Gayatri Ekbote, N. Negalur, D. Tanna, M. Bindroo, D. Raval, S. Bajad, Rajiva Gupta, W. Kazi
{"title":"Classifying ANCA-associated vasculitis and correlating outcomes based on anti-PR3/MPO serology: A prospective study from a tertiary care center","authors":"Gayatri Ekbote, N. Negalur, D. Tanna, M. Bindroo, D. Raval, S. Bajad, Rajiva Gupta, W. Kazi","doi":"10.4103/amjm.amjm_19_22","DOIUrl":"https://doi.org/10.4103/amjm.amjm_19_22","url":null,"abstract":"Introduction: Diagnosis and management of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a challenge for all. Overlapping features in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) make diagnosis sometimes difficult. We aimed to classify clinical features and outcomes of proven AAV according to their serology, viz., anti-PR3/myeloperoxidase (MPO) by the enzyme-linked immunosorbent assay (ELISA). Materials and Methods: This was a prospective observational study of a total of 66 patients. This study included all consequent (old and new) AAV patients visiting a tertiary care center in northern India from August 2012 to June 2018. Patients were followed up for a minimum of 6 months. ANCA was done by both immunofluorescence assay and ELISA. Results and Conclusion: When compared, serological classification yielded findings similar to clinical counterparts [PR3/MPO vs. GPA/MPA]. The majority [80.3%] of patients were PR3-positive and were GPA clinically. Lung involvement was common in the PR3 group; however, there was no significant difference between the two groups [viz., PR3 and MPO, P = 0.18]. ENT involvement was significantly higher in the PR3 group when compared with the MPO group [P-value=0.009]. The difference in renal involvement in both the groups was not significant [P = 0.28]. Renal biopsy findings were similar in both the PR3/MPO groups. The median follow-up period was 18 vs. 12 months in the PR3 and MPO groups, respectively. Relapse was significantly higher in the PR3 group [P = 0.017]. The PR3 group significantly required rituximab for second induction treatment [P = 0.028]. Eight patients (12.12%) died during the study period. There was no significant difference in mortality, and there was permanent organ damage in both the PR3 and MPO groups. Autoantibody-based classification is supplemental to the clinical segregation of AAV phenotypes.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129348014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Norethisterone enanthate–induced cerebral sino-venous thrombosis (CSVT): A rare case report","authors":"V. Sharmila, Sri Kalluri","doi":"10.4103/amjm.amjm_23_22","DOIUrl":"https://doi.org/10.4103/amjm.amjm_23_22","url":null,"abstract":"Cerebral sino-venous thrombosis is a potential life-threatening condition that requires rapid diagnosis and urgent treatment. The association between progestin-only pill used for the treatment of menstrual disorders and cerebral venous thrombosis has rarely been reported in the literature. We report a case of cerebral venous thrombosis following the intake of norethisterone for menorrhagia in a young woman. Although venous thrombosis is usually linked to the ingestion of estrogen, rather than progestogen, this case illustrates that patients who are prescribed progestogen-only pills for gynecological disorders may develop thrombosis.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132368847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Hakeem, A. Valsan, Niveda Srivatsa, K. Shrutiraaj, Swaraj Khajuria, N. Mohan, Kingshuk Kohli
{"title":"An unusual presentation of filariasis as pyrexia of unknown origin: Case report","authors":"S. Hakeem, A. Valsan, Niveda Srivatsa, K. Shrutiraaj, Swaraj Khajuria, N. Mohan, Kingshuk Kohli","doi":"10.4103/amjm.amjm_27_22","DOIUrl":"https://doi.org/10.4103/amjm.amjm_27_22","url":null,"abstract":"Filariasis is a common, yet neglected tropical disease and has a wide spectrum of clinical presentations. It is particularly endemic in certain regions of India. We report this case due to the rare isolation of Microfilariae from the bone marrow aspirate preparation. Here, we report a patient with a history of pyrexia of unknown origin (PUO). The relevant investigations done failed to identify the causative organism. After ruling out routine causes of fever, bone marrow analysis was done and it revealed Microfilariae in the aspirate. The surprising aspect of the case is the absence of eosinophilia in the complete blood picture. The patient was treated with anthelmintics and the fever subsided within 48 h. This case emphasizes the importance of bone marrow study in patients with PUO and the presence of microfilaria in the absence of eosinophilia.