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  Most popular articles (Since August 02, 2018)

 
 
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ORIGINAL ARTICLES
Assess knowledge and practice of internship students regarding assisted body mechanics to reduce musculoskeletal disorders and to develop safety guideline on manual handling technique
PGN Swamy, Ruhi Varghese, Archana Kokani
July-December 2017, 5(2):11-17
Introduction: Assisted body mechanics is used to describe the movement we make each day during normal activities, including lying in bed, sitting, standing, lifting, pulling, pushing and walking. Body mechanics can be both good and bad and can have direct effects on back. Good body mechanics will help remedy and prevent future back problem, while bad body mechanics contribute to back problem and other muscle and bone problems. Nursing is a job that needs a lot of bending our back, arms and legs and pushing, pulling patients, because of which many nurses are at risk for developing physical strains and back injuries or even fractures. Aim: The main aim of the study was to assess the knowledge and practice of internship students regarding assisted body mechanics to reduce the musculoskeletal disorders with a view to develop safety guideline on manual handling technique. Methodology: A descriptive approach was used to collect data from 100 internship nursing students using self administered knowledge questionnaire and practice checklist at Sumandeep Nursing College. Result: The study result shows that 85% of internship students had average knowledge regarding assisted body mechanics, 84 % were practicing good body mechanics technique, 14% had fair practice, and 2% had poor practice of body mechanics.
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Comparison of accuracy of Root ZX II and Root ZX Mini in presence of various irrigants: an in vitro study
DS Vaid, NC Shan, DM Kothari, PS Bilgi
January-June 2015, 3(1):28-33
Aim: Comparison of the effect of QMix, 7% maleic acid and 2.5% sodium hypochlorite on the accuracy of Root ZX II and Root ZX Mini apex locator. Methodology: 45 single rooted teeth were decoronated. Patency was checked and coronal flaring was done. They were then divided into 3 groups: i) QMix, ii) 7% Maleic acid and iii) 2.5% Sodium hypochlorite. The actual length of each tooth was determined before embedding them in an alginate model. 5ml of the respective irrigant was introduced into the canal. Working length was measured with Root ZX and Root ZX Mini apex locators. For each sample, an average of a total of three readings was considered. Statistical analysis was performed using Anova, Two Way, Post hoc, Paired t-tests. Results: Group I (QMix) showed no statistically significant results. Group II (7% Maleic acid), showed statistically significant difference from the actual length with Root ZX Mini (p=0.002). Group III (2.5% sodium hypochlorite) showed statistically significant difference from the actual length with Root ZX II (p=0.04) and Root ZX Mini (p=0.0002). A statistically significant difference was seen in the readings by both the apex locators (p=0.005). Conclusion: QMix does not affect the accuracy of apex locators. Root ZX II is more accurate than Root ZX Mini in the presence of 7% maleic acid and 2.5% sodium hypochlorite.
  196 12 -
EDITORIAL
Paradiagm shift in diabetes care: to rural, pregnant women: Indian rural diabetic females should also be aimed at.
Hetal Pandya, Arti Muley
July-December 2017, 5(2):1-3
  124 29 -
The international classification of headache disorders: Anything new in 3rd edition?
