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ABSTRACT Purpose Polycystic ovary syndrome (PCOS) is heterogenous condition with commonly associated symptoms include irregular menstrual cycle, hirsutism, baldness, adult acne, and weight gain There have been few attempts at profiling the voice characteristics of women with polycystic ovary syndrome. Videokymography enables to detect even subtle variations in vocal fold vibrations. The aim of the present study was to study the videokymographic characteristics among women with PCOS. Methods A cross-sectional study was carried out among 50 women with and without PCOS diagnosed on ultrasonography. Videokymography was carried out and the characteristics were perceptually analyzed using a vocal fold kymographic rating scale. The analysis of the kymogram was done for the following characteristics; presence of vocal fold vibration,interference of surroundings, Cycle to cycle variability, left-right asymmetry,cycle aberrations and shape of lateral peaks. The kymographic images were obtained for all the participants of both the groups and a subjective consensus evaluation was done by two clinicians. The percentage of participants with the listed kymographic characteristics were tabulated. Chi Square test was also done to decide if there was a significant difference between the two groups for different kymographic features of vocal fold vibration. Results Six of the 25 women with PCOS were found to have abnormal kymographic features such as surrounding structural interference, presence of cycle to cycle variability and the shape of lateral peaks. Conclusion Early detection of the vocal abnormalities in individuals with PCOS would help in the vocal rehabilitation especially for professional voice users.
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Humans , Adult , Polycystic Ovary Syndrome/complications , Voice , Vocal Cords/diagnostic imaging , Cross-Sectional Studies , KymographyABSTRACT
Background: The ethanolic extract of Callicarpa lanata (EECL), belonging to the family Verbenaceae, were studied for hepatoprotective activity in Wister rats with liver damage induced by ethanol.Methods: Ethanol treated rats showed significant increase in the levels of serum enzyme activities, total bilirubin and reduction in total proteins reflecting the liver injury caused by ethanol. EECL, at a dose of 400 and 200mg/kg body weight exhibited hepatoprotective effect by lowering the Serum Glutamate Pyruvate Transaminase (SGPT), Serum Glutamate Oxaloacetate Transaminase (SGOT), Serum Alkaline Phosphate (SALP), Gama Glutamyl Transpeptidase (GGTP), total Bilirubin to a significant extent and also significantly increased the levels of total protein in a dose dependent manner.Results: The results were highly significant at dose level of 400mg/kg body weight (p <0.01) and significant at dose level of 200mg/kg body weight (p <0.05). The effects of EECL at both levels were comparable with standard drug silymarin. The hepatoprotective activity was also supported by histopathological studies of liver tissue.Conclusions: In-vivo hepatoprotective activity of ethanolic leaf extract of Callicarpa lanata (EECL) against Ethanol induced acute liver injury in rats showed significant results in a dose dependent manner.
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Primary fallopian tube cancer (PFTC) is a rare malignancy with an incidence of 0.14-1.8% of all genital malignancies. Presentations of fallopian tube cancer are mostly nonspecific and include abdominal pain, profuse watery or serosanguinous discharge. Here, we present the case of a 51-year-old patient with FIGO stage 1A PFTC. It was diagnosed as hematosalpinx intraoperatively, during total laparoscopic hysterectomy and diagnosed as PFTC on histopathology. Further management was by laparoscopic staging. A high index of suspicion is needed in peri and postmenopausal women who present with unexplained uterine bleeding, profuse discharge, pelvic pain, adnexal mass or abnormal pap smear.
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Purpose; Urologic diseases affected by testosterone can be associated with smaller penis size compared to the normal population. We sought to compare penile length in children with unilateral cryptorchidism and normative data from a cohort of healthy Korean boys. Materials and Methods: This study was performed in 259 Korean boys (212, normal cohort; 47, cryptorchidism) aged 6–24 months, each of whom had been ought to an outpatient clinic at one of five tertiary hospitals (Gyeongsangnam–do Province) between April 2014 and June 2015. Penile length was measured via stretched penile length (SPL) and testicular size was measured using orchidometry (mL). Results: SPL in children with cryptorchidism was significantly shorter compared to a cohort of healthy Korean boys aged 6–24 months (3.7±0.5 cm and 4.3±0.8 cm, p<0.001), although there were no differences with regard to height, body weight and contralateral testicular size between the two groups. According to the stratified ages (6–12, 12–18, and 18–24 months), SPL in children with cryptorchidism was persistently shorter at their ages than those without. Conclusions: It might be that the penile length aged 6–24 months of children with unilateral cryptorchidism is shorter than that of a cohort of healthy Korean boys.
