International Archives of BioMedical and Clinical Research 2020-10-26T06:40:50+00:00 Dr. Farhan Ahmad Khan, MD Open Journal Systems <p style="text-align: justify;">International Archives of Biomedical and Clinical Research (IABCR) is an open access, international, peer-reviewed, quarterly multidisciplinary medical research journal that focuses on communicating high quality research articles, reviews, Short communications, case reports, Letter to Editor, Drug News and updates in the field of Medical, Dental and other allied health and BioMedical Sciences. The Journal publishes 4-four issues in a year.</p> <h3>Connecting Researchers Globally</h3> <p style="text-align: justify;">IABCR offer Researchers, Academicians a better option when it comes to Open Access Journal publishing. Our platform vies to become the standard for all open access publications, irrespective of subjects or branches and aims to bring together researchers from all over the world and under a single global organization to form a community that actively creates new data and shares it with everyone with the utmost ease and simplicity.</p> <h3>Ethical guidelines for journal publication</h3> <p style="text-align: justify;">The Editor-in-Chief/Editor of International Archives of BioMedical and Clinical Research (IABCR) is responsible for determining which of the research papers/articles submitted to the journal should be printed. The publication decision is based on the recommendation of the journal's reviewers. The Editor-in-Chief /Editor may be maneuvered by the policies of the journal's editorial board and constrained by such legal requirements as shall then be in force regarding libel, copyright infringement and plagiarism. The Editor-in-Chief/Editor may consult with other editors or reviewers in getting to this determination.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> To Study Clinical Profile and Outcome of Dengue Fever with Reference to Serological Test (IgM & NS1) in a Tertiary Care Hospital 2020-09-30T18:57:24+00:00 Jay Dhadke Latika Banshiwala Shakira Savaskar <p><strong><em>Background: </em></strong><em>Dengue is the most prevalent viral disease which is mosquito-borne in origin. Incidence of dengue has found to be increased and has become a major public health concern. The aim of the present study was to study clinical profile of dengue in the age group of one year to 14 years and to study certain environmental risk factors of dengue. &nbsp;<strong>Methods:</strong></em> <em>In this prospective clinical study total patient selected were 250 attending in the Outpatient department of Paediatrics of Dr. V. M. Govt. Medical College, Solapur, Maharashtra, India from Sept.2016 to Aug-2018 i.e.2 Years. A detailed case history, a complete physical examination was carried out. The patients were subjected to following routine and special investigations. Clinical grading of disease severity was as done according to WHO guidelines. The data collected was compiled, tabulated, analyzed and subjected to statistical tests done using SPSS. <strong>Results: </strong>In present study total 7222 were hospitalized and out of 7222 patients 250 tested positive for dengue. Out of which 134 (53.60%) were males and 116 (46.40%) were females. Out of the 250 patients, 83 were aged between 1 to 5 years i.e. 33%, 90 were aged between 6 to 10 years i.e. 36.5%, 77 patients were aged between 11 to 14 years i.e. 30.4%. 100 patients (40%) belonged to urban population and 150 patients (60% ) belonged to rural population. 83 (33%) patients falls in the age group of 1 to 5 years out of which 42 were males and 41 were females. 90 patients were in the age group of 6 to 10 years out of which 50 were males and 40 females. 77 patients belong to the age group 11 to 14 years out of which 40 were males and 37 were females. In the month of Jan to March 42 cases reported i.e. 16.8%, April to June 23 cases were reported i.e. 9.2%, July to September 161 cases were reported i.e. 64.4% and 24 cases in the month of October to December i.e. 9.6%. Out of 250 patients all were having fever (100%) and nausea and vomiting 48 cases (19.5 %) were the least noted symptoms in the study. Out of 250 patient’s pallor was observed in 33 cases (13%), icterus in 10 cases (4%), lymphadenopathy in 5 cases (2%), Epistaxis in 22 cases (8.6%), petechiae in 87 cases (34.7%), malaena in 83 cases (33%), haematuria in 43 cases (17.4%). of 250 hepatomegaly was seen in 49 cases (19.5%), splenomegaly in 43 cases (17.3%), cold peripheral extremities was seen in 38 cases (15.2%), hypotension is seen in 60 (23.9%), mild hypotension in 22 cases (8.8%), moderate hypotension in 25 cases (20%) and severe in 13 cases (5.6%), pleural effusion in 28 cases (11%) and ascites in 25 cases (10 %). Leucopenia was seen in 88 cases (35 %), leucocytosis in 63 cases (25 %), thrombocytopenia in 120 cases (48 %), hyperbilirubinemia in 20 cases (08 %), haematocrit &gt; 42 % in 75 cases (30 %). Out of 250 cases IgM positive was seen maximal in 153 cases (60.8%), only NS 1 was seen in 98 (39.10%), both IgM and NS 1 in 44 (17.3%). 