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Background & objectives: Due to lack of appropriate statistical knowledge, published research articles contain various errors related to the design, analysis and interpretation of results in the area of biomedical research. If research contains statistical error, however, costly, it may be of no use and the purpose of the investigation gets defeated. Many biomedical research articles published in different peer reviewed journals may retain several statistical errors and flaws in them. This study aimed to examine the trend and status of application of statistics in biomedical research articles. Study design, sample size estimation and statistical measures are crucial components of a study. These points were evaluated in published original research articles to understand the use or misuse of statistical tools. Methods: Three hundred original research articles from the latest issues of selected 37 journals were reviewed. These journals were from the five internationally recognized publication groups (CLINICAL KEY, BMJ Group, WILEY, CAMBRIDGE and OXFORD) accessible through the online library of SGPGI, Lucknow, India. Results: Among articles assessed under present investigation, 85.3 per cent (n=256) were observational, and 14.7 per cent (n=44) were interventional studies. In 93 per cent (n=279) of research articles, sample size estimation was not reproducible. The simple random sampling was encountered rarely in biomedical studies even though none of the articles was adjusted by design effect and, only five articles had used randomized test. The testing of assumption of normality was mentioned in only four studies before applying parametric tests. Interpretation & conclusions: In order to present biomedical research results with reliable and precise estimates based on data, the role of engaging statistical experts need to be appreciated. Journals must have standard rules for reporting study design, sample size and data analysis tools. Careful attention is needed while applying any statistical procedure as, it will not only help readers to trust in the published articles, but also rely on the inferences the published articles draw.
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Background: The patient partnership is desirable for the optimal management of comorbidities. This became significant more so during the coronavirus disease 2019 (COVID-19) crisis wherein health infrastructure was overburdened. Objectives?The aim of this study was to estimate the clinicoepidemiological profile, health literacy regarding predisposing risk factors, and disease management in patients with COVID-19-associated mucormycosis (CAMCR). Materials and Methods?A structured questionnaire-based study on randomly chosen 100 microbiologically proven patients of CAMCR, consisting of 38 multiple choice questions, was designed with each answer having a patient and assessor response to it. Results?A male predilection was seen (68%) with rhino-orbital (73%) being the commonest anatomic site. Forty-nine percent of the study participants had pre-existing diabetes of which 62% did not carry out regular blood sugar monitoring and in 18%, blood sugars were controlled prior to COVID-19. Thirty-five percent of patients with mild COVID-19 illness were treated with unwarranted steroids and 56% of patients had fluctuating blood sugar levels, during COVID-19 illness. Seventy-nine percent of patients were not vaccinated against COVID-19, 16% only partially vaccinated. Seventy-one percent of patients were not aware of red flag signs and of mucormycosis with 8% presenting early, on noticing nasal symptoms. Conclusion?This study observed diabetes as the most common comorbidity in patients with CAMCR. A lacuna in the health literacy of diabetics presenting with CAMCR was found. Additionally, knowledge regarding glycemic control during COVID-19 illness with or without the use of steroids and awareness of the “red flag” signs of CAMCR were mostly lacking. Interventions to improve awareness amongst patients with diabetes should help in optimal glycemic control, and avoid potential complications like severe COVID-19 illness, and mucormycosis
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Introduction: The Nasolacrimal duct is the terminal part of the nasolacrimal apparatus or tear apparatus. The anatomy of lateral nasal wall is Important for planning the surgeries on lacrimal duct through intranasal approach. Objective: The current study was designed to review the anatomy of nasolacrimal duct in relation to the lateral nasal wall. Material and method: Thirty sagittal sections (14 right and 16 left side) of head and neck of formalin fixed adult cadavers of known sex, gender, ethnicity present in department of anatomy GMCH, Chandigarh were studied. The following parameters were made using a digital calliper and rounded off to the nearest millimetres. 1.Length of nasolacrimal duct (NLD Length) 2. Nearest distance from the nasolacrimal duct to maxillary sinus ostium (NLD - MSO) 3. Nearest distance from the NLD to the anterior nasal spine. (NLD- ANS)4. Nearest distance of the intranasal orifice of the NLD to the nasal floor (NLD- NF) 5. Nearest distance of the intranasal orifice of the NLD to the nasal roof. (NSD- NR) 6. Nearest distance of the intranasal orifice of the NLD to the anterior attachment of the Inferior concha. (NSD- AIT). Observations: In our study the average length of the NLD was 19.8±1.57mm. The intranasal orifice of the NLD was observed to be located on an average of 24.5±2.6mm from the anterior nasal spine, ranging from 5.5-2. 