Current Issue Volume 2, Number 3 , September-December 2017

ORIGINAL ARTICLE
Tushar Bhati, Brijesh K Sharma

A Comparative Study of Surgical Treatment of Hemorrhoids: Stapled vs Open and Closed Hemorrhoidectomy

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:109-113]



Hemorrhoids and piles are used interchangeably very often but originally the words have entirely different meanings. Surgical treatment of hemorrhoids has been suggested for third- and fourth-grade hemorrhoidal disease and include removal of hemorrhoidal tissue. Stapled hemorrhoidectomy [minimally invasive procedure for hemorrhoid (MIPH)] introduction received much enthusiasm as it offers patients a significantly improved postoperative comfort level. The aim of this study is to make comparative assessment of following procedures for hemorrhoids: Stapled hemorrhoidectomy, open hemorrhoidectomy, closed hemorrhoidectomy, in terms of operative time, hospital stay, postoperative complications, and cost-effectiveness.

Keywords:Comparative study, Hemorrhoids, Stapler.

How to cite this article: Bhati T, Sharma BK. A Comparative Study of Surgical Treatment of Hemorrhoids: Stapled vs Open and Closed Hemorrhoidectomy. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):109-113.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Navendu Agarwal, Brijesh K Sharma

Intraoperative Findings and Technique Modification in Acute Cholecystitis in Early and Delayed Groups of Laparoscopic Cholecystectomies: A Randomized Control Prospective Study

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:114-117]



Introduction: Cholecystectomy is the most common surgery performed. The invention of laparoscopic cholecystectomy has made it extremely convenient and safe, but still the question of when to perform the surgery persists. This study attempts to compare the intraoperative findings of acute cholecystitis patients of the early and delayed group and its impact in surgery.

Materials and methods: Institutional-based prospective randomized control study was done on two groups of patients who were diagnosed and admitted to the General Surgery outpatient department (OPD) of Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India from November 2015 to November 2017. The early group was operated within 7 days of the appearance of symptoms and the delayed group was operated after 6 weeks. Intraoperative findings and modification of technique were duly noted in both and analysis done by applying the chi-square test.

Results: Acute complications are found to be more in an early group like turbid bile or pus with distended gallbladder in the early group, but adhesions are much more in the delayed group. Technique modification is more required in early as compared with the delayed group.

Conclusion: An early cholecystectomy is a convenient option for a patient with a nonsignificant technique modification to manage the intraoperative complications.

Keywords: Adhesions, Delayed, Early, Laparoscopic cholecystectomy, Technique modifications.

How to cite this article: Agarwal N, Sharma BK. Intraoperative Findings and Technique Modification in Acute Cholecystitis in Early and Delayed Groups of Laparoscopic Cholecystectomies: A Randomized Control Prospective Study. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):114-117.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Jitendra K Gupta, Pawan Kumar, Usha Acharya

Study of Production of Alloantibodies in Multiple Transfused Thalassemia Patients in Pediatric Age Group

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:118-121]



Introduction: Thalassemia is a heterogeneous group of genetic disorders in which blood transfusion is life saving for thalassemia patients. Repeated transfusion causes multiple unexpected antibodies other than anti-A or B.

Aim: To detect and subtype the irregular antibodies in sera of thalassemia patients in Jaipur.

Materials and methods: A total of 100 patients of proven thalassemia were included in the study at Mahatma Gandhi Medical College and Hospital and JK Lon Hospital, Jaipur, Rajasthan, India. Information on transfusion history was recorded, 5 mL of blood was collected from each subject, and plasma was separated. These samples were subjected to direct Coomb’s test (DCT) by column gel agglutination (CGA) technique.

Results: In the present study, the alloantibodies which were most common among the seven positive samples out of 100 are anti-D, anti-K, anti-E, and anti-MN, with an incidence of 28.57, 28.57, 28.57, and 14.3% respectively. Blood group O had maximum number of alloantibodies (57%). According to number of transfusions, alloantibodies of thalassemia major patients showed statistically significant increase with increase in number of transfusion.

