International Journal of Research in Medical Sciences
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Causes, prevalence and treatment of myopia: a review
Get PDFThe aim of this work is to investigate the causes, prevention strategies, and prevalence of myopia, a common refractive error increasingly recognized as a global public health concern. A comprehensive literature review was conducted using major academic databases, including PubMed, Google scholar, and Web of Science, with selected keywords to identify relevant studies on myopia’s etiology, prevention, and treatment. Evidence indicates that myopia arises from an interplay of genetic predisposition and environmental influences. Individuals with a family history of myopia are at higher risk; however, lifestyle factors, particularly prolonged near work and limited outdoor activity, significantly contribute to onset and progression. The prevalence of myopia varies widely across regions, with rapid increases noted in many parts of the world, especially in urbanized settings. Preventive strategies, such as encouraging outdoor time for children and limiting excessive near work or screen use, have shown promise in reducing risk. For individuals with established myopia, several management options exist, including orthokeratology (ortho-k) lenses, multifocal contact lenses, and other optical interventions, which aim to slow disease progression. Addressing myopia requires both public health initiatives to promote preventive lifestyle changes and early clinical interventions to manage its impact. By understanding its multifactorial causes and employing evidence-based prevention and control strategies, it is possible to mitigate the growing burden of myopia and preserve long-term visual health
Beneath the surface: unravelling a frontal epidermoid cyst–a case study
Get PDFEpidermoid cysts are rare, benign congenital lesions that account for a small percentage (0.3–1.8%) of primary intracranial tumors. These cysts arise from ectodermal cells that become trapped during the early closure of the neural tube in embryonic development. But their occurrence in the frontal lobe is extremely rare, with about 20 cases reported in literature. A 42-year-old male with a history of hypertension presented with generalized tonic-clonic seizures. magnetic resonance imaging (MRI) of the brain revealed a right frontal lobe lesion with mass effect, characterized as a non-enhancing intra-axial lesion. This imaging led to a preoperative diagnosis of low-grade glioma. The patient underwent a right frontal craniotomy with total microsurgical excision of the lesion and duroplasty under general anesthesia. Histopathological analysis of the lesion confirmed it to be an epidermoid cyst. Intracerebral epidermoid cysts, especially those located in the frontal lobe, are exceedingly rare and pose diagnostic challenges due to their similarity to more common brain lesions such as gliomas. Advanced imaging techniques, particularly diffusion-weighted MRI, are crucial in differentiating these cysts from other intracerebral tumors. Complete surgical resection is the definitive treatment, effectively preventing recurrence. The rarity of frontal lobe epidermoid cysts underscores the importance of thorough diagnostic and surgical strategies in managing this unique case
Integrative ayurvedic approach in post-ischemic stroke rehabilitation with special reference to Pakshaghata: a case report
Get PDFIschemic stroke, comprising approximately 85% of all strokes globally, is a major cerebrovascular disorder. In Ayurveda, a similar condition is identified as Pakshaghata, categorized under Vatavyadhi. It results from aggravated Vata dosha, which governs motor and sensory functions, invading the shareera dhamani and leading to hemiplegia, speech loss and pain. A 67-year-old male patient, known case of hypertension for 2 years with poor medication adherence, presented with weakness and pain over the right upper and lower limbs, difficulty in walking without support and restricted right upper limb movement since 1½ months. A cerebrovascular accident occurred on 21/04/24 during nocturnal hours, with subsequent right-sided hemiparesis, facial deviation and slurred speech. CT revealed a chronic lacunar infarct in the right corona radiata, while MRI indicated an acute infarct in the left posterior capsulo-ganglionic region. The patient was admitted to the Kayachikitsa IPD on 14/06/24 with spasticity, hemiplegic gait, muscle weakness, exaggerated reflexes and an extensor plantar response. Following 14 days of integrative Ayurvedic treatment, the patient regained the ability to walk without support and raise the right upper limb, reflecting enhanced motor function and quality of life. VAS score reduced from 9 to 0, Ama assessment score dropped from 6 to 0 and NIHSS score improved from 8 to 6 indicating reduced stroke severity. This case demonstrates the potential role of conservative Ayurvedic interventions in post-stroke rehabilitation
Personality correlates of job stress and organisational citizenship behaviour among hospital professionals
Get PDFBackground: Understanding the role of personality in occupational stress and organisational citizenship behaviour (OCB) is crucial in healthcare environments, where professionals often face high-pressure situations. In Indian healthcare settings, research on how personality dimensions impact stress levels and prosocial workplace behaviours remains limited. Aim was to examine the correlation between big five personality dimensions (extraversion, agreeableness, conscientiousness, openness and neuroticism), occupational stress, and OCB among hospital professionals.
