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2022 | September-December | Volume 7 | Issue 3

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Aarushi Chopra, Deepak Raisingani, Ashwini B Prasad, Harshit Srivastava, Deeksha Khurana, Siddhi Dhadda

To Evaluate the Prevalence of C-Shaped Canal in Mandibular Second Molars Using CBCT Analysis

[Year:2022] [Month:September-December] [Volume:7] [Number:3] [Pages:5] [Pages No:67 - 71]

Keywords: Cone-beam computed tomography, Endodontic therapy, Maxillary second molar

   DOI: 10.5005/jp-journals-10057-0215  |  Open Access |  How to cite  | 


Aim: The goal of this study was to use cone-beam computed tomography (CBCT) to determine the prevalence of C-shaped canals in second mandibular molars. Materials and methods: A total of 1,500 CBCT scans were screened and evaluated in Rajasthan patients. C-shaped canals in the second mandibular molars were discovered. Results: In the second mandibular molars, the overall prevalence of C-shaped canals was 3.99%. There was no significant difference found based on gender or side of occurrence. Conclusion: In comparison to other subpopulations, the prevalence of C-shaped canals in second mandibular molars in the Rajasthan population is high. During clinical work, clinicians should be aware of the possible asymmetry, different configurations along the root, and location of the danger zone of this anatomic variation.


Original Article

Komal Girdhar, Puneet Rijhwani, Mukesh Sarna, Pardeep Agarwal, Sumeet Garg, Mohammed Shoaib

To Evaluate the Association of Neck Circumference and Mid-arm Circumference to the Components of Metabolic Syndrome

[Year:2022] [Month:September-December] [Volume:7] [Number:3] [Pages:3] [Pages No:72 - 74]

Keywords: Metabolic syndrome, Mid-upper arm circumference, Neck circumference

   DOI: 10.5005/jp-journals-10057-0218  |  Open Access |  How to cite  | 


Background: Metabolic syndrome (MS) has been long recognized as a risk factor for diseases like diabetes and coronary diseases; hence an easy and inexpensive screening tool is required for early diagnosis and appropriate intervention. Hence the present study was conducted to establish the role of neck circumference (NC) and to explore the role of mid-arm circumference for the screening of MS in day-to-day practice. Materials and methods: The present study was a hospital-based observational, descriptive, and comparative analysis conducted at a tertiary care center in West India after taking Ethical Committee clearance and written informed consent. A total of 159 subjects aged 18–65 years were selected consecutively after inclusion and exclusion criteria, from patients attending General Medicine's Outpatient Department and Inpatient Department. The sample size was calculated at an α-error of 0.05 and a study power of 80%. Results: Neck circumference (NC) and mid-arm circumference were found to be statistically significantly associated with MS and its individual components and cardiovascular risk factors like lipid profile, fasting blood glucose, blood pressure (BP), and waist circumference. Conclusion: In this study, NC, waist circumference, and mid-upper arm circumference (MUAC) were all found to be significantly associated with metabolic parameters. Our results indicated that NC, waist circumference, and MUAC in routine clinical measurement are necessary to screen for metabolic disorders, including dyslipidemia, diabetes, and hypertension. However, NC was discovered to be a simple yet reliable measure that can be used to enhance anthropometric indices in the diagnosis of MS and abdominal obesity.


Original Article

Pallaavi Goel, Puneet Rijhwani, Sumeet Garg, Ram K Jat, Mukesh K Sarna, Pardeep Agarwal, Somesh Gupta, Ambika Tyagi

Correlation of C-reactive Protein, Procalcitonin, and Lactate Levels with Mortality in Sepsis

[Year:2022] [Month:September-December] [Volume:7] [Number:3] [Pages:3] [Pages No:75 - 77]

Keywords: C-reactive protein, Lactate, Procalcitonin, Sepsis

   DOI: 10.5005/jp-journals-10057-0216  |  Open Access |  How to cite  | 


Background: There is no gold standard tool to definitively diagnose sepsis and no consistent system to predict outcomes. In any clinical setup, laboratory biomarkers are very important and can serve in determining the suitable treatment course. Serum lactate is one of these biomarkers that is known to be linked with mortality in patients with sepsis. Even procalcitonin (PCT) has been said to be a biomarker very useful in diagnosing sepsis. C-reactive protein (CRP) is an acute phase reactant and another sensitive marker of sepsis. Materials and methods: A prospective observational study was conducted in a tertiary care center in Jaipur, Rajasthan, India, including 160 study participants who were admitted to the intensive care unit (ICU) and diagnosed with sepsis. Detailed history and examination were made, followed by blood investigations. Written informed consent was obtained from all participants, and Institutional Ethics Committee approval was taken at the beginning of the study. Statistical analysis was done after adequate data collection. Results: Mean CRP (mg/L) was 9 ± 1.41, mean PCT (ng/mL) was 1.6 ± 0.56, and mean lactate (mmol/L) was 2.1 ± 1.97 among the study subjects. Mean CRP was found to be significantly higher in expired subjects (77 ± 31.1) as compared to survivors (9 ± 1.41). This difference was statistically significant as p < 0.05. Mean PCT (ng/mL) was found to be significantly higher in expired subjects (11.1 ± 0.14) as compared to survivors (1.6 ± 0.56). This difference was statistically significant as p < 0.05. Mean serum lactate was found to be higher in expired (3.4 ± 0.77) subjects as compared to survivors (2.1 ± 1.97), but this difference was not statistically significant as p > 0.05. Conclusion: The combined biomarker approach using CRP, PCT, and lactate depicted a better performance in predicting 28-day mortality.


