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   2016| July-December  | Volume 7 | Issue 2  
    Online since June 30, 2016

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Spectrum of thrombocytopenia: A clinicopathological study with review of the literature
Ekta Paramjit, Rajiv Rao, S Sudhamani, Prakash Roplekar, Zeba Shaffi, Sukriti Roy
July-December 2016, 7(2):121-124
Background: Thrombocytopenia has been defined as a subnormal number of platelets in the circulating blood and may result from four processes: Artifactual thrombocytopenia, deficient production of platelets, accelerated destruction, and abnormal distribution or pooling of the platelets. Aims: To find out the etiology of thrombocytopenia with clinicopathological correlation, to grade it on the basis of platelet count, and to know the age and sex distribution of the cases. Materials and Methods: The study was conducted from January 2015 to June 2015. A total of 300 cases of thrombocytopenia were selected. All the patients with platelet counts less than 150 Χ 10 3 / micro liter (μL), were included. On the basis of platelet count, the cases were divided into the four grades and clinicopathological correlation was done. Statistical Analysis: Simple random sampling, mean, and percentage. Results: The most common cause for thrombocytopenia was infection. Alcoholic liver disease was the most common noninfective cause. Maximum number of patients were in the age group of 20-39 years. The commonest grade of thrombocytopenia was Grade 1, the least common being Grade 4. Conclusion: Thrombocytopenia is usually associated with infections such as malaria, dengue, sepsis, and viral diseases. It is less common in noninfective conditions, for example alcoholic liver disease. It is seen mainly in adults, significantly more in males, and present as Grade I.
  15,376 741 2
From a brewer to the faraday of statistics: William Sealy Gosset
Abhay B Mane
July-December 2016, 7(2):147-149
William Sealy Gosset (1876-1937) was an immensely talented statistician to be remembered for his contributions to the development of modern statistics. Better known to the statistical world by his pseudonym, "Student," Gosset's name is associated with the discovery of the t-distribution and its use. He was a brewer of Guinness' Brewery in Dublin, Leinster, Ireland and the pioneer in the analysis of small samples. The most famous work, "The Probable Error of a Mean," published in "Biometrika" made a clear distinction between population parameters and sample estimates of them. He will be remembered as a practical scientist for his discoveries of the frequency distribution of the variance of normal samples and of the ratio of the mean to the standard deviation to the theory of statistics. His life was one full of fruitful scientific ideas that the Student's test of significance finds a unique place in the history of scientific method.
  11,916 551 -
Pattern of pelvic inflammatory disease in women who attended the tertiary care hospital among the rural population of North India
Seema Dayal, Amit Singh, Vineet Chaturvedi, Mani Krishna, Vivek Gupta
July-December 2016, 7(2):100-104
Introduction: The term "pelvic inflammatory" disease refers to any infection in the lower reproductive tract of women. Women living in rural areas are usually not aware of the symptoms. They go to health-care providers only after alarming symptoms develop. Aim: The aim of the present study is to find out frequency of pelvic inflammatory disease (PID), their clinical symptoms, microorganism isolation, and histopathological evaluation of these women who attended the tertiary care hospital. Setting and Design: Tertiary care hospital and retrospective study. Materials and Methods: A total of 247 women with clinical symptoms of PID was included in the study. The performa was filled that included relevant clinical details. Microbe culture and histopathology were the diagnostic tools used. Statistical Analysis: Percentage. Result: The frequency of PID was 15.38%. Maximum number of patients belonged to the age group of 31-40 years (41.29%). Abdominal pain (75.50%) was the chief clinical complaint. Leukocytosis (72.06%) and Gram's stain positivity (51.82%) was also seen. Staphylococcus aureus was most common microbe isolated (8.50%) in culture. Chronic cervicitis (11.33%) was common on histopathology, though endometritis (6.47%) is diagnostic for PID. Conclusion: PID is the most common disease causing morbidity and mortality in infected women. Therefore, measures should be taken regarding early diagnosis so as to provide treatment before the complications develop.
