To evaluate peripheral neuropathy of ulnar sensory nerve through nerve conduction studies in Type 2 diabetic patients

Background: Secretory defects or defects in action of insulin precipitate a condition of chronic hyperglycemia known as diabetes mellitus, a metabolic disorder progressive in nature with long asymptomatic stage. Diabetic neuropathy is the most life threatening complication. Aims and Objectives: Early detection of peripheral neuropathy helps to take remedial measures in controlling the progression of the disease. Materials and Methods: Forty clinically detectable peripheral neuropathy Type 2 diabetic patients and 40 age-matched control subjects were selected for the study and nerve conduction test of ulnar sensory nerve was done and distal latency (DL), sensory nerve action potential (SNAP), and sensory nerve conduction velocity (SNCV) were recorded using RMS-EMG-EP-MAK II machine to predict the extent and type of neuropathy in diabetics. Results: Significant difference (P < 0.05) of DL, SNCV, and SNAP of ulnar sensory nerve was found in clinically detectable peripheral neuropathy group as compared to controls. Predominantly, axonal type (loss of amplitude) of neuropathy was present in study group. Conclusion: Electrophysiological variables of ulnar sensory nerve were affected in most of the subjects suggesting axonal loss and demyelinating changes in the nerve.

Assessment of Wave V latency and Wave I-V Interpeak latency in preterm babies by Brainstem Evoked Response Audiometry

Background: Early screening of hearing impairment optimizes communication, social, academic, and vocational outcomes for each child with hearing loss measurement of the auditory brain stem response which is considered the most sensitive method of assessing the auditory activity of neonates. Aims and Objectives: This study aims to compare wave V latency and interpeak I-V latency by brainstem auditory evoked response in preterm babies (32 weeks–36 weeks) with age-specific normal response and intergroup comparison (Group 1–32 weeks, Group 2–34 weeks, and Group 3–36 weeks) for the identification of hearing impairment if any. Materials and Methods: The present study was done on 50 preterm newborn, and after satisfying inclusion and exclusion criteria, preterm babies were subdivided into three groups on the basis of gestational age (Group A: 32 weeks [n = 12], Group B: 34 weeks [n = 18], and Group C: 36 weeks [n = 20]). Babies were subjected to brainstem evoked response audiometry (BERA) test on RMS EMG EP MARK-II machine in the neurophysiology unit of the Department of Physiology, Gandhi Medical College, Bhopal. Interpretation of the data as compared to normal values was done. Results: A trend toward decrease in absolute peak latencies of wave V with advancing gestational age was observed indicating progressive maturation, but the values recorded in all the three groups were longer as compared to the normal term values suggesting impairment in the maturation process. Wave I-V interpeak latencies values showed appreciable prolongation in all groups as compared to normal term values. Conclusion: The present study has shown that the preterm babies had altered BERA findings signifying hearing impairment.

Haematological Profile In HIV Infected Patients With Comparison To CD4 Count

Background:To study various hematological parameters in HIV positive patients, to determine CD4+T lymphocyte counts in HIV positivepatients, to compare hematological parameters in patients onART.Material And Methods:Hematological profile was done using HORIBA PENTRA XLR Hematology Analyzer and slides stained in Field stains & Leishmanstain with CD4 Count was done using Partex Flow Cytometer. Result:Most commonly 54% cases are presented with Anaemia Followed by 11% cases with leukocytosis and 5% cases with thrombocytopenia. In anemias commonest is hypochromic microcyticanaemiaseen in 61% ofanaemiacases, followed by 37% patients with normochromic normocytic anemia. Conclusion:Anemiais the most common abnormality followed by leukocytosis followed by thrombocytopenia and leucopenia. Within the spectrum of all Anaemia Hypochromic Microcyticanaemiais the commonest.

Histopathological Spectrum Of Head And Neck Lesions At Tertiary Care Hospital: 1531 Cases Study

Background:Head and neck lesions are commonly encountered in patients across all age groups. This region encompass a multitude of congenital, inflammatory or neoplastic lesions.To study different Head and neck lesions, find out frequency of benign and malignant head and neck lesions, histopathological appearance, compare and correlate the various histopathological Head and Neck lesions in relations to age, gender, and site of distribution at P. D. U. Medical College & Hospital, Rajkot, Gujarat, India. Material And Methods:Received specimens were fixed in 10% formalin overnight, processed, blocks were made and sectioning was done and stained with Harris Haematoxylin and Eosin stain in histopathology laboratory. Result:Total 1531 cases were studied during the periodof 1stAugust 2019 to 31stJuly 2021. Out of 1531 cases 991 were males and 550 females respectively. The most affected age group was 41-60 years. Most common anatomical site affected was Nose and Paranasal sinuses. This study include Infectious diseases as a leading cause of Head and Neck lesions because it includes period of Covid Pandemic with most common infection was Mucormyosis. Conclusion:We concluded that site specific data is helpful in evaluating common and rare lesions of head and neck and it also give idea about which site affects more frequently. We also concluded that period during which study is conducted is having huge impact on result.

