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Traumatic oral lesions: Pictorial essay
Swati Phore, Rahul Singh Panchal
March-April 2018, 11(2):94-98
Oral mucosal lesions are a common occurrence and very often dentists are called on to see such patients. Among many causes, trauma is one of the leading for oral mucosal diseases. Oral traumatic lesions are diverse in which some present as acute lesions while the majority are chronic lesions. Clinical presentation of traumatic lesions varies significantly and most of the occasions, the cause and the effect can be established with thorough history and clinical examination. Although biopsy of such lesions is not required in most of the occasions, some may warrant histological investigations to exclude conditions which clinically mimic traumatic lesions. This paper provides an overview of common and some rare traumatic conditions of the oral mucosa.
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Dental implications of an adult jaundice patient: A rare case report
Swati Phore, Rahul Singh Panchal
March-April 2018, 11(2):171-174
The color of a lesion is due to its nature and to its histological substratum. To ease diagnosis, oral cavity lesions have been classified according to their color. In the oral cavity, jaundice is classified under yellow lesions as diffuse macular yellow lesions. This interpretation of the lesions by its color is the first step to diagnosis. It should be taken into account that, as happens with any other classification, the yellowish group of lesions includes items with different prognosis as well as possible markers of systemic disorders. In this case report, the author discusses the oral manifestations of a patient with icterus and its dental implications.
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Effect of central obesity on lipid profile in healthy young adults
Shaikat Mondal, Surajit Kumar Mukhopadhyay
March-April 2018, 11(2):152-157
Background: Increased abdominal obesity is related to adverse metabolic markers. Waist circumference (WC) alone has been shown to correlate more strongly to direct measures of abdominal fat accumulation. Waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) are other parameters to estimate abdominal obesity. Increase in total cholesterol (TC), and triglyceride (TG) increases health risks; whereas, decrease in high density lipoprotein cholesterol (HDL-C) increases future health risk. Aim: The aim of the present study was to find if any correlation exist between central obesity and serum lipid profile in otherwise healthy young adults. Materials and Methods: A cross-sectional study was conducted with 76 (male = 41, female = 35) apparently healthy young adults. Weight, height, WC, and hip circumference were measured. WHR and WHtR were calculated from measured parameters. Serum lipid profile parameters were obtained from venous blood collected after overnight fasting (i.e., 12 h fasting). Pearson's correlation (with α = 0.05) was used to obtain a correlation between central obesity parameters and lipid profile parameters. Statistical analyses were performed in GraphPad Prism 6.01 windows based software. Results: Mean age of the subjects was 18.83 ± 0.85 years. Correlation of WC with TC (r = 0.08, P = 0.45), TG (r = 0.21, P = 0.05) and HDL-C (r = −0.06, P = 0.56) was insignificant. Correlation of WHR with TC (r = 0.07, P = 0.49), TG (r = 0.26, P = 0.02) and HDL-C (r = 0.07, P = 0.50) and WHtR with TC (r = 0.09, P = 0.41), TG (r = 0.17, P = 0.12) and HDL-C (r = 0.03, P = 0.74) also showed insignificant correlation. Conclusion: Indirectly measured central obesity has an insignificant correlation with serum lipid profile in healthy young adults.