Sanjay Prakash
January-June 2018, 6(1):1-2
DOI:10.4103/JIHS.JIHS_11_18  
  109 43 -
ORIGINAL ARTICLES
Electrocardiographic changes in organophosphate poisoning - A prospective study of 50 cases at a tertiary care center in Gujarat
Sanket Makwana, MN Saiyad, Vaishali Makwana
July-December 2017, 5(2):18-24
Introduction: Organophosphates (OP) are irreversible cholinesterase inhibitors, producing nicotinic and muscarinic effects. Cardiac complications with these compounds are often fatal. Early recognition of abnormal rhythm protects the patients against acquiring life-threatening arrhythmias. Hence, this study was done to determine the ECG findings in patients with OP poisoning. Aims & Objectives: To determine the various electrocardiographic changes & its importance in acute Organophosphate poisoning. Materials and methods: This prospective observational study of 50 cases was conducted for 2 years in a tertiary care institute. All adults with history of OP poisoning, admitted within 12 hours were enrolled. Patients with cardiac disease or treated from outside were excluded. Diagnosis was made by history, clinical features and confirmed by serum cholinesterase level. ECG analysis of each case was done for rate, rhythm, ST-T changes, PR and QTc intervals, and conduction defects etc. Results: Mean age in the study group was 30.66 ± 11.70(SD). Male:Female ratio was 1.94:1. 78% were suicidal, 22% were accidental and 6(12%) cases expired. Most common mode of poisoning was ingestion 45 cases (90%). Most common ECG abnormality was Sinus Tachycardia in 12(24%) followed by ST-T changes 8(16%), QTc prolongation in 6(12%), Sinus Bradycardia 4(8%), Extrasystole 2(4%), PR Prolongation 1(2%), AF 1(2%) and VT 1(2%). Conclusion: Poisoning with OP compounds can produce significant ECG abnormalities especially sinus tachycardia, non specific ST-T changes and QTc interval prolongation. Since these abnormalities can cause lethal arrhythmia and cardiac damage, careful observation of the electrocardiogram of the patients exposed to OP compound is necessary, parallel to the appropriate medical management.
  118 23 -
Evaluation of the knowledge of MDR- TB among the Multi-Purpose Workers, under the Revised National Tuberculosis Control Programme, in the mid hills of Himachal Pradesh, India
AK Singh, B Chawla, S Chawla, DK Bhaglani
July-December 2017, 5(2):4-10
Introduction: Knowledge of MDR- TB in Multi- Purpose Workers (MPWs) is cornerstone for implementation of RNTCP, so its evaluation is necessary. Methods: A Cross sectional study in 174 MPWs was conducted. Seven questions about MDR- TB were asked. Answers graded as no answer, incorrect answer and correct answer were allocated zero point, zero and two points respectively. Total score by the MPWs (out of 14), converted to percentage, was used to categorize the knowledge as no knowledge (0%), poor knowledge (> 0 and ≤ 25 %), fair (> 25 and ≤ 50 %), good (>50 and ≤ 75%) and > 75% as excellent knowledge. Comparison was done with the years of job, the training and DOTS provision status. The data was analyzed in SPSS Statistics version 21 and Microsoft Excel 2010 software. Results: Only 9.2% MPWs had received Modular training. 85.6% had provided DOTS and 86.8% had more than five years of job experience. 9.1% workers had no knowledge about MDR-TB. 16.6%, 53.4% and 20.6% workers had poor, fair and good knowledge respectively. Significant difference of knowledge by gender was found (p-value = 0.02). 15.8% and 52.5% of untrained workers had poor and fair knowledge, respectively. 88.8% of workers having good knowledge were the DOT Providers (p- value of 0.04). 66.7% workers having good knowledge had job experience of more than 20 years (p- value = 0.001). Conclusion: Knowledge about MDR- TB in MPWs has a significant relation with DOTS provision status and the years of service rendered. Absence of Modular trainings leads to poor knowledge of the worker.
  103 27 -
REVIEW ARTICLE
Situation analysis of sexually transmitted infections in India
Niraj Pandit, Jatin Chhaya
January-June 2018, 6(1):3-7
DOI:10.4103/JIHS.JIHS_12_18  
Sexual and reproductive health is important component of well-being of human health. It has close relationship with responsible, safe, and satisfying reproductive life. Unaccountable sexual health results in sexual and reproductive ill-health. HIV/AIDS is recently found pandemic disease, but sexually transmitted infections (STIs) are present since ancient time. The history of reproductive tract infection (RTI)/STIs is interesting from name change to treatment change strategy. It is very important to know the historical changes of disease and pattern of disease in country. The present review article is trying to evaluate various aspects of RTI/STIs including historical studies and SWOT analysis for the future challenges.
