Basic life support: Awareness, attitude, and knowledge among junior doctors, physiotherapists, and nursing staffs in a tertiary care center of Sikkim

Background: Basic life support (BLS) is a lifesaving skill which every health-care personnel must know. It has been added to the curriculum but still studies have shown poor knowledge and skill among them in India. Aims and Objectives: The aim of our study was to assess attitude and knowledge of BLS among healthcare personnel in a tertiary care center of Sikkim and to recommend training of BLS according to the finding of our study. Materials and Methods: A questionnaire based cross-sectional study was done among junior doctors, physiotherapists, and nursing staffs, who were willing to participate. The questionnaire collected data under the heading of demographics, attitude, awareness, and knowledge about various domains of BLS. Analysis was done with standard statistical software. Results: Among 208 completed surveys, 24 (11.5%) were males and 184 (88.5%) were females, majority of them (76.4%) were nursing staff and belonged to 20�-year age group (76%). Mean score of the participants were 13.43 � 3.725 with a range from 2 to 21. The necessity of BLS training and the requirement of mandatory renewal was strongly agreed by 77.4% and 33.2% participants respectively. Conclusion: We conclude that they all need the trainings at frequent interval to know about the importance of BLS, to gain confidence and to improve their skill which will help them in timely saving of many lives in as well as outside the hospital. This can be achieved if institutes help in conducting the BLS session regularly despite being already in curriculum.

Malignant Melanoma Infiltrating the Bone Marrow.

Malignant melanoma with infiltration into the bone marrow is seldom reported in the literature, for they are exceedingly rare. The primary site is not always apparent and a sizeable number of cases have been attributed to an occult primary. Metastasis to bone marrow is a terminal event usually occurring in stage IV of the disease and can be a focus of residual tumor cells which can cause a relapse.The current documentation is of a case of melanoma occurring as a rectal primary with anemia, thrombocytopenia, and leukoerythroblastic reaction. The marrow aspirates and trephine biopsy showed round to spindle-shaped malignant cells with intracytoplasmic brown-black coarse pigment, suggestive of melanin. The patient was diagnosed with stage IV melanoma but was lost for follow-up. The recognition of such an entity is important for both pathologists and clinicians alike. This case is being reported for the novelty of such an occurrence.

Body temperature in assessment of 7th day outcome in acute stroke patients – A hospital-based study

Background: Worldwide stroke is accounted as the second leading cause of death and third cause of disability. Changes in physiological variables such as temperature, blood pressure, blood glucose levels, and their deleterious effect in terms of mortality and morbidity are of major concerns for the treating physicians. Aim and Objectives: The aim of the study was to study changes in temperature and its relation to 7th day outcome in acute stroke patient. Materials and Methods: A prospective hospital-based study was conducted, after approval of Institutional Ethical committee, recruiting 150 acute stroke patients presenting within 6 h of developing symptoms. Temperature was recorded every 8 h for 48 h and stroke severity was assessed using modified Rankin scale on admission and on the 7th day after admission. Results: Categorical variables were analyzed using Chi-square analysis and means of continuous variables were compared using analysis of variance. For any significant difference in mean temperature at two consecutive readings, paired sample t-test was used. Multinomial logistic regression analysis was done to predict outcome in acute stroke patients. The difference in the mean temperature at 8 h, 16 h and 40 h after admission was significant between male and female patients. Temperature at 16th h of admission was found to be significant for improved, status quo, and worsened comparison. Temperature at 24th h of admission was also found to have significant value but only for status quo and worsened outcome. Conclusion: The authors conclude that the mean temperature of the patients remained within the normal range in the first 48 h. The temperature at various intervals may not consistently predict the 7th day outcome in acute stroke patients.

