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  Citation statistics : Table of Contents
   2017| September-December  | Volume 7 | Issue 3  
    Online since September 15, 2017

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Premedication with oral gabapentin versus intravenous paracetamol for post-operative analgesia after tibial fracture surgery
Mohammad Khalili, Hesameddin Modir, Afsaneh Norouzi, Abolfazl Mohammadbeigi, Seyed Arash Bagherinejad Somesara
September-December 2017, 7(3):115-118
Introduction: Much attention has been devoted to the management of post-operative pain. Pain reduction brings more comfort and leads to faster recovery and mobilisation of a patient. In addition, it reduces thromboembolic events and eventually the length of hospital stay and cost of treatment. This study was conducted to compare the efficacy of gabapentin versus paracetamol for post-operative analgesia after tibial fracture surgery. Materials and Methods: This study was designed as a randomised, controlled clinical trial, in which 96 patients undergoing elective tibial fracture surgery under general anaesthesia were divided into three groups (gabapentin, paracetamol and placebo). Half an hour before induction of anaesthesia, patients received 300 mg oral gabapentin or 1000 mg paracetamol or 100 ml normal saline (these two latter as intravenous infusions) according to their groups. Surgery was performed under general anaesthesia, with similar anaesthetic regimen for all patients. The pain intensity was measured using a visual analogue scale ruler at 2, 4 and 6 h after operation. Collected data were recorded then and analysed using the statistical software SPSS. Results: At 2, 4 and 6 h after surgery, no significant differences were observed between the two paracetamol and gabapentin groups in terms of pain intensity. Pain intensity in the placebo group was significantly higher than the two case groups. Mean opioid consumption as a rescue intervention was not significantly different between the three groups. However, the placebo group included a larger number of patients requiring opioid analgesics, which was significantly different. Conclusion: A significant pain reduction was observed in both case groups as compared to placebo. Gabapentin and paracetamol had similar efficacies in post-operative analgesia after tibial fracture surgery. No difference was found between the three groups in terms of mean opioid analgesic requirements.
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Immature gastric teratoma: A rare tumour
Ajay Yadav, Akash Mathur, Arpita Jindal, Hemant Malhotra
September-December 2017, 7(3):142-144
Gastric teratoma is a very rare tumour. We reviewed the literature and found that only around 100 cases have been reported. Almost all reported cases of gastric teratoma were of mature variety. Only a few cases were of immature variety. The rarity of the disease makes the diagnosis very difficult most of the cases occurred in infants. The disease is more common in males than in females. Majority of cases have been reported to arise from the greater curvature and posterior wall of the stomach. Histopathological examination confirms the diagnosis. Treatment of choice is surgical excision with close follow up. Following surgical excision prognosis is excellent. Hence, in an infant who presents with abdominal lump gastric teratoma should be kept as one of the differential diagnosis. Here, we are reporting a case of immature teratoma.
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The sun will rise and we shall start again
Rohan Bhatt
September-December 2017, 7(3):99-100
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Effect of cigarette smoking on myocardial workload in young adults
Sunil Kumar Jena
September-December 2017, 7(3):109-112
Background: Cigarette smoking is a major independent risk factor for coronary artery disease and other cardiovascular (CV) events. Cigarette smoking causes sympathovagal imbalance leading to various CV events. Thus, this study was proposed to evaluate the status of smoking in young adults and its effect on myocardial workload. Materials and Methods: This case–control study was conducted among 60 smokers (case) and 48 non-smokers (control). Participants selected for this study (both cases and controls) were MBBS students of a health university in Odisha. Cigarette smoking status was quantified by pack year (PY). Recordings of blood pressure (BP) and heart rate (HR) were done between 7.30 and 8.30 am after taking 10 min rest. HR was calculated by carotid pulsation. Recording of BP was done in the right arm sitting position, auscultatory method. Two parameters i.e., systolic BP (SBP) and HR were used to calculate rate pressure product (RPP). Results: Smoking status suggested that the smokers recruited were of low intensity of smoking or light smokers. HR, SBP and RPP of smokers were more than that of non-smokers. This variation was found to be significant at P < 0.0001. A quantitative analysis suggested that smokers had 19.25 times more risk to develop CV disease than non-smokers which was also significant at P < 0.0001. Conclusion: Various studies suggested that heavy chronic smokers are suffered from CV diseases. This study suggested that short duration of smoking as well as smoking history of low PY increases myocardial workload and risk of heart disease.