  7,365 744 1
Clinical and radiological findings in psoriatic arthritis: A hospital-based cross-sectional study
Neetha Vijayakumaran, Neelakandhan Asokan, Jijith Krishnan, Beena Narayanan
July-December 2016, 7(2):91-95
Context: There is limited published data on psoriatic arthritis (PsA) from India. Aims: To analyze the clinical and radiological findings of patients with PsA attending a tertiary care teaching hospital. Settings and Design: Cross-sectional descriptive study in a dermatology department of a tertiary care teaching hospital over a 1- year period. Materials and Methods: Demographic profile, clinical profile, and radiological changes of patients with PsA were studied. Statistical Analysis Used: Qualitative data were analyzed using means, percentages, and chi-square test and quantitative data were analyzed using Spearman's rank correlation and Z-test. Results: There were 53 patients (35 males). The most common age group was 40-59 years. The age of onset was earlier among females. The most common type of PsA was asymmetric oligoarthritis (35/53; 66%). Overlapping types were seen in 19 (35.8%) patients. The knee was the most common joint involved (21/53; 39.6%) followed by the distal interphalangeal (DIP) joint and shoulder joint (18/53 each; 34%). Enthesitis and dactylitis were present in 3 (6%) and 7 (13.2%) patients, respectively. Nails were affected in 47 (88.7%) patients; the most common finding was pitting of the nail plates. There was no correlation between clinical type of PsA and the severity of disease as assessed by Psoriasis Area and Severity Index (PASI) and body surface area of involvement (BSA). Twenty-five (47.2%) patients were either overweight or obese. A majority of the patients (41/53), particularly females (17/18), had central obesity. 34% of the patients had systemic hypertension (HT), diabetes mellitus, or both. The most common (24.5%) radiological change was marginal erosion of the phalanges. Conclusions: Asymmetric oligoarthritis was the most common clinical type of PsA. The knees, shoulders, and DIP joints were the more commonly affected joints. Severity of psoriasis was not associated with any particular type of PsA. A majority of patients, particularly females, had central obesity. The most common radiological finding was marginal erosion.
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The study of obesity among children aged 5-18 years in Jaipur, Rajasthan
Anjali Jain, Ashish Jain, JP Pankaj, BN Sharma, A Paliwal
July-December 2016, 7(2):125-130
Background: Prevalence of TV and computers in today's times has also driven the regular outdoor activities of children out from their lives. An increased calorie intake along with a decreased physical activity level has a great bearing on the level of obesity found in children. The present study was done with the objective to study the obesity among children of aged 5-18 years in Jaipur, Rajasthan. Methods: A Cross sectional study was undertaken on children of 5-18 years of urban field practice area, Mahatma Gandhi Medical College and Hospital, Jaipur. Simple random sampling was done. A semi-structured questionnaire was developed, pilot study was carried out to draw the necessary questionnaire which was tested and retested for necessary modifications. Body Mass Index (BMI) 10 was derived by dividing the subject's mass by the square of his or her height, Statistical test was applied in our study accordingly. Results: 12.5% children were overweight having percentage between 85 to 95, while only 5.6% children were obese having percentage equal or greater than 95. Out of 564 boys 101 (17.9%) were obese or over-weight and out of 436 boys 69 (15.9%) were obese or over-weight. Among 783 vegetarian children, 14.8% were obese and overweight. Conclusions: Children eating more frequent junk foods were more obese and overweight as comparative eating them in low frequency. Children with lesser physical activity were more obese.
  4,972 392 4
Vitreous potassium concentration as a predictor of postmortem interval: A cross-sectional study among natural death cases at a tertiary care center in rural Haryana
Rajesh Duraisamy Rathinam, Abhishek Singh, Karkala Jayaprakash, Pooja Goyal, Pankaj Chikkara, Sanjeev Kumar Khichi, Shwetank Goel
July-December 2016, 7(2):96-99
Background: Time since death (TSD) is an important parameter to the forensic expert. Only a few studies are available in the literature to determine the relationship between the vitreous potassium (K + ) concentration and TSD especially among natural death cases in the state of Haryana and, thus, information on the same is patchy and scanty. Objective: To determine the relationship between changes in the vitreous K + concentration and increasing TSD among natural death cases. An additional objective was to derive a formula for determining TSD from changes in levels of vitreous K + in the study subjects. Materials and Methods: In this study, autopsy cases brought to the mortuary of the Department of Forensic Medicine and Toxicology of a tertiary care center, were the subjects for collection of vitreous humor for the determination of vitreous K + . Data of 90 such cases where autopsy confirmed the cause of death as natural death were included in this study. Determination of K + level in the collected sample was done by ion-selective electrode method (Biolyte 2000 autoanalyzer, Biocare, Lujhu Township, Taiwan). Results: A linear relationship was observed between vitreous K + concentration and TSD in both the eyes. External factors like seasonal variations and temperature, gender difference, and age had no appreciable effect on the concentration of vitreous K + in either eye. In this study, the linear regression equations obtained from K + concentration (y) versus time (x) for the two groups among injury (trauma) cases were as follows: For the right eye: Regression line (y) = -4.303 x + 2.148 and for the left eye: Regression line (y) = -5.260 x + 2.209. The K + levels are found to increase up to 40 h after death. Conclusion: The study highlighted the usefulness of the relationship between vitreous K + concentration and TSD in both the eyes. The formula calculated from the current study could prove to be more appropriate as it is based on a more recent study and more reliable tests.