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Deaths reported after pentavalent vaccine compared with death reported after diphtheria-tetanus-pertussis vaccine: An exploratory analysis
Jacob Puliyel, Jaspreet Kaur, Ashish Puliyel, Visnubhatla Sreenivas
March-April 2018, 11(2):99-105
Introduction: Immunization is one of the most effective public health tools available to prevent death and disease. Serious adverse events following immunization (AEFI) are rare. However, coincidental sudden-infant-death-syndrome (SIDS) deaths do occur temporally associated with vaccination. In 2010, the Government of India (GoI) introduced a new standard operating procedure (SOP) to report AEFI. There have been stray newspaper reports of deaths soon after the administration of the pentavalent vaccine (PV) which was introduced by the GoI in December 2011. This study was conducted to examine if there is an epidemiological signal from the data collected passively under the new SOP. Materials and Methods: We used data provided by the GoI on the number children who received three doses of diphtheria-tetanus-pertussis vaccine (DTP), the number receiving PV and the number of deaths in the vaccinated within 72 h. Results: After PV was introduced in the states, 45 million infants received DTP vaccination and 25 million received PV. There were 217 deaths within 72 h after DTP was administered and 237 following PV. There were 4.8 deaths per million vaccinated with DTP (95% confidence interval [CI]: 4.2–5.5) and 9.6 deaths (95% CI: 8.4–10.8) per million vaccinated with PV (odds ratio 1.98 (95% CI 1.65-2.38) There were 4.7 additional deaths (95% CI: 3.5–5.9), per million, vaccinated with PV instead of DTP (P < 0.0001). Discussion: Deaths following DTP vaccination would include the natural rate of deaths within that window period, plus deaths if any, caused by DTP. For purposes of this study, we assumed that all the deaths associated with DTP are coincidental SIDS deaths. Taking that as the base rate of SIDS, we look for any increase in the death rate after PV. This study demonstrated an increase in reports of sudden unexplained deaths within 72 h of administering PV compared to DTP vaccine. Whether improvements in AEFI surveillance system or other factors contributed to this increase cannot be ascertained from this study. Conclusion: These findings do not warrant deviation from current vaccination schedule, but the differential death rates between DTP and PV do call for further rigorous prospective population-based investigations.
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Platelet-Rich fibrin: A “wonder material” in advanced surgical dentistry
Nikunj Maniyar, Gargi S Sarode, Sachin C Sarode, Jahanvi Shah
July-August 2018, 11(4):287-290
One of the promising innovations in the field of surgical dentistry is the use of platelet-rich fibrin (PRF), alone or as an additive with other biomaterials. It accelerates the healing mechanism of the tissue and reduces the inflammation. The following article summarizes the role of PRF in the process of healing, its advantages, disadvantages, and clinical implications including advanced surgical dentistry.
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India's national health protection scheme: A preview
Reema Mukherjee, Manisha Arora
September-October 2018, 11(5):385-388
India has recently announced the “Ayushman Bharat–National Health Protection Scheme (AB-NHPS),” one of the largest government health insurance schemes in the world. The scheme aims to provide quality health care to the poor and vulnerable families, a step forward toward the government's commitment on universal health care. The beneficiary households under the AB-NHPS will be based on the deprivation and occupation status of the family, drawn from the Socioeconomic and Caste Census database. The scheme will take care of all the secondary health care and most of the tertiary health care procedures. The road map envisaged for the implementation of the scheme consists of number of challenges such as funding, acceptance by the states, exclusion of primary health care, and outpatient expenditure from the scheme. We conclude that successful implementation of the said scheme will require robust planning, stringent regulations, simplified processes, and continuous monitoring using advanced technological E-health platforms.
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Publications pressures, difficulty of being good, and the Sunday gentleman
Amitav Banerjee
January-February 2019, 12(1):1-3
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Dietary diversity and its determinants: A community-based study among adult population of Durgapur, West Bengal
Archan Mukherjee, Sourabh Paul, Indranil Saha, Tapas Kumar Som, Gautam Ghose
July-August 2018, 11(4):296-301
Introduction: Proper diet is essential from the very early stages of life for proper growth and development. Increasing the variety of foods and food groups in the diet helps to ensure adequate intake of essential nutrients. The study was conducted with the objective to assess the dietary diversity pattern and to find the association between dietary diversity score and selected sociodemographic variables among adult population, if any. Materials and Methods: A community-based cross-sectional study was conducted between December 2016 and January 2017 among 216 adults with the help of dietary diversity questionnaire from rural and urban field practice area of the Department of Community Medicine, IQ City Medical College, Durgapur, West Bengal, India. Pearson's Chi-square test, Mann–Whitney U-test, and binary multivariable logistic regression analysis were performed using SPSS software. Results: The median dietary diversity score of the participants was 6. Nearly 45.4% of participants had adequate dietary diversity scores. Most common food groups consumed by the participants were starchy staples (100%), followed by oil and oil-based items (99.5%) and milk and milk products (86.1%). Age, residency, type of family, and occupation have a significant association with adequate dietary diversity. Conclusion: Awareness program on dietary diversity should be organized to make people aware about the importance of dietary diversity. Proper diet is essential from the very early stages of life for proper growth and development. Increasing the variety of foods and food groups in the diet helps to ensure adequate intake of essential nutrients.
