International Journal of Medical Research & Review (IJMRR)
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Aggressive nasopalatine duct cyst with nasal involvement
Get PDFNasopalatine duct cyst is a non-odontogenicdevelopmental cyst typically located in the maxillary midline between the tooth roots of central incisors, these cysts are infrequent and can often be misdiagnosed as periapical lesion or cyst. In this article, we present a case of which was clinically and radiographicallyprovisionally diagnosed as nasopalatine duct cyst in a 62 year old male patient with complaint of swelling in midline of palate. The lesion was surgically removed, and histopathologically confirmed the provisional diagnosis, thus concluding that it can be a diagnostic dilemma in clinical and radiological examinations
Cancer- A disease we should care about
Get PDFCancer is primarily an illness of aging. It is being postulated that the Cancer cells use stop inhibitors to cover the body destructive mechanisms and seem to be healthy cells before such destructive mechanisms to flee destruction. Researchers have created artificial promoters that contain DNA sequences which initiate organic phenomenon solely in cancerous cells. A few individuals inherit faulty genes from their ancestors that place them at a higher risk of developing diseases like cancer
Psychological manifestations in post myocardial infraction patients
Get PDFBackground: In the past few years a very important observation that came to light is the increase in prevalence of some psychiatric disorder in chronically ill patients. Symptoms of depression and anxiety are common following myocardial infarction (MI). Both the symptoms have been linked with increased risk of recurrent coronary artery disease (CAD), Severe psychological stress, major life events, and depression causes myocardial infarction (MI) in 15% of case of Coronary Artery Disease (CAD) and are associated with higher rates of morbidity and mortality.
Objective: (1) To establish the diagnosis of myocardial infarction in patients. (2) To study and correlate various psychological manifestations in these patients.
Methodology: The patients for the present study were taken up from those admitted in ICCU and OPD of department of Medicine G.M.C, Ambikapur, during the study period. 50 patients were studied having CAD (Myocardial infarction). The patients were history taken in detailed & examined (Physical and Psychiatric), investigated with reference to ECG proven myocardial infarction or cardiac enzymes proven MI.
Results: We have found 46% of prevalence rate of depression in our study. Majority of patients (20%) have mild depression (score 10-13) on (HAD-Scale), 12% have major depression, 42% had Anxiety. Majority of patients 26% have mild anxiety. Only 6% have severe anxiety (score > 30) in our study.
Conclusion: Personality feature of CAD patients are associated with emotional as sympathetic arousal which result in increases in catecholamine as consequent increase in mobilization of free fatty acid from adipose tissue, aggregation of platelets which may precipitate MI. So, a thorough research, prevention and rehabilitation of psychologically oriented care can increase the patients sense of security and is fundamental basis of successful medical care
Extrapulmonary tuberculosis in surgical aspect- expanded challenging disease spectrum
Get PDFIntroduction: This study was designed to analyse wide spectrum magnitude of extra pulmonary tuberculosis in surgical aspect with its clinico-patho-radiological profile and treatment modalities.
Material and Methods: The study was conducted in postgraduate Department of Surgery in collaboration with Department of Chest and Tuberculosis,Pathology and Radio diagnosis of Rohilkhand Medical College and Hospital Bareilly, Uttar Pradesh, India, after formal approval from institutional ethics committee. This study is of prospective study, in duration of January 2015 to April2018.
Inclusion criteria: All suspected cases of extra pulmonary tuberculosis (EPTB).
Exclusion Criteria: (1) HIV patients (2) Patients with pulmonary tuberculosis.
Result: A total of 59 patients with suspected EPTB were included, investigated and treated with or without surgical intervention followed by standard ATT regimes. Pathological / Microbiological: FNAC, Histopathology, AFB insputum &CBNAAT, BACTEC 460, ADA.
Radiological: X–Ray chest, X-ray abdomen.Ultra-Sonography (USG), Contrast Enhanced Computer Tomography (CECT). Patients admitted in emergency department and attending surgical out patient department were investigated and treated as per protocol. In our study 39 patients out of 59 underwent different surgical procedure and followed by antitubercular treatment regime. 20 Non-operated patients treated medically with antitubercular treatment regime [ATT].
Conclusion: EPTB has same national health issue as pulmonary tuberculosis. For tuberculosis control, EPTB-A challenging disease should be early diagnosed and surgically and medically treated to decrease related morbidity and mortality
Ultrasonographic analysis of the anatomical relationship between femoral vessels in the upper part of thigh in critically ill patients– a cross sectional study
Get PDFObjective: Femoral vessels are one of the frequently used sites of cannulation in intensive care units. In resource limited settings cannulations are done blindly without ultrasonographic guidance based on a traditional belief that in the upper thigh vein keeps a medial relationship to artery. In this trial we tried to analyse the anatomical relationship of femoral vein to femoral artery using ultrasound in critically ill patients.
