SBV Journal of Basic, Clinical and Applied Health Science

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2019 | July–September | Volume 2 | Issue 3

EDITORIAL

M Ravishankar, S Parthasarathy

Acupuncture: Does it Need a Real Relook?

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:2] [Pages No:87 - 88]

Keywords: Acupuncture, Analgesia, Anesthesia, Points

PDF  |  DOI: 10.5005/jp-journals-10082-02228  |  Open Access |  How to cite  | 

REVIEW ARTICLE

Rebecca Lefroy, Nikesh Dattani, Fatemeh Sakhinia, Julien Al Shakarchi, Anthony Jaipersad, Arun Pherwani

Changes in Renal Disease: A Vascular Perspective

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:6] [Pages No:89 - 94]

Keywords: Renal disease, Renal replacement therapy, Vascular access

PDF  |  DOI: 10.5005/jp-journals-10082-02219  |  Open Access |  How to cite  | 

Abstract

This paper aims to review and discuss important advances in renal medicine that have occurred in the last 50 years. This has shaped the way that patients with end-stage renal failure (ESRF) are managed, with emphasis on renal replacement therapy (RRT), and has resulted in wide-reaching improvements in each patient’s journey. These changes have been summarized in an easily accessible form and addressed from the perspective of the United Kingdom.

REVIEW ARTICLE

Varughese Padinjattadathu George

Histopathological Spectrum of Granulomatous Skin Lesions: A Review

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:10] [Pages No:95 - 104]

Keywords: Cutaneous tuberculosis, Granulomatous dermatosis, Histopathological study, Leprosy

PDF  |  DOI: 10.5005/jp-journals-10082-02215  |  Open Access |  How to cite  | 

Abstract

Background and objectives: Granulomatous dermatoses are the most frequently encountered dermatological disorders in tropical countries with leprosy and tuberculosis as the leading causes. Although granulomatous skin lesions are very prevalent in society today, dermatopathologists often face diagnostic challenges while reporting these lesions due to the similar histopathological features or tissue reaction patterns seen in these lesions with diverse etiologies. The purpose of this study is to review the various causes and patterns of granulomatous skin lesions and a sequential approach to diagnosis of individual lesions accurately. Materials and methods: A comprehensive search of all literature available on granulomatous skin diseases between 2000 and 2018 was conducted, using keywords such as “granulomatous dermatosis,” “cutaneous tuberculosis,” “leprosy,” and “histopathological study” in the databases such as PubMed, ProQuest, and Google Scholar. The articles that satisfied the criteria were included in the final review. Results: The available evidence from the existing systematic literature reviews and articles suggested that the various tissue reaction patterns observed in granulomatous skin lesions are classified as epithelioid, palisaded, suppurative, xanthogranulomatous, foreign body, and other granulomatous patterns. These tissue reaction patterns are caused by infections, foreign bodies, metabolites, chemicals, and malignancies. Conclusion: Granulomatous dermatoses are a heterogeneous group of skin disorders that are frequently encountered in diagnostic dermatopathology. The histomorphology of a granuloma has to be correlated with the clinical history and ancillary techniques including special stains, culture, and molecular methods are necessary to arrive at a definitive diagnosis.

Original Article

Krishnagopal Srikanth

A Study of Self-perception and Self-perceived Importance of Final Year UG Students Regarding Acquisition of Core Competencies in Ophthalmology

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:3] [Pages No:105 - 107]

Keywords: Confidence levels, Ophthalmology skills, Self-perceived importance, Undergraduate students

PDF  |  DOI: 10.5005/jp-journals-10082-02212  |  Open Access |  How to cite  | 

Abstract

Introduction: Competency is an ability to perform a task fruitfully, confidently, and responsibly. At present, the UG curriculum is vast, and imparting skill is a challenge and rarely evaluated. Aims: To study the self-perception of confidence level pertaining to four core competencies in ophthalmology—recording visual acuity, pupillary response to light, extraocular movements, and confrontation fields and to study the self-perceived importance of these competencies. Materials and methods: Study involved students of 9th semester. A questionnaire was administered testing competencies regarding visual acuity testing, pupillary light reflex, confrontation fields, and extraocular movements. The responses were marked on the Likert scale. Results were expressed as percentages. Results: Confidence level for various competencies was 98.6%, 97.1%, 96.4%, and 85.7% for visual acuity, extraocular movements, pupillary light reflex, and confrontation fields, respectively. The self-perceived importance of these competencies was 95.7% for extraocular movements, 94.3% pupillary light reflex, visual acuity 92.1%, and 78.4% for confrontation testing. Conclusion: More than 98% of the students were confident in visual acuity testing, and it was the least for confrontation fields 78%. The self-perceived importance also showed almost similar results, 95.7% for extraocular movements and 78.4% for confrontation testing.