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Ayurvedic management of rheumatoid arthritis: A case study
Sonam S Bhinde, Sagar M Bhinde, R Galib, Pradeep K Prajapati
March-April 2018, 11(2):186-190
Rheumatoid arthritis (RA), an auto-immune inflammatory disease is one of the challenging conditions for the physicians to handle due to its chronicity, incurability, complications, morbidity, etc. In spite of potent anti-inflammatory agents and powerful immune-suppressive agents, its prognosis is not good, as these drugs have certain limitations including dependency and other side effects restricting quality of life. Considering these inconveniences, alternatives are being searched from traditional systems. Ayurveda through its armamentarium can provide leads in the management of this condition that is similar to Amavata in its clinical presentation. Amavatari rasa is one of the familiar medicaments used throughout India by Ayurvedic physicians for Amavata. In the current study, a clinical experience with Amavatari rasa is placed. A 32-year-old female with diagnosed history of RA was treated by Amavatari rasa. She received 250 mg of Amavatari rasa thrice a day with lukewarm water for 8 weeks and at the end of the treatment, 35% improvement was observed in the overall effect of therapy.
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Hand hygiene compliance among health-care personnel in intensive care unit of a tertiary care super specialty institute
Manodeep Sen, Meenakshi Sharma, Anupam Das, Amit Kumar Singh
May-June 2018, 11(3):210-214
Introduction: Hospital-acquired infections complicate 7%–10% of hospital admissions. Patients in the Intensive Care Units (ICUs) are more likely to be colonized or infected. Most of these infections are spread by carriage of microorganisms on the health-care workers' (HCW) hands. Hand hygiene (HH) is the single most important measure to prevent this. Despite relative simplicity of HH procedures and recommendations, compliance with HH is still poor. Aim and Objectives: To assess HH compliance among health-care personnel in the ICU of Ram Manohar Lohia Institute of Medical Sciences, Lucknow. Materials and Methods: A prospective cross-sectional observational study using direct observation technique was done. A single observer collected all HH data. A survey was done, before the study, pertaining to perception and knowledge, opportunities, steps, actions, and attitude toward HH. The nursing staff, doctors, and allied health-care personnel were taken as a sample size. The observations were noted for all five moments of HH before and after patient contact. Results: A total of 10 HCW were observed over 50 h of observation period, spread over 1 month, which created 535 HH opportunities. HH actions actually performed by the HCW were 498, and overall compliance of the study group was 93.1%. Conclusion: The average level of compliance with recommended HH techniques among health-care personnel was 93.1% which is appropriate for critical care areas.
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To wear or not to wear: Is it time to return the borrowed white coat?
Amitav Banerjee
July-August 2018, 11(4):285-286
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Hand hygiene and hospital-acquired infections
Sarit Sharma
May-June 2018, 11(3):201-202
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Do research workshops lead to research: Or is it like lecturing birds how to fly?
Amitav Banerjee
September-October 2018, 11(5):383-384
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Constraint-Induced movement therapy is a potential treatment for improving upper limb function in stroke patients
Sajid Ali, Maryam Shabir, Muhammad Mustafa Qamar, Ayesha Basharat, Javid Ali, Waqas Ahmad
September-October 2018, 11(5):395-399
Introduction/Background: Task-oriented training is a therapeutic approach based on the system theory of motor control. Constraint-induced movement therapy improves upper extremity function in stroke by increasing the use of their affected upper limb. The aim of this study is to compare the different types of goal setting, one is task-oriented and other is constrained-induced movement therapy in stroke rehabilitation. Constrained-induced movement therapy goal setting combined with a task-oriented approach to improve upper limb function in subacute stroke patients. Materials and Methods: This was a randomized clinical trial study, conducted in Lahore in which 40 stroke patients had participated, randomly assigned into two groups. Group A comprised task-oriented movement therapy and Group B comprised constraint-induced movement therapy. The measurement was taken at baseline, after 1 and 2 months. Results: The baseline readings were the same. Constrained-induced movement therapy showed a significant improvement in grip, grasp, pinch, and gross motor activities VS task-oriented movement therapy (<0.05). Conclusions: This study concluded that constrained-induced movement therapy is a potential treatment for upgrading motor limit of upper limb and activities of step-by-step living in patients with stroke.
