International Journal of Research in Medical Sciences
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Gq1b IgG-positive myeloradiculoneuropathy with spinal cord demyelination and autonomic dysfunction
Get PDFHere, we present a case of a 43-year-old woman who developed acute-onset progressive weakness in both lower limbs, with a distinct sensory level at D3-D4, and bowel/bladder incontinence, demonstrating an unusual overlap of central and peripheral nervous system involvement. Magnetic resonance imaging (MRI) revealed linear hyperintensities from C6 to D3 spinal levels while nerve conduction studies confirmed peripheral demyelination, creating a diagnostic challenge. Serological testing identified strongly positive GQ1b IgG antibodies with equivocal GQ1D reactivity, while comprehensive panels ruled out neuromyelitis optica, myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and paraneoplastic aetiologies. The patient showed dramatic improvement following IVIG therapy, supporting an antibody-mediated pathophysiology affecting both spinal cord and peripheral nerves. This case showcases the heterogeneity of presentation of GQ1b-associated disorders by demonstrating its potential to cause concurrent central demyelination and peripheral neuropathy. Our findings underline the importance of considering atypical presentations in anti-ganglioside antibody disorders, where immunotherapy may be effective. This type of presentation of anti GQ1b reactive disease is rarely documented in the existing literature
Association of body mass index and psychological stress in medical students: a cross-sectional study
Get PDFBackground: Stressful life circumstances have many known negative implications on personal health. Medical students are especially exposed to very stressful life which may impact their health and behaviour. So, This study aimed to analyze the association between psychological stress and BMI in medical students in Sikkim.
Methods: This cross-sectional study measured BMI and stress in 132 MBBS students from Sikkim, India between the age group of 18-26 years. The relation between them was analyzed using the student t-test and Pearson’s correlation. P value<0.05 was taken as significant.
Results: Higher grades of BMI were associated with higher values of total stress, but the P value (0.85) was not significant. BMI and weight were also higher in groups with greater severity of stress (mild, moderate and severe), but the associations were not significant (p=0.035).
Conclusions: This study shows no significant association between stress and BMI in medical students. However, higher BMI values were seen with increased total stress and the degree of stress. Further studies with larger sample sizes and diverse regions may provide a conclusive association between stress and BMI. Universities must adopt measures to minimize stress and stress-associated changes in BMI in medical students. Psychological and stress-related counselling should be given to at-risk students to prevent eating disorders
A cross-sectional study on elevated levels of serum amylase as a predictive factor for appendiceal perforation in patients with acute appendicitis
Get PDFBackground: Acute appendicitis is a common surgical emergency, and appendiceal perforation can lead to serious complications. Early identification of perforation is critical to improving outcomes. Serum amylase has been suggested as a potential marker for perforated appendicitis, but its diagnostic accuracy remains under-investigated. This study aimed to evaluate the diagnostic utility of elevated serum amylase levels as a predictive factor for appendiceal perforation in patients with acute appendicitis.
Methods: An observational study was conducted at Hi-tech medical college and hospital, Bhubaneswar, from December 2023 to February 2025. Sixty-four patients diagnosed with acute appendicitis and undergoing appendectomy were included. Preoperative serum levels of amylase and lipase were measured. Postoperative histopathological examination confirmed the diagnosis of perforated or non-perforated appendicitis. Statistical analysis was performed using chi-square test, t-test, and ROC curve.
Results: Among the 64 patients, 28 had perforated appendicitis, and 36 had non-perforated appendicitis. The mean serum amylase level was significantly higher in the perforated group (72.1±27.3 mg/dl) compared to the non-perforated group (30.1±11 mg/dl) (p<0.0001). No significant difference was observed between groups regarding serum lipase.