30 cases (12%) were having gall bladder wall oedema, 25 cases (10%) having ascites and 28 case (11%) were having pleural effusion. </em><strong><em>Conclusions</em></strong><em>: </em><em>Our study concluded that out of 7222 patients 250 patients were dengue positive and all were having fever as a predominant symptom. Thrombocytopenia was seen in 120 patients and out of that 24 required platelet rich plasma and only 8 required single donor platelet apheresis. In this study dengue IgM was positive in 153 cases and dengue NS1 was positive in 98 cases which shows that dengue IgM and NS1 are good serological markers of dengue fever.</em></p> <p>&nbsp;</p> 2020-09-30T00:00:00+00:00 Copyright (c) 2020 Jay Dhadke, Latika Banshiwala, Shakira Savaskar A Study to Assess Thrombocytopenia in High Risk Neonates in a Tertiary Care Hospital: A Prospective Observational Study 2020-09-30T18:57:25+00:00 Saurabh Piparsania Prashant Kumar Choudhary Priyanka Shrivastava <p><strong><em>Background: </em></strong><em>Thrombocytopenia is a significant cause of morbidity and mortality in high risk neonates. The present prospective observational study was conducted to assess incidence of thrombocytopenia in High Risk Neonates in a Tertiary Care Hospital.</em></p> <p><strong><em>Methods:</em></strong> <em>This prospective observational study was carried out at Neonatal Intensive Care Unit (NICU) of a tertiary care hospital over a period of 6 months. A total of 140 high risk neonates (intramural + extramural) admitted to the NICU during this period formed the study group. Enrolled neonates were observed prospectively. Platelet count of less than 150,000/cu mm was taken as the cut off point for determining thrombocytopenia. Data was analyzed using SPSS version 22.&nbsp; P value less than 0.05 was considered significant.</em></p> <p><strong><em>Results: </em></strong><em>In the present study total high risk neonates were 140 in which 63.57% were males and 36.42% were females. The gestational age was normal in 50.71%, moderate to late preterm in 23.57%, very preterm in 17.85%, extreme preterm in 6.42% high risk neonates.&nbsp; The incidence of thrombocytopenia was 60.71% among the high risk neonates. Mild thrombocytopenia was observed in 16.47% neonates, moderate thrombocytopenia in 34.11% and severe thrombocytopenia in 49.41%.</em></p> <p><strong><em>Conclusions</em></strong><em>: </em><em>Our study concluded that incidence of thrombocytopenia was 60.71% among the high-risk neonates. Mild thrombocytopenia was observed in 16.47% neonates, moderate thrombocytopenia in 34.11% and severe thrombocytopenia in 49.41%.</em></p> <p>&nbsp;</p> 2020-09-30T14:29:23+00:00 Copyright (c) 2020 Saurabh Piparsania, Prashant Kumar Choudhary, Priyanka Shrivastava Correlation of CPK-MB and LVEF with Pulmonary Edema in Cases with Scorpion Sting 2020-09-30T18:57:25+00:00 Adarsh Purohit Sandeep Choudhary <p><strong><em>Background: </em></strong><em>To study correlation between rise in CPK-MB and Fall in Left Ventricular Ejection Fraction (LVEF) with Pulmonary Edema in cases with Scorpion Sting. </em></p> <p><strong><em>Methods:</em></strong> <em>Design: Randomised Controlled Trial, Subjects: 126 patients with scorpion sting. All the patients enrolled in the study were monitored clinically in ICU and investigated for markers of myocardial injury by S.CPK-MB and 2D Echocardiography for LVEF at admission. <strong>Results: </strong></em><em>in our study </em><em>patients </em><em>with left ventricular ejection fraction less than 40% had higher than normal value of serum CPK-MB (120.28 ± 88.76 IU/L), but the value of this cardiac enzyme was comparatively higher (155.1 ± 65.94) in those with normal left ventricular output. The cases with ejection fraction between 40-60% demonstrated the lowest values of CPK-MB (94.25 ± 94.25). It was observed that mean serum CPK-MB level was higher (130.4 ± 104.6 IU/L) in cases with pulmonary edema than in those without edema (113.3 ± 68.1 IU/L); however, this difference was statistically insignificant (p&gt;0.20).</em> <em>Our second indicator of myocardial injury left ventricular ejection fraction was significantly lower (33 ± 14%) in cases with pulmonary edema when compared to those without edema (54 ± 11%), p-value being &lt;0.01</em><em>.</em></p> <p><strong><em>Conclusions</em></strong><em>: </em><em>There is no direct relationship in CPK-MB level and fall in LVEF, meaning thereby there are other physiological factors affecting LVEF rather than only direct myocardial injury. Pulmonary Edema is mainly due to fall in LVEF. LVEF is a better indicator of the severity of myocardial injury than CPK-MB and can help in guiding the treatment.</em></p> <p>&nbsp;</p> 2020-09-30T14:21:06+00:00 Copyright (c) 2020 Adarsh Purohit, Sandeep Choudhary A Prospective Study on Clinical Profile Prognostic Factors in Cases of Acute Respiratory Distress in Infant 2020-09-30T18:57:25+00:00 Supriya A Patil <p><strong><em>Background: </em></strong><em>Acute respiratory infections are the significant cause of illness and death in children. Low socioeconomic status and malnutrition increase morbidity and mortality. W.H.O. reported that pneumonia is the single largest infectious cause of death in children all over the world. It is estimated that 16% of all deaths of children under 5 years old are due to pneumonia.</em></p> <p><strong><em>Methods:</em></strong> <em>Total 240 infants up to 12 month were included in this study. This study was conducted in Department of pediatrics. This study conducted of duration over a period of two year.