International Journal of Medical Research & Review (IJMRR)
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Clinico-Histopathological Correlation of Non-NeoplasticDermatological Lesions
Full text linkObjective: Non-neoplastic skin disorders are more common than neoplastic skin disorders whichhave included Infectious diseases, non-infectious erythematous lesions, papular & squamousdisorders, connective tissue diseases, non-infectious vesiculobullous / Vesiculopustular disorderse.tc. The pattern of skin diseases varies from one country to another and across different parts ofthe same country. So due to the variable spectrum, the histopathology of skin diseases is varied.Each clinical presentation is common to different histopathological pictures & thus definitely requireshistopathology for confirmation.
Design: This study was conducted by Dr D. Y. Patil Medical Collegeand Hospital, Navi Mumbai from October 2018 to October 2020. Subjects: One hundred and fiftynon-neoplastic specimens of skin biopsies submitted in the histopathology; Department of Pathologywere considered as the subjects of the study.
Material and Methods: Histopathological resultswere presented in tabular and graphical forms. Mean, median, standard deviation and ranges werecalculated for quantitative data. The Chi-square test and t-test with p<0.001 was consideredsignificant.
Results: The mean age of our study participants was 41.9 years with a standarddeviation of 36.5 years. The majority of our study participants were females: 29.4 % of patientspresented with infectious lesions, 22.7 % of patients presented with papulosquamous lesions, and12.7 % of patients presented with vesiculobullous lesions. The most common infectious non-neoplastic skin lesion was leprosy, the most common papulosquamous skin lesion was dermatitis,and the commonest vesiculobullous skin lesion was Pemphigus Vulgaris.
Conclusion: An integratedapproach by dermatologists and pathologists is recommended to increase the accuracy of diagnosisand for better management of the patien
The Knowledge and Attitude Regarding Hazards of Tobacco Chewing among People of Early Adulthood at Selected area, Jaipur
Full text linkIntroduction: Healthy habits are a vital role to survive for long period even, such as eating well,avoiding harmful substances, exercising and yoga etc. Second-hand smoke (SHS) has two maincomponents, sidestream and mainstream smoke. Non-smokers can get affected by breathing incigarette smoke at home and in other areas outside home..
Material and methods: It isdescriptive non-experimental study carried out among the mothers of under-five children atSPMCHI, Jaipur city (Rajasthan). Study was conducted in year 2020 and 60 mothers under-fivechildren were selected by using purposive non-probability sampling method. A pilot study wasperformed on 10 mothers of under-five children to test reliability and feasibility of study. Reliabilityof knowledge tool was conducted through Kuder and Richardson Formula 20 (KR20) result was 0.72and reliability of 5 point rating scale was analyzed by using the Cronbach alfa method it was 0.89.
Results: Level of knowledge mothers of under-five children, which 60% (36) had poor knowledge,25% (15) had average knowledge and 15% (9) had good knowledge regarding impact of passivesmoking. Level of attitude of mothers under-five children, that 20% (12) had an unfavourableattitude, 67% (40) had neutral attitude, and 13% (8) had favourable attitude. It evidenced that forcorrelation between knowledge and attitude calculated value of Karl Pearson’s correlation coefficientis 0.11 and tabulated value of correlation coefficient is 0.250 for df 58 at 0.05 level ofsignificance.
Conclusion: Present study reveals most of socio-demographic variables indicate asignificant association with level of knowledge regarding impact of passive smoking among mothersof under-five children except age and smoking habit of family member
A Multi-centre Study to Evaluate the Long-Term Efficacy and Safety of Biosimilar Infliximab (Infimab™) in Ankylosing Spondylitis in Real-world Clinical Settings - A perspective from Eastern India
Full text linkIntroduction: Owing to dearth of data on infliximab biosimilars in Indian patients, a pan-India case database-based study with infliximab biosimilar BOW015 (Infimab™) was carried out to capture its efficacy and safety in real world clinical settings in India. Here, we assessed its efficacy and safety in ankylosing spondylitis (AS) among patients in the East India cohort.