  90 39 -
ORIGINAL ARTICLES
Incidence rate of oral submucous fibrosis (OSMF) and its etiology in patients visiting Government Dental College and Hospital, Jamnagar (GDCH, Jamnagar)
RN Jha, PB Kalyani, SV Savarkar
January-June 2014, 2(1):11-15
Objectives: To assess the incidence rate of OSMF and its etiology in patients attending OPD at GDCH, Jamnagar. Material and Methods: The diagnosis of OSMF was based on clinical examination and evaluating patients “signs and symptoms. Results: The total number of patients affected by OSMF in this time duration was 268. Out of these, 230 (85.82%) were male, while 38 were female (14.18%). Therefore, male: female (M:F) ratio was 6:1. 104 males in the age group of 21-30 years constituted a single majority. Conclusion: This study reveals that the incidence rate of OSMF in patients visiting GDCH, Jamnagar was 1%. Males were more affected than females. It was seen that the major etiological factors in the development of OSMF was areca nut and gutkha usage by the patients.
  110 17 -
Adverse effects of steroid use in dermatophytic infections: a cross sectional study
Som Jitendra Lakhani, Freny Bilimoria, Jitendra D Lakhani
July-December 2017, 5(2):63-68
Background: Dermatophytosis is a type of superficial fungal infection which is a cause of significant morbidity especially in the Indian subcontinent. One of the major causes of the rising trend in the incidence of dermatophytosis is the unwarranted use of steroids in the management of fungal infection. Methods: A cross sectional study of dermatophytic fungal infections was carried out with research question of ‘Is steroid formulation abused in dermatophytic infections? What are their effects and side effects?’ All patients of dermatophytic infection were primarily selected over period of six months of which patients who had history or findings of some form of steroid use were further analyzed. Quantitative and qualitative data were collected in regards to steroid formulations about type, duration of use, route of administration and their availability by prescription or “over the counter”. Dermatological signs of steroid use were noted. Results: Of total 180 patients of dermatophytosis, 72 patients (40%) had used steroid formulations either topical (52), intralesional (9) or injectable (11) and 108 did not. Most patients (50 of 72) (69%) were from rural background and had long mean duration of illness (24 ± 3 weeks). Multiple site infection of dermatophytosis was present in 60 of 72 (83%) and in 51of 108 (47.22%) in steroid misuse and in non-steroid use patient group respectively. Cutaneous adverse effects were common in steroid modified dermatophysis patients. Unauthorized use of steroid was in form of self application, over the counter availability, use of steroid preparation of relatives and others. Conclusions: Misuse of steroid formulations in dermatophytic infections may lead to adverse effect as well as chronicity. Awareness of this problem is needed for prevention of steroid modified dermatophytosis, which is a rising menace.
  97 26 -
Sociodemographic and immunological profile of human immunodeficiency virus patients in tribal population
Naveen Kumar Dulhani, Yasmeen Khan
January-June 2018, 6(1):14-17
DOI:10.4103/JIHS.JIHS_6_18  
Aim: To study the sociodemographic and immunological profile of HIV seropositive patients attending antiretroviral therapy (ART) center of a tertiary care hospital. Methodology: This was a retrospective observational study conducted at an ART center of a tertiary care hospital from October 2016 to December 2017. It was a retrospective cohort study. Results: In our study, the total number of patients was 295. Majority of the patients were between 15 and 45 years of age. Males were 52% and females were 46%, with a male-to-female ratio of 1.3:1. Married tribal patients were the most affected. Majority of the patients were homemakers and nonagricultural workers; larger group belonged to low socioeconomic status. Heterosexual transmission was the commonest route of infection. Conclusion: Reproductive age group, low socioeconomic status, illiterate, tribal population, and homemakers were found to be associated with HIV positivity; heterosexual transmission was the commonest mode of infection.
