International Journal of Research in Medical Sciences
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Donor site outcome after oral mucosa harvest for urethroplasty: a prospective study
Get PDFBackground: Congenital or acquired defects of the male urethra may be repaired utilizing varied substitute materials, such as genital or extragenital skin and oral mucosa (OM). Currently, the application of OM has emerged as the most dependable and favoured alternative to urethral reconstructive surgery. This study aimed to examine oral morbidity and patient satisfaction within a uniform cohort of patients who underwent oral mucosa harvesting with a standardised procedure.
Methods: The study was carried out in the Department of urology, Narayana medical college and hospital, Nellore between January 2023 to March 2025. 38 cases were included in the study, at the time of admission, detailed history, clinical examination and necessary radiological examination were done.
Results: The results showed that 2 (5%) of 38 patients had early oozing. 3 cases (7%) had accidental lip and cheek bites in whom harvest site was not closed. The graft site was sutured in 26 patients (68.42%). In 8 patients (21.05%) the graft site was left open. At one month only 1 patient (2.63%) was unable to whistle and he was able to do so by 3 months. 2 patients (5.26%) had parotid swelling during first week of surgery which subsided at 2 weeks with conservative treatment. 24 patients (63.15%) of 38 had restricted mouth opening only during first week.
Conclusions: Restricted mouth opening and Pain are the only long-term complications in our study which were not bother-some. Pain appears to be worse after suturing donor site. Bilateral buccal mucosal graft harvesting has no extra problems as compared to unilateral harvesting. Hence in case of long urethral stricture, two independent Strips are preferable than single strip involving lip
Accessory lobe of liver: intra-operative incidental finding: a rare case report
Get PDFAn accessory lobe of liver is a rare congenital anomaly, but is usually an incidental finding during abdominal surgeries. The condition is usually asymptomatic. Here, we report a case where the accessory liver lobe was an incidental finding during laparoscopic Cholecystectomy. An accessory liver lobe resection should be done to prevent complications and malignant transformation
Fibromatosis colli: a case series of three infants
Get PDFFibromatosis colli is a rare, benign fibrous lesion of the sternocleidomastoid muscle in infancy. It typically presents as a firm; non-tender neck swelling within the first few weeks of life and is strongly associated with birth trauma. We report a series of three infants with fibromatosis colli, emphasizing the role of clinical evaluation, ultrasonography, and fine-needle aspiration cytology (FNAC) in diagnosis, with physiotherapy as the mainstay of management. A four-week-old male presented with a left cervical swelling following breech delivery. Ultrasound showed fusiform thickening of the left sternocleidomastoid, and FNAC confirmed fibromatosis colli. He was managed conservatively with physiotherapy. A six-week-old female presented with right-sided neck swelling after a forceps-assisted delivery. Ultrasound revealed an ellipsoid enlargement of the right sternocleidomastoid, and FNAC showed spindle fibroblastic cells. She responded well to physiotherapy with near-complete resolution at three months. A three-week-old male had bilateral sternocleidomastoid thickening with restricted neck movement after prolonged labor. Ultrasound confirmed bilateral fusiform thickening, and FNAC ruled out malignancy. Physiotherapy led to gradual improvement over 4 months. Early recognition of fibromatosis colli is crucial to avoid unnecessary investigations and parental anxiety. Timely physiotherapy results in spontaneous regression in most cases, while surgery is reserved only for refractory cases
Regional cancer burdens: a retrospective analysis of demographic and diagnostic patterns in Bangladesh
Get PDFBackground: Regional cancer data from low and middle-income countries (LMICs) like Bangladesh remain limited, hindering evidence-based oncology planning. This study examines demographic and diagnostic patterns among cancer patients at two tertiary centers in northern Bangladesh to inform resource-sensitive cancer control strategies.
Methods: We conducted a retrospective analysis of 547 cancer cases diagnosed between 2019 and 2021 at two major tertiary care centers. Patient records were reviewed for age, sex, residential location and cancer type. Descriptive statistics were applied to explore demographic distributions and diagnostic trends over time.
Results: The 41–60 years age group consistently accounted for the majority of cases, followed by the 61–80 years group. Females represented a growing proportion of diagnoses, increasing from 60.64% in 2019 to 69.92% in 2021. Breast cancer was the most prevalent malignancy each year (37.35% in 2019; 45.71% in 2020; 42.28% in 2021). Colorectal, stomach, cervical and lung cancers followed in frequency, with lung cancer showing an upward trend in 2021 (12.20%). Geographic analysis showed the largest patient share from Sadar, with consistent contributions from Birgonj, Birol and Phulbari and steady representation from peripheral areas over the three years.