9mm.The average distance from the nasal roof was found to be 32.2±1.67mm and 16.08±1.71mm from nasal floor. In addition, the average distance from the anterior attachment of inferior nasal concha was found to be 14.82±2.37mm. In our study the NLD was an average of 4.08±0.67mm anterior to MSO at the level of the anterior attachment of the MT. On Comparing right and left side The NLD Was found to be slightly longer 22.7 in comparison of 22.2 mm on left side. The distance of NLD From MSO was also found to be larger on left side. The distances of NLD-ANS, NLD NR, NLD -AIT and NLD- NF were also longer on left side. Conclusion: We found that most of the parameters were closer to a study done by Ertugel while the NLD-NF distance was more in our specimen. Running title: nasolacrimal duct: morphometry, surgical importance
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Purpose: To evaluate and correlate corneal endothelium parameters with the severity of primary glaucoma. Methods: This prospective case?control study was conducted on 150 eyes of 80 newly diagnosed primary open?angle glaucoma (POAG), chronic primary angle?closure glaucoma (cPACG), and normal?tension glaucoma (NTG) patients in a tertiary care center. Endothelial parameters including endothelial cell count (ECC), percentage of hexagonal cells, and coefficient of variation of cell size were analyzed. Glaucoma cases were further sub?grouped into early, moderate, and severe glaucoma and compared for endothelial parameters. Chi?square, Fischer’s exact test, independent sample t?test, and analysis of variance were performed using IBM® SPSS® Statistics version 28. Results: The ECC was markedly reduced in cases (2281 cells/mm2) versus controls (2611 cells/mm2) (P < 0.001). The POAG (2251 cells/mm2) and cPACG (2287 cells/mm2) eyes had significantly a lower ECC compared to healthy controls (P < 0.001), whereas NTG eyes had a lower mean ECC (2538 cells/mm2), but it was not statistically significant (P > 0.05) when compared with controls. The ECC decreased with an increase in severity as patients with early glaucoma had an ECC of 2284 cells/mm2, moderate 2261 cells/mm2, and severe 2086 cells/mm2, and the difference was statistically significant. Conclusion: A significant decrease in corneal ECC was observed in POAG and cPACG patients when compared with healthy controls of the same age group. Mechanical damage following an elevated intra?ocular pressure for a longer duration may be attributed to morphological and consequent functional damage to endothelial cells.
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Ameloblastoma is a benign, locally aggressive neoplasm that needs extensive surgical resection. The goal of this article is to obtain an in?depth review of benign ameloblastomas to determine the available level of evidence and the possible benefit of targeted therapeutics for the treatment of ameloblastoma and BRAF V600E mutation in ameloblastoma. An electronic literature search was conducted according to PRISMA guidelines in PubMed/MEDLINE, EBSCO, and Web of Science for eligible studies published between 1975 and 2021. The systematic review is registered with INPLASY (INPLASY202260018). The review included 2 case series and 17 case reports. The histopathological type, anatomic location, expression of BRAF mutation, additional mutations, and molecular?targeted therapies of the 19 reviewed articles were summarized and tabulated. Interestingly, the majority of the primary site of ameloblastoma was located in the mandible (80.9%) compared to the maxilla (17%). The tumour size was reported in nine of the included studies. Most of the included studies in the review exhibited ameloblastoma with BRAF V600E mutations and responded to molecular?targeted therapies. Molecular therapies employing BRAF and/or MEK inhibitors in ameloblastoma with BRAF V600E mutations proved to be an appropriate treatment based on the limited available evidence. It is essential further to deepen our understanding at th
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Transient ischemic attack (TIA) is a diagnostic challenge for all physicians due to the temporariness of symptoms and the absence of any definitive diagnostic test. There is a very high risk of TIA being followed by an ischemic stroke, hence require urgent investigation and preventive strategies. At the same time, it is also important to distinguish TIA from other close differentials, to avoid wrong diagnoses leading to harmful, misdirected medical management. In this report, we will discuss the case of a middle-aged male patient with stable pre-operative vitals who was posted for total parotidectomy and suddenly developed jerky movement of the upper limb and transient aphasia on the operation theater table along with raised blood pressure. This is a very rare presentation of TIA that needs to be differentiated from other close differentials as this form is mostly associated with severe carotid occlusive disease and, hence, carries a high risk of stroke.