  95 27 -
Awareness towards eye donation among general population: a cross-sectional study from rural Haryana
Manpreet Kaur, Anurag Ambroz Singh, Abhishek Singh
July-December 2017, 5(2):25-30
Introduction: Understanding the reasons why people do or do not donate the eyes is crucial to address the problem of undersupply of cornea and designing any intervention. Aim of this study was to assess the level of awareness towards eye donation and factors influencing among general population residing in the rural area of Haryana state. Methods: We conducted a cross-sectional study during September-December 2014. Patients attending OPD for the purpose of seeking care for their common ailments or diseases formed the study population. Total 360 adults were interviewed using pre-designed and pre-tested questionnaire in local language. Results: Total 76.9% of participants were aware about eye donation. Education, religion and occupation were found to be important predictors for awareness. Sex and age were not significantly associated with awareness. Awareness about eye donation was significantly lower among illiterates (odds ratio 0.14) compared to those who had higher education. Perceived reasons for willingness to donate eyes were pleased to help the blind, doing good to humanity and noble cause. Reasons for unwillingness to donate eyes were, they don’t want his/her body to be buried with disfigurement, religion and family permission. Conclusion: Willingness to corneal donation of the studied community is relatively good. This rural population is a good target for mobilization for pledges. Motivators for willingness to donate were the feeling of pleasure in helping the blind and the belief that the act of donation is doing good to humanity, while the dislike to separate the eye from the body after death was the main reason for not being willing to donate.
  97 19 -
Efficacy of color doppler imaging over CT angiography in peripheral arterial disease
Chinmay Parikh, Parthiv Brahmbhatt, Chandra Raychaudhuri
July-December 2017, 5(2):45-52
Introduction : PAD is an atherosclerotic occlusive condition in which plaque builds up in the distal arteries. Until 10 years ago, conventional angiography and digital subtraction angiography were the only angiographic techniques used in peripheral vascular disease and are considered gold standard. However, the complications and patient discomfort associated with these techniques have prompted the need of less invasive means of assessing the peripheral arterial system. Aim of the study was to compare efficacy of USG and MDCT angiography for investigating the lower limb arterial disease. Method: 40 patients suspected of lower limb PAD were included. Patients with previous amputation surgery were excluded. In all patients color Doppler sonography and multi-detector CT angiography was done. A comparative study of multi-detector CT angiography and color Doppler sonography was undertaken. Result: 50% patients had complaints in left lower limb and 25% in right lower limb. 22% had bilateral lower limb pain which was more on the left side (12%). Three patients examined by angiography showed irregularity of arterial wall on both sides, which appeared as calcifications on CT angiography (sensitivity 100%) while only 2 of them appeared on color coded Doppler examination (sensitivity 75%). Conclusions: Color Doppler USG is the initial modality of choice in PAD. CT Angiography is a better for segmental length assessment, collateral circulation along with a road map reproduction of the arterial system. USG is better than CT angiography in diagnosis of Grade 1 &2 cases, with better assessment of soft plaques, segmental flow and recanalization in PAD.
  87 23 -
A study on drug utilization pattern of metformin and its different formulations used in patients with type-2 diabetes mellitus in tertiary care teaching hospital
Dhaval B Joshi, Jitendra D Lakhani, Ronak Y Siddhpuria, Hiral P Tandel, Nisarg R Hajariwala
January-June 2018, 6(1):22-26
DOI:10.4103/JIHS.JIHS_15_18  
Background: Drug utilization evaluation is conducted to determine the rational use of drug by describing the drug usage pattern. This study aimed to describe the drug utilization pattern of metformin and its oral formulations. Objectives: The objectives of the study were to identify the prescribing pattern of metformin in fixed-dose combination (FDC), along with adjuvant antidiabetic therapy and it is prescribing in different formulations. Methodology: This is an observational study in which a total of 100 type 2 diabetic patients visited to or admitted in General Medicine Department, Dhiraj General Hospital , Piparia, Vadodara, were included as per our inclusion criteria. Result: Among 100 type 2 diabetic patients, 15 patients received monotherapy and 85 patients received combinational therapy of metformin. Out of 120 FDCs of metformin prescribed in 100 patients, plain (conventional release) formulations were most commonly prescribed (39.17%). Among FDC therapy of metformin, glimepiride + metformin, and glimepiride + pioglitazone + metformin combinations were most commonly found. As an adjuvant therapy with metformin, human analog insulin was most commonly prescribed. The sulfonylureas (SUs) were found to be the most commonly prescribed oral antidiabetic drug class along with metformin (SUs). In this study, we found 49% of the patients receiving metformin with low medication adherence. Conclusion: The practice of metformin monotherapy is limited and it is frequently prescribed in combinations with other antidiabetic agents. We observed an almost equal utilization of different oral formulations of metformin. A low medication adherence with metformin emphasizes the need for appropriate patient counseling and therapeutic interventions.
