Δευτέρα, 25 Μαρτίου 2019

Medical Journal of Dr. D.Y. Patil Vidyapeeth (Med J DY Patil Vidyapeeth)

Machine learning in medicine: Will doctors meet their waterloo?
Amitav Banerjee

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):95-97



Artificial intelligence in medicine: The way forward
Pranay Goel

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):98-99



The good old family doctor
Dilip Kanade

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):100-100



Home visits and family physician
Vadisha Bhat

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):101-102



Rare presentation of squamous cell carcinoma: A case report
Subhashish Das

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):103-104



Fungal corneal ulcer: A prospective study on the causative fungus and the response to the present treatment protocol at ANIIMS, Andaman and Nicobar Islands-first time present
Sujit Das, H Sanjeev, Amit Banik

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):105-110

Background: Fungal keratitis accounts for 50% of all microbial keratitis, depending upon the geographic location. Filamentary fungi are predominant in tropical and subtropical climates. Treatment is given based on clinical diagnosis supported by the presence of fungus in potassium hydroxide (KOH) mounting, rather than on culture report because culture takes time. Reported studies from northern part of the country revealed Aspergillus as the most common fungus, whereas Fusarium was reported to be the most common fungus in southern part of the country. Aspergillus fumigatus is the most common fungus isolated in our study and the response to standard treatment is good. Aim of the Study: To identify spectrum of fungi, response to the standard treatment given, and sensitivity of KOH preparation in clinically diagnosed fungal corneal ulcers and to identify the predisposing factors and culture-positive cases (both Sabouraud's and blood culture). Methods: All patients who were clinically diagnosed to have fungal corneal ulcer, based on history, clinical features, and slit-lamp findings over a period of 1 year, were included in the study. All patients were subjected to corneal scraping and the material was examined by KOH mounting, Gram staining, and specific culture techniques. The ulcer was treated as per the standard treatment protocol followed in the institution, and the response to treatment was analyzed. Results: The study included 40 patients, with males being predominated (n = 36). KOH positivity was seen in 34 (85%) cases whereas KOH negativity was seen in 6 (15%) cases. Gram stain was positive in 6 (15%) cases. The culture was positive in all cases (100%). The most common fungus isolated was A. fumigatus – 24 (60%) cases. The response to the treatment after 8 weeks was found in 34 (85%) cases. Enucleation was done in 7 (17.5%) cases. Total therapeutic keratoplasty was done in 7 (17.5%) cases. Total penetrating keratoplasty was done in 4 (10%) cases. Conclusions: Rapid diagnosis and early institution of antifungal therapy are necessary to prevent ocular morbidity and blindness. Although culture helps in definite diagnosis and identification, direct microscopic detection of fungal structures in corneal scrapes permits a rapid presumptive diagnosis. 


Correlation and comparison of dactyloscopy and palatoscopy with blood groups among dental students from Western Maharashtra
Smriti Ramdas, Sushma Bommanavar, Rajendra Baad, Nupura Vibhute, Uzma Belgaumi, Vidya Kadashetti, Wasim Kamate

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):111-115

Background: Identification plays a major role in any crime investigation. Study of finger prints (Dactyloscopy) and palatal rugae patterns (Palatoscopy) have been recognized and accepted as gold standard for personal identification worldwide. Yet another biological record that remains timeless throughout the lifespan of a person is the blood group. Research works have been carried out on Dactyloscopy/Palatoscopy and blood groups independently. However, studies focusing on correlation and comparison of both these parameters have not been undertaken to a great extent. Aim: The aim of the present study is to correlate and compare Dactyloscopy and Palatoscopy with blood group among dental students from western Maharashtra population. Materials and Methods: A total of 200 dental students with age group ranging between 18-25 years with known blood group were included in the study. Finger print, Palatal rugae patterns were obtained and compared and the data was subjected to Excel sheet 2016 and Chi square test. Results: There was significant association between finger print patterns and ABO - Rh factors (χ2 statistic= 30.6, P value = < 0.05) and No correlation exists between palatal rugae patterns with blood groups and Rh factor (χ2 statistic= 17.71, P value = P > 0.05). Conclusion: Hence, the study concluded that finger prints rather than palatal rugae when correlated with suspect's specific blood group - Rh factor can be used to narrow down the suspect list and can also prove significant in identifying individuals in case of any disaster. Though the comparison of palatal rugae and finger print with blood group - Rh factor yielded no result. 