Conclusions: Elevated serum amylase levels were associated with perforated appendicitis in patients with acute appendicitis. Serum amylase demonstrated high diagnostic accuracy and could serve as a predictive marker for appendiceal perforation. Further studies are warranted to validate these findings and explore the clinical utility of serum amylase in the early diagnosis of perforated appendicitis
Meningeal abnormalities: a radiologist's guide to comprehensive imaging and differential diagnosis
Get PDFMeningeal abnormalities encompass a wide spectrum of pathological conditions affecting the protective layers of the central nervous system the dura mater, arachnoid mater, and pia mater. These abnormalities may arise from infectious, neoplastic, inflammatory, traumatic, or post-surgical origins and often present with non-specific clinical symptoms such as headache, seizures, or altered mental status. As such, neuroimaging plays a pivotal role in their evaluation, providing critical information for accurate diagnosis and effective management. This article serves as a comprehensive guide for radiologists, offering a structured approach to the imaging and differential diagnosis of meningeal diseases. It begins with a review of the normal meningeal anatomy, including recent discoveries about the glymphatic system and the fourth meningeal layer, and proceeds to detail the utility of key imaging modalities, particularly magnetic resonance imaging (MRI) and computed tomography (CT), in assessing meningeal pathology. Emphasis is placed on distinguishing between pachymeningeal and leptomeningeal involvement based on enhancement patterns, as well as identifying hallmark imaging signs such as dural thickening, nodular lesions, and enhancement distribution. Common and rare disease entities including meningitis, meningioma, dural metastases, neurosarcoidosis, and carcinomatous meningitis are explored through detailed imaging features and differential considerations. The article also highlights advanced techniques including contrast-enhanced 3D FLAIR, dynamic contrast-enhanced MRI, and emerging applications of artificial intelligence in meningeal evaluation. Through illustrative case examples and a systematic diagnostic framework based on current evidence, this guide aims to enhance radiologists' diagnostic accuracy and clinical confidence, ultimately contributing to more timely and informed management of patients with meningeal abnormalities
A descriptive study on coverage of hepatitis B vaccination among final year MBBS students in a private medical college, Bengaluru urban of India
Get PDFBackground: Hepatitis B is one of the most common infections seen in all age and all around the world with high mortality and morbidity. Healthcare workers (HCW) are at risk of contracting the hepatitis B virus (HBV) from infected patients. Hence his study was conducted with an objective to study the coverage and factors affecting hepatitis B vaccination among medical students.
Methods: The descriptive study was carried out among final year MBBS students of B. R. Ambedkar medical college, Bengaluru by adopting convenient sampling technique. A total of 72 students had given consent for the study.
Results: Majority of the students 86% seem to have a good knowledge regarding hepatitis B and 97.2% have responded that it is necessary to get vaccinated. But on the other side only 33.3% students have been vaccinated with a minimum of single dose against hepatitis B. Top 3 reasons for not being vaccinated are lack of motivation, no need felt and never thought of vaccination.
Conclusions: This study reveals that only 33.3% have been vaccinated with a minimum of single dose and 66.6% students are not vaccinated against hepatitis B. After the completion of analyses, the students were briefly educated on the necessity of vaccination, completion of course and the complications that could be avoided in future by volunteering to get vaccinated. Following this event, we saw the 91.7% of students who are motivated or have changed their perception towards vaccination. This shows the importance of health education and counselling
A rare occurrence of progressive encephalomyelitis with rigidity and myoclonus in a case of breast carcinoma on treatment: a case report
Get PDFProgressive encephalomyelitis with rigidity and myoclonus (PERM) is a subtype of Stiff-Person syndrome (SPS) and it is characterized by progressive muscle rigidity, painful spasms, and stimulus sensitive abnormal involuntary movements (myoclonus). PERM is distinct from classical SPS in view of its more rapid progression, additional neurological symptoms, and poorer prognosis. It is an autoimmune-mediated disorder of the central nervous system (CNS), particularly affecting inhibitory pathways and can present as a paraneoplastic syndrome. We present the case of a 65-year-old woman with metastatic breast cancer who initially presented with spasmodic abdominal contractions misdiagnosed as intractable hiccups. Her symptoms progressed to include jaw stiffness, dysarthria, dysphagia, and generalized myoclonus, requiring invasive mechanical ventilation. Investigations showed normal brain imaging, unremarkable cerebrospinal fluid analysis, and positive amphiphysin antibodies in paraneoplastic encephalitis panel thus confirming PERM. She was treated with methylprednisolone (500 mg/day for 5 days) followed by intravenous immunoglobulin (IVIG) (2 g/kg over 5 days), resulting in complete resolution of symptoms and ventilator weaning. This case highlights the importance of recognizing PERM in cancer patients and demonstrates the potential efficacy of immunotherapy in its management
Mobile phones and minds: linking usage to stress and academic performance in undergraduates
Get PDFBackground: Mobile phones have become ubiquitous among students, providing easy access to communication and information. However, excessive use has been associated with negative outcomes, including decreased academic performance and increased psychological stress. Understanding the relationship between mobile phone usage, stress and academic achievement is essential to promote healthy study habits and overall well-being among undergraduate students.
Methods: This cross-sectional study included 110 first-year Allied Health and Physiotherapy students from JN Medical College, Belagavi, who provided informed consent. Participants completed a structured questionnaire detailing demographic information, mobile phone usage patterns and study habits. Academic performance was assessed using self-reported grades and recent examination scores, while stress levels were evaluated using a standardized stress assessment scale.