  84 23 -
REVIEW ARTICLES
Telemedicine and telehealth - The Indian scenario
A Singh, A Roy, P Goyal
January-June 2016, 4(1):3-8
The health care industry is currently undergoing a massive and irreversible transformation and change. Time is approaching when telemedicine/e-health initially shall be visibly practiced in majority of the Indian hospitals as a separate department before eventually fusing into respective medical specialties in spite its slow growth in India. This review appraises current scenario of telemedicine and telehealth in India. Official documents belonging to the Health ministry and finally related literature were examined. Telemedicine can enhance basic/specialty healthcare for India’s population which is predominantly rural. Indian Medical Personals, by large are not computer savvy’s, virtually lack awareness and exposure with regard to the application of information and communication technology in Medicine. These are foremost bottlenecks to the growth of Telemedicine in India. The present study outlines telemedicine strong and weak points. Undoubtedly, the advantages outweigh its disadvantages, but just like any other innovations, it has some drawbacks.
  86 13 -
ORIGINAL ARTICLES
An evaluation of barriers to blood donation from a tertiary care teaching institution
Anurag Ambroz Singh, Manpreet Kaur, Abhishek Singh
January-June 2018, 6(1):18-21
DOI:10.4103/JIHS.JIHS_7_18  
Introduction: The demand for blood transfusion is increasing over time, and we need to cope up with this demand. The aim of this study was to evaluate the perceived barriers to blood donation and to assess any association between the demographic variables with the barriers predicting blood donation. Methodology: This cross-sectional study was carried out for 3 months, i.e., from July to September 2015. All patients who never donated blood were included in this study. Purposive sampling technique was adopted. Study participants were interviewed using a pretested questionnaire. Results: A total of 150 patients were enrolled into the study. The variables that were significant in the univariate model included male gender, age group 25–44 and older, and education more than 10th standard. Perceived barriers to blood donation were fear of needles (29.33%), too inconvenient (28.67%), and fear of collapse after donating blood (24.67%). About 17.33% were of the view that they might contract the disease in the process of blood donation. 17.33% cited a reason for not donating blood as lack of time. Nearly 8% of participants had a fear of seeing blood. Five percent were of the view that blood donation reduces the lifespan. Of the barriers, which negatively predicted blood, donation was fear of pain, fear of seeing blood, fear of anemia, and no access to the blood bank. Conclusion: Based on inputs of this study, community outreach activities such as blood donation campaigns may be initiated to alleviate people's fear of blood donation. Health authorities can utilize this data to tailor the interventions to raise voluntary blood donation rates.
  68 29 -
Evaluation of mesiodistal inclination of permanent maxillary and mandibular first molars in different Angle's molar relation: A cephalometric study
Dweepika Garg, Santosh Kumar Goje
January-June 2018, 6(1):8-13
DOI:10.4103/JIHS.JIHS_5_18  
Introduction: Angle's molar relationship is the most widely used classification in spite of the introduction of various other classifications. At the end of the treatment, the molars are finished in a Class I, II, or III molar relation. Thus, it is important to know the ideal inclinations of upper and lower 1st molars, thereby assisting in achieving a stable relationship. Aims and Objectives: The aim and objective of this study was to evaluate the mesiodistal inclination of permanent maxillary and mandibular first molars in Angle's Class I, II, and III molar relationships in relation to the occlusal plane. Methodology: Lateral cephalograms of 16–30-year-old individuals with Class I, II, and III molar relations were selected and traced in Dolphin imaging software, and the angle between the first molar and occlusal plane was calculated. Results: There was a statistically significant difference in the inclination of maxillary 1st molar in between Class I and Class III. No significant difference was noted in the inclination of maxillary first molar in case of Class I and Class II. In case of mandibular molars, there was a statistically significant difference in case of Class I and Class II and between Class I and Class III. Conclusion: When the end molar relationship of a case is planned to be Class I, the upper molar should be at an angle of 84.12° to the occlusal plane. When the end molar relationship of a case is planned to be Class II, the upper molar should be 84.15° to the occlusal plane. When the end molar relationship of a case is planned to be Class III, the upper molar should be inclined at an angle of 87.07° to the occlusal plane.