</em></p> <p><strong><em>Results: </em></strong><em>The result of this study retrieved that 198 cases were recovered &amp; discharged, 20 cases left against medical advice &amp; 22 cases were expired.</em></p> <p><strong><em>Conclusions</em></strong><em>: This study concludes that malnutrition, poverty, lack of breast feeding, lack of immunization and overcrowding were the most important risk factors for acute respiratory infections.</em></p> <p><strong><em>&nbsp;</em></strong></p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T14:15:47+00:00 Copyright (c) 2020 Supriya A Patil Association of Human Papilloma Virus (HPV And Oral Cavity Squamous Cell Carcinoma (OSCC): Indian Scenario 2020-10-26T06:31:58+00:00 Parvinder Singh Sandhu GSN Raju Mini Bedi <p><strong><em>Background: </em></strong><em>About 80-90% of HNSCC are associated with known risk factor e.g. smoking, tobacco chewing &amp; alcohol abuse. The role of human papilloma virus (HPV) in the etiology of HNSCC has emerged in last few years. Many studies have proved HPV in oropharyngeal cancer but there are very few studies regarding role of HPV in oral cavity which constitutes the 90% of HNSCC. The purpose of this study was to look for the prevalence of HPV in HNSCC in India.</em></p> <p><strong><em>Method: </em></strong><em>This was a prospective observational study. 50 cases of suspected malignant ulcers of oral cavity were biopsied. Having confirmed the lesion as SCC, HPV 16 and 18 analysis was done on frozen samples by PCR.</em> <strong><em>Results: </em></strong><em>The most common site of OSCC was oral tongue (50%). About 80% of the patients had some form of addiction. 36% of the patients had early stage disease whereas 64% had late stage disease with 76% cases of well differentiated SCC. Only 2 (4%) patients were found to be HPV positive.</em> <strong><em>Conclusions</em></strong><em>: HPV is an important etiological agent in HNSCC in western patients but its role in OSCC has yet not been significant. In India, tobacco and alcohol are commonly identified etiological agents of HNSCC. The rarity of HPV might be due to the differences in the cultural and sexual behavior. Also, HPV vaccine is predicted to reduce the incidence of oral cancer due to HPV. However, further studies are required to label HPV as etiological factor for OSCC proper.</em></p> <p>&nbsp;</p> 2020-09-30T00:00:00+00:00 Copyright (c) 2020 Parvinder Singh Sandhu, GSN Raju, Mini Bedi Functional Outcome of Intertrochanteric Fractures Treated with Proximal Femoral Nail 2020-10-26T06:40:50+00:00 Anilkumar Bapugouda Patil <p><strong><em>Background: </em></strong><em>Intertrochanteric fractures are common in old age group. These fractures are three to four times more common in elderly women, and the mechanism of injury is usually due to low energy trauma like simple fall or due to road traffic accidents.</em></p> <p><strong><em>Methods:</em></strong> <em>Total 120 cases of fracture were included in this study. Out of 120 cases fracture were seen due to fall in 108 cases and due to road traffic accident in 12 cases. This study was conducted in Department of Orthopedics. The duration of study was over a period of one and half year.</em></p> <p><strong><em>Results: </em></strong><em>In this study, we were included total 120 cases. Among all cases 70 were female and rests were male. We were found 12 cases of rod traffic accident &amp; 108 cases sustained the fracture due to fall.</em></p> <p><strong><em>Conclusions</em></strong><em>: This study concludes that the PFN should be the method of choice for surgical treatment of intertrochanteric femoral fractures.</em></p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T00:00:00+00:00 Copyright (c) 2020 Anilkumar Bapugouda Patil Cutaneous Side Effects of Steroid Use in Dermatophytosis 2020-09-30T18:57:26+00:00 Bansal Charu Md Raihan <p><strong><em>Background: </em></strong><em>Dermatophytosis is a common, superficial fungal infection of the skin. Recently, there has been tremendous increase in the incidence of dermatophytosis attributed mainly to misuse of steroids in the management of fungal infection.</em></p> <p><strong><em>Methods:</em></strong> <em>A cross sectional study of 6 months duration was done in patients with dermatophytic fungal infections, diagnosed clinically, with history or findings of some form of steroid use. Both quantitative and qualitative data were collected regarding steroid formulations about type, duration of use, route of administration and their availability by prescription or “over the counter”. Various cutaneous and systemic adverse effects of steroids were also observed.</em></p> <p><strong><em>Results: </em></strong><em>Out of the total 200 patients of dermatophytosis, 120 patients (60%) had used steroid formulations either topical(80%), oral(12.5%), intralesional or injectable(7.5%).The mean duration of illness in patients who had used steroids was 24 ± 3 weeks. Multiple site infection of dermatophytosis was present in 65% with steroid misuse and in 40.8% with nonsteroid use patient group. Cutaneous adverse effects were common in patients with steroid misuse, as suggested by relatives, friends, chemist, general practitioners or due to self-medication.