Methods: A cross-sectional study was conducted among 254 full-time employees from Santosh Hospital in Ghaziabad, Uttar Pradesh, India using purposive sampling. Participants included doctors, nurses, technical, and non-technical (administrative) staff. Standardized tools- the big five inventory (BFI), occupational stress index (OSI), general health questionnaire (GHQ-12), and organisational citizenship behaviour checklist (OCB-C)- were administered as physical forms. Descriptive statistics and inferential statistics (Pearson correlation) were performed.
Results: Neuroticism was positively correlated with occupational stress (r=0.201**) and negatively with OCB (r=–0.170**), indicating a dual relationship. OCB was significantly associated with extraversion (r=0.142*), agreeableness (r=0.187**), and conscientiousness (r=0.145*). Psychological distress (GHQ scores) correlated negatively with extraversion, agreeableness, conscientiousness, and openness. The mean OCB score was 64.24 (SD±12.51), suggesting moderate prosocial workplace behaviour (* = p<0.05, ** = p<0.01).
Conclusions: Personality dimensions significantly influence both job stress and OCB. These findings underscore the importance of personality in healthcare context, specifically Indian healthcare scenario among doctors, nurses, technical and non-technical/administrative staff
Breast reconstruction after radical mastectomy for giant phyllodes tumor: a case report
Get PDFWe present the case of a 40-year-old woman with a giant phyllodes tumor in the left breast, detected after breastfeeding and progressively growing over two years. In August 2023, a biopsy confirmed the diagnosis, and in March 2024, a radical mastectomy was scheduled, as negative surgical margins could not be guaranteed with a conservative approach. The initial intervention included vacuum-assisted closure (VAC) therapy to manage infection risk and prepare the wound for later reconstruction. Thirty days later, breast reconstruction was performed using a latissimus dorsi flap, which was elevated, dissected, and placed over the thoracic defect. The surgery was completed without complications, and the patient had a satisfactory recovery, being discharged three days postoperatively. At the three-month follow-up, the flap showed good integration and favorable evolution. This case highlights the importance of timely breast reconstruction in patients undergoing radical mastectomy for phyllodes tumors and the effectiveness of the latissimus dorsi flap as a reconstructive option in complex scenarios
Microalbuminuria as an indicator of sepsis and to predict mortality in patients admitted in intensive care unit
Get PDFBackground: Sepsis remains a major cause of morbidity and mortality worldwide. Early recognition is critical, but conventional diagnostic methods such as culture require more than 24 hours, delaying targeted therapy. Microalbuminuria, a marker of systemic endothelial dysfunction and capillary leak, may provide a rapid and non-invasive predictor of outcome. Objective of this study was to assess the role of microalbuminuria in predicting mortality among patients with sepsis admitted to the intensive care unit (ICU).
Methods: This prospective observational study was conducted in the ICU of Travancore Medical College, Kollam, from August 2022 to January 2024. A total of 122 adult patients with sepsis were enrolled after applying inclusion and exclusion criteria. Spot urine samples were collected within 6 hours of admission (ACR1) and at 24 hours (ACR2) to measure the albumin–creatinine ratio (ACR). The change in ACR (ΔACR = ACR1-ACR2) was calculated. Associations of ACR values with mortality and ICU stay were analysed using non-parametric tests, correlation studies, and ROC curve analysis.
Results: ACR2 was significantly higher among non-survivors than survivors (mean 284.3 vs. 77.0, p<0.001). Survivors showed a significant decline in ACR between 6 and 24 hours, while non-survivors had a significant increase. ΔACR correlated negatively with ICU stay duration (ρ = -0.303, p<0.001). ROC analysis identified ΔACR ≤21.5 as the optimal cutoff for predicting mortality, with sensitivity 83.9%, specificity 86.9%, and accuracy 86.2%.