Methods: This cross sectional study analysed the anatomical relationship of femoral vein to femoral artery at 2cm, 4 cm and 6 cm from the mid inguinal point in both thighs of the patients using ultrasonography. The study was done among patients admitted in a multidisciplinary intensive care unit.
Results: Three hundred limbs of one hundred and fifty patients were analysed by ultrasonography. A total of 900 measurements were taken at three different levels of both legs. At 2 cm below the mid inguinal point, in 256 limbs (85.3%) femoral vein was medial to femoral artery (95% Confidence Interval82.82% to 89.14%), at 4 cm below the mid inguinal point, in 210 limbs (70%) femoral vein was postero medial to femoral artery (95% CI64.47% to 75.13%),and at6 cm below the mid inguinal point in 200 limbs(66.7%)femoral vein was posterior to femoral artery(95% CI 61.02% to 71.98%).
Conclusion: Femoral vein showed variable relationship to femoral artery in the upper part of the thigh. As the distance increased from mid inguinal point, variation from normal relationship was also found to be increasing
Commissioning of two different algorithms for stereotactic Radiosurgery M6 FI+ CyberKnife system
Get PDFIntroduction: Cyber Knife M6 FI+ a very precise robotic stereotactic radiosurgery system which is capable of delivering very high radiation dose to the tumour while minimizing radiation exposure to normal organs and tissues. MultiPlan treatment planning system is used with the CyberKnife unit and the algorithms used for optimization are Ray-Tracing and Monte Carlo. Our CyberKnife M6 FI+ system commissioning is done as per the vendor recommendation and meeting the local regulatory guidelines.
Materials and Methods: Clinical beam data measurement is carried out using Radiation Field Analyzer, Diode E, Pinpoint chamber, Semiflex ionization chamber and Unidose E Electrometer. FC-65 ionization chamber used in absolute dose calibration. The mechanical accuracy of the robot and image stability was verified using Radiochromic film (EBT3), E2E and Iris QA toolkits along with software. StereoPHAN is used for the patient-specific QA point dose measurement.
Results: Tissue phantom ratio, Off-centre ratio, Output factor, Percentage depth dose, open beam profile and absolute dose calibration are done as per the protocols. E2E performed for two different modes- static and motion. Iris aperture size measured for all the field sizes. The patient-specific QA delivered for both algorithms.
Discussion: Clinical beam data measurements are within ±1% of composite data set, overall standard deviation for Output Factors of the fixed and Iris collimators are 0.0026 and 0.0063. The absolute dose was calibrated to 1cGy per MU. E2E, Iris QA and Laser and radiation coincidence values are within the tolerance. Patient-specific QA point dose measurement variation for Ray-Tracing and Monte Carlo is 3% and 2%.
Conclusion: These exercises are mandatory to achieve the accurate, precise and high quality of treatment which also includes patient safety
A study to evaluate HbA1C as an independent diagnostic criterion comparing to fasting plasma glucose and postprandial glucose levels as a standard test for diagnosis of diabetes
Get PDFAims and objectives: 1) To compare and correlate glycosylated haemoglobin (HbA1C) as an independent criteria in diagnosis. 2) To define the sensitivity and specificity of HbA1C estimates at the ADA recommended cut off of ≥ 6.5%.
Study design and methods: Subjects were first tested for Fasting plasma glucose and two-hours post 75 grams glucose challenge, HbA1c was estimated for the all the subjects.
Results: The sensitivity and specificity of HbA1C at the ADA recommended ≥ 6.5% cut off value in newly detected diabetic patients was 96.70% and 82.92%respectively with a positive predicted value of 56.05% and a negative predictive value of99.11 % .75.00 % at a p<0.001.We find that we miss 42% of people with diabetes if fasting plasma glucose levels are considered. Given the risks associated with PPG levels in our population it is important that these criteria be used in screening programmes.