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Polycystic Ovarian Disease (PCOD) is an endocrine disorder that causes metabolic changes in women of reproductive age. PCOD has evolved into a lifestyle disorder as a result of sedentary habits, fast food consumption, and a poor lifestyle. The precise cause of PCOD is mysterious, but high levels of insulin, hyper androgen, and LH are the main causes. PCOD symptoms include irregular menstruation, oligomenorrhea, acne, hirsutism, hair loss, obesity, and constipation. PCOD is not directly stated in the Samhita, but clinically it is similar to Aartavavaha strotas dushti, Nastaartava, Granthi, Santarponnth vyadhi, and Yonivyapad. In this present case study, a 22 year old female patient came with symptoms of irregular, delayed menstruation, scanty menses, acne on the face and hair fall. The USG report reveals polycystic patterns of both ovaries with Right ovary volume 11.6cc and Left ovary volume 11cc, both ovaries are bulky in size with increased stromal echogenicity and multiple (10-12) small follicles (2-5mm) arranged in peripheral distribution. She had taken the medication so many times but she had not been completely cured. As a result she came to our hospital for Ayurvedic treatment. Result was made on the basis of Clinical symptoms relief and USG report. So in this case study, we will look at an Ayurvedic approach in the management of Polycystic Ovarian Disease.
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Abstract Sustained release matrix tablets of 100 mg losartan potassium HCl were fabricated with two release retarding polymers namely HPMC K100 M and affinisol by direct compression method. Nine trial formulations were prepared by varying content of these polymers, each from 50 mg to 100 mg; keeping the total weight of the tablet 310 mg. The best formulation was selected based on in vitro drug release profile for 12 hours conducted in Type II dissolution apparatus at 50 rpm and water as dissolution medium. Pre-compression parameters such as bulk density, tap density, Carr's index and Hausner ratio were evaluated for the selected tablet. The tablets were subjected to thickness, weight variation test, drug content, hardness and friability. Drug release kinetics, surface morphology and accelerated stability study were investigated for that selected formulation. Formulation F4 with the composition of 75 mg HPMC K100M and 100 mg affinisol was selected as the best formulation that extended the drug release up to 12 hours. Pre-compression parameters and other tableting properties were within the Pharmacopoeia limit. Release kinetics analysis proved non-fickian zero-order drug release and that was further confirmed by surface morphology of the tablets before and after dissolution study visualized by SEM. The developed formulation was found to be stable for one month stored at 60 âC.
