iosr-JDMS   Volume-19 ~ Issue-12 ~ December 2020

Abstract: Background: SARS-CoV-2 virus is a beta corona virus and the disease caused by this is the COVID-19. The disease was declared as a pandemic on March 11,2020 by WHO.Though Chest X-ray is not a sensitive tool in the early stage of the disease,it is a very useful diagnostic tool to monitor the rapid progression of the disease. Materials and Methods: In this prospective randomised controlled study,102 patients were included based on the inclusion and exclusion criteria. A chest X-ray was obtained from the patient at the time of admission and the radiological findings were statistically analysed......

Key words: SARS-CoV-2, COVID-19, Reticulonodular opacities

[1]. Johns Hopkins University. Coronavirus Resource Center. October 9, 2020. Johns Hopkins University. https://coronavirus.jhu.edu/map.html. Accessed October 9, 2020.
[2]. Center for Health Security. SARS-CoV-2 Genetics. Johns Hopkins Bloomberg School of Public Health. April 16, 2020.
[3]. World Health Organization. WHO Director-General's Opening Remarks at the Media Briefing on COVID-10. Geneva: World Health Organization; 2020
[4]. Hansell DM, Bankier AA, MacMahon H et al (2008) Fleischner Society: glossary of terms for thoracic imaging. Radiology 246(3):697–722. https://doi.org/10.1148/radiol.2462070712
[5]. Rubin GD, Ryerson CJ, Haramati LB et al (2020) The role of chest imaging in patient management during the COVID-19 pandemic: a multinational consensus statement from the Fleischner Society. Radiology. https://doi.org/10.1148/radiol.2020201365.

Abstract: Background: TB is the most common opportunistic infection in HIV patients. HIV patients are at increased risk for developing drug-resistant tuberculosis as the disease advances and CD4+ T cells decrease. TB is the major cause of morbidity and mortality in patients with HIV infection. Materials and Methods: This is hospital based prospective observational study including all the consecutive MDR-TB patients co-infected with HIV presented to Government Hospital for Chest and Communicable Diseases. Results: Out of 38 patients 71% were male, 11% were females. Majority of the patient were in the age group of 30-50 years of age. 68.45 were smokers. 92% patients had a previous history of tuberculosis and ATT usage, with 71% using irregular treatment. 71% patients were diagnosed as HIV positive prior to MDR-TB detection among which 74% were using ART irregularly. 73.7% patients....

Key Word: HIV, MDR-TB, co-infection, low CD4+ T cells.

[1]. National AIDS Control Organization. Guideline for prevention and management of common opportunistic infections/malignancies among HIV-infected adults an adolescent. New Delhi: National AIDS Control Organization, Ministry of Health and Family welfare, Government of India; 2013.
[2]. World Health Organization. Global Tuberculosis Report 2018. Geneva: World Health Organization; 2018
[3]. https://www.who.int/tb/areas-of-work/tb-hiv/en/
[4]. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2020
[5]. Wolday D, Hailu B, Girma M, Hailu E, Sanders E, Fontanet A L. Low CD4+ T-cell count and high HIV viral load precede the development of tuberculosis disease in a cohort of HIV-positive Ethiopians. The International Journal of Tuberculosis and Lung Disease. 2003 Feb 1;7(2):110-6.

Abstract: Aim: To predict the severity of Community Acquired Pneumoniausing hypoalbuminemia and thrombocytopenia.
Materials and Methods: A prospective study was conducted on 90 patients with CAP, hospitalized in Government Hospital for Chest and Communicable Disease, Visakhapatnam, from June 2019 to January 2020. The primary outcomes measured were requirement of ICU admission, duration of hospital stay, and 30-day mortality in CAP patients. Results: Among the 90 patients hospitalized, 87.8% patients had hypoalbuminemia (Serum Albumin < 3.5g/dl) and 8.9% had thrombocytopenia (Platelet counts < 100×103/mm3) within 24 hours of admission.36.7% of patients required ICU admission, the...

