International Journal of Medical Research & Review (IJMRR)
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Haematological toxicity in cancer cervix patients treated with concurrent chemoradiation by conventional technique- correlation with bone marrow radiation dose
Get PDFIntroduction: The standard of care for treatment of cancer cervix is concurrent chemoradiation followed by brachytherapy in the majority of cases. Conventional radiotherapy with chemotherapy causes haematological toxicities which may be related to radiation to pelvic bone marrow. The present study aims to study the haematological toxicities and correlate with the mean dose to the bone marrow.
Material and Methods: Retrospective data of cancer patients treated in the institute in the year 2019 was retrieved. Haematological toxicities were analyzed in terms of CTCAE criteria. Mean dose to bone marrow was calculated after the delineation in the CT scan. The correlation between haematological toxicity and mean bone marrow was done using a paired t-test for statistical significance.
Results: The data of 20 patients were retrieved. Anaemia Grade, I and Grade II-IV was seen in 65% and 35% respectively. Leukopenia Grade I and Grade II-IV were seen in 85% and 15% respectively and Lymphopenia Grade I and Grade II-Iv were seen in 55% and 45% respectively. The mean dose to bone marrow did not show any statistical significance with the severity of haematological toxicity. There was no Grade II-IV toxicity of neutropenia and thrombocytopenia.
Conclusion: Conventional radiotherapy can safely be practice for patients with cancer cervix with acceptable haematological toxicities
Posterior segment intraocular foreign body with secondary retinal detachment in a phakic eye: a case report
Get PDFIntraocular foreign bodies (IOFBs) are an important cause of visual loss. The current case describes a case of retained intraocular foreign body with secondary retinal detachment in a phakic eye in a 38-year-old man. The foreign body was safely removed through the sclerotomy port without touching the crystalline lens. The current case report wanted to show the anatomic and visual outcomes of vitreoretinal surgery in such cases
A Study on the correlation between platelet indices and severity score in acute ischemic stroke
Get PDFBackground: Acute ischemic stroke results from the sudden loss of blood circulation to an area of cerebral hemispheres leading to irreversible brain injury and neurological deficits persisting for more than 24 hours or until death. It accounts for 80-87% of all strokes. The present study aimed to find the association between various hematological indices such as Mean platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet to Lymphocyte ratio (PLR), and National Institute of Health Stroke Scale (NIHSS).
Methods: It was a prospective study done at the Department of Medicine at Great Eastern Medical School and Hospital in which 80 patients with Acute Ischemic stroke were divided into two groups basing on the NIHSS score. Proper Exclusion criteria were carried out and the patients\u27 blood samples were taken. Various Platelet and hematological indices were measured and statistical analysis was done using SPSS Software.
Results: There is a positive correlation between PLR and NIHSS scores. It is a statistically significant association. But there is no statistical significance between Platelet indices and NIHSS score.
Conclusion: Being Low cost and easy to measure the nature of PLR, these indices can be used in the prediction of the prognosis in Acute Ischemic Stroke Patients
A descriptive study on the hypertensive crisis in Visakhapatnam, Andhra Pradesh, India
Get PDFObjective: The objective of the present study, A Descriptive study on Hypertensive Crisis in Visakhapatnam, India was to evaluate the modes of presentations, clinical profile, and spectrum of target organ damage in patients with hypertensive emergencies.
Material and Methods: The study population included patients admitted in this hospital with severely elevated blood pressure with clinical or laboratory evidence of acute target organ damage.
Result: The clinical and laboratory profile of 50 of these patients were evaluated. Males had higher chances of developing a hypertensive emergency compared to females. The commonest presenting symptoms were chest pain, dyspnoea, and neurological deficit. The majority of the patients have known hypertensives. Higher levels of blood pressure at presentation were associated with an adverse outcome. Acute LVF was the commonest target organ damage observed. In-hospital mortality of 14% was observed in the present study.
Conclusion: Known hypertensives are at a higher risk of presenting with acute target organ damage associated with chest pain. Acute LVF is the commonest form of target organ damage encountered in the present study
Spectrum of MRI abnormalities in pediatric seizures
Get PDFBackground: Seizure is a pediatric emergency. Accurate determination of the etiology of seizures is very important to start an effective treatment. The study aims to determine the spectrum of Imaging abnormalities by Magnetic Imaging Resonance (MRI) in children who presented with seizures.