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Tablets/analysis , In Vitro Techniques/methods , Pharmaceutical Preparations/analysis , Losartan/agonists , Drug Compounding/methods , Dissolution , Drug Liberation/drug effects , MethodsABSTRACT
Gingival enlargement is a complication associated with certain drugs (antihypertensives, anticonvulsants, and immunosuppressants). Amlodipine is a calcium antagonist and is structurally similar to nifedipine but pharmacodynamically different from it. The prevalence of amlodipine induced gingival enlargement is reported to be 3.3% which is lower than other calcium channel blockers. We wanted to determine the prevalence of amlodipine (calcium channel blocker) mediated gingival enlargement in patients undergoing treatment for hypertension for more than 6 months and explore how the patients' age, gender, treatment duration, and oral hygiene are related to gingival enlargement. METHODSPatients taking amlodipine were inspected for the presence of gingival enlargement using Bokenkamp and Bornhorst Index. Periodontal status of the patient was evaluated with Gingival Index, Plaque Index, Probing Pocket Depth and Clinical Attachment Loss. RESULTSIn our study, 5 patients out of 108 patients on amlodipine were clinically diagnosed with enlargement, patients were prescribed amlodipine with a dosage of 2.5 mg and 5 mg. Enlargement was seen in patients prescribed with a dosage of 5 mg/day. Enlargement was found to begin at the interdental papilla and progress to marginal gingiva. The frequency of gingival enlargement induced by Amlodipine was found to be 4.6%. The ratio of enlargement in males and females was 4:1. Plaque index and gingival index were found to be poor in patients with drug-induced enlargement. CONCLUSIONSDentists and/or periodontists should be aware of the complications of certain systemic drugs such as calcium channel blockers so as to diagnose complications or problems like gingival enlargement
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Phytochemicals are any of various biologically active compounds found in plants. These are produced by plants and have biological activity. It has been reported that Murraya koenigii leaf extract is traditionally used to cure dysentery. Dysentery is an intestinal inflammation, primarily of the colon. It can lead to mild or severe stomach cramps and severe diarrhoea with mucus or blood in the faeces. It is the infection in the intestinal tract. One enzyme, which is involved in its biochemical pathway, is known as alcohol dehydrogenase (which have pdb id.1Y9A). The molecular docking was studied by biovia discovery studio. In which the interaction is done between the phytochemical of the plant with the enzyme. The stability of the interaction was evaluated based on –CDocker energy and –CDocker interaction energy.
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Background: Good nutrition during adolescence is critical to cover the deficits suffered during childhood and should include nutrients required to meet the demands of physical and cognitive growth and development, provide adequate stores of energy for illnesses and pregnancy and prevent adult onset of nutrition-related diseases. Poorly nourished adolescent mothers are more likely to give birth to low birth weight babies, perpetuating a cycle of health problems which pass from one generation to the next. Therefore, this study was aimed to assess the nutritional status of school going adolescent girls of Agroha block of Haryana.Methods: Study area was two senior secondary and two high schools (randomly selected) of Agroha block of district Hisar (Haryana). Study design was school based cross-sectional study. Study participants were three hundred and forty-four adolescent girls studying in class 9th, 10th, 11th and 12th. Study tool was pre-designed and pre-tested questionnaire. Percentages and Chi- Square. Statistical Package for Social Sciences (SPSS) software version 20.0 was used.Results: Out of total girls, 8.72% were found to be thin followed by severely thin (0.58%). Thirteen (3.78%) girls were found to be overweight followed by obese (0.58%).Conclusions: Nutritional status of adolescent girls was found to be satisfactory.
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Introduction: Spontaneous haemoperitoneum is rare duringpregnancy but a life threatening complication. It is consideredidiopathic as the source of bleeding is not known.Case report: Presenting here a case of 20 years primigravidapatient who was taken up for caesarean section because ofpersistent foetal tachycardia. Patient had no significant pastor family history, had normal hemogram and coagulationprofile with all other normal investigations. Unexpectedlyintra-operatively hemoperitoneum was observed for which noidentifiable cause could be established.Conclusion: Though it is a rare entity but it can be lifethreatening. Shock and foetal distress have a much moregradual onset when the amount of bleeding is less severe.