Keywords: Community-acquired pneumonia, hypoalbuminemia, thrombocytopenia, 30-day mortality

[1]. Marrie TJ.Acute Bronchitis and Community-Acquired Pneumonia. In: Fishman AP,editor. Fishman's Pulmonary disease and disorder. New York: McGraw-Hill; 2015. pp. 1966-1967
[2]. Liu JL, Xu F, Zhou H, Wu XJ, et al. Expanded CURB-65: a new score system predicts severity of community-acquired pneumonia with superior efficiency. Scientific reports. 2016 Mar 18; 6:22911.
[3]. Prina E, Ranzani OT, Torres A. Community-acquired pneumonia. The Lancet. 2015 Sep 12;386(9998):1097-108.
[4]. Fine MJ, Auble TE, Yealy DM, Hanusa BH, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. New England journal of medicine. 1997 Jan 23;336(4):243-50.
[5]. Arnold FW, Wiemken TL, Peyrani P, Ramirez JA, et al. Mortality differences among hospitalized patients with community-acquired pneumonia in three world regions: results from the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study. Respiratory medicine. 2013 Jul 31;107(7):1101-11.

Abstract: Plamodium falciparum,plasmodium vivax are protozoan disease spread by female anopheles mosquito bite which constitutes most important of parasitic disease of humans. Scrub typhus caused by orientia tsutsugamushi which spreads due to bite of trombiculid mite is also a common cause of acute febrile illness in many parts of Asia including Indian sub continent.Chikungunya spreads by the bite of Aedes mosquito is quite a less common cause of patient presenting with acute febrile illness. Presentation and laboratory features of above diseases are common which includes high grade fever, low platelet count and multi organ system including cardiovascular, haematological, neurological manifestation involvement ultimately leading to shock, bleeding tendencies ,delirium, seizure, peripheral neuropathy etc. Coinfection of all four illness along with involvement of central nervous system and peripheral nervous system in the form of neuropathy is extremely rare. Here we report a case which had involvement of both CNS and PNS inform of demyelinating and axonal neuropathy with co-infection of plasmodium vivax,plasmodium falciparum,scrub typhus and chickengunea the above described illness

[1]. Kamath V, Ganguly S, Avinash B L. A comparative study of concurrent infections of rickettsial infection, Malaria, Typhoid, and Chikungunya with Dengue. APIK J Int Med 2019;7:120-6
[2]. Gangula RS, Stanley W, Vandanapu A, Prabhu MM. Guillain-Barre Syndrome with Falciparum Malaria and Scrub Typhus Mixed Infection-An Unusual Combination. J Clin Diagn Res. 2017;11(9):OD10-OD11. doi:10.7860/JCDR/2017/28390.10629
[3]. Ghosh S, Das SK, Sharma A. Uncommon neurological manifestations of a common tropical vector borne disease. Trop Parasitol 2015;5:61-3
[4]. Chakravarty A, Ghosh B, Bhattacharyya R, Sengupta S, Mukherjee S. Acute inflammatory demyelinating polyneuropathy following plasmodium vivax malaria. Neurol India 2004;52:130-1
[5]. Phillips A, Aggarwal GR, Mittal V, Singh G. Central and peripheral nervous system involvement in a patient with scrub infection. Ann Indian Acad Neurol 2018;21:318-21

Abstract: Introduction: Chromophobe renal cell carcinoma (CRCC) is accounting for 5.9% of all RCC cases and has a better prognosis but chromophobe RCC with sarcomatoid changes a rare entity associated with poor prognosis in most studies. Here, we present a unique case of CRCC with sarcomatoid transformation of a 60 yr old male from Tripura. We report herein the clinical, histological, and immunohistochemical features of a case of sarcomatoid chromophobe renal cell carcinoma .Case Report : A 60 year-old man referred a two-month history of constant left flank pain, and hematuria. After radiological confirmation left radical nephrectomy was performed and specimen was sent......