  3,756 1,530 1
Role of families in tuberculosis care: A case study
Janmejaya Samal, Ranjit Kumar Dehury
July-December 2016, 7(2):150-152
  4,794 491 2
Cutaneous pseudolymphoma: A case report
Mayur Bhobe, Naguesh Pai Kakode, Shubhlaxmi Pednekar, Varadraj Pai
July-December 2016, 7(2):144-146
Pseudolymphomas are a group of disorders, which clinically and histopathologically mimic lymphomas. A 38-year-old female presented with a plaque over the forehead. A biopsy revealed a nodular infiltrate of lymphocytes that was suggestive of pseudolymphoma. The lesion spontaneously regressed over 9 days of biopsy, leaving behind hyperpigmentation.
  4,979 268 -
Procerus sign revisited
Eswaradass Prasanna Venkatesan, Balakrishnan Ramasamy, Ramadoss Kalidoss, Ali Raza
July-December 2016, 7(2):152-153
  4,499 216 -
Psoriasis can markedly impair the quality of life of patients irrespective of severity: Results of a hospital-based cross-sectional study
Ajith Vettuparambil, Neelakandhan Asokan, Beena Narayanan
July-December 2016, 7(2):111-114
Background and Objectives: There are conflicting opinions in previous studies whether the quality of life (QoL) of patients with psoriasis is affected by its severity. The aim of the study was to assess the QoL of patients with psoriasis attending a tertiary care teaching hospital in central Kerala, India; and to find out if severity of psoriasis as measured by psoriasis area severity index (PASI) affects the QoL. Materials and Methods: We did a cross-sectional study of 49 patients with psoriasis. QoL was assessed using the Malayalam version of the Dermatology Life Quality Index (DLQI). PASI was used to calculate the clinical severity of the disease. We calculated Spearman's rank correlation coefficient between these two scores. Results: Thirty-three (67.3%) patients had marked (moderate or above) impact on overall QoL. Among the various domains of the QoL, symptoms and feeling were found to be affected most, followed by work and school and daily activities. There was no significant correlation between PASI and the overall DLQI (Spearman r = 0.131, P = 0.37), though the domain of leisure activities showed moderately significant positive correlation (Spearman r = 0.037; P = 0.03) with PASI. Conclusion: Psoriasis markedly affects the QoL of the sufferers, especially in the domains of symptoms and feeling, work, and school as well as daily activities. This study does not provide evidence that impairment of QoL is related to severity of psoriasis.
  3,760 450 5
Stress in preschool children and its correlation with salivary chromogranin A
Sunil Kumar Jena, Biswabhusan Mohanty
July-December 2016, 7(2):105-110
Background: When preprimary school students enter school, there is definitely a chance of developing psychological stress, which for a prolonged period is harmful to their lives. Different researchers have proved that salivary chromogranin A is a potent biomarker of psychological stress. There are very less studies regarding preschool stress. Thus, we proposed this study to find out the severity of stress in preschool children and its correlation with salivary chromogranin A. Materials and Methods: Fifty-six preprimary school students in the age group of 2.5-5 years were involved in this study. The severity of stress was evaluated by a self-structured questionnaire, preprimary stress questionnaire (PPSQ) and these questionnaires were distributed to different study groups, i.e., no stress, mild stress, moderate stress, and severe stress. Salivary chromogranin A was estimated by enzyme-linked immunosorbent assay (ELISA) test. Result: Out of 56 participants, 7 did not face stress, 14 faced mild stress, 14 faced moderate stress, and 21 faced severe stress. The mean rank stress score rose with severity of stress and was found to be significant. The mean salivary chromogranin A level was analyzed between the different groups and found to be significant at P < 0.001. Correlation coefficient between stress and salivary chromogranin A was 0.875 and significant at P < 0.01. Conclusion: We found that preprimary school students faced stress in different severities and their salivary chromogranin A was raised. Salivary chromogranin A was considered as a biomarker of psychological stress in this study because it is noninvasive and easy to collect from the samples of all the small children with convenience.
