AMEI's Current Trends in Diagnosis & Treatment

Register      Login

Table of Content

2021 | July-December | Volume 5 | Issue 2

EDITORIAL

Richa G Thaman

Autoregulation of FA Competence by Medical Education Teachers

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:3] [Pages No:63 - 65]

   DOI: 10.5005/jp-journals-10055-0138  |  Open Access |  How to cite  | 

ORIGINAL RESEARCH ARTICLE

Indermeet Mangat, Parmeet Kaur, Bikramjit Singh

High-resolution Ultrasonography of Meniscal Pathologies: Can It Serve as First-line Imaging Modality in Comparison to Magnetic Resonance Imaging

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:5] [Pages No:66 - 70]

Keywords: Lateral meniscus, Medial meniscus, Meniscal tears, Magnetic resonance imaging, Sonography

   DOI: 10.5005/jp-journals-10055-0132  |  Open Access |  How to cite  | 

Abstract

Purpose: The knee joint injury is very usual in our daily life and many sports activities. As the attachment site for multiple tendons, ligaments, and associated bursae, knee disorders are indeed very common. The purpose of this study is to examine the effectiveness of sonography in the diagnosis of meniscal pathologies employing magnetic resonance imaging (MRI) correlation. Methods: In this prospective study, 50 participants with knee injuries were referred for sonography and MRI in our department. A high-resolution sonography examination was combined with an examination of the contralateral normal knee, and then MRI was used to confirm the diagnosis. Results: The study includes 50 participants with an average age of 37 years. The majority of participants were in the age-group of 21–30 years, with a maximum of 18 (36%). In diagnosing meniscal pathologies, sonography and MRI had a high level of agreement (k value = 0.674). Conclusion: Sonography is a valuable tool for evaluating patients with knee injuries and can be used as a primary imaging investigation because it allows for a quick, interactive, and cost-effective examination of meniscal injuries in the knee joint. MRI should be used to confirm the findings of sonography in meniscal pathologies.

ORIGINAL RESEARCH ARTICLE

Chetna Joshi, Adeeba Saleem, Vikram Khare, Darakshan Saifi, Supriya Naren, Aamir Malick Saifi

Comparison and Evaluation of Efficacy of Soft Splint, Transcutaneous Electric Nerve Stimulation and Ultrasound in Temporomandibular Disorders

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:9] [Pages No:71 - 79]

Keywords: Myofascial pain, Transcutaneous electric nerve stimulation, Ultrasound

   DOI: 10.5005/jp-journals-10055-0128  |  Open Access |  How to cite  | 

Abstract

Introduction: Myalgia is easy to diagnose and difficult to treat. There are various treatment modalities which include use of analgesics, hard splint, surgery, etc. Methodology: The present study aimed to compare and evaluate the efficacy of ultrasound, TENS, and splint in patients with myalgia. A total of 33 patients were included in the study. Three groups were made. Group I consisted of 11 patients of ultrasound, group II had 11 patients of TENS, and group III had 11 patients of soft splint. Pain, muscle tenderness, and mouth opening were the parameters for the study. Pain and muscle tenderness were measured on VAS and mouth opening was measured using vernier calliper. Patients coming with pain in facial area were randomly allocated into three groups. Ultrasound and TENS therapy were given for the period of 1 week and splint therapy for 1 month. Patients with splint were asked to wear splint at night to check for any parafunctional activity for a period of 1 month. Results: Follow-up was done on 0th day, 7th day, 30th day, and 90th day. Results showed that 80% of patients in ultrasound group were relieved of pain when compared to TENS (45%) and splint (36%). The efficacy of ultrasound in alleviating pain is highest on 30th day when compared to TENS and splint. Conclusion: Thus with the present study it can definitely be concluded that ultrasound, TENS, and splint can be the choice of treatment in treating patients with pain in facial muscles.