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Introduction: Competition for admission to medical collegein India is intense as the number of applicants for nationaleligibility cum entrance test (NEET) always exceeds theavailable seats. The choice of a career in the medical fieldis a complex personal decision influenced by a multitude offactors. Current study was done with the objectives to studysocio-demographic profile of newly selected medical students,to assess reasons of choosing medical stream as a career andto determine the association of socio-demographic and otherfactors with number of attempts taken by the medical studentsfor selection.Material and methods: This was a cross–sectional studycarried out among 96 newly entered medical students ofMaharaja Agrasen Medical College, Agroha (Dist. Hisar),Haryana. Appropriate statistical tests like chi-square (χ2)test and Fisher’s exact test were applied and mean, mode,percentages were also measured.Result: Out of total 39 students (40.6%) belonged to familywhere one or more member was in medical profession.However 86 students (89.6%) choose the medical professionby their own choice. Most of students (72.9%) were attendingregular classes during 11th & 12th in their schools. Maximumnumber of students (46.9%) cleared the NEET in their 2ndattempt. Maximum selection was in students who spent 9-12hours for study for preparation. Out of total 60.4% studentsspent 5-7 hours for sleep during preparation period. Out oftotal 91.7% students were joined coaching for preparationpurpose. Majority of students (67.7%) migrated from theirnative place for study purpose.Conclusion: In our study maximum students have chosenmedical profession because of their personal interest. Inpresent study maximum newly entered medical students werethose who have attended schools regularly in 11th and 12thclasses. Adequate sleep hours for students play constructiverole in favorable outcome.
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Background: Phototherapy is safe and effective in neonatal hyperbilirubinemia. Despite its worldwide application, questions regarding methods of optimizing efficacy remain unanswered, turning the infant is believed to be one of the methods to improve. Severe neonatal hyperbilirubinemia is associated with kernicterus, condition characterized by athetoid spasticity, gaze and visual abnormalities, and sensory-neural hearing loss. It may also be associated with mental retardation. Aim of this study was conducted to compare the efficacy of intermittent with continuous phototherapy.Methods: Study was conducted in 100 neonates from February 2018 to July 2018 in Sree Balaji medical college and hospital. Inclusion criteria were weight >2000 grams, absence of other concomitant diseases, and hyperbilirubinemia not requiring exchange transfusion. The neonates were randomly divided into two groups. Continuous phototherapy group received phototherapy on and off for 2 hours and half an hour respectively and the intermittent phototherapy group on and then off for one hour. Serum total bilirubin levels were measured in every 36 hours.Results: Mean age of the patients was 3.89'1.83(p=.91) days, mean baseline bilirubin was 17.56mg/dl'1.42 (p=0.36), while the mean follow-up bilirubin was 12.85mg/dl'1.65 (p=.95), and the mean difference between the baseline and follow-up bilirubin was 4.7 mg/dl'1.19 (p=.32). For group A and B babies, the mean difference between the baseline and follow-up bilirubin was 4.78 mg/dl'1.20 (p=.32) and 4.63mg/dl'1.18(p=0.32) respectively. The difference between the mean age, mean baseline bilirubin, mean follow-up bilirubin, and the mean decrease in bilirubin for both the groups was statistically not significant.Conclusions: Intermittent and continuous phototherapies were found to be equally effective for reducing neonatal hyperbilirubinemia.
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The objectives of the study were to isolate and identify livestock associated methicillin resistant Staphylococcus aureus (LA-MRSA) and methicillin sensitive S. aureus (LA-MSSA) from clinical mastitis cases and to compare their antibiotic susceptibility, biofilm formation and in vivo pathogenicity in Galleria mellonella larva model. A total of 60 milk samples were collected from cows suffering from mastitis and processed for isolation and identification of S. aureus using standard conventional methods. All the recovered S. aureas isolates were subjected for detection of MRSA and/or MSSA employing phenotypic (Cefoxitin disc assay) and genotypic (the mecA gene PCR) assays. Antibiotic susceptibility pattern of LA-MRSA and LA-MSSA test isolates was determined using disc diffusion method, biofilm formation by 96 well microtiter plate assay and pathogenicity testing in G. mellonella larvae. On microbiological, biochemical and PCR analyses, 14 S. aureus isolates were confirmed. Of these, 4 were tested as LA-MRSA and the remaining 10 isolates were LA-MSSA. Comparative evaluation suggested that MRSA isolates were resistant to different classes of antibiotics and were equally lethal to G. mellonella larvae. However, bioflim forming ability was significantly higher (p < 0.001) in the MSSA test isolates. An association of biofilm formation and pahogenicity testing was not observed between LA-MRSA and LA-MSSA test isolates. Further, LA-MRSA were resistant to different classes of antibiotic and were more lethal to G. mellonella larvae. These preliminary observations are of great concern as the LA-MRSA infections in the community have been documented and warrant in depth research for such pathogens
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We report a case of two months old infant diagnosed with acute myocarditis, with a ventricular septal defect (VSD) of 0.9 mm size, admitted to our hospital with gangrene of left foot. A below knee amputation was planned under general anaesthesia with caudal block. Digoxin and diuretics were continued. Induction was done with fentanyl and sevoflurane and supraglottic device was used to secure the airway. Caudal block with bupivacaine was administered.The recovery was satisfactory and postoperative stay was uneventful.