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Background: Whole brain radiotherapy for patients with brain metastasis from lung cancer – prognostic significance of RTOG-RPA score. Aim: To evaluate the prognostic significance of Recursive partition Analysis (RPA) score in predicting the survival in patients with brain metastasis from Non-Small Cell Lung Cancer (NSCLC). Materials and methods: 35 patients diagnosed to have brain metastasis (BM) from primary NSCLC who had received palliative whole brain radiotherapy (WBRT) with or without chemotherapy from March 2014 to Mar 2017 were analyzed in this study. Data regarding the patient age, gender, performance status, histology, number of BM, time of metastasis, neurosurgical resection, radiotherapy details were collected and analyzed. Patients were divided into 3 groups according to RPA classification. The differences in clinical characteristics and treatment variables were analyzed by chi square test and overall survival analysis using Kaplan Mayer. The Cox proportional hazards regression model was used to determine statistically significant variables related to survival. Results: In univariate analysis histology, number of BM, extra cranial metastases, KPS and RPA score were identified to have prognostic significance. The result of multivariate analysis by the Cox proportional hazard model showed that RPA, no of mets and Extra cranial mets were significant. S. Jeeva, K. Chandralekha, V. Vanitha, M. Sornam, Balasubramanium, P. Vidya. Whole brain radiotherapy for patients with brain metastasis from lung cancer – Prognostic significance of RTOG-RPA score. IAIM, 2019; 6(5): 32-39. Page 33 Conclusions: Our study showed that RPA is good prognostic indicator in assessing the prognosis of patients with brain metastasis in NSCLC.
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Background: Patients with high grade gliomas have poor survival even with aggressive multimodality approach. The aim of our study is to evaluate the predicting factors affecting the survival outcome in patients with high grade gliomas (HGG). Materials and methods: 46 patients diagnosed to have high grade gliomas (HGG) treated in our Radiotherapy department during the period of March 2014 to March 2017 were analyzed in this single centre retrospective study. All patients underwent maximal safe surgery followed by postoperative radiotherapy with or without temozolamide chemotherapy. Data regarding the patient age, gender, performance status, histology, grade of the tumor, tumor location, extent of surgery, radiotherapy, and chemotherapy details were collected and analyzed. The differences in clinical characteristics and treatment variables were analyzed by chi square test and overall survival analysis using Kaplan Mayer method. The Cox proportional hazards regression model was used to determine statistically significant variables related to survival. Results: The median survival of patients with HGG in this study was 9 months. The median survival of patients with grade III and IV glioma was 19 and 4 months respectively. In univariate analysis histology, grade, laterality were identified to have prognostic significance. The result of multivariate analysis showed that performance status, grade, histology, extent of surgery is significant for survival. S. Jeeva, V. Vanitha, K. Chandralekha, M. Sornam, Balasubramanium, P. Vidya. Predictive factors for survival and outcome in patients with high grade gliomas: A single centre retrospective study. IAIM, 2019; 6(3): 24-31. Page 25 Conclusion: Our study showed that histology, grade, extent of surgery is the significant factors in assessing the prognosis of patients with HGG. The survival of HGG was poor in spite of combined modality treatment.
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PURPOSE: This pilot study was to find the influence of complete denture on the brain activity and cognitive function of edentulous patients measured through Electroencephalogram (EEG) signals. MATERIALS AND METHODS: The study recruited 20 patients aged from 50 to 60 years requiring complete dentures with inclusion and exclusion criteria. The brain function and cognitive function were analyzed with a mental state questionnaire and a 15-minute analysis of power spectral density of EEG alpha waves. The analysis included edentulous phase and post denture insertion adaptive phase, each done before and after chewing. The results obtained were statistically evaluated. RESULTS: Power Spectral Density (PSD) values increased from edentulous phase to post denture insertion adaption phase. The data were grouped as edentulous phase before chewing (EEG p1-0.0064), edentulous phase after chewing (EEG p2-0.0073), post denture insertion adaptive phase before chewing (EEG p3-0.0077), and post denture insertion adaptive phase after chewing (EEG p4-0.0096). The acquired values were statistically analyzed using paired t-test, which showed statistically significant results (P<.05). CONCLUSION: This pilot study showed functional improvement in brain function of edentulous patients with complete dentures rehabilitation.