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Ratan Tata and a new car: Bill Gates and newer vaccines
Amitav Banerjee
March-April 2018, 11(2):89-91
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Normality in sex ratio of India: Where are we lacking?
Niraj Pandit, Jatin Chhaya
November-December 2018, 11(6):574-575
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Prevalence and risk factors of hypertension among women in a rural community of Maharashtra
Maj Rekha Sharma, Ravikant Nair, Raj Kumar, Dashrath Basannar
September-October 2018, 11(5):400-405
Background: There are very few epidemiological studies on the prevalence of hypertension and its risk factors among women in the rural population. This cross-sectional study was carried out to determine the same in a rural community. This study was carried out in a rural population of Maharashtra in a rural field practice area of a Medical college with which the author is affiliated. The present study is thus a novel effort to measure the burden related to hypertension and related sociodemographic factors in a rural setting among women aged >30 years. Materials and Methods: A random sample of 220 women of 30 years and above were selected from a rural area. The study participants were selected using simple random sampling technique using lottery method. Numbers were allotted to every individual. All the women were then listed. This became the sampling frame. An individual was taken as the sampling unit. The pre-tested pro forma was used to collect the data by trained doctors. Results: Maximum participants in the study were from age group 30–39 years (33.6%), followed by 40–49 years (23.2%). Mean and standard deviation (SD) of age among study participants was found to be 47.7 ± 13.4 years. A total of 155 (70.5%) of the study participants used tobacco in one or the other smokeless form. About 29.5% of the study participants never used tobacco in the lifetime. The most common form of smokeless tobacco consumption was Mishri (71.6%) followed by tobacco which was used by 27% of the participants. Supari was also consumed by few of the participants. About 51.4% of the participants consumed >5 g (World Health Organization recommended level) of salt per day. All the participants consumed extra salt in the form of pickle/papad/table salt over and above that consumed in meals. About 8.2% of the study participants were found to be underweight while 21.2% were overweight. 3.2% of the study participants were in Grade I obesity and only one (0.4%) was in morbid obesity category. 70% of the study participants who had waist-hip ratio ≤ 0.85, whereas 30% of them had ratio > 0.85. Nearly 52% of the study participants gave a positive family history of hypertension among first-degree relatives. Only 22 (68.7%) of those participants diagnosed with hypertension were taking antihypertensive drugs and nearly half of these participants 12 (54.5%) were taking regular medication. 34.1% of participants had systolic blood pressure (BP) >140 than mmHg (isolated systolic hypertension) while 37.2% had diastolic BP >90 mmHg (isolated diastolic hypertension). The mean systolic BP calculated was 130 mmHg with SD 20.7 with 95% confidence interval (CI) of mean to be 127.5–132.8 mmHg, whereas diastolic BP was 83 mmHg with SD 11.1 with 95% CI of mean to be 81.7–84.6 mmHg. The overall prevalence of hypertension among the study participants was calculated to be 23.6% with 95% CI to be 18.2–26.8 mmHg. Conclusion: Prevalence of systolic hypertension in rural community was 34.1% and of diastolic hypertension 37.2% with an overall prevalence of 23.6%. Significant associations were found between the presence of hypertension and various sociodemographic variables using Chi-square test. Furthermore, there was a significant association between hypertension and consumption of smokeless tobacco, low physical activity level.
