Parosteal Osteosarcoma with Focal Metaplasia: A Case Report
A. Krite, H. Abid, M. Elidrissi, A. ElIbrahimi, A. ElMrini
Sch J App Med Sci | 772-774
DOI : 10.36347/sjams.2020.v08i03.001
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It is the most common type of juxtacortical or surface osteosarcoma and accounts for 5% of all osteosarcomas. It typically presents in early adulthood and middle age with a peak incidence in the third decade. It affects females slightly more than males. Patients usually present with a painless, slowly enlarging mass. They are usually located at the metaphysis (80-90%), most commonly at the posterior aspect of the distal femur (60%), followed by either end of the tibia, and then the proximal humerus. Parosteal osteosarcomas are usually low-grade lesions are usually treated with surgical resection and no neoadjuvant chemotherapy or radiation. As they are frequently metaphyseal in location, large parosteal osteosarcomas or those with deep medullary invasion may require limb salvage, including joint replacement. Parosteal osteosarcomas have an excellent prognosis (80-95% long-term survival).
Original Research Article
March 7, 2020
Determination of Hepatitis B Virus Carriers among Voluntary Blood Donors in Some Parts of Nigeria
Kingsley Kalawari Odiabara, Edna Ogechi Nwachuku, Ndokiari Boisa, Ebirien-Agana Samuel Bartimaeus
Sch J App Med Sci | 775-782
DOI : 10.36347/sjams.2020.v08i03.002
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This study was designed to determine the prevalence of hepatitis B virus carriers among voluntary blood donors in some parts of Nigeria. A total of 183 blood samples were collected from subjects in North Central and consisted of 137 males and 46 females; 176 blood samples were collected from subjects in North East and consisted of 129 males and 47 females, while 173 blood samples were collected from subjects in South-South region and consisted of 123 males and 50 females. The mean age of the study population were 34.89±9.19years, 39.81± 9.60 years and 39.92 ± 9.27 year in North Central, North East and South-South regions respectively The specimens were tested for hepatitis B surface antigen, Hepatitis C and HIV to rule out co-infection with hepatitis, using enzyme-linked immunosorbent assay. The results were analyzed using statistical analysis system (SAS STAT 15.1) and p-values < 0.05 were considered significant. Overall, the percentage prevalence of HBsAg negative by gender was 63.16% for males and 23.87% for the females while the prevalence of HBsAg positive by gender was 9.96% for the males and 3.01% for the females. The percentage prevalence of HBsAg negative irrespective of sex for the three zones combined was 87.03% while the percentage prevalence of HBsAg positive was 12.97%. The distribution of viral load shows that North Central zone has a viral load of 31.8439+12.784 IU/mol x 104 for male subjects and 0.3378+28.008 IU/mol x 104 for the female sugjects while in the North East zone, mean viral load values were 0.3454+16.171 IU/mol x 104 and 0.0561+28.008 IU/mol x 104 for the male and female subjects respectively. The mean viral load values for male and female subjects from the South South zone were 0.7583+16.738 IU/mol x 104 and 0.7976+25.568 IU/mol x 104 respectively. These findings indicate the percentage of asymptomatic hepatitis B virus carriers in the population is high impying that progression of these carriers into the full hepatitis B infection.....
Acute Myeloid Leukemia “Cup-Like”: About A Case and Litterature Review
H. Yahyaoui, A. Jahdaoui, A. Raissi, E. Boufrioua, M. Oujidi, M. Ait Ameur, M. Chakour
Sch J App Med Sci | 783-785
DOI : 10.36347/sjams.2020.v08i03.003
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Cup‑like acute myeloid leukemia (CL AML) is a rare form of acute myeloid leukemia, but its frequency is probably underestimated because it is a poorly understood and little described entity. Characterized by a particular biological profile: hyperleukocytosis, massive blastosis, disseminated intravenous coagulation, nuclei marked by a clear nuclear invagination, relatively stereotyped immunophenotype: CD34- / HLA-DR- / MPO + / CD117 + / CD13 +. Often associated with a normal karyotype, CL AML cytology is highly predictive of molecular abnormalities affecting NPM1 and FLT3.
Original Research Article
March 7, 2020
Symptomatic Catheter Associated Urinary Tract Infection in Icus and Post Operative Ward at a Tertiary Care Centre, Hyderabad
Dr. S Ruth Ramya, Dr. N Sridevi, Dr. G Jyothi Lakshmi
Sch J App Med Sci | 786-789
DOI : 10.36347/sjams.2020.v08i03.004
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Purpose: Catheter associated urinary tract infections (CAUTI) are one of the major concerns of nosocomial infection, which lead to significant mortality, morbidity and additional hospital stay. The objective is to study the incidence of CAUTI, to isolate the pathogens and detect their antibiotic sensitivity pattern. Material and Methods: It is a prospective study of 1 year, conducted from January 2018 to December 2018, at tertiary care centre, Hyderabad. The demographic data of catheterized patients is collected from the ICU and post operative wards, as per criteria given by CDC. The urine from the symptomatic patients was collected from the catheter and processed in Microbiology laboratory. The pathogens were isolated and susceptibility to antibiotics was tested. Results: The CAUTI rate in Neurosurgical ICU was 0, Respiratory ICU was 6.966, Acute surgical care was 1.55 and Post operative ward was 1.33. The isolated organisms are Escherichia coli, Klebsiella, Enterococci, Staphylococcus aureus and Candida species. Conclusion: The incidence of CAUTI in ICUs and Post operative ward is low. The rates are less than 5 and 10 per 1000 catheter days. This can be attributed to good preventive practices and empirical usage of antibiotics in ICUs and POW.
Original Research Article
March 7, 2020
Risk factors of UTI in Pregnant Women and the Maternal and Perinatal Outcome in Pregnant Women attending CMH Dhaka
Major Umme Ruman, Mir Masudur Rhaman, Brig General Rokeya Khan
Sch J App Med Sci | 790-795
DOI : 10.36347/sjams.2020.v08i03.005
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Objective: In this study was designed to see the risk factors of UTI in pregnant women and the maternal and perinatal outcome in pregnant women attending CMaH Dhaka. Methods: In this case control study, women enrolled in antenatal OPD of CMH Dhaka during July, 2016 to December 2016, were randomly allocated into case and control group. The inclusion criteria for pregnant women during the 13th - 26th weeks of pregnancy in the case group was the positive urine cultures of bacteria (more than 10 5 colonies growth in a standard positive urine culture). The same with negative culture was control group. Then parameters such as parity, sexual activity, type of delivery, and infants' birth weight were recorded in questionnaire. Results: Incidence of UTI in mid trimester pregnancy during study period was 26%. Risk factors like previous history of UTI, sexual activity and multipara were higher in case group. Highest age incidence was between 20-30 years. Predominantly patients were asymptomatic. Lower abdominal pain was a common symptoms. Eshcherichia coli was commonest organism. Prevalence of bacteriuria was more in women with history of UTI earlier in pregnancy. Premature rupture of membrane was significantly higher in case group. Caesarean section was higher in the case group. According to this study, the average weight of newborns whose mothers had UTI was 2.83 kg and it was 0.44 kg lower than the newborns of healthy mothers. Conclusion: According to the conducted study, UTI in mothers is the major reason for comparatively lower birth weight of infants. Routine urine check up during pregnancy helps to diagnose this early and prompt treatment is beneficial for infant.
Original Research Article
March 7, 2020
Prevalence of Comorbidity of Depressive Disorders and Panic Disorder in Patients Diagnosed With Migraine (With and Without Aura)
Dr. Parul Sharma, Dr. Meghna Gupta
Sch J App Med Sci | 796-800
DOI : 10.36347/sjams.2020.v08i03.006
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Migraine is a common neurological disorder and that be severely disabling during attacks, and has been observed to be associated with other psychiatric disorders like panic disorder and depressive disorders. The disease burden maybe magnified when psychiatric co morbidities are present [1]. Objective: In this study, we have tried to find out the prevalence and comorbidity of depressive disorders and panic disorder in patients diagnosed with migrainous headache, with and without aura, coming to psychiatry OPD of MMMC&H, Kumarhatti,Solan. Material and Methods: International Society for Headache, criterion (ICHD-3) [2] was applied to screen patients having migrainous headache (with and without aura). 220 such patients, who gave consent for the study, were selected for the study and MINI Scale [3] was applied to these patients to find out which of these, had a diagnosable comorbidity with panic disorder and depressive disorders. Observations: The prevalence of Panic Disorder was found to be 11.5% in cases of migraine without aura whereas it was 14.3% in cases of migraine with aura showing no significant association (p=0.665).Prevalence of Depression was found to be 29.2% in cases of migraine without aura whereas it was 64.3% in cases of migraine with aura, thus showing statistically highly significant association (p<0.001). Conclusion: Odds Ratio of panic disorder in cases of migraine with aura as compared to migraine without aura was 1.288( 95% CI : 0.409-4.059: p= 0.666), showing insignificantly more chances of Panic Disorder in cases of migraine with aura as compared to migraine without aura. Cases of migraine with aura had significantly higher odds of having depression as compared to cases without aura (OR: 4.371; 95% CI: 1.900-10-058: p = 0.001).
