ARCHIVES(Journal of Harmonized Research in Medical and Health Sciences)


Title: UNCONTROLLED BRAIN EPENDOYMOMA METASTASIS TO THE SKIN
Author: Abed Agbarya, Zaki el Zagzoug, Fadi Atrash and Prof. Dr. Bowirrat Abdalla
Keyword: Brain Ependoymoma, Metastasis
Page No: 01-04
Abstract: An otherwise healthy 44 - year-old female, was referred to the emergency department at the European Gaza Hospital in January 2009 for Dizziness, headache and Nausea. MRI was done and showed large left fronto-parietal cerebral space-occupying lesions with large lobulated cystic like lesion with ring enhanced wall and solid enhanced inter cystic component, measuring globally 5x6.5 x5 cm in the cranio-caudal, anteroposterior and transverse diameters respectively. Glioblastoma was highly suspected (Panel A, arrow). The patient underwent surgical resection and no post-operative radiotherapy was given due to shortage in equipment but a specimen was taken. The patient’s condition did not improve and right side hemeparesis and dysarthria was observed. Biopsy showed cellular Ependymoma composed of delicate network of small blood vessels and of closely packed polygonal cells having marked pleomorphism, irregular nuclei and moderate amount of eosinophilic cytoplasm, chromatin was diffusely basophilic, prominent nucleoli, there are no mitotic figures, the tumor cells arranged around and attached to the central blood vessels forming pseudorosettes and no vascular invasion were examined. In February 2009, the patient underwent second surgical resection, pathological examination showed cellular Ependymoma. On May 2009 the patient referred to Augusta Victoria Hospital (AVH), Jerusalem, where she received radiotherapy (the dose was above 45-50 Gy), she finished her radiotherapy on July 2009 and returned to Gaza with relatively good condition. On December 2012 the patient presented with fungating mass at left partial region, complete excision was done on January 2013, tissue was sent for pathology which showed Epandymoma grade- III (reported by Al-Shifa Hospital, Gaza on February 2013). On March 2013 the patient complained from dyspnea and CT scan was done and showed seeding Epenyemoma metastasis to the left cerebral hemisphere, left upper neck lymphoadenopathy and right lung nodules was observed (Panel B). On April 2013 the patient referred again to AVH for chemotherapy but she received radiotherapy 25 fractions to head and Left neck alone, she was presented with bleeding fungating mass about 4X4 cm, and left neck lymph nodes enlargement. On May 2013 biopsy was taken from the mass the blocks was sent to the Nazareth hospital’s lab and showed metastatic ependymoma (Panel C, D). On August 2013 the patient condition deteriorated sharply with severe dyspnea and she was confined to bed. She died on November 2013.Download PDF


Title: SIALOLITH IN SUBMANDIBULAR GLAND- A REPORT OF THREE CASES AND REVIEW OF LITERATURE
Author: Dr. Tulsi Subramaniam, Dr.Arun Subramaniam, Dr.Asha Chowdhery, Dr. Vaibhavi Raut
Keyword: Sialolithiasis, sialolith, submandibular gland, Wharton’s duct
Page No: 05-09
Abstract: Sialolithiasis (salivary stones) is the most common disorder of the salivary glands. The majority of sialoliths developing in the salivary glands are in submandibular gland or its duct (Wharton’s duc t). There are many theories that have been proposed in the literature for the formation of salivary calculi. This article discusses review of literature, clinical and radiographic case report of three patients with sialolithiasis. Keywords- Sialolithiasis, sialolith, submandibular gland, Wharton’s duct Download PDF