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115226063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Strengthening the component of obtaining feedback from patients and using the same to facilitate the teaching of medical students","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/amjm.amjm_21_22","DOIUrl":"https://doi.org/10.4103/amjm.amjm_21_22","url":null,"abstract":"The process of assessment and delivering feedback to the medical students has been acknowledged as the key aspects to ensure comprehensive professional development. This calls for the need to utilize every learning opportunity and provide students with some form of constructive feedback for aiding them to attain the learning competencies. The exposure or interaction with patients plays an important role in helping the medical students establish linkage between theoretical knowledge and clinical practice and understands the practical relevance of the learned topics. Feedback received from patients can prove to be a significant add-on and help students to ascertain what has been done well and which area needs improvement. To conclude, patients are an important stakeholder and, apart from contributing to the advancement of medicine, can also help medical students learn various skills through both formal and informal ways. The need of the hour is to actively involve patients in the process of clinical teaching and make students learn medicine from the beneficiary perspective.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126724907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Nwachukwu, A. Ayeni, Olutomiwa Omokore, Adetomilayo Arijeniwa, Segun Odejayi, P. Uduagbamen
{"title":"Quaint metastasis and markedly elevated prostate-specific antigen: An unusual manifestation of prostate cancer","authors":"N. Nwachukwu, A. Ayeni, Olutomiwa Omokore, Adetomilayo Arijeniwa, Segun Odejayi, P. Uduagbamen","doi":"10.4103/amjm.amjm_24_22","DOIUrl":"https://doi.org/10.4103/amjm.amjm_24_22","url":null,"abstract":"Prostate cancer is one of the most common malignancies in males globally with records of approximately 1.6 million diagnosis and over 0.36 million deaths annually. The discovering and subsequent clinical application of the prostate-specific antigen (PSA) improved the diagnostic rates. Values of PSA (a tissue-specific marker) persistently greater than 4 ng/mL are regarded as abnormal hence histological studies are often required to confirm malignancy. Adenocarcinomatous cells, commonly osteoblastic, typically metastasize to the lumbar region via the veins of Batson. We report a case of prostatic cancer in a 69-year-old Nigerian with markedly elevated PSA, thoracic spine, and pelvic metastasis.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115091929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recent advances in transport medium for avulsed tooth: A review","authors":"M. Venugopal","doi":"10.4103/AMJM.AMJM_34_21","DOIUrl":"https://doi.org/10.4103/AMJM.AMJM_34_21","url":null,"abstract":"Avulsion is one of the most severe types of traumatic injuries seen during childhood and adolescence. Apart from physical trauma, it also causes psychological trauma to the affected child. Immediate replantation is very essential for the long-term survival of teeth. However, when immediate replantation cannot be accomplished, the medium in which the tooth is stored becomes very important. The life of the avulsed tooth may be extended by the prevention of desiccation of periodontal ligament fibers by the usage of appropriate storage media. The choice of an ideal storage medium is essential for maximum preservation of traumatized periodontal ligament fibers of avulsed teeth; this also decides the success of the replanted tooth and long-term prognosis. A number of natural and synthetic storage mediums have been studied till date. This review discusses some recent additions in storage media for avulsed teeth. It reviews the characteristics of some less discussed storage media, which would help us to increase awareness among the health-care workers and broaden their horizon. This would, in turn, help them in reducing extraoral dry time of the avulsed tooth in case of emergencies. This review mainly focuses on less commonly discussed storage media for avulsed teeth and the effect of different properties of these media on their efficacy.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122982367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrating e-learning in MBBS curriculum: Potential challenges and solutions","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/AMJM.AMJM_12_22","DOIUrl":"https://doi.org/10.4103/AMJM.AMJM_12_22","url":null,"abstract":"The traditional mode of teacher-centered learning in the form of face-to-face lectures in classroom settings has been widely employed as a pedagogical strategy in medical education. Nevertheless, in the last few decades, there has been a shift toward adoption of e-learning considering globalization and the availability of the Internet. E-learning has been successfully employed in various streams of health sciences in different parts of the world with encouraging results. Even though e-learning is being present for quite some time now, the process of transition from traditional to e-learning has its own challenges and it has influenced the overall impact in determining the precise effectiveness. To conclude, e-learning in medical education is associated with multiple benefits for both the students and teachers. It is the need of the hour to identify the potential challenges and accordingly take corrective measures to overcome them and thereby ensure seamless integration with the traditional curriculum.