Methods: It is a hospital-based prospective observational study which was carried out in Government Medical College and Rajindra Hospital, Patiala. This study included 50 pediatric patients in the age group between 0 months to 18 years who were referred to the Department of Radiodiagnosis for brain MRI between October 2017 to September 2019.
Results: Neuroimaging abnormality was found in 19 (38%) cases. 31 (62%) patients had no abnormal finding. The most common imaging findings were inflammatory granuloma in 5 (10%) patients. Other findings were- Hypoxic-ischemic injury (HII) in 4 (8%), Mesial temporal sclerosis in 2(4%), cerebral atrophy in 1(2%), Hemorrhage in 1(2%), Tuberous sclerosis in 1(2%), Focal cortical dysplasia in 1(2%), Lissencephaly in 1 (2%), Joubert syndrome in 1(2%), and Arachnoid cyst in 1 (2%) patients.
Conclusion: The MRI was able to identify brain lesions in 38% of pediatric patients who presented with seizures. The study revealed inflammatory granuloma as the commonest cause of seizures in children, followed by Hypoxic-Ischemic Injury. Early recognition of potentially treatable diseases helps in timely treatment and arrest of disease progression. It is recommended to use MRI as a primary investigation during the evaluation and management of pediatric seizures
Application of Thyroid Peroxidase (TPO) and Hector Battifora Mesothelial-1 (HBME-1) immunohistochemical markers in the diagnosis of papillary thyroid carcinoma of the thyroid
Get PDFBackground: Thyroid cancer is the most common endocrine malignancy accounting for >90% of malignancies of endocrine glands. The inter and intraobserver variation in the histomorphological diagnosis of Papillary Thyroid Carcinomas may sometimes pose a diagnostic difficulty. Application of IHC biomarkers may play an active or complementary role in their accurate classification.
Aim: The present study was conducted to evaluate if HBME-1 and TPO immunohistochemical analysis can reliably differentiate papillary carcinomas from other thyroid lesions.
Material and Methods: 50 cases of benign and malignant thyroid lesions were taken. Immunohistochemical staining for HBME-1 and TPO was performed. HBME-1 and TPO score was interpreted as absent and positive. Medical records were retrieved and their clinical data, surgical treatment, and pathological findings were noted.
Results: Out of 50 cases, 19 (73.1%) cases were diagnosed PTC, 4 (15.4%) cases were FTC, 3(11.5%) cases were of MTC and 24 cases of benign thyroid lesions. TPO expression was found positive in 91.7% of cases of Benign thyroid lesions. In malignant thyroid lesions, negative expression of TPO was seen in 63.16%, 0% and 33.33% of PTC, FCT, and MCT respectively. HBME-1 showed negative expression in 83.3% of cases of benign thyroid lesions. Whereas, in malignant thyroid lesion HBME-1 expression was positive in 78.95%, 50% and 0% cases of PTC, FCT, and MCT respectively.
Conclusion: Testing for expression of HBME-1 has been shown to improve the diagnostic accuracy for thyroid malignant nodules. The combination of HBME-1, and TPO may contribute to an accurate diagnosis of papillary thyroid carcinoma
A meta-analytic comparison of 8 methods of closed anterior shoulder dislocation reduction
Get PDFBackground: Anterior shoulder dislocation is a common injury, accounting for 95% of all shoulder injuries. However, many doctors and hospitals do not have a fixed protocol for the treatment of dislocations. The current study have compared 8 different techniques for shoulder dislocation reduction in this study.
Methods: Eight different methods namely the Scapular Manipulation, Matsen’s Traction-Countertraction, Kocher’s, Spaso, External Rotation, Cunningham, Modified Milch, and the FARES methods were compared on the basis of efficacy, pain experienced during reduction (VAS score), and time taken for reduction.
