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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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1.  BRIEF COMMUNICATION
Management of Breast Hypertrophy: Our Experience
Prema Dhanraj, MS Mahesh, N Naveen, K Ramesh Babu, Rajashekar Jade
[Year:2015] [Month:January-March] [Volume:1 ] [Number:1] [Pages:25] [Pages No:21-25] [No of Hits : 607]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0007 | FREE

ABSTRACT

Breast hypertrophy and sagging of the breast are two different benign disorders of breast that can occur during various stages of women’s life from adolescence to menopause. A woman can seek a plastic surgeon for breast reduction for reasons both physical and psychological. Breast reduction surgery or reduction mammoplasty is a plastic surgical procedure by which the sizes of large breasts are reduced. During this procedure, excess skin, fat and breast tissue are removed. The procedure recreates a breast with the desired appearance, contour and volume. Breast lift operation/mastopexy is a procedure where only skin is removed with repositioning of the nipple higher on the chest wall and is the procedure of choice in small but sagging breast.
We present a series of five cases, two presenting with virginal hypertrophy, one with gestational hypertrophy and other two with postmenopausal sagging and hypertrophy. Four patients underwent reduction mammoplasty and one patient underwent mastopexy. None of our patients complained of any problems and were satisfied with the results.

Keywords: Breast hypertrophy, Reduction mammoplasty, Mastopexy.

How to cite this article: Dhanraj P, Mahesh MS, Naveen N, Babu KR, Jade R. Management of Breast Hypertrophy: Our Experience. J Med Sci 2015;3(1):21-25.

Source of support: Nil

Conflict of interest: None

 
2.  ORIGINAL RESEARCH
A Clinical Audit of Quality Indicators in Anesthesia Practice
Maya Nadakarni, Desi Prakruthi, Sahajananda H
[Year:2015] [Month:July-September] [Volume:1 ] [Number:3] [Pages:14] [Pages No:47-51] [No of Hits : 536]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0014 | FREE

ABSTRACT

Background: To measure and monitor the quality of care in anesthesia, which is lacking in India. The objective of this audit was to formulate a set of quality indicators and use them to audit our daily anesthetic practice.

Materials and methods: We applied eight quality indicators to audit 4,147 medical records of our hospital. We measured the quality of anesthesia care in the preoperative, intraoperative, and postoperative period by collecting and analyzing the various data.

Results: We found out the weaker areas where quality of anesthesia care could be improved. In 160 (3.85%) patients, preanesthetic check-up was lacking; in 569 (13.72%) patients, anesthesia plan was modified on the day of surgery. A total of 378 (9.11%) patients were ventilated following anesthesia. A total of 123 (2.96%) patients were in recovery room for more than the normal expected time and 187 (4.50%) patients were shifted to the ICU for further intensive care. There was no mortality in our audit findings.

Conclusion: In this audit, we found several areas where improvements could be done. In future, the quality of anesthesia services will be monitored by quality assurance programs using quality indicators, which will improve the perioperative outcome. A dramatic change is expected in anesthesia practice for the betterment of patient care. At present we should try to adopt these practices and improve anesthesia delivery services.

Keywords: Anesthesia, Monitoring, Quality indicators.

How to cite this article: Nadakarni M, P Desi, H Sahajananda. A Clinical Audit of Quality Indicators in Anesthesia Practice. J Med Sci 2015;1(3):47-51.