Keywords: Renal cell carcinoma.

[1]. Tanaka et al. BMC Urology 2013, 13:72 http://www.biomedcentral.com/1471-2490/13/72 .
[2]. de Peralta-Venturina, M. et al. Sarcomatoid differentiation in renal cell carcinoma: a study of 101 cases. Am. J. Surg. Pathol. 25, 275–284 (2001).
[3]. Mian, B. M. et al. Prognostic factors and survival of patients with sarcomatoid renal cell carcinoma. J. Urol. 167, 65–70 (2002).
[4]. Alevizakos, M., Gaitanidis, A., Nasioudis, D., Msaouel, P. & Appleman, L. J. Sarcomatoid renal cell carcinoma: population-based study of 879 patients. Clin. Genitourin. Cancer 17, e447–e453 (2019).
[5]. Shuch, B. et al. Cytoreductive nephrectomy for kidney cancer with sarcomatoid histology–is up-front resection indicated and, if not, is it avoidable? J. Urol. 182, 2164–2171 (2009).

Abstract: Background: Hospital acquired infection (HAI) contribute significantly to pediatric morbidity and mortality. Although there are many factors involved in development of HAIs, some of the common procedures done in PICU setup like phlebotomy, intravenous peripheral and central line insertion are potent sources of Hospital Acquired Infections (HAIs). Few projects have been carried over across the globe which shows decline in spread of sepsis if proper standardized protocols are carried out in a planned and organized process. One such process is known as Plan-Do-Study-Act (PDSA) cycle. The present study is a quality improvement project using multiple PDSA cycles and Fishbone matrix to decrease the percentage of IV line related complications in PICU. Material and Methods: Pediatric Intensive Care patients were studied over a period of 6 weeks. The first 2 weeks included baseline data collection of the status of IV extravasations. Using PDSA (Plan-Do-Study-Act) cycles, interventions...

Keywords: Thrombophlebitis, PDSA cycle, Aseptic techniques

[1]. Kumar A, Kumar P. Nosocomial sepsis surveillance in the NICU. J Neonatol. 2009; 23: 34-43.
[2]. Crawfod A, Bianchi J, Walker G. Standardizing aseptic technique to avoid HCAIs. Nursing Times. 2015; 111: 16-8.
[3]. Wilson M, Wilde M, Webb ML, Thompson D, Parker D, Harwood J. Nursing interventions to reduce the risk of catheter-associated urinary tract infection: Part 2: Staff education, monitoring, and care techniques. J Wound Ostomy Continence Nurs. 2009; 36: 137-54.
[4]. Wise CG, Billi JE. A model for practice guideline adaptation and implementation: empowerment of the physician. Jt Comm J Qual Improv. 1995; 21: 465-76.
[5]. Livesley N., Sooden A., Pahwa P. Using quality improvement to address asepsis during intravenous procedures among neonates at Swami Dayanand Hospital, Delhi. USAID. June 2017..

Abstract: The practice of dentistry in private practice and in the public sector faces important challenges as science and technology are constantly renewed. The interactions between the dentist and the patient attract the discussion of addressing the issue of quality. Concerns about health care quality, patient safety, and the cost of timely dental care have caused the concept of quality to take center stage. The protagonism of quality in dentistry is slow, but constant, and for that reason, it is important to generate discussion and share information about instruments such as the DQA to ensure a culture of constant improvement