Conclusion: From the current study, it can be concluded that alloantibodies to minor group antigens are more frequent among thalassemia patients, which need more frequent blood transfusions.

Keywords: Alloantibodies, Direct Coomb test, Multiple transfusion, Thalassemia major.

How to cite this article: Gupta JK, Kumar P, Acharya U. Study of Production of Alloantibodies in Multiple Transfused Thalassemia Patients in Pediatric Age Group. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):118-121.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Rajesh K Sharma, Ved P Mamoria

A Prospective Study on Prevalence and Antibiotic Susceptibility Pattern of Acinetobacter baumannii in Clinical Samples obtained from Patients admitted in Various Wards and Intensive Care Units

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:122-127]



Introduction: Acinetobacter baumannii is a nonfermentative and nonmotile, Gram-negative coccobacillus, which is the most often identified pathogen among Acinetobacter species that causes wide range of infection in humans. It has emerged as one of the most troublesome pathogens for health care institutions globally. Acinetobacter baumannii strains resistant [multidrug-resistant A. baumannii (MDR-Ab)] to all known antibiotics have now been reported.

Aim: To determine the prevalence and antimicrobial susceptibility pattern of A. baumannii isolates in the clinical samples obtained from patients admitted in various wards and intensive care units (ICUs).

Materials and methods: A total of 9,540 clinical specimens [from the patients of inpatient department (IPD)] were collected between March 2016 and February 2017 from various wards and ICUs of Mahatma Gandhi Hospital (MGH), Sitapura, Jaipur, Rajasthan, India. All tests were done at microbiology lab of Mahatma Gandhi University of Medical Sciences & Technology, Jaipur, Rajasthan, India, using standard protocol.

Results: Of 9,540 (45%) clinical specimens, 4,293 specimens from various wards and ICUs were culture positive. Out of 4,293 positive cultures, Acinetobacter isolates were 276 (6.42%). From 276 Acinetobacter isolates, 230 (83.33%) strains were confirmed as A. baumannii strains and remaining 46 (16.67%) strains as other Acinetobacter species. Maximum frequency of Acinetobacter isolates was from respiratory tract intubated patients (endotracheal samples: 59.5%). Maximum frequency of A. baumannii isolates was recovered from ICUs (63.04%) compared with wards. In our study, most Acinetobacter isolates were resistant (80-99%) to third- and fourth-generation cephalosporins, quinolones, penicillins, aminoglycosides, carbapenems, and macrolides. Drugs of choices are colistin (99.13%), tigecycline (67.83%), cefoperazone/sulbactam (44.78%), minocycline (40.87%), ampicillin + sulbactam (36.09%), doxycycline hydrochloride (10.43%), and cotrimoxazole (9.57%).

Conclusion: Acinetobacter species is an emergent and global hospital-acquired pathogen. Drug resistance pattern of A. baumannii is quite alarming in our health care settings, so effective infection control practices and judicious use of antibiotics is mandatory.

Keywords: Endotracheal, Intensive care units and wards, Multidrug-resistant Acinetobacter baumannii, Nosocomial infection.

How to cite this article: Sharma RK, Mamoria VP. A Prospective Study on Prevalence and Antibiotic Susceptibility Pattern of Acinetobacter baumannii in Clinical Samples obtained from Patients admitted in Various Wards and Intensive Care Units. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):122-127.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Aditya Soni, Vikas Gaur, Manju Bhaskar, Prerak Kumar, Shubhangi Singh

Body Image in Students: Relationship with Eating, Media Influence, and Self-esteem

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:128-134]



Introduction: This study was carried to examine the body image satisfaction and its relationship with self-esteem, body mass index (BMI), and influence of media on body image. Another objective was to observe any existing relationship between gender and body image dissatisfaction.