Title: STUDY OF ANAEROBIC THRESHOLD IN HEALTH
Author: Dr. Sonal P. Karpe, Dr. Priti L. Meshram
Keyword: Anaerobic threshold, Age, Gender, Height, Weight, BMI, lifestyle.
Page No: 10-16
Abstract: Introduction: The anaerobic threshold (AT), also known as the lactate threshold, lactic acid threshold, gas exchange threshold, or ventilatory threshold, is considered an estimator of the onset of met abolic acidosis caused predominantly by the increased rate of rise of arterial [lactate] during exercise. It is an accurate marker of fitness or exercise tolerance of an individual. The objective of the study was to study anaerobic threshold in normal healthy adults and to study variations in exercise tolerance as per demographic and anthropometric parameters. Methodology: This prospective study was conducted at a cardiopulmonary exercise testing unit of a tertiary care public hospital. 50 healthy adult participants with no history of cardiac and respiratory disorders were screened for and included in the study to determine their anaerobic threshold. Results: Anaerobic threshold (AT) in healthy adults was higher in males compared to females. As the age increased Anaerobic threshold decreased. There was a positive correlation between AT and height. The weight showed no significant correlation with AT. There was significant inverse correlation between Body Mass Index (BMI) and AT. The AT of nonsedentary subjects was significantly higher than sedentary subjects. Majority of subjects showed significant improvement in their AT after lifestyle modification in the form of moderate physical activity for three months. Conclusion: The Anaerobic threshold varied in the population studied as per their age, gender and anthropometric parameters. AT was more in males and younger subjects. Height and BMI and physical activity showed a more consistent correlation with AT than weight. Key words: Anaerobic threshold, Age, Gender, Height, Weight, BMI, lifestyle. Download PDF


Title: COMPARATIVE EVALUATION OF THE SLEEP QUALITY IN MALE VERSES FEMALE STUDENTS OF NURSING AT SCHOOL OF NURSING AND MIDWIFERY OF MBU
Author: Morteza Alibakhshi-kenari
Keyword: Disorders of excessive somnolence, Education, nursing students sleep, Sleep disorders, Pittsburgh Sleep Quality Index (PSQI).
Page No: 17-30
Abstract: Aims: Traditionally science students exhibit poor sleep quality and impaired academic and professional performances due to high sleep deprivation and high incidences of daytime dysfunctions. The prese nt study was aimed to evaluate the sleep quality in nursing students from the School of nursing and midwifery, university of Martyr Beheshti University (MBU) in Tehran. Study design: Sleep quality was evaluated by filling out the Pittsburgh Sleep Quality Index (PSQI). Place and Duration of Study: School of nursing and midwifery of Martyr Beheshti University (MBU) in Tehran, during 1 November, 2012 to 1 May, 2014. Methodology: 133 nursing students were divided into different groups (on the basis of age; group to 4); each group was further divided into two groups based on sex. Mean values of the score obtained for each PSQI category were analyzed by the Student t-test and 95% of Confidence of Intervals, to investigate the statistical differences among the male verses female groups and the correlation between the group and its respective score. Results: Findings showed that nursing students presented a fairly poor subjective sleep quality. Mean scores of sleep quality (PSQI category 1), sleep latency (PSQI category 2), sleep duration (PSQI category 3) and sleep efficiency (PSQI category 4) of female students were found significantly high in comparison to male students, while mean score of sleep disturbances (PSQI category 5), use of hypnotics/anti33 depressants (PSQI category 6) and daytime dysfunction (PSQI category 7) were non-significantly different among female and male students. Conclusion: The poor sleep quality in nursing students suggests that authorities should have specific guidance on sleep hygiene and should provide support for students presenting disturbances in day-time activities. Keywords: Disorders of excessive somnolence, Education, nursing students sleep, Sleep disorders, Pittsburgh Sleep Quality Index (PSQI). Download PDF


Title: GLEASON SCORE CONCORDANCE IN SINGLE CORE PROSTATE CANCER PATIENTS IS INFLUENCED BY THE NUMBER OF FRAGMENTS SAMPLED AT BIOPSY
Author: Ricardo Kupka, Marcos Francisco Dall’Óglio, Alexandre Crippa Sant’Anna, José Pontes Júnior, Luís Felipe Piovesan, Aguinel José Bastian Júnior, Willian Nahas, Miguel Srougi
Keyword: Biopsy, Prostate Cancer
Page No: 31-37
Abstract: Introduction Prostate cancer (PCa) is the most common male malignancy in western countries and the second leading cause of cancer death in men (1). The disseminated use of serum prostate-specific an tigen (PSA)-based screening for PCa has led to an increase in the proportion of patients with low-stage and low-volume PCa (2,3). As a result, the prevalence of single positive core disease appears to have significantly increased. Single core PCa is expected to be clinically insignificant, indolent and to have lower positive surgical margins (PSM) (4). Systematic reviews have provided inadequate information for assessing the comparative effectiveness of the treatments and any associated harms (5). The risk of dying from PCa is approximately 3%, suggesting that conservative management may be appropriate for many men (6,7). These recent changes may explain the renewed interest in active surveillance (AS) with delayed therapy for highly select patients, particularly those diagnosed with well-differentiated tumors (Gleason < 6) and a low volume. Most single positive core PCa are included in this group (8). Studies comparing the entry criteria for AS protocols, especially in terms of the biopsy parameters, are needed to clarify the best candidates for AS. The Gleason score (GS) is an important parameter in the treatment of PCa when combined with the PSA, clinical stage and prostate size (9,10). Therefore, the accurate determination of the GS on the diagnostic needle biopsy is a crucial component of the algorithm for treatment selection (9). The Gleason grading system has consistently been shown to predict the outcome in patients with PCa. Because a transrectal ultrasonographic prostate biopsy may provide only a sampling of the cancer, the potential exists for a discrepancy between the patient biopsy and pathological GS (11). Single core PCa is one of the most important criteria for AS as it should behave like an indolent disease; however, can single core PCa actually be considered to be an indolent tumor? Studies have shown that using more biopsy cores may minimize discrepancies with the GS (12). Because the number of cores sampled may help improve the selection criteria for AS, we analyzed the relationship between the number of cores sampled with the concordance and discrepancy in the GS in a single core group. The aim of our study was to compare the clinical and pathological findings of PCa patients diagnosed by a single positive core or by multiple positive cores at biopsy who underwent a radical retropubic prostatectomy (RRP). We also evaluated the influence of the number of sampled cores at biopsy in these two groups. Download PDF