</em></p> <p><strong><em>Conclusions</em></strong><em>: Misuse of steroid formulations in dermatophytic infections may result in various cutaneous and systemic side effects. Strict drug control policies and awareness of adverse effects of steroid abuse are truly the need of the hour to control this menace. </em></p> <p><em>&nbsp;</em></p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T14:39:19+00:00 Copyright (c) 2020 Bansal Charu, Md Raihan A Study of Fungal Isolates in Clinically Diagnosed Patients of Tinea Incognito attending A Tertiary Care Center in Central Uttar Pradesh 2020-09-30T18:57:26+00:00 Aliya Rizvi Mohammad Asad Haroon Sanjeev Sahai <p><strong><em>Background: </em></strong><em>Tinea incognito is a dermatophytic infection that lacks the classical features of a typical fungal infection and result from repeated use of immunosuppressive agents like steroids.&nbsp; The aim of this study was to investigate the occurrence of fungal isolates among clinically suspected cases of tinea incognito in the dermatology OPD and to study the association between these fungal isolates and type of disease presented.</em></p> <p><strong><em>Methods:</em></strong> <em>One hundred clinically suspected cases of tinea incognito attending the Dermatology OPD of a tertiary care centre were enrolled and were referred to the Department of Microbiology for the isolation and identification of etiological agent. Skin Scrapings were used as specimens for direct microscopic examination after potassium hydroxide (KOH) mounts and remaining specimen was used to inoculate the culture media.</em></p> <p><strong><em>Results: </em></strong><em>Among the 100 patients, KOH mount demonstrated fungal elements in 85 patients. Sixty two KOH-positive cases and 9 KOH-negative cases showed growth of fungus on culture.&nbsp; All KOH positive cases except for 2 cases were dermatophytes. Among the total 71 culture positive samples, 86% demonstrated growth of dermatophytes while in the remaining 14% non-dermatophytes were isolated. Trichophyton rubrum was isolated in approximately one-third of the cases. The dermatophytic fungal isolates in decreasing order of occurrence were T. rubrum, T. mentagrophytes, T. tonsurans, T. interdigitale, Microsporum ferrugineum, &nbsp;&nbsp;&nbsp;&nbsp;M. audouinii and T. schoenleineii.</em></p> <p><strong><em>Conclusions</em></strong><em>: </em><em>An increased level of awareness along with better government policies regarding the sales of steroid formulations would prevent mismanagement of tinea cases.</em></p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T14:42:49+00:00 Copyright (c) 2020 Aliya Rizvi, Mohammad Asad Haroon, Sanjeev Sahai Evaluate an Association Between Isotretinoin and Depression in Acne Patients: An Open Labelled Prospective Study 2020-09-30T18:57:27+00:00 Shafia Nisar Kakroo Mirza Aumir Beg Basit Kakroo Md Ashraf Jamal <p><strong><em>Background: </em></strong><em>Acne vulgaris is a multifactorial disease in which there are abnormalities in follicular keratinization, sebum production, proliferation of Propionibacterium and inflammation.&nbsp;It is a common disorder among young adults causing a considerable psychological impact. Treatment options include topical comedolytics, topical and systemic antibiotics, hormonal manipulations, and oral retinoids.&nbsp; Isotretinoin is a synthetic oral retinoid that is very effective in the treatment of moderate to severe acne. But there have been many reports associating isotretinoin with depression, though no clear evidence has been established. <strong>Aim: </strong>To determine whether oral isotretinoin increases the risk of depression in patients with acne.</em></p> <p><strong><em>Methods:</em></strong> <em>160 patients, with moderate to severe acne were treated with oral isotretinoin 0.5 mg/kg/day for a period of 3 months. Their acne and depression scoring was done at baseline and then every month for the first 3 months and then at 6 months.</em></p> <p><strong><em>Results: </em></strong><em>It was found that the acne scoring reduced from 4.10 ± 0.47 to 0.60 ± 0.61 (P&nbsp;= &lt; 0.001) at the end of 3 months. There was a significant decrease in depression score from 4.89 ± 4.8 to 0.42 ± 1.12 (P&nbsp;&lt; 0.001) at the end of 3 months. Both the acne and depression scores continued to remain low at the end of 6 months at 0.5 ± 0.52 and 0.18 ± 0.51, respectively.</em></p> <p><strong><em>Conclusions</em></strong><em>: This study concluded, that oral isotretinoin&nbsp;shows effective results in acne. Our study revealed no association between depression and isotretinoin but showed significant reduction in depression scores.</em></p> <p>&nbsp;</p> 2020-09-30T14:46:14+00:00 Copyright (c) 2020 Shafia Nisar Kakroo, Mirza Aumir Beg, Basit Kakroo, Md Ashraf Jamal A Sternal Sparing Approach to Mitral Valve Replacement – Comparative Study 2020-09-30T18:57:27+00:00 Mohd Azam Haseen Amit Srivastava <p><strong><em>Background: </em></strong><em>A variety of techniques including Mini-sternotomy, right anterior mini-thoracotomy, Port Access approach (Heartport), indirect endoscopic techniques and robotic techniques have been described to reduce incision size in mitral valve surgery. We used a mini-thoracotomy technique (Right Antero Lateral Thoracotomy - RALT) for mitral valve patients and compared our results with the conventional technique (mid sternotomy). </em></p> <p><strong><em>Methods: </em></strong><em>We randomly allocated 100 consecutive patients presenting to our