Τετάρτη, 12 Ιουνίου 2019

Medicine and Health Sciences

Understanding physician burnout syndrome: Antithesis of physician well-being
Bhaskara P Shelley

Archives of Medicine and Health Sciences 2019 7(1):1-10



Learning with emotions: The relationship between emotions, cognition, and learning in medical education
Meghan McConnell

Archives of Medicine and Health Sciences 2019 7(1):11-12



Lycopene restores liver function and morphology of ifosfamide-intoxicated rats
Elias Adikwu, Bonsome Bokolo

Archives of Medicine and Health Sciences 2019 7(1):13-17

Introduction: Low incidence of liver toxicity has been anticipated with the clinical use of ifosfamide (IFO); however, there is possible hepatotoxic concern with its use. There is a paucity of effective drugs that can protect liver or regenerate hepatocytes during damage. In this light, the protective effect of lycopene (LYP) was examined against a rat model of IFO-induced liver injury. Materials and Methods: Forty adult albino rats were randomized into eight groups (A–H). Group A (control) was orally treated with water, whereas groups B–D were orally treated with 10–40 mg/kg of LYP daily for 7 days, respectively. Group E was treated with 150 mg/kg of IFO on the 7th day intraperitoneally (ip), whereas groups F–H were pretreated orally with 10, 20, and 40 mg/kg of LYP daily, respectively, before treatment with IFO on the 7th day (ip). On the 8th day, rats were sacrificed, blood was collected, and serum was separated and evaluated for biochemical parameters. Rats were dissected; liver was collected, weighed, and evaluated for biochemical parameters and histology. Results: Significant (P < 0.001) increases in aminotransferases, total bilirubin, conjugated bilirubin, gamma-glutamyl transferase, lactate dehydrogenase, and malondialdehyde levels with significant (P < 0.001) decreases in superoxide dismutase, glutathione, catalase, and glutathione peroxidase levels were obtained in IFO-treated rats when compared to control. Liver of IFO-treated rats showed periportal and pericentral necroses of hepatocytes. However, The aforementioned parameters were significantly restored in a dose-dependent manner at 10 mg/kg (P < 0.05), 20 mg/kg (P < 0.01) and 40 mg/kg (P < 0.05) of LYP-pretreated rats. Conclusion: This study showed that IFO-induced liver damage was restored in a dose-dependent manner by pretreatment with LYP. 


Utilization of noncommunicable disease services provided by public health facilities in Kasaragod, Kerala
CK Bhagyalakshmi, Prakash Babu Kodali

Archives of Medicine and Health Sciences 2019 7(1):18-24

Background: The burden of noncommunicable diseases (NCDs) is high with significant impact on households in the form of out-of-pocket expenditure. Provision of NCD services through public health facilities is considered as cost-effective and efficient means. Aim: The study aimed to assess the proportion of individuals using NCD services provided through public health facilities and identify the factors associated with its use in Kasaragod district of Indian state of Kerala. Materials and Methods: A cross-sectional survey of 375 individuals was conducted in Kasaragod District of Kerala state. The data obtained were analyzed using descriptive and analytical statistical methods using Statistical Package for the Social Sciences version 20. Results: About 56.28% of individuals with NCD, received NCD services from public health facilities; these services were primarily comprised screening services. In addition, 40.69% of total individuals with NCDs received treatment services from government health facilities. Insurance coverage, perception about quality, perceived barriers in accessing health services, health worker visit, knowledge about NCD services, and information provided by frontline health workers were significantly influencing NCD service utilization in public health facilities. Conclusion: Individual's usage of screening services provided by government facilities is higher than that of treatment services. Overall, the utilization of NCD services provided through the public health system could be said to be less than satisfactory. It could be improved by addressing the perceived barriers with respect to the quality of services provided in public health facilities. In addition, employing the frontline health workers to bridge the awareness gap in NCD service provision could help in improving NCD service utilization. 


Correlation between sputum and bronchoscopy-guided cytology (bronchoalveolar lavage fluid, transbronchial needle aspiration, and bronchial brush) with bronchial biopsy in the diagnosis of pulmonary pathology
Pushpanjali R Ojha, Renu Madan, Reena Bharadwaj

