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Volume 10, Number 1--4, January-December 2024
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CASE REPORT

Dennis Henry, Priya K Sharath, Monica Davuluri

Myiasis in Chronic Alcoholic Patient: A Case Report

[Year:2024] [Month:January-December] [Volume:10] [Number:1--4] [Pages:4] [Pages No:1 - 4]

Keywords: Case report, Infestation, Irritant contact dermatitis, Maggots, Myiasis

   DOI: 10.5005/jp-journals-10045-00239  |  Open Access | 

Abstract

Myiasis, a pathological condition characterized by the infestation of viable mammalian tissues through the deposition of eggs or larvae by flies, predominantly of the Diptera order, has exhibited a preeminent prevalence within tropical regions. This phenomenon is notably concomitant with suboptimal personal hygiene practices and occasionally compounded by constraints in manual dexterity. We present a case report of a 48-year-old male of Indian origin who presented with was diagnosed and was under treatment for irritant contact dermatitis but to our surprise, on examination, myiasis infestation was revealed.

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RESEARCH ARTICLE

Veena Vijayashankar, Ravish H Shankaraiah, Sathish Chandra M Ranganatha, Shruthi M Narayanamurthy, Rachana R Annadani

A Cross-sectional Study to Assess the Knowledge Regarding Prevention of Rabies among Adults in an Urban Poor Locality of Bengaluru

[Year:2024] [Month:January-December] [Volume:10] [Number:1--4] [Pages:4] [Pages No:1 - 4]

Keywords: Knowledge, Prevention, Rabies, Urban locality

   DOI: 10.5005/jp-journals-10045-00240  |  Open Access | 

Abstract

Background: Rabies being a 100% fatal disease, is also 100% preventable if timely postexposure prophylaxis (PEP) is taken. The knowledge of adult decision-makers of the family becomes pivotal to understanding their health-seeking behavior so that appropriate actions can be planned to decrease the incidence of human rabies. Objectives: To assess the knowledge about rabies prevention and to determine the factors influencing their knowledge. Materials and methods: A community-based; cross-sectional study was conducted among 86 adults in an urban poor locality of Bengaluru. A House-to-house survey was done and the knowledge of the adult responsible respondents regarding transmission and prevention of rabies was collected using a predesigned, pretested questionnaire in the local language. Data were entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0. Results were expressed using descriptive and inferential statistics. A p < 0.05 was considered statistically significant. Results: The study included 86 adults with their mean age being 34.16 ± 12.12 years. The majority of them were males (67.4%) and most of the study subjects were literate (88.3%). The knowledge regarding transmission of the disease, animals involved, immediate measures to be taken and PEP was low. The factors influencing the knowledge of the study subjects were found to be significantly associated with their literacy status. Conclusion: Knowledge regarding prophylaxis against rabies is inadequate among adults in the urban poor locality. There is a need for regular, responsive, social, and behavior change communication/programs to improve their knowledge on prevention of the disease and increase demand/utilization of essential health services.

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LETTER TO THE EDITOR

Sumaya, Kusuma K Nagaraju, Vijayashankar Shivashankar, Jayashree Harihara Kempachar

An Institutional Perspective on the Application of the International Reporting System for Serous Fluid Effusions

[Year:2024] [Month:January-December] [Volume:10] [Number:1--4] [Pages:1] [Pages No:1 - 1]

   DOI: 10.5005/jp-journals-10045-00243  |  Open Access | 

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CASE REPORT

Kayla C Wands, Amanda Samuel, Andrea Sparks, Keiko Meshida, Gary Wind, Kerrie Lashley, Kieran Wolf, Georgia Dau, Jean B Kalima, Caitlyn Koo, Austin Rasmussen, Betsy Tang, Guinevere Granite

Sciatic Nerve Bilateral High Bifurcation between the Two Heads of the Piriformis Muscle in a 92-year-old White Female Donor: A Case Report