[1]. Project Team Oral Care. Conclusions and reommendations from a pilot study focusing on outcome indicators for oral health care (Conclusiesenaanbevelingenuiteen pilot studienaaruitkomstindicatoren in de mondzorg). May 2015. (Dutch)
[2]. EGOHID. Health Surveillance in Europe. A selection of essential oral health indicators. Recommended by European Global Oral Health Indicators Development Project (Catalogue); 2005.
[3]. Carrs, S et al. Roles, relationships, perils and values: development of a pathway between practice development and evaluation research. Rev Quality in Primary Care. 2008; 16: 157-64. Pag. 2.
[4]. Álvarez, M et al. Guía de diseño y mejora de procesos asistenciales mejorados. 2nd. Eedition Spain: Junta de Andalucía. Consejería de Salud 2009; Pag. 13.
[5]. Robert Wood Johnson Foundation. The state of health care quality in America. Available from: http://www.rwjf.org/contect/dam/files/legacy-files/article-files/2/currentstateofquality.pdf. Accessed 28 Jun 2016.

Abstract: Background: In last few decades there has been an increase in the caesarean section rates leading to a lot of discussion regarding the indications of caesarean section and need for caesarean section audits.World Health Organisation recommends the use of the Ten-Group Robson's classification as the global standard for assessing Caesarean Section Rate. We conducted this study to see how Robson's classification helps us to analyse Caesarean Section Rate. Methods: This is a cross sectional study conducted for a period of 12 months from January 2017 to December 2017. All women delivered during this period were divided according to Robson's 10 group classification. Overall Caesarean Section Rate, relative...

Keywords: Robson's classification, Caesarean section rates, caesarean audit

[1]. WHO Statement on Cesarean Section Rates; WHO/RHR/15.02. Available at http://www.who.int/reproductivehealth/publications/maternal_perinatal_heal th/cs-statement/en/.
[2]. Molina G, Weiser TG, Lipsitz SR, et al. Relationship between cesarean delivery rate and maternal and neonatal mortality. JAMA 2015; 314: 2263-2270).
[3]. Ana Pilar Betran et al. Interventions to reduce unnecessary caesarean sections in healthy women and babies. DOI:https://doi.org/10.1016/S0140-6736(18)31927-5.
[4]. Torloni MR, Betran AP, Souza JP et al. Classifications for caesarean section: a systemic review. PLoS One 2011;6(1):e14566.
[5]. Radhakrishnan T, et al. Increasing trend of caesarean rates in India: Evidence from NFHS-4. JMSCR. 2017 Aug; 5(8).

Abstract: Background- Seizure is a paroxysmal event due to abnormal, excessive hypersynchronous discharge from an aggregate of CNS neurons. Depending on the distribution of discharge, this abnormal CNS activity can have various manifestations, ranging from dramatic convulsive activity to experiential phenomena not discernible by an observer. Objectives-Computed Tomography evaluation of patients with seizure disorder.Material and Methods- This prospective observational study is based on radiological findings in 110 patients suffering from epilepsy who were referred to the radiology department...

Keywords: Computed tomography, NCC, solitary ring enhancement.

[1]. World Health Organisation.
[2]. Harrison's – Principles of Internal Medicine 17th edition.
[3]. Epilepsia-2009 March; 50 supplement 3: 39-49.
[4]. Guberman A. and Z.F.G. Jawprslopseudohypothyroidism and epilepsy : diagnostic value of computerized cranial tomography, 1979 epilepsia vol. 20:541-553..

Abstract: Background: Testes are ovoid or walnut shaped bodies that have the organization of compound tubular glands with a thick fibrous capsule. Testes having both exocrine and endocrine function and various cell types. Though many studies have been done still some important values need further investigation in this field for future reproductive science. Materials and Methods: The study was conducted in the Department of Anatomy, Gauhati Medical College during the period of May,2012 to May,2014. The study was conducted on the testis of human, pig, goat and albino rat. They were divided into four mammals group Group-I, Group-II, Group-III, and Group- IV respectively consisting of 6 to...