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Background: The genital tract tuberculosis is one of the most common causes of tubal factor infertility. This study was conducted to compare the results of different diagnostic methods used in screening for female genital tuberculosis in suspected cases attending Gynecology OPD at RMC, Ajmer.Methods: This prospective study was conducted in department of obstetrics and gynecology, J. L. N. Medical College, Ajmer, Rajasthan, for studying incidence of genital tuberculosis by various diagnostic methods (viz. AFB smear examination, AFB Lowenstein Jensen culture method, TB-PCR and CBNAAT).Results: Prevalence of genital TB was 5.5% in study population of 200 selected women meting the inclusion criteria. 72% women were in between 20-30 years age group. Oligomenorrhoea (24%) was found to be significant symptom with P value of <0.05. TBPCR and CBNAAT were found to be statistically significant with P value of <0.001 for diagnosing FGTTB.Conclusions: We concluded that genital tuberculosis is paucibacillary disease, TBPCR and CBNAAT appears to be rapid and sensitive diagnostic modality.
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Background: Non albicans species are emerging increasingly as significant ICU pathogens. The increasing incidence of C. tropicalis infections is a significant problem because of its ability to develop rapid resistance to fluconazole.Methods: The study was designed to isolate, evaluate the risk factors and outcome of C. tropicalis infection from intensive care units. Identification was done by the biochemical methods. A total of 89 patients culture positive for C. tropicalis were selected for retrospective analysis over a period of one year. We collected various data about risk factors and outcome from the medical records.Results: A total of 89 patients culture positive for Candida tropicalis were analysed. Majority of these culture isolates were obtained from their blood (59.55%) followed by urine samples (31.46%). The indwelling devices (93.2%) remained a highest risk followed by prolonged administration of antibiotic therapy (92.1%) and admission in ICU for more than a week (88.8%). Overall mortality rate was 31.5%. Mortality was higher in patients with longer total length of stay in hospital (89.3%; p 1.000), indwelling devices (85.7%; p 0.5663) and in whom the antimicrobial therapy was administered for prolonged duration (82.1%; p 0.7581), although these factors remained statistically insignificant. 92.1% of isolates were sensitive to amphotericin B and showed 52.8%; 9.0% sensitivity to itraconazole and fluconazole respectively.Conclusions: C. tropicalis is now classified as the third or fourth NAC species being commonly isolated from clinical samples and associated with persistent systemic infections leading to a longer stay in the hospital. Several virulence factors seem to be responsible for high dissemination and mortality.
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Background: Access to menstrual hygiene resources is a basic human and healthcare right. A substantial number of women in rural areas and urban slums do not use sanitary napkins due to its prohibitive cost and difficult access, leading to consequences like infections and the subsequent morbidity, school absenteeism and decreased social participation. The study explored the reasons for non-usage of sanitary napkins in an urban slum of Delhi. It was further studied if there would be a high acceptance if low-cost product was made available at health-centre.Methods: A cross-sectional study was done to assess the magnitude and reasons for not using sanitary napkins and acceptability of low-priced sanitary napkins provided through RHTC.Results: Most women (47%) do not use sanitary napkins because its price was perceived as high as against the benefit that can be accrued. Difficult in access to product purchase was the second important reason for non-usage. A low-priced sanitary napkin provided through RHTC was an acceptable solution to them.Conclusions: Increasing the accessibility of affordable sanitary napkins through health centers can increase in usage of sanitary napkins.