Title: TECHNICAL FABRICATION AND CLINICAL APPLICATION OF ELCLIPSE OCCLUSAL SPLINTS
Author: Biljana Kapusevska
Keyword: Eclipse occlusal splints, repositioning splints, solid occlusal splints soft occlusal splints, bruxism
Page No: 38-46
Abstract: Abstract Introduction: The focus of this investigation is alternative methods of technical fabrication and clinical application of eclipse occlusal splints with light polymerization. Purpose: The consideration of the fact that the bruxism is present in up to 90% of our population, led us to our goal to help these patients through exhibition of a method for fabrication of hard and soft occlusal eclise splints whose indication is dependent upon the type of bruxism. Material and methods: To evaluate the effectiveness of manufactured occlusal therapeutic appliances and to discern the advantages and disadvantages arising from this technique of preparation, we treated 120 patients divided into two groups which were again divided into two subgroups. The first subset of the first group of patients had masticatory muscles complaints, and in the second TMJ afflictions. The second group consisted of bruxism patients with solitary attrition in the first and additional hyperemia of the dental pulp in the second subgroup. Results: Registration of the results was performed according to anamnestic data of the patients. After 6 months in the first group, first and second subset, ratio between recovered patients to treated patients was 8/14 and 6/10, in the second group the first and second sub-group was 4/26, 10 /20. After 18 months this ratio in the first and second subset of the first group was 8/22 and 12/18 , while the first and second subset of the second group was 0/30 and 2/28. Conclusion: We conclude that the quality of technical development and clinical application of eclipse splints is better compared to the conservative method of making splints for occlusal treatment. Indexing terms/Keywords: Eclipse occlusal splints, repositioning splints, solid occlusal splints soft occlusal splints, bruxism Download PDF


Title: NEEDLE STICK INJURIES TO STAFF NURSES IN A MEDICAL INSTITUTION OF CENTRAL INDIA
Author: Prashant Bagdey, Arun Humne, Sonali Wankhede, Abhaykumar Dhanorkar
Keyword: Staff nurse, Hypodermic needle, needle stick injury
Page No: 47-52
Abstract: Background: Percutaneous injuries caused by needle sticks, pose a significant risk of occupational transmission of blood borne pathogens. Their incidence is considerably higher than current estimate s, and hence a low injury rate should not be interpreted as a nonexistent problem. Aims and Objectives:- To Study prevalence of needle Stick injuries among staff nurses during patient care and some factors influencing the prevalence of needle stick injury. Methods: Study design- Cross sectional Study, Study setting – Tertiary care hospital in Nagpur. Study duration Aug 2009 to Feb-2011, Sample size – 450 Staff nurses working in hospital involved in patient care directly. Using interview technique information regarding needle stick injury (NSI) was recorded in predesigned and pretested preformed. Data was analysed using STATA software. Results: Mean age of Staff nurse was 44.63 + 7.90 years. Maximum nurses were posted in Medicine 18.22%, Surgery (15.56%), and OBGY (12.22%). OT (11.78%) and Pediatrics (10%). Mean duration of service is 19.48 + 7.77 years the case incidence of NSIs was 31.78% (143/450). The total number of episodes of NSIs among respondents was 341 (range: 1-5 episodes) with incidence rate of episodes i.e. 2.39 per person/Year among them. The causal devices in 215 cases (63.64%) were hypodermic needles and the main causes of percutaneous injuries with hypodermic needles were during injecting drugs (38.4%) and handling sharp wastes (32.9%). Conclusion: Nurses working in Govt Medical College and Hospital Nagpur are frequently exposed to blood-borne infection. NSIs were highly prevalent in these nurses therefore more intensive education programs should be directed at nurses to increase their awareness of and compliance with universal precautions (UP). We recommend a surveillance system and a center for managing injured persons. Key words: Staff nurse, Hypodermic needle, needle stick injury Download PDF