Keywords: Seminiferous tubule; Human Testes; Mammals testes

[1]. Baily : cited in " Baily's textbook of Histology" by Copenhaver, W.M, mary, B .Bunge , Richard P Bunge, Male reproductive system, 16th Eds, PP – 548, reprint, 1975.
[2]. Bloom,W. And Fawcett,Don,w., A Textbook of Histology , Male reproductive system,1978, 10th Edn, ( Asian Edn) PP-805.
[3]. Goldstein M. & Mehta A.(2016). Male Reproductive System, Gray's Anatomy-The Medical Basis Of Clinical Practice,Editor: Susan Standring,41st Edition,Section 76, P-1272.
[4]. Waugh A. & Grant A.(2018). Ross and Wilson Anatomy and Physiology in Health and Illness,13th Edition, Section 2,P-233.
[5]. Johnson, A.D., Gomes, W.Rand Vandemark, N. L.: cited in "The Testis" I, 1970, xii published by AP. NY and London.

Abstract: Background: "Amputation" derived from a Latin word "amputare‟ (to cut out) has been defined as "removal of part or all of a body part enclosed by skin. The most common indication for amputation varies from study to study. Trauma, complications of diabetes mellitus (DM) and peripheral arterial occlusive disease (PAOD) are some of the common indications recorded. Complications of DM has been widely accepted as the most common cause with figures ranging from 25% to 90% depending on the study.The surgeon when removing the limb is primarily concerned with saving the life of a patient or getting rid of a diseased or badly injured part of body.The aim of this study is to outline the incidence, patterns, causes and complications of lower limb amputation among patients at a tertiary care hospital. Materials and Methods: This study is...

Keywords: Amputation, Gangrene, lower limb amputation, Peripheral Arterial Occlusive Disease, Diabetes mellitus

[1]. Bailey & Love‟s Short Practices of Surgery, 27th Edition.
[2]. Banerjee SN. Editor. Rehabilitation management of amputees. Williams & Wilkins; 1982. Banerjee SN, editor. Rehabilitation management of amputees. Williams & Wilkins, 1982.
[3]. Farsi Z, Azarmi S. Effect of roy‟s adaptation model-guided education on coping strategies of the veterans with lower extremities amputation: a double-blind randomized controlled clinical trial. International journal of community based nursing and midwifery. 2016; 4(2):127.
[4]. Akiode O, Shonubi AO, Musa A, Sule G. Major limb amputations: an audit of indications in a suburban surgical practice. Journal of the National Medical Association. 2005; 97(1):74.
[5]. Unwin N. Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia. British Journal of Surgery. 2000; 87(3):328-37.

Abstract:Covid-19 pandemic has dramatically changed the current practice scenario in the health care sector. In the late January 2020, Covid-19 was declared as public health emergency by World Health Organization.The nosocomial spread from asymptomatic carriers & infected patients via droplets is very likely in the speech clinics1.
Specifically talking about Speech therapists who are involved in speech rehabilitation of the operated cleft palate patients; they generally cater to the pediatric population. Children with operated cleft palate are at risk of wide range of speech disorders. These are nasal emission,articulation......

[1]. Marrie TJ.Acute Bronchitis and Community-Acquired Pneumonia. In: Fishman AP,editor. Fishman's Pulmonary disease and disorder. New York: McGraw-Hill; 2015. pp. 1966-1967
[2]. Liu JL, Xu F, Zhou H, Wu XJ, et al. Expanded CURB-65: a new score system predicts severity of community-acquired pneumonia with superior efficiency. Scientific reports. 2016 Mar 18; 6:22911.
[3]. Prina E, Ranzani OT, Torres A. Community-acquired pneumonia. The Lancet. 2015 Sep 12;386(9998):1097-108.
[4]. Fine MJ, Auble TE, Yealy DM, Hanusa BH, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. New England journal of medicine. 1997 Jan 23;336(4):243-50.
[5]. Arnold FW, Wiemken TL, Peyrani P, Ramirez JA, et al. Mortality differences among hospitalized patients with community-acquired pneumonia in three world regions: results from the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study. Respiratory medicine. 2013 Jul 31;107(7):1101-11.