Conclusions: This study reveals stable demographic patterns and evolving cancer type distributions in a regional Bangladeshi population. The increasing female predominance and persistent burden of breast cancer highlight the need for gender-sensitive screening programs. The rising proportion of lung cancer and continued diagnostic insufficiency underscore the importance of strengthening cancer registries, decentralizing oncology services and improving access to care in remote areas of LMICs
Assessment of quality of life in patients undergoing maintenance hemodialysis in a tertiary care hospital
Get PDFBackground: The increasing prevalence of end-stage renal disease (ESRD) in India necessitates a deeper understanding of its impact on patient well-being. This study aimed to assess the quality of life (QOL) among hemodialysis (HD) patients in a North Indian setting using the kidney disease QOL-36 (KDQOL-36) instrument and to explore the associated demographic and clinical factors influencing their QOL.
Methods: We conducted an observational, cross-sectional study over two months (May-June 2024) at a tertiary care hospital in Jammu, India. A total of 100 patients aged 18-75 years, diagnosed with ESRD and undergoing maintenance HD for at least three months, were included after providing informed consent. Data was collected using a demographic questionnaire and the validated KDQOL-36 instrument. Statistical analysis was performed using SPSS ver 25.0.
Results: The study cohort comprised 100 patients (66% male) with a mean age of 58.08±12.3 years. The mean QOL scores indicated significant impairment across multiple domains: Physical component summary (PCS) was 41.19±8.24, mental component summary (MCS) was 42.52±7.84, symptom/problem list was 77.75±14.57, and effects of kidney disease was 56.56±16.48. The most profoundly affected domain was the burden of kidney disease, with an exceptionally low mean score of 24.00±15.24. A majority of patients reported that the disease interfered with their life (88%), felt like a burden to their family (74%), and were bothered by fluid (94%) and dietary (88%) restrictions.
Conclusions: This study highlights a profound impairment in the QOL among HD patients in North India, particularly concerning the overwhelming burden of the disease. The findings underscore the urgent need for renal healthcare systems in India to integrate routine QOL assessments into standard practice. Shifting towards a more holistic, patient-centered approach that includes targeted psychosocial support is crucial to alleviate the immense disease burden and improve overall well-being in this vulnerable population
Giant mature cystic teratoma of the ovary mimicking a 36-week pregnancy in a 14-year-old female
Get PDFA dermoid cyst is a mature cystic teratoma, most common benign germ cell tumor of the ovary. It arises from totipotent germ cells and can contain well-differentiated tissues from all three germ layers. It is one of the most common benign ovarian neoplasms, occurring in a wide range of sizes. Early diagnosis is essential to prevent potential complications such as torsion, rupture, internal haemorrhage or malignant transformation. Most commonly seen in reproductive age group (20-40 years). Large mature cystic teratoma of ovary exceeding 10cm is extremely rare teratoma. Here we are presenting the case of giant mature cystic teratoma of ovary in 14-year adolescent female, which was mimicking 36weeks pregnancy. Patient had complaints of abdominal distension with decrease appetite and weakness since 2months. On per abdominal examinations there was a lump, which was mimicking 36weeks pregnancy. Which was managed with exploratory laparotomy and left salpingo-oophorectomy and kept her on regular follow up
Bidirectional relationship between anxiety and gastrointestinal symptoms: a case control study
Get PDFBackground: Many patients of anxiety manifest lot of gastrointestinal (GI) symptoms in the form of bloating, diarrhoea, heartburn and constipation. Conversely patients suffering from common GI diseases like irritable bowel syndrome have anxiety symptoms. Severity of one can aggravate the other condition. Gut and brain communicate through gut-brain axis. Gut microbiome and hypothalmo-pituitary-adrenal system and a host of metabolic products play an important role in this axis.
Methods: Thirty-eight patients with moderate-to-severe GI symptoms and anxiety were evaluated with appropriate scales for diagnosis and severity. The quality of life was also assessed in them. Thirty-eight healthy subjects with no GI symptoms and no/mild anxiety symptoms were similarly evaluated as control group.
Results: Key predictors of anxiety severity and GI symptoms severity were statistically analysed. There was a strong link between GI symptoms and anxiety severity and inverse relationship with the quality of life.
Conclusions: Evidence suggests a bidirectional relationship between gastrointestinal symptom severity and anxiety, mediated by the gut-brain axis.
Association of metabolic syndrome in patients with vitiligo
Get PDFBackground: Vitiligo can trigger inflammatory processes due to decreased number of melanocytes and their anti-inflammatory effects as well as oxidative stress. Metabolic syndrome includes hypertension, abdominal obesity, dyslipidemia, glucose intolerance, leading to cardiovascular disease, diabetes mellitus and stroke. Because of the systemic nature of vitiligo, metabolic syndrome or its component may be observed in vitiligo. To observe association of metabolic syndrome in patients with vitiligo.