Linguistic validation and psychometric testing of the Filipino version of the Breast-Q Reconstruction Module

Background@#The introduction of new therapeutic options and advances in the field of breast surgery has put the importance of patient satisfaction and quality of life at par with long-term survival. These essential parameters help physicians and patients decide on the appropriate approach when managing both malignant and benign breast conditions. They have also been used to measure the outcome and success of breast surgery, whether cosmetic or reconstructive, using patients’ perspectives. To date, there is no available questionnaire that is translated, culturally adapted, and validated among Filipino patients to specifically assess their quality of life (QOL) and satisfaction after breast reconstructive surgery.@*Objective@#This study aims to translate a previously validated, internationally accepted, patient-reported outcome (PRO) instrument, the Breast-Q Reconstruction Module, and validate its use among Filipino patients. @*Methods@#This is a tool validation study of a Filipino translation of the Breast-Q Reconstruction Module for the preoperative and postoperative settings. Forward and backward translations were done for the two questionnaires and were finalized after assessment of accuracy and feasibility by language professionals and bilingual patients. We recruited patients referred to the Division of Plastic Surgery of a tertiary government hospital for breast reconstruction to answer the final questionnaires, with 15 re-taking each questionnaire after two weeks. Psychometric properties of the questionnaires, including internal consistency, construct validity, test-retest reliability, and acceptability, were then evaluated. @*Results@#We included 30 patients in this validation study. The internal consistencies of the translated Preoperative and Postoperative Breast-Q Reconstruction Module had high Cronbach’s α coefficients (range: 0.92–0.98 and 0.97–1.00, respectively). Internal consistency was also supported by high mean item-total correlations in all dimensions. The two questionnaires had good test-retest reliability as supported by high intraclass correlation (range for Preoperative: 0.995–1.000 and for Postoperative: 0.95–1.00). Construct validity was supported by inter-scale correlations with low to moderate Spearman’s coefficients (range for Preoperative: 0.22–0.34 and for Postoperative: 0.11–0.27). The sexual well-being dimension had the lowest inter-scale Spearman’s coefficient in both questionnaires and is the only dimension with low acceptability. @*Conclusion@#The translated Preoperative and Postoperative Breast-Q Reconstruction Module has high internal consistency, test-retest reliability, acceptability, and low to moderate construct validity among Filipino patients after breast reconstruction surgery. However, the “Satisfaction with the Nipple Reconstruction” subscale is pending since there were no qualified respondents in the sample population. In considering how their relatively conservative culture influences the way Filipino patients tend to view the importance of sexual satisfaction as it relates to their medical management, the sexual well-being domain is suggested to be interpreted separately when assessing the patient’s overall satisfaction with breast reconstruction procedure.

Beyond Creatinine - A Focus on Mineral Bone Disease

Background:Chronic kidney disease (CKD) is a term that encompasses all degrees of decreased renal function, from damaged–at risk through mild, moderate, and severe chronic kidney failure. CKD is now a public health problem affecting an estimated 10-13% of the world population. The Kidney disease: Improving global outcomes (KDIGO) define CKD as either structural or functional kidney damage or a decreased glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2 for at least 3 months. CKD-mineral and bone disorder (CKD-MBD) is a broader, newly defined term to define the mineral, bone, hormonal, and calcific cardiovascular abnormalities occurring in CKD. Ours study aims to evaluate the prevalence CKD-MBD in CKD stages 3, 4 and 5. Material And Methods:Ours is a retrospective observational study involving Patients >18 years known cases of CKD as per KDIGO guidelines with a minimum follow up duration of 3 or more months. Result:Our study population had a mean age of 52.8 years with male preponderance (72%). All of the patients had some form of MBD present. Conclusion:Our study was able to demonstrate a very high prevalence of CKD-MBD in patients of CKD indicating a need for better understanding the factors behind MBD in Indian patients and the need to emphasize on preventing and treating MBD in patients.

A study of venous drainage of thyroid gland in 50 cadavers.

Introduction: The thyroid gland is drain by mainly three vein, superior thyroid vein, middle thyroid vein, inferior thyroid vein. Some time fourth thyroid vein of kocher is also present. Material and Methods: Anatomy of venous drainage of thyroid gland was studied in 50 formalin embalmed cadaver, aged between 60 to 80 years. Dissection method was use for this study. Result and Observation: Middle thyroid vein found to be absent in 12 cases. No abnormality found in superior thyroid vein and inferior thyroid vein. Termination of all veins was traced. Thyroid vein of kocher was not found in any cases. Conclusion: A better understanding of the anatomic variability in superior thyroid vein, middle thyroid vein and inferior thyroid vein may be useful not only to minimize the risk of bleeding, but it also can help to perform a more accurate dissection with the goal of preserving the laryngeal nerves and parathyroid glands, especially because of its location and relationships with other adjacent structures.

