JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH最新文献

{"title":"Comparison of the Pharmacokinetics, Bioequivalence and Safety of Aqueous Progesterone Formulation Administered as either Intramuscular or Subcutaneous Injection versus Oil-based Progesterone Formulation Administered as Intramuscular Injection: A Randomised Study","authors":"Sonal S. Mehta, A. Chaturvedi","doi":"10.7860/jcdr/2023/56291.17889","DOIUrl":"https://doi.org/10.7860/jcdr/2023/56291.17889","url":null,"abstract":"Introduction: Progesterone is the treatment of choice for support of the luteal phase of controlled ovarian stimulation cycles in women undergoing an Assisted Reproductive Technology (ART) treatment. Available progesterone preparations include oral, vaginal and oil-based Intramuscular (i.m.) formulations. Oral formulation has poor bioavailability whereas vaginal formulations cause side-effects such as vaginal discharge and/ or local irritation. Oil-based progesterone formulations for i.m. use are associated with discomfort and pain at the injection site. Hence, a novel aqueous-based progesterone formulation for i.m./Subcutaneous (s.c.) was developed to avoid the local tolerability issues of the existing parenteral formulations. Aim: To assess single-dose Pharmacokinetics (PK) and relative bioavailability of i.m. (test-1; T1) or s.c. (test-2; T2) administration of novel aqueous progesterone formulation with i.m. (reference; R) administration of oil-based progesterone formulation. Materials and Methods: In this open-label, three-sequence, three-period, single-dose, cross-over study, 51 healthy human postmenopausal female subjects between 45 to 65 years of age were included. The study was conducted at Lambda Therapeutic Research Limited, Ahmedabad, Gujarat, India, between 21 May 2018 to 06 July 2018. Subjects were randomised to a single 25 mg dose of T1, T2 or R in three-periods (Period-I: T1, R, T2; Period-II: T2, T1, R; Period-III: R, T2, T1) with ≥18 days washout period. Blood samples were collected at prespecified time points in each period and analysed using validated liquid chromatography with tandem mass spectrometry. PK parameters {maximum plasma concentration (Cmax), time to reach Cmax (Tmax), area under the plasma concentration vs. time curve (AUC0-t), AUC from time 0 to ∞ (AUC0-∞), plasma half-life (t1/2)} were calculated from the plasma concentration vs. time profile by non compartmental model. The total study duration was about 47 days (11 hours prior to the drug administration in Period-I until the last ambulatory sample in Period-III). All patients provided written informed consent form and an approval from the Conscience-Independent Ethics Committee (CIEC) was taken. Descriptive statistics were calculated and reported for PK parameters for baseline corrected and uncorrected data. Results: Of 72 screened patients, 51 patients were included for the PK and statistical analysis. The mean±SD age of the patients was 55.1±4.67 years. The baseline corrected PK data shows that in T1, T2 and R arms, mean (range) Tmax were 1.00 (0.50– 1.75), 1.00 (0.75–1.75) and 8.00 hours (1.00–12.00), mean±SD t ½ (h) were 15.43±5.81, 15.27±6.68 and 19.80±6.35; mean±SD Cmax (ng/mL) were 101.91±73.07, 51.67±14.81 and 18.89±7.89, and mean±SD AUC0-t (ng/mL) were 385.10±89.29, 349.63±64.41 and 371.50±56.25, respectively. Similarly, the AUC0-∞ was also comparable in all three arms. The baseline uncorrected data were also in line with baseline corrected data. For AU","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"25 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76565228","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":"Antiproliferative and Proapoptotic Effects of Vitamin D3 in Human Neuroblastoma Cell Lines SH-SY5Y: An In-vitro Study","authors":"Kruti N. Parikh, Kavitha Ramasamy Kavitha Ramasamy, Kranthi Karunai Kadal Kranthi Karunai Kadal, Punnagai Kumaravelu","doi":"10.7860/jcdr/2023/60147.17298","DOIUrl":"https://doi.org/10.7860/jcdr/2023/60147.17298","url":null,"abstract":"Introduction: Neuroblastoma is the most common and earliest childhood tumour with complicated biological and clinical characteristics. The treatment includes chemotherapy, radiation therapy, surgical resection, stem cell therapy and many other modes, making the management difficult to tolerate and unacceptable. Thereby increasing the need to develop novel therapies or repurpose already existing ones with anticancer potential. Many studies have shown that vitamin D3 has anticancer properties. Vitamin D3 receptors have been found in neuroblastoma cell lines, according to research. Anticancer property of vitamin D3 hasn’t been studied much in neuroblastoma cell lines. Aim: To evaluate the antiproliferative and proapoptotic effects of vitamin D3 on human neuroblastoma cell lines-SH-SY5Y. Materials and Methods: The present study was an in-vitro study in which human neuroblastoma cell lines SY5Y (a total of 2 cell lines) were obtained from National Centre for Cell Science (NCCS), Pune, Maharashtra, India, and control cells are cells from the cell lines that were left untreated. The antiproliferative effect of vitamin D3 in human neuroblastoma cell lines evaluated using the MTT (3-(4,5-dimethylthiazolyl-2)-2,5 diphenyltetrazolium bromide) assay. After 48 hours of incubation and treatment with six different (0.01, 0.1, 1, 10, 100, and 1000 ng/mL) concentrations of vitamin D3, the percentage of viable cells was determined using spectrophotometry