practice for mitral valve surgery between two groups. The first group (test group) consisted of 50 patients in which mitral valve surgery was performed via mini-right anterolateral thoracotomy (RALT group) approach. The control group (50 patients) underwent classical mitral valve surgery through median sternotomy (MS group). Standard aortic and bicaval cannulation with antegrade blood cardioplegia was adopted in both groups. </em></p> <p><strong><em>Results: </em></strong><em>The mean age of patients in RALT group was 31.8</em><em> ±6.2</em><em> years and in MS group was 32.2</em><em> ± 7.8</em><em> years. The two groups were comparable with respect to age, sex, mitral valve lesion, ejection fraction and NYHA class. The mean CPB time (min) and mean aortic clamp time (min) were significantly less in MS group as compared to RALT group. However, the mean total operative time in RALT and MS group was almost similar. The average blood loss (in ml) via Mediastinal drains was significantly higher in MS group, requiring more blood transfusion as compared to RALT group (p&lt;0.001). The mean extubation time in RALT group was 5.2 ± 0.5</em><em> hours </em><em>and 9.5 ± 2.2 hours in </em><em>MS group, which was statistically</em><em> significant in lower in RALT (P&lt;0.001). In MS group, 11 patients (22%) suffered from postoperative complications versus 10 patients (20%) in the RALT group, with no significant difference between the groups. There was no reported mortality in both the group. </em></p> <p><strong><em>Conclusions: </em></strong><em>The cosmetic appearance in RALT group was excellent, that rivals that of robotically assisted techniques and the patients' wounds were scarcely apparent in the female patients. The study demonstrates the efficacy and safety of this technique, with excellent cosmetic results and no additional cost or risk to the patients.</em></p> <p>&nbsp;</p> 2020-09-30T18:27:11+00:00 Copyright (c) 2020 Mohd Azam Haseen, Amit Srivastava Our Experience of Rigid Esophagoscopy for Esophageal Foreign bodies 2020-09-30T18:57:27+00:00 Mohd Azam Haseen Mayank Yadav Sumit Pratap Singh Sayyed Ehtesham Hussain Naqvi Nadeem Raza M H Beg <p><strong><em>Background: </em></strong><em>Foreign body (FB) in esophagus is a common emergency presentation. If not managed properly it can lead to absolute obstruction of esophagus along with other life-threatening complications. Children make up roughly 80% of patients presenting to emergency departments with an esophageal FB. </em></p> <p><strong><em>Methods: </em></strong><em>Retrospective observational study done in department of Cardiothoracic surgery at J.N. Medical college AMU, Aligarh. We included 308 patients of all age groups after excluding patients with preexisting esophageal diseases. All these patients underwent Rigid esophagoscopy (RE) for retrieval of their FB under General anaesthesia with endotracheal intubation. </em></p> <p><strong><em>Results: </em></strong><em>There was male preponderance in ratio of 1.5:1 with children younger than 6 years of age comprising 80% of the patients. Upper esophagus (71%) was the favoured site for FB lodgment. The most common FB’s were coins (31.1%) followed by disc batteries (9.1%). Success rate of FB retrieval was 98%. There were no major complications and no mortality in study group.</em></p> <p><strong><em>Conclusions: </em></strong><em>Our experience of using RE for removal of esophageal FB has been good with no major complications and almost 100 results. Regarding the debate of rigid versus flexible endoscope, we prefer to use rigid esophagoscopy for children and sharp and impacted foreign bodies of any age group and flexible endoscopy for older patients with non-impacted FB. However, a center has to be proficient in both techniques as they are complimentary and very much needed to cater to needs of all variety of esophageal FB’s.</em></p> <p><em>&nbsp;</em></p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T18:30:21+00:00 Copyright (c) 2020 Mohd Azam Haseen, Mayank Yadav, Sumit Pratap Singh, Sayyed Ehtesham Hussain Naqvi, Nadeem Raza, M H Beg Effect of ARNi (Angiotensin Receptor–Neprilysin Inhibitors) in Post Mitral Valve Replacement / Repair patients with Heart Failure: A Retrospective Analysis 2020-09-30T18:57:28+00:00 Amit Srivastava Sanjay Kumar Mohd Azam Haseen Arvind Kumar Pandey <p><strong><em>Background: </em></strong><em>Arrhythmias Induced Cardiomyopathy (AiCM) is generally a reversible condition triggered by Tachycardia, Atrial fibrillation (AF) or Premature Ventricular Contractions (PVC). The most important pillar in the Management of the AiCM remains the initiation of therapy for control of Arrhythmias (Medical management or Ablations) with the optimization of HF management</em></p> <p><strong><em>Methods: </em></strong><em>We had Seven patient of mitral valve disease who underwent open heart surgery. Post-surgery they developed signs and symptoms of heart failure along with arrhythmias (AF) and deteriorating Ejection Fraction (EF)<strong>Results: </strong>When even after optimal drug therapy their symptoms were not controlled, they were switched to ARNi from ACEi. On 6 months of therapy their symptoms improved along with their EF, QOL and arrhythmias<strong> Conclusions: </strong>So, we concluded that in these subset of patients ARNi can be tried to manage AiCM with good clinical results. </em></p> <p>&nbsp;</p> 2020-09-30T18:32:11+00:00 Copyright (c) 2020 Amit Srivastava, Sanjay Kumar, Mohd Azam Haseen, Arvind Kumar Pandey Mitral Valve Thrombectomy: A Novel and Safe Approach for Stuck Mitral Valve 2020-09-30T18:57:28+00:00 Anil Jain Rahul Singh Jigar Shah Kinnnaresh Baria <p><strong><em>Background: </em></strong><strong><em>Objective:</em></strong><em> To retrospectively evaluate and compare the outcome of mitral valve thrombectomy (Group A) versus Redo mitral valve replacement (Group B) for acute mitral prosthetic valve thrombosis (PVT).