Category Archives: Research Articles

Adenocarcinoma spectrum_Narang S

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Adenocarcinoma: Morphological & Topographical spectrum: a two year analysis
Narang S,1 Prajapati R,2 Jain R3

Professor,1 Assistant Professor,3 Tutor2

1Department of Pathology, Index Medical College Hospital and Research Centre, Indore, MP, India

2Department of Pathology, R D Gardi Medical College, Ujjain, MP, India

3Department of Pathology, M.G.M Medical College, Indore, MP, India
ABSTRACT
Aim

To study of adenocarcinoma of various sites and classify them into morphological categories according to International Classification of Diseases for Oncology (ICD-O, Third edition).

Background

The word cancer is enough to strike fear in the heart of any man because it is this one menace that researchers have been unable to curb, It is for this reason that many ideas are thought of and pursued with the hope of unraveling this mystery. In keeping with this a study delineating the morphological and topographical spectrum of adenocarcinoma was carried out in the Department of Pathology MGM Medical College and M Y Hospital Indore, MP, India.

Material Methods

A retrospective study of adenocarcinoma cases diagnosed during last 2 years, from January 2007 to December 2008 was carried out. ICD-O (3rdEd.) was used as reference to categorize the cases according to anatomical site and morphology.

Results

Total 325 cases were included, out of which, the maximum, i.e. 221 cases (68%) of Adenocarcinoma were found between third and fifth decades. The average for males was 48.1 years while for females was 47.8 years. The frequency of Adenocarcinoma was highest among those involving breast (56.50%), followed by those involving digestive system (30.24%). Regarding the topographical distribution of Adenocarcinoma, the maximum number of cases (26.07%) of Adenocarcinoma belonged to ICD-O category C-50 i.e. breast.

Conclusion

As far as the behavior pattern of the Adenocarcinoma was concerned, most of the cases in our study were invasive type. Hence keeping this in mind the topographical spectrum prevalent in the area and having a high index of suspicion can prove to be useful for early detection, treatment, improved survival rate and reduced mortality in such cases.
KEY WORDS
Adenocarcinoma, Glandular epithelium, ICD-O, Morphologic categories, Topographic spectrum.

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Urgent carotid endarterectomy_Bedi HS

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Urgent carotid endarterectomy for acute cerebral ischemia

Bedi HS,1 Pandian JD,2 Gupta A3

Head CTVS,1 Professor & Head Neurology,2 Head Cardiac Anesthesia3

Department of Cardiovascular Endovascular & Thoracic Surgery,1 Department of Neurology,2 Department of Cardio Vascular Anesthesia3

1-3Christian Medical College & Hospital , Ludhiana, Punjab, India
ABSTRACT
Background

Carotid endarterectomy (CEA) is well established as the elective treatment for severe symptomatic carotid stenosis . In contrast, the merits of CEA performed as an emergency procedure in patients with acute stroke or fluctuating neurological deficit remain controversial.

Material Methods

CEA was performed as an emergency procedure on 16 patients within 4 to 48 hours after the onset of symptoms. Patients selected for urgent surgery fulfilled the following criteria: acute onset of fluctuating hemispheric neurological symptoms, significant carotid pathology, absence of cerebral hemorrhage, absence of massive cerebral damage and stable cardiopulmonary conditions. The patients presented with a crescendo-TIA in 7, evolving (stuttering) stroke in 3 and fluctuating neurological deficits in 6 - corresponding to a contralateral carotid stenosis.

Results

Following CEA, the neurological deficits improved instantaneously to complete recovery in 10 patients. The symptoms of 4 patients improved to non-disabling deficits, and remained unchanged in two patients. 14/16 patients were discharged within 8 days after admission. The neurologic status after discharge did not deteriorate in any of the patients during follow up - in fact it further improved in 4 of the patients (2 in whom there had been no change and 2 in whom there had been a partial improvement).

Conclusion

Emergency CEA may be beneficial for selected patients with stroke in evolution and fluctuating neurological deficits. Careful adherence to selection criteria, judicious intraoperative shunting, intensive unit care post surgery and an experienced team are recommended.
KEY WORDS
Carotid endarterectomy; Crescendo TIA; stroke in evolution

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Mobile phone_das D

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Mobile phone surveillance and relationship between quantitative cultures and type of mobile device: A pilot study
Das D,1 Khera R,2 Sumit R3

Assistant Professor,1,3 9th Semester M.B.B.S Student2

1-3Sikkim Manipal Institute of Medical Sciences, Sikkim, India
ABSTRACT

Aim

In this study an attempt was made to compare the mobile phone microbiota from health care workers among various departments and individuals from community not exposed to health care and correlate the quantum of bacterial load with the type of mobile phone.

