Category Archives: April 2014

Current Issue Volume 1 Issue 1

Gogia_Ebola virus

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Outbreak of Ebola virus click alarm for devastating epidemic
Gogia P,1 Ambey R,2 Singh A,3 Gaur A,4 Patel GS5

Post Graduate Student,1 Assistant Professor,2 Associate Professor,3,4 Professor5

1,2,4,5Department of Pediatrics, G R Medical College, Gwalior, M P, India

3Department of Pathology, Index Medical College Hospital and Research Center, Indore, MP, India

ABSTRACT
Ebola viral disease formerly known as ebola hemorrhagic fever is a severe, often fatal illness in human, outbreaks having case fatality rate upto 90%.It was first noted in 1976 , and is a WHO risk group 4 pathogen, many outbreaks have occurred since then but 2014 outbreak is worst outbreak in terms of cases and fatalities. Unfortunately the infecting Ebola virus detected this outbreak is Zaire strain, the most pathogenic strain of Ebola. Health agencies are forced to term this outbreak as an “unprecedented epidemic” seeing its devastating impact.
KEY WORDS
Ebola, global alert, Zmapp

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narang_poem

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ULCERATIVE COLITIS

Narang S

Professor

Department of Pathology, Index Medical College Hospital and Research Center, Indore, M P, India

ULCERATIVE COLITIS: POEM
Begins in the rectum and backwards it goes

No mercy to any part of colon it shows.

Continuous it is, skip areas without

Ulcerative colitis it is, without a doubt.

Mucosa has ulcers, you should know

Linearity & superficiality they show.

 

Muscle contracted & narrow, problem does pose

Provides it, the appearance of a garden hose.

 

Sometimes it waxes and sometimes wanes

Accordingly active or resolving status it gains.

 

Crypt abscesses are always produced

And goblet cells are markedly reduced.

 

Congestion & mucosal regeneration noted have been

Dysplasia to Neoplasia-spectrum entire is seen.

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singh_lung

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Evaluation of Lung Function by Spirometry in 12-14 yrs Adolescents in schools of Raipur city Chhattisgarh

Singh V 1, Kurrey VK2, Khandwal O3, Phuljhele S3

Resident1, Assistant Professor2, Associate Professor3

1-4Department of Paediatrics, Pt JNM Medical College Raipur, Chhattisgarh, India

ABSTRACT
Aim
The study was carried out in normal school children in Raipur city to determine pulmonary functions in the age group 12-14 years.
Background
Spirometry is a important tool to assessment of lung function by evaluating forced vital capacity (FVC), forced expiratory volume in first second (FEV1), the ratio of FEV1 to FVC, peak expiratory flow rate (PEFR). Indian norms for spirometric test values are different from Western and other norms. Even within the country the test values differ between different regional and ethnic groups.
Material Methods
This is Cross sectional analytical observational study. 267 subjects were evaluated through pulmonary function test by Spirometry. Results were expressed as Mean ± SEM (Standard error of mean). Pearson’s correlation coefficient(r) is calculated between dependent and independent variables. Prediction equations were developed using the multiple linear regression procedure.
Results
In our study spirometric parameters for boys were higher than girls. All Spirometric values were found to increase in relation to increase in height in both girls and boys except for the FEV1 %. All Spirometric values were found to increase in relation to increase in Age (12 to 14 years) in both girls and boys except for the FEV1 %.
Conclusion
This study shows, all the independent variables (age, weight, height and BSA) have linear positive correlation with lung function parameters, both for boys and girls. Height is the most important and reliable single independent variable. Regression equations for spirometry variables for region have been developed.
KEY WORDS
Forced Vital Capacity (FVC), Forced Expiratory Volume in First Second (FEV1), Peak Expiratory Flow Rate (PEFR)

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veerbhadra_hypothermia

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Comparative study of various techniques to measure neonatal hypothermia