Original Research Article
March 10, 2020
Acceptability issues of Continuous Glucose Monitoring among Diabetes Patients attending Clinic in North Bihar
Dr. Amit Kumar Das
Sch J App Med Sci | 801-803
DOI : 10.36347/sjams.2020.v08i03.007
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Aim: Continuous Glucose Monitoring (CGM) provides significant benefits for diabetes management. To introduce this modern technique to patient population understanding patient’s perceptions of CGM benefits and potential annoyances is important. The main objective of the study is to acmes the acceptability issues of CGM among diabetes patients attending clinic in north Bihar. Methods: A total of 40 diabetic adults went through a 7-day observational study. After the monitoring period, they completed a survey regarding acceptability of CGM sensors. Results: More than 90% of the study participants agreed that the CGM sensor and receiver were easy to use (37/40), useful (38/40), and provided relevant information that was of interest to them (36/40). Furthermore, 85% (34) felt more safe (15% neutral) while sleeping and 78% (31) more confident (22% neutral) about avoiding serious hypoglycemia. 84% would choose to be inserted again. Conclusion: Introduction of CGM in elderly patients with well-controlled diabetes resulted in high satisfaction without imposing additional diabetes distress. Furthermore, an added benefit in glucose control with stabilizing glycemia in target range was proven.
Original Research Article
March 10, 2020
Cutaneous Manifestations in Diabetic Patients and its Correlation with HbA1c Level
Anurag Chaurasia, Vinay Soni, Raviprakash Pandey, Manoj Indurkar
Sch J App Med Sci | 804-810
DOI : 10.36347/sjams.2020.v08i03.008
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Introduction: Cutaneous manifestations of DM are very important to the clinician as some of them can prompt the physician to the early detection of diabetes and also reflect the glucose level and lipid metabolism over period of time. Long standing Diabetes Mellitus (DM) leads to permanent and irreversible functional damage in cells of the body, which may be a cause for various complications. Skin being the largest organ of the body, is readily available for examination and study in case of cutaneous disorders of diabetes. Objective: To see the association of skin manifestations with HbA1c in diabetes patients. Material and Methods: 300 known case of diabetic patient were taken and after taking the informed consent, demographic details, duration of diabetes, mode of treatment for diabetes, and glycemic profile were documented. Complete history and examination of all the patients with regards to onset of cutaneous manifestations was taken. Result: 300 patients (45.7% male and 54.3% female), mean age was 53+10.2 years and mean duration of diabetes 7.1+4 years. Mean HbA1c was 8.7+2.7 with 68.7% patients belongs to uncontrolled glycemic group. Most frequently observed skin disease was Bacterial infections (24%), Fungal infections (22.7%), Acanthosis Nigricans (20.4%), Diabetic foot (13.7%), Nail changes (6.6%), Acrochordons (12%), Necrobiosis Lipoidica (7.8%), Viral infections (4.7%), Pruritus (9%) and Xanthelasma (6.2%). There was significant association of uncontrolled diabetes with bacterial (p = 0.013) fungal (p = 0.005) and viral infection (0.045). Females especially had a higher frequency of Acanthosis Nigricans (p = 0.048) and Acrochordons (0.037). Conclusion: Patients with type 2 DM have high frequency of skin infections especially Bacterial and Fungal. Other manifestations like Acanthosis Nigricans and Diabetic foot are comparatively less common.
Original Research Article
March 10, 2020
A Study to Evaluate the Effect of Sahaja Yoga Meditation on General Health, Emotional Wellness and Behavior Pattern on College Students
Nisha Rathor, Priyanka Kulshreshtha, Govindnarayan Mundra, Ram Krishna Tiwari, Sanchita Singh, Pallavi Shah, Shaileshkumar Sahajayogi
Sch J App Med Sci | 811-815
DOI : 10.36347/sjams.2020.v08i03.009
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Meditation is considered as the doorstep of peace from ancient Indian civilization. Sahaja yoga is a method of meditation to connect an individual from within; results in thoughtless awareness and peaceful mind. The present study has been conducted on a group of students of 16-21 years of age from Sheth N. K. T. T. College Thane, India. The students were examined physically for their oxygen level, pulse rate, body temperature on different points on palm (known as chakras) as well as subjected to questionnaires; The Short Form (36) Health Survey (SF-36) and Strengths and difficulties questionnaire (SDQ) for their physical and emotional health as well as behavior pattern before and after 12 weeks of meditation. The collected data was analyzed to understand the correlation between the variables and sahaja yoga meditation. The study showed a significant, beneficial change in the oxygen level, pulse rate. The overall health score analyzed by SF-36 and behavior score analyzed by SDQ improved in all participants significantly. The study showed a significant improvement in general, emotional health and behavior pattern on practicing sahaja yoga meditation for 12 weeks.
Original Research Article
March 13, 2020
Glucose and Lipid Profile in Patients with Ischemic Cerebrovascular Accidents
Dr. Gaurav Gupta, Dr. Mohammad Aquiqe, Dr. Richa Giri, Dr. Saurabh Agarwal
Sch J App Med Sci | 816-820
DOI : 10.36347/sjams.2020.v08i03.010
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Background: Different mechanisms are responsible for the development of Dyslipidemia in individuals with diabetes. Defects in insulin action and hyperglycemia could lead to Dyslipidemia in patients with diabetes. Methods: Cross sectional study carried out in patients presenting with ischemic stroke to medicine emergency unit of the LLRH Hospital from January 2018 to October 2019.Patient of age group 40-80 years The subjects in the present study were 450 patient comprised of 235 cases with ischemic stroke of age group of 40-80 years and 215 health y controls of age group of 40-80 years. Results: It is observed that mean serum level of TC, TG, HDL-C, and LDL-C in controls was 186±36.7 mg/dl, 124.7±58.3, 51.6±15.8 mg/dl, and 112±38.3 mg/dl respectively. The mean serum value of TC, TG, HDL-C, and LDL-C in ischemic stroke cases was 271.2±28.4 mg/dl, 216.0±58.2 mg/dl, 24.3±6.5 mg/dl, and 201.7±32.1 mg/dl respectively. It is observed from the table---that serum level of TC, TG, HDL-C, and LDL-C was higher in ischemic stroke cases than control population, and the differences was highly significant (p value<0.001). Conclusion: Our study show statistically significant association (p < 0.001) of increased levels of HbA1c and Dyslipidemia (TC, TG, HDL-C, and LDL-C) in patients of ischemic stroke.
A Review on Hereditary Palmoplantar Keratoderma
Shivanu Mathon, Manu Singh
Sch J App Med Sci | 821-826
DOI : 10.36347/sjams.2020.v08i03.011
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PPK require a precise diagnosis to determine the underlying defects, to know the predisposition for internal malignancy and for proper genetic counselling. The disorder can be diffuse (non- transgradient or transgradient) or focal loclised to pressure points. Non-transgradient PPK do not extend beyond the palms on the hands and the sole on the feet while Transgradient PPK extend beyond the palms and soles on their dorsal aspects and to flexor aspect of wrist. Skin around the mouth, eyes, nose, and over the elbows and knees may also be affected. Precise classification of disease helps in choosing the appropriate therapeutic modality.
Original Research Article
March 13, 2020
Peripheral Blood Assessment of Impact of Malaria on Haematological Parameters of Pregnant Women Attending Ante-natal in Two Tertiary Hospitals in Port Harcourt, Nigeria
Ken-Ezihuo Stella Urekweru, Bartimaeus, Ebiren-agana Samual, Ibeh, Nancy Chiatogu, Jeremiah, Zacchaeus Awortu
Sch J App Med Sci | 830-839
DOI : 10.36347/sjams.2020.v08i03.013
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In pregnancy and malaria, changes in haematological parameters could be due to normal physiological adaptation to pregnancy-induced stress on the haematological system or it could be a result of response to pathological changes due to malaria infection. The cross-sectional study aimed at using venous blood to assess the effect of malaria infection on the levels of haematological parameters in malaria-infected pregnant women attending ante-natal clinics of two tertiary hospitals in Port Harcourt and compared it with non-infected subjects to ascertain the extent of the influence of malaria coexisting with pregnancy. Ethical clearance was obtained from the Ethical Board of the two tertiary Hospitals. About 3mls of venous blood was drawn from 240 subjects comprising 80 malaria-infected pregnant women, 80 non-infected pregnant women and 80 apparently healthy non-pregnant women. Sysmex KX21 auto analyzer was used to analyze haematological parameters. Malaria parasite was diagnosed by Microscopy, pregnancy test done with Rapid Diagnostic Kit and data analyses with Statistical Analysis Software (SAS version 9.4). ANOVA was used for comparison of mean differences and level of significance set at P<0.05. Results in this study showed that RBC 3.94±0.04x106/µL, Hb 10.96±0.10 g/dl, MCHC 33.18±0.17 g/dl, lymphocyte 1.94±0.05 x103/µL and platelet 202.43±5.31 x103/µL, of the malaria-infected and RBC 3.80±0.04 x106/µL, Hb 10.68± 0.10 g/dl, MCHC 32.38±0.11 g/dl ,lymphocyte 1.99±0.07 x103/µL and %, platelet 214.83± 5.54 x103/µL of non-infected pregnant women were significantly reduced (p=0.0001) compared to the values of RBC 4.35±0.04 x106/µL, Hb 11.76±0.12 g/dl , MCHC 34.53± 0.13 g/dl , lymphocyte 2.39± 0.50 x103/µL and platelet 247± 6.19 x103/µL of the non-pregnant women. Packed cell volume 33.00±0.30% of infected pregnant women, 33.09± 0.24% of the non-infected women were also significantly reduced (p=010) compared to the non-pregnant values 34.17±0.30%. WBC and Neutrophil values
Original Research Article
March 13, 2020
Prospective Evaluation of MRCP as A Non-Invasive Diagnostic Tool in Patient with Suspected Obstructive Biliopathy
Dr. Saket Ballabh, Dr Karunakaran, Dr. R. Ganesh
Sch J App Med Sci | 840-876
DOI : 10.36347/sjams.2020.v08i03.014
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Diseases of the biliary tree and the pancreas are common in India and worldwide. Causes of bile duct obstruction may be benign or malignant. Benign causes may be due to intraluminal causes e.g. Choledocholithiasis, Haemobilia or parasites. Non- invasive imaging modalities of biliary system include USG, CT. Invasive methods include direct cholangiographic methods like ERCP, Percutaneous Transhepatic Cholangiography (PTC) and Intraoperative Cholangiography. USG is the primary screening modality. This prospective study was done to evaluate the role of MRCP as a non-invasive diagnostic tool in patients with suspected obstructive biliopathies and to compare and correlate the MRCP findings with those of other modalities. MRCP was comparable with Direct Cholangiography in identifying the level of block in 57 of 60 cases (95%) MRCP showed high sensitivity (100%) and diagnostic accuracy (96.29%) in identifying the level of block. MRCP is not only comparable with direct cholangiography in its diagnostic ability, but it has the tremendous advantage of being noninvasive. MRCP is still an evolving technique, it has established itself as clinically useful noninvasive investigation and comparable with direct cholangiography for the evaluation of various pancreatic or biliary ductal diseases.