Original Article

Gokul D Yatheendranathan, Sudhakar Ankaiya, J Lalith Kumar

Comparative Study between Two Triple-therapy Regimens in Treating Helicobacter pylori: Related Peptic Ulcer Disease

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:4] [Pages No:108 - 111]

Keywords: Comparison, Endoscopy, Helicobacter pylori, Triple-therapy

PDF  |  DOI: 10.5005/jp-journals-10082-02222  |  Open Access |  How to cite  | 

Abstract

Background: Helicobacter pylori (H. pylori) infection has increased worldwide and it is found to be positive in more than 50% of the specimens taken during endoscopy. The goal of the study is to compare the efficacy of two triple-therapy regimens in eradication of H. pylori and to evaluate the cost factor involved. Aims: • To compare and study between two triple-therapy regimens in treating (H. pylori)-related peptic ulcer disease. • To find the cost efficacy between two triple-therapy regimens. Materials and methods: A randomized single-blinded study was conducted at a tertiary care hospital from 2016 to 2018. Upper gastrointestinal endoscopy was performed on all the patients after spraying them with a topical local anesthetic agent (10% lignocaine spray). Two biopsy specimens were taken from the antrum of the stomach. The rapid urease test (RUT) was considered positive, if a color change from yellow to pink was noted in the RUT kit within 10 minutes. The sample size was calculated and fixed at 60. The RUT-positive patients were divided into two groups by computer-generated random allotment. Group I patients were started on regimen I comprising omeprazole 20 mg twice daily, clarithromycin 500 mg twice daily, and amoxicillin 1,000 mg twice daily for 2 weeks. Group II patients were started on regimen II: OCM: omeprazole 20 mg twice daily, clarithromycin 500 mg twice daily, and metronidazole 400 mg twice daily for 2 weeks. The endoscopic RUT was performed in the beginning and after 6 weeks to check for eradication of H. pylori. The ethical committee approval was obtained (IEC no. 2017/308) and data were collected using a proforma and were entered in the Excel sheet. The statistical analysis was done by SPSS (version 23). Descriptive statistics regarding age, sex, and inference with regimens were calculated and recorded. Results: Among the patients administered regimen I, H. pylori was eradicated in 27 (90%). And among the patients administered regimen II, H. pylori was eradicated in 28 (93.3%). This difference was not statistically significant with p value of 0.323. However, it was observed that regimen II was cheaper than regimen I.

Original Article

Naren KA Kumar, Stanley James

Risk Stratification in Perforated Peptic Ulcer: The Peptic Ulcer Perforation Score

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:3] [Pages No:112 - 114]

Keywords: Mortality, Peptic ulcer, Perforation operation time interval, Risk assessment

PDF  |  DOI: 10.5005/jp-journals-10082-02220  |  Open Access |  How to cite  | 

Abstract

Background: Peptic ulcer is one of the most common diseases among Indian population. It can lead to several complications such as perforation, bleeding, etc., which require prompt diagnosis and treatment to reduce mortality and morbidity. This study aims to stratify the risk in patients with peptic ulcer perforation (PULP) using the PULP score. Materials and methods: It is a single-center prospective observational study conducted for a period of 1½ years with data collection for 1 year and analysis and write-up for 6 months (June 2017–November 2018). The study involved patients who underwent emergency surgery for perforated peptic ulcer (PPU). The PULP score and the perforation operation time interval are applied to all patients and their outcome is studied. Results: A total of 71 patients were included in the study; 6 patients died with a mortality rate of 8.5%. The mean PULP score in patients who expired was found to be 9. Complications occurred in 21 patients and the most common complication being the postoperative wound-site infection and acute respiratory distress syndrome (ARDS), which were significantly found in patients with the perforation operation time interval more than 24 hours. Conclusion: The PULP score is a reliable predictor of morbidity and mortality in patients who were operated for PULPs. The perforation operation time interval is a significant factor in predicting the mortality, complications, and the duration of hospital stay.