Materials and methods: Exploration of relationship of body image satisfaction with BMI, media influence, self-esteem, and other variables like socioeconomic demographic data, overall satisfaction in life (academic/professional), and current health status was carried out via a cross-sectional study using 5-item-based Likert scale in 303 participants.

Results: Males showed less concern about body image. Significant relationship of body mass was seen with BMI (p < 0.001), eating attitude (p < 0.001), influence of media (p < 0.001), and self-esteem (p < 0.001). Overweight students had a significantly higher prevalence of dissatisfaction (p < 0.001) than students with low weight who reported a higher body image satisfaction.

Conclusion: To conclude, this study proves that there exists a significant relationship between eating attitude, media influence, and self-esteem with body image. Adequate anticipatory measures are required for improvement in individuality, selfacknowledgment, and individual contrasts while keeping up ideal weight and dynamic lifestyle.

Keywords: Body image, Body mass index, Media, Selfesteem.

How to cite this article: Soni A, Gaur V, Bhaskar M, Kumar P, Singh S. Body Image in Students: Relationship with Eating, Media Influence, and Self-esteem. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):128-134.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Kuldeep S Yadav, Amit Nijhawan, Rishika Agarwal, Madhu Njihawan, Preetkamal, Manisha Nijhawan

Validity of Screening Questionnaire for Detection of Psychiatric Manifestations in Chronic Dermatoses

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:135-137]



Skin being the largest organ of the body determines its appearance that may aid in sexual and social communication. Changes in a person’s external appearance secondary to any dermatologic disease can deter self-esteem and social interaction. Psychosocial burden of skin disease can affect the overall disability experienced by the person. The present study attempted to find out the validity of a screening questionnaire [General Health Questionnaire 12 (GHQ-12)] to find the psychiatric morbidity in patients suffering from chronic dermatoses. The questionnaire was found to be a valid and reliable instrument to screen psychiatric morbidity in patients with chronic dermatoses attending outpatient setting. There were only 6 (30%) false-positive cases and reliability was found to be 91.4%.

Keywords: Chronic dermatosis, General Health Questionnaire- 12.

How to cite this article: Yadav KS, Nijhawan A, Agarwal R, Njihawan M, Preetkamal, Nijhawan M. Validity of Screening Questionnaire for Detection of Psychiatric Manifestations in Chronic Dermatoses. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):135-137.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Shipra Shrivastava, Nalini Mishra

Impact of Reorientation and Training of Active Management of the Third Stage of Labor in a New Medical College of Chhattisgarh, India

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:138-142]



Introduction: Active management of third stage of labor (AMTSL) is a best practice that reduces the incidence of postpartum hemorrhage (PPH). The present study was done with an objective to document the prevalent practice in regard to various components of AMTSL and the impact of reorientation session.

Materials and methods: A total 200 women fulfilling the inclusion criteria (low-risk singleton pregnancy at term) and anticipating vaginal delivery were enrolled in the study. In the first stage of the study, observation and documentation of ongoing practice of management of third stage of labor in 100 consecutive women (group I) was followed by reorientation session. In the second stage, again 100 women were observed and documented as above (group II). The changes and its impact in terms of blood loss and incidence of PPH were noted and compared with group I.

Results: None of the women of group I was given injection oxytocin in comparison to 77 women of group II. Controlled cord traction (CCT) was done in 44 women of group I as against 97 of group II women. No significant change in the timing of cord clamping was observed. The PPH occurred in only three women of group II in comparison to 11 of group I (p ≤ 0.05).

Conclusion: The level of adherence to AMTSL was low particularly for the use of oxytocin as first-line prophylactic uterotonic. The change in practice after a session of reorientation was positive and was associated with significant reduction in the incidence of PPH. The study reiterates the importance of frequent trainings.

Keywords: Active management of third stage of labor, Maternal mortality, Postpartum hemorrhage, Visual estimation of blood loss.