Source of support: Nil

Conflict of interest: None

 
3.  REVIEW ARTICLE
Touching Greater Horizons in the Management of Diabetic Neuropathy: Epalrestat in Advanced Role
Manish Maladkar, Chitra Tekchandani, Aakash Siddhanti
[Year:2016] [Month:January-March] [Volume:2 ] [Number:1] [Pages:25] [Pages No:9-14] [No of Hits : 167]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0025 | FREE

ABSTRACT

The major factor contributing to the pathogenesis of type 2 diabetes and its various complications is insulin resistance (IR). The lesser known and interesting element that has been unfolding is about the existence of IR in neurons associated with disrupted phosphatidylinositol 3-kinase/protein kinase B (PI3k/Akt) pathway with subsequent adverse effect on nerve function. Hyperactivity of polyol pathway is identified as the prime convincing mechanism elucidating the metabolic link between hyperglycemia and nerve dysfunction. Additionally, in the polyol trail, reduction in glutathione leads to redox imbalance and eventually neuropathy.
Epalrestat, the aldose reductase inhibitor (ARI), has been extensively evaluated for its efficacy and safety in the treatment of diabetic neuropathy. Addition of methylcobalamin to Epalrestat therapy has shown faster and better resolution of neuropathy. Epalrestat-induced activation of PI3k/Akt signaling pathway promotes proliferation and migration of endothelial cells, with potential benefits of improved blood supply to damaged nerves. Further evidences reveal upregulation of nerve growth factor (NGF) by Epalrestat that has resulted in wound healing in diabetic patients. Increase in nerve fiber length is the other compatible finding with Epalrestat therapy in patients suffering from diabetic neuropathy. Moreover, Epalrestat has demonstrated significant protection against oxidative stress via induction of glutathione biosynthesis.

Keywords: Diabetic neuropathy, Epalrestat, Glutathione, Methylcobalamin, Nerve growth factor, Neuronal insulin resistance, Oxidative stress, Phosphatidylinositol 3-kinase/protein kinase B (PI3k/Akt) pathway.

How to cite this article: Maladkar M, Tekchandani C, Siddhanti A. Touching Greater Horizons in the Management of Diabetic Neuropathy: Epalrestat in Advanced Role. J Med Sci 2016;2(1):9-14.

Source of support: Nil

Conflict of interest: None

 
4.  CASE REPORT
Nitrobenzene along with Organophosphorous Compound Poisoning
Veeresh Hosur, GS Karthik, S Rangalakshmi, H Sahajananda
[Year:2016] [Month:July-September] [Volume:2 ] [Number:3] [Pages:13] [Pages No:56-58] [No of Hits : 106]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0039 | FREE

ABSTRACT

Major cause of premature mortality globally and 113,914 suicides are recorded annually from India. Variety of chemicals have been used. Nitrobenzene is used as a pesticide. Here, we report a case of acute poisoning with nitrobenzene which is an organic compound, where clinical evaluation and timely management, helped to save a life.

Keywords: Acute methemoglobinemia, Atropine, Intermediate syndrome, Methylene blue, Nitrobenzene poisoning, Organophosphorous poison, Pralidoxime.

How to cite this article: Hosur V, Karthik GS, Rangalakshmi S, Sahajananda H. Nitrobenzene along with Organophosphorous Compound Poisoning. J Med Sci 2016;2(3):56-58.

Source of support: Nil

Conflict of interest: None

 
5.  ORIGINAL ARTICLE
Study of Clinical Profile of Community-acquired Pneumonia with Special Reference to C-reactive Protein and Procalcitonin Levels
KC Prajwal, MV Krishna, Sharanappa Patil
[Year:2016] [Month:April-June] [Volume:2 ] [Number:2] [Pages:17] [Pages No:27-30] [No of Hits : 81]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0030 | FREE

ABSTRACT

Introduction: Pneumonia is defined as an infection of the pulmonary parenchyma. Despite being the cause of significant complications and deaths, pneumonia is often wrongly diagnosed, mistreated, and underestimated. The incidence rates are highest in old-aged patients. In the current prospective observational study, we intend to study the utility of procalcitonin (PCT) level and serum C-reactive protein (CRP) level for diagnosing pneumonia.

Design: Prospective observational studies. Materials and methods: The study was conducted in RajaRajeswari Medical College and Hospital, Bengaluru, during the period extending from June to May 2014. Eighty patients, aged more than 18 years, with diagnosis of pneumonia were included in the study. Serum PCT levels were calculated using BRAHMS PCT Kryptor immunofluorescent assay (Biomerieux, France). Other routine investigations, including CRP, sputum culture, and endotracheal secretions cultures, were done. Chisquare analysis was done to assess its prognostic and diagnostic significance. Data were analysed with Statistical Package for the Social Sciences (version 17.0 for Windows).