[Year:2024] [Month:January-December] [Volume:10] [Number:1--4] [Pages:4] [Pages No:1 - 4]

Keywords: Case report, Common fibular (peroneal) nerve, High bifurcation of the sciatic nerve, Piriformis syndrome, Popliteal sciatic nerve blocks, Tibial nerve

   DOI: 10.5005/jp-journals-10045-00244  |  Open Access | 

Abstract

The sciatic nerve (SN) is the largest nerve in the human body. It is made-up of ventral rami from lumbar to sacral spinal nerves and ultimately bifurcates into the common fibular (peroneal) nerve (CFN) and the tibial nerve (TN), most frequently just proximal to the popliteal fossa. Together, these nerves provide motor innervation to the lower leg muscles as well as the majority of sensory innervation to the skin of the lower leg. Sciatica is the term used to describe pain caused by compression of the SN, and it classically presents nerve pain, numbness, tingling, and weakness in the affected extremities. This case report details a 92-year-old white female donor who was found to have a bilateral high bifurcation of her SNs that passed between two heads of the piriformis muscle (PM). Identification of this anatomical variation inspired the initiation of a longitudinal research project at the Uniformed Services University of the Health Sciences (USUHS), during which we will analyze 70 cadavers with the objective of describing and quantifying the prevalence of high bifurcation of the SN variations and the involvement of the PM. This and other similar variations of the SN bifurcations have clinical implications, including diagnosis and treatment of sciatica pain, popliteal nerve block administrations, and surgical planning, all of which will be discussed here.

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RESEARCH ARTICLE

KS Manjula, NS Sumantara, Kirtilaxmi Benachinmardi, Prathibha Keshavamurthy, SMR Usha, Sadaf Idris, Chandrakala Channaveeradevaru

SARS-CoV-2-specific Antibody Response Pattern in Human Breast Milk—Post-COVID-19 Vaccination: A Longitudinal Study

[Year:2024] [Month:January-December] [Volume:10] [Number:1--4] [Pages:5] [Pages No:1 - 5]

Keywords: Covishield, Immunoglobulin A, Immunoglobulin G, Lactation, Pregnancy

   DOI: 10.5005/jp-journals-10045-00245  |  Open Access | 

Abstract

Background: The COVID-19 pandemic was controlled by mass vaccination of the population of all countries throughout the world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affected both pregnant and lactating mothers equally. The objectives of the study were to provide information on vaccine-induced breast milk antibody immunoglobulin (Ig) A and IgG response in the serum of mothers and to observe the persistence of these antibodies postvaccination at different periods in lactating women. Materials and methods: The study is a longitudinal, prospective, monocentric study in a tertiary care hospital for the duration of 1 year from March 2022 to 2023. A total of 150 blood and 150 breast milk samples were collected from 50 participants at three different intervals. The samples were collected within 1 week (T1), 6 weeks (T2), and 6 months (T3) from delivery. SARS-CoV-2 specific IgA antibody was detected by enzyme-linked immunosorbent assay (ELISA) using a COVID-19 human IgA ELISA kit from Raybio. ELISA detected SARS-CoV-2 specific IgG antibody using the access SARS-CoV-2 IgG assay. Results: The mean serum concentration of SARS-CoV-2 receptor binding domain-specific IgG (RBD-S-IgG) antibodies [signal-to-cutoff ratio (S/CO)] in vaccinated individuals were 5.35 (6.26), 9.80 (10.68) and 6.89 (8.93) in 1st week, 6th week, and 6th month, respectively. The mean breast milk concentration of SARS-CoV-2 RBD-S-IgA antibodies (units/mL) was 75.93 (106.19), 109.02 (150.50), and 318.23 (443.82) in 1st week, 6th week, and 6th month respectively. Around 78% of study participants had anti-SARS-CoV-2 IgG in their serum, and 88% of them had anti-SARS-CoV-2 IgA in their milk at 1st week. Conclusion: Postvaccination, breastfeeding should be encouraged in lactating mothers, as it will have the additional benefit of providing secretory IgA against SARS-CoV-2.