</em></p> <p><strong><em>Methods: </em></strong><em>104 patients underwent redo surgery for obstructive mitral PVT in our center from January 2016 to March 2018 were included.&nbsp; Patients having acute PVT of other valves were excluded. Pre-operative, peri-operative and post-operative parameters affecting the outcome with follow-up data were measured. Group A (n = 26) underwent mitral valve thrombectomy &amp; group B (n = 78) were treated by redo mitral valve replacement (MVR). Diagnosis of prosthetic valve obstruction was made on the basis of history, clinical examination, echocardiography and fluoroscopy. Total cross clamp and CPB time, hemodynamic status, ionotropic support, ventilation time, intensive care, total hospital stay, morbidity and mortality were also recorded for comparison. Echocardiography was done before discharge. </em></p> <p><strong><em>Results: </em></strong><em>No statistical difference was found on the basis of gender, age, interval between initial MVR and redo operation, anticoagulation status, functional class, international normalized ratio, echocardiography and fluoroscopy. The mean CBP time &amp; cross clamp time was significantly less in group A than group B. Similarly mean ventilation time, Ionotropic support, mean ICU stay and mean hospital stay in group A was significantly less than group B.&nbsp; </em></p> <p><strong><em>Conclusions: </em></strong><em>PVT is a dreaded complication after mechanical MVR with high mortality without timely and effective surgical intervention. Mitral valve thrombectomy being a less aggressive surgical technique is recommended because of better outcome in terms of morbidity and mortality.</em></p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T18:34:38+00:00 Copyright (c) 2020 Anil Jain, Rahul Singh, Jigar Shah, Kinnnaresh Baria Prevalence of Intestinal Metaplasia and Dysplasia in Infectious and Non-infectious Chronic Gastritis 2020-09-30T18:57:28+00:00 Manoj Saxena <p><strong><em>Background: </em></strong><em>Chronic gastritis is characterized as nearness of incessant mucosal provocative changes driving in the end to mucosal decay and intestinal metaplasia.</em></p> <p><strong><em>Aim: </em></strong><em>This prospective study was carried out to know the prevalence of Intestinal Metaplasia (IM) in gastric biopsies, and to find out the association between H. pylori, Intestinal metaplasia and dysplasia and to assess the age and sex distribution of the IM in gastric biopsies.</em></p> <p><strong><em>Methods: </em></strong><em>This prospective study was performed in age group of 26-75 years, attending outpatient Medicine department. A total number of 50 antral gastric biopsies were collected in the department of Pathology and examined histologically to detect intestinal metaplasia. These biopsies were stained by Giemsa to detect H. pylori organisms.</em></p> <p><strong><em>Results: </em></strong><em>H. pylori was found in n = 23 patients (26-75 years; mean age 48.4). Intestinal metaplasia in general was found in 8 patients. Intestinal metaplasia that is associated with H. pylori seen in n = 6 patients, while intestinal metaplasia without H. pylori seen in n=2 patients. Among intestinal metaplasia 1 case show dysplasia.</em></p> <p><strong><em>Conclusions: </em></strong><em>This study has revealed that the prevalence of intestinal metaplasia is higher among patients with chronic gastritis and mainly in those patients who are positive for H. pylori with an active chronic gastritis. Intestinal metaplasia mostly affects patients above the age of 45 years.</em></p> <p>&nbsp;</p> 2020-09-30T18:36:59+00:00 Copyright (c) 2020 Manoj Saxena Distribution pattern of ABO and Rh blood group among blood donors at Hospital Blood Bank in Delhi- An initial step to evaluate preparedness to fight an epidemic 2020-09-30T18:57:28+00:00 Rubeena Naz Mohroo Mohammad. Jaseem Hassan Sabina Khan Nehal Ahmad Sujata Jetley <p><strong>Introduction: </strong>The ABO and Rh blood group systems is most important of all blood groups systems in both blood transfusion and transplant medicine. Antigens present on the surface of RBC’s play an important role in understanding genetics, inheritance pattern, medicolegal issues, disease susceptibility and transfusion safety. It is important to study the distribution of blood group in different population for clinical studies, their relation with disease and environment. The effective management of blood bank and safe transfusion services can be achieved by understanding distribution of ABO and Rh blood groups, as its frequency varies time to time from one population to other.</p> <p>The aim of present study is to determine the distribution pattern of ABO and Rh blood group among the donors at our hospital so as to assess the preparedness of our blood bank to combat ongoing epidemic and to correlate with other studies carried in different regions of India.