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   Table of Contents - Current issue
January-April 2022
Volume 3 | Issue 1
Page Nos. 1-33

Online since Thursday, March 24, 2022

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Demystifying hepatitis B vaccination for public: Aspiration for global eradication p. 1
Tarika Sharma
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Home management of intestinal stoma: An evidence based review p. 3
Harmeet Kaur Kang, Mamta Choudhary
Shortened hospital stays for clients with an intestinal stoma have shifted the focus from institutional care in hospitals to self-care of ostomies to the home setting. Clients with intestinal ostomy experience numerous changes in physical functioning, psychosocial health, and in their sexual life after creation of stoma. This enhances the importance of a guide for home management of intestinal stoma to assist home care clinicians and stoma care nurses, who are determined to make ostomates self-reliant. This evidence-based review focused on published articles from the Medline, CINAHL, Social Sciences Citation Index, Psych INFO, a hand search through selected journals published since 2000, and from references lists, to prepare home management guide for intestinal stoma. This article provides information regarding measures to protect skin around stoma, daily care management for ostomates, and ways to prevent peristomal skin complications.
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Assessment of knowledge and practice trends about COVID-19 disease and vaccination among patients with type 2 diabetes mellitus attending an outpatient department of a tertiary care hospital p. 8
Jayshree Swain, Ankit Manglunia, Swayamsidha Mangaraj, Jaspreet Singh, SL Sravya, Pooja Jadhao
Background: COVID-19 pandemic has been the most challenging health-care crisis of modern times which has severely impacted the health-care and economic infrastructure of all affected nations. Diabetic people are at an increased risk of morbidity as well as mortality from COVID-19 infection. Efforts to stop the spread of any pandemic depend upon the people's knowledge regarding the preventive measures as well as their attitudes and healthy practices. The purpose of this study is to assess the knowledge, attitude, and healthy practices of the diabetic population in our part of the country toward COVID-19 pandemic as well as toward ongoing vaccination drive in our country. Materials and Methods: This is an observational study, face-to-face interview with the type 2 diabetes patients attending our endocrine outpatient department regarding the knowledge, attitude, and practice questionnaire. The knowledge questionnaire took into account the current knowledge regarding COVID-19 and its relationship with diabetes mellitus as well as healthy practices to be followed during pandemic. Results: Among our study population, around 78% of the participants had an average knowledge while 10% still had below-par knowledge. There was significant discordance between knowledge and healthy practices among the studied subjects. Even when patients had knowledge about the precautions to be taken, they were not following it strictly. In our study, nearly 54% of the subjects expressed confidence over the efficacy of the vaccine. Similarly, 53% of the subjects knew that they are supposed to follow social distancing norms and wear masks even after vaccination to prevent the spread of COVID-19. Conclusion: The knowledge of our diabetic population related to COVID-19 pandemic is still average. Even with average knowledge, there is a wide gap between knowledge and health practices. The attitude of the diabetic population toward vaccination is still below par which could have implications regarding vaccine acceptability.
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Histopathological spectrum of skin lesions in the elderly: Experience from a tertiary hospital in Southeast Nigeria p. 14
Chinedu Onwuka Ndukwe, Chinwe Chioma Ndukwe, Joseph Chukwuma Uzoigwe, Anthony Onyeka Eni, Christian Sunday Nnamani, Onyekachi Chibueze Nwokoro, Michael Emeka Chiemeka
Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Materials and Methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1, and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1 ± 9.5 years. In the female patients, it was 70.1 ± 7.5 years. The most common disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. The most common was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms, and papulosquamous disorders are the three most common histologically diagnosed skin lesions in our geriatric population. The most common skin malignancies in this group of patients are SCC and malignant melanoma.
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Correlation of immunohistochemical expression of p16, Ki-67, and p53 with histopathological diagnosis of noninvasive cervical lesions: A multicenter study from South East Nigeria p. 20
Christian C Ogbu, Chinedu Onwuka Ndukwe, Michael Emeka Chiemeka, Kingsley C Madubuike, Cornelius Ozobia Ukah
Background: There is a high burden of cervical cancer in our environment. Most patients present late when the prognosis is guarded. Hence, accurate diagnosis of preinvasive lesions from cervical biopsies is important for clinical decisions and patient management. The aim of the study is to correlate the expression of p16INK4a, p53, and Ki-67 with histopathological diagnosis of noninvasive cervical lesions. Materials and Methods: The paraffin blocks of all cervical biopsies (excluding cases histologically diagnosed as invasive lesions) seen in two histopathology laboratories in Nnewi, Southeast Nigeria, over a 10-year period (2011–2020) were retrieved from the archives of both facilities. The cases were subjected to immunohistochemistry using p16INK4a, Ki-67, and p53 monoclonal antibodies. Results: There were 23 normal/reactive (45.1%), 6 low-grade squamous intraepithelial lesion (11.8%), and 22 hIL (43.1%). There is a very strong positive correlation between p16INK4a expression and the histopathological diagnosis (Spearman's correlation = 0.98). There is a strong positive correlation between Ki-67 expression and the histopathological diagnosis (Spearman's correlation = 0.70). There is a weak positive correlation between p53 expression and histopathological diagnosis (Spearman's correlation coefficient = 0.40). Conclusion: p16INK4a shows the best correlation with histopathological diagnosis of noninvasive cervical lesions and may be a very useful adjunct to H and E for diagnosing preinvasive cervical lesions. However, p53 correlates poorly with histopathologically diagnosed noninvasive cervical lesions and therefore may not be diagnostically useful.
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Outcomes of supraflex sirolimus eluting coronary stents p. 25
Vishal Virendra Singh, Sheikh Mohammad Tahir, Sanjiv Sharma
Background: The introduction of Sirolimus Eluting Coronary Stents (SES) was a major breakthrough in interventional cardiology. The large, randomized, clinical trials using SES have shown a remarkable reduction in angiographic restenosis and target vessel revascularization (TVR) compared with bare-metal stents as well as other drug-eluting stents (DESs). However, there is only limited data on the outcome of Indian patients treated by DES of Indian origin. The purpose of the study was to evaluate the outcomes of the supraflex sirolimus-eluting coronary stents for the treatment of coronary artery disease and to determine major adverse cardiovascular and cerebrovascular events (MACCE). Materials and Methods: This was a single-centre, observational, nonrandomized study that enrolled unselected real-world patients at a tertiary care center who had undergone implantation with supraflex sirolimus-eluting stents. The primary end-point of the study was MACCE, which is a conglomeration of cardiac death, target lesion revascularization (TLR), TVR, cerebrovascular accident (CVA), and heart failure at 1-year follow-up. Results: A total of 100 patients were intervened successfully with sirolimus-eluting stents. Out of total patients, diabetes and hypertension were observed in 38% and 35% of patients. According to ACC/AHA classification, there were 68% Type B lesions and 32% Type C lesions. At 1-year follow-up, MACE was found to be 11%, which is a composite of 4% TLR, 3% TVR, 1% CVA, and 5% heart failure. Diabetes (P = 0.02), hypertension (P = 0.01), kidney dysfunction (P = 0.002), and LV function (P = 0.01) strongly correlate with outcome (MACCE). Conclusion: There was an acceptable rate of adverse events after implantation of the supraflex sirolimus-eluting stents, although it was slightly higher compared to other studies. Diabetes, hypertension, kidney dysfunction, and LV function strongly correlate with outcome (MACCE).
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Insights from training drive for coronavirus disease-19 vaccination in India p. 32
Priyanka Sharma, Geeta Pardeshi
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