How to cite this article: Shrivastava S, Mishra N. Impact of Reorientation and Training of Active Management of the Third Stage of Labor in a New Medical College of Chhattisgarh, India. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):138-142.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Pooja Mishra, Nikhil Marwah, Asmita Sharma, Thejavinuo, Bharathi Padiyar

Evaluation of the Knowledge and Belief of Expectant Mothers in Their Last Trimester about Importance of Primary Teeth and Their Care

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:143-147]



Objective: “An ounce of prevention is worth a pound of cure” can be applied in pediatric dentistry to reduce the risk of early childhood caries (ECC). Prevention can bring revolutionary change in field of ECC, especially by creating awareness among expectant mothers who play a role of primary caregivers in infant’s oral health. The aim of this study is to evaluate the knowledge and belief of expectant mothers in third trimester about importance of primary teeth and their care.

Materials and methods: A total of 500 expectant mothers were randomly selected and questionnaire was prepared regarding their approach toward infant oral health care and role of primary teeth in their child’s life.

Results: The results of the study indicated that expectant mothers had minimal knowledge about primary teeth and also the role of teeth. In spite of this poor knowledge, the results also revealed that most expectant mothers were also eager to know information regarding children’s teeth.

Conclusion: Implementing educational awareness about primary teeth and their importance can bring change in mindset of expectant mothers, thus decreasing risk for ECC.

Keywords: Early childhood caries, Expectant mother, Infant oral health, Primary teeth.

How to cite this article: Mishra P, Marwah N, Sharma A, Thejavinuo, Padiyar B. Evaluation of the Knowledge and Belief of Expectant Mothers in Their Last Trimester about Importance of Primary Teeth and Their Care. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):143-147.

Source of support: Nil

Conflict of interest: None


RESEARCH ARTICLE
Puneet Rijhwani, Chand M Agarwal, Abhishek Charan, Kanishk Sharma, Namrata Pareek

Prevalence of Vitamin D Deficiency in Diabetes Mellitus and Its Correlation with Glycated Hemoglobin

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:148-150]



Introduction: The modern-day lifestyle and industrialization has led to the deficiency of sunshine vitamin, i.e., vitamin D, in all age groups. Vitamin D deficiency has its implications in almost each system and has widespread manifestation. This deficiency has far more severe outcomes when associated with diabetes.

Aim: To evaluate vitamin D level in type II diabetes patients.

Materials and methods: One hundred diabetic patients will be screened for serum 25-hydroxyvitamin D level by enzymelinked immunosorbent assay technique and the results will be statistically analyzed.

Results: In our study, vitamin D was deficient in 42%, insufficient in 40%, and normal in 18% cases. Deficiency was seen more in female diabetics. This study has significant correlation with glycated hemoglobin (HbA1c) level and vitamin D level, i.e., as HbA1c increased, so is the vitamin D deficiency.

Conclusion: Vitamin D was deficient in more than 80% of diabetic patients. Therefore, all diabetic patients should be investigated for vitamin D level.

Keywords: Diabetes mellitus, HbA1c, Vitamin D.

How to cite this article: Rijhwani P, Agarwal CM, Charan A, Sharma K, Pareek N. Prevalence of Vitamin D Deficiency in Diabetes Mellitus and Its Correlation with Glycated Hemoglobin. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):148-150.

Source of support: Nil

Conflict of interest: None


RESEARCH ARTICLE
Priyamvada Gupta, Manisha Agrawal, Durga Jethava, DD Jethava

A Comparison of the Effect of Dexmedetomidine and Esmolol in Attenuating Stress Responses during Laparoscopic Surgeries

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:151-156]



Introduction: The creation of pneumoperitoneum leads to increased mean arterial pressure and systemic vascular resistance as a result of stimulation of the sympathetic system leading to increased release of catecholamines and vasopressin. In order to prevent these hemodynamic changes, various pharmacological agents like clonidine, esmolol, or dexmedetomidine are used. Hence, there is need for this study.

