International Journal of Research in Medical Sciences
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A retrospective analysis: comparison of nephrotoxicity caused by concurrent weekly cisplatin in patients of head & neck cancer and cervical cancer
Get PDFBackground: Cisplatin is the most common chemotherapeutic drug which is used concurrently with radiation therapy due to its radio sensitizing effect. Cisplatin is known to cause substantial amount of nephrotoxicity and adequate hydration is absolutely essential while administering cisplatin. Once weekly regimen is widely used both in the treatment of head & neck cancers as well as cervical cancer. The main aim of this study is to compare the incidence and severity of nephrotoxicity in patients of head and neck and cervical cancer treated with concurrent chemoradiation
Methods: From January 2023 to December 2023, data of 50 patients each of head and neck cancer and cervical cancer patients treated at our institute was evaluated. Cisplatin was used weekly at the dose of 40 mg/m2 with adequate hydration and necessary pre medications in all the patients. CBC, RFT and Serum Electrolytes were done prior to each cycle. RIFLE criteria were used to classify renal impairment
Results: 50 patients each of head and neck and cervical cancer were selected. Total 5 cycles of concurrent cisplatin were planned in both the arms according to the institutional protocol. During the course of treatment, Renal impairment was seen in 32 out of 50 patients (64%) in head and neck cancer arm whereas in ca cervix arm it was seen in only 14/50 patients (28%)
Conclusions: Renal impairment is more pronounced in head and neck cancer patients as compared to cervical cancer patients thus more aggressive hydration measures are required in patients of head and neck cancer
The use of autologous fat grafting in facial and body rejuvenation: efficacy, innovative techniques and complications
Get PDFAutologous fat grafting has revolutionized facial and body rejuvenation by providing natural, biocompatible, and long-lasting results. This review explores recent advancements in harvesting, processing, and injection techniques, emphasizing their efficacy, safety, and aesthetic outcomes. Fat grafting not only restores volume but also demonstrates regenerative properties due to adipose-derived stem cells (ADSCs), enhancing skin texture and elasticity. Modern methods, such as nanofat grafting, offer promising results for delicate areas and scar treatment. Additionally, fat grafting has gained popularity in body contouring, breast reconstruction, and soft-tissue repair, with reported fat retention rates between 60% and 80%. However, complications like fat necrosis, cyst formation, and partial resorption are not uncommon. Rare but severe risks, such as fat embolism, underscore the need for meticulous technique and careful patient evaluation. This review highlights the importance of patient selection and optimized protocols to achieve consistent outcomes, minimize risks, and explore the regenerative potential of fat grafting for emerging applications in medicine
Study of serum insulin and thyroid hormones levels among infertile females in Bangladesh
Get PDFBackground: Infertility affects 8-10% of couples worldwide, with altered insulin and thyroid levels as potential factors. This study examines fasting serum insulin and thyroid hormones in women with primary and secondary infertility.
Methods: The study included 100 women, with 50 experiencing primary infertility (Group A) and 50 with secondary infertility (Group B). Age-matched fertile women served as the control group. Data were recorded on a standardized data sheet following written consent. Statistical analysis was performed using unpaired Student’s t-tests with SPSS software, version 12.
Results: In this study, the mean fasting serum insulin and TSH levels were significantly higher in infertile women compared to fertile women (p<0.001). Within the infertility group, serum fasting insulin was higher in women with primary infertility than in those with secondary infertility, although this difference was not statistically significant. The mean TSH levels in both infertility groups were significantly elevated compared to the fertile group. Among those with infertility, 28% of women with primary infertility and 24% with secondary infertility had hypothyroidism, while elevated serum insulin levels were observed in 22% and 20% of these groups, respectively. Among the hypothyroid infertile women, 64.2% (9 of 14) with primary infertility and 58.3% (7 of 12) with secondary infertility also had hyperinsulinemia.
