MGM Journal of Medical Sciences

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2017 | April-June | Volume 4 | Issue 2

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RESEARCH ARTICLE

Shibban K Kaul, Chander P Puri

From the Editors’ Desk

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/mgmjms-4-2-iv  |  Open Access |  How to cite  | 

Abstract

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RESEARCH ARTICLE

Mayur Jain, Alaka Deshpande, Abhijit Pancholi

Goitrous Hypothyroidism: Changing Clinical Profile

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:5] [Pages No:55 - 59]

   DOI: 10.5005/jp-journals-10036-1140  |  Open Access |  How to cite  | 

Abstract

Introduction

On availability of sensitive techniques and better understanding of pathogenesis, hypothyroidism is being detected in early stages in milder forms. The clinical picture is changing in the third millennium compared with what was described 50 years ago.

Materials and Methods

This is a comparative study of goitrous and nongoitrous cases referred for functional evaluation of the thyroid.

Results

One hundred and five cases of goitrous hypothyroidism are studied with hormonal and immunological parameters along with cytology; 80% of the cases were asymptomatic/had protean manifestations. The etiology was autoimmune thyroiditis as evident from raised levels of thyroperoxidase antibodies as well as histopathology.

Conclusion

Autoimmune thyroiditis is the commonest cause of goitrous hypothyroidism, i.e., being increasingly detected in the early stages with milder form. Clinicians need to be aware of the changing profile of goitrous hypothyroidism.

How to cite this article

Deshpande A, Pancholis A, Jain M. Goitrous Hypothyroidism: Changing Clinical Profile. MGM J Med Sci 2017;4(2):55-59.

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RESEARCH ARTICLE

Juhi Mittal, Amita Kashyap, Priyanka Kapoor

Morbidity Profile of People Living in the Vicinity of Mobile Towers, Jaipur City, Rajasthan, India

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:5] [Pages No:60 - 64]

   DOI: 10.5005/jp-journals-10036-1141  |  Open Access |  How to cite  | 

Abstract

Introduction

In 2011, the International Agency for Research on Cancer classified mobile phone radiation as group 2B (possibly carcinogenic). Studies showed association with ailments like drying of the skin and fluid in the eyes, sleep disorder, lack of concentration/memory loss, tumors/cancers. Yet another study showed no significant association. According to data from the International Telecommunication Union, there are over 800 million mobile phone subscribers in India. The approximate estimate of cell towers in Jaipur city is 5,678. Hence, this study was done with the objective to find out morbidity profile of people living in the vicinity of mobile towers in Jaipur; secondary objective was to compare morbidity profile among people exposed to low vs high to moderate (HTM) level of mobile radiation.

Materials and methods

Observational cross-sectional analytical study was planned in four areas of Jaipur city having mobile tower for >10 years: Jawahar Nagar, Sanganer, Vidyadhar Nagar, and Vaishali Nagar. “Detex 189” was used to assess the radiation level, and SF-36 questionnaire was used to assess physical and mental morbidity.

Sample size

The sample size was 720 people, assuming 10% prevalence of radiation-related mental morbidity among people living in the vicinity of mobile tower, at 95% confidence interval with 2.5% absolute allowable error and keeping nonresponse as 25%, which will cover all morbidities.

Results and conclusion

Except for sleep disturbances (p-value = 0.002), there was no significant difference in presenting common health problems and diseases as per level of radiation. Status of physical functioning, bodily pain, vitality, mental health, overall physical component score, and mental component score was found to be significantly low among the people who are exposed to HTM level of radiation (with p-value = 0.000, <0.001, <0.001, < 0.001, 0.028, 0.002 respectively), but it did not limit their day-to-day work performance (p = 0.848), social functioning (0.420), and feeling of general health (p = 0.176). Since people in HTM radiation were significantly older (p = 0.002), these differences need further verification.

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RESEARCH ARTICLE

Kishor Khotkar, Sameer Chaudhari, Pradeep R Jadhav, Yeshwant A Deshmukh

Assessment of Medication Adherence in Type II Diabetic Patients: A Cross-sectional Study

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:5] [Pages No:65 - 69]

   DOI: 10.5005/jp-journals-10036-1142  |  Open Access |  How to cite  | 

Abstract

Introduction

Diabetes is a chronic disorder and requires longterm therapy. Lack of adherence to antidiabetic medication causes suboptimal glycemic control and can lead to treatment failures, development of complications, and increased mortality.

Aim

To study the medication adherence among type II diabetic patients at a tertiary care hospital in Navi Mumbai, Maharashtra, India.