ORIGINAL RESEARCH ARTICLE

Amrit Kaur Pelia, Tejinder Kaur, Sarika Kapila, Amit Dhawan, Ramandeep Singh Bhullar

Efficacy of Isoamyl 2-Cyanoacrylate Tissue Adhesive and 3-0 Vicryl Rapide Sutures in Impacted Mandibular Third Molar Surgery: A Comparative Study

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:5] [Pages No:80 - 84]

Keywords: 3-0 Vicryl rapide suture, Isoamyl 2-cyanoacrylate tissue adhesive, Third molar surgery, Wound closure, Wound healing

   DOI: 10.5005/jp-journals-10055-0129  |  Open Access |  How to cite  | 

Abstract

Aim: The present study was undertaken to compare the efficacy of isoamyl 2-cyanoacrylate tissue adhesive with 3-0 vicryl rapide suture for wound closure after the removal of impacted mandibular third molar. Materials and methods: In this prospective study done in 2018–2020, sample consisted of 60 patients with unilateral impactions divided in two groups equally. In group I, wound closure was done with tissue adhesive and in group II with 3-0 vicryl rapide suture. Patients were evaluated for pain, swelling and trismus preoperatively, immediate postoperatively, postoperative day 2 and 7. Bleeding was assessed immediate postoperatively, postoperative day 2 and 7. Healing was assessed on postoperative day 2 and 7. Observations: Statistically significant difference was observed in terms of pain on postoperative day 2 and 7 between both the groups (p value—0.028* and 0.002*). In the immediate postoperative period, there was statistically highly significant difference in bleeding between the two groups (p value—0.000**). Statistically significant difference was also observed in terms of wound healing on postoperative day 2 and 7 (p value—0.011* and 0.024* respectively). Statistically significant difference was observed for time of closure and total number of rescue analgesic taken between two groups (p value—0.000** and 0.000**, respectively). Conclusion: This study concluded that vicryl rapide suture is an optimal alternative for wound closure after removal of impacted mandibular third molar as compared to tissue adhesive.

ORIGINAL RESEARCH ARTICLE

Sunita Arora, Arshpuneet Kaur, Mandeep S Khurana, Jaskiran K Sandhu

To Study the Role of Urinary Uric Acid to Creatinine Ratio as a Marker of Perinatal Asphyxia and Its Severity in Newborns

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:4] [Pages No:85 - 88]

Keywords: Asphyxia, HIE (Hypoxic–ischemic encephalopathy), UUA/Cr (Urinary uric acid to creatinine ratio)

   DOI: 10.5005/jp-journals-10055-0133  |  Open Access |  How to cite  | 

Abstract

Objective: To compare urinary uric acid and creatinine ratio (UUA/Cr) among asphyxiated and nonasphyxiated neonates. Background: Perinatal asphyxia is the leading cause of neonatal morbidity and mortality. The last few decades have seen many improvements in modern medicine but still, there is a lack of easily available biochemical markers to diagnose perinatal asphyxia more so in institutional deliveries. Study design: Cross-sectional, comparative study. Setting: NICU and postnatal wards of tertiary care center. Participants: Forty asphyxiated and 40 healthy term newborns were enrolled in the study. Two milliliters of cord arterial blood was collected for a blood gas analysis in asphyxiated neonates only. Spot urine samples were collected within the first 24 hours of life in both asphyxiated and nonasphyxiated groups and analyzed for UUA/Cr ratio. Results: The mean UUA/Cr ratio was found to be higher in asphyxiated (2.41 ± 0.58) than in nonasphyxiated neonates (1.58 ± 0.17) (p <0.001). There was a positive correlation between the UUA/Cr ratio and the severity of hypoxic–ischemic encephalopathy among asphyxiated neonates (p <0.001). A negative correlation was found of UUA/Cr ratio with Apgar score and umbilical cord blood pH. The cutoff value of the UUA/Cr ratio of 1.36 has 97.5% sensitivity, 100% specificity, 100% positive predictive value, 97.5% negative predictive value, and 98.7% accuracy. Conclusion: This ratio can be used as a reliable diagnostic marker to detect perinatal asphyxia in neonates where adequate birth history is not available.