Title: PREDICTING MEDICAL STUDENTS’ PERFORMANCE IN ANATOMY USING IN-COURSE ASSESSMENT TESTS: CASE STUDY OF A NIGERIAN MEDICAL SCHOOL
Author: Ajayi A, Leko B J, Eweoya O O, Oyewo O O, Ayeni R O
Keyword: Medical education, Anatomy, in-course test, progressive assessment test, professional examination
Page No: 53-58
Abstract: Abstract In an attempt to determine the correlation between performance in in-course assessments and professional examination in Anatomy for medical undergraduates, the present study examined the pe rformances of students from a medical school in the south western part of Nigeria. 905 medical students, who sat for the professional Anatomy examination in four consecutive academic sessions (2002/2003 – 2005/2006), were studied and data analyzed for mean, standard deviation and range of scores in in-course, professional examination and overall performance for each session as well as the four sessions combined. Correlation coefficient (r) between in-course assessment, professional examination and overall score were also determined. Based on the pooled data, the following equation was derived for predicting students’ overall performance in anatomy from their in-courses; Y = 28.6 + 0.43X (where y = overall score % and x = in-course assessment scores %). Keywords: Medical education, Anatomy, in-course test, progressive assessment test, professional examination Download PDF


Title: ISOLATION AND CHARACTERIZATION OF FUNGI FLORA FROM THE SOIL SAMPLES OF ADEKUNLE AJASIN UNIVERSITY, AKUNGBA-AKOKO STAFF SCHOOL PLAYING GROUND
Author: Olajubu, F. A. and Folorunso, V. T.
Keyword: Playing ground; fungi; keratinophiles; AAUA; Staff school.
Page No: 59-65
Abstract: Soil is an unconsolidated or loose combination of organic and inorganic materials that support the survival and multiplication of various pathogenic and non-pathogenic microorganisms including fung i. The school playing ground is often the delight of school children as they enjoy playing with little or no supervision. This study was then designed to examining the soil samples of the playing ground to ascertain the possibility or otherwise of the children picking harmful fungi from the soil of their playing ground while recreating. The playing ground was mapped out into five regions namely West (Ws), East (Es), North (Ns), South (Ss) and Central (Cs) for sample collection. The soil plate method and hair baiting technique were used for the isolation of the fungi while the identification of the isolates was done through colonial morphology (macroscopy) and microscopy. The soil sample label Cs, collected from the Central part of the playing ground yielded more fungi species(7). The most frequently isolated fungus was Aspergillus niger. Other saprophytes isolated includes Penicilliumsp, Fusariumsp, Rhizopusstolonifer and Alternariaalternata Somekeratinophiles isolated include Chrysosporium indicum, Trichophytonmenta grophytes, Fusarimsolani and Microscoporium gypseum. Since some of these fungi species have been incriminated in some disease conditions and there is need to maintain the soil’s microbiota, it is suggested that the students be well guided as regard developing and maintaining simple hygienic culture and not in support of any form of soil treatment. Key words: Playing ground; fungi; keratinophiles; AAUA; Staff school. Download PDF


Title: A REVIEW ON LIVER FUNCTION MARKERS AND DENGUE INFECTION
Author: Brindha Durairaj, Santhoshkumar Muthu*, Shyaam Sharan SV
Keyword: Hepatic involvement, Dengue, ALT, AST.
Page No: 66-69
Abstract: The dengue viruses transmitted by mosquito vectors largely infect many cell types and cause diverse pathological and clinical effects in infected individuals. There are plenty of clinical and resea rch reports available which strongly suggest that liver involvement take place during dengue infections. This review is aimed to describe the level of liver marker enzymes in dengue infected patents based on clinical observations Keywords: Hepatic involvement, Dengue, ALT, AST. Download PDF