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Humans , Brain , Denture, Complete , Dentures , Electroencephalography , Mastication , Pilot Projects , RehabilitationABSTRACT
Two-dimensional echocardiography (2D-echo) is sensitive in detecting floating bodies in the left atrium. Identification of a freefloating left atrial thrombus, as a source of embolus, is a common indication for 2D-echo. Screening for other cardiac conditions such as valvular heart diseases often, if not common, reveal floating bodies in the left atrium. The differential diagnosis of a floating body in the left atrium will be discussed.
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PURPOSE: The Tutorial Group Effectiveness Instrument was developed to provide objective information on the effectiveness of small groups. Student perception of small group effectiveness during the problem base learning (PBL) process has not been previously studied in Xavier University School of Medicine (Aruba, Kingdom of the Netherlands); hence, the present study was carried out. METHODS: The study was conducted among second and third semester undergraduate medical students during the last week of September 2013, at Xavier University School of Medicine of the Netherlands. Students were informed about the objectives of the study and invited to participate after obtaining written, informed consent. Demographic information like gender, age, nationality, and whether the respondent had been exposed to PBL before joining the institution was noted. Student perception about small group effectiveness was studied by noting their degree of agreement with a set of 19 statements using a Likert-type scale. RESULTS: Thirty-four of the 37 (91.9%) second and third semester medical students participated in the study. The mean cognitive score was 3.76 while the mean motivational and de-motivational scores were 3.65 and 2.51, respectively. The median cognitive category score was 27 (maximum score 35) while the motivation score was 26 (maximum score 35) and the de-motivational score was 12 (maximum score25). There was no significant difference in scores according to respondents' demographic characteristics. CONCLUSION: Student perception about small group effectiveness was positive. Since most medical schools worldwide already have or are introducing PBL as a learning modality, the Tutorial Group Effectiveness Instrument can provide valuable information about small group functioning during PBL sessions.
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Humans , Caribbean Region , Surveys and Questionnaires , Education, Medical , Educational Measurement , Ethnicity , Informed Consent , Learning , Motivation , Netherlands , Problem-Based Learning , Program Evaluation , Schools, Medical , Students, MedicalABSTRACT
Xavier University School of Medicine admits students mainly from the United States and Canada to the undergraduate medical program. A previous study conducted in June 2013 used the Dundee Ready Educational Environment Measure to measure the educational environment and impact of different teaching and learning methods in the program. The present study aims to obtain information about students' perceptions of changes in the educational environment, which underwent modifications in teaching and learning, in January 2014. Information was collected about the participants' semester of study, gender, nationality, and age. Students' perceptions of the educational environment were documented by noting their degree of agreement with a set of 50 statements grouped into five categories. Average scores were compared among different groups. The mean total and category scores were compared to those of the 2013 study. Sixty of the sixty-nine students (86.9%) who enrolled in the undergraduate medical program participated in the survey. The majority were male, aged 20-25 years, and of American nationality. The mean+/-SD total score was 151.32+/-18.3. The mean scores for students' perception in the survey categories were perception of teaching/learning (38.45), perception of teachers (33.90), academic self-perceptions (22.95), perception of atmosphere (36.32), and social self-perception (19.70). There were no significant differences in these scores among the different groups. All scores except those for academic self-perception were significantly higher in the present study compared to the previous one (P<0.05). The above results will be of particular interest to schools that plan to transition to an integrated curriculum.
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Humans , Male , Atmosphere , Canada , Curriculum , Education, Medical , Educational Measurement , Ethnicity , Follow-Up Studies , Learning , Self Concept , Students, Medical , United States , NetherlandsABSTRACT
PURPOSE: Xavier University School of Medicine adopted an integrated, organ system-based curriculum in January 2013. The present study was aimed at determining students' perceptions of the integrated curriculum and related assessment methods. METHODS: The study was conducted on first- to fourth-semester undergraduate medical students during March 2014. The students were informed of the study and subsequently invited to participate. Focus group discussions were conducted. The curriculum's level of integration, different courses offered, teaching-learning methods employed, and the advantages and concerns relating to the curriculum were noted. The respondents also provided feedback about the assessment methods used. Deductive content analysis was used to analyze the data. RESULTS: Twenty-two of the 68 students (32.2%) participated in the study. The respondents expressed generally positive opinions. They felt that the curriculum prepared them well for licensing examinations and future practice. Problem-based learning sessions encouraged active learning and group work among students, thus, improving their understanding of the course material. The respondents felt that certain subjects were allocated a larger proportion of time during the sessions, as well as more questions during the integrated assessment. They also expressed an appreciation for medical humanities, and felt that sessions on the appraisal of literature needed modification. Their opinions about assessment of behavior, attitudes, and professionalism varied. CONCLUSION: Student opinion was positive, overall. Our findings would be of interest to other medical schools that have recently adopted an integrated curriculum or are in the process of doing so.