Methods: This case control study included 54 vitiligo patients and 54 age and sex matched controls according to inclusion and exclusion criteria. Detailed history, physical examination and laboratory investigations were done in all participants and revised National Cholesterol Education Program Adult Treatment Panel III criteria were used for diagnosis of metabolic syndrome. Data were analyzed by using SPSS (Statistical Package for Social Sciences) Version 23.
Results: Metabolic syndrome was present in 20 (37.0%) patients with vitiligo and in 9 (16.7%) control subjects. Frequency of metabolic syndrome was significantly higher in vitiligo patient compared to control (p=0.017). Systolic blood pressure, diastolic blood pressure, fasting plasma glucose and mean serum triglycerides level were significantly higher in the patient group than that of control group, whereas serum high density lipoprotein cholesterol was significantly lower in the patient group than that of control group. There were no significant difference between cases and controls regarding waist circumference.
Conclusions: Presence of metabolic syndrome was higher in patients with vitiligo. Further large-scale studies are needed to establish it
Impact of hormonal contraceptives and hormone replacement therapy on gastrointestinal health: a comprehensive review
Get PDFHormonal contraceptives and hormone replacement therapy (HRT) are widely used worldwide. While benefits are well established, exogenous hormones can affect the gastrointestinal (GI) system. These complications often nonspecific and delayed are underrecognized. In this review, we surveyed PubMed/MEDLINE/Embase through September 2025, assessing hormonal contraceptives or HRT in relation to GI/hepatobiliary outcomes. It was found that estrogen-containing contraceptives are most strongly linked to hepatocellular adenoma (HCA), with dose–duration dependence; lesions typically stabilize or regress after hormone withdrawal. Focal nodular hyperplasia showas no causal relationship and usually does not require contraceptive cessation once confidently diagnosed. Estrogen-induced cholestasis reflects down-regulation of canalicular transporters (e.g., BSEP, MRP2) and is more likely in genetically predisposed women, such as those with prior cholestasis of pregnancy. Estrogen increases biliary cholesterol; progestins reduce gallbladder contractility, together promoting lithogenesis – This effect is stronger with HRT than low dose combined contraceptives. Estrogen-associated pancreatitis occurs primarily via severe hypertriglyceridemia and is amplified by familial dyslipidemias, diabetes, or metabolic syndrome. Hormonal agents modulate motility and visceral sensitivity, contributing to nausea, bloating, and early satiety; symptom fluctuations may be greater with hormone-free intervals. Epidemiology consistently links combined oral contraceptives to Crohn’s disease in a dose- and duration-dependent fashion. Long-term hormonal therapy can influence GI health via hepatic, lipid, immune, and motility pathways. Absolute risks are low for most users, but individualized counselling, shared decision-making, and targeted monitoring improve safety while preserving therapeutic benefits. Further mechanistic and longitudinal studies are needed to refine risk stratification.
Agreement between arterial and venous electrolyte levels in patients admitted to intensive care unit: a retrospective study
Get PDFBackground: Electrolyte disturbances are common in critically ill patients and can significantly influence morbidity and mortality. Prompt detection is essential; however, serum electrolyte estimation using automated analyzers (AA) in central laboratories often suffers from delayed turnaround times. Point-of-care (POC) arterial blood gas (ABG) analyzers provide rapid results; however, their reliability compared to that of conventional autoanalyzers remains uncertain. This study aimed to evaluate the agreement between sodium and potassium levels measured in arterial and venous samples using the GEM 3500 (ABG) and Vitros 5600 (AA) analyzer, respectively.
Methods: A retrospective study was conducted on 200 intensive care unit (ICU) patients in a secondary healthcare hospital between January and June 2024. The electrolytes were reported from both arterial and venous blood samples sent to the clinical biochemistry laboratory on the same day and at the same time. GEM 3500 and Vitros 5600 analyzers are used, respectively. Both methods use the direct ISE method. Statistical analyses included the Wilcoxon signed-rank test, Spearman’s correlation, and Bland-Altman plots to assess correlation and agreement.
Results: The mean and standard deviation of sodium values (136.33±9.22 mmol/l in venous and 135.23±9.57 mmol/l in arterial blood) and potassium values (4.20±1.01 mmol/l and 4.01±0.97 mmol/l) were observed. The differences were statistically significant (p<0.001). Spearman’s correlation showed strong positive relationships (r=0.819 for sodium; r=0.844 for potassium, p<0.001). Bland-Altman analysis demonstrated that 97.5% of the sodium and 93.5% of the potassium values fell within the limits of agreement, suggesting good concordance.
Conclusions: Sodium and potassium measurements obtained from arterial samples using the ABG analyzer can be used interchangeably with serum values derived from venous samples analyzed on an automated chemistry analyzer for the management of critically ill patients