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"295 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126019568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic factors for recurrence of Tolosa Hunt syndrome","authors":"J. Rissardo, Ana Letícia Fornari Caprara","doi":"10.4103/amjm.amjm_13_22","DOIUrl":"https://doi.org/10.4103/amjm.amjm_13_22","url":null,"abstract":"","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126744138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asha Joseph, V. Ramanarayanan, Krishnan Venugopal, V. Prabath Singh, Kavitha Dhruvan, K. Sagar
{"title":"Standards of practice among endodontists in Kerala, India: An exploratory study","authors":"Asha Joseph, V. Ramanarayanan, Krishnan Venugopal, V. Prabath Singh, Kavitha Dhruvan, K. Sagar","doi":"10.4103/AMJM.AMJM_7_22","DOIUrl":"https://doi.org/10.4103/AMJM.AMJM_7_22","url":null,"abstract":"Background: The field of endodontics is greatly evolving with the brisk entry of not just new materials but also numerous technology-based advances. Factors governed by the practitioner such as the canal preparation technique, the disinfection regimes followed, the standard of obturation, and the quality of coronal and apical seal all in turn greatly influence the prognosis of the endodontic treatment. Objective: To assess the attitude concerning the materials and techniques used during endodontic treatment among the endodontists in Kerala. Materials and Methods: An online questionnaire-based cross-sectional study was done among endodontists in Kerala. The questionnaire assessed several key aspects of endodontic practice. A comparison was made based on the nature of practice and years of practice. Results: A total of 165 responses were obtained. A high percentage of participants (>75%) routinely employed preoperative radiographs. A combination of apex locators along with radiographs was most preferred for working length determination, and calcium hydroxide was the most preferred root canal sealant. Almost half of the endodontists did not use any form of magnification. Conclusion: Despite several booming advances in technology, endodontists still do not strictly follow the implementation of important regimes such as the incorporation of magnification or use of a rubber dam in their practice, which still needs to be meticulously incorporated into practice, which would raise the standards of clinical practice.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122164723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Involvement of husbands in birth preparedness of their partner: A cross-sectional survey from a rural area of Ernakulam, Kerala","authors":"S. Mohandas, P. Francis, Nimitha Paul","doi":"10.4103/AMJM.AMJM_9_22","DOIUrl":"https://doi.org/10.4103/AMJM.AMJM_9_22","url":null,"abstract":"Background: In India, a country driven by a patriarchal society, the involvement of men in their wife’s pregnancy and childbirth has been considerably low. This remained static until the International Conference on Population and Development held in Cairo in 1994 which prompted the equal responsibility of men and women in reproductive health. Objective: The aim of this article is to assess the involvement of husbands in birth preparedness and to determine factors associated with their involvement in the birth preparedness of their partner. Materials and Methods: A community-based cross-sectional study was done in the rural field practice area of Amrita Community Health Training Center at Njarackal, Ernakulam. The minimum calculated sample size was 103; three wards from the panchayath were selected and women who were currently pregnant or had a child less than 2 years of age were interviewed using a semi-structured pre-tested questionnaire. Data were tabulated using Microsoft Excel and analyzed using SPSS version 20. Results: Of the 102 respondents, good involvement of husbands in birth preparedness was found to be 50%. A significant association was seen between husbands’ involvement and age of respondent (>27 years) as well as with the presence of an older child in the couple. Conclusion: As 50% of husbands had only poor involvement, sessions need to be planned under MCH for sensitizing husbands to their role in ensuring a healthy pregnancy, especially in primigravida, as it is seen that there is an association between higher-order births and involvement.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129387014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}