Journal of Mahatma Gandhi University of Medical Sciences and Technology

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2020 | May-August | Volume 5 | Issue 2

Original Article

Shalu Sharma, Bushra Fiza, Sumit Kumar Tiwari, Maheep Sinha

Evaluation of Serum Calcium Levels in Patients with Epileptic Seizure

[Year:2020] [Month:May-August] [Volume:5] [Number:2] [Pages:3] [Pages No:35 - 37]

Keywords: Anti-epileptic drugs, Epileptic seizure, Hypocalcemia

PDF  |  DOI: 10.5005/jp-journals-10057-0112  |  Open Access |  How to cite  | 

Abstract

Introduction: Epilepsy is a disorder of the central nervous system, characterized by an epileptic seizure. Epileptic seizures occur due to abnormal synchronous activity in the brain. Calcium is an essential component of bone. Hypocalcemia enhances neuronal excitability, and there are many causes of which include hypocalcemia, vitamin D deficiency, and PTH resistance. Materials and methods: The study was conducted in Department of Biochemistry in association with the Department of Neurology of Mahatma Gandhi Medical College and Hospital, Jaipur. Fifty patients diagnosed for epileptic seizure and 50 controls, visiting the inpatient department (IPD) and outpatient department (OPD) of Neurology fulfilling the inclusion criteria, were enrolled for the study. Result: The present study showed significantly lower level of serum calcium in patients with epileptic seizure when compared to controls. Conclusion: The serum calcium was measured between epileptic seizure and controls. Our present study showed significantly lower value of calcium. It is therefore suggested that there should be regular screening for calcium in patients with epileptic seizure. The serum calcium is biomarker of bone metabolism; so, the correlation can be further studied with some more bone metabolism markers in epileptic seizure patients.

Original Article

Maulik Sharma, Rajkamal Kanojiya, Shefali Goyal

Evaluation of Risk Factors for Amputation and Mortality in Patients of Necrotizing Fasciitis

[Year:2020] [Month:May-August] [Volume:5] [Number:2] [Pages:9] [Pages No:38 - 46]

Keywords: Amputation, Debridement, Fasciotomy, Gangrene, Necrotizing fasciitis

PDF  |  DOI: 10.5005/jp-journals-10057-0130  |  Open Access |  How to cite  | 

Abstract

Background: Necrotizing fasciitis (NF) is a serious infection of the skin and soft tissues including subcutaneous tissue and fascia, which rapidly progresses along the deep fascia and becomes a medical and surgical urgency. Delayed treatment is associated with loss of limb and infection and is the most common cause of mortality. The purpose of our study is to identify the risk factors which may be used to predict amputation and mortality in patients with NF. Materials and methods: All adult patients presented in General Surgery OPD/emergency and plastic surgery OPD of MGUMST with NF were assessed, admitted, and treated with broad-spectrum antibiotics from January 2019 to June 2020. All routine blood parameters were evaluated and were provided proper emergency surgical treatment. The surgical interventions included incision and drainage, debridement, fasciotomy, and amputation. The clinical data and demographic characteristics within the first day of admission and after 48–72 hours were documented. Important data associated with the investigations and treatment of NF, i.e., wound appearance, site of infection, organisms involved, and laboratory data within the first day of admission and after 48–72 hours, surgical intervention and outcome, were documented. Patients were divided into two groups: survival and mortality which were further grouped into two groups: those with amputation and without amputation. Results: Among 100 patients with diagnosis of NF, 20% died and 10% underwent amputation. From multivariable analysis, the predictors of mortality among patients of NF were patients of age >60 years [risk ratio (RR) = 58.57, 95% CI = 3.64–941.85, p = 0.004], having diabetes mellitus (DM) (RR = 28.70, 95% CI = 1.78–461.51, p = 0.017), gangrene (RR = 3.86, 95% CI = 1.91–7.75, p = 0.0002), severe sepsis (RR = 158.14, 95% CI = 9.96–2508.89, p = 0.0003), involvement of multiple sites (RR = 9.06, 95% CI = 4.25–19.31, p = 0.0001), total leukocyte count (RR = 158.14, 95% CI = 9.96–2508.89, p = 0.0003), and serum creatinine (RR = 126.28, 95% CI = 7.92–2013.12, p = 0.0006) on admission and within 48–72 hours of admission and the independent predictors of amputation among patients of NF included having gangrene (RR = 173.73, 95% CI = 10.91–2764.80, p = 0.0003), severe sepsis (RR = 6.00, 95% CI = 1.86–19.26, p = 0.002), total leukocyte count (RR = 6.00, 95% CI = 1.86–19.26, p = 0.002), and serum creatinine (RR = 64.68, 95% CI = 3.92–1064.68, p = 0.003) on admission and within 48–72 hours of admission. Conclusion: In our study, we concluded that gangrene, severe sepsis, total leukocyte count >25,000, and serum creatinine values >1.6 mg/dL on admission as well as within 48–72 hours, as independent predictors for both amputation and mortality and some other factors like age >60 years, the involvement of multiple sites, DM mainly predicting the mortality rate independently.