Background

Inanimate object like mobile phones in the hospital environment are contaminated and are known to be considered as sources of Hospital Care Associated Infection (HCAI). It is also important to know the bacterial load on mobile phones and knowledge regarding mobile phone as source of nosocomial infection among health care workers (HCW) compared to people from community.

Material Methods

Study population and size included 100 healthcare workers from various departments of a tertiary care hospital and 50 individuals from a middle class community of East Delhi. Self structured questionnaire were distributed among the study population and quantitative culture from mobile phones were done.

Results

Total thirtee six of 100 mobile hand sets of health care workers (HCW) were colonized of which 6 were polymicrobial colonisation with average bacterial load of 2709. In the community based survey, 19 (38%) of the mobile handsets were colonized having average bacterial load of 2490 CFU per handset.

Conclusion

Mobile phones used by HCWs in daily practice may be a source of nosocomial infections in hospitals. There is a threat of spreading infection by mobile phone if not disinfected properly. This is similar to the importance of hand hygiene in preventing spread of infection. If use of mobile phones is imperative, then strict mobile friendly disinfection policies need to be formulated and implemented.
KEY WORDS
Hospital Care Associated Infection (HCAI), Colonisation, Polymicrobial

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chourasia_stature

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Estimation of stature from head length

Chourasia RS1, Bamne A2Gohiya V3, Sukla SN4, Pandey R5
Assistant Professor,1,2,4 Professor,3 Professor & Head5

1-5Department of Anatomy, Index Medical College Hospital and Research Center, Indore, MP, India
ABSTRACT
AimIn this study an attempt has been made to derive a linear regression equation for estimation of stature from the length of head.BackgroundEstimation of stature from head length is considered as an important parameter in medico-legal and forensic examinations. When highly decomposed and mutilated dead bodies with fragmentary remains are brought for postmortem examination, it becomes difficult to identify the deceased.

Material Methods

The present study is conducted on 506 medical students 255 male and 251 female of age group between 18 - 25 years, was conducted at Index medical college hospital and research center Indore. The measurements were taken by using standard anthropometric instruments..

Results

The observed data was subjected to statistical analysis like‘t’ test for correlation coefficient. The value of ‘t’ was found to be statistically significant. Simple linear regression equation derived has been used for estimation of height..

Conclusion

It is concluded that the head length provides good reliability in estimation of stature in forensic examinations & in medicolegal cases and the correlation between present parameters can be helpful in medico-legal cases for identification of individuals.
KEY WORDS
Anthropometry, Head length, Stature.

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sharma_universalprecautions

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Role of knowledge in practicing universal precautions among staff nurses
Sharma BK1, George S2
Associate Professor (Biostatistics),1 Lecturer2

1Department of Community Medicine, Sri Aurobindo Institute of Medical Science (SAIMS), Indore, MP, India

2Department of Medical Surgical Nursing, SAIMS, Nursing College, Indore, MP, India
ABSTRACT
AimAuthors aimed to present the importance and association of knowledge with practices of universal precautions.BackgroundStaff nurses are at high risk of exposure to infectious agents. Knowledge and practices towards universal precautions are necessary to prevent hospital associated infections.

Material Methods

An observational study was conducted at different selected hospitals of Indore city. A total of 130 staff nurses were sought for informed consent considered as subject. The demographic profile had identified and associated with knowledge and practice of universal precautions. The main study tool was self-administered questionnaire.

Results

Mean practices (49.6%) of universal precautions were significantly lower than mean knowledge (73.35%). 61.5% staff nurses had good knowledge but 43.8% were practicing at good level while none showed the practice excellence. The knowledge were not found associated (p>0.05) with practices of universal precautions. The practices of universal precautions reported strongly associated (p<0.002) with work experience but significantly (p<0.03) associated with knowledge. The workload of a staff nurse was identified as a distracter because no significant association (p>0.05) was evidenced between nurse patient ratio with knowledge and practice of universal precautions.

Conclusion

Various studies have been shown that use of universal precautions lower the risk of hospital associated infection. Staff nurses had good knowledge but low practices of universal precautions. A good practice of universal precaution is a powerful tool to reduce the risk of contracting infections in clinical settings. Age, gender, course taken and clinical experience has their own effect towards knowledge and practice of universal precautions.
KEY WORDS
Universal Precautions, Knowledge, Infection, Practice, Nosocomial infection.