Conclusions: The study found higher fasting serum insulin and TSH levels in infertile women, often linked to hypothyroidism, menstrual irregularities, and ovulatory dysfunction. It emphasizes the need to assess TSH and insulin levels in infertility evaluations
Updates in chronic cholestatic liver diseases: Indian expert recommendations for diagnosing and managing complex cases
Get PDFCholestatic liver diseases (CCLDs) encompass hepatobiliary disorders leading to impaired bile secretion or reduced production, causing liver damage and fibrosis. Diagnosis relies on differentiation between hepatocellular and cholestatic diseases based on liver function tests (LFTs). Histological testing aids in detecting cholestasis-related alterations, crucial for identifying conditions like primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). Non-invasive tests like FIB-4 and aspartate transaminase to platelet count ratio index (APRI), nonalcoholic fatty liver disease (NAFLD) fibrosis scoring, and elastography, offer alternatives to liver biopsy for fibrosis assessment. Evolving diagnostic procedures, such as endoscopic ultrasound-guided biopsies, complement traditional methods. Chronic cholestatic liver disease management includes treatment with ursodeoxycholic acid (UDCA). Alcoholic liver disease requires abstinence and nutrition therapy, while NAFLD management involves lifestyle changes and medications. Drug-induced liver injury necessitates prompt discontinuation and may involve UDCA, corticosteroids, and targeted therapies. Emerging treatments include farnesoid X receptor agonists, peroxisome proliferator-activated receptor agonists, fibroblast growth factor 19 agonists, and immunosuppressive agents for conditions like PSC and nonalcoholic steatohepatitis. Ongoing evaluations explore various drug classes with newer therapeutic targets for these liver conditions
Comparative study of the outcome and early complications between stapled and open hemorrhoidectomy
Get PDFBackground: Hemorrhoids also known as piles are vascular cushions in the anal canal that help with stool control. When these cushions are swollen or inflamed, they become a disease. The signs and symptoms depend on the type present. Internal hemorrhoids often result in painless, bright red rectal bleeding while defecating whereas external hemorrhoids mostly present with pain and swelling in the area of the anus.
Methods: This study was conducted in the department of surgery, GMC Jammu during the time period of one year. After seeking consent to be a part of study, patients were subject to either of the procedures based on their allotted groups and aim was to compare the outcome and early complications between stapled and open hemorrhoidectomy groups.
Results: A total of 90 patients were taken for the study and 45 patients were recruited to each group. VAS (visual analog scale) scores for pain were better in the stapled group. None of the stapled patients complained of bleeding beyond first post-op week. In the open group 1 patient continued to complain of bleeding during defaecation even at 45 days. The mean hospital stay was lower and return to work was earlier in stappled group as compared to open group. The incidence of postoperative fever, incontinence to flatus, urinary retention, mucus discharge, unhealed anal wound, anal stenosis and recurrence was more in the open group as compared to stappled group.
Conclusions: Our study affirms stapled hemorrhoidectomy as a superior procedure in terms of early outcomes, with lesser post-op pain and bleeding, early hospital discharge, early return to work, less complications and low recurrence rate as compared to open hemorrhoidectomy
Revumenib: the newly approved food drug administration drug for the treatment of relapsed acute leukemia with a KMT2A translocation
Get PDFOn November 15, 2024, the US food and drug administration (FDA) granted approval for Revumenib for the treatment of relapsed or refractory acute leukemia in adult patients and pediatric patients aged 12 months or older who exhibit a lysine methyltransferase 2A (KMT2A) translocation. This subset of acute leukemia is driven by the pathological interaction between menin proteins and the KMT2A gene, a critical epigenetic regulator. This interaction facilitates the rearrangement of KMT2A, which underpins leukemogenesis, contributing to the pathophysiology in approximately 10% of acute leukemia cases
A case of Sheehan syndrome in early pregnancy
Get PDFSheehan syndrome is also known as hypopituitarism due to necrosis of the anterior pituitary gland due to hypotension or shock, secondary to postpartum bleeding. It generally occurs in postpartum bleeding after a full-term delivery as there is physiological hyperplasia of the pituitary gland which demands more blood supply. After severe postpartum haemorrhage, there is inadequate blood supply to the pituitary gland which results in necrosis of the gland. The first and most common symptom of Sheehan syndrome is absence of lactation. Other symptoms may include amenorrhoea, hot flashes. Sheehan syndrome is still a significant cause of morbidity and mortality in less developed countries. The diagnosis of Sheehan syndrome may not present immediately after birth. But rarely, it can be seen in the first trimester due to incomplete abortion. In our case a 35-year female G5P4L4 with one month and fifteen days of amenorrhoea came with complain of bleeding per vaginal and severe generalised weakness. After stabilisation patient was evaluated and it came to know that patient has hypopituitarism
Study of prescription pattern of antihypertensives in diabetes with hypertension patients in geriatric population at tertiary care centre: a prospective observational study
Get PDFBackground: Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are prevalent chronic conditions that significantly affect elderly health, especially in India, where the dual occurrence of these diseases exacerbates cardiovascular risks. This study examines the prescription patterns of antihypertensive medications in geriatric patients with both conditions at a tertiary care center in Maharashtra, India.