  71 26 -
ORIGINAL ARTICLE
A microbial study on water used by street food vendors and microbial flora found on their hands, in a densely populated urban area of Vadodara, Gujarat
Vedant V Shrimali, Krunal Kiritbhai Shah
July-December 2017, 5(2):81-86
Introduction: Street vended food is not only appreciated for their unique flavours, convenience and the role which they play in the cultural and social heritage of societies, it also becomes important and essential for maintaining nutritional status of populations. Method: Vendors were chosen randomly for obtaining various samples. Samples were taken after informed consent. Sterile swabs were used to collect sample from the palms, fingers and area between fingers from both the hands of the individuals preparing or contacting the food. Water samples were collected in sterile containers using aseptic precautions. Samples were inoculated on suitable culture media and subjected for identification after obtaining growth. Result: Total of 14 water samples and 28 swabs were collected from 14 different street vendors. Average of 1100 cfu/ml of water sample was isolated. Organisms isolated from water samples were Pseudomonas spp. E coli and Klebsiella. From the swabs taken from both the hands, major organism isolated was Coagulase negative staphylococci followed by Staphylococcus aureus and E coli. Conclusion: Quality of food offered by street vendors directly affects the health of a person and population in general. Our study shows poor quality of hand hygiene maintained by street vendors as well as poor quality of water used for preparation of food, which may affect quality of food provided.
  74 21 -
VIEW POINT
SOFA vs APACHE II as ICU scoring system for sepsis: A dilemma
JD Lakhani
July-December 2015, 3(2):3-7
  75 19 -
ORIGINAL ARTICLES
To compare the efficacy of incentive spirometry and resistive inspiratory devices on ventilatory muscle strength in patients with moderate dyspnea in Chronic Obstructive Pulmonary Disease (COPD)
Kalpesh Satani, Ratan Khuman, Surbala Devi, Gopal Nambi
January-June 2013, 1(1):14-19
Backgrond: Dyspnea is one of the main complain of the COPD patients. In the general setting it is treated by medical and physiotherapeutic intervention. Incentive Spirometry and Resistive Inspiratory Devices are 2 main treatment approaches in physiotherapy. Objective: The objective of this study is to compare the efficacy of Incentive Spirometry and Resistive Inspiratory Devices on ventilatory muscle strength in COPD patients with mild to moderate dyspnea. Method: 30 COPD patients with mild to moderate dyspnea were randomly assigned to Incentive Spirometry group (Group A) and Resistive Inspiratory Device group (Group B). The duration of protocol was 4 weeks and both the groups received 2 sessions per day. Pre-treatment RPE and IC are compared with post-treatment data i.e, at the end of 4 weeks. Analysis was based on the ICS and Borg’s RPE scale. Results: The test showed significant improvement (p<0.05) in both ICS and RPE score. Using unpaired t-test mean improvement in group A and B was 566.06 ml and 695.2 ml respectively, t =1.049 (p=0.303) for ICS and using Mann-Whitney ‘U’ test median in group A and B was 2.5, U = 106 (p=0.782) for RPE score, since p>0.05 the comparison showed difference as not significant. This result showed that there is no significant difference between the 2 groups. Interpretation & Conclusion: It is concluded that there is no significant difference between the 2 groups. Both the interventions (Incentive Spirometer and Resistive Inspiratory Device) are equally effective, both in improving ventilatory muscle strength and reducing the perception of dyspnea in COPD patients with mild to moderate dyspnea.