ORIGINAL RESEARCH ARTICLE

Avinash Tiwari, Anterpreet Arora, Shyamal Koley

LH-type Distribution in Diabetes Mellitus Patients and Nondiabetics

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:3] [Pages No:89 - 91]

Keywords: ABO typing, Diabetes mellitus, LH specificity, LH typing

   DOI: 10.5005/jp-journals-10055-0136  |  Open Access |  How to cite  | 

Abstract

Introduction: Diabetes mellitus is a major health disorder which is proving to be epidemic globally with alarming rate. The current study was done to find the of LH-type distribution in the patients of diabetes mellitus type-2. Methods: The samples of blood of the diagnosed cases of diabetes mellitus type-2 (n = 100) were randomly collected from the laboratory of Department of Physiotherapy, Guru Nanak Dev University, Amritsar, India. They were typed for the both ABO and LH blood groups and compared with an equal number (n = 100) of appropriate controls. Results: It was specified that patients suffering with diabetes mellitus of type-2 in comparison with the normal population considered as controls were overwhelmingly LH-negative with p-value highly significant (p <0.001) and that this was chiefly noticeable in diabetes mellitus patients with A and B blood groups. Conclusion: The persistence of hyperglycemic environment of the erythrocyte membrane in diabetes mellitus patients and saturation of the membrane receptors with glucose molecules leave less availability of receptors to get bound with the anti-LH lectin Erythrina lithosperma. So we have come to the conclusion from the results of the current study that the patients suffering from diabetes have blood group LH-negative in more individuals in comparison with the nondiabetics.

REVIEW ARTICLE

Rahat Kumar, Avlokita Sharma, Pratyush Sharma, Richa Thaman

Role of Artificial Intelligence in Diagnosis and Treatment of Various Medical Diseases in Patients

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:7] [Pages No:92 - 98]

Keywords: Algorithms, Artificial intelligence, Machine intelligence, Therapeutics

   DOI: 10.5005/jp-journals-10055-0131  |  Open Access |  How to cite  | 

Abstract

Artificial intelligence (AI) is defined as the capability of a machine to imitate intelligent human behavior in general. With a tremendous rise in computer capability the artificial intelligence by using various algorithms is helpful in helping medical experts for better diagnosis and treatment. Humans’ mind first plans a goal and then requires AI to achieve this goal through supervised and unsupervised learning. The various algorithms used in AI are the artificial neural network, k-nearest neighbor, support vector machine, decision trees, regression analysis classifiers, Bayesian network, random forest, discriminant analysis. AI has various benefits as in breast cancer diagnosis and staging in whole-slide images histopathology study on lung adenocarcinoma and squamous cell carcinoma patients, faster interpretation, and diagnosis in the medical fields in quick diagnosis and treatment of cardiovascular disorders, psychiatric disorders, gastroenterology, surgery, ophthalmology, etc. The more useful is the interpretation and planning of the regimens for cancer diagnosis and treatment. However, AI lacks holistic approach of management and so can never replace treatment by humane methods but AI can be a useful supplement for doctors for planning therapeutics.

CASE REPORT

Sangeeta Pahwa, Sandeep Kaur

A Rare Case of Unsafe Abortion in COVID Times

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:3] [Pages No:99 - 101]

Keywords: Fetal head, Hysterectomy, Ileostomy, Unsafe abortion

   DOI: 10.5005/jp-journals-10055-0126  |  Open Access |  How to cite  | 

Abstract

A 29-year-old female, Para 3 Live2 with previous three cesarean sections presented in septic shock after undergoing unsafe abortion for intrauterine fetal demise at 5 months of amenorrhea by untrained person, diagnosed as intrauterine fetal demise at 5 months of amenorrhea. After the procedure, the patient underwent ultrasound which revealed fetal head in peritoneal cavity and perforation of the anterior uterine wall. On laparotomy, after retrieving the head from peritoneal cavity, perforation was found to be irreparable as well as the cecum, colon, and uterus were adherent. During hysterectomy, the cecum got perforated, cecal repair done followed by ileostomy. The patient was discharged in satisfactory condition.