Original Article

Isha Kriplani, Swati Garg, Priyanka Goel, Manisha Chowdhary

Role of Luteal Phase Endometrial Injury in Outcome of In Vitro Fertilization

[Year:2020] [Month:May-August] [Volume:5] [Number:2] [Pages:3] [Pages No:47 - 49]

Keywords: Endometrium, Implantation failure, IVF, Pregnancy

PDF  |  DOI: 10.5005/jp-journals-10057-0132  |  Open Access |  How to cite  | 

Abstract

Introduction: The development of receptive endometrium is necessary for successful implantation, which is now considered a rate-limiting step for the success of in vitro fertilization (IVF). Lately, scratching of endometrium before embryo transfer (ET) is being investigated as a possible technique to increase implantation rate. By improving endometrial receptivity, the endometrial injury might increase implantation and clinical pregnancy rates. Materials and methods: A total of 100 patients, who met the inclusion criteria, were randomized into two groups, group I (study group) in which endometrial scratching was done before ET, and group II (control group) in which endometrial scratching was not done. All the patients had previous history of implantation failure at one or more occasions. Results: In group I, 19/35 patients who underwent IVF conceived whereas in group II, 9/30 patients conceived. The conception rate in intervention group was higher than the control group for patients who underwent conventional IVF and this difference was found to be statistically significant, p value 0.049. In group I, 29 (58.0%) babies were born to 50 women who underwent intervention and in group II, 15 babies were born. This difference in carry-home baby rate was statistically significant (p = 0.005). Conclusion: The benefit of luteal phase endometrial injury cannot be refuted and larger multicenter randomized controlled trials are required for conclusive evidence.

Original Article

Ganesh Narain Saxena, Saumya Mathur

A Randomized Controlled Study of Efficacy and Safety Profile of Levosulpiride and Itopride in Functional Dyspepsia

[Year:2020] [Month:May-August] [Volume:5] [Number:2] [Pages:7] [Pages No:50 - 56]

Keywords: Dyspepsia, Itopride, Levosulpiride, Relief

PDF  |  DOI: 10.5005/jp-journals-10057-0131  |  Open Access |  How to cite  | 

Abstract

Introduction: Dyspepsia is a clinical problem of considerable magnitude for the healthcare system due to the high prevalence and chronic and recurrent nature of symptoms. Earlier dyspepsia was referred to as a heterogeneous group of symptoms in the upper abdomen and retrosternal which are related to ingestion of meals and include heartburn, regurgitation, epigastric pain, epigastric burning, postprandial fullness/distension, early satiety, bloating, belching, anorexia, nausea, and vomiting. This has prompted the search for newer agents with equal efficacy but lower side effect potential such as levosulpiride and itopride. Aim and objectives: To evaluate and compare the efficacy of the newer drugs like levosulpiride and itopride in functional dyspepsia. Observations and results: The most common presenting symptoms in the present study were epigastric fullness (81%), upper abdominal pain (55%), early satiety (52%), and epigastric burning (45%). Less common symptoms were bloating (27%), belching (11%), heartburn (10%), and nausea (8%). Conclusion: Drugs, itopride and levosulpiride, were equally effective in ameliorating different symptoms of functional dyspepsia at the end of 4 weeks of treatment. There was a significant reduction in mean global symptom score (GSS) and mean duration score and mean score of severity in follow-up visits at the 2nd and 4th week from the day of presentation (p value < 0.05).