Conclusion: Our study shows that HbA1C is comparable to FPG levels estimation but is not superior enough to replace blood glucose estimation. Use of post prandial glucose levels are better in detecting diabetes than fasting plasma glucose levels. A combination of post prandial glucose with HbA1C may be a superior single test that can overcome the cumbersome oral glucose tolerance test
Incidence of Helicobacter Pylori in upper gastrointestinal lesion
Get PDFIntroduction: Helicobacter pylori are gram-negative bacillus. It is noninvasive and live in gastric mucus, with the small proportion of bacteria adherent to the mucosa. Its spiral shape and flagella render Helicobacter pylori motile in mucus environment. Helicobacter pylori is an important pathogen in human causing chronic gastritis and playing a major role in the development of peptic ulcers and gastric cancer.
Material and Methods: Study was conducted in Mahatma Gandhi Medical College and hospital, Jaipur (from Jan 2014 to March 2015). 57 Gastrointestinal biopsies were taken who have symptom of dyspepsia. All biopsies taken from different sites were brought in 10%buffered formalin. After overnight fixation in formalin, the tissues were processed in automated tissue processor for dehydration, clearing, and paraffin embedding. Section were cut in rotary microtome at 4 micrometer thickness. The section was stained for Hematoxylin and Eosin stain and Geimsa overnight stain.
Result: The present studyincluded 57 cases of upperGIT biopsies (gastro esophageal duodenal biopsies). The incidence of Helicobacter Pylori was seen with chronic gastritis in our study.
Conclusion: H.pyloriareetiologically associated with chronic active gas triti s, duodenal ulcer, gastric ulcer, primarygastric B-cell lymphoma or mucosalassociated lymphoid type lymphoma (MALT lymphoma) and gastric adenocarcinoma. Helicobacter pylori induced chronic gas trit is were encountered in 16(47.22%) casesofthe presentstudy. Overnight Giemsa stain was done on all the patients and a histopathological diagnosis was made along with the study of the incidence of Helicobacterpylori positivity in all these patients
Detection and quantification of liver fat with MRIT1 dixon sequence in patients with hepatic steatosis and it’s comparison with USG
Get PDFIntroduction: Hepatic steatosis also known as fatty liver is due to abnormal and excessive accumulation of lipids with in hepatocytes. It is the most common chronic disease of liver. Magnetic resonance techniques can detect fatty liver more accurately than ultrasonography and become primary modalityto assess hepatic steatosis both quantitatively and qualitatively.
Aims: The aims of this study were detection and quantification of liver fat by MR technique in patients of hepatic steatosis. Comparison of USG and MRI in detection and quantification of liver fat.
Material and Methods: This cross-sectional study was carried out on 50 patients in Department of Radiodiagnosis, Government Medical College, Rajindra Hospital, Patiala in whom risk factors for hepatic steatosis were present. Considering T1 Dixon MRI of liver as reference its comparison with USG was done in these patients for detection of hepatic steatosis and quantification of liver fat.
Results: USG had sensitivity 73.68%, specificity 66.67%, positive predictive value 87.50% and negative predictive value 44.44% as compared to MRI T1 Dixon sequence for detection of fatty liver. When grading of fatty liver on USG was compared with percentage quantification of liver fat on MRI T1 Dixon sequence of liver, there was considerable overlapping of fat percentage in each grade.
Conclusion: Advantages of MRI as compared to USG is its more sensitivity and specificity for detection of hepatic steatosis, early detection of hepatc steatosis, quantify liver fat, objective and not observer dependent
Use of cutaneous silent period parameters as a diagnostic indicator in patients with restless legs syndrome-a study in south Indian population
Get PDFObjective: The objectives of this study were to investigate cutaneous-silent- period (CSP) parameters- CSP latency and CSP duration in patients with ‘Restless legs Syndrome’ and compare it with that of normal healthy controls.
Methods: Thirty patients diagnosed with restless legs syndrome were included in this study. The cutaneous silent period was evoked by electrical stimulation of sural nerve whereby both CSP parameters CSP latency and CSP duration were recorded and analyzed.
Results: The mean latencies of CSP among the thirty RLS patients were 101.95±12.12 while the control group showed 96.23± 9.16. There is a statistically significant high average latency in RLS patients (101.95± 12.12) than control group (96.23± 9.16) with p value=0.044. This study also showed the average CSP duration to be high in RLS patients (42.25± 11.12), when compared to the control group – 36.75± 8.35 (p value=0.035).
Conclusion: While RLS is a common sensorimotor disorder, the diagnosis of RLS is purely clinical and there are no objective tests for the diagnosis. Unfortunately, the awareness is poor among the lay population, general practitioners and even specialists in the Indian subcontinent. The authors feel that the CSP test can be used as an objective method supporting the diagnosis of RLS. Furthermore, we believe that this paper will help create awareness in addition to encouraging more research in this arena from medical personnel in India