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REVIEW ARTICLE

Mary Stephen, Jayasri Periyandavan

A Review on Basics of Nystagmus

[Year:2024] [Month:January-December] [Volume:10] [Number:1--4] [Pages:3] [Pages No:1 - 3]

Keywords: Acquired, Congenital, Nystagmus, Oculomotor, Visual function

   DOI: 10.5005/jp-journals-10045-00246  |  Open Access | 

Abstract

Due to its complex etiology and influence on visual function, nystagmus is a complex oculomotor illness that poses a considerable challenge to clinicians and researchers alike. Nystagmus is characterized by involuntary rhythmic eye movements. An extensive summary of the several types of nystagmus, both acquired and congenital, will be given in this article. By providing a thorough analysis of nystagmus, this review helps researchers, doctors, and other healthcare professionals gain a deeper knowledge of the condition and work together to address its complex oculomotor disorders.

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RESEARCH ARTICLE

Shaveta Kataria, Ashina Singla, Priyanka Thandi, Mohit Kumar, Afreen Ali

Entamoeba histolytica: Current Status in All the Suspected Patients Having Gastrointestinal Infections in a Tertiary Care Hospital, Jaipur

[Year:2024] [Month:January-December] [Volume:10] [Number:1--4] [Pages:1] [Pages No:1 - 1]

Keywords: Amoebic serology, Entamoeba histolytica, Gastrointestinal infections, Immunoglobulin G antibody, Stool microscopy

   DOI: 10.5005/jp-journals-10045-00248  |  Open Access | 

Abstract

Background: Intestinal parasites are widely prevalent in developing countries due to poverty, illiteracy, malnutrition, health status, contaminated drinking water resources, etc. The prevalence of amoebiasis varies in the different parts of the world. The diagnosis and conclusion of Entamoeba histolytica infection is difficult. In most developing countries, the diagnosis of Entamoeba infection is made by microscopic examination, which is usually subjective, has low sensitivity and specificity, and is also associated with high false positivity rates. Materials and methods: The present descriptive observational study was planned to study all the suspected patients having gastrointestinal infections attending a tertiary care teaching hospital over a period of 6 months. Fresh stool samples were collected, and macroscopic and microscopic examination was done using a wet mount and iodine mount. The serum samples of routine stool microscopy-positive patients were processed for amoebic serology and were then tested for immunoglobulin G (IgG) antibody levels using an enzyme immunoassay. Results are analyzed statistically. Result: Eight stool samples (1.55%) were found to be positive for E. histolytica/dispar/moshkovskii. Out of these positive patients, five were positive for amoebic serology. The majority of the patients belonged to the 26–36 years age-group, with male-to-female ratio of 1.67/1. A predominance of positive cases was observed in September and October. Conclusion: The prevalence of intestinal parasitic infections is low in the present study. This depicts the improvement in the living conditions, hygiene practices, epidemiological surveillance, and the systematic management of populations.

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RESEARCH ARTICLE

Ashwini Hungund, Nadia Rose, Aditya Kheny

Observational Analysis of Endotracheal Tube Cuff Pressure Changes during Laparoscopic Surgery in Trendelenburg and Reverse Trendelenburg Position

[Year:2024] [Month:January-December] [Volume:10] [Number:1--4] [Pages:5] [Pages No:1 - 5]

Keywords: Cuff pressure, Endotracheal tube, Laparoscopic cholecystostomy, Laparoscopy, Trendelenburg