and compared with control cells (untreated cells from cell lines). Different vitamin D3 (250 ng/mL, 500 ng/mL, 1000 ng/mL) doses were applied to cells and they were then incubated for 24 hours, Cell death and malformations were then observed using a phase contrast microscope, and Deoxyribonucleic Acid (DNA) fragmentation was investigated using gel chromatography. The obtained results were expressed as percentage of inhibition and tabulated in Microsoft Excel Sheet Version 16.16.27 and scatter plot graph was used to calculate IC50 (Half maximal inhibitory concentration). Results: The vitamin D3 showed antiproliferative property in SH-SY5Y cells at an IC50 of 164 ng/mL when tested against human neuroblastoma cells using the MTT assay. Phase contrast microscope demonstrated that vitamin D3 treated cells showed condensation of nuclei, shrinkage of the cytoplasm, convolution of outline and cell peeling demonstrating apoptosis. DNA fragmentation also showed typical DNA ladder formation confirming apoptosis in vitamin D3 treated cells, which showed that the treated cells’ DNA was more damaged than the control cells’ DNA. Conclusion: Vitamin D3 exhibited both proapoptotic and antiproliferative properties, as demonstrated by the MTT assay, Phase Contrast, and DNA fragmentation.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"14 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78452770","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":"Rare Antinuclear Antibody Patterns: Relevance in Routine Laboratory Reporting","authors":"Vidya Bhakta","doi":"10.7860/jcdr/2023/60084.17321","DOIUrl":"https://doi.org/10.7860/jcdr/2023/60084.17321","url":null,"abstract":"Introduction: Uncommon patterns on Human Epithelial 2 (Hep 2) substrate during Antinuclear Antibody (ANA) screening by Indirect Immunofluorescence (IIF) microscopy are not routinely reported by many laboratories since their clinical relevance is not well established. Aim: To elucidate rare ANA patterns on Hep 2 and their possible association with clinical presentation. Materials and Methods: A retrospective study was conducted on ANA reports in the duration January 2021 to March 2022 at the Department of Laboratory Medicine, Dr. Sulaiman Al Habib Medical Group, Olaya Medical Complex, Riyadh, Saudi Arabia, to recognise rare ANA patterns. Gold standard method of IIF on Hep 2 was used for screening. Statistical evaluation was done to obtain frequencies of various ANA patterns. Those with frequency of less than 1% were classified as rare patterns. Results: Overall, 4207 consecutive ANA reports were evaluated out of which 1388 were positive and 210 (4.99%) demonstrated rare ANA patterns including nuclear, cytoplasmic and mitotic subtypes. Most commonly encountered among the rare ANA patterns was intercellular bridge (AC 27) with frequency of 0.78% (n=33). Systemic Lupus Erythematosus (SLE) (10/210) was the most often observed clinical association with rare cytoplasmic and mitotic patterns at titer ≥1:160. Conclusion: Uncommon ANA patterns may be useful in initial work-up of autoimmune illness hence, should be routinely reported. Further studies to enlighten the significance of these patterns, analogous antibodies could be of diagnostic relevance in autoimmune and other diseases.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"21 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78471301","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":"E-cadherin Immunoexpression Patterns in Gastric Carcinoma Histological Subtypes: A Hospital-based Descriptive Study","authors":"T. Divyagna, C. Jyothi, Kavitha Yeslavath, Swapna Kumari Banuri, Sowjanya Rakam, S. Goud, Kavitha Toopali, I. Sreelakshmi","doi":"10.7860/jcdr/2023/60578.17542","DOIUrl":"https://doi.org/10.7860/jcdr/2023/60578.17542","url":null,"abstract":"Introduction: Gastric carcinoma is the second common Gastrointestinal (GIT) malignancy. Based on Global Cancer Observatory (GLOBOCAN) 2020 data, it is the 5th most common neoplasm and the 4th most common cause of death. Epithelialcadherin (E-cadherin) is a transmembrane glycoprotein which plays a crucial role in maintaining cell-cell adhesion. Loss of E-cadherin contributes to enhanced invasion and metastasis in human cancers. Aim: To study E-cadherin immunohistochemical expression in tumour cells and its association with gastric carcinoma histotypes. Materials and Methods: It is a hospital-based descriptive study conducted at Department of Pathology, Osmania General Hospital, Hyderabad, Telangana, India from January 2010 to December 2012 as it was my dissertation. Routine histopathology and immunohistochemistry for E-cadherin were done on the sections. E-cadherin immunohistochemical staining and expression in tumour cells were evaluated according to the study by Jawhari A et al., Scores (0-3) were applied: 0-No staining; 1-Only cytoplasmic staining; 2-Cytoplasmic and membranous staining in the same case, 3-Normal membranous immunoexpression. Staining was evaluated based on absence of membranous expression scores (0 and 1) versus the presence of membranous expression (scores 2 and 3). Statistical analysis of the data was done by Chi-square test using Epi Info software. Results: Total 70 cases were studied, of which 48 were gastric biopsies and 22 were gastrectomies. Gastric adenocarcinomas were classified as intestinal 40 cases (57.14%) and diffuse 30 cases (42.85%) according to Lauren’s classification. Membranous staining of E-cadherin