Materials and methods: Data were collected from multiple centers across the eastern region of India. Patients diagnosed with AS, within the preceding 4-6 months during the preceding one year were included in the study. Patients who were given BOW015 for other indications, prior innovator infliximab or other biologics were excluded from the study. Primary variable was Ankylosing Spondylitis Disease Activity Scale (ASDAS) response defined as change of > 2 in the ASDAS score from the baseline by 4-6 months of follow up.
Results: The cohort consisted of 149 patients, predominantly male (69.8%), with mean (±SD) age of 36.75 (±11.11) years and mean (±SD) body weight of 58.26 (±15.4) kgs. Of the treated patients, 91 (61.1%) patients were administered four doses, 10 (6.7%) patients were administered three doses, 37 (24.8%) patients were administered two doses and 11 (7.4%) patients were administered only a single dose of BOW015. In the final analysis set, 81 patients had data at baseline and 4th visit. Among the 81 patients, 74 (91%) patients achieved major improvement, 5 (6%) patients achieved clinically important improvement and 2 (3%) were non-responders at 4th visit. Secondarily, cross categorization of the cohort into disease activity categories by number of infusions administered from baseline to 4th visit and assessment of trends in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were also carried out and these too confirmed the efficacy of BOW015.
Conclusion: Infimab™ (BOW015) showed significant improvement in ASDAS and BASDAI in patients with AS at the end of 4-6 months of follow up with its clinical benefits being apparent as early as first dose of BOW015
A Study to Assess the Knowledge and attitude regarding impact Of Passive Smoking among Mothers of Under Five Children Attending Immunization Clinic at Selected Hospital of Jaipur (Raj)
Full text linkIntroduction: Healthy habits are a vital role to survive for long period even, such as eating well,avoiding harmful substances, exercising and yoga etc. Second-hand smoke (SHS) has two maincomponents, sidestream and mainstream smoke. Non-smokers can get affected by breathing incigarette smoke at home and in other areas outside home..
Material and methods: It isdescriptive non-experimental study carried out among the mothers of under-five children atSPMCHI, Jaipur city (Rajasthan). Study was conducted in year 2020 and 60 mothers under-fivechildren were selected by using purposive non-probability sampling method. A pilot study wasperformed on 10 mothers of under-five children to test reliability and feasibility of study. Reliabilityof knowledge tool was conducted through Kuder and Richardson Formula 20 (KR20) result was 0.72and reliability of 5 point rating scale was analyzed by using the Cronbach alfa method it was 0.89.
Results: Level of knowledge mothers of under-five children, which 60% (36) had poor knowledge,25% (15) had average knowledge and 15% (9) had good knowledge regarding impact of passivesmoking. Level of attitude of mothers under-five children, that 20% (12) had an unfavourableattitude, 67% (40) had neutral attitude, and 13% (8) had favourable attitude. It evidenced that forcorrelation between knowledge and attitude calculated value of Karl Pearson’s correlation coefficientis 0.11 and tabulated value of correlation coefficient is 0.250 for df 58 at 0.05 level ofsignificance.
Conclusion: Present study reveals most of socio-demographic variables indicate asignificant association with level of knowledge regarding impact of passive smoking among mothersof under-five children except age and smoking habit of family member
New Onset of Diabetes in Adults with Post-Covid Infection in a TertiaryCare Hospital
Full text linkAim/Scope: This study is aimed to investigate the incidence of diabetes after infection with thecoronavirus (COVID-19). SARS COV2 is a rapidly spreading disease which causes morbidity andmortality. One of the most important complications associated with covid 19 is Diabetes Mellitus.
Materials & Methods: This was a retrospective descriptive study of (50 diabetic and 50 non-diabetic) patients who had a previous history of covid-19 and who are infected during the secondwave (Aug’21-Oct’21) at a tertiary care hospital, Hyderabad, India. Data collected including patientdemographic and baseline characteristics like patient’s age, sex and history of covid infection wereanalyzed using Statistical Package for Social Sciences (SPSS) software version 22.0.