Archives of Medicine and Health Sciences 2019 7(1):25-32

Background: Pulmonary pathologies constitute a major ailment in terms of morbidity and mortality. Recent technological advancements provide cytological analysis that accentuates accurate diagnosis, early intervention, management, and ease of clinical follow-up with improved outcomes. This study aimed to correlate the sensitivity and describe advantages and disadvantages of the various cytological means of the diagnosis of lung pathologies along with the sequential approach. Materials and Methods: This was a prospective study performed during the period of January 2013 to January 2015. Samples of sputum and bronchoscopy-mediated bronchoalveolar lavage (BAL) fluid, air-dried and alcohol-fixed smears of bronchial brushing (BB), transbronchial needle aspiration (TBNA), and formalin-fixed bronchial biopsy tissues were received, processed, and analyzed from all clinically and radiologically suspected cases of pulmonary pathologies. Results: Two hundred cases of lung lesions were included with all the four cytological sampling interventions and tissue biopsy in the present study with an age range of 21–90 years and male:female ratio of 2.45:1. There were 111 neoplastic and 89 nonneoplastic cases. The diagnostic sensitivity was maximum with BB cytology for nonneoplastic as well as neoplastic lesions. The overall diagnostic utility observed in 200 cases reveals sputum cytology as least sensitive and BB cytology as most sensitive investigation. Conclusion: Sputum cytology is used in patients who are unfit for bronchoscopy and inpatients for their routine evaluation of underlying infection. BAL enhances yield from intraluminal lesions, and TBNA enhances yield in submucosal and mediastinal lesions. The proposed protocol for cytomorphological diagnosis should be as sputum > BAL > TBNA > BB in order of ease. 


Risk factors related to human papillomavirus infection in oral squamous cell carcinoma
Alberto Rodriguez-Archilla, Adriana Stuardo-Parada

Archives of Medicine and Health Sciences 2019 7(1):33-37

Background: In addition to tobacco and alcohol consumption, some infectious pathogens such as human papillomavirus (HPV) have been proposed as carcinogenic factors in oral cancer. Objective: The objective of the study is to assess the possible influence of HPV detection in oral squamous cell carcinoma (OSCC). Materials and Methods: A PubMed search through April 2018, using the following Medical Subject Headings terms, was performed: “mouth neoplasms” and “papillomavirus infections.” Studies with findings on HPV detection in OSCCs were assessed. From 77 studies with full-text availability, 59 were excluded for several reasons: no usable/irrelevant data (32), tonsils, base of tongue and non-OSCC cases studies (26), and animal testing studies (1). The data were analyzed using statistical software RevMan 5.3 (The Cochrane Collaboration, Oxford, UK). For dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratios (ORs) using Haenszel–Mantel method with 95% confidence intervals. Results: Eighteen studies on HPV detection in OSCCs were included in this meta-analysis. The mean percentage of HPV detection in OSCC was 37.1%. Oral cancer patients showed a higher risk of being infected with HPV than controls (OR: 4.85) and they were more likely to be infected with high-risk HPV (OR: 11.46). A larger number of smokers had HPV-infected tumors (OR: 1.45). Younger age, gender, tobacco and/or alcohol consumption, tumor differentiation degree, tumor size (T-status), and lymph node metastasis (N-status) were factors that did not have a significant influence on HPV-infected oral cancers. Conclusion: HPV infection, especially of high-risk HPV, is more frequent in patients with OSCC. 


Primary localized cutaneous amyloidosis – A clinicopathological study
Suguna Belur Venugopal, Aparna Muralidhar

Archives of Medicine and Health Sciences 2019 7(1):38-41

Introduction: Cutaneous amyloidosis can be a manifestation of a systemic disorder or can result from localized process confined to the skin. Involvement of apparently normal skin is known as primary localized cutaneous amyloidosis. Histopathologically, amyloid appears as amorphous, eosinophilic material with hematoxylin and eosin stain. Congo red staining with apple-green birefringence under polarized microscopy confirms the diagnosis. Materials and Methods: Thirty-nine patients with a differential diagnosis of cutaneous amyloidosis reporting to the dermatology outpatient department of our hospital from November 2015 to May 2018 were studied. Twenty-six cases showed features of amyloidosis on histopathology. These were categorized into morphologic types of amyloidosis and correlated with the available clinical history. Congo red staining and observation under polarized microscope were done. Results: We encountered lichen and macular types of cutaneous amyloidosis with slight female predominance. Majority of the lesions were pruritic with involvement of the pretibial region. A history of friction was given by a few. All cases diagnosed clinically were concordant histopathologically. However, a single case of lichen amyloidosis was diagnosed solely based on histology. Microscopically, hyperkeratosis, amyloid deposits in the papillary dermis, and perivascular inflammation were the most consistent findings. All the cases showed apple-green birefringence with Congo red stain under polarized microscope. Conclusion: Cutaneous amyloidosis can have a wide range of differential diagnosis due to its varied clinical presentation. Histopathology, with the use of special stains, helps in identifying amyloid with a high degree of accuracy. 