CASE REPORT

Manavdeep Kaur, Parminder Singh

Acute Dengue Myositis: A Case Report

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:2] [Pages No:102 - 103]

Keywords: Creatine kinase, Flavivirus, Myositis

   DOI: 10.5005/jp-journals-10055-0125  |  Open Access |  How to cite  | 

Abstract

Dengue is an arthropod-borne viral infection caused by genus flavivirus. The most important flaviviruses that cause fever and myalgia syndrome are dengue viruses 1–4. Dengue viral infection causes many complications such as pneumonia, bone marrow failure, hepatitis, retinal hemorrhages, maculopathy, and myositis. Neurologic complications such as encephalitis, Guillain–Barre syndrome, phrenic neuropathy, subdural hematoma, and cerebral vasculitis are less common. Limited case series have indicated the possibility of skeletal muscle invasion causing myositis. We present a case of a 54-year-old male who presented with high-grade fever and muscular pain in both upper and lower limbs. His serum creatine kinase (CPK) value was 619 U/L. He was managed conservatively and low-dose corticosteroids were given. Our case highlights the severe muscle involvement in dengue infection which is a rare entity.

CASE REPORT

Sukhpreet Kaur, Reena Sood, Swati Sharma

Intrauterine Twin Gestation with Tubal Ectopic: A Rare Spontaneous Heterotopic Pregnancy

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:3] [Pages No:104 - 106]

Keywords: Heterotopic, Intrauterine twin gestation, Pregnancy

   DOI: 10.5005/jp-journals-10055-0130  |  Open Access |  How to cite  | 

Abstract

Heterotopic pregnancy is a condition in which an ectopic pregnancy coexists with an intrauterine pregnancy. It can be a life-threatening condition and can be easily missed, with the diagnosis being overlooked. A very high degree of suspicion is required to reach the diagnosis. Some of the known risk factors associated are assisted reproductive techniques, infertility, and previous history of pelvic inflammatory disease. The diagnosis is still challengeable in patients with heterotopic pregnancy without identifiable risk factors and with spontaneous pregnancy and those who usually attend first with uncomplicated heterotopic pregnancy, are usually overlooked.

CASE REPORT

Hargurdas Singh, Gurinder Mohan, Jivtesh Preet Singh, Akansha , Kapeesh Khanna

A Rare Case of Left Atrial Mass with Nonhemorrhagic Infarct in a Patient of Inherited Thrombophilia

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:3] [Pages No:107 - 109]

Keywords: Cardioembolic stroke, Intracardiac mass, Nonhemorrhagic infarct, Protein S

   DOI: 10.5005/jp-journals-10055-0134  |  Open Access |  How to cite  | 

Abstract

Inherited thrombophilias are a group of inheritable conditions that predispose individuals to venous or arterial thrombosis like deficiencies of the endogenous anticoagulants protein S, protein C, antithrombin, etc. Protein S deficiency is associated with a well-documented risk of venous thromboembolism but arterial thrombotic and thromboembolic events are very rare. Intracardiac masses are mass lesions present in either ventricles or atrium and include benign or malignant cardiac tumors, thrombus, or vegetation as well as infectious and nonbacterial thrombotic or marantic endocarditis. Cardioembolic stroke has been reported previously in patients with intracardiac masses like atrial myxoma, cardiac sarcoma, mitral stenosis with atrial fibrillation but very rare in Protein S deficiency. We report a case of embolic ischemic stroke due to intracardiac mass in a known case of protein S deficiency.