Conclusions: Serial measurement of urine ACR, particularly ΔACR, within the first 24 hours is a simple, rapid, and cost-effective predictor of mortality in sepsis and can be especially valuable in resource-limited settings
High-risk jejunal gastrointestinal stromal tumor: case report and comparative review of international guidelines
Get PDFGastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, arising from interstitial cells of Cajal. Diagnosis and management have advanced through molecular testing, surgery, and tyrosine kinase inhibitors. Although usually seen in older adults, GISTs may occur in younger patients with atypical symptoms. We report a high-risk jejunal GIST and compare major international guidelines to inform management. A literature review and guideline comparison were conducted using recent recommendations from ACG, AGA, ESMO, BSG, ESGE, NICE, JSCO, and the Royal College of Pathologists. These were correlated with the clinical, imaging, surgical, and histopathological findings of a 40-year-old male patient. The patient presented with abdominal distension, obstructive symptoms, and a palpable mass. CT revealed a 14×13×11 cm well-circumscribed mass in the epigastric/mesogastric region. Surgery identified a jejunal tumor 30 cm distal to the ligament of Treitz, requiring en bloc resection and primary anastomosis. Histopathology confirmed a spindle-cell GIST (CD117+, DOG1+, CD34–, Ki-67: 5/50 HPF) with high-risk features. Postoperative recovery was uneventful. Guidelines consistently recommend R0 resection, immunohistochemical confirmation, mutational profiling, and long-term surveillance. Adjuvant imatinib is advised for high-risk disease. This case underscores the need for early recognition and guideline-based management of GISTs, particularly in patients with nonspecific symptoms and large abdominal masses. International concordance emphasizes imaging, endoscopic ultrasound with biopsy, immunohistochemistry, and molecular testing for risk stratification. Surgery remains the cornerstone of treatment, with adjuvant therapy in high-risk cases. Multidisciplinary care is essential to optimize outcomes
CytoSorb hemoadsorption in rhabdomyolysis-induced acute kidney injury: a case report from a tertiary hospital in Bangladesh
Get PDFRhabdomyolysis is a serious clinical condition involving the breakdown of skeletal muscle, leading to the release of intracellular components into circulation. Among its complications, acute kidney injury (AKI) is the most critical, occurring in up to 50% of cases. This report presents the case of a 42-year-old male with schizophrenia and hypertension who developed rhabdomyolysis-induced AKI following a fall. He exhibited markedly elevated creatine phosphokinase (CPK) levels (360,000 u/l) and deteriorating renal function. In addition to supportive management, CytoSorb hemoadsorption was initiated. Over three sessions, CPK levels dropped to 174 u/l, and serum creatinine declined from 3.53 mg/dl to 2.16 mg/dl. This case demonstrates that CytoSorb therapy can be effective even in limited-resource settings where myoglobin assays are unavailable, offering a promising strategy for early intervention in rhabdomyolysis-induced AKI. Our experience suggests early initiation of hemoadsorption could serve as an effective adjunct in managing challenging cases where conventional therapies alone may be insufficient
Aflatoxin contamination in food crops in Kenya: a systematic review
Get PDFAflatoxins, a group of toxic secondary metabolites produced by Aspergillus flavus and A. parasiticus fungi species, is a sub-chronic and multifaceted agricultural productivity and public health problem in sub-Saharan Africa. The health impacts of aflatoxin exposure are severe and long-term. Characterization of aflatoxin forms is a valuable aspect of this challenge because different forms; aflatoxin B1, B2, G1, and G2 which vary in toxicity and occurrence according to environmental factors and processing conditions. This systematic review bridges the existing gaps by aggregating evidence of levels and extent of aflatoxin contamination of maize, wheat, sorghum, and groundnuts in Kenya from 2010 to 2025. This systematic review employs a narrative synthesis to analyze aflatoxin infestation of maize, wheat, sorghum, and groundnuts in Kenya based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA 2020) standards. The search includes a number of electronic databases and grey literature sources. The four studies indicate that aflatoxin infestation of Kenyan maize remains a significant public health and food security concern, with infestation levels frequently being higher than the regulatory limit (10 µg/kg). The results quantify high infestation in the Rift Valley and Meru County, respectively, as well as associate extreme infestations in Eastern Kenya with associated health dangers like HCC. Regional disparities, driven by moisture, and problems such as broken kernels, insect damage, and excessive moisture levels continue to emerge as contamination drivers. These findings underscore the need for specific interventions to address the environmental and human-related causes of aflatoxin accumulation in maize
A rare case of refractory active antibody mediated rejection who had recurrence of immunoglobulin a nephropathy in the form of crescentic glomerulonephritis
Get PDFImmunoglobulin A nephropathy is one of the most common recurrent glomerulonephritis after kidney transplantation. Recurrence rate is around 30% at 10 years after transplant. Rarely, rapid deterioration of renal function may occur suggestive of presence of crescents. Presence of donor specific antibodies can predict poor transplant outcomes. Compliance to immunosuppressive medications will prevent development of donor specific antibodies and prolong allograft survival. Authors hereby report a case of refractory active antibody mediated rejection who developed recurrent Immunoglobulin A nephropathy 3 years after renal transplantation