Correlation of Body mass index with premenstrual syndrome and age at menarche in medical students

Background: The female reproductive cycle encompasses various physiological phenomenon and menstruation being one such is associated with various problems affecting the quality of life. Premenstrual syndrome (PMS) is one of them. Body mass index (BMI) is considered a modifiable risk factor for PMS and is also related to the age at menarche. Aim and Objectives: To determine the correlation of BMI with PMS and the age of onset of menarche among medical students. Materials and Methods: The cross-sectional study was conducted at a Medical College at Gangtok, among 100 consenting participants after obtaining due permission from the Institutional Ethics Committee. Apart from demographic details, height and weight were recorded along with age of onset of menarche. The presence or absence of PMS was evaluated using Calendar of Premenstrual experiences, a self-reported dairy measure of PMS developed by Mortola et al. Results: Mean age of participants was 20.7 years and at mean age of 12.5 years they attained menarche. Girls who had either low or high BMI attained menarche at a higher age, but the difference was not significant (P = 0.142). Association between PMS and BMI was poor (0.027, P = 0.869). The correlation analysis found a poor negative correlation (?0.052, P = 0.606) between BMI and age at menarche. The correlation between age at menarche and the presence of PMS was positive (0.182, P = 0.07). Conclusion: PMS was seen in 53% of the study population, but only 24% had a high BMI. Deviated BMI from normal had menarche at a higher age and there was a poor correlation between the BMI and PMS.

TREATMENT FOR A REFRACTORY CHRONIC TENDOACHILLES TENDINITIS WITH PLATELET-RICH PLASMA INJECTIONS: A CASE REPORT

To define the pain and functional improvement of the patient with chronic Achilles tendinitis treated with a single PRP (platelet-rich plasma) injection. Chronic Tendoachilles tendinitis is a severe cause for a decrease in physical activity and persistent pain. It arises secondary to an account of repetitive use or exaggerated overload. Platelet-rich plasma therapy is used to provide local regenerative healing of the tendon. This report describes a 50-year-old Active female who presented with continuous pain in bilateral Tendoachilles for Approximately 6 years duration. A single Platelet-rich plasma injection is given to the patient with chronic tendoachilles tendinitis to reduce pain and improve function and improved VAS (visual analogue score) score from 9 to 0 seen at 1-year follow-up. The patient has been pain-free for the past 2 years and is back to daily functional physical activity. A single injection of PRP in each tendoachilles distally has shown significant relief in pain and improvement in day-to-day physical activity and a rapid recovery from chronic TA tendinitis.

Amelioration of Acrylamide Induced Neurotoxicity in Wistar Rats

Present study was undertaken to study the neurotoxicity of oral acrylamide (ACR) and its amelioration using α-tocopherol, reduced glutathione (GSH) and hot aqueous extract (HAE) of Ocimum sanctum. Forty five male Wistar rats were divided into 12 groups. The study showed a significant reduction in the body weight of the rats fed with ACR in comparison to the other groups while body weight was restored in the rats fed with α-tocopherol and HAE. Neurotoxicity in rats fed with ACR was evident with the results of histopathology and oxidative stress (high MDA and decreased activities of GSH, SOD, GST and CAT in brain). Co-administration of α-tocopherol and HAE lowered these changes however, there was no marked improvement seen in neural damage but improvement was evident in behavioral as well as physiological changes at a marked point. Histopathology of brain in ACR alone fed group showed extensive neural degeneration and massive deposition of fibrin which was substantially decreased and ameliorated with the co-administration of α-tocopherol and HAE. These results support the oxidative stress results as well. Our results suggests that α-tocopherol and HAE can be useful for protecting brain tissue against ACR induced neurotoxicity through minimizing the free radical mediated oxidative stress

Clinical and Radiological Study of Serum Fluoride in Relation to Knee Osteoarthritis

@#Introduction: Fluorosis has been associated with an increased risk of degenerative changes in the knee. Multiple studies have found an association between arthritis and elevated fluoride levels. We aim to delineate if elevated fluoride level has any direct correlation with the degree of radiological grading and clinical symptoms in knee arthritis. Materials and Methods: A cross-sectional study of 80 knee arthritis patients was conducted from February 2017 to April 2018. Serum fluoride levels were measured and patient’s pain scores, WOMAC scores and radiological grading were correlated with the elevated fluoride levels. Results: In our study, 30 out of 80 patients had increased serum fluoride level. Statistically significant differences were noted in VAS score, WOMAC score and Kellgren and Lawrence radiological grades between patients with normal serum fluoride level and those with elevated fluoride level. Conclusion: There is an increased risk of knee arthritis in patients with elevated blood fluoride levels and patients with increased fluoride levels are associated with more severe symptoms and radiographic disease.