Original Article

Kamakshi Tomar, Shilpi Rijhwani, Puneet Rijhwani

Evaluation of Phytochemicals Found in the Leaves of Jasminum sambac L. for Antimicrobial Activity

[Year:2020] [Month:May-August] [Volume:5] [Number:2] [Pages:4] [Pages No:57 - 60]

Keywords: Antimicrobial activity, Jasminum sambac, Phytochemicals

PDF  |  DOI: 10.5005/jp-journals-10057-0128  |  Open Access |  How to cite  | 

Abstract

Jasminum sambac Linn. (Family—Oleaceae) was tested for antibacterial activity against three important pathogenic bacteria, i.e., Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Powdered leaf material was extracted with different solvents from non-polar to polar viz., n-hexane, chloroform, ethyl acetate, methanol, and water using Soxhlet apparatus. All the solvent extracts were evaporated to dryness using a hot dry air oven. The dry residue was dissolved in respective mother solvents (1:10 w/v) and tested for the presence or absence of various phytochemicals. An antimicrobial test was also followed to check the antimicrobial activity. Among five solvents tested, methanol, n-hexane, and ethyl acetate extracts showed significant antibacterial activity and chloroform extract showed less activity when compared with control (respective mother solvent). Water extract did not show any activity against all three microorganisms.

CASE REPORT

Akanksha Jharwal, Deepak Raisingani, Prachi Mital, Lalita Poonia

Endodontic Management of the Maxillary First Molar with Two Palatal Canals: A Case Report

[Year:2020] [Month:May-August] [Volume:5] [Number:2] [Pages:5] [Pages No:61 - 65]

Keywords: Anatomic variations, Canals, Cone-beam computed tomography, Maxillary molar, Root canal treatment

PDF  |  DOI: 10.5005/jp-journals-10057-0125  |  Open Access |  How to cite  | 

Abstract

The major goals of root canal treatment are to remove irritants from the root canal system, fill or obturate the cleaned and shaped system, and prevent future recontamination of sealed root canals. However, endodontic treatment is also dependent on having sound knowledge of the internal anatomy of human teeth, especially when anatomic variations are present, clinicians should carefully explore the pulpal floor, further by changing the X-ray projection angle to confirm the existence of variation and prevent the missed canals, all of which are necessary for a successful root canal therapy. These clinical case reports present the application of cone-beam computed tomography as a useful imaging technique in endodontics for the management of teeth with aberrant anatomy.

CLINICAL INNOVATION

Garima Gaur, Siddharth Mehta, Kamal Bajaj, Priya R Sharma, Esha Nagpal, Kimi Mittal

Visiogauge: A Modified MBT Gauge

[Year:2020] [Month:May-August] [Volume:5] [Number:2] [Pages:3] [Pages No:66 - 68]

Keywords: Bracket positioning, MBT gauge, Visiogauge

PDF  |  DOI: 10.5005/jp-journals-10057-0140  |  Open Access |  How to cite  | 

Abstract

Bracket placement is an integral part of orthodontic treatment and it is needless to say that appropriate placement of the brackets is the most desirable. Over time, many devices and aids have been made to help an orthodontist to achieve this aim of placing the bracket to the most desirable position, but for some other reason, most of them have failed to achieve the desired position. In the present scenario, the most useable instrument for this purpose is the MBT gauge, which even though has its shortcomings, but has proven quite effective. One of its major disadvantages has been its non-ergonomic design because of which the orthodontist has no direct or indirect vision for the placement and as a result, the operator has to bend in a fatiguing posture or place it arbitrarily. To overcome this obstacle, we have custom-made “Visiogauge” which has an ergonomic-friendly design to help the doctor in achieving ease to use indirect vision. It not only would cater to the orthodontist to correct posture but would also enable him to achieve a higher level of precision in bracket positioning making it the required third eye.

SURVEY

Shavan K Yadav, Anant G Nigam, Renuka P Chinchalkar, Mili R Meghpara

Assessment of Knowledge and Attitude of Pediatricians and General Dentists toward Infant Oral Health Care, Jaipur

[Year:2020] [Month:May-August] [Volume:5] [Number:2] [Pages:3] [Pages No:69 - 71]

Keywords: Attitude, General dentists, Infant oral health care, Knowledge, Pediatricians

PDF  |  DOI: 10.5005/jp-journals-10057-0138  |  Open Access |  How to cite  | 

Abstract

Introduction: Oral health is the foundation upon which dental health must be built. Pediatricians examine infants several times during their 1st and 2nd years of life. Parents usually seek pediatricians’ advice in securing their child\'s normal growth and development. The aim of this study was to assess the knowledge and attitude regarding infant oral health in pediatricians and general dentist and to make aware about the preventive oral health care (OHC) needs for the infants to their parents. Materials and methods: A total of 100 pediatricians and 100 general dentists who participated in the study were randomly selected. Objective questionnaires related to infant OHC were distributed among the pediatricians and general dentists and asked to fill the pro forma. They were requested to fill an objective questionnaire without providing any oral health information. Results and conclusion: The results were statistically analyzed and it was concluded that there was a lack of knowledge among pediatricians as compared to the general dentist but overall both lacked the current concepts of pediatric dentistry.

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