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Humans , Caribbean Region , Curriculum , Surveys and Questionnaires , Focus Groups , Humanities , Licensure , Problem-Based Learning , Schools, Medical , Students, Medical , NetherlandsABSTRACT
PURPOSE: The learning environment at Xavier University School of Medicine (XUSOM), Aruba has not been previously studied. Hence, the present study was carried out using the Dundee Ready Education Environment Measure (DREEM) to obtain student perceptions about the learning environment and compare the same among different subgroups of respondents. METHODS: The questionnaire was administered to undergraduate medical students in their first to fifth semester during the first two weeks of June 2013. The students' perceptions were evaluated by noting their degree of agreement with a set of 50 statements using a Likert-type scale. The mean overall score and the scores of subcategory were calculated and compared among different respondents (P<0.05). RESULTS: Seventy-three of the 86 students (84.9%) completed the questionnaire. The overall mean+/-SD score was 131.79+/-22.86 (maximum score 200). The mean+/-SD score for students' perception of teaching/learning was 31.99+/-6.23 (maximum score, 48), while the score for students' perceptions of teachers was 30.05+/-5.54 (maximum score, 44). The mean+/-SD scores for students' academic self-perception, students' perception of the atmosphere, and students' social self-perception were 21.88+/-5.11 (maximum score, 32), 30.92+/-8.59 (maximum score, 48), and 16.96+/-4.71 (maximum score, 28), respectively. There were no differences in scores according to the respondents' personal characteristics. CONCLUSION: The student responses about the learning environment at the institution were positive. We plan to obtain regular student feedback as the curriculum becomes progressively more student-centered and integrated.
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Humans , Atmosphere , Curriculum , Surveys and Questionnaires , Education , Learning , Schools, Medical , Self Concept , Students, Medical , NetherlandsABSTRACT
Objective: Chronic hemodialysis affects various body systems, one of which is the respiratory system. Since respiration is the prime source for speech, vocal dysfunctions are expected to be present in patients with chronic hemodialysis. The present study attempts to shed light on the changes in acoustic and aerodynamic characteristics of voice, if any, in patients with chronic hemodialysis. Materials and Methods: Phonation of sustained vowel/a/sample was subjected to acoustic analysis using VAGHMI software. Sustained duration of/a/,/s/, and/z/ was recorded for the purpose of aerodynamic analysis. The independent t test was employed to find the significant difference between the two groups. Results: Chronic hemodialyzed subjects showed significant deviation in frequency, perturbation, and aerodynamic measures when compared to normal subjects. These results are discussed with respect to the underlying pathophysiology. Conclusion: The results of the present study revealed that subjects with chronic hemodialysis exhibit clinical evidence of voice disorders. Vocal deviations in chronic hemodialyzed subjects are explained due to the influence of the renal system on the respiratory and the phonatory system and the negative fluid balance effect of hemodialysis.
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Adult , Hoarseness/etiology , Humans , Male , Renal Dialysis/adverse effects , Renal Insufficiency/complications , Renal Insufficiency/epidemiology , Vocal Cords , Voice Disorders/etiology , Voice QualityABSTRACT
All pregnant women attending the antenatal clinic of a large hospital in Vellore, India (Christian Medical College Hospital) were screened for HIV infection between October 1987 and June 1992. A total of 36,953 blood samples were thus screened and 20 infected women were identified. Among these 18 women had acquired HIV infection from their husbands, who were also detected to be HIV infected. While these 18 women were monogamous, all the husbands had multiple sex partners. Two of the 20 women in this series were commercial sex workers. Among the 20, 17 (85%) women belonged to low socio-economic status, while three were from well-to-do families, with the husbands being businessmen or teachers. As the overall prevalence (0.054%) of HIV infection among pregnant women was relatively high and equal to or higher than many States in the USA and in areas outside London in the UK, the authors recommend that strict universal precautions be instituted in all obstetric practice in India.