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goel_placentaprevia

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Incidence of placenta previa in previous cesarean section
Goel A
Postgraduate Student

Department of Obstetrics and Gynecology, G R Medical College, Gwalior, MP, India
ABSTRACT
AimTo study the incidence of placenta previa in previous cesarean section and compare it with incidence of placenta previa in women with no prior cesarean section.BackgroundThere is an evident literature support which suggest that the chances of placenta previa are not only more in patients who had a previous history of cesarean section but the chances also increases with the number of cesarean section in past. The overall incidence of placenta previa is 0.2-0.5% in western studies. It may be more in Indian population. As there were not many studies on this important topic from Indian subcontinent.

Material Methods

Total 484 patients with history of previous Lower Segment cesarean Section were selected for study purpose. 496 subjects with no previous history of cesarean section were selected for control purpose. Clinical examination and USG was done at 28 weeks to detect placenta previa.

Results

Ten cases of placenta previa were found in the study group and incidence of placenta previa was calculated to be 2% in this group compared to incidence of only 0.6% i.e. 3 cases in control group (p< 0.05). Also the chances of finding placenta being morbidly adherent were increased in the study group as we found 2 cases of placenta increta and 3 cases of placenta accreta among these.

Conclusion

Incidence of placenta previa is high in patients with previous cesarean section as well as chances further increases with the successive increase in number of cesarean section in past.
KEY WORDS
Placenta Previa, Adherent Placenta, Cesarean section.

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singh_lung

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Evaluation of Lung Function by Spirometry in 12-14 yrs Adolescents in schools of Raipur city Chhattisgarh

Singh V 1, Kurrey VK2, Khandwal O3, Phuljhele S3
Resident1, Assistant Professor2, Associate Professor3

1-4Department of Paediatrics, Pt JNM Medical College Raipur, Chhattisgarh, India
ABSTRACT
Aim
The study was carried out in normal school children in Raipur city to determine pulmonary functions in the age group 12-14 years.
Background
Spirometry is a important tool to assessment of lung function by evaluating forced vital capacity (FVC), forced expiratory volume in first second (FEV1), the ratio of FEV1 to FVC, peak expiratory flow rate (PEFR). Indian norms for spirometric test values are different from Western and other norms. Even within the country the test values differ between different regional and ethnic groups.
Material Methods
This is Cross sectional analytical observational study. 267 subjects were evaluated through pulmonary function test by Spirometry. Results were expressed as Mean ± SEM (Standard error of mean). Pearson’s correlation coefficient(r) is calculated between dependent and independent variables. Prediction equations were developed using the multiple linear regression procedure.
Results
In our study spirometric parameters for boys were higher than girls. All Spirometric values were found to increase in relation to increase in height in both girls and boys except for the FEV1 %. All Spirometric values were found to increase in relation to increase in Age (12 to 14 years) in both girls and boys except for the FEV1 %.
Conclusion
This study shows, all the independent variables (age, weight, height and BSA) have linear positive correlation with lung function parameters, both for boys and girls. Height is the most important and reliable single independent variable. Regression equations for spirometry variables for region have been developed.
KEY WORDS
Forced Vital Capacity (FVC), Forced Expiratory Volume in First Second (FEV1), Peak Expiratory Flow Rate (PEFR)

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veerbhadra_hypothermia

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Comparative study of various techniques to measure neonatal hypothermia

Veerbhadra CD1, Ambey R2, Gaur A3, Singwekar AG4
Resident1, Assistant Professor2, Associate Professor3, Professor4

1-4Department of Paediatrics, G R Medical College Gwalior, M P, India
ABSTRACT
Aim
To compare different available modes (forehead infrared thermometer ,axillary temperature by thermister probe and digital thermometer, with axillary temperature by gold standard mercury thermometer) of temperature measurement in neonatal hypothermia in order to come out with most accurate one among them.
Background
Hypothermia is very important in essential newborn care as it can lead to mild to severe life threatening complication, so detecting hypothermia takes important role in its management.
Material Methods
Study Design: Setting was Neonatal Intensive Care Unit (Level 3), Kamla Raja Hospital ,Gajra Raja Medical College, Gwalior, India. A Prospective study of one year (July 2010 - June 2011 ) duration done with 1690 admissions of neonatal intensive care unit (full fill inclusion criterion ) by applying Fisher test on 2×2 contingency table to get sensitivity , specificity , positive predictive value , negative predictive value and accuracy of above 4 methods by STATA 9.1 (STATA corporation, college station , TX, USA).
Results
Digital thermometer is having highest sensitivity (99.1%), specificity (98.1%), positive predictive value (97.4%) and negative predictive value(99.3%).
Conclusion
Digital axillary thermometry is the best alternative to mercury thermometer for measuring neonatal temperature compared with axillary temperature by thermister probe and forehead temperature by infrared thermometer.
KEY WORDS
Neonatal temperature recording, Digital thermometer, Forehead infrared thermometer, mercury thermometer, Thermister probe.

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