Materials and methods

A cross-sectional, observational study was conducted for a period of 1 year in the Diabetology Clinic in a tertiary care hospital. A total of 100 type II diabetic patients, who were on antidiabetic drug therapy for at least 6 months, were enrolled. Blood glucose was measured and details of drug therapy were noted. Medication adherence was assessed using Morisky Medication Adherence Scale and adherence scores were calculated.

Results

Only 1% had high medication adherence, while 34% had moderate and 65% had low medication adherence. Medication adherence issues identified in type II diabetics were that they forgot to take/bring their medication when traveling, stoppage of medication once glycemic control is achieved, and difficulty in adhering to medication plan. Only 19% were having optimally controlled glycemic levels, whereas 81% were having uncontrolled glycemic levels. Medication adherence scores were lower (reflecting lower adherence) in type II patients with uncontrolled glycemic levels than those having optimally controlled glycemic levels, but this difference was not statistically significant.

Conclusion

Overall, the medication adherence was low in type II diabetic patients. The study shows that to improve medication adherence, better counseling and health education of patients are required.

How to cite this article

Khotkar K, Chaudhari S, Jadhav PR, Deshmukh YA. Assessment of Medication Adherence in Type II Diabetic Patients: A Cross-sectional Study. MGM J Med Sci 2017;4(2):65-69.

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RESEARCH ARTICLE

Nitin Goel, Anshuman Pandey, Alankar K Gupta

Laparoscopic Ventral Hernia Repair: Our Experience in 75 Patients

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:5] [Pages No:70 - 74]

   DOI: 10.5005/jp-journals-10036-1143  |  Open Access |  How to cite  | 

Abstract

Introduction and aim

Laparoscopic ventral hernia repair has become a method of choice for treatment of ventral hernias. It has benefits of shorter hospital stay, less pain, and better cosmetic results, although it continues to remain a challenging procedure, more so in reoperative abdomen and in patients with serious comorbidities. The aim of this study is to evaluate our experience of laparoscopic ventral hernia repair carried out by a single surgical team.

Materials and methods

Ventral hernia, both primary and incisional hernia, was repaired by laparoscopic intraperitoneal onlay mesh (IPOM) repair in 75 patients at a single center within 3 years between January 2013 and December 2016. This was done at a tertiary care center by a single operating team standardizing the procedure and evaluating the learning curve.

Results

Seventy-five patients underwent laparoscopic IPOM repair of which 45 were females and 30 males. The average age was 52 years (35—72) and size of defect ranged from 4 to 12 cm. Dual mesh with expanded polytetrafluoroethylene was used in all patients. Sixty-two cases were incisional hernias, 10 paraumbilical hernias, and 3 umbilical hernias. Of these, 14 were recurrent incisional hernias after open mesh hernioplasty out of which two cases recurred after laparoscopic IPOM. Mean operative time was 60 to 130 minutes. There were no conversions to open technique. The average hospital stay was 2 to 3 days. One patient had postoperative Richter's hernia which was managed by relaparoscopic reduction and transfascial closure of the defect. Three patients had postoperative ileus, three developed minor wound infection, and one patient had seroma. The average follow-up period was around 12 months.

Conclusion

Laparoscopic IPOM ventral hernia repair is a safe procedure in most cases with benefits of rapid recovery and better patient outcomes, more so in large recurrent incisional hernias and in patients with serious comorbidities.

How to cite this article

Pandey A, Masood S, Chauhan S, Gupta AK, Goel N, Noman K. Laparoscopic Ventral Hernia Repair: Our Experience in 75 Patients. MGM J Med Sci 2017;4(2):70-74.

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RESEARCH ARTICLE

Kamakshi Garg, Abhishek Bose, Harmandeep S Chahal, Simran Kaur

Anorectal Surgeries under Local Anesthesia: A Single Center Experience

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:4] [Pages No:75 - 78]

   DOI: 10.5005/jp-journals-10036-1144  |  Open Access |  How to cite  | 

Abstract

Introduction

Surgeries done under local anesthesia are associated with fewer perioperative risks and postoperative complications compared to general or spinal anesthesia. This study was contemplated to test the feasibility and efficacy of local anesthesia in anorectal surgeries.