Results: In thestudy among covid infected(n=50) subjects who were tested diabetic after Long Covid, 28(56%)were hospitalized, 13(26%) were found to have ICU admissions and 9(18%) were discharged withmild covid symptoms and the subjects(n=50) who didn’t have any symptoms of diabetes after LongCovid, majority 32(64%) were found to be discharged with mild covid symptoms, 5(10%) werefound to have ICU admissions and 13 (26%)were found to be hospitalized with the critical covidcondition. It was observed that patients hospitalized with critical covid conditions were susceptible toonset of diabetes (p-value: 0.10)
Conclusion: This study showed a high incidence of complicationsin patients infected with COVID-19 with diabetes being the most common one. Patients with poorglycemic control should be routinely monitored and treated appropriatel
Effect of Garbh Sanskar (Yoga) on Maternal and Perinatal Outcome
Full text linkAims and Objectives: ‘Garbh’ implies embryo in the womb and ‘Sanskar’ implies instructing thepsyche. The objective of this prospective interventional study was to assess the effects of Garbhsanskar on maternal and fetal outcomes.
Material and Methods: A total of 200 antenatal motherswere selected at Aarogya Hospital, Vaishali, Ghaziabad and Chitra Vihar, Delhi, and asked to attendthree sessions of Garbh sanskar for one 1year (Jan 2019 to Jan 2020). Information booklet andstructured questionnaires were provided to assess their performance and feedback during thisperiod.
Result: Analysis of maternal and fetal outcome showed that out of 200 females, 20% hadLSCS, 6% had an instrumental vaginal delivery and 74% had a normal vaginal delivery. Only 7%developed some medical complications like PIH, GDM etc. Mean stress score decreased from 38 to12(by 46.4%) while mean anxiety score decreased from 40 to 8(by 64%) after Garbh Sanskar. Only16% of babies were LBW (< 2.5 kg), 88% had Apgar >7 and 6% of neonates required NICUadmission.
Conclusion: Garbh Sanskar is highly effective in reducing maternal stress, anxiety,medical co-morbidities and incidence of operative deliveries and gives better neonatal outcomes interms of better growth, birth weight and Apgar, hence its practice must be encourage
Set up errors in Brain tumours – A retrospective study to review the current practice of PTV margins in the institution
Full text linkSet up errors in Brain tumours – A retrospective study to review the current practice of PTV margins in the institution
Chaturvedi D.1 , Mehta A.2 , Kumar P.3*
1 Diksha Chaturvedi, Junior Resident, Department of Radiation Oncology, Shri Ram Murti Institute of Medical Sciences, Bareilly, Uttar Pradesh, India.
2 Ankita Mehta, Senior Resident, Department of Radiation Oncology, Shri Ram Murti Institute of Medical Sciences, Bareilly, Uttar Pradesh, India.
3* Piyush Kumar, Professor and Head, Department of Radiation Oncology, Shri Ram Murti Institute of Medical Sciences, Bareilly, Uttar Pradesh, India.
Corresponding Author: Dr. Piyush Kumar, Professor and Head, Department of Radiation Oncology, all authors are affiliated to Shri Ram Murti Institute of Medical Sciences, Bareilly, Uttar Pradesh, India, E-mail: [email protected]
Abstract
Background
Radiotherapy in brain tumors needs accuracy and reproducibility of the patient’s position. There may be set up errors which are taken care by adding planning target volume (PTV) margin. Lesser PTV margins may lead to tumor miss or greater margins may lead to unnecessary radiation of normal brain tissue. The present study is done to evaluate whether the current practice of PTV margins in our institute is optimum or not.
Materials and methods
Eleven patients of brain tumours who received adjuvant radiotherapy were retrospectively selected for determining the setup errors. These patients were immobilised in supine position and contrast enhanced CT of head was taken for radiotherapy planning. Delineation of gross tumor volume and clinical target volume was done with 5 mm PTV margin. The treatment was delivered by 3-Dimensional Conformal Radiotherapy or Intensity Modulated Radiotherapy Technique. The set up errors in three dimensions were determined retrospectively for all images. PTV margins were calculated using International Commission on Radiation Units And Measurements Report 62, Stroom’s and Van Herk formulae.