  77 16 -
REVIEW ARTICLES
Management of prolactinoma during pregnancy and postpartum
J Lakhani Om, Lakhani Rishma, M Desai, S Tripathi
January-June 2015, 3(1):3-7
Prolactinoma is classified as microprolactinoma when it measures <10 mm and macroprolactinoma when it measures ≥10 mm. Prolactinoma is an important cause of amenorrhea and infertility in premenopausal female. With early diagnosis and treatment with dopamine agonist, many patients have restoration of fertility within few months of treatment. In presence of estrogenic environment of pregnancy there is a tendency for prolactinoma to increase in size during pregnancy. This may be associated with visual field compromise and rarely pituitary apoplexy. This review discusses some key points in management of prolactinoma during pregnancy and postpartum. In case of microprolactinoma, the risk of complications are low hence it is recommended to keep a close follow up of patient without any need for intervention. In case of macroprolactinoma it is recommended to use barrier contraception to prevent pregnancy for at least 6-12 months after detection and starting treatment to allow proper shrinkage of the tumor with dopamine agonist. Once pregnancy is confirmed -In those with low risk features, dopamine agonist is stopped and a close follow up is advised. In those with high risk features, it is recommended to continue the dopamine agonist therapy with a close follow up. Postpartum period generally doesn’t pose much threat to prolactinoma and treatment may be discontinued if patient wishes to breast feed her infant.
  60 26 -
CASE REPORTS
Carbamazepine-induced toxic epidermal necrolysis
Kushal Gohel, Rashmi Mahajan, Megha Patel, Harsh Patel
January-June 2018, 6(1):27-30
DOI:10.4103/JIHS.JIHS_9_18  
Toxic epidermal necrolysis (TEN) is an uncommon; however, life-threatening dermatological condition which occurs most frequently by the use of drugs. Some group of medications, such as antiepileptics, antibiotics as well as antivirals, can induce such adverse drug reaction (ADR). Among the antiepileptics, carbamazepine is widely prescribed in case of epilepsy and trigeminal neuralgia. Here, we report a case of 22-year-old male with seizure disorder with a history of carbamazepine-induced skin lesions. Patient along with caregiver had approached local physician for increased seizure episodes but did not mention about the allergic history, and he was restarted on carbamazepine. As a result, the patient again developed skin lesions for which he consulted the dermatology outpatient department of the hospital. After outpatient department consultation, he was admitted to the ward for further clinical management. On hospitalization, the patient was diagnosed with carbamazepine-induced TEN (body surface area >40%). The management included immediate withdrawal of carbamazepine and supportive therapy with corticosteroids, antibiotics, antiepileptics, and antiallergic medications. After 15 days of rigorous treatment and hospitalization, the patient was discharged, as erosions healed with reepithelization. Based on this case, it can be concluded that reinitiation of a medication with a history of known allergy can result in TEN which is a serious life-threatening ADR. For the prevention of such ADR, thorough patient medical history should be obtained on each consultation. In addition, the patient and caregiver have to be informed about the clinical condition and the drugs which can provoke such adverse reaction.
  54 28 -
A cost-effective method of restoring primary anterior teeth with loss of crown structure
Adrija Buch, Swara Shah, Pratik B Kariya, Anisha Keshan
January-June 2018, 6(1):31-33
DOI:10.4103/JIHS.JIHS_10_18  
Managing a child with severely mutilated anterior teeth is a task for pedodontists. Although various options are available today for esthetically rehabilitating anterior teeth, they are costly and technique sensitive. In the present case, we esthetically rehabilitated a 5-year-old child with severe early childhood caries with chairside fabricated indirect composite shell crowns. The technique described in this case report is simple, requires minimal compliance from the child, is less technique sensitive, and can be completed in an accepted chairside time.
  57 23 -
ORIGINAL ARTICLES
Hs-CRP levels in patients with periodontitis- a cross sectional study
MA Shah, BK Shah, BB Modi, EB Shah, DH Dave
January-June 2015, 3(1):15-20
Background: During the last century, cardiovascular disease (CVD) has common occurrence in most of the population and the great attendant mortality, loss of independence, impaired quality life and social and economic costs forming a compelling reason for public health concern. C reactive protein (CRP) in particular has been the focuses of attention as a key marker of atherosclerosis and elevated level constitutes a risk predictor for CVD. Aim: The present study focuses the association between periodontal inflammatory status as assessed by clinical periodontal sum score (CPSS) and levels of CRP and to co-relate periodontal destruction levels with levels of hs- CRP. Methodology: Patients with chronic generalized periodontitis were selected. Periodontal destruction of the patient included in the study was recorded by CPSS and blood was tested for hs-CRP levels. Mean, Standard deviation and range of CPSS and hs-CRP were calculated. The correlation between CPSS and hs-CRP that is clinical index and biochemical marker was made by Spearman correlation test for significant. Results: A total of 20 patients had participated in this study. The CPSS ranged from 31 to 205 and the hs-CRP levels ranged from 0.18 to 16.45. 2 tailed Spearman correlation test showed significant p value (0.05). Conclusion: Statistical significant co-relation was found between periodontal disease as assessed by CPSS and hs-CRP level. Results of this study point to the importance of diagnosing cases of severe periodontal destruction, and the need for proper health education and prompt periodontal therapy for the cases identified.