Original Article

Rasikapriya Duraisamy, Banupriya Balasubramanian, Soundararajan Palanisamy

Utility of Pediatric Early Warning Scoring System in Predicting Clinical Deterioration in Children: A Review

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:4] [Pages No:115 - 118]

Keywords: Early warning scoring system, Pediatric, Rapid response, Severity of illness

PDF  |  DOI: 10.5005/jp-journals-10082-02221  |  Open Access |  How to cite  | 

Abstract

Objective: To review the available evidence on effectiveness of the pediatric early warning score (PEWS) in predicting clinical deterioration in children in healthcare settings. Materials and methods: The electronic databases like PubMed, Google Scholar, etc., were searched up to December 2018, systemically using keywords including early warning scoring system, rapid response, pediatric, and severity of illness. Studies included should have used PEWS for assessing the severity in children in bedside, emergency, and oncology settings. The outcome had to identify the clinical deterioration in children and shifting to PICU/activation of the rapid response team. Results were normatively synthesized. Results: On total screening of 1,254 papers, 52 papers met the criteria and 10 papers were included to write the review article as it met the inclusion criteria. It revealed that PEWS is used extensively in varied settings. But still PEWS had limited use because of variation of scores according to settings. Positive outcomes were identification of sick children and intervention with multidisciplinary team work and effective communication and confidence in treating children. Conclusion: Despite many studies reporting the usefulness of PEWS, no evidence was available for which PEWS to be used. Further research on PEWS is needed for assessing the impact of PEWS implementation and outcome in resource-limited settings.

View Point

N Ananthakrishnan

Appraisal of Scholarly Activities of Medical Faculty for Career Advancement and Recognition: A Suggested Scheme in the Indian Context

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:3] [Pages No:119 - 121]

Keywords: Faculty appraisal, Faculty career progression, Faculty scholarship

PDF  |  DOI: 10.5005/jp-journals-10082-02217  |  Open Access |  How to cite  | 

Abstract

Assessment of medical faculty in India for career advancement and recognition still remains one-dimensional, focusing only on research output in the form of published papers of specified type in specified journals. No importance is given for other activities of faculty including teaching research, outreach, patient care, administration, and innovation. A scheme is suggested in the context of Indian medical schools giving weightages for all activities of faculty based on their disciplinary affiliation. This scheme is suggested as a model and not meant to be normative or prescriptive but as a suggestion of a wider horizon of appraisal to a fairer dimension.

CASE REPORT

KJ Krishnapriyanka, S Parthasarathy

Successful Management of Postherpetic Neuralgia of L1 Nerve with Transverse Abdominis Plane Block: A Case Report

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:2] [Pages No:122 - 123]

Keywords: Herpes zoster, Neuralgia, Refractory pain, Transverse abdominis plane block

PDF  |  DOI: 10.5005/jp-journals-10082-02213  |  Open Access |  How to cite  | 

Abstract

Postherpetic neuralgia (PHN) is a chronic pain syndrome associated with the reactivation of a primary infection with varicella-zoster. It is common with the intercostal nerve, which is easy to target and neurolysis. But PHN of L1 nerve dermatome is difficult to access for an isolated single nerve block. In our case, we had a 54-year-old male with severe L1 PHN (NRS pain score of 8–9/10), which was refractory to multiple drugs. A combined iliohypogastric/ilioinguinal nerve block did not produce any significant analgesic effect. We administered a transverse abdominis plane (TAP) block with a combination of local anesthetics and steroids to accomplish satisfactory analgesia. We repeated the block after 15 days to achieve an NRS pain score of 2/10 and later prescribed a minimal dose of duloxetine (10 mg once a day) only. The patient was followed up for 2 months with adequate pain relief. There were no side effects. We report this case to emphasize that fascial plane blocks could also prove fruitful in targeting specific nerves in cases of refractory PHN.

LETTER TO THE EDITOR

Muneeb Mohammed, Sundaramurthy Annamalai, Ajeesh K Padmanabhan

Underutilization of Diffusion Capacity of Lung for Carbon Monoxide in Severity Assessment and Prognostication of COPD

[Year:2019] [Month:July–September] [Volume:2] [Number:3] [Pages:1] [Pages No:124 - 124]

PDF  |  DOI: 10.5005/jp-journals-10082-02214  |  Open Access |  How to cite  | 

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