Methods: A prospective, cross-sectional study was conducted at government medical college, Aurangabad, from March 2023 to August 2024. Patients aged 60 and older with HTN and T2DM were included. Prescription data for antihypertensive medications were collected and analyzed.
Results: The study included 1023 prescriptions, with 57.09% male patients. The most commonly prescribed antihypertensives were telmisartan (38.05%) and amlodipine (31.96%). Monotherapy was prescribed to 22.48% of patients, while 61.97% received two-drug combinations, and 14.66% received three-drug combinations. Only 0.88% of patients were prescribed more than three drugs. The most common combination therapy was Telmisartan and Amlodipine (59.78%). The majority of prescriptions were generic (91.18%), and 85.23% were from the national essential drug list (EDL) (India 2022), indicating cost-effective and standardized treatment practices.
Conclusions: The study reveals a preference for ARBs and calcium channel blockers for managing HTN in elderly patients with T2DM. The widespread use of combination therapies and generic drugs reflects an efficient approach. Additionally, the study follows the WHO prescription parameters, with the average number of drugs per encounter being 1.93, and a high percentage of prescriptions aligning with EDLs
A study of unclaimed bodies autopsied at AIMS, B.G. Nagara: a retrospective study
Get PDFBackground: An unidentified dead body always presents a challenge for forensic specialists and investigating officers. However, when a deceased person is found in a disfigured, skeletonized or decomposed state, the identification process becomes significantly more difficult and stressful for forensic professionals. The objective of this study was to examine the demographic patterns in cases of unidentified bodies found in and around AIMS B.G. Nagar, India.
Methods: A retrospective cross-sectional study was performed on 84 cases of unidentified deceased individuals brought for post-mortem examination at the department of forensic medicine and toxicology, AIMS, in B.G. Nagar, Karnataka, between January 2021 and December 2024. To maintain consistency in data collection, a standard proforma was utilized, focusing on unidentified bodies and excluding identified cases.
Results: Over the study period, 796 necropsies were performed, of which 84 cases (10.55%) involved unidentified bodies. Of these, 25 cases (29.76%) were identified, while the remaining cases stayed unidentified. The highest number of deceased individuals were in the 41–50 age group, with the majority being male. November saw an increase in deaths, accounting for 11 cases (13.1%). Additionally, 39 cases (46.4%) were found at bus stops, highways and roads. The primary cause of death was natural, with disease and pathological conditions responsible for (60.7%) of the fatalities.
Conclusions: This study highlights the common causes of death in the study area and emphasizes the necessary public health measures to be taken
The digital dentist: robotics in dental practice
Get PDFThe integration of robotics into dentistry marks a significant technological advancement, leading to transformation in traditional dental practices. This review explores the varied applications of robotics in dentistry, including surgical procedures, implantology, orthodontics, prosthodontics, and endodontics, highlighting their ability to improve accuracy, reduce human error, and streamline workflow. Robotic systems, such as surgical assistants, CAD/CAM-enabled devices, and AI-powered diagnostic tools, are revolutionizing patient care by providing minimally invasive options and superior treatment outcomes. However, these innovations are not without challenges. High initial costs, a steep learning curve, and concerns about the loss of human touch in dental care hinder widespread adoption. Patient skepticism and fear, coupled with ethical considerations about replacing traditional methods with automated systems, also pose barriers. Additionally, technical limitations, such as extended preparation times and the need for robust maintenance, underscore the complexity of integrating robotics into clinical practice. The current trend emphasizes the growing collaboration between robotics, artificial intelligence, and digital dentistry, aiming to create more accessible and reliable solutions. With advancements in autonomous systems and AI, robotics holds the potential to bridge gaps in accessibility, provide care in remote areas, and redefine the scope of dental practice. This review highlights the need for further research, interdisciplinary collaboration, and public education to address existing limitations and foster acceptance of robotics in dentistry, ultimately paving the way for a future of more precise and patient-centered dental care