A View on Combination Antiplatelet Agents in Ischemic Stroke.

The evaluation of antiplatelet agents for prevention of ischemic stroke is being focused as a strategy for stroke reduction. The aim of this analysis was to focus specifically on the necessity of combination antiplatelet agents for secondary prevention of ischemic strokes. Aspirin, clopidogrel, ticlopidine and the combination of aspirin plus extended-release dipyridamole are all effective in reducing the risk of recurrent ischemic strokes and transient ischemic attack. Furthermore, the combinations of all above drugs show some merits and demerits in one or more condition. National guideline endorses any of these antiplatelet agents as appropriate treatment options but more research into this strategy is needed. Choosing a single antiplatelet agent or the combination must be tailored according to patient characteristics, cost, disease condition and tolerability. Other classes of antiplatelet drugs should undergo clinical trials to optimize antiplatelet therapy.

A study of inter-pedicular distances of the lumbar vertebrae measured in dried vertebrae in Gujarat.

The reduced inter-pedicular distance is one of the common causes of primary narrowing of the spinal canal. Stenosis of the spinal canal due to decreased inter-pedicular distance is to the best of our knowledge, virtually unexplored so we under took this study of inter-pedicular distance. Eisestein S measured inter-pedicular distance in Caucasoid, Zulu Negroid and Sotho Negroid population which is compared with data of present study. Methods: All measurements were made by using Electronic Digital Vernier Calipers. Transverse diameter of the lumbar spinal canal was measured as the minimum distance between the medial surfaces of the pedicles of a given vertebra (Inter-pedicular distance. Results & Observation: Inter-pedicular distances of lumbar vertebral canal at levels L1 to L5 was measured in dry vertebrae of 63 subjects (32 male, 31 female) from Gujarat of age group 35 to 80 yrs. Mean transverse diameter (Inter-pedicular distance) is minimum at L1 (22.6 mm in male and 21.3 mm in female) and maximum at L5 (27.0 mm in male and 26.4 mm in female) showing a gradual increase from level L1 to L5. The inter-pedicular distance increased steadily from L1 to L5 in all populations in both sexes. The Gujarati population has greater IPDs at all level from L1 to L5 than that of Zulu Negroid and Sotho Negroid. But IPDs in Gujaratis are lower at L1, & L2 in male and L1, L2 & L3 in female and greater at L3, L4 & L5 in male and L4 & L5 in female than that of Caucasoid. Conclusions: A comparison between the present data and the data published data on inter-pedicular distance at lumbar levels of other populations also shows that there are marked differences between the mean values reported for the population of different geographic areas. The present study confirms that there is ethnic as well as racial variation in the size of the lumbar vertebral canal, thus, emphasizing the need to have normal values and ranges for the transverse diameter of the canal for different populations.

Dermatomycosis in and around Aurangabad.

A total of 175 cases of dermatophytoses were studied. Out of all the clinical types, Tinea corporis (T. corporis) was found to be the predominant clinical type (24.57%) followed by tinea cruris (T. cruris) (22.28%). Incidence of Tinea barbae (T. barbae) and Tinea imbricata (T. imbricata) was the least (2.85%) and 0.57% respectively. Out of 175 cases of dermatophytoses, 66 (37.71%) cases were positive on microscopic examination, out of which 27 (40.90%) cases were positive by culture also. Out of the 175 cases of dermatophytoses, 109 (62.28%) were engative on microscopic examination, out of which 13 (11.92%) were culture positive. In this study, Trichophyton was the commonest genus of dermatophyte isolated, with Trichophyton rubrum (T. rubrum) being the commonest species (28.12%), followed by Trichophyton mentagrophyte. (T. mentagrophyte) (25.0%) Trichophyton soudanense (T. soundanense), which is a rare species (not reported from any studies) was isolated from cases of T. corporis and T. cruris.

Duane's retraction syndrome with facial hemiatrophy (a case report).

This report deals with a young girl with Duane's retraction syndrome who also had left facial hemiatrophy (Parry-Romberg syndrome). Report of such an association is probably first of its type to be documented in literature.

Plasma electrolytes and enzymes in country liquor poisoning.

Plasma sodium, potassium, bicarbonate, calcium, magnesium, pseudocholinesterase, amylase and alkaline phosphatase were estimated in 43 cases of country-liquor poisoning and 29 normal controls. In the poisoned subjects, plasma potassium, magnesium and amylase levels were elevated, while plasma bicarbonate levels were diminished; and plasma pseudocholinesterase and alkaline phosphatase were not affected. Plasma calcium and pseudocholinesterase were elevated in poisoned patients who recovered; however, these were diminished in fatal cases. Plasma bicarbonate and amylase were affected depending upon the severity of poisoning.