Original Article

Kanika Suri, Puneet Rijhwani, Somesh Gupta, Mukesh Jain, Sumeet Garg, Pardeep Agarwal, Mukesh Sarna, Manish R Pahadia

Prevalence of Hemorrhagic Stroke Subtypes, Etiological Causes and Its Association with Various Stroke Related Risk Factors: An Observational Study

[Year:2022] [Month:September-December] [Volume:7] [Number:3] [Pages:6] [Pages No:78 - 83]

Keywords: Bleed, Hemorrhage, Hemorrhagic stroke, Hypertension, Stroke

   DOI: 10.5005/jp-journals-10057-0217  |  Open Access |  How to cite  | 


Background: Hemorrhagic stroke (HS) is a significant cause of mortality and morbidity worldwide. This observational study aimed to determine the prevalence of HS subtypes and their association with various stroke-related risk factors. Materials and methods: We conducted a prospective analysis of 38 patients diagnosed with HS at a tertiary health center in Rajasthan, India. We analyzed data related to demographic variables, clinical features, imaging findings, and risk factors related to HS. Result: In our study, the male-to-female ratio was 5.3:1. The most common age-group affected by HS was 60–69 years. The incidence of intraparenchymal bleeding was 81.6%, and subarachnoid was 18.4%. Basal ganglia (50%) was the most frequent site of HS. Hypertension (HTN) was the most commonly associated risk-factor associated with HS. Chi-square analysis observed a significant association between HS and HTN (p = 0.041) and cardiovascular disease (CVD) (p = 0.005). Conclusion: In our study, we observed a higher prevalence of HS in males and older adults. HTN was the most commonly associated modifiable risk-factor. Prompt identification and control of risk factors, particularly HTN, may help in the prevention and management of HS. More studies are needed to confirm the findings and explore the underlying mechanisms.



Priyank H Shah, Puneet Rijhwani, Ram K Jat, Manish R Pahadia, Krutarth H Shah, Bhavesh S Gauswami, Riya R Maheshwari

A Rare Presentation of Hyperthyroidism as Pyrexia of Unknown Origin

[Year:2022] [Month:September-December] [Volume:7] [Number:3] [Pages:3] [Pages No:84 - 86]

Keywords: Hyperthyroidism, Pyrexia of unknown origin, Thyrotoxicosis

   DOI: 10.5005/jp-journals-10057-0213  |  Open Access |  How to cite  | 


Introduction: The disease known as hyperthyroidism is brought on by the thyroid gland producing too many thyroid hormones. Thyrotoxicosis is a condition brought on by an overproduction of thyroid hormone for whatever reason. The most typical cause of hyperthyroidism is Grave's disease. Other causes include multinodular goitre, toxic adenoma, thyroid inflammation, iodine overconsumption, excessive synthetic thyroid hormone use, and, in rare cases, pituitary adenoma. Signs and symptoms: Vary between people and may include irritability, muscle weakness, sleeping problems, a fast heartbeat, heat intolerance, diarrhea, enlargement of the thyroid, hand tremors, and weight loss. Treatment depends partly on the cause and severity of the disease. Treatment options: Antithyroid drugs (carbimazole, methimazole, and propylthiouracil), surgery (thyroidectomy), β-blockers, diet (avoid food rich in iodine), and radioiodine. The presentation of hyperthyroidism as pyrexia of unknown origin (PUO) is rarely reported. So here we report a patient with a rare association of hyperthyroidism with PUO.