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Carcinosarcoma of the Breast: A retrospective observational study
Deepti Sharma, Garima Singh
September-December 2017, 7(3):113-114
Background: Carcinosarcoma of the breast is an extremely rare breast condition, accounting for 0.1% of all breast malignancies. Limited data are available in English literature on this issue due to paucity of cases. Hence, we retrieved data of carcinosarcoma of breast for evaluation of clinicopathological characteristics, treatment, and outcome of this emerging issue. Materials and Methods: A retrospective observational study was conducted from January 2011 to December 2015 in our Department of Radiotherapy. A total of four patients were identified during this period for analysis in this study. Various parameters such as age, clinical features, clinical stage, and the treatment received by the patients were recorded and analyzed for outcome. Results and Discussion: Median age at the time of presentation was 42 years (range 28–46 years). Seventy five percent females were post-menopausal. The most common symptom was slowly growing lump in the breast. All of the patients, except one, were negative for oestrogen receptor/progesterone receptor (ER/PR) and human epidermal growth factor receptor 2 (HER2/neu) receptors. All patients underwent surgery followed by adjuvant therapy,except one. Median follow-up was 23 months (range 2–66 months). Conclusion: Carcinosarcoma of the breast is a rare entity with poor outcome. There are no specific treatment guidelines. Surgery is the main treatment modality, and it should be followed by adjuvant chemo and radiotherapy.
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Clinico-radiological profile of pulmonary sarcoidosis: A study of 150 patients
Rahul Gupta, Anchal Gupta, Mohd Ilyas, Mohi Kalsotra
September-December 2017, 7(3):119-123
Objective: The main aim of this study was to study the radiological, including radiographic and computed tomographic, histopathologic and clinical profiles in patients of pulmonary sarcoidosis. Materials and Methods: A prospective study of 150 patients suspected of having sarcoidosis was carried out with their routine chest radiographs and computed tomography scans performed followed by histopatholgical analysis of the lymph nodes. Results: Most of the patients evaluated belonged to the Stage-I sarcoidosis least number of patients were from Stage-IV disease. Conclusion: All the modalities should be combined with clinico-radiologico-pathological diagnosis of the disease to avoid inconvenience to the patient and misdiagnosis.
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A demographic study on relation between uric acid and diabetes parameters in the Chhattisgarh State of India
Parul Thakur, Ashwini Kumar, Pradeep Kumar Patra, Awanish Kumar
September-December 2017, 7(3):124-129
Objective: Epidemiological evidence suggest that conflicting data exist for the relation between serum uric acid (SUA) and various diabetes-associated parameters. Therefore, measurement of SUA levels could play a valuable role as predictor marker in early type 2 diabetics as well as a potent antioxidant therapeutic. This work is a small demographic study in the patients of Chhattisgarh to find a relation between the SUA level and diabetes parameters in diabetics and controls. Materials and Methods: This was a small sample set case–control study. Patients were divided into two groups, namely, control (n = 25) and type 2 diabetics (n = 30). Biochemical estimation of parameters was performed using commercially available enzymatic kits. Results: Plasma glucose, serum triglyceride, glycated haemoglobin and creatinine were higher in diabetic patients than in controls. SUA showed a significant lower level in test patients (2.97 ± 0.22) as compared to control (4.35 ± 0.64). A negative correlation of r = −0.8159 was obtained between SUA and plasma glucose levels. Conclusions: Results suggest that variation in uric acid (UA) levels from normal to pre-diabetes and diabetes condition could be an important biomarker. Further validations may pave the way for UA measurement as a diagnostic and prognostic marker in type 2 diabetes mellitus.