Results: The Matsen’s Traction-Countertraction method had the highest efficacy, while the Scapular Manipulation method had the least VAS scoring. The FARES Method had the fastest reduction time on average. Interpretation and
Conclusions: As per the data analyzed, the FARES and Scapular Manipulation method appear to be the most effective in reducing anterior dislocations, having consistently high success rates, and low VAS scores and reduction times. These 2 methods may be recommended to new practitioners to treat acute shoulder dislocations
A study of the role of MRI and arthroscopy in the management of knee joint lesions
Get PDFObjectives: Aim of this study is to evaluate the types and incidence of injuries in internal derangement of the knee joint by MRI and to compare with arthroscopy findings in selected cases and to assess whether MRI can be used as a primary diagnostic tool for internal derangement of the knee joint.
Material and Method: This prospective study was done in the Department of Radiodiagnosis Chirayu Medical College and Hospital Bhopal, Madhya Pradesh, India. A total of 100 patients who were referred to the department with strong clinical suspicion of internal derangements of knee joint, underwent magnetic resonance imaging evaluation of knee followed by arthroscopy in selected cases, wherever indicated from August 2014 to July 2019.
Results: Majority of patients in the current study group belonged to the age group 20-29 years (31%) with a mean age of 24.3 years. In this study, the majority of patients were males constituting 76 % of cases. The most common clinical presentation was that of pain in knee joint seen in 79% of cases. The second most common presentation was swelling seen in 54%. The most common positive clinical test was McMurray’s test for meniscal tear seen positive in 48% of cases. In the current study left knee involvement was more common than right knee, constituting 54%. Medial meniscal tears were more common than lateral meniscal tears 49 (73.2%).
Conclusion: MRI is a useful non-invasive modality having high sensitivity, specificity and accuracy in the diagnosis of meniscal and cruciate ligament injuries. MRI should be done in every patient of suspected internal derangement of the knee joint, to save a patient from unnecessary arthroscop
A study to find the characteristic imaging findings of various ring-enhancing lesions using MR imaging
Get PDFIntroduction: Multiple ring-enhancing lesions are one of the most commonly encountered neuroimaging abnormalities. A study was conducted to find the characteristic imaging findings of various ring-enhancing lesions on MRI.
Materials and methods: It was a prospective study conducted in the department of radiodiagnosis, GSL Medical College. All age groups of both gender with cerebral ring-enhancing lesions detected in contrast MR studies were taken up for spectroscopy. Patients with a history of claustrophobia and individuals with metallic implants insertion, cardiac pacemakers, and metallic foreign body in situ were excluded. The MRI scan was performed MRI PHILIPS ACHIEVA HDxt 1.5 T, the active shielded superconducting magnet of 1.5telsa magnetic field using SENSE coils for the acquisition of images.
Results: Out of 30 study participants, under <45 years category tuberculoma was the common (37%) lesion whereas in >45 years category metastases was common (15%), 44% were female and 56% were males. Depicts T1 signal intensity showed hypointense signal intensity on T1W sequence in 65 (95.5%) cases. Only 4.6% of cases showed isointense signal intensity on T1W image. T2 signal intensity in 73.5% of cases showed hyperintense signal intensity.
Conclusions: MRI is an excellent, non-ionizing imaging modality with multiplanar imaging capabilities for excellent grey-white matter differentiatio
Impact of examination stress on response time in first-year medical students
Get PDFBackground: Stress has been seen to deteriorate normal physiological functions as well as the psychological functions of the brain. Medical students face a range of enduring normative stressors in the form of academic demands. This brings upon an amount of stress on the students which is related to the examinations and concerns with achieving high grades consequently referred to as academic-related stress. Thus, it becomes crucial to set upon a tool for measuring this stress in order to present methods for overcoming it. In the present study, one such method is evaluated by assessing the reaction time of first-year medical entrants.
Material and Methods: The effect of stress on response time in 50 normal healthy medical students of Sawai Man Singh Medical College, Jaipur in the age group of 18 to 21 years was explored in the study. Visual Reaction Time was recorded through the computer program.
Results: There was an increase in visual reaction time for the red color in both the sexes during stressful situations as compared to stress-free situations. While a decrease in Visual Reaction Time was seen for green color. A decreased auditory reaction time for both sexes was seen in stressful situations.
Conclusion: The results revealed that stress within a limit facilitates positive feedback to Central Nervous System information processing consequently decreasing the reaction time