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2021 | January-March | Volume 4 | Issue 1

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[Year:2021] [Month:January-March] [Volume:4] [Number:1] [Pages:1] [Pages No:00 - 00]

   DOI: 10.5005/jbcahs-4-1-v  |  Open Access |  How to cite  | 



Envisioning toward Building a Fairer and Healthier World: A Joint Effort

[Year:2021] [Month:January-March] [Volume:4] [Number:1] [Pages:1] [Pages No:1 - 1]

   DOI: 10.5005/jp-journals-10082-03109  |  Open Access |  How to cite  | 


Original Article

R Adityan, Selvan C Senthamil, S Karthiga, CS Prabhu, B Padhmini

Triphasic Single Bolus and Biphasic Split Bolus Techniques in Computed Tomography Urography: A Pilot Study

[Year:2021] [Month:January-March] [Volume:4] [Number:1] [Pages:8] [Pages No:2 - 9]

   DOI: 10.5005/jp-journals-10082-02275  |  Open Access |  How to cite  | 


Aim and objective: Our study's objective is to examine the image quality, radiation dose, and scan time of the split bolus technique in computed tomography (CT) to evaluate urinary tract diseases. Background: Computed tomography is one of the commonly preferred medical imaging modalities in diagnostic radiology for visualizing several diseases with higher resolution images. However, radiation dose reduction is one of the most crucial causes of a CT examination. Multidetector CT (MDCT) has updated several technical advancements of CT scanner for clinical purposes. The excretory system's radiological investigation is called urography, which is done in conventional radiography in the old days. Urolithiasis is considered a common disease affecting 12% of the global population in their lives. Materials and methods: In our study, 10 patients underwent a split bolus technique for CT urography (CTU) examination at the Mahatma Gandhi Medical College and Research Institute, Puducherry. Among the 10 patients, 6 patients are adult male, 1 patient is a pediatric male, and 3 patients are adult female. The study was conducted in an MDCT (GE optima 660) scanner. The split bolus technique protocol followed in this study is an initial bolus of 40 mL contrast media given intravenously at 3.5 mL/second flow rate with an interbolus delay of 8–10 minutes to allow the contrast media opacify the ureter and urinary bladder. After 8–10 minutes, the remaining 50 mL of contrast media and 20 mL saline chaser are given, and images were acquired at 25 seconds for the arterial phase and 70 seconds for the venous phase, nephrogenic and excretory images in a single acquisition, which eliminates the need of separate acquisition. Results: The image quality of the split bolus technique provides comparable results with a single bolus technique for interpretation. The total dose length product (DLP) of the split bolus technique is less than the single bolus technique. So, as a result, the radiation dose is reduced in the split bolus technique. The entire procedure from patient preparation to postprocedure care ranges from 35 to 55 minutes, and the scan time is similar for both the techniques. In our study, various pathologies were also diagnosed, such as, renal cyst was reported in 40% of the patients, and other diseases like hydronephrosis, renal calculus, contracted, a lesion in the kidney, and pyelonephritis were diagnosed in the rest of the patients. Conclusion: The split bolus technique can be considered for reducing radiation exposure to the patient for the CTU examination. The split bolus technique has some limitations compared to the single bolus technique. Nevertheless, split bolus gives comparable image quality with the less patient dose, making the technique considered for various contrast-enhanced CT investigations.


Original Article

R Arungobi, Selvan C Senthamil, G Kowsalya, I Jeraldpaul, P Sudhakar

Coronary Computed Tomography Angiography in Suspected Coronary Artery Disease: A Rapidly Developing Noninvasive Study

[Year:2021] [Month:January-March] [Volume:4] [Number:1] [Pages:6] [Pages No:10 - 15]

   DOI: 10.5005/jp-journals-10082-03105  |  Open Access |  How to cite  | 


Background: The death rate of people in developing countries keeps on increasing, which is due to coronary artery disease (CAD). Coronary computed tomography angiography (CCTA) has improved as a valuable noninvasive diagnostic imaging test to evaluate and manage patients with clinical suspicion of CAD. Aim and objective: This study aims to describe the rapidly developing noninvasive CCTA-based diagnostic imaging test for patients with clinical suspicion of CAD. Materials and methods: We had included 50 patients for this study; patients presenting with signs and symptoms of CAD who were referred for CCTA were included. The patient's blood urea and serum creatinine values were checked before undergoing CCTA. The contrast media used for the study was iohexol (Omnipaque 350 mg/mL). After giving the beta-blockers, the computed tomography (CT) coronary angiogram was done using GE healthcare Optima 660-128 slice CT scanner. Result: Our present study shows 64% (32 out of 50 patients) were diagnosed as normal, 18% (9 out of 50 patients) were diagnosed as low risk, 12% (6 out of 50 patients) were diagnosed as intermediate —risk, and 6% (3 out of 50 patients) were diagnosed as high-risk group based on CAD reporting and data system (CAD-RADS) score. Conclusion: Based on our observations, we have summarized that the CCTA is a noninvasive imaging technique that is clinically useful, cost-effective, and for outpatient investigation.



Senthil Shanmugam, Charumathi Thayalan, Velkumar Vasudevan

Virtual Chest Physiotherapy for COVID-19 Patients: A Case Report

[Year:2021] [Month:January-March] [Volume:4] [Number:1] [Pages:2] [Pages No:16 - 17]

   DOI: 10.5005/jp-journals-10082-03102  |  Open Access |  How to cite  | 


Aim and objective: This case report addressed the idea about the effect of virtual chest physiotherapy in improving the respiratory complications of COVID-19 patients. A 50-year-old female was diagnosed as COVID-19 positive at a tertiary care hospital, Pondicherry, with no specific complaints and quarantined in home, and as a preventive measure, we treated with a diaphragmatic deep breathing exercise, pursed-lip breathing, chest mobility exercise, and incentive spirometry virtually through video call for a duration of 2 weeks consisting of two sessions per day. Case reviewed after 2 weeks confirmed COVID-19 negative, and we made an assessment on chest expansion and respiratory rate. The patient showed a normal respiratory rate of 21 breaths per minute and chest expansion of 2.5 cm. Virtual chest physiotherapy was found to be an effective mode of treatment for COVID-19 patients under home quarantine.