Materials and methods

This study was done in the Department of Surgery, Dayanand Medical College & Hospital, Ludhiana, Punjab, India. A total of 50 patients presenting with anorectal problems, aged more than 16 years and qualifying for grades I and II of American Society of Anesthesia classification, were selected for the study, after informed consent. A cocktail of bupivacaine hydrochloride 0.5%, lidocaine 2%, sodium bicarbonate and adrenaline, was injected around the perianal skin. Intraoperative parameters, such as blood pressure, pulse, respiratory rate, and intensity of pain were recorded in all the patients. Each patient was closely monitored postoperatively for timing and frequency of analgesic dose, need for bladder catheterization, immediate and delayed complications, time needed for patient to be ambulant and length of hospital stay.

Results

The duration of procedures was 19 ± 6 (mean ± standard deviation) minutes. Patients required analgesic dose after 4.25 ± 1.14 hours, with almost half (48%) requiring it after 6 hours. Majority of patients (82%) were ambulatory within the 1st hour with a meantime of 50 ± 13 minutes. Three cases had complicated postoperative course, with perianal infection and fissure formation.

Conclusion

Local anesthesia is effective and safe for anorectal surgeries, reducing recuperating time and allowing early ambulation. Such day care procedures, requiring lesser monitoring, can emerge as a preferred technique in low-resource settings, considering their cost-effectiveness.

How to cite this article

Chahal HS, Garg K, Bose A, Kaur S. Anorectal Surgeries under Local Anesthesia: A Single Center Experience. MGM J Med Sci 2017;4(2):75-78.

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REVIEW ARTICLE

Deepak Modi, Stacy Colaco, Aiman Lakdawala

Role of Y Chromosome Microdeletions in the Clinical Evaluation of Infertile Males

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:10] [Pages No:79 - 88]

   DOI: 10.5005/jp-journals-10036-1145  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Colaco S, Lakdawala A, Modi D. Role of Y Chromosome Microdeletions in the Clinical Evaluation of Infertile Males. MGM J Med Sci 2017;4(2):79-88.

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REVIEW ARTICLE

Alaka Deshpande, Sadhana A Mandlik, Aparna S Lakhe, Jyoti V Jethe, Vinnet Sinha

Photoplethysmography and Its Clinical Application

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:8] [Pages No:89 - 96]

   DOI: 10.5005/jp-journals-10036-1146  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Jindal GD, Lakhe AS, Jethe JV, Mandlik SA, Jain RK, Sinha V, Deshpande A. Photoplethysmography and Its Clinical Application. MGM J Med Sci 2017;4(2):89-96.

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CASE REPORT

Nandkishor Raut, Saket Sathe

A Case of Fournier's Gangrene of Penis leading to Complete Loss of Penile Urethra

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:3] [Pages No:97 - 99]

   DOI: 10.5005/jp-journals-10036-1147  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Sathe S, Singhania P, Joshi N, Shringarpure S, Raut N, Tiwari N. A Case of Fournier's Gangrene of Penis leading to Complete Loss of Penile Urethra. MGM J Med Sci 2017;4(2):97-99.

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CASE REPORT

Siddharth Shah, Shivali Tripathi

A Case of Postoperative Hypotension in a Patient of Sheehan's Syndrome

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:2] [Pages No:100 - 101]

   DOI: 10.5005/jp-journals-10036-1148  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Tripathi S, Shah S, Kumar S. A Case of Postoperative Hypotension in a Patient of Sheehan's Syndrome. MGM J Med Sci 2017;4(2):100-101.

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CASE REPORT

Priyanka R Patgiri

A Case of Progressive Supranuclear Palsy/Steele—Richardson—Olszewski Syndrome

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:3] [Pages No:102 - 104]

   DOI: 10.5005/jp-journals-10036-1149  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Patgiri PR, Biswas TK. A Case of Progressive Supranuclear Palsy/Steele—Richardson—Olszewski

Syndrome. MGM J Med Sci 2017;4(2):102-104.

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CASE REPORT

Shekhar Patil, Fernaz Sherdiwala, Jeetendra Gavhane, Ishani Nathwani, Ankita Patel, Natesan Rewathi

Cervical—pharyngeal—brachial Variant of Guillain—Barré Syndrome: A Sequel of Leptospirosis

[Year:2017] [Month:April-June] [Volume:4] [Number:2] [Pages:2] [Pages No:105 - 106]

   DOI: 10.5005/jp-journals-10036-1150  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Sherdiwala F, Gavhane J, Nathwani I, Patel A, Rewathi N, Patil S. Cervical—pharyngeal—brachial Variant of Guillain—Barré Syndrome: A Sequel of Leptospirosis. MGM J Med Sci 2017;4(2):105-106.

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