</p> <p><strong>Material and methods:</strong> A retrospective study was carried out at our hospital blood bank. The study includes both voluntary and replacement donors. The donors were first screened according to criteria for blood donation. The blood samples were obtained by venepuncture method and Blood grouping ABO and Rhesus was done by antigen antibody micro-agglutination tube test. The data was collected in MS Excel spread sheet coded appropriately and analysed by using Statistical Package for Social Sciences (SPSS) software version 24.</p> <p><strong>Results:</strong> Total number of donors were 7822, among which 7681were males and 141 were females. The most common blood group was B (35.40%) and least common was AB (9.65 %) in both males and females. Incidence of ABO blood group showed B blood groups was commonest (35.40%), followed by blood group O (30.96%), blood group A (23.98%) and the least was blood group AB (9.65%). In Rh grouping, 95.63% donors were Rh positive and 4.37% were Rh negative. The maximum donors belonged to 18 -30 years of age group.</p> <p><strong>Conclusion</strong>: This study helps us to know the exact distribution of blood group in our community, which will ultimately help us to plan accordingly in case of any epidemic or disaster. This study also benefits, by collecting data from different regions of India to prepare for future health challenges and smooth functioning of transfusion services and availability of respective blood groups round the clock and to meet the increase demands, thus preventing mortality associated with non-availability of blood at the time of emergency.</p> 2020-09-30T18:40:56+00:00 Copyright (c) 2020 Rubeena Naz Mohroo, Mohammad. Jaseem Hassan, Sabina Khan, Nehal Ahmad, Sujata Jetley Assessment of Lumbar Facet Joint Nerve Blocks in Chronic Low Back Pain: A Tertiary Care Hospital Based Study 2020-09-30T18:57:29+00:00 Sidharth Verma Manvi Verma Sanjog R Mekewar Jayeeta Verma Raghbirsingh P Gehdoo Surekha Patil Bhavika Verma <p><strong><em>Background: </em></strong><em>Lumbar facet joint nerve blocks may be repeated to reinstate pain relief without any deleterious effects. The basis for intra-articular injections has been the inflammation of the joint. Therefore, the main purpose of the study was to evaluate lumber facet joint nerve blocks in managing chronic low back pain.</em></p> <p><strong><em>Methods:</em></strong> <em>The total population was included in this study 120.All cases were divided in non-steroid and steroid group. This study was conducted in Department of Anesthesia. The duration of study was over a period of two year.</em></p> <p><strong><em>Results: </em></strong><em>The result of this study revealed that significant alteration in pain scores from baseline, at 3, 6, 12, 18, and 24 months in both groups, in which no differences occur among Groups I and II.</em></p> <p><strong><em>Conclusions</em></strong><em>: This report reveals lumbar facet joint pain diagnosed by controlled, comparative local anesthetic blocks may be treated with lumbar facet joint nerve blocks either with or without steroid.</em></p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T18:43:08+00:00 Copyright (c) 2020 Sidharth Verma, Manvi Verma, Sanjog R Mekewar, Jayeeta Verma, Raghbirsingh P Gehdoo, Surekha Patil, Bhavika Verma A Prospective Study on Serum Uric Acid Levels in COPD patients in a Tertiary Care Hospital 2020-09-30T18:57:29+00:00 Mahesh Kumar Singh <p><strong><em>Background: </em></strong><em>It is a known fact that chronic cigarette smoking, passive cigarette smoke exposure and even indoor air pollution resulting from biomass cooking or heating damages the respiratory system and causes pulmonary diseases include chronic obstructive pulmonary disease (COPD).</em></p> <p><strong><em>Methods:</em></strong> <em>This case control study conducted for 184 total cases. Out of 184 cases, 74 cases were included in control cases &amp; 110 cases of COPD.&nbsp; This study was conducted in Department of Biochemistry. The duration of study was over a period of one year.</em></p> <p><strong><em>Results: </em></strong><em>This case- control study were included 184 total cases. Out of 184 cases, 48 cases of male &amp; 26 cases of female in Control. Whereas in COPD cases 74 were male &amp; 36 were female. We were found 52 mild, 42 moderate &amp; 16 severe cases of COPD.</em></p> <p><strong><em>Conclusions</em></strong><em>: This study concludes that, elevated serum uric acid level may be a noninvasive indicator for COPD severity</em></p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T18:49:27+00:00 Copyright (c) 2020 Mahesh Kumar Singh A Study of Anaemia in Hypothyroidism 2020-10-08T15:53:10+00:00 Syam Mohan Sangeeta Singhal Anjum Mirza Chughtai <p><strong><em>Background: </em></strong><em>Thyroid hormones are important for maintaining the red cell mass. Patients with hypothyroidism has high chance of anaemia. But it is not given importance mostly in clinical practices. The anaemia seen in hypothyroidism can be either microcytic, normocytic or macrocytic.</em></p> <p><strong><em>Methods:</em></strong> <em>The study was conducted in the department of Physiology and department of Medicine in J N Medical College, Aligarh. 