Veerbhadra CD1, Ambey R2, Gaur A3, Singwekar AG4

Resident1, Assistant Professor2, Associate Professor3, Professor4

1-4Department of Paediatrics, G R Medical College Gwalior, M P, India

ABSTRACT
Aim
To compare different available modes (forehead infrared thermometer ,axillary temperature by thermister probe and digital thermometer, with axillary temperature by gold standard mercury thermometer) of temperature measurement in neonatal hypothermia in order to come out with most accurate one among them.
Background
Hypothermia is very important in essential newborn care as it can lead to mild to severe life threatening complication, so detecting hypothermia takes important role in its management.
Material Methods
Study Design: Setting was Neonatal Intensive Care Unit (Level 3), Kamla Raja Hospital ,Gajra Raja Medical College, Gwalior, India. A Prospective study of one year (July 2010 - June 2011 ) duration done with 1690 admissions of neonatal intensive care unit (full fill inclusion criterion ) by applying Fisher test on 2×2 contingency table to get sensitivity , specificity , positive predictive value , negative predictive value and accuracy of above 4 methods by STATA 9.1 (STATA corporation, college station , TX, USA).
Results
Digital thermometer is having highest sensitivity (99.1%), specificity (98.1%), positive predictive value (97.4%) and negative predictive value(99.3%).
Conclusion
Digital axillary thermometry is the best alternative to mercury thermometer for measuring neonatal temperature compared with axillary temperature by thermister probe and forehead temperature by infrared thermometer.
KEY WORDS
Neonatal temperature recording, Digital thermometer, Forehead infrared thermometer, mercury thermometer, Thermister probe.

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verma_proton

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Proton Pump Inhibitors in Gastroesophageal reflux in Pretems: A Systematic Review
Verma N1, Pancholi R2, Verma R3
Consultant Neonatologist1, 2, Associate Professor3

1,2Department of Neonatology, Bansal Hospital, Bhopal, M P, India

3Department of Pharmacology, L N Medical College, Bhopal, M P, India

ABSTRACT
Background
Gastroesophageal reflux is primarily physiological in newborns, especially in prematures less than 34 weeks of gestation. Recently there has been a surge in the use of anti reflux medications especially proton pump inhibitors to treat significant reflux in newborns the rewards of which are questionable and hence their use needs to be addressed.
Material Methods
A PubMed search was done using the key words “gastroesophageal reflux”[all fields] and “preterm”[all fields] and/or “term” [all fields] and/or “newborn”[all fields]. The articles included were randomized trials, prospective studies, retrospective studies, review articles and observational studies.
Conclusion
As per current evidence, the risk to reward ratio of proton pump inhibitors does not favour it to be routinely recommended for treatment of gastroesophageal reflux in preterm newborns.
KEY WORDS
Gastroesphageal reflux, Preterm, Newborn, Proton pump inhibitors

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goyal_meropenem

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Meropenem: Current PERSPECTIVES
Goyal V K1, Rajput S S2
Assistant Professor1, Senior Resident2

1Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, India

2Department of Pediatrics, G R Medical College, Gwalior, M P, India

ABSTRACT
Meropenem is an ultra broad spectrum parenteral carbapenem with excellent safety profile and minimal drug interactions. It is effective in a variety of tissue infections. But to prevent emerging drug resistance, its use should be restricted to complicated/serious infections not amenable to other antimicrobials
KEY WORDS
Carbenem, meropenem, drug resistant enterobacteriaceae (DRE).

