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   Table of Contents - Current issue
September-December 2022
Volume 3 | Issue 3
Page Nos. 59-96

Online since Thursday, November 3, 2022

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Chest computed tomography findings in COVID-19: A pictorial review p. 59
Jitender Singh, Tarika Sharma
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Vitamin D levels and antenatal complications in pregnant Nigerian Igbo women p. 67
Joseph Ifeanyi Brian-D Adinma, Joseph Eberendu Ahaneku, Echendu Dolly Adinma, Joseph Odilichukwu Ugboaja, Victor Nwabunwanne Oguaka, Nneoma Dolores Adinma-Obiajulu, Mark Matthew Edet
Background: Serum levels of Vitamin D have been linked to some complications in pregnancy such as diabetes mellitus and premature rupture of membranes (PROM). While some studies suggest inverse relationship between serum Vitamin D levels and poor pregnancy outcomes, others report a J-shaped (curvilinear) or U-shaped relationship. Objective: The objective of the study is to determine the relationship between serum Vitamin D and some selected pregnancy complications among pregnant Nigerian Igbo women. Subjects and Methods: A prospective, cross-sectional study conducted on 256 consecutive consenting antenatal women in Anambra state, Southeastern Nigeria. Maternal blood obtained was assayed for 25 hydroxyvitamin D3 using high-pressure liquid chromatography. A pro forma was used to elicit information with respect to the biosocial characteristics of the subjects. Data obtained were analyzed using SPSS version 23, and the relationship between Vitamin D levels and antenatal complications was determined using Chi-square at P < 0.05 at 95% confidence interval being considered statistically significant. Results: The overall results showed that no participant had hypovitaminosis D. It also showed that there is maximum safe limit for serum Vitamin D beyond which the prevalence of hypertensive disorders/preeclampsia, preterm labor, and PROM rises. However, higher serum Vitamin D appears to be protective against clinical and laboratory-diagnosed malaria and malaria parasitemia. The study showed an inverse relationship between the degree of malaria parasitemia and serum Vitamin D levels. Conclusion: Despite the importance of Vitamin D in both skeletal and extra-skeletal health, there appears to be a safe upper limit. Therefore, Vitamin D supplementation should be reserved for proven cases of hypovitaminosis in pregnancy, especially in our locality where there is abundance of sunshine and low prevalence of hypovitaminosis D.
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Role of pleural fluid “Cell Block” in malignant pleural effusion: Underutilized, sensitive, and superior over conventional fluid cytology; Does it will decrease need for thoracoscopy guided procedures? p. 73
Shital Patil, Sham Toshniwal, Ayachit Rujuta
Background: Malignant pleural effusion missed routinely because of less diagnostic yield of conventional fluid cytology. Materials and Methods: Prospective multicentric study conducted during January 2014 to June 2016 in Venkatesh chest hospital, and Pulmonary Medicine, MIMSR medical college Latur, to find diagnostic yield of conventional pleural fluid cytology and pleural fluid “cell block” in malignant pleural effusion and compare yield of pleural fluid cell block with conventional cytology technique. The study included 200 cases of unexplained, exudative pleural effusion with Adenosine deaminase (ADA) ≤30/IU/l and pleural fluid cytology is either positive for malignant cell with or without cell type differentiation, or cytology suspicious for malignant cell. All cases were subjected to cell block preparation. Statistical analysis was done by using Chi-test. Observation and Analysis: In study of 200 cases, mean age of group was 68 ± 9.5 years and adenocarcinoma was predominant malignancy in 72% cases, mesothelioma in 10% cases, squamous cell carcinoma in 7% cases and 9% cases were having primary tumor outside the thoracic cavity. In study cases, pleural fluid cytology was positive in 42% cases (84/200), and pleural fluid cell block was positive in 96% cases (192/200) in detecting malignant pleural effusion (P < 0.0001). Remaining six and two cases were diagnosed by using image-guided and thoracoscopy-guided pleural biopsies, respectively. Immunohistochemistry (IHC) was done in all pleural fluid cell block preparation for calretinin, cytokeratin, and epidermal growth factor receptor. Conclusion: Pleural fluid cell block is sensitive, superior, cost-effective, and specific diagnostic method over conventional pleural fluid cytology. “Cell block” specimens are enough for primary diagnosis and IHC analysis necessary for cell typing. It will decrease the need for more invasive and costlier diagnostic methods like thoracoscopy and image-guided pleural biopsies. We recommend cell block for every exudative pleural fluid samples with ADA <30 IU/l.