Original Research Article
March 13, 2020
Lipoprotein (A) in Acute Myocardial Infarction among Middle Aged Population with Coronary Angiographic Correlation- An Observational Study
Dr. Arun Ranganathan, Dr. P. Deepa
Sch J App Med Sci | 877-880
DOI : 10.36347/sjams.2020.v08i03.015
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Acute myocardial infarction (AMI) is one of the leading causes of mortality among coronary artery disease (CAD). Lipoprotein (a) Lp(a) may aggravate atherosclerosis by pro-thrombotic, pro-inflammatory and pro-atherogenic effects This observational study was conducted in 206 acute Myocardial Infarction patients of age less than 45 years of both sexes who underwent coronary angiogram in Department of Cardiology,Government Stanley Medical College for 6 months after getting informed consent. This study was performed to determine the levels of Lp(a) in acute myocardial infarction. Coronary angiogram was performed for all acute myocardial infarction patient and serum Lp(a) and LDL levels were analysed. In our study, the difference in Lp(a) values between obstructive CAD & non – obstructive CAD were not statistically significant (p value 0.863). Eight patients who had positive family history had high Lp(a) levels. Important findings in this study includes that the Lp(a) levels were independent of high LDL( Low density Lipoprotein) values and the level of Lp(a)is higher in women(67%) than in men (33%). With regard to management, this group of patients need a targeted approach apart from regular statins and they may have to be treated with extended release Niacin
Original Research Article
March 13, 2020
An Annoyance and Sleep Disturbance Related to Environmental Noise Exposure Outside in Dhaka Airport Area
Dr. Abul Bashar, Dr. Nusrat Khan, Dr. Abul Eshrat, Dr. ASM Shahidullah
Sch J App Med Sci | 881-886
DOI : 10.36347/sjams.2020.v08i03.016
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Background: Noise has been shown to fragment sleep, reduce sleep continuity, and reduce total sleep time. Sleep is a biological imperative and a very active process that serves several vital functions. Undisturbed sleep of sufficient length is essential for daytime alertness and performance, quality of life, and health. Methodology: A cross sectional study is to estimate the degree annoyance and sleep disturbance related to soud occupational noise exposure in Dhaka Airport Area at 100 people. The municipality is characterized by homogeneous social structure and living conditions of the residents. For noise measurements, a Noise Level Analyzer was used. Three measurements were per formed at daytime (between 9 and 10:30 am, 2 and 3:30 pm, and 6 and 7:30 pm) and two at night (between midnight and 1:30 am, and 3:30 and 5:00 am). Equivalent noise levels (Leq) were automatically calculated as continuous steady noise levels that would have the same total Aweighted acoustic energy like the real fluctuating noise measured over the same period. Results: Majority 35(35.0%) patients had sound level 55-60 dB (LAeq,24 hour) followed by 21(21.0%) 60-65 dB (LAeq,24 hour), 19(19.0%) <55 dB (LAeq,24 hour), 17(17.0%) 65-70 dB (LAeq,24 hour) and 8(8.0%) had >70 dB (LAeq,24 hour). Regarding cardiovascular effect, 15(15.0%) had myocardial infarction, 13(13.0%) hypertension, 9(9.0%) ischaemic heart disease, 5(5.0%) stroke. Regarding psychological effects 12(12.0%) had depression, 7(7.0%) anxiety, 3(3.0%) fatigue, 2(2.0%) primary insomnia and 2(2.0%) impaired concentration. Regarding other effects, 7(7.0%) had headache, 4(4.0%) visual or hearing impairment, 3(3.0%) obstructive sleep apnoea, 2(2.0%) effect on birth weight. Conclusion: The study evaluated the level of annoyance and sleep disturbance that is perceived by the residents of Niketon Housing Project. It was also provide information about the various sources of environmental noise perceived by the dwellers. It is to estimate.....
Original Research Article
March 13, 2020
Assessment of Nurse's Knowledge about Cardiopulmonary Resuscitation (CPR) in Intensive Care Units and Emergency Department in Basra Teaching Hospital
Ahmed T. Saud, Abdulkareem Salman Khudhair, Aliaa H. Ali
Sch J App Med Sci | 887-893
DOI : 10.36347/sjams.2020.v08i03.017
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Objective: This study aims to assess the nurses' knowledge about cardiopulmonary resuscitation (CPR), and to find out the relationship between knowledge of the nurses and their demographic variables (gender, age group, Academic qualification, Years of work experience and formal training). Methodology: A descriptive cross-sectional design study was conducted at Al-Basra teaching hospital, starting from November 24th, 2019 to January 11th, 2020. A non-probability (purposive) sample of (40) nurses, those who were working in the coronary care unit , intensive care unit, and emergency unit at Al-Basra teaching hospital . The data were collected through questionnaire, and it is consist two part, Part 1 Included (8) items, and Part 2 (40) items. Data collected by means of structured self-report technique with the subjects. Validity of the instrument had been achieved by 8 experts from different scientific branches having at least 10 years of experience in their field of work. Results: The findings revealed that majority of nurses had poor knowledge about cardiopulmonary resuscitation. There is significant association between the nurse’s knowledge and academic qualification at p-value 0.05 and there was no significant association between the nurse’s knowledge and their gender, age group, Years of work experience, and Formal training. Conclusion: The researcher concluded that majority of the study sample are female, Most of study sample have poor knowledge about cardiopulmonary resuscitation at total mean (0.44). Recommendations: Programs training study about cardiopulmonary resuscitation with a larger sample size to determine the effectiveness of CPR training on Nurses CPR knowledge.
Original Research Article
March 13, 2020
Microbial Contamination of Hospital Nebulization and Link to of Nurse's Staff Knowledge in Emergency Departments
Sunduss.B.Dawod, Abdulkareem Ali Qassim, Farhan L. Aaiz, Kholouod abdulkareem
Sch J App Med Sci | 894-896
DOI : 10.36347/sjams.2020.v08i03.018
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Background: Nebulization is an important tool in the treatment of respiratory conditions. Nurses are primary health care providers for using the nebulizers in a hospital setting and may have been identified as the potential vehicle which may cause major nosocomial infections if they are colonized by different bacteria and fungi. Aim of the study was to access the knowledge of nursing staff towards the presences of microbes in nebulization inhalation therapy equipment. Methods: A cross sectional study was conducted at two hospitals in Basra city of period from (1/2-15-5/2018). (50) Nurses who work in Emergency Departments of these two hospitals. consist three parts were used to that where by using questioner presented two the sample consisting there parts, part 1 includes Demographic characteristics. Part 2 consist of (14) a questionnaire related to subject of the study. part 3 : includes collection swabs from contamination nebulize cup (n=25)using sterile cotton swabs .collected sample were placed in sterile tubes containing (5ml)brain heart infusion broth (BHIB) and transferred into the laboratory to incubator at 370 C for 12-24 h after that streaked onto 5 special agars. Conclusion: In this study, the level of knowledge regarding nebulization contaminations among nursing staff was inadequate. Considering the important role of nurses in nebulization contaminations, there is an imperative need for health education to improve the knowledge of the nurses toward nebulization contaminations and types of organism. Nurse’s lack of knowledge may be a barrier in prevention of infections. Hence, this study was carried out to assess the current knowledge Relationship sig p≤ 0.01.
Case Report about Myelodysplasic Syndrome/Myeloproliferative Neoplasm with Ringed Sideroblasts and Thrombocytosis (Mds/Mpn-Rs-T) and Review of Litterature
Yahyaoui H, Raissi A, Jahdaoui A, Awati M, ED-DYB S, Oujidi M, Boufrioua E, AIT Ameur M, Chakour M
Sch J App Med Sci | 897-901
DOI : 10.36347/sjams.2020.v08i03.019
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MDS/MPN-RS-T is a clinical-biological entity of haematological malignancies border between myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN), declared in 2016 by WHO as a separate entity of its own unlike old classifications. Its particularity lies in the association of an MDS with ringed sideroblasts (MDS-RS) with a MPN represented in this case by its similarity to an essential thrombocytemia (ET) because of thrombocytosis. Clinically, the association of splenomegaly with chronic "refractory" anemia guides the diagnosis. Cytology is a large-scale orientation tool. It sometimes targets some signs of peripheral dysgranulopoiesis with thrombocytosis and giant platelets. Bone marrow smear shows hyperlobed megakaryocytes (similar as those found in ET or primary myelofibrosis (PMF), sometimes cytoplasmic degranulation of the granular line and often many signs of dyserythropoiesis with more than 15% of ringed sideroblasts (RS) in Prussian blue staining. However, the molecular study retains its full scope to confirm the diagnosis by objectifying the mutation SF1B3 (spliceosome gene) generally found in MDS-RS, accompanied by the mutations found in negative BCR-ABL MPN (JAK2, CAL-R and MPL), thus explaining the hybrid nature of this rare myeloid entity. This genotype can be more complex when associated with other mutations characteristic of MDS (ASXL1, DNMT3A, SETBP1 or TET2) thus worsening the prognosis of patients. We report here a case of a 56-year-old patient followed for ET whose diagnosis was renewed in MDS / MPN-RS-T by cytology and molecular biology.