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Unsolicited academic invitation to young Indian authors and a way to limit it: A prospective cohort study
Shaikat Mondal, Himel Mondal, Sarika Mondal
January-February 2019, 12(1):4-10
Background: E-mail addresses of the corresponding author can be accessed from open-access online articles. These addresses are commonly collected by journal promoters and used to send invitations to authors with attractive publication offer to allure young authors. Aim: The aim of this study was to ascertain the quantity and type of unsolicited academic invitations and to find the effect of an intervention on the reduction of quantity of invitations. Materials and Methods: A total of seven young authors had participated in the study. In preintervention phase, each Sunday, the authors counted their unsolicited e-mails and reported it for consecutive 6 months. A list of commonly used words/phrases in those e-mails was made. That list was used to make e-mail filters to divert unsolicited e-mails to a different label (SPAM STUDY). In postintervention phase, the participants reported the number of unsolicited e-mails received in different labels for consecutive 3 months. Results: The authors received average 5.27 ± 0.93 (2.04 ± 0.28 in inbox and 3.23 ± 0.89 in spam label) academic invitations per day in the preintervention phase. Majority of the e-mails (98.97%) requested for submission of the manuscript. Postintervention total unsolicited academic e-mails (5.43 ± 1.25) remain unchanged (P = 0.67); however, e-mails to inbox (0.08 ± 0.02/day) were significantly (P < 0.0001) decreased. Conclusion: Young authors receive lots of unsolicited academic invitations; most of them request to submit manuscript. These unsolicited e-mails can be diverted to a different e-mail label by creating e-mail filters. This would help authors to reduce the burden of unsolicited mails in inbox.
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One-sided brain over the head: Cutis verticis gyrata
Priyanka Date, Sonia Jain
May-June 2018, 11(3):245-247
Cutis verticis gyrata (CVG) is a rare disease manifesting as convoluted folds and furrows, resembling sulci and gyri formed from thickened skin of the scalp. It can be congenital or acquired and primary or secondary. We report a rare case of 28-year-old male with a localized variant of primary essential CVG.
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Patient satisfaction at a primary level health-care facility in a district of West Bengal: Are our patients really satisfied?
Abantika Bhattacharya, Sita Chatterjee, Abhishek De, Somak Majumder, Kanti Bhusan Chowdhury, Mausumi Basu
July-August 2018, 11(4):326-331
Introduction: Many recent studies have shown an increased association between patient's satisfaction levels, patient's compliance, and success of treatment. Aim: The aim of this study is to assess the level of satisfaction among patients who have utilized the outpatient department services provided in the primary care level health institution. Materials and Methods: A health center-based observational cross-sectional study was conducted from July 2011 to October 2011 at Guskara Primary health center, Burdwan among 422 patients using a pre-designed pre-tested structured schedule. Results: Overall, mean satisfaction score was 2.97 ± 0.37. Highest satisfaction scores were observed among 18–20 years, males were more satisfied regarding technical quality of care, whereas females reported higher satisfaction regarding interpersonal manner, unmarried/single group reported the highest satisfaction with most of the services, literate group reported higher satisfaction than the illiterate group, affluent patients reported higher satisfaction regarding technical quality of care, financial aspect. Conclusions: Causes of dissatisfaction were long waiting time, the inadequacy of seating arrangement in the waiting area, inadequate cleanliness of surroundings, inadequate toilet facilities, nonavailability of medicines, and behavior of doctor.
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Artificial intelligence in medicine: The way forward
Pranay Goel
March-April 2019, 12(2):98-99
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World Health Organization hemoglobin color scale: A useful point-of-care test to detect anemia
Manoj Gopal Madakshira, Jimna Joy, Puja Dudeja
March-April 2018, 11(2):133-136
Background: Anemia is a global problem with higher prevalence in India. Anemia is known to affect endurance and will have a direct impact on the productivity of combatants. Hence, it is important to recognize and treat anemia in combatants. A cost-effective point-of-care test in the hands of the primary health-care provider will be a useful tool for diagnosis of anemia. This study endeavors to validate a point-of-care hemoglobin test-World Health Organization (WHO) hemoglobin colur scale (HbCS) against the gold standard test (GST) of cyan methhemoglobin method. Materials and Methods: The test validation study was conducted at a mid-zonal peripheral hospital. The participants were assessed for hemoglobin status by the WHO HbCS at the Outpatient department by means of capillary blood sample using a lancet. Subsequently, venous blood sample was drawn and processed by GST at the hospital laboratory. The hemoglobin values obtained were statistically analyzed. Results: A total of 200 participants were included in the study with a predominant age group of 19–40 years with most belonging to the male sex. The HbCS showed a mean difference of 1.21 g/dl in comparison with GST. The study showed HbCS to have a high sensitivity and negative predictive value. The ideal cutoff value was found to be 12 g/dl having the maximum area under the receiver operating characteristic curve. Conclusion: HbCS is an effective diagnostic tool to assess mild to moderate anemia in a resource-poor setting.