CASE REPORT

Arvinder Singh, Manjeet Kaur, Sumanjeet Kaur

Neurofibromatosis II: A Disease of Multicentric Central Nervous System Masses

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:4] [Pages No:110 - 113]

Keywords: Magnetic resonance imaging, Neurofibromatosis, Schwannomas

   DOI: 10.5005/jp-journals-10055-0137  |  Open Access |  How to cite  | 

Abstract

Neurofibromatosis (NF) is an autosomal dominant disorder with two reported types. Neurofibromatosis type I presents with the cutaneous manifestations and involves astrocytes and the neurons. Neurofibromatosis II involves meninges and the Schwann cells in the central nervous system with presentation as bilateral schwannomas, multiple meningiomas, and cord ependymomas. Our present case was presented with bilateral hearing loss and chronic headache. MRI of the brain showed bilateral vestibular schwannomas extending up to bilateral cerebellopontine angle cisterns, mass lesion in relation to the right trigeminal nerve, multiple extra-axial dura-based mass lesions, posterior fossa mixed signal lesion, optic nerve sheath tumors, and two intradural intramedullary cervical cord ependymomas with surrounding cord edema.

CASE REPORT

Sanjeev K Saggar, Richa G Thaman, Kawalinder K Girgla

Sensory Chronic Inflammatory Demyelinating Polyneuropathy—A Variant of Chronic Inflammatory Demyelinating Polyneuropathy: A Rare Case Report

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:2] [Pages No:114 - 115]

Keywords: Chronic inflammatory demyelinating polyneuropathy (CIDP), Compound muscle action potential (CMAP), Guillain-Barre syndrome (GBS), Nerve conduction studies (NCS), Sensory nerve action potential (SNAP)

   DOI: 10.5005/jp-journals-10055-0135  |  Open Access |  How to cite  | 

Abstract

Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) is progressive, sometimes relapsing disorder of peripheral nerves. It usually develops over months or years. Abrupt onset resembling Guillain-Barre syndrome (GBS) can occur and symptoms can persist. Pure sensory form of CIDP is rare and visualized in just 5% patients of CIDP. Case description: A 44-year-old female presented to emergency department with a 12-month history of progressively worsening numbness in hands, feet, and extreme weakness. She had decreased pin prick and touch sensation in a stocking-glove distribution. Patient's history and nerve conduction study were indicative of sensory variant of CIDP. Discussion: In patients who exhibit pure sensory form of CIDP, clinically sensory deficit predominantly manifests. Moreover, there is decrease in amplitude of sensory nerve action potential (SNAP) in case of sensory nerve, i.e., sural nerve, median sensory nerve, etc. In a given case, nerve conduction studies showed more than 50% decrease in SNAP. A significant decrease in amplitude of SNAP with no motor nerve conduction abnormality is the requirement for the sensory variant of CIDP, which is a characteristic feature seen in the given case.

MEDICAL EDUCATION

Cheng Hwee Ming, See-Ziau Hoe

Untangle the Convoluted NOTs: Learning Renal Physiology

[Year:2021] [Month:July-December] [Volume:5] [Number:2] [Pages:5] [Pages No:116 - 120]

Keywords: Concept, Learning, Negative statements, Renal physiology

   DOI: 10.5005/jp-journals-10055-0127  |  Open Access |  How to cite  | 

Abstract

Using definite, negative statements (the NOTs) can help reinforce and strengthen students’ conception of physiology. A NOT statement implies that there is always the expected homeostatic response or compensatory mechanism that will be observed when the body is challenged and fluctuations occur. These NOT sentences highlight the built-in design, homeostatically wired in integrated physiology. Examples using this “untangle the NOT” teaching and learning approach in renal system are given here. We also created a character, a Japanese medical student, named Miss Take (pun on mistake) to illustrate some of the common misconceptions in understanding renal physiology.

© Jaypee Brothers Medical Publishers (P) LTD.