Materials and methods: A total of 60 patients were randomized into two equal groups: group D—dexmedetomidine was administered as loading dose 1 μg/kg administered slowly over 15 minutes before induction followed by maintenance infusion of 0.5 μg/kg/hour throughout the period of pneumoperitoneum. Group E—esmolol was administered as loading dose at 1 mg/kg administered slowly over 5 minutes before induction followed by maintenance infusion of 0.5 mg/kg/ hour throughout the period of pneumoperitoneum. Intraabdominal pressure was maintained at 12 to 14 mm Hg throughout the procedure. The infusions were discontinued immediately after the release of pneumoperitoneum. Heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were recorded at frequent intervals as per the pro forma. Data were analyzed using appropriate statistical tests.

Results and conclusions: As compared with esmolol, dexmedetomidine is more effective for attenuation of the pressor responses to pneumoperitoneum and thus achieving hemodynamic stability during laparoscopic surgeries (p < 0.05).

Keywords: Dexmedetomidine, Esmolol, Laparoscopic, Pneumoperitoneum.

How to cite this article: Gupta P, Agrawal M, Jethava D, Jethava DD. A Comparison of the Effect of Dexmedetomidine and Esmolol in Attenuating Stress Responses during Laparoscopic Surgeries. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):151-156.

Source of support: Nil

Conflict of interest: None


RESEARCH ARTICLE
Surbhi Chaturvedi, Rajendra K Sureka, Rishika, Apoorv Sharma, Manamita Mandal

Forgotten Psychiatric Comorbidity in Neurological Disorders

[Year:2017] [Month:September-December] [Volumn:2 ] [Number:3] [Pages:71] [Pages No:157-161]



Introduction: Neurological disorders like headache, stroke, and seizures are associated with many psychiatric comorbidities like anxiety, depression, psychosis, eating disorders, personality disorders, etc. In order to look for the association of psychiatric comorbidities in epilepsy, headache, and stroke, this study was undertaken as very few studies have been reported from this part of the country so that we can help patients in improving their quality of life.

Materials and methods: This study was done in Mahatma Gandhi Medical College and Hospital, Jaipur, India, by the Department of Neurology and the Department of Psychiatry at the time of 1st visit. Fifty patients each of proved epilepsy, stroke, and headache were enrolled after consent and they were put to screening using the Global Mental Health Assessment Tool (GMHAT) questionnaire and at the same time, Department of Psychiatry assessed comorbidities—depression and anxiety—and made diagnosis using Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) scale respectively.

Results: The GMHAT tool showed that 50% of the patients having headache, 80% of the patients who had stroke, and 72% of the patients suffering from epilepsy had psychiatric comorbidities. The HAM-A scale showed that 40% of the patients with headache, 16% of patients suffering from epilepsy, and 30% of patients with stroke had anxiety as psychiatric comorbidity. The HAM-D scale showed depression in 30% of the patients having headache, 36% of the patients with epilepsy, and 60% of the patients who had stroke.

Conclusion: Results of our study showed that depression and anxiety are the most frequently encountered psychiatric comorbidities in patients with epilepsy, headache, and stroke. In our study, it was seen that depression was more common as compared with anxiety in patients with epilepsy and stroke, and anxiety was more common as compared with depression in patients with headache. To confirm our findings further, larger multicenter studies are needed. Anxiety and depression should be evaluated by clinicians using these simple screening instruments that can rapidly detect symptoms of these comorbidities in their busy clinical settings.

Keywords: Epilepsy, Headache, Psychiatric comorbidity, Stroke.

How to cite this article: Chaturvedi S, Sureka RK, Rishika, Sharma A, Mandal M. Forgotten Psychiatric Comorbidity in Neurological Disorders. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):157-161.

Source of support: Nil

Conflict of interest: None


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