Results: Students reporting higher daily mobile phone usage exhibited significantly lower academic performance compared with those with limited usage (p<0.05). Additionally, frequent mobile phone use was associated with elevated stress levels, suggesting a direct relationship between screen time, psychological stress and learning outcomes. Students who managed mobile phone usage effectively demonstrated better academic scores and lower stress, highlighting the potential impact of controlled use on educational achievement and mental health.
Conclusions: Excessive mobile phone usage among undergraduates is linked to poorer academic performance and higher stress levels. Awareness and strategies to regulate mobile phone use may help improve learning outcomes and reduce stress in this population
Clinical and immunological outcomes in HIV-2 and HIV-1 and 2 co-infections at a tertiary care centre in Maharashtra
Get PDFBackground: HIV-2 and HIV-1 and 2 co-infections are rare but clinically significant subtypes with varying response to treatment and progression of disease exist. Not much data from central India especially Maharashtra is available regarding their immunologic courses. The objective was to examine the sociodemographic characteristics, baseline and follow-up CD4 trends, and antiretroviral therapy (ART) outcomes in HIV-2 and HIV-1 and 2 dually infected patients.
Methods: Retrospective analysis was conducted among 27 patients co-infected with HIV-2 or HIV-1 and 2 who were attending a tertiary ART centre in Maharashtra. Baseline and most recent CD4 counts and ART regimen were analysed. Demographic data, and treatment outcomes like alive on ART, died, transfer out, stopped, and opted out were described using descriptive statistics.
Results: Tenofovir-lamivudine-dolutegravir (TLD) was prescribed in the majority of patients. Mean CD4 baseline count of survivors on ART was 352.3 cells/µl, and recent CD4 improved to 519.3. High mortality was observed in those on protease inhibitor-based regimens (ZL+LPV/r, TL+LPV/r).
Conclusion: TLD-based ART produced better immunological outcome. Protease inhibitor-containing regimens needed in HIV-2, could be associated with poor prognosis in patient on ART
Descending colon perforation due to accidental swallowing of dentures: an interesting case report
Get PDFIngesting foreign bodies is a common occurrence, particularly in children and in a few adults (Mentally incapable, alcoholics, and people wearing dentures). Swallowed dentures are a multidisciplinary problem that concerns various fields like surgery, endoscopy, anaesthesiology, dentistry, psychiatry, neurology, thoracic surgery, and emergency medicine. Hence, swallowed dentures are considered a unique type of foreign body apart from coins, batteries, and needles. Most foreign bodies pass through the intestines without a problem. The reported complications due to ingestion of swallowed dental prosthesis include trachea-oesophageal fistula and perforation of the colon. Here, we are reporting a case of a 40-year-old male patient presenting with descending colon perforation and on surgical exploration found to have a denture protruding from the colon
Exploring the effectiveness of CADAVIZ in enhancing learning outcomes in undergraduate medical students
Get PDFBackground: Cadaver-based learning is fundamental to mastering human anatomy. However, accessing delicate, deep-seated regions such as the cerebellum is challenging. In this regard the virtual dissection table (VDT) is a useful supplement. This study investigates the effectiveness of CADAVIZ, a VDT, in enhancing anatomical understanding among undergraduate medical students.
Methods: After obtaining ethical approval and informed consent, 250 participants attended a standardized lecture on cerebellar anatomy followed by a pre-test to assess their baseline knowledge. The participants were then randomly assigned to three Groups: Group A attended practical session with a cadaveric specimen of the human cerebellum, Group B participated in an interactive session on cerebellar anatomy using CADAVIZ, and Group C engaged in practical sessions with both a cadaveric specimen and CADAVIZ. Lastly, post-tests were conducted to assess knowledge retention after the respective practical sessions.
Results: The mean pre-test score for Group A was 4.88±0.17 and the mean post-test score was 7.35±0.21, registering a mean percentage increase of 60.68±5.41%. Group B obtained a mean pre-test and post-test score of 4.73±0.19 and 7.75±0.15, respectively, reflecting a mean percentage increase of 78.92±5.27% (p=0.127). Group C, on the other hand, recorded a mean pre-test and post-test score of 3.99±0.13 and 6.96±0.16, respectively, yielding a mean percentage increase of 81.84±4.81% (p=0.005).
Conclusions: As compared to Group A, the percentage increase in Group C was significantly (p=0.005) higher, indicating that the blended learning with both cadaveric specimen and CADAVIZ enhanced anatomical learning more than a practical session with cadaveric specimen alone