Original Research Article
March 18, 2020
The Role of Urinary N-Acetyl-Beta- D-Glucosaminidase to Determine the Activity of Lupus Nephritis
Dr. A.S.M Julfekar Helal, Dr. Md. Hafizur Rahman
Sch J App Med Sci | 902-905
DOI : 10.36347/sjams.2020.v08i03.020
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Objective: In this study our main goal is to evaluate the role of urinary N-acetyl-beta- D-glucosaminidase to determine the activity of lupus nephritis. Method: This cross-sectional prospective observational type of study was conducted among 60 Diagnosed lupus nephritis patients (active and inactive) at Department of Nephrology, Dhaka Medical College Hospital, Dhaka. From January 2017 to December 2017. The informed written consent was taken from each patient. Results: during the study, 62(mIU/ml) is the best uNAG cutoff value for determination of lupus nephritis activity.Among 29 active lupus nephritis cases raised uNAG was found in 28 cases and among 31 inactive lupus nephritis cases raised uNAG was found in 2 cases.uNAG in determination of lupus nephritis activity showed accuracy, sensitivity, specificity, PPV and NPV were 0.950, 0.966, 0.935, 0.933 and 0.967 respectively. Conclusion: From our study we can conclude that, uNAG is a useful biomarker for determination of lupus nephritis activity. Further large-scale study should be carried out for reaching optimal goal.
People’s University Protocol for Autologous Blood Injection for Chronic Recurrent Temporomandibular Joint Dislocation
Darpan Bhargava, Karthik Hegde, Sabhrant Singh, Yogesh Sharma
Sch J App Med Sci | 906-908
DOI : 10.36347/sjams.2020.v08i03.021
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Dislocation of the jaw joint or temporomandibular joint (Jaw Joint or TMJ) occurs when one or both mandibular condyles are displaced in-front of the articular eminence. Autologous blood injection as a treatment for chronic recurrent TMJ dislocation was first reported by Brachmann, in 1964. There is a requirement for the clinicians to follow a set guideline for such injections. Based on the clinical outcome with such patients, a management protocol for autologous blood injection for chronic recurrent temporomandibular joint dislocation is proposed.
Original Research Article
March 13, 2020
A Comparative Study of Neurological Soft Signs in Patients of Schizophrenia and Obcessive Compulsive Disorder
Pirdutt Bansall, Nidhi Gupta
Sch J App Med Sci | 909-915
DOI : 10.36347/sjams.2020.v08i03.022
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Objectives; the objective of this study is to find out the casual relationship of neurological soft signs to schizophrenia and OCD. Methods: The study was initiated after taking approval of the Institute Ethics Committee. A total of 30 schizophrenic patients, 30 OCD patients and 30 controls were included in the study. Their diagnosis were confirmed by consultant and then were administered Neurological Evaluation Scale developed by Robert Buchanan. The accumulated data was then analyzed statistically. Results; This study shows higher prevalence of neurological soft signs in schizophrenia as compared to OCD patients and controls. Conclusion; to ascertain their role in etiogenesis and pathogenesis of schizophrenia and OCD further research is needed.
Original Research Article
March 18, 2020
Different Types of Presentation of Chronic Suppurative Otitis Media (CSOM)
S.M. Masudul Alam, Kamrul Hassan Tarafdar, Sheikh Hasanur Rahman, Md Sirajul Islam Mahfuz
Sch J App Med Sci | 916-920
DOI : 10.36347/sjams.2020.v08i03.023
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Objectives: To evaluate different types of presentation of tubotympanic and atticoantral varieties of chronic suppurative otitis media (CSOM). Methods: It was a prospective study conducted in the department of otolaryngology & Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH), Dhaka, from September 2008 to February 2009. Fifty cases were selected by random sampling. Results: The tubotympanic type was more common presentation than the atticoantral type. Most common extracranial complication was mastoid abscess, followed by postauricular sinus. Most common intracranial complication of CSOM was meningitis. Tubotympanic variety had mild (26-40dB) hearing loss and atticoantral variety had moderate (41-55dB) hearing loss. Cholesteatoma and facial nerve palsy were found 78.94% and 5.26% respectively. Conclusion: Tubotympanic variety of disease is more common than atticoantral type of disease. Complications are associated with atticoantral diseases.
Original Research Article
March 18, 2020
Outcomes of Adjunctive Membrane Sweeping with Labour Induction at Term in a Tertiary Hospital, South-West, Nigeria
Jolayemi Waliyat A, Fasanu Adeniyi.Olanipekun, Adekanle Daniel Adebode, Komolafe Johnson. Olusanmi
Sch J App Med Sci | 921-926
DOI : 10.36347/sjams.2020.v08i03.024
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Membrane sweeping is the insertion of the digit beyond the internal cervical os followed by circumferential passes of the digit causing separation of the membranes from the lower uterine segment. The study aimed to determine the effect of membrane sweeping in conjunction with induction of labour in a teaching hospital in south western Nigeria. It was a randomized controlled trial among pregnant women with valid indications for labour induction at term in Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Osogbo. Seventy-six women were randomised into "sweep" and "no-sweep" groups with 38 in each arm. The women were blinded to the groups and only the doctors who performed the initial vaginal examination knew the allocation. The outcome of induction of labour, induction to delivery interval, usage of Oxytocin for augmentation of labour, the pain scores, usage of analgesia and satisfaction level were determined between the two arms of the study. The collected data was analysed using Statistical package for Social Sciences (SPSS- 20) Software. Level of significance was set at <0.05.Seventy-six women were recruited for the study, 38 women had their membrane swept before commencement of induction while 38 women had only induction without membrane sweeping. No patient dropped out from the study. Swept women had higher spontaneous vaginal delivery rate (100% compared with 84.2%, p=0.011), shorter induction to delivery interval (mean 10hours compared with 14hours, p=0.001), fewer required oxytocin use (39.5%compared with 78.9%, p < 0.001) and less requirement for analgesia (31.6% compared 68.4%, p = 0.001) The study revealed that membrane sweeping at initiation of labour induction had significant effect on the spontaneous vaginal delivery rate, reduced oxytocic drug use, shortened induction to delivery interval and reduced usage of analgesia.
Original Research Article
March 18, 2020
A Study of Magnetic Resonance Imaging in Stroke
Dr. Sanchita L Bilagoji, Dr. Aman Gupta, Dr. Chandrajeet Yadav, Dr. Shoaib Hussain
Sch J App Med Sci | 927-930
DOI : 10.36347/sjams.2020.v08i03.025
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Globally, stroke is the 2nd leading cause of death and 3rd leading cause of disability. Stroke on an average occurs 15 years earlier among the population in low and middle income countries. This study was done to assess the role of Magnetic Resonance Imaging in the evaluation of stroke with MRI by just doing a few sequences- T1WI, T2WI,FLAIR,SWI,DWI which each takes about 5 minutes, thus saving the precious ‘door to needle time’ we can accurately detect the aetiology of stroke, differentiate acute, subacute and chronic ischemic strokes, salvageable tissue, intra vascular thrombus and guiding in thrombolytic therapy without increasing the risk of radiation exposure to the patient an in case of CT. In our study 100 patients underwent MRI head and majority of patients were in age group 60-69 years. Male preponderance was observed with a M: F ratio of 7:3.About 34% patients had both diabetes mellitus and hypertension. About 45.3% of patients presented clinically with hemiplegia. Infarction was the most common aetiology of stroke seen in 87% most common followed by intracerebral haemorrhage seen in 12% patients. With DWI and ADC sequence the exact age of infarct could be diagnosed and were categorized into four groups based on the time since onset of stroke. 8% cases of hyperacute, 78.1% patients with acute, 9.2% patients had subacute and 4.6% patients had chronic infract were diagnosed. Patients with hyperacute infract as aetiology of stroke showed changes in DWI sequence, whereas 80 patients with acute, subacute and chronic infract as aetiology of stroke showed changes in both T2 and DWI sequences. The results obtained from our study are well comparable with other stroke surveys.
Original Research Article
March 19, 2020
Study of Prevalence of Left-Atrial Enlargement among the Patients with Hypertension
Dr. Nikhil Gupta, Dr. Rajeev Gupta, Dr. BS Yadav
Sch J App Med Sci | 931-933
DOI : 10.36347/sjams.2020.v08i03.026
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Background: Previous studies have shown a link between Left atrial enlargement (LAE) with the increase in the risk of stroke and cardiovascular diseases (CVD). Indian data is lacking on the exact prevalence of LAE. Aims and Objectives: To study the prevalence of LAE and its associated risk factors. Materials and Methods: Hundred patients having were studied in the Department of Medicine, Gandhi Medical College and Hamidia Hospital, Bhopal. After a complete physical examination, echocardiogram was performed in all the patients. In present study LAE is defined if the LA diameter is more than 4.0 cm in men and 3.8 cm in women. We performed multivariable logistic regression analysis to identify risk factors for LAE. Results: Prevalence of LAE was 8%. The prevalence of LAE was higher in men (9.37%). On multivariable logistic regression analysis advancing age (OD;1.034), increased systolic blood pressure (SBP) (OR: 2.862), increased diastolic blood pressure (DBP) (OR: 1.32), abnormally high BMI (OR: 3.721), increased prevalence of diabetes (OR: 1.245), increased left ventricular myocardial index (LVMI) (OR: 1.023), and decreased left ventricular ejection fraction (LVEF), decreased heart rate (HR), and decreased estimated glomerular filtration rate (eGFR) were found to be the major risk factors of LAE. Conclusion: A significant number of patients had LAE. Among the risk factors advancing age, increased SBP, increased BMI, presence of diabetes mellitus, increased LVMI, decreased eGFR, decreased LVEF, and decreased HR were more common.