Results and conclusion: C-reactive protein was positive in 60 (75%) of the patients, and PCT was positive in 45 (56.25%) patients; 28 patients had PCT levels 0.5 to 1.5 ng/mL, 1 (3.6%) had CRP <6 mg/mL, 27 (96.4%) had CRP >6 mg/mL; 17 patients had PCT values >1.5 ng/mL and CRP was positive in all patients (p < 0.001). Streptococcus pneumonia was the most common and isolated in 8 (10%) patients. C-reactive protein is a useful and better adjuvant in the diagnosis of community-acquired pneumonia (CAP). Positive PCT levels indicate a bacterial etiology for pneumonia. A high PCT level is a poor prognostic indicator and is associated with a higher mortality.

Keywords: Biomarker, Pneumonia, Procalcitonin, Prognosis, Prohormone.

How to cite this article: Prajwal KC, Krishna MV, Patil S. Study of Clinical Profile of Community-acquired Pneumonia with Special Reference to C-reactive Protein and Procalcitonin Levels. J Med Sci 2016;2(2):27-30.

Source of support: Nil

Conflict of interest: None

 
6.  CASE REPORT
Bilateral Femoral Neck Fracture due to Electric Shock
Rahul Peswani, BL Chandrakar, Rakesh Thakkar
[Year:2016] [Month:January-March] [Volume:2 ] [Number:1] [Pages:25] [Pages No:18-20] [No of Hits : 78]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0027 | FREE

ABSTRACT

Simultaneous bilateral fractures of the femoral neck are rare injuries in patients without underlying pathological conditions. We report a case of a 50-year-old male, who sustained bilateral femoral neck injury resulting from electric shock with 440 V of direct current. Bilateral femoral neck fracture is rare. Bilateral femoral neck fracture due to electric shock is even rarer. This case report highlights bilateral femoral neck fracture without primary and secondary bone disease. Late presentation and unclassified pattern of fracture are the other features.

Keywords: Bilateral adductor tenotomy, Bilateral femoral neck fracture, Electric shock injuries, Violent muscle contraction.

How to cite this article: Peswani R, Chandrakar BL, Thakkar R. Bilateral Femoral Neck Fracture due to Electric Shock. J Med Sci 2016;2(1):18-20.

Source of support: Nil

Conflict of interest: None

 
7.  CASE REPORT
A Rare Case of Nocturnal Urinary Incontinence and Menuria after Lower Segment Cesarean Section
Priyakshi Chaudhry, Deepti S Shrivastava, Sindhu Bhute, Suhas Jajoo
[Year:2016] [Month:January-March] [Volume:2 ] [Number:1] [Pages:25] [Pages No:23-25] [No of Hits : 69]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0029 | FREE

ABSTRACT

Misgav Ladach technique for lower segment cesarean section (LSCS) is considered advantageous universally, but debate still continues about nonclosure in layers and further consequences; hence, careful selection of cases and intraoperative decision of closure in layers is important. The classical Youssef’s syndrome comprises cyclic hematuria, amenorrhea, menuria, and complete urinary continence in a patient who had LSCS. Hereby, we present a case report of a woman who suffered with chronic pelvic pain, menuria, and nocturnal eneuresis after her LSCS for obstructed labor, although not exactly the same as Youssef syndrome but rare in occurrence and relieved after adhesiolysis and gonadotropin-releasing hormone (GnRH) analog therapy.

Keywords: Menuria, Nocturnal eneuresis, Obstructed labor.

How to cite this article: Chaudhry P, Shrivastava DS, Bhute S, Jajoo S. A Rare Case of Nocturnal Urinary Incontinence and Menuria after Lower Segment Cesarean Section. J Med Sci 2016;2(1):23-25.

