, total bilirubin, alkaline phosphatase, albumin, high-density lipoprotein, and >6 (excellent) for triglycerides. TEa observed less than or close to CLIA suggests quality requirement met, and TEa observed more than CLIA (urea, creatinine, BID, SGPT, protein, and calcium) suggests methodologies need evaluation. Conclusion: Sigma metrics help to assess analytical methodologies and augment laboratory performance. Each and every laboratory can use sigma metrics as a guideline for QC strategy and a self-assessment tool for proper functioning.
{"title":"Sigma metrics – a good quality control guide to assess analytical performance of a clinical chemistry laboratory","authors":"Lincy Raj C, Poornima RT, Malawadi BN","doi":"10.3126/ajms.v15i7.64838","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.64838","url":null,"abstract":"Background: Clinical laboratories function to deliver accurate, reliable, and timely reported results which are used in decision-making, diagnosis, and monitoring. Sigma metrics help to assess analytic methodologies and provide benchmarks for laboratories to design protocols for internal quality control (IQC), address poor assay performance, and assess the efficiency of existing laboratory processes. Thus, this study was undertaken to estimate the coefficient of variation (CV%), bias%, and total allowable error (TEa) of quality control (QC) samples using EM 200, to compare the TEa using Clinical Laboratories Improvement Act (CLIA) guidelines, and to analyze the sigma metrics of level 1 QC samples.\u0000Aims and Objectives: The aims and objectives of the study are to estimate the CV%, Bias%, TEa of QC samples using EM 200, to compare the TEa using CLIA guidelines, and to analyze the sigma metrics of level 1 QC samples.\u0000Materials and Methods: A cross-sectional study was carried out in the Central Biochemistry Lab, Karwar Institute of Medical Sciences, Karwar. IQC data level 1 of 15 analytes was analyzed using EM200 for 3 months. CV% is calculated from internal quality data, whereas bias% is obtained from an external quality assurance program. Sigma metrics were calculated using bias% and CV%. TEa was calculated and compared with CLIA guidelines.\u0000Results: We have < 3 sigma values (unstable, unacceptable) for urea, creatinine, BID, serum glutamic oxaloacetic transaminase, serum glutamate pyruvate transaminase (SGPT), protein, cholesterol, calcium, 3–6 (ideal) for glucose, uric acid, total bilirubin, alkaline phosphatase, albumin, high-density lipoprotein, and >6 (excellent) for triglycerides. TEa observed less than or close to CLIA suggests quality requirement met, and TEa observed more than CLIA (urea, creatinine, BID, SGPT, protein, and calcium) suggests methodologies need evaluation.\u0000Conclusion: Sigma metrics help to assess analytical methodologies and augment laboratory performance. Each and every laboratory can use sigma metrics as a guideline for QC strategy and a self-assessment tool for proper functioning.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716267","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 : 2024-07-01DOI: 10.3126/ajms.v15i7.65415
Arka Banerjee, Pranab Kumar Ghosh, Hindol Mondal
Background: Urolithiasis is a common condition in daily urological practice. Medical Expulsive Therapy (MET) is non-invasive approach for removal of ureteric stone. In MET, alpha-blocker Tamsulosin is commonly used in treating urolithiasis but it does not address the pathology of inflammation presents in such condition. With addition of low dose Deflazacort as anti-inflammatory agent, there may have a potential to improve the pathology and outcome of the treatment. Aims and Objectives: This study aims to find the efficacy of low-dose deflazacort combined with tamsulosin in the MET for distal ureterolithiasis. Materials and Methods: This prospective randomized controlled trial was conducted from December 2022 to December 2023 in Rampurhat Government Medical College and Hospital. A total of 130 patients with ureteric stone ≤10 mm were randomized into two groups. Tamsulosin group received tamsulosin (0.4 mg once daily for 28 days). Deflazacort group received tamsulosin (0.4 mg once daily for 28 days) with deflazacort (12 mg once daily for 10 days). All subjects were reviewed on 14 days and 28 days. Stone expulsion rate, time to stone expulsion, analgesic use, number of colic episodes, and hospitalization were recorded. Adverse effects of drugs were noted. Results: Among 130 patients randomized, 4 patients were lost to follow-up and 8 patients required early intervention. Deflazacort group had similar rate of stone expulsion (88% vs. 80%, P=0.548). There were significantly shorter expulsion time (10.15 days vs. 14.28 days, P<0.001) and less number of colic episodes (33 episodes vs. 21 episodes, P=0.026) and less analgesic requirements (65% vs. 82.5%, P=0.022) in deflazacort group. No significant side effects were noted during the study. Conclusion: Low-dose deflazacort added to tamsulosin provides a significant advantage in ureteric stone expulsion without any extra side effects. With a comparable rate of stone passage, there are more rapid stone expulsion, low analgesic requirement, and less colic episodes when low-dose deflazacort is added to tamsulosin for ureteric stone ≤10 mm.