Results
The overall population set up error was 0.034,-0.048, 0.028 in X, Y, Z directions respectively. The population systematic error was calculated to be 0.107, 0.069, 0.092 and population random error was 0.221, 0.202, 0.217 in X, Y, Z directions respectively. The calculated setup margin as per the three formulas was less than 5 mm in all directions.
Conclusion
The present study showed that the institutional protocol of 5 mm is optimum to counter the setup errors. 
Laboratory profile of COVID-19 Patients at the time of admission
Full text linkBackground: COVID-19 is a recent pandemic, the complete picture of which is yet to be described. Recent advances in the treatment and improved outcomes have been contributed mainly by knowing the pathological and biochemical status of the patients. Further improvement in understanding this disease at all levels will help in formulating appropriate management plans.
Objective: To describe the various biochemical and haematological parameters of COVID – 19 positive patients at the time of admission to the hospital for treatment. Method: We analysed the biochemical and haematological parameters of 100 COVID patients admitted to our hospital from June 2020 to September 2020.
Results: 60.6% of our subjects were between 40 and 70 Years. 74.7% of the cases were males. Fever and cough were the most frequent complaints and 49. 5% of them had pneumonia at the time of admission. 19% of the patients needed ICU management. The most common haematological abnormality was lymphopenia seen in 79.9% followed by Eosinopenia seen in 46.5%. Reactive lymphocytes were seen in the majority of the patients (84 %). Toxic granules in the neutrophils, fragmented RBCs and significant left shift of neutrophils are found in small proportions. CRP was elevated in 92% of our patients, followed by elevated Ferritin in 78.2%. D-Dimer was elevated in 44.4% of the patients.
Conclusion: The majority of Covid patients at presentation have deranged coagulation and increased D-Dimer. Lymphopenia is the most common haematological abnormality
Parasitic Hypoproteinemia :A Diagnostic Dilemma in an Immuno competent Patient
Full text linkStrongyloidiasis is caused by a nematode helminth which causes multisystem involvement with signsand symptoms related to the gastrointestinal, pulmonary, dermatological and nervous systems. Theindex case discussed here presented with edema, hypoalbuminemia, malnutrition and anemia withurease positive duodenal ulcer. Duodenal biopsy suggested malabsorption, and strongyloidiasis wasdetected in the biopsy, which clinched the diagnosis and treatment was given with ivermectin, afterwhich the patient improved and responded to treatment. The importance lies in the fact thatparasitic infections may cause malabsorption even in immunocompetent patients, which is a rareentity but must not be missed as it responds to treatment promptly, which is cheap and effectiv
Volumetric and dosimetric effects of different slice thickness in radiotherapy planning Computed Tomography for head and Neck cancer
Full text linkIntroduction: Accurate estimation of target and Organ at Risk Volume is required to ensuretreatment efficacy and minimal normal tissue toxicity in radiotherapy planning. ComputedTomography slice thickness plays a vital role in volume estimation. It highly impacts smaller volumeorgans such as 1-3cm3.
Materials and Methods: CT datasets of 20 head and neck cancer patientswere recruited for this study in each CT data three CT series with a slice thickness of 1.5mm, 3mmand 5mm were imported to the TPS. Eclipse TPS of version 13.6 was used for delineation andtreatment planning.
Results: The variability of volumes with CT slice thickness was significant,especially for small volume structures. The maximum volume error of 63% was found in >3ccvolume structures with 5mm slice thickness. Whereas in larger volume structures the differenceswere observed 2%in terms of volume and mean dose. And in terms of homogeneity and conformity,there is no significant difference was found.
Conclusion: This study concludes that for head andneck cancer which has many smaller volume structures 1.5mm slice thickness will accuratelyestimate the volume which is clinically useful for OAR near the PTV