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Malignant Mesothelioma of Testis: A Report of Three Cases and Review of Literature
Nirav Priyadarshi, Suresh Bhat, Fredrick Paul, Suyog Shetty
January-February 2018, 11(1):60-62
Malignant mesothelioma of the testis is a rare condition. It usually affects the elderly. The common clinical manifestations include painless testicular mass. The tumor markers are normal. Ultrasonography helps in differentiating it from testicular tumors as these are situated at the periphery of the testis. Inguinal orchidectomy is diagnostic. Staging is usually done with abdominal computed tomography scan and chest X-ray. Role of adjuvant chemotherapy, radiotherapy, and lymph node dissection is controversial.
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Acanthosis nigricans: A cutaneous marker for metabolic syndrome
Nirali Girish Shah, Swapna S Khatu, Neeta R Gokhale, Yuvraj E More, Deepak Khismatrao
January-February 2019, 12(1):16-21
Background: Acanthosis Nigricans (AN) is an easily identifiable dermatoses characterized by thickened, hyperpigmented plaques. Metabolic syndrome refers to a clustering of metabolic risk factors including central obesity, glucose intolerance, hyperinsulinemia, low HDL cholesterol, high triglycerides and hypertension. AN is a skin marker associated with this syndrome. Aims and Objectives: This study aimed to determine the relationship between AN and metabolic syndrome by studying its clinico-epidemiological features and also the relation of severity of AN over neck with metabolic syndrome. Methodology: This is a case-control study. One hundred consecutive patients of AN attending dermatology OPD of a tertiary care hospital were included in this study. They were evaluated for AN and severity of AN over neck was assessed. Age and sex matched 100 controls were included in the study. Epidemiological, clinical and anthropometric characteristics (height, weight, waist circumference) were measured of all the cases and controls. Body Mass Index (BMI) was calculated. Fasting Blood Sugar, High Density Lipoprotein and Serum Triglyceride levels were estimated. Result: The average age of the patients was 32.4 years and females (62%) were more than the males (38%). Neck was involved in all the patients. There was statistically significant correlation of increasing severity of AN with each component of Metabolic syndrome. On comparing between cases and controls, each component of metabolic syndrome was raised in cases as compared to the controls. 70% cases had Metabolic syndrome which was statistically significant. Conclusion: There was a high prevalence of AN in subjects with metabolic syndrome. Also there was a positive correlation between severity of AN and Metabolic syndrome.
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Umbilical polyp; an anomaly of omphalomesenteric duct remnant from birth in a 3-year-old male child: A case report and review of literature
Ifeoma Florence Ezejiofor, Jideofor Okechukwu Ugwu, Chinedu Onwuka Ndukwe, Kingsley Chike Madubuike, Nnamdi Sergius Ozor
March-April 2018, 11(2):175-177
The umbilical polyp is a rare congenital lesion characterized by bright reddish round mass resulting from the persistence of omphalomesenteric duct enteric mucosa at the umbilicus. Umbilical tissue specimens are uncommonly received in the Histopathology Department of Nnamdi Azikiwe University Teaching Hospital. Approximately, one is seen out of every 300 samples received in this center. The aim of this article is to report a rare case of umbilical polyp which was present at birth in a 3-year-old male child who presented with umbilical ulcer with a bloody discharge on contact. This article is the first of its kind in Nigeria and therefore aims to create awareness of this rare condition among Nigerian histopathologists and to differentiate it from more common umbilical anomalies.
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