From Editors’ Desk.

We are pleased to apprise the members of the Editorial Board, Reviewers, and Research Scholars that within a span of less than 3 years, MGM Journal of Medical Sciences (MGMJMS), a quarterly peer-reviewed scientific journal, has been indexed in Indexed Copernicus with IC value of 83.47 for 2015. The journal is also indexed in Google Scholar, EBSCO, Genamics JournalSeek, and many more indexing and abstracting sources of international repute.

From Editor’s desk.

Healthcare-associated infections (HAIs), also called hospital-acquired infections and nosocomial infections, account for considerable morbidity and mortality all over the world. Reported prevalence rates range widely: Italy 5%, France and UK 6%, and USA 10%. Prevalence rate of HAIs in Indian hospitals has been reported to range from 18 to 35% in intensive care units (ICUs).

From Editor’s desk.

Generalized obesity, in which there is increase in total body fat, is a well-recognized major risk factor for type 2 diabetes, coronary artery disease, hypertension, and other related metabolic disorders. Global incidence of obesity has increased to near epidemic proportions, which correlates well with increasing incidence of the disorders mentioned above.

From Editor’s desk.

This issue contains an interesting article entitled: ‘In Silico-based Study of Cytochrome P450 and Multidrug Resistance Protein 1 from Docking Perspective to Understand Kidney Failure’ by Vasudha Satalkar et al about novel ways of finding nephrotoxic potential of drugs by Bioinformatics Data Analysis.

Pulmonary Thromboembolectomy in Chronic Thromboembolic Pulmonary Hypertension: A Case Report and Review of Literature.

Chronic thromboembolic pulmonary hypertension (CTEPH) is an important cause of severe pulmonary hypertention (PH) resulting in significant morbidity and mortality. Chronic thromboembolic PH occurs when a pulmonary embolism fails to undergo complete thrombolysis leading to vascular occlusion and pulmonary hypertension. Despite the fact that CTEPH is a potential consequence of pulmonary embolus, diagnosis requires a high degree of vigilance as many patients will not have a history of thromboembolic disease. The ventilation perfusion scan is used to evaluate for the possibility of CTEPH although right heart catheterization and pulmonary artery (PA) angiogram are needed to confirm the diagnosis. Pulmonary thromboendarterectomy is the first-line treatment for patients who are surgical candidates. This case report and review describes the pathophysiology, risk factors, diagnosis, and management of CTEPH. As it is a potentially curable cause of PH, its accurate diagnosis is vital. The gold standard and effective treatment for CTEPH is pulmonary endarterectomy (PEA). Pulmonary endarterectomy is an uncommon procedure with less than 50 years of experience worldwide. Research on the development of new surgical approaches is essential. In the present case, a new successful surgical technique for PEA was introduced. Conclusion: The surgical procedure used on the present patient was a unique technique. We do not claim that our technique is better than the original San Diego technique, but it is suggested as a modification that may improve patient survival. However, this procedure has its own limitations and cannot be used for clots that are located distally. Therefore, further experience should be obtained in order to overcome the limitations and improve the applicability of the technique.

Tertiary Prevention of Ischemic Heart Disease: Post Coronary Artery Bypass Surgery.

Coronary heart disease is more prevalent in Indian urban populations and there is a clear declining gradient in its prevalence from semi-urban to rural populations. Epidemiological studies show a sizeable burden of coronary heart disease in adult rural (3-5%) and urban (7-10%) populations. Thus, of the 30 million patients with coronary heart disease in India, there would be 14 million who are in urban and 16 million in rural areas. In India, about 50% of coronary heart disease-related deaths occur in people younger than 70 years compared with only 22% in the West. Extrapolation of these numbers estimates the burden of coronary heart disease in India to be more than 32 million patients. In India, there are large spectrums of patients who present at tertiary stage when first examined. These patients are left with very little margin of safety. Heart disease is one of the commonest causes of mortality and morbidity worldwide. Coronary artery bypass graft (CABG) surgery is a frequently used cardiothoracic revascularization to treat coronary artery disease (CAD). In addition to physical impairments and activity restrictions in the immediate postoperative period, patients encounter some obstacles to exhibit improvements in quality of life in the long run. Cardiac tertiary prevention programs generally consist of the prevention of disease progression and patient suffering. Aim of these interventions is to reduce the negative impact of disease by restoring function and reducing disease-related complications and therefore, include the rehabilitation of disabling conditions. Cardiac rehabilitation programs are interventions aimed to reduce mortality and morbidity of patients with ischemic heart diseases through promoting a healthier lifestyle among patients. These programs are used to restore, maintain, or improve both physiologic and psychosocial outcomes and finally the quality of life in patients through a combination of exercise, education and psychological support.

Dengue, a Global Scourge.