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One-year clinical evaluation of nanohybrid resin composite in the restoration of occlusal and proximo-occlusal cavities in Nigeria
Lillian Lami Enone, Adenike Ololade Awotile, Cyril Ilemobade Adegbulugbe, Lara O Agbaje, Loto Adolphus Odogun, Afolabi Oyapero
September-December 2017, 7(3):130-136
Background: This study aimed to evaluate the clinical performance of nanocomposites in a Nigerian adult population. Resin composites are becoming the preferred direct restorative material in restoring occlusal and proximo-occlusal cavities due to their aesthetic properties and good clinical service. Materials and Methods: This was a clinical study evaluating the clinical performance of a nanohybrid resin composite in the restoration of occlusal and proximo-occlusal cavities in Nigerian adults. This study was done in the Conservative Dentistry Clinic of the Lagos State University Teaching Hospital, Ikeja, from April 2014 to September 2015. The restorations were evaluated immediately at baseline, 3, 6 and 12 months postoperatively for colour match, marginal discolouration, surface roughness, anatomical form, marginal adaptation, retention, post-operative sensitivity and secondary caries using the modified USPHS criteria. Statistical analysis was performed using Fisher's exact test and a 5% level of significance was considered statistically significant. Results: Males had more proximo-occlusal (26.7) than occlusal (6.7) cavities while the females (43.3) had more occlusal cavities. The nanohybrid occlusal restorations had 100% alpha scores at baseline for anatomical form which dropped to 93.3% at 12 months with 6.7% of the restorations scoring Bravo, whereas all nanohybrid proximo-occlusal restorations had 100% alpha scores from baseline to the 12-month review. All occlusal and proximo-occlusal restorations evaluated for surface texture and marginal adaptation had alpha scores at baseline which dropped to 93.3% at 12 months. Conversely, all nanohybrid occlusal and proximo-occlusal restorations scored 100% for colour match and retention, sensitivity and secondary caries from baseline to 12 months. Conclusion: The clinical performance of natural elegance nanohybrid resin composite (Henry Schein®) was satisfactory in the restoration of occlusal and proximo-occlusal cavities in Nigerian adults over a 1 year evaluation period.
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Analysis of biological and mechanical related performance parameters of Malaysian senior youth archers
Zahari Taha, Mainul Haque, Rabiu Muazu Musa, Mohamad Razali Abdullah, Ahmad Bisyri Husin Musawi Maliki, Siti Musliha Mat-Rashid, Norlaila Azura Kosni, Aleesha Adnan
September-December 2017, 7(3):137-141
Background: Archery is a close skill sport in which the archer interacts with body and equipment. The interaction between the archer's body and the equipment could influence archery shooting scores. It is vital for an archer to be cognisance with any movements during these interactions process. Objectives: This study investigates the various biomechanical interactions and their association with archery performance. A total of 32 archers drawn from different programmes participated in the study. Materials and Methods: A sum of four shimmer sensors were used to examine, compare and differentiate the postural sway, movement of the bow, muscular activations of the muscle flexor digitorum superficial, muscle extensor digitorum and resting heart rate of the archers. The archers shoot six arrows at a distance of 50 m, and the selected parameters were streamed during the aiming, stance and the releasing phases of the arrows in real time at a sampling rate of 51.2 Hz using an Android phone. Results: Cluster analysis classified the archers into two groups, namely, high-performance archers (HPA) and low-performance archers (LPA). Standard, step-wise backward and step-wise discriminant analysis differentiated the two groups with three and two dependents variables with an acceptable accuracy of 83.38% and 90.63%. Pairwise t-test comparisons revealed that HPA shows higher muscular extensor activations and lower postural sway with greater shooting scores while LPA recorded higher postural sway and corresponding lower shooting scores. Conclusions: Some biological and biomechanical related parameters such as muscle extensor activation and postural sway could determine shooting accuracy in archery sport.
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Generic medicine and prescribing: A quick assessment
Mainul Haque
September-December 2017, 7(3):101-108
Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts. The Food and Drug Administration (FDA) describes that generic drugs are essential possibilities that allow better access to healthcare for all Americans. They are replicas of brand-name drugs and are the identical as those of brand-name drugs in dosage form, safety, strength, route of administration, quality, performance features, and anticipated to use. Healthcare authorities and users can be guaranteed that FDA-approved generic drug products have met the same stiff principles as the innovator drug. The company that made Bayer aspirin fought in court enthusiastically to keep generic versions off the shelves, in the 1920s. The company lost in court, and consumers suddenly had an array of choices in generic aspirin. The Supreme Court of India uttering ‘the Supreme Court's ruling will prevent companies from further seeking unwarranted patents on HIV and other essential medicines.’ Generic medicine cannot be sold at a price higher than the branded medicine, so it is regularly a low-priced option. Thereafter, both the end user and the government who pay for part of the price of the medicine under the Pharmaceutical Benefits Scheme in Australia are benefitted. The treatment of diseases using essential drugs, prescribed by their generic names, has been emphasised by the WHO and many national health policies. Although there are some improvements in generic medicine prescribing, it has been advised by the WHO that ‘countries should intensify efforts to measure and regularly monitor medicine prices and availability, and adopt policy measures to address the issues identified.’
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