背景：泌尿系结石是泌尿外科日常工作中的常见病。药物排石疗法（MET）是一种非侵入性的输尿管结石清除方法。在 MET 中，α-受体阻滞剂坦索罗辛常用于治疗尿路结石，但它并不能解决此类病症中出现的炎症病理问题。添加低剂量的地氟沙星作为抗炎药，可能会改善病理和治疗效果：本研究旨在探讨小剂量地氟沙考联合坦索罗辛治疗远端输尿管结石 MET 的疗效：这项前瞻性随机对照试验于2022年12月至2023年12月在Rampurhat政府医学院和医院进行。共有 130 名输尿管结石≤10 毫米的患者被随机分为两组。坦索罗辛组接受坦索罗辛治疗（0.4 毫克，每天一次，共 28 天）。地氟沙考特组在服用坦索罗辛（0.4 毫克，每天一次，共 28 天）的同时服用地氟沙考特（12 毫克，每天一次，共 10 天）。所有受试者分别于 14 天和 28 天接受复查。记录了结石排出率、结石排出时间、止痛药使用情况、绞痛发作次数和住院情况。结果：在随机抽取的 130 名患者中，有 4 名患者失去了随访机会，8 名患者需要早期干预。地氟沙星组的结石排出率相似（88% 对 80%，P=0.548）。地氟沙星组的排石时间明显更短（10.15 天 vs. 14.28 天，P<0.001），绞痛次数更少（33 次 vs. 21 次，P=0.026），镇痛剂需求更少（65% vs. 82.5%，P=0.022）。研究期间未发现明显的副作用：结论：在坦索罗辛的基础上添加小剂量德拉扎考特，在输尿管结石排出方面具有明显优势，且无任何额外副作用。在结石排出率相当的情况下，当输尿管结石≤10 毫米时，在坦索罗辛中添加低剂量的非拉唑酮，结石排出速度更快，镇痛剂需求量更低，绞痛发作次数更少。
{"title":"Role of low-dose deflazacort with tamsulosin versus tamsulosin alone for medical expulsive therapy of ureteric stone","authors":"Arka Banerjee, Pranab Kumar Ghosh, Hindol Mondal","doi":"10.3126/ajms.v15i7.65415","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.65415","url":null,"abstract":"Background: Urolithiasis is a common condition in daily urological practice. Medical Expulsive Therapy (MET) is non-invasive approach for removal of ureteric stone. In MET, alpha-blocker Tamsulosin is commonly used in treating urolithiasis but it does not address the pathology of inflammation presents in such condition. With addition of low dose Deflazacort as anti-inflammatory agent, there may have a potential to improve the pathology and outcome of the treatment.\u0000Aims and Objectives: This study aims to find the efficacy of low-dose deflazacort combined with tamsulosin in the MET for distal ureterolithiasis.\u0000Materials and Methods: This prospective randomized controlled trial was conducted from December 2022 to December 2023 in Rampurhat Government Medical College and Hospital. A total of 130 patients with ureteric stone ≤10 mm were randomized into two groups. Tamsulosin group received tamsulosin (0.4 mg once daily for 28 days). Deflazacort group received tamsulosin (0.4 mg once daily for 28 days) with deflazacort (12 mg once daily for 10 days). All subjects were reviewed on 14 days and 28 days. Stone expulsion rate, time to stone expulsion, analgesic use, number of colic episodes, and hospitalization were recorded. Adverse effects of drugs were noted.\u0000Results: Among 130 patients randomized, 4 patients were lost to follow-up and 8 patients required early intervention. Deflazacort group had similar rate of stone expulsion (88% vs. 80%, P=0.548). There were significantly shorter expulsion time (10.15 days vs. 14.28 days, P<0.001) and less number of colic episodes (33 episodes vs. 21 episodes, P=0.026) and less analgesic requirements (65% vs. 82.5%, P=0.022) in deflazacort group. No significant side effects were noted during the study.\u0000Conclusion: Low-dose deflazacort added to tamsulosin provides a significant advantage in ureteric stone expulsion without any extra side effects. With a comparable rate of stone passage, there are more rapid stone expulsion, low analgesic requirement, and less colic episodes when low-dose deflazacort is added to tamsulosin for ureteric stone ≤10 mm.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691673","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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