Source of support: Nil

Conflict of interest: None

 
8.  CASE REPORT
Multidetector Computed Tomography Evaluation of Juvenile Nasopharyngeal Angiofibroma
Nayana R Somayaji, Rahul Talwade, Anil K Shukla, V Seetha Pramila, R Nagesh, GU Pravin
[Year:2016] [Month:April-June] [Volume:2 ] [Number:2] [Pages:17] [Pages No:38-41] [No of Hits : 62]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0033 | FREE

ABSTRACT

Juvenile nasopharyngeal angiofibroma is relatively uncommon accounting for 0.5% of all head and neck tumors occurring exclusively in adolescent males. It is a microscopically benign, yet locally aggressive tumor with high rates of recurrence and results in severe morbidity. Diagnosis requires high index of suspicion as it mimics other sinonasal conditions, like sinonasal polyp, neurofibroma, nasopharyngeal carcinoma, etc. A case of 14-year-old boy with history of swelling in the right cheek, bilateral nasal obstruction, epistaxis, and watering from right eye referred for multidetector computed tomography is reported in this study.

Keywords: Juvenile nasopharyngeal angiofibroma, Multidetector computed tomography, Nasal obstruction, Pterygopalatine fossa, Sinonasal polyp.

How to cite this article: Somayaji NR, Talwade R, Shukla AK, Pramila VS, Nagesh R, Pravin GU. Multidetector Computed Tomography Evaluation of Juvenile Nasophar yngeal Angiofibroma. J Med Sci 2016;2(2):38-41.

Source of support: Nil

Conflict of interest: None

 
9.  CASE REPORT
A Case of Cyclopentolate Induced Psychosis
Vishnu Vardhan, Sharath Vishwaraj
[Year:2016] [Month:April-June] [Volume:2 ] [Number:2] [Pages:17] [Pages No:36-37] [No of Hits : 57]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0032 | FREE

ABSTRACT

Cyclopentolate is the cycloplegic drug of choice in children older than 1 year. Though rare, if absorbed systematically, it is known to cause Central Anticholinergic Syndrome. Children are especially prone due to their lower body weight. Symptoms and signs in children include flushing, tachycardia, feeding intolerance, seizures, and drowsiness. We may also see behavioral changes and transient psychotic reactions. We describe a case in which the patient had acute behavioral and psychotic manifestation following instillation of cyclopentolate.

Keywords: Central anticholinergic syndrome, Cyclopentolate, Psychosis.

Key message: Central Anticholinergic Syndrome, though rare, can occur following topical instillation of cyclopentolate and other mydriatic agent. Clinicians using cyclopentolate must be aware of it.

How to cite this article: Vardhan V, Vishwaraj S. A Case of Cyclopentolate Induced Psychosis. J Med Sci 2016;2(2):36-37.

Source of support: Nil

Conflict of interest: None

 
10.  CASE REPORT
Methylphenidate-induced Obsessive Compulsive Disorder in Attention Deficit Hyperactivity Disorder
Amar Bavle, Sharath Vishwaraj
[Year:2016] [Month:January-March] [Volume:2 ] [Number:1] [Pages:25] [Pages No:21-22] [No of Hits : 56]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10045-0028 | FREE

ABSTRACT

Introduction: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders. It is most often treated with methylphenidate (MPH). A 6-yearold male with ADHD was started on MPH. He developed severe obsessive-compulsive disorder (OCD), which lasted for 1 day and was self-limiting. There was complete remission on stopping MPH, without any specific treatment for OCD.

Keywords: Attention def icit hyperactivity disorder, Methylphenidate, Obsessive-compulsive disorder, Side effects.

How to cite this article: Bavle A, Vishwaraj S. Methylphenidateinduced Obsessive Compulsive Disorder in Attention Deficit Hyperactivity Disorder. J Med Sci 2016;2(1):21-22.

Source of support: Nil

Conflict of interest: None

 
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