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gupta_editorial

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Bringing Together Research and Practice
Dr Piyush Gupta
Professor of Pediatrics
University College of Medical Sciences, Delhi; and Editor-in-chief, Indian Pediatrics (2008-2013), New Delhi, India. Correspondence to: Dr Piyush Gupta, Block R-6-A, Dilshad Garden, Delhi 110095.
ABSTRACT
Research, to be meaningful to the community, should be able to affect or mold the practice of medicine, favorably. It is in this context that the International Journal of Medical Science Research & Practice (freely available at https://www.ijmsrp.com/) is being launched. And I feel fortunate to be writing the inaugural editorial. The aim of the journal is to bring together the researcher and the practitioner on the same platform, so as to build up the providers, expertise, and capacity for evidence-informed practice. IJMSRP is a quarterly, open access, peer reviewed journal with wide scope of subjects, i.e. basic medical science subjects (anatomy, physiology, biochemistry), para-clinical subjects (pathology, microbiology, pharmacology, forensic medicine, community medicine); and clinical sciences (medicine, surgery, obstetrics gynecology, orthopedics, pediatrics, ophthalmology, otolaryngology, psychiatry, dermatology, medical ethics, and medical education) etc. Professionals of all levels should benefit from the wide range of high quality, accessible articles published in this journal.What constitutes research and what kind of research deserves to be published is a never-ending debate. To me, every research is pertinent and merits publication as long as it is ethical, relevant (to be able to have an impact on practice of the specialty) and topical (applicable to current needs). The basic idea of a research is to clear doubts. The generalizability of the results would, however, depend upon the robustness of the methodology adopted to answer the research question. As there can be different paths to reach a destination, there can be several methodologies to answer a research question. Mount Everest has been conquered through various routes, and yet a perfect route is yet to be discovered—the ‘perfect route’ here referring to one where the mountaineer doesn’t face death, illness or any other hindrances in achieving the goal. Such a route may, perhaps, never be discovered yet the mighty peak will continue to be the attraction of the climbers, to satisfy their passion of adventure. Same is true for research; all methods have one/another flaw and thus there is no method ‘too perfect’ to answer a research question. Knowing that fully well, we seek answers, even though they may not be the ultimate unchallengeable truth to the research question, relevant to the practice of medicine. It is a boon in disguise that no research is perfect. Had it been, there would be no new hypotheses, no new postulates, and no new theories to work upon.Another question is “whether every research has to be novel”? Papers are often rejected for the lack of novelty. The editors not only look for a novelty in the research question, but equally so in the methods undertaken to solve this question. This may need some debate. Repetition of older experiments is also essential, not only to validate the earlier findings, but also to find out whether the results would change with change in setting of the study or experiment, or over a period of time. At the same time, a novel twist in the selection of participants, inclusion criteria, tools, case-definitions, outcome measures, study devotion, follow-up and statistical methods can serve to bring a new dimension to research. This needs to be amply highlighted when a paper is being sent for publication, so as to quench the editor’s inevitable thirst for novelty. No research question is ever too stale despite it being repeated. There can always be newer settings, different tools, diverse population groups, and novel outcome measures with the same research question. What’s more important is the honesty and confidence with which the research is conducted.For me, another desirable function of a research is that it should be able to generate more queries than it is able to answer. This is essential for a cascading and never-ending quest for knowledge. Once Mount Everest was conquered, it was not that the mountaineers stopped scaling the peak; rather, it was pursued with more vigor, it was planned with more knowledge and it revealed more of the mountain than had been known before. Several new questions were generated during each ascent and the focus then shifted to answering these, taking into consideration new parameters for the success of a journey like the shortest route, the safest route, the most feasible route, the least use of technological assistance, a differently-abled person as the traveler, preventing mortality and morbidity related to high altitude climbing, etc. A research question therefore remains alive by leaving in its wake more questions. That is the beauty of research. The natural hierarchical progression of translational research starts with the generation of research question, execution of technical research and its transformation into operational research before being finally absorbed as a policy into the (health) system.Fellow editors and researchers, the choice is yours. You can hunt for the perfect research, the one that efficiently gives a precise and correct answer, or you can look for the research where you are left newer questions to contend with. As for me, I believe that every research is perfect as long as it provides new dimensions, presents understandable strong evidences and admits limitations. You can look for the perfect research according to the parameters you set, but odds are, it’s right in front of your eyes.
KEY WORDS
Medical Journal, Research, Practice

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garg_granuloma

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EXTENSIVE PATCH TYPE GRANULOMAS ANNULARE: A RARE CASE REPORT
Garg Anubhav1, Garg Sushma2, Gupta L K3, Khare A K4, Mittal Asit3
Assistant Professor1, Consultant Physician2, Associate Professor3, Professor and Head4

1Department of Dermatology, Venereology and Leprosy , G R Medical College, Gwalior, M P, India

2 Gwalior, MP, India

3,4Department of Dermatology, Venereology and Leprosy , RNT Medical College, Udaipur, Rajasthan, India

ABSTRACT
A 16-year-old girl presented with multiple, asymptomatic, progressive, hyperpigmented patches of 6 months duration over trunk and thighs. Histopathology showed features of interstitial granuloma annulare. The clinical diagnosis was consistent with patch type granuloma annulare.
KEY WORDS
Granuloma annulare, patch type granuloma annulare, interstitial pattern, palisading granuloma, necrobiosis

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garg_anonychia

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Anonychia congenita totalis with epilepsy and mental retardation
Garg Anubhav1, Garg Sushma2, Saraswat P K3
Assistant Professor1, Consultant Physician2, Professor and Head3

1,3 Department of Dermatology, Venereology and Leprosy , G R Medical College, Gwalior-474001, M P, India

2 Gwalior, MP, India

ABSTRACT
Anonychia congenita is a rare disorder characterized by absence of several or all fingernails and/or toenails since birth. A 35-year-old man with mental retardation presented with a history of absence of all nails since birth. There was also a history of epileptic fits since early childhood.
KEY WORDS
Anonychia, anonychia congenita, RSPO4 gene

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ambey_image

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Title : Bilateral Portwine Stain in a child with Sturge Weber Syndrome

Author: Dr. Ravi Ambey Co-Author: Dr. Arjun Singh

A 3 year old child presented with generalized seizures for one year. Child was the product of nonconsanguinous marriage with no family history of seizure and developmentally appropriate for age. On examination child was having very peculiar pattern of portwine stain on face. It involved the territory of Right ophthalmic division and Left mandibular division of trigeminal nerve. On right side it involved forehead, nose, upper eye lid and bulbar conjunctiva and on left side it involved left cheek, part of pinna, mandibular area, lip, oral mucosa and neck . Child was having nine ash leaf spots over trunk and extremities. Intraocular pressure was normal. On CT scan of head there was bilateral tram track calcification in cerebral cortex with atrophy. Child was started with valproic acid and seizure free for last three months.

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