Avneet Kaur, Harshit Srivastava, Deepak Raisingani, Ashwini B Prasad, Prachi Mital, Deeksha Khurana

Reattachment of Maxillary Central Incisor Using Laser Crown Lengthening and Prefabricated Fiber Post: A Case Report on Preserving the Natural

[Year:2022] [Month:September-December] [Volume:7] [Number:3] [Pages:4] [Pages No:87 - 90]

Keywords: Complicated crown fracture, Dental trauma, Fiber post, Tooth reattachment

   DOI: 10.5005/jp-journals-10057-0214  |  Open Access |  How to cite  | 


Aim: To reattach the Fractured Maxillary Central Incisor using a laser crown lengthening procedure and a fiber post. Background: Anterior crown fractures are a frequent type of traumatic dental injuries that mostly affect the maxillary incisors, and their aftereffects can make it difficult to create and carry out an effective treatment strategy. Reattaching the fractured component itself is one of the therapeutic techniques. Fragment reattachment is a minimally invasive and reasonably priced treatment technique that can quickly restore form and function in crown-root instances. Due to its simplicity, natural esthetics, and long-lasting beauty due to the preservation of the original morphology, color, and surface texture, it ought to be the first option and a viable alternative to conventional procedures. Case description: A 25-year-old male patient came to the Department of Conservative Dentistry and Endodontics with fractured segment. Patient was given local anesthesia, the fractured segment was removed and placed in normal saline. Straight line access was prepared and sectional obturation was done. Then, laser crown lengthening was done to expose the fractured margin, post space was prepared, and bevelling was done on remaining tooth structure. Finally, prefabricated fiber post and the tooth fragment were luted with dualcure resin cement. Conclusion: An easy and effective method for treating fractured anterior teeth is tooth fragment reattachment following crown lengthening using the original tooth fragment and a fiber-reinforced post. It seems to provide the best possible functional and esthetic results. Clinical significance: If the fractured segment is available, then reattachment seems to be a conservative and viable option.



Pankaj Somani, Shiteez Agarwal, Jitendra Singh, Arvind Ranwa, Anurag Shrivastava, Anchal Chauhan, Anmol Randhawa, Bhawani S Sharma

Contrast-enhancing Sequestered Intervertebral Disc in Lumbosacral Spine: A Case Report and Review of Literature

[Year:2022] [Month:September-December] [Volume:7] [Number:3] [Pages:4] [Pages No:91 - 94]

Keywords: Case report, Low backache, Lumbar disc herniation, Peripheral rim contrast enhancement, Sequestered disc fragment, Severe lumbar canal stenosis

   DOI: 10.5005/jp-journals-10057-0219  |  Open Access |  How to cite  | 


A 57-year-old male patient presented with severe low backache associated with left lower limb radiculopathy over the posterolateral aspect of leg and foot for the last 1 month, acute in onset and gradually progressive with left foot drop, and hypoesthesia for the last 10 days. Contrast-enhancing magnetic resonance imaging (CE-MRI) was suggestive of peripheral rim-enhancing sequestered disc fragment in the left posterolateral spinal canal at L4-L5 level, extending into the medial aspect of left neural foramina leading to severe spinal canal stenosis. Microscopic lumbar discectomy was done. A large sequestered disc with granulation tissue was found inside the left neural foramina, densely adherent to adjacent dura mater and nerve root which was removed by careful gentle manipulation and meticulous dissection without dural tear and cerebrospinal fluid (CSF) leak. The patient had significant improvement in his symptoms with complete relief in pain and hypoesthesia immediately after surgery and gradual improvement in the power of the left lower limb from 1/5 to 4/5 over a period of 2 weeks. Here we review the literature and discuss the significance of rim enhancement in the case of sequestered lumbar prolapse intervertebral disc (PIVD) and its differential diagnosis.



Manish R Pahadia, Puneet Rijhwani, Rajeev Sharma, Komal Girdhar, Ankita Tilala, Abhinav Garg

Unmasking of Brugada Syndrome by Tropical Fever—An Unusual Presentation: A Case Report

[Year:2022] [Month:September-December] [Volume:7] [Number:3] [Pages:3] [Pages No:95 - 97]

Keywords: Brugada syndrome, Case report, ST elevation, Sudden cardiac death

   DOI: 10.5005/jp-journals-10057-0220  |  Open Access |  How to cite  | 


Introduction: Brugada syndrome is a rare inherited syndrome characterized by arrythmia leading to an increased risk of sudden cardiac death, despite a structurally normal heart. Diagnosis is based upon a specific ECG finding either spontaneously or after a sodium blocker test. Case description: We hereby report the case of a young male who presented to us with fever and chest pain which was initially evaluated on the lines of tropical fever but eventually lead to the diagnosis of Brugada Syndrome. Discussion: Brugada syndrome should be considered in young patients presenting with chest pain with ECG findings of ST elevation after differentiating it from Myocardial Infarction, which is its closest differential. Conclusion: Brugada syndrome is a diagnosis that requires high level of clinical suspicion. Since it can cause sudden cardiac death, a preventive intervention is required. Clinical significance: This case signifies the importance of differentiating ST elevation of Myocardial Ischaemia and Brugada syndrome. Since the management of both is different and prevention strategies need to be employed for Brugada syndrome.


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