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Biochemical, physiological, and anthropometric changes associated with years of training in weightlifting p. 80
Prince De-Gualle Deku, Max Effui Annani-Akollor, Monday Omoniyi Moses, Bright Oppong Afranie, Isaac Azo Tiguridaane, Simon Koffie, Abigail Oforiwaa Doku, Lady Gwendoline Akwa
Background: Most Ghanaian youths engage in weight training mostly for bodybuilding with littles attention to biochemical, physiological, and anthropometric changes on the long run. This study investigated the effect of duration of training (DOT) on biochemical, physiological, and anthropometric parameters of weightlifters. Materials and Methods: University setting and a cross-sectional descriptive study design were adopted. Sixty-six adult male weightlifters with a mean age of 25.98 ± 5.66 served as study sample. Modified Behavioral Regulation in Exercise Questionnaire-2 was administered. Self-reported DOT (grouped into 0–12 months, 1–5 years, and >5 years) and demographic and lifestyle information were collected. Anthropometric, physiological, lipid profile, total protein, albumin, globulin, and glomerular filtration rate (GFR) data were obtained. Results: Most of the participants greatly valued weight training (scale of 5 = 4.63 ± 0.89). Longer DOT was significantly associated with increased chest circumference (P = 0.013), arm circumference (P = 0.010), and diastolic blood pressure (P = 0.038). Statistical significance was only observed for dietary supplement intake and plasma globulin levels (P = 0.030). Association between GFR and dietary supplement intake was insignificant (P = 0.256). Conclusions: Weight training positively influences biochemical, physiological, and anthropometric indices of weightlifters. Investment in and motivational intervention in weight training would be beneficial to health lifestyle. A study with larger sample size on elite weightlifters could elicit further findings.
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Barriers to health-care access amid the coronavirus disease 2019 pandemic in children with non-coronavirus disease illnesses from India p. 87
Abhineet Mathur, Priyanka Meena, Jerin C Sekhar, Puneet Kaur Sahi, Aashima Dabas, Mukta Mantan, Sangeeta Yadav
Background: Coronavirus disease 2019 (COVID-19) and the nationwide lockdown have resulted in profound disruptions in health care. Thus, the study was done to assess the barriers faced by caregivers of children with chronic diseases in accessing healthcare services due to the lockdown. Methods: A questionnaire-based telephonic survey was performed after 2 months of nationwide lockdown in children with chronic diseases at a tertiary hospital in India. Barriers faced were recorded and compared with the place of residence and socioeconomic status (SES). Results: A total of 101 children with mean ± standard deviation age of 9.7 ± 3.6 years and median (interquartile range) disease duration of 48 (12, 84) months were included. The majority (84.6%) was on daily therapy and 65.3% reported disrupted treatment. Patients residing away from the capital had greater difficulty in investigations and in transport to the hospital (P < 0.05) compared to those in the capital. Patients from lower SES had more difficulty in procuring medications (64.1% and 35.4%; P = 0.006), transport (62.3% and 29.1%; P = 0.003), and perceived significant effect of COVID-19 on their child (47.2% and 16.7%; P = 0.002) compared to middle SES. Conclusions: Disrupted health-care access during COVID-19 suggests the need for health-care systems to be better equipped to manage patients with chronic illnesses during such pandemics.
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Behçet's disease presenting as cerebral venous thrombosis p. 92
Pratibha Prasad, Prem Shanker Verma
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Combined welsh and modified ramam regimen in the management of an actinomycetoma patient with sulfonamide drug sensitivity p. 94
K Geetha
Mycetoma is a chronic, suppurative granulomatous infection which has been declared as a neglected tropical disease by the World Health Organization. The clinical manifestations include the classical triad of swelling, sinus tracts, and discharge. It is of two types, eumycetoma (true fungi) or actinomycetoma (filamentous aerobic bacteria), and is more prevalent in tropical and subtropical areas. Here is a case report of mycetoma patient who presented to the outpatient department with the classical triad of symptoms. Histopathological confirmation of actinomycetoma was made and started with Welsh regimen. As he developed drug sensitivity to cotrimoxazole, it was stopped. He was continued with amikacin as per Welsh regimen along with doxycycline 100 mg twice daily instead of cotrimoxazole for 3 cycles with complete cure. Regular monitoring with hemogram, renal function tests, and audiogram were done before and after each cycle. There are multiple reports of treatment of actinomycetoma by various antibiotics such as cotrimoxazole, dapsone, streptomycin, trimethoprim, rifampicin, and amoxicillin–clavulanic acid combination. This case report highlights the importance of individualization of treatment regimen based on the clinical scenario.
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