Pro-life or pro-abortion – Women's attitude toward abortion in Darjeeling, India
Pallabi Dasgupta, Romy Biswas, Dilip Kumar Das, Jayanta Kumar Roy

Archives of Medicine and Health Sciences 2019 7(1):42-47

Background and Objective: Despite liberal abortion law in India, majority of abortions are unsafe. Behavioral theory suggests that women's attitudes may influence their abortion decisions. The present study was conducted to find out women's attitude toward abortion and its predictors. Materials and Methods: A community-based cross-sectional study was conducted in Naxalbari block of Darjeeling district, West Bengal, India, among 420 women aged 15–49 years using a predesigned, pretested interview schedule. The women's attitude regarding abortion practices was determined based on Likert's three-point scale. Two-stage cluster analysis was used to classify the overall attitude of women. Binary logistic regression was used for finding out predictors of abortion attitude. Results: More than half (53.5%) of the women had an overall pro-life attitude and 46.5% women had an overall pro-abortion attitude. Women who were less educated with <5 years' schooling, unaware of legality of abortion, and never aborted had significantly higher odds of having overall pro-life attitude. Majority women viewed abortion as a sin (81.4%); 62.1% of women disagreed with abortion as a method of family planning; 87.4% disagreed with sex selection before abortion; and 57.4% women agreed on women's right to decide for abortion. Conclusion: Women's attitude of abortion depicted complex personal and moral choices marred with social stigma within which abortion decisions are made. For developing a pro-choice outlook, life skills education for women, creating supportive family environment, sensitizing young men through extensive awareness campaigns, and advocacy through health-care providers are needed. 


Correlation of cord blood bilirubin values with neonatal jaundice in healthy newborns: A prospective observational study
Jehangir Allam Bhat, Sajad Ahmad Sheikh, Roshan Ara

Archives of Medicine and Health Sciences 2019 7(1):48-52

Background and Objective: Hyperbilirubinemia is the most common clinical condition requiring evaluation and treatment in the newborn and a frequent reason for hospital readmission during the 1st week of life. Although generally a benign, postnatal, transitional phenomenon, a few neonates develop marked potentially hazardous bilirubin levels that can pose a direct threat of serious brain injury. The present study was conducted to investigate the predictability of pathological jaundice on cord blood bilirubin (CBB) values. Materials and Methods: This was a prospective observational study conducted on 289 healthy newborns. Babies were divided into two groups: Group A who developed physiological jaundice and Group B who developed pathological jaundice. CBB was estimated in all newborns who were then followed up to the 5th day of life. Babies who developed jaundice requiring treatment were admitted in neonatal intensive care unit for phototherapy. Other neonates were checked regularly up to the 5th day of life and values were recorded on the 5th day by estimation of serum bilirubin. Results: Incidence of pathological hyperbilirubinemia in our study was 11.2%. A statistically significant correlation between CBB and development of pathological jaundice was observed. Gender, age, mode of delivery, and birth weight has no correlation with cord bilirubin and the subsequent development of jaundice. CBB <2.5 mg/dl when compared with subsequent development of jaundice has high specificity (83.92%) and negative predictive value (87.35%). Cord blood value of >3.5 mg/dl has high sensitivity (97.06%), specificity (99.22%), positive predictive value (94.29%), and negative predictive value (99.61%) in predicting future development of future pathological jaundice. Conclusion: The present study suggests that in healthy term babies (CBB ≤2.5 mg/dl), cord serum bilirubin can help to identify those newborns who are unlikely to require further evaluation and intervention. These newborns can be discharged with assurance to parents. Babies with CBB level ≥3 mg/dl should be followed more frequently. Thus, this study concludes that cord blood total bilirubin levels reliably predict the occurrence of pathological hyperbilirubinemia. 


Growth changes in two age groups with different malocclusions in individuals of Central India
Shail Kumari, Shirish M Bapat, Kshitij Gupta

Archives of Medicine and Health Sciences 2019 7(1):53-56

Objective: Comparative evaluation of McNamara's analysis in Class I, Class II, and Class III individuals of Central India in two different age groups. Materials and Methods: 240 individuals belonging to Central India were divided into two main groups: Group I comprised 120 children (10–14 years) and Group II comprised 120 adults (18–22 years). McNamara's analysis was used to assess skeletal, dental, and soft tissue parameters. Results: Statistically significant difference was found for facial axis angle, mandibular length, and maxillary length in children and adults in dental/skeletal Class I individuals. In Class II division 1 individuals, statistically significant difference was found in children and adults for maxillary length, mandibular length, and lower anterior facial height. In Class II division 2 individuals, statistically significant difference was found in children and adults in maxillomandibular difference and lower anterior facial height. In Class III individuals, the difference was in nasolabial angle. Conclusion: The growth of maxilla is usually completed by 10-14 years of age. The present study suggests that the growth of maxilla is continuous in adults, and nasolabial angle decreases with age in Class III individuals. Hence, planning of extractions in earlier age should be decided with caution. 


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

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