It is estimated that each year about 50 million dengue infections occur, out of which about 500,000 (one percent) develop dengue hemorrhagic fever who need hospitalization. In India, Over 35000 dengue cases have been reported this year till 30th September with 64 deaths. Of course there must be a very large number of unreported cases in addition.

Concomitant Repair of Superficial Femoral Artery and Vein in a Case of Peripheral Vascular Trauma.

Vascular trauma results from penetrating, blunt or iatrogenic injuries. Young males are at highest risk and the leading causes of injury include motor vehicle crashes, falls, wounds from firearms, wounds from cutting or piercing instruments and burns. Peripheral vascular injuries account for 80% of all cases of vascular trauma. We report the case of a 21-year-old male patient with history of fall from 10 feet height on to a sharp metallic plate. Patient presented to emergency department with a lacerated wound of 15 × 10 cm on right mid thigh with active pulsatile bleed. After fluid resuscitation, patient was immediately shifted to operation room where examination revealed complete transaction of superficial femoral artery and vein with 10 cm tissue loss of both. Both vessels were reconstructed using saphenous venous graft from opposite thigh. Postoperatively, patient made a steady recovery with strong pedal pulsations and no edema or neurological deficit. Patients with hard signs of arterial trauma should be taken for surgical exploration without any diagnostic investigations. Traumatic muscular lacerations with gross contamination of wound precluded the use of any prosthetic graft and hence saphenous venous graft was most appropriate. Review of literature reveals that patients with concomitant peripheral arterial and venous injuries have a very high amputation rate and simultaneous reconstruction of both leads to improved chances of limb salvage. It is our recommendation that such patients should receive postoperative anticoagulation to avoid thrombosis of graft in venous position.

Editorial.

esearch in medical institutions not only leads to an expansion of knowledge and discovery of new medical treatments and cures, but more importantly it also passionately blends purposeful curiosity and innovative creativity with disciplined process, patient observation, and untiring perseverance.

Swine Flu Epidemic in India.

This year swine flu (caused by H1N1 virus) has affected over 34,000 people in India so far, out of whom over 2,100 died, as per the figures collected by Union Health Ministry till April 2, 2015. According to researchers from Massachusetts Institute of Technology, the strain of H1N1 virus, which is responsible for the current epidemic, is a mutated virus of 2009 strain, in which the hemagglutinin protein has undergone mutations. One of these mutations has been linked to increased severity of disease (explaining the increased mortality) and another one to its increased infectivity (explaining the large numbers of cases). Fortunately, the two swine flu vaccines (one parenteral and other nasal), currently available in India, have addressed these mutations and are fully effective.

Editorial.

We have pleasure in bringing out the 4th issue of Volume 1 of the MGM Journal of Medical Sciences. With this issue, we shall complete 1 year of this recently launched journal. We are sure, with good response of our esteemed readers, this prestigious publication will grow steadily from issue to issue and earn a niche slot among research publications in medical sciences, not only in India but also in the international domain.

Editorial.

Welcome Azeezia Colg Of Dental Sci. & Research ABSTRACT ‘Teaching is not just another profession. It is a divine responsibility to guide and enlighten’, is said very rightly by our honorable Prime Minister of India, Shri Narendra Modi on Teachers’ Day eve on 5th September, 2014. Teaching is one of the noblest professions. Teachers imbibe in themselves the qualities of perseverance, integrity and dedication towards the profession of teaching, by virtue of which they are held in high esteem not only by pupils but also by the entire society. An example is Dr Sarvepalli Radhakrishnan, a great revered academic philosopher and scholar. When he became President of India and some of his well wishers expressed their desire for celebrating his birthday, he replied ‘instead of celebrating my birthday, it would be my proud privilege if 5th September is observed as Teachers’ Day’. The keynote of our culture is Acharya Devo Bhava. The scriptures tell us that if you see your Guru and God together, then fall at your Guru’s feet first. This is because your Guru shows you the way to God. And this is why the word ‘guru’ means ‘remover of darkness’. It is the teacher who through intelligence, patience and wisdom polishes the pupil’s intellect and aptitude and shapes their bright future, and that is what should be celebrated.

Editorial.

In our daily lives, we get sucked so willingly into nurturing an engrossingly busy schedule that over time it converts itself into a necessity for fulfilling our self-actualization needs. We are busy bees building our own beehives. It then takes a shock event to occur, for us to realize our frog in the well-situation. It is then that we eventually seek wisdom from the macro picture and realize the tininess of our micro beehive.

Research: An Integral Part of Education and Health Promotion.

Research is a harmonious opera that passionately blends purposeful curiosity and innovative creativity with disciplined process, patient observation and untiring perseverance. Such is the importance of research that without it, humans would still have been scratching each other’s back, sitting aside other apes in forests formed over millions of years, literally! Just look around wherever you are and try to identify anything man-made, that does not have its roots in research. In a lighter vein, this search might be far more difficult than research itself, and hence a potentially new topic for research!