Ananda V Cassinadane, Aravindan Thiruvalavan

Erythematous Rash as a Feature of COVID-19: A Case Report of an Upcoming Entity

[Year:2021] [Month:January-March] [Volume:4] [Number:1] [Pages:2] [Pages No:18 - 19]

   DOI: 10.5005/jp-journals-10082-03104  |  Open Access |  How to cite  | 


Aim and objective: The sole purpose of this case report is to highlight the relatively rare dermatological manifestations of COVID-19 and their correlation that would aid in early diagnosis and management of the same. Background: Many new manifestations of SARS-CoV-2 are being observed as days progress. This case report focuses on the cutaneous implications of COVID-19 that may aid physicians in the early identification of COVID-19 cases. Case description: A 24 -year-old Indian male patient with a sedentary lifestyle, developed mild dizziness which progressed to fever, followed by severe myalgia. He got himself admitted in a tertiary care hospital, since he tested positive for COVID-19 and was discharged on day 7 with proper advice. On day 8, he developed mild itchy erythematous papular rashes involving elbow flexures, trunk, and palms lasting for 2 weeks. Conclusion: Though uncommon, this particular pattern of erythematous rashes was found to be a prominent feature in this patient's case. Emphasizing on the cutaneous involvement in COVID-19 infected patients, which in some cases, can be an early sign and can aid in its early diagnosis. Clinical significance: The significance of this particular case report lies in the fact that with new evolving strains of SARS-CoV-2, these skin-related minor symptoms can help in effective strategic control of the infection, if detected at the right time.



Rajarajeswari Ranganadane, Saravanakumar S Sumathi, Srinivasan Abu Raghavan, Asmathulla Shafiulla, Girija Subramanian, Maithili Karpaga Selvi Nachimuthu

Cardiovascular Risk in Hashimoto's Thyroiditis: Role of Thyroid Autoimmunity

[Year:2021] [Month:January-March] [Volume:4] [Number:1] [Pages:3] [Pages No:20 - 22]

   DOI: 10.5005/jp-journals-10082-03106  |  Open Access |  How to cite  | 


Hashimoto's thyroiditis (HT) is the most common autoimmune thyroid disease synonymous with hypothyroidism. The link between hypothyroidism and the risk of cardiovascular diseases is of contemporary interest. Studies have indicated the prevalence of metabolic syndrome and endothelial dysfunction in HT patients. HT per se might possess a role in atherosclerosis. Association of HT with dyslipidemia and chronic inflammation leading to endothelial dysfunction has been documented. However, the role of thyroid autoimmunity in promoting cardiovascular diseases remains unclear. Further studies unraveling the causal relationship between HT and cardiovascular disease would provide greater insight into the management of atherogenic complications observed in HT patients.



Strengthening the Delivery of Rural Medical Education: Identification of the Potential Challenges and Responding to Them with Feasible Solutions

[Year:2021] [Month:January-March] [Volume:4] [Number:1] [Pages:3] [Pages No:23 - 25]

   DOI: 10.5005/jp-journals-10082-03103  |  Open Access |  How to cite  | 


The existing practice of training medical students in medical colleges is hospital driven, with limited and variable focus toward posting them in rural settings. However, in the global vision to produce a primary healthcare physician and attain universal health coverage, it is a must that all the medical students should be given exposure to rural medical education. The process of planning and implementing the delivery of rural medical education has multiple inherent challenges and each of these needs to be effectively addressed to ensure the accomplishment of the intended learning outcomes. It has been advocated that the outcome of rural medical education is much better once students are posted for longer durations and in settings wherein rural experience opportunities are well distributed throughout the training period. In conclusion, the delivery of rural medical education is the need of the hour and is based on the principle of training medical students in a community-oriented approach. The medical colleges and public health sector have to work with utmost collaboration to ensure that medical students are benefited, and in the long run, the prevailing issue of maldistribution of trained specialists is eliminated and an improvement in health indices is observed.



Kaviraja Udupa, Meena Ramanathan, M Ramanathan

SWOT Analysis in Yoga Research

[Year:2021] [Month:January-March] [Volume:4] [Number:1] [Pages:5] [Pages No:26 - 30]

   DOI: 10.5005/jp-journals-10082-03101  |  Open Access |  How to cite  | 


This article is based on the “Open House Discussion on Yoga Research: Strength, weakness, opportunities, and threat (SWOT) analysis” that was organized during the international seminar cum workshop conducted by the Centre for Yoga Therapy, Education and Research (CYTER), an innovative center of Sri Balaji Vidyapeeth (SBV), on “Wholistic Approach of Yoga Therapy in Health and Disease” as part of the International Health Research Convention 2019 organized by SBV in July 2019. In this article, we have discussed various factors and dimensions of strength, weakness, opportunities, and threats (challenges or risks) in yoga research especially in the Indian context based on the open house discussion. We have also discussed the ways that could be adopted to improve the standard of yoga research to provide more reliable, authentic, and validated data to evidence-based research. Yoga therapy is a newly emerging field; hence, it is important to analyze the inherent strengths that make research in this field useful for a large section of society as well as the weaknesses that may hinder the quality research in yoga therapy. It is also important to find out possible opportunities that can enhance or boost the work done in this field and know the threats that can retard or hamper quality research.


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