   DOI: 10.5005/jp-journals-10045-00241  |  Open Access | 

Abstract

Introduction: Although intraoperative monitoring and control of cuff pressure are suggested to reduce the incidence of sore throat and other complications postoperatively, it is not routinely practiced by many anesthesiologists. In this study, we assessed the effect of patient positioning and pneumoperitoneum on endotracheal cuff pressure during laparoscopic surgeries with nitrous oxide (N2O) anesthesia in the Trendelenburg position and reverse Trendelenburg position. Materials and methods: It was a prospective observational study on 96 patients scheduled for laparoscopic cholecystectomy (LAP CHOLE) and laparoscopic hysterectomy (TLH). Cuff pressure was measured at the time of first inflation of cuff up to 20–30 cm H2O, and airway pressure was noted as zero reading. Cuff pressure was measured after 5 minutes subsequently, before pneumoperitoneum, 5 minutes after pneumoperitoneum, and at 15-minute intervals till desufflation and prior to extubation. Results: In our study, the increase in cuff pressure in the Trendelenburg position was 33.92 ± 4.32, 30.19 ± 3.07, and 31.10 ± 3.50, and in the reverse Trendelenburg position was 33.25 ± 3.82, 32 ± 6.45, and 30.81 ± 5.82 after 5, 15, and 30 minutes after the start of pneumoperitoneum, respectively. There was no significant difference between the two groups. The number of deflations was higher during the first 60 minutes for both groups. Our study showed a poor correlation between the airway pressures and ETT cuff pressures, contrary to previous studies. Conclusion: The use of N2O increases the cuff pressure, and ETT cuff pressure continues to increase during the 1st hour of N2O anesthesia. There is no correlation between airway pressures and endotracheal cuff pressure when the airway pressures are maintained within normal limits. So, regular monitoring of endotracheal tube (ETT) cuff pressure should be a part of the safe practice of anesthesia where N2O is used.

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RESEARCH ARTICLE

Ashwini Hungund, Rashmi Raghavendra, Ranjini Shome, Arko Misra

Retrospective Survey of Purpose and Outcome of Preoperative Cardiology Opinion for Patients Undergoing Intermediate-risk Noncardiac Surgeries at a Tertiary Care Center

[Year:2024] [Month:January-December] [Volume:10] [Number:1--4] [Pages:5] [Pages No:1 - 5]

Keywords: Cardiology opinion, Elective surgery, Preanesthesia check-up

   DOI: 10.5005/jp-journals-10045-00242  |  Open Access | 

Abstract

Background: In the current perioperative care, the practice of getting routine investigations and specialty opinions for minor and intermediate surgeries is questioned as it adds to the cost of healthcare without any change in perioperative management and outcome. We did a retrospective study to find out the validity of cardiology opinions for minor and intermediate surgeries in a tertiary care teaching center. Objective: To investigate the role of cardiology opinion for intermediate/low-risk surgeries in terms of change in treatment, change in anesthetic management, further coronary artery disease (CAD) workup, and predicting adverse perioperative events. Materials and methods: Retrospective study of the case files of patients who had undergone minor/intermediate risk surgeries. Only those patients’ case files with good functional capacity were considered. We looked for the reason for obtaining cardiology opinion, the outcome of opinion in terms of change in treatment, further workup, advice for any change in anesthetic management, and predicting adverse perioperative outcomes. Results: A total of 32% of the opinions were sought for patients without any risk factors for major adverse cardiac events (MACE). Overall, 73 requests by both surgeons and anesthesiologists (69%) did not specify the reason for cardiology opinion. Clearance for the surgery was the most common reason quoted by surgeons for cardiology consultation. Electrocardiogram (ECG) changes were the reason for this, as quoted by anesthesiologists. Antihypertensive medications were started only for four patients. Except in one case, none of the patients had any problems during the perioperative period. All cases were managed as per routine protocols. Conclusion: Cardiology opinion for minor/intermediate risk surgeries has not contributed to perioperative management or in predicting complications. The practice of obtaining cardiology opinions does not follow the guidelines. Cardiology consultation for risk stratification and clearance for surgery should not be done; rather, a request should be made if it is going to change the course of perioperative management.

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