  62 17 -
Amelioration of cisplatin-induced hepatotoxicity by statins in rats
RA Maheshwari, GU Sailor, AK Sen, R Balaraman
January-June 2015, 3(1):21-27
Aim: This study was aimed to investigate the effect of simvastatin (SIM) and rosuvastatin (ROS) on the extent of tissue damage in cisplatin (CIS) induced hepatotoxicity. Methodology: Hepatotoxicity was induced in rats with single intraperitoneal injection of 7 mg/kg cisplatin. Group 1 received 0.5% sodium carboxy methyl cellulose, group 2 and 3 received SIM and ROS, respectively, and group 4 was injected single dose of CIS (7 mg/kg, i.p.).Group 5 and 6 were treated with SIM (10 mg/kg, p.o.) and ROS (10 mg/kg, p.o.) daily from 5 days before to 5 day after intraperitoneal administration of CIS, respectively. Liver function tests like AST, ALT and Total bilirubin, and markers of oxidative stress such as liver malondialdehyde (MDA) level, superoxide dismutase (SOD), catalase (CAT) activities and reduced glutathione (GSH) were measured. All tissues were investigated for histopathological changes. Results: CIS treated rats showed a significant increase in AST, ALT and total bilirubin. Moreover, cisplatin caused liver damage with a higher MDA level, depletion of SOD, CAT activity and GSH. SIM and ROS ameliorate CIS induced liver damage due to improvement in liver function, oxidative stress, and histological alteration. Conclusions: These finding suggests that simvastatin and rosuvastatin may have a protective effect against cisplatin-induced liver damage via amelioration of lipid peroxidation as well as due to improvement of liver function.
  60 18 -
To study clinical profile of peripheral neuropathy in type 2 diabetes mellitus using nerve conduction velocity
Amit Shah, Dhruvin Shah
July-December 2017, 5(2):69-76
Introduction: Diabetes is one of the leading non communicable disease throughout the world. Due to its chronic nature it causes a number of complications. Diabetic peripheral neuropathy is one of the most dreaded complications of diabetes as it is associated with significant morbidity. Diagnosis of neuropathy is commonly done by NCV which is a gold standard test for it. Other simpler method to detect early loss of protective vibration sensation, to find out feet at risk of future complications is the need of the hour. Hence this study was done to study the symptoms of peripheral neuropathy in type 2 diabetic patients and to correlate these with patient's age, duration of diabetes, glycemic parameters and other microvascular complications. Methodology: This was a cross sectional study carried out in 40 patients with symptoms of peripheral neuropathy in the Department of General Medicine at Dhiraj General Hospital, Sumandeep Vidyapeeth, Piparia, Vadodara district, Gujarat. All patients were subjected to detailed clinical history, examination of their feet and neuropathy testing by NCV using the RMS NCV/EMG machine using a hand held biothesiometer. Results: Out of the total of 40 patients, 30 were males and 10 were females. Increasing age of the patients, increasing duration of diabetes, smoking and poor glycemic control were significant risk factors for the development of neuropathy. It was also consistently associated with other microvascular complications like retinopathy and nephropathy. The most frequently encountered symptom of neuropathy in our study was burning feet. Conclusion: The study concludes that increasing diabetes duration is an independent and strong risk factor and considering the dreaded complications of end stage diabetic foot disease, routine screening of all type 2 diabetic patients should be done in daily practice.
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