50 patients with hypothyroidism was included in the study. The diagnosis of hypothyroidism was confirmed by serum TSH levels. They were then sent for complete blood count and peripheral smear study. </em></p> <p><strong><em>Results: </em></strong><em>38 out of the 50 patients included in the study were females and rest are males. 24 patients were found to be anaemic. Of these 22 are females and 2 are males.&nbsp; The number of mild, moderate and severe anaemic patients were 7, 15 and 2 respectively. 6 patients were found to be having microcytic anaemia, 13 having normocytic and 5 patients were having macrocytic anaemia. </em></p> <p><strong><em>Conclusions</em></strong><em>: </em><em>Moderate anaemia (62.5%) is found in maximum number of hypothyroid patients included in this study. Morphologically, normocytic anaemia is the most common followed by microcytic and macrocytic types. Anaemia should not be overlooked in the management of hypothyroidism. </em></p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T18:51:27+00:00 Copyright (c) 2020 Syam Mohan, Sangeeta Singhal, Anjum Mirza Chughtai Retrospective Evaluation of Presentation and Management of Liver Abscess Patients 2020-09-30T18:57:30+00:00 Pawan Kumar Pankaj Kumar Kumar Ratnesh <p><strong>Background: </strong>Liver abscesses are potentially lethal diseases if early diagnosis and treatment are not instituted. They are prevalent all over the globe and pyogenic abscesses are predominant over amoebic. Hence; the present study was conducted for evaluating presentation and management of Liver abscess patients.</p> <p><strong>Materials &amp; Methods: </strong>Data records of a total of 50 patients of liver abscess were analysed. Complete demographic and clinical details of all the patients were obtained from the record files. A separate Performa was made and treatment protocol followed along with follow-up details was recorded. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software.</p> <p><strong>Results: </strong>Pain abdomen, fever and anorexia were found to be present in 98 percent, 92 percent and 96 percent of the patients respectively. Nausea/ vomiting, Diarrhea, cough and weight loss were present in 28 percent, 38 percent and 86 percent of the patients. Pallor, jaundice, hepatomegaly and pleural effusion were the main associated signs identified among patients of liver abscess.In 82 percent of the patients, abscess drainage was done using percutaneous needle aspiration, while in 12 percent of the patients; abscess drainage was done by pigtail drainage.</p> <p><strong>Conclusion: </strong>Liver abscess is a serious health condition which has a poor prognosis if left untreated. Early recognition of the signs and symptoms is necessary for improving the prognosis along with morbidity and mortality associated with it.</p> <p>&nbsp;</p> <p>&nbsp;</p> 2020-09-30T00:00:00+00:00 Copyright (c) 2020 Pawan Kumar, Pankaj Kumar, Kumar Ratnesh Evaluation of Anatomy of the Maxillary Sinus Ostium: An Institutional Based Cadaveric Study 2020-09-30T18:57:30+00:00 Rohin Garg <p><strong><em>Background: </em></strong><em>Size, shape of maxillary sinus differs from individual to individual even both the same side of a same person. Variation in the landmark of maxillary sinus implies a significant challenge to a surgeon. Therefore, the aim of the present study was to assess the anatomy of maxillary sinus ostium.</em></p> <p><strong><em>Methods:</em></strong> <em>The present observational study was carried out on 50 sagittal sections of head and neck of Indian origin. The cadavers used in this study. The middle meatus was then studied for the variations possible in the opening of the maxillary sinus ostium. The following parameters were taken into consideration: Position of the ostium (anterior/middle/ posterior) in the hiatus semilunaris, Shape of the ostium, Vertical and horizontal diameters of the ostium, Perpendicular distance from the ostium to the lower border of the inferior concha and upper border of the hard palate. The data obtained were tabulated and analyzed using Statistical Package for the Social Sciences, Version 21.0 (SPSS, Chicago, IL).&nbsp; </em></p> <p><strong><em>Results: </em></strong><em>In the present study, the maxillary sinus ostium was located in the anterior 1/3<sup>rd</sup> in 18% of the cases, in the middle 1/3<sup>rd</sup> in 34% of cases and posterior 1/3rd of the hiatus semilunaris in 48% of the cases. The shape of ostium was observed as oval in 58% of cases and circular in 42% of cases. The mean vertical diameter of the ostium was found to be 2.04mm and mean horizontal diameter of 2.54 mm. The perpendicular distance from the maxillary ostium to the lower border of the inferior concha was found to be 15.01 mm and perpendicular distance from the maxillary osmium to the upper border of hard plate was found to be 17.1 mm.</em></p> <p><strong><em>Conclusions</em></strong><em>: </em><em>This study concluded that the maxillary sinus ostium was found in posterior 1/3rd of the hiatus semilunaris in maximum cases. The shape of ostium was observed as oval in maximum cases. The mean horizontal diameter was greater than mean vertical diameter of the ostium. </em></p> <p><strong><em>&nbsp;</em></strong></p> <p>&nbsp;</p> 2020-09-30T00:00:00+00:00 Copyright (c) 2020 Rohin Garg