Original Research Article
March 21, 2020
Role of Selected Clinical Signs in Predicting Fatal Outcome in Severely Malnourished Children Admitted in Hospital
Dr. Farhana Akhter Faruque, Dr. Md. Ataur Rahman Dr. Md. Nurul Absar, Dr. Joyashree Chakraborty
Sch J App Med Sci | 989-995
DOI : 10.36347/sjams.2020.v08i03.036
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Introduction: Nutritional deficiency constitutes a major public health problem worldwide and often associated with fatal outcome [1]. The malnutrition scenario presented by UNICEF in 2011 showed that 52 million children under 5 years of age were moderately or severely wasted, More than 29 million under 5, an estimated 5 percent suffered from severe wasting, Bangladesh has a very high prevalence of malnutrition-above 15 per cent[2]. However, a recent hospital-based systematic surveillance study in a diarrhoea treatment centre in Dhaka, Bangladesh revealed that severe wasting, severe stunting and severe under-nutrition in under 5 children were 3%, 11% and 16% respectively[3]. Every year over 4 million children are born in Bangladesh and nearly 289,000 of them die before reaching their fifth birthday. Aim of the study: To determine the role of four clinical signs (bradycardia, low volume pulse, impaired consciousness and delayed capillary refilling time) in predicting the death of severely malnourished children admitted in the hospital. Materials & Method: All the cases of severe acute malnutrition in age group of 3 months to 59 months were included during the study period of March 2016 to September 2016. History, physical findings and particularly four clinical signs- bradycardia, low volume pulse, impaired consciousness and capillary refill time > 3 sec were recorded for all the children. They were treated as per WHO guideline with prevention and treatment of hypoglycemia, hypothermia, dehydration, electrolyte imbalance, treatment of infections and other problems including shock and severe anaemia. Feeding was started with F-75 formula for one week, then replaced by F-100.They were also given multivitamin, folic acid and zinc. Outcome particularly death of the patients were recorded, co-morbidities, duration of their hospital stay were also recorded. Children who had any one or more of the four clinical signs were then considered as case and rest as control .........
Original Research Article
March 19, 2020
Comparison of HRCT with Lung Sonography in the Diagnosis of Pulmonary Edema & ILD
Sonam Verma, Amlendu Nagar, Pramod Sakhi, Kumud Julka, Sheetal Singh
Sch J App Med Sci | 934-938
DOI : 10.36347/sjams.2020.v08i03.027
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Introduction: Pulmonary Edema is defined as fluid accumulation in the lungs causing change in the normal balance between the air & fluid, create a reverberation phenomenon represented by multiple B-lines. Normal lung appears on Lung Sonography as "black". Pulmonary Edema on Lung Sonography appears as "black & white" or “white" lung, whereas on HRCT it appears as septal thickening & GGO’s. ILD is characterized by distortion of airways & interstitium, followed by fibrosis. ILD on Lung Sonography represented as multiple, bilateral B-lines due to pulmonary fibrosis. Whereas ILD on HRCT appears with septal thickening, GGO’s, traction bronchiectasis & honeycombing. Objective: To evaluate the significance of B-lines & compare the sensitivity of Lung Sonography & HRCT in the diagnosis of Pulmonary Edema & ILD. Methodology: In a retrospective case control study, 50 subjects diagnosed as Pulmonary Edema & ILD by HRCT were compared on Lung Sonography for evaluating the distance between B-lines. Results: The B7 lines correlated with Interlobular septal thickening, whereas B3 lines correlated with GGO’s on HRCT chest. Lung Sonography have 72% sensitivity and 46% diagnostic accuracy in ILD patient and Lung Sonography have 80% sensitivity and 54% diagnostic accuracy for pulmonary Edema as compare to HRCT. Conclusion: The sonographic features of Pulmonary Edema & ILD are characteristic, but non-specific. B-lines can be used as a bedside and alternative monitoring tool for Pulmonary Edema. Lung Sonography is an attractive & promising technique, which may become an important clinical tool to be integrated with HRCT and PFT in the screening & follow-up of Pulmonary Edema and ILD.
Original Research Article
March 19, 2020
Common Bacterial Isolates in Sputum of AE-COPD Patients in National Institute of Diseases of the Chest & Hospital (NIDCH)
Md. Hasanur Rashid, Olia Sharmeen, Nigar Sultana Ahmed
Sch J App Med Sci | 939-944
DOI : 10.36347/sjams.2020.v08i03.028
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Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disabling disease. It is a spectrum of airway disease characterized by the chronic bronchitis (airway obstruction) & emphysema (parenchymal destruction).The major cause for morbidity & mortality in worldwide is COPD &it is the fourth leading cause of death in world. Objective of the Study: To identify the most common bacterial organism isolated from sputum of COPD patients from Out Patient in National Institute of Diseases of the Chest & Hospital (NIDCH). Material & Methods: Patients who were >40 years old attended Medical OPD at National Institute of Diseases of the Chest & Hospital (NIDCH), Mohakhali, Dhaka, Bangladesh from January 2018 to December 2018, diagnosed with COPD and having symptoms of acute exacerbation were screened for participation. Samples were collected in sterile vial & sent within 2 hours to the central laboratory. Sputum sample to be deemed acceptable for analysis; Microbiological study done by using a low magnification lens (x100) reveals <10 epithelial cells & >25 leucocytes per field. Selected sputa were processed microbiologically for quantitative study following accepted laboratory method. Results: Total of 70 patients, fulfilling the inclusion & exclusion criteria, 40 male & 30 female with 57% & 43%. Out of 70 patients, 19 showed the overgrowth of the normal commensal in sputum, so only 51 patients (72%) showed growth with culture positive. In terms of age, the study group belongs to a wide range from 40 years to > 80 years with maximum patients (35%) belonging to the age group of 50 -60 years followed by 60-70 years (25%) and 40-50 years (21.88%), Streptococcus pneumonia (14 cases, 27%), Hemophilus influenza(10 cases, 20%), Pseudomonas aeruginosa (7 cases, 14%), Moraxella catarrhalis (6 cases, 12%), Eschericia coli (4 cases, 8%), Staphlococcus aureus (3 cases, 6%), Citrobacter freundii (3 cases, 6%), Klebsiella pneumonia (2 cases, 4%), Acinetobacter.....
Original Research Article
March 19, 2020
“Effect of Risk Factors on Short Term Mortality in Patients of Stroke with Hyperglycaemia”
Md. Aminul Islam, Quamruddin Ahmed, A. R. M. Saifuddin Ekram, Lakshman Chandra Barai
Sch J App Med Sci | 945-952
DOI : 10.36347/sjams.2020.v08i03.029
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Background: Stroke is the third most common cause of death in the developed world after ischaemic heart disease and all cancers and is the most common cause of physical disability. It is established by several studies that stroke patients having hyperglycaemia on admission have adverse short term outcomes in terms of mortality and also increased rate of haemorrhagic conversion after thrombolytic therapy in ishchaemic stroke. If we can explore other factors having significant effects on short term mortality along with hyperglycaemia, poor outcomes of stroke patients would be predicted more accurately. Moreover this study will open a number of new windows of thinking. Objectives: To study the effect of hyperglycaemia on the 30 day prognosis of patients admitted with stroke and its relationship with other risk factors. Materials and methods: It was a hospital based prospective study carried out in patients admitted in the Neuro-Medicine and Medicine units of Rajshahi Medical College Hospital admitted with the diagnosis of Stroke as confirmed by imaging of the brain (CT scan or MRI) From January 2008 to January 2009. 100 consecutive patients of stroke having a raised blood sugar level (above 10.0 mmol/l) formed the study group while 100 similar patients of stroke with normal blood sugar level (less than 8.00 mmol/l) constituted the control group. Results: Total 200 patients were enrolled. Highest number of both male and female patients were between ages 51 and 65 (42.2% male & 53.3% female). Highest mortality was from age group 35-50 years (20.1%), which was statistically significant (p<.05) Mortality was more in male both among normoglycaemic (4.8) and hyperglycaemic group; here mortality was significantly higher in male (p<.05).Moreover patients with Glasgow coma scale below 8 0n admission had the highest mortality. Conclusion: Male sex, middle age (35-50years), and Glasgow coma scale below 8 were established as poor outcome predictors in stroke patients along with...