Client satisfaction and its correlates of directly observed treatment short course therapy in a tuberculosis unit of Bankura, West Bengal
Sumana Samanta, Aditya Prasad Sarkar, Dibakar Haldar, Asit Baran Saren, Gautam Narayan Sarkar, Indrajit Saha

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):116-121

Background: Tuberculosis (TB) is a curable disease still millions of people suffer and many of them die from this disease. Just providing anti-TB medication is not sufficient to ensure that patient to be cured. Objective: The objective of this study is to assess the treatment outcome rates and to find out the determinants of patient satisfaction. Materials and Methods: A clinic-based, descriptive, crosssectional study was conducted in Lokepur Tuberculosis unit (TU) from July 2015 to June 2016. Simple random sampling was adopted to select 50% of the Directly Observed Treatment Short Course (DOTS) centers under that TU. Afterward, complete enumeration of the adult TB patients receiving Category I treatment and registered from June to October 2015 was done from the selected DOTS centers. Exit interview of the patients was conducted using pretested predesigned questionnaire and treatment outcomes were recorded from TB register. Data were entered in MS Excel Spreadsheet and analyzed by SPSS 22.0 version. Results: Treatment success rate of Category I TB patients was about 87%. Almost 76% patients were satisfied with the given services. Treatment success rate was higher among the satisfied (97%) than the not satisfied (57%) clients and the difference was statistically significant. Client satisfaction was statistically associated with gender, residence, educational level, first caregiving person, and decision maker in getting treatment. Conclusion: Concern given to urban slum areas, improvement of literacy status of the patients, arrangement of the alternative sources of income for TB-affected family, and improvement of the knowledge of first caregiving persons are the steps to be taken at this hour. 


Anorectal malformations: Early outcome analysis from a high-volume tertiary care institute
Rahul Gupta, Arun Kumar Gupta, Arvind Kumar Shukla, Vinita Chaturvedi, Pramila Sharma, Ramesh Tanger

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):122-130

Context: Associated malformations in anorectal malformation (ARM) are of important implication with regard to final outcomes since the anorectal lesions that cause intestinal obstruction are correctable with operative intervention. Aims: To study the presentation, types of anomalies, associated malformations, and procedures performed in relation to the type of anomaly and early outcomes analysis of ARM patients in the neonatal period. Settings and Design: A retrospective study was performed from January 2016 to December 2016. Subjects and Methods: The study included all patients with ARM admitted in the Neonatal Intensive Care Unit. Results: There were 216 neonates having ARM with 173 males and 43 females (m:f = 4:1). High-type ARM was seen in 177 (81.94%) cases, while low type in 39 (18.06%) neonates. Associated malformations were documented in 67 (31.02%) neonates. Esophageal atresia (EA) was the most common (51) associated anomaly. Among the 200 procedures undertaken for ARM, left transverse loop colostomy was the most common (132). Only 83 (38.42%) neonates were diagnosed on the 1st day of life. There were 67 (31.02%) deaths, 145 (67.13%) survivors, and 4 (1.85%) cases left against medical advice. There were only 9 (17.65%) survivors among those associated with EA. Cardiovascular was the most common (39) cause of mortality followed by septicemia (30). Conclusions: An overall high mortality rate of 31.02% and an extremely high rate (74.51%) among those associated with EA were present. In spite of the progress made in the field of neonatal care, associated malformations compounded with a high volume of patients in our resource-limited institution negatively influence the outcome of ARM in the newborn period. Strict infection control measures for prevention of septicemia and investigations for other associated malformations are recommended to improve the outcomes. 


Prospective randomized comparative trial of dexmedetomidine versus esmolol for attenuation of extubation response
Nirav Kotak, Rahul Mamde, Pushkar M Desai

Medical Journal of Dr. D.Y. Patil Vidyapeeth 2019 12(2):131-135

Background and Aims: General anesthesia is known to elicit stress response during endotracheal intubation, but the equally important period of extubation is usually not addressed. The aim was to compare dexmedetomidine and esmolol for attenuation of extubation response. Materials and Methods: In this prospective randomized double-blind trial, 100 American Society of Anesthesiologists I/II patients between 18 and 60 years of age undergoing abdominal and lower-limb surgeries were randomly allocated into two groups (n = 50 each). Patients in Group D received dexmedetomidine (0.5 μg/kg intravenous [IV] bolus) over 10 min and in Group E received esmolol (1 mg/kg bolus IV) before extubation. Hemodynamic parameters, namely, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were compared at baseline, 10 min before extubation, at extubation, and at 1, 3, 5, 10, and 15 min thereafter. Data were expressed as mean ± standard deviation and analyzed using Student's unpaired t-test and Chi-square test. P <0.05 was considered statistically significant. Results: Patients in Group D exhibited lower HR, SBP, DBP, and MAP at the time of extubation till 15 min postextubation (P < 0.001) although the difference was clinically insignificant. Incidence of hypotension was similar in both groups (6% vs. 4%). Two patients in Group D developed bradycardia which was successfully treated with injection glycopyrrolate, while none exhibited any complication in Group E. Conclusion: Dexmedetomidine is a better, effective, and safe alternative to esmolol in attenuating stress response during extubation. 


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