Title: A CASE OF HOLT ORAM SYNDROME WITH DEXTROCARDIA
Author: Fairy Susan Varghese, Sunil K Agarwalla, Sadhana Panda
Keyword: Holt Oram syndrome, TBX5 gene, autosomal dominant, limb defects, ostium secundum ASD
Page No: 70-74
Abstract: Holt-Oram syndrome (HOS) is an autosomal-dominant condition characterized by congenital cardiac and forelimb anomalies. It is caused by mutations of the TBX5 gene, a member of the T-box family that en codes a transcription factor. Secundum-type atrial septal defect (ASD) and ventricular septal defect (VSD) are the most common heart defects. Other cardiac defects range from asymptomatic conduction disturbances (first-degree heart block) to multiple structural defects. Almost every type of cardiac anomaly has been reported, either singly or as part of a group of multiple defects .The cause of these disparate clinical features is unknown. Here we report a case of a new born baby with absent left thumb and radius and the presence of an ostium secundum atrial septal defect suggestive of holt oram syndrome along with an incidental finding of asymptomatic dextrocardia..The purpose of the report is to highlight the varied clinical presentations of this rare entityDownload PDF


Title: A CLINICAL STUDY TO EVALUATE THE EFFECT OF KATUKA (PICRORHIZA KURROA ROYLE EX BENTH.) ON AMLAPITTA
Author: Dr. Shilpa
Keyword: Amlapitta, Pitta predominating disease, Katuka, pharmacodynamic properties, Pitta Shamak.
Page No: 75-82
Abstract: Abstract Due to urbanisation and changed life style people are inviting many health problems, Amlapitta being one among them. It is a common problem of the society in present time, due to ir regular and improper food habits, busy and stressful lifestyle. Symptoms like Kukshidaha, Tiktamlodgar, Utklesh etc. cause disturbance in day to day activities of the sufferer. Though Amlapitta is not a life threatening disease, if left untreated or neglected, it may invite major health problems. Inspite of voluminous work done on Amlapitta and its management in Ayurveda, it still remains a common problem leading to complications, as in most of the cases no permanent cure is achieved except symptomatic relief to some extent. Hence this disease has been taken for the present study. Clinical study has been conducted in two groups. In group-II patients the drug Katuka has been given along with Sitopala (Anupana) as per reference ßdVqdk flrk•oysák--------------------------------AAß Gad Nigraha (38/26). But on the basis of pharmacodynamic properties of Katuka viz. Tikta Rasa and Sheeta Veerya which are Pitta Shamak, it has been tried singly without the additive effect of Sitopala in group-I patients, as Amlapitta is a Pitta predominating disease. Statistically significant results were found in both the groups. But results were better in group-II as compared to group-I. Keywords: Amlapitta, Pitta predominating disease, Katuka, pharmacodynamic properties, Pitta Shamak. Download PDF


Title: THREE UNIQUE INITIATIVES OF KMC FOR DENGUE PREVENTION IN KOLKATA CITY, INDIA, DURING 2014
Author: Debashis Biswas, Tarun Safui, Subrata Maulik, Basudeb Mukherjee, Bithika Mandal, Baishakhi Biswas and Atanu Banerjee
Keyword: Aedes aegypti, Kolkata, travel-associated dengue, 3-tier monitoring, data-bank
Page No: 83-86
Abstract: Information regarding travel-associated dengue in Kolkata City is abysmally lacking. By strengthening its intra-departmental disease surveillance system, the health department of Kolkata Municipal Corporation (KMC) has for the first time succeeded in studying the issue. During January to August 2014, identifying 183 laboratory-diagnosed indigenous cases of dengue apart, the KMC people came across 15 residents of the city who contracted the disease after they had returned from travel to different dengue-endemic areas outside the city. One of them had visited Sri Lanka and one Thailand. The rest 13 citizens brought in the dengue infection from places around India. Preventing import of travel-associated dengue is just not feasible in the present era of globalisation, when one can easily move from one place to another in a jiffy. In view of this, the health department of Kolkata Municipal Corporation has given a top priority on controlling the population of the dengue-bearing mosquito Aedes aegypti. Keywords: Aedes aegypti, Kolkata, travel-associated dengue, 3-tier monitoring, data-bank Download PDF