  3,736 316 1
Evaluate the effect of bethanechol on blood glucose levels in euglycemic Wistar albino rats through oral glucose tolerance test
RN Suresha, Siddamma Amoghimath, MK Jayanthi, SL Shruthi
July-December 2016, 7(2):115-120
Objective: To evaluate the effect of bethanechol on blood glucose levels in euglycemic Wistar albino rats through oral glucose tolerance test (OGTT). Materials and Methods: Twelve Wistar albino rats weighing around 150-200 g of either sex were randomly selected from the central animal facility, and were divided into two groups. The control group received distilled water (25 mL/kg body wt.) per orally, test groups received bethanechol (3.6 mg/kg/day) per orally for 5 days. On the fifth day, following overnight fasting, 1 h after drug administration in all the groups of rats OGTT was performed, by administering oral glucose in dose of 0.6 gm/kg body weight. The capillary blood glucose (CBG) levels were measured at 0 min, 60 min, and 150 min, by rat tail snipping method using glucometer (ACCUCHEK). Results: The CBG levels of the bethanechol group was less when compared to the control group at all time intervals and the difference was statistically significant. Conclusion: Bethanechol showed the hypoglycemic activity when given for 5 days orally to euglycemic albino rats through OGTT.
  3,672 256 1
Headache presenting as cerebral venous thrombosis associated with heterozygous methylenetetrahydrofolate reductase gene mutation: A case report
Muhammed Jasim Abdul Jalal, Murali Krishna Menon
July-December 2016, 7(2):136-140
Headache is among the most common pain problems encountered by the primary care physician. Cerebral venous thrombosis (CVT) is relatively rare in young adult males. Homocysteinemia is a significantly independent prothrombotic risk factor for atherogenic thrombotic cardiovascular, cerebrovascular, and peripheral vascular diseases. Methylenetetrahydrofolate reductase (MTHFR) gene mutation results in high serum homocysteine levels. Here, we report a 45-year-old male who presented with acute onset severe headache. Brain imaging showed thrombosis of superior sagittal sinus. The level of serum homocysteine was elevated and there was heterozygous CG677T polymorphism of the MTHFR gene.
  3,468 245 -
Atypical presentation of craniofacial fibrous dysplasia in an adult
Padma B Prabhu, Swetha Mediyala Hanumappa, Kuzupally Vallon Raju
July-December 2016, 7(2):133-135
Fibrous dysplasia is a sporadic fibroosseous anomaly affecting the skeletal system. Craniofacial synostosis is one of its subtypes with ocular complications. We report a case of craniofacial fibrous dysplasia in a 44-year-old lady who presented with complaints of recent onset of blurring of vision in both eyes. She gave a history of swelling in the medial aspect of left eye since childhood with minimal increase in size with age. A bony swelling was seen along the medial wall of left orbit associated with deviated nasal septum to the right. She had best corrected visual acuity (BCVA) of 20/20 in eyes, normal color vision, visual fields and fundus findings. Her computed tomography (CT) scan was suggestive of fibrous dysplasia involving multiple bones (frontal, sphenoid, ethmoid, maxillary, and pterygoid bones) bilaterally. Visual evoked potential was abnormal bilaterally.
  3,242 298 -
Paracetamol-responsive patent ductus arteriosus in a late preterm very low birth weight neonate at 4 weeks postnatal age
Amitoj Singh Chhina, Arvind Shenoi
July-December 2016, 7(2):131-132
Pharmacological closure with cyclooxygenase (COX) inhibitors, such as indomethacin and ibuprofen, forms the first line of treatment for a patent ductus arteriosus (PDA) in preterm neonates. However, their efficacy decreases with increasing postnatal and postconceptual age. Paracetamol is gaining acceptance worldwide as an alternative drug for PDA closure and can be used when COX inhibitors are contraindicated, although its efficacy at advanced postnatal age is not well described. Here, we describe a late preterm neonate (36 weeks, 1150 g birth weight) with a hemodynamically significant PDA, where COX inhibitor therapy could not be initiated due to thrombocytopenia, and where oral paracetamol was started at 4 weeks postnatal age and caused ductal closure after a 6-day course.
  3,059 296 -
Posttraumatic both loop ileal prolapse through patent vitello-intestinal duct in a neonate: A rare occurrence
Md Hadiuzzaman Zaman, Shibsankar Barman, Sumitra Kumar Biswas, Kalyani Saha Basu
July-December 2016, 7(2):141-143
Umbilical cord hernia (UCH) is consisting of 20% of all congenital abdominal wall defects. Vitello-intestinal duct (VID) is the communicating embryonic structure which disappears between the 5 th and 9 th weeks of intrauterine life. Here, we present an interesting case of ruptured UCH with both loop ileal prolapse through patent VID.
  2,872 207 -
Malnutrition in under-five children
Manas Pratim Roy
July-December 2016, 7(2):155-155
  2,236 212 -
Knowledge and awareness of diabetes among diabetic patients in hilly terrains of Mandi district, Himachal Pradesh
Rohit Sharma, Hetal Amin, Pradeep Kumar Prajapati
July-December 2016, 7(2):154-155
  2,196 226 -