Original Research Article
March 19, 2020
“Cardiac Troponin I Level in STEMI and Clinical Correlation with Left Ventricular Dysfunction in Bangladeshi Population”
Md. Abul Kalam Azad, Kofil Uddin, Lakshman Chandra Barai, Bijon Kumar Saha, Md. Anisul Goni Khan, Mohammad Nizamul Hossain Sowdagar, Mohammad Harun-Ur-Rashid Khan, Biplab Kumar Das
Sch J App Med Sci | 953-960
DOI : 10.36347/sjams.2020.v08i03.030
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Background: Coronary Heart Disease (CHD) is the most common category of the heart disease and is found to be the single most important cause that leads to premature death in the developed world. Recognizing a patient with ACS is important because the diagnosis triggers both triage and management. cTnI is 100% tissue-specific for the myocardium and it has shown itself as a very sensitive and specific marker for AMI. Objective: To determine the relationship of serum troponin I after first acute myocardial infarction with left ventricular ejection fraction as assessed by echocardiography. Methods: A total of 40 patients of acute myocardial infarction were included in the study. Troponin I concentration was measured by ELISA method and echocardiographic ejection fraction was calculated by modified Simpson’s rule. Echocardiographic ejection fraction was compared with serum troponin I concentration. Patients with previous myocardial infarction were excluded. Results: There was strong negative correlation between troponin I concentration and left ventricular ejection fraction with an increasing troponin level, there was a fall in ejection fraction. The Pearson’s correlation coefficient was –0.69, which was statistically significant (p<0.0001). In our study, we observed that patients with ejection fraction >50%, though small in number were having cTnI levels at 24 hrs ≤ 8 ng/ml. Patients with ejection fraction <50% (left ventricular systolic dysfunction) were having cTnI levels at 24 hrs ≥ 17 ng/ml. Therefore a presumptive cut off level of cTnI ≤ 8 ng/ml may be taken to consider normal left ventricular systolic function in STEMI. The normal range of Troponin I in apparently health individual without STEMI was observed to be <1.0 ng/ml. The mild increase in Troponin I at 24 hrs of STEMI with preserved EF >50% may be due to peak value of biomarker achieved at 24-36 hrs after myocardial injury as most of troponin I are attached to myofibrils. Conclusion: Serum troponin I .....
Original Research Article
March 21, 2020
The Attitudes of Medical Students in University of Port Harcourt to Cadaveric Dissection
Peter D. Okoh, John N. Paul, Edna I. Ogbonda
Sch J App Med Sci | 961-965
DOI : 10.36347/sjams.2020.v08i03.031
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Background: The attitudes of Medical Students to Cadaveric dissection was studied in students from 200-300 levels at the University of Port Harcourt. Materials and Methods: Questionnaires were administered randomly to 400 students in the departments of Anatomy, Physiology and Medicine in the Faculty of Basic Medical Sciences, College of Health Sciences; 362 students responded. Results and Discussion: Out of 400 students only 362 completed the questionnaires. Only the completed questionnaires were used for this study. The uncompleted ones were excluded. 149 (41.2%) were males and 213(58.8%) were females. The mean age was 22.6 years. 28 (7.7%) were between the ages of 17 and 19 years, 307 (84.8%) were between the ages of 20 and 25 years and 27 (7.5%) were between the ages of 26 and 30 years. From the result, 316 (87.3%) of the students had previously seen a dead body and 183 (50.5%) had been very traumatized by the event. When the students were asked about their feelings before they entered the dissecting room, majority of the students indicated that they were tensed, 149 (41.2%), 93 (25.7%) were excited 37 (10.2%) said they were peaceful, 31(9.1%) were fearful and 50 (13.8%) were without any obvious emotions. Analysis of the data obtained shows that although some students expressed a positive attitude toward the experience at their first entrance and during subsequent dissections, a few students reported a negative attitude initially, which includes fear, nausea, nightmares, rhinitis, irritation and redness of eye, revulsion at the smell of the cadavers, drowsiness and restlessness. Conclusion: These initial stress reactions dissipated after some weeks of exposure to dissection room. Suppression and repression were used by students to cope with these feelings. Some students reported that cadaveric dissections were a better way to learn or teach anatomy as it brings the knowledge home seeing the structures and how they are situated in proximity to one another.
Original Research Article
March 21, 2020
A Study of Hepatic Dysfunction with Severity of Dengue Fever
Dr. Riyaz Ahmed, Dr. Kavya ST, Dr. Amar Prakash Aravind
Sch J App Med Sci | 966-969
DOI : 10.36347/sjams.2020.v08i03.032
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Background: Dengue viruses belong to flavivirus, which include four serotypes 1,2,3 and 4. Dengue virus infection manifestations vary from asymptomatic to severe dengue with shock. An estimated 50 million dengue infections occur annually and approximately 2.5 billion people live in dengue endemic countries. Liver is affected in the form of derangements of liver function tests. Objectives: 1. to study the frequency and pattern of hepatic dysfunction in dengue fever 2. To find out the correlation of Hepatic dysfunction with severity of Dengue fever. Methods: An observational cross-sectional study done on patients admitted in hospitals attached to Bangalore Medical College and Research Institute, Bangalore, Karnataka, between June 2019-November 2019. Confirmed Dengue patients are included after meeting inclusion and exclusion criteria. Complete Blood count, liver function tests are estimated at the time of admission. Results: Out of 100 patients, 27 developed Dengue fever with warning signs and 10 patients developed severe Dengue. Multivariate analysis showed that low albumin of <3.5 gm/dl was associated with severe dengue, which was statistically significant (p value 0.028). Conclusions: Early changes in liver enzymes and serum albumin may be detected in patients with dengue fever. Low serum albumin levels if present may be a marker of the critical phase of the disease and an early indicator of plasma leakage due to altered vascular permeability and a useful predictor of severity of dengue fever.
Sigmoid Perforation Following A Fracture of the Acetabulum: About A Case and Review of the Literature
A Krite, H Abid, M ElIdrissi, A ElIbrahimi, A ElMrini
Sch J App Med Sci | 970-975
DOI : 10.36347/sjams.2020.v08i03.033
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Injuries sigmoid colon or pelvic associated with acetabular fractures colon have a prevalence of less than 3%. Even more exceptional appear directly colonic perforation by bone trauma since a case was found in the literature. This is the mechanism that has been retained in the comments submitted. This case told us evoke a digestive lesion in a pelvic trauma (usually a severe polytrauma) with unexplained infectious syndrome. The use of imaging (CT abdominopelvic) avoids diagnostic delay may jeopardize the vital prognosis of the patient.
Original Research Article
March 21, 2020
Assessment of the Effect of Exposure to Plastics on Some Biochemical Parameters among Workers in Plastic Industries in Port Harcourt, Nigeria
Idaye Reuben, Davis G.Tamuno-emine, Ebirien-Agana S. Bartimaeus
Sch J App Med Sci | 976-983
DOI : 10.36347/sjams.2020.v08i03.034
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Plastics have a widespread use globally. The chemicals referred to as additives used in its manufacturing are capable of exerting a number of toxicological effects on biological tissues especially the endocrine system. This cross sectional study was aimed at assessing the effect of exposure to plastics on some biochemical parameters among workers in plastic industries in Port Harcourt, Nigeria. The study population comprised of 80 subjects divided into two groups: the exposed group consisting of 40 workers, occupationally exposed to plastic additives and an age-matched control of 40 workers who were not occupationally exposed. Serum samples were obtained from the participants and laboratory investigations such as total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides, superoxide dismutase, reduced glutathione, malondialdehyde, testosterone and estrogen levels were determined using standard procedures. Statistical analysis was done using Graph Pad Prism version 5.03 and variation in means was considered significant at p<0.05. The results show a significantly decreased values in triglycerides and malonaldehyde, and increased values in testosterone, estrogen, testosterone/estrogen ratio when compared with the control group at p<0.05.There was, however, no significant difference among the groups in total cholesterol, high density lipoprotein, low density lipoprotein, atherogenic indices, superoxide Dimutase (SOD) and reduced glutathione. In conclusion, the exposed subjects exhibited a change in lipid profile, atherogenic indices, oxidative stress markers and reproductive hormone levels which may predispose them to cardiovascular diseases.
Original Research Article
March 21, 2020
Assessment of Hypoxic Ischemic Changes in Perinatal Asphyxia of First Ultasonogram of Brain: A Study in Dhaka Shishu Children Hospital, Dhaka, Bangladesh
Hossain MM, khan AI, Islam I Sarker DD, Sultana M
Sch J App Med Sci | 984-988
DOI : 10.36347/sjams.2020.v08i03.035
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Background: In in perinatal asphyxia, hypoxic ischemic brain injury remains most serious condition causing significant mortality and long term morbidity. Early detection of intracranial changes and its consequences will enhance timely intervention and better outcome. Cranial sonography can be done to assess the abnormalities of brain in perinatal asphyxia. Objective: The objective of this study was to evaluate usefulness of assessment of Hypoxic Ischemic Changes in perinatal asphyxia of first Ultasonogram of Brain. Methods: This was an observational study conducted from March 2018 to January 2019 at department of radiology and imaging, Dhaka Shishu Children Hospital, Dhaka, Bangladesh. Total 100 neonates with perinatal asphyxia were included in this study. Cranial USG was done in all cases and sonographic abnormalities were evaluated. Results: This study was 56 term (>37 weeks of gestation) and 44 preterm (<37 weeks of gestation) newborn having birth asphyxia were taken as cases in this study. Common cranial sonographic findings of preterm babies were periventricular leukomalacia 29% (13), germinal matrix hemorrhage 14% (6), Intraventricular hemorrhage 11% (5) cerebral oedema 7% (3) and normal 39% (17). Common cranial USG findings in term babies were cerebral oedema 43% (24), intracerebral hemorrhage 5% (3), Focal cerebral infarct 4% (2), Intraventricular hemorrhage 2% (1) and normal 46% (26). Conclusion: This study found that transcranial sonography is useful to identify the abnormalities in brain of asphyxiated neonate and helps to predict the neurodevelopmental outcome. So proper management plan can be done.
Original Research Article
March 21, 2020
Hepatitis Viruses in Hemodialysis Patients at a Tertiary Care Hospital
Dr. K.Sravanthi, Dr. V. Sudha Rani, Dr. G. Jyothi Lakshmi
Sch J App Med Sci | 996-1000
DOI : 10.36347/sjams.2020.v08i03.037
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Hepatitis C virus and Hepatitis B virus are the most important infections transmitted in Hemodialysis patients. HBV and HCV are the major cause of liver diseases in these patients. These infections lead to serious complications like cirrhosis and hepatocellular carcinoma. Hence the present study was done to determine the seroprevalence of HCVand HBV in chronic renal failure patients undergoing Hemodialysis. The study was a prospective study conducted over a period of 1 year from 2018-2019 in Chronic Renal failure patients undergoing Hemodialysis. A total of 60 serum and plasma samples were collected and tested for HBV by HBsAg ELISA, HCV by Anti HCV ELISA, HCV RNA by HCV RT PCR. All the patients were seronegative for HBsAg. Anti HCV antibodies were detected in 13(21.66%) patients. HCV RNA was detected in 25(41.66%) patients.To conclude Hemodialyis patients are at risk of acquiring blood borne viral infections like HBV and HCV. Prevention and adherence to universal precautions are the main factors for the control of these blood borne viral infections. Hence use of dedicated dialysis machines, screening of patients for Blood borne viral infections for every 3 months and training of staff is recommended to reduce the risk of complications in these patients.
Male Breast Carcinoma Presenting As a Lump in Axilla: Case Report
Dr. Kamepalli Venkateswarlu, Dr. S Kalyan Kumar, Dr. Prithviraj Vivek Patil, Dr. Chinmay S Gandhi
Sch J App Med Sci | 1001-1003
DOI : 10.36347/sjams.2020.v08i03.038
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Carcinoma of an accessory mammary gland is an extremely rare tumor. A 63 year old male patient presented with a hard mass of 2×2cm in the right axilla. Excisional biopsy showed an adenocarcinoma histopathologically which is similar to breast carcinoma originating in an accessory mammary gland. There is no evidence of primary lesion in both the mammary glands or in the other organs.
Original Research Article
March 27, 2020
« Autoantibodies and Systemic Lupus Erythematosus in a Moroccan Population »
Hazime R, Rami M, Brahim I, El Moumou L, Admou B
Sch J App Med Sci | 1004-1012
DOI : 10.36347/sjams.2020.v08i03.039
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Introduction: Systemic lupus erythematosus is characterized by various autoantibodies which prevalence and clinical significance vary among populations. The aim of our research is to study the immunological profile of autoantibodies in Moroccan population with lupus. Patients and methods: Seventy-seven patients with lupus meeting at least four criteria of the 1997 ACR had an ANA screening by indirect immunofluorescence method (IIF) on HEp-2 substrate (Kallstad, Biorad, threshold = 1: 160), followed by the identification of specific anti-DNAn antibodies ( Aeskulisa, threshold: 16 IU / ml), anti-SSA, SSB, Sm, RNP, Nucleosomes, Histones [ELISA (ENA profile, Biorad) Immuno-Dot (D-Tek, Aesku)] and anti-phospholipid (APL-ELISA, DRG threshold: 10 IU / ml). Results: The mean age of the patients was 37.1 ± 14.13 with female predominance (Sex ratio M / F: 15.7). The clinical manifestations of SLE were dominated by rheumatological (80.6%), dermatologic (76.1%), renal (58.2%), respiratory (34.3%) neurological (28.3%) and cardiac (26.7%) symptoms. The ANA were found in all patients, anti-DNAn in 74.6%, associated with anti-nucleosome Ab and anti-histone in 58.5 and 36.5% of cases respectively. The SSA, Sm, RNP and SSB specificities were noted in 47.8; 37.3; 32.8% and 26.9% of cases respectively, and 19.4% of cases had Antiphospholipids Abs. A statistically significant association was established between anti-DNAn, anti-Sm and anti-RNP with renal impairment (p = 0.0007), pleurisy (p = 0.033) and Raynaud's phenomenon (p = 0.022) respectively. Conclusion: The data in our series show a particularly high level of anti-DNAn Ab and anti-SSA, with a correlation of anti-Sm Ab with pleurisy and anti-RNP with Raynaud's phenomenon. These results underline the interest of these markers in the clinico-immunological characterization of SLE.
Original Research Article
March 27, 2020
The Socio- Demographic Status of Diabetic Patientattending at NHNs in Dhaka City
Lutful Kabir, Mostarial Jannat, ASM Rahenur Mondol, Zia Hayder Bosunia, Mostafa Kabir Ahmed, Shafiqus Saleheen, Afjal Hossain, Abu Hena Md. Shohel Rana
Sch J App Med Sci | 1013-1018
DOI : 10.36347/sjams.2020.v08i03.040
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Objective: In this study our main aim is to evaluate the socio- demographic status of diabetic patient. Method: This retrospective Cohort study was conducted among 430 Diabetic population of adult age group (≥18 years) of all socioeconomic strata attending at different NHNs in Dhaka city from October 2017 to October 2018. Results: Among the patients, (77%) had education level SSC or above, (10%) illiterated and (13%) primary passed. Most of the patients 79.50% leading sedentary life style and from the remaining patients 10.2% were light worker, moderate worker was 6.50% and heavy worker only 3.7%.Only 68(15.8%) had knowledge about foot care and 36(8.40%) had knowledge about sick day management out of 430 patients. Most of the patients 47.7% treated with combined oral drugs and 30.9% with oral drug plus insulin during their intervening time. Conclusion: From our result we can say that, pattern of diabetes management at different NHNs (National Healthcare Networks) in Dhaka city were heterogeneous. In some cases, diabetes education was poor and guide line based treatment regimens were lacking at initial and follow up visit on the light of present recommendations. Further study is needed for better outcome.
Persistent Mullerian Duct Syndrome – Rare form of Intersex Disorder – A Case Report
Debaditya Samanta, Mousumi Bag, Asim Kumar Manna
Sch J App Med Sci | 1019-1021
DOI : 10.36347/sjams.2020.v08i03.041
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Persistent Mullerian duct syndrome is a rare form of intersex disorder, characterized by presence of the uterus and fallopian tubes in a otherwise 46 XY male.[1] We report a 21 years old boy with bilateral cryptorchidism presented with bilateral inguinal hernia having presence of uterus and bilateral fallopian tubes diagnosed as PMDS.
Original Research Article
March 27, 2020
Assessment of Severity of Peritonitis Using Mannheim Peritonitis Index
Abhishek Kumar, Ashok Kumar Gupta
Sch J App Med Sci | 1022-1027
DOI : 10.36347/sjams.2020.v08i03.042
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Background: Despite advancement in diagnosis, management and critical care of patients with peritonitis due to various etiology, prognosis remain poor. Early assessment by scoring system will influence the management and prognosis. Aim: Evaluation of Mannheim Peritonitis Index Score for predicting the outcome in patients with peritonitis. Material and Method: Prospective study of 100 patient admitted and operated in National Institute of Medical Sciences & Hospital. The structured scoring system i.e. Mannheim Peritonitis index was applied along with other clinical and biochemical parameter recorded in pre-structured Performa. Data was analyzed for predicting mortality and morbidity. Results: In present study the mortality was found to be 17% with mean MPI score 31.35 with a standard deviation of 5.2 while in cured group the mean MPI score was 17.78 with a standard deviation of 6.3. The p value is highly significant as it was < .0001. Conclusion: MPI is disease specific, easy scoring system for predicting the mortality in patient with peritonitis. Increasing score are associated with poorer prognosis, needs intensive management and hence it should be routinely in clinical practice.
Original Research Article
March 30, 2020
Diabetic Retinopathy & Occurrence of Glaucoma in Patients with Diabetes Mellitus in Patna Medical College Hospital, Patna, Bihar
Dr. Gautam Kumar
Sch J App Med Sci | 1028-1031
DOI : 10.36347/sjams.2020.v08i03.043
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Background: Vision is a means of communication of man with the external world. The impact of visual loss due to various ocular morbidities has profound implications for the person affected and the society as a whole. Diabetes has become one of the world’s most important public health problems & WHO indicate that 19% of world’s diabetic population lives in India. Diabetes related microvascular complications cause visual disability even in younger age group individuals. Aim: To estimate the magnitude of Glaucoma and diabetic retinopathy in diabetic patients in our institution. To create awareness about avoidable blindness in diabetic patients. To enlighten and thereby motivate the patient for further evaluation and follow up. Materials and methods: The study is a hospital- based, non- interventional, cross-sectional study. The ocular disorders are evaluated in 500 consecutive diabetic patients attending ophthalmology outpatient department of Kanyakumari medical college hospital. Estimation of visual acuity, slit lamp examination, intraocular pressure, retinoscopy & fundus examination, visual field analysis, gonioscopy are done to detail the defective vision. Result: analysis Data is analysed using SPSS. The common manifestations are cataract- 346 (69%), diabetic retinopathy- 94 patients (18.8%), glaucoma– 34 (6.8%). Patients with cataract are well managed by cataract extraction techniques. Prime importance is to create awareness and also diagnose the early changes of retinopathy and glaucoma. Treatment of glaucoma if instituted early will go a long way in preventing avoidable blindness Therefore periodic visual screening along with control of hyperglycemia and associated risk factors is needed to ensure good quality of vision.
Shoulder Arthotabes A Rare Cause of Bone Destruction About A Case
M. Tahar, M. Oussama, El. Noufal, S. Sidibé, B. Fawzi
Sch J App Med Sci | 1032-1034
DOI : 10.36347/sjams.2020.v08i03.044
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The current rarity of osteoarticular manifestations of syphilis tends to make people forget certain aspects of the affection and to ignore them. Tabetic arthropathy is due to loss of proprioceptive innervation, causing artificial destruction important circles. Given the difficulty in treating this joint form, prevention based on the management of syphilis at a early stage is essential.
Original Research Article
March 30, 2020
Comparison of Subarachnoid Block with Low Dose Bupivacaine –Fentanyl and Conventional Dose of Bupivacaine for Transurethral Resection of Prostrate
Dr. Felin Paul P, Dr. Mahilamani PP, Dr. Paramasivan A
Sch J App Med Sci | 1035-1039
DOI : 10.36347/sjams.2020.v08i03.045
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Background: Sub Arachnoid block is the anaesthetic technique of choice for Transurethral Resection of Prostrate (TURP) because the complications of the surgery can be detected early as the patient remains awake. But the side effects of sympathetic blockade in elderly are more with the conventional dose of Bupivacaine (7.5mg). We aimed to evaluate the effects of adding 25 mcg of Fentanyl to low dose Bupivacaine in Subarachnoid block for elderly patients undergoing TURP. Methods: 40 elderly patients of ASA 1 to 3 electively scheduled for TURP under lumbar subarachnoid block was enrolled and randomly grouped into group B and group F. Group B received 7.5 mg of 0.5% hyperbaric bupivacaine (1.5ml) and group F received 5mg of 0.5% Bupivacaine with 25 mcg of Fentanyl (total of 1.5ml) intrathecally. Level of peak sensory block, time to attain peak sensory block, maximum motor block,time to two segment regression, time to S2 segment regression, duration of motor block, haemodynamic stability and incidence of complications were compared. Results: The sensory block was adequate in both the groups. There was statistically significant difference in the maximum motor block and duration of motor block between the groups. Maximum motor block and duration of block were less in group F(p<0.001). Hypotension and shivering were more in group B. Addition of 25 mcg Fentanyl with low dose hyperbaric Bupivacaine provides adequate anaesthesia for TURP with better haemodynamic stability, early recovery from motor block and lower incidence of side effects in elderly patients when compared to the conventional dose of hyperbaric Bupivacaine.
Hormonal Effect on Dry Eye in Menopausal Women—A Reveiw Article
Dr. Jyoti Bhuyan, Dr. Bishnu Prasad Das, Dr. Baby Deka
Sch J App Med Sci | 1040-1042
DOI : 10.36347/sjams.2020.v08i03.046
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Various researches have been done to understand dry eye in the recent years, which have included the dry eye state and hormonal effect on dry eye. The term Dry eye syndrome or disease (DES/DED) is a multifactorial ocular surface disease that refers to a condition those results in inadequate lubrication of the ocular surface. DES causes symptoms of ocular pain, discomfort and decreased visual acuity and tears film instability with potential damage to the ocular surface and ultimately affects quality of life of patients. It is more prevalent in females specifically in the menopausal and postmenopausal age group. This is probably due to imbalance of sex hormones. Various studies reported potential role of hormones replacement therapy in menopause associated dry eye. This review article will help to understand the influence of sex hormones in dry eye in menopausal women.
Original Research Article
March 30, 2020
The Efficacy of MRI in Staging of Carcinoma of Uterine Cervix correlation with FIGO Staging
Dr. Shah Muhammad Mustaquim Billah, Dr. Nafisa Jafreen, Dr. Ummay Salma Sharkar
Sch J App Med Sci | 1043-1047
DOI : 10.36347/sjams.2020.v08i03.047
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Cervical cancer is the most common genital malignancy among the women in the developing countries. The current staging system, that is the FIGO clinical staging system, has got some limitation and inconvenience to the patient. Magnetic Resonance Imaging is accepted as a preferred imaging modality to assess the parametrial invasion, tumor size, lymph node metastasis, evaluation of the main prognostic factors and selection of therapeutic strategy. Hence this study was conducted for comparison of FIGO staging with MRI staging for better staging of Carcinoma Cervix, treatment and follow up. Objectives: The present study was aimed to find out the sensitivity, specificity, positive and negative predictive value and accuracy of MRI in staging carcinoma cervix by comparing with the FIGO clinical staging system, which was taken as the reference. Methods: Our study involved 55 patients who were newly diagnosed cases of carcinoma cervix, already staged clinically by the FIGO system and referred to the radiology department for MR imaging of pelvis during the period July 2016 to June 2018. MR imaging of the pelvis and screening of abdomen was done for these patients. Patient was then staged with MRI. Then the predicted stage for each patient with the two methods were compared. The sensitivity, specificity, positive and negative predictive values were obtained. The analysis done by standard Chi square test. Results: In assessing whether the lesion was confined to cervix or extended beyond cervix accuracy was 94.55%. In assessing the parametrial extension MRI had a accuracy of 92.7%. In assessing the bladder mucosal invasion MRI had an accuracy of 96.3%. In assessing the rectal mucosal invasion MRI had accuracy of 96.3%. Clinical staging and MR staging concurred in 85.45% of cases and differed in 14.45% of cases. Conclusion: Magnetic resonance imaging in carcinoma cervix has a good sensitivity, specificity, positive predictive value, negative predictive value and diagnostic ......
Original Research Article
March 30, 2020
Amplification Based Detection of Four Target Genes of Staphylococcus Isolates by Multiplex PCR
Dr. M. Mallika, Dr. L. Prashanthi, Dr. N. Padmapriya, Dr. G. Jyothi Lakshmi
Sch J App Med Sci | 1048-1053
DOI : 10.36347/sjams.2020.v08i03.048
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Background: MRSA infections have become a global health problem. The community acquired MRSA has been increasingly reported. Hence characterization of these strains is important to prevent the spread of infections in hospitals and community. Aim: The present study evaluated the amplification based detection of four target genes of Staphylococcus isolates by multiplex PCR. Method: A total of 100 exudate samples from suspected cases of Orthopaedic infections were collected. Majority of the isolates were Staphylococcus, which were identified and speciated based on cultural characteristics and biochemical reactions and coagulase test. Antibiogram was done by Kirby Bauer disc diffusion and Methicillin resistance by cefoxitin disc diffusion method. Amplification based detection of four target genes of Staphylococcus isolates was done by multiplex PCR. Result: Out of total 100 samples processed. 27 Gram positive cocci were isolated. Out of 27, 23 were Staphylococcus aureus,4 were CONS. Out of all staphylococci isolated (27), 20 Staphylococcus aureus and 1 out of 4 CONS showed methicillin resistance .Multiplex PCR confirmed the results as Genus staphylococcus by the presence of 16SrRNA (100%), species by the presence of femA (95.8%), methicillin resistance by the presence of mecA (87.5%) and community acquired MRSA by the presence of luk PVL (40%).Conclusion: Multiplex PCR assay was found to be rapid and accurate procedure for confirmation of genus, species ,methicillin resistance and community acquired strains. Hence multiplex PCR is considered as Gold standard.
Corona: A Review on Current Clinical Sympathetic
Sarvesh Sharma, Himesh Soni, Jitender K. Malik, Sanjay Khare, Vimal Kumar
Sch J App Med Sci | 1054-1061
DOI : 10.36347/sjams.2020.v08i03.049
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Corona virus (COVID-19) is an enveloped RNA virus that is diversely found in humans and wildlife. A total of six species have been identified to cause disease in humans. They are known to infect the neurological, respiratory, enteric, and hepatic systems. The past few decades have seen endemic outbreaks in the form of Middle East Respiratory Syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome related coronavirus (SARS-CoV). Yet again, we see the emergence of another outbreak due to a new strain called the SARS-CoV-2 virus. The most recent outbreak initially presented as pneumonia of unknown etiology in a cluster of patients in Wuhan, China. The epicenter of infection was linked to seafood and exotic animal wholesale markets in the city. SARS-CoV-2 is highly contagious and has resulted in a rapid pandemic of COVID-19. As the number of cases continues to rise, it is clear that these viruses pose a threat to public health. This review will introduce a general overview of coronavirus and describe the clinical features, evaluation, and treatment of COVID-19 patients. It will also provide a means to raise awareness among primary and secondary healthcare providers during the current pandemic. Furthermore, our review focuses on the most up-to-date clinical information for the effective management, prevention, and counseling of patients worldwide. In December 2019, several patients from Wuhan, China were admitted with symptoms of pneumonia. As the number of patients presenting with similar symptoms started to rise, the causative agent was eventually isolated from samples. It was initially called the 2019 novel coronavirus (2019-nCoV) and has been recently relabelled as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the disease it causes has been named coronavirus disease 2019 (COVID-19). Over the next few weeks, the virus spread from Wuhan to affect different provinces in China and, after a few months, it is now present in 109 countries......
Immune Thrombocytopenic Purpura in Children - A Review
Ponnumony John Solomon, Alen Chidambaram Priya Margaret
Sch J App Med Sci | 1062-1066
DOI : 10.36347/sjams.2020.v08i03.050
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Immune Thrombocytopenic Purpura is one of the most common bleeding disorders of childhood. It presents with petechiae and bruising in a well looking child. It is caused by immune mediated destruction of platelets. Nowadays many centres in the world do not do bone marrow examination for diagnosis in typical cases of immune thrombocytopenic purpura. Majority of them get cured within 12 months, but about 20% of the cases continue to bruise/bleed on and off beyond 1year also. Most children with ITP do not need treatment, but sometimes there will be need to treat because of the risk of life threatening bleeding. Steroids, IVIg, and Anti-D (Rho) immunoglobulin are standard first line treatments depending upon the situation. When the platelet count is very low there is a risk of intracranial bleed, and hence appropriate treatment should be given in such cases. The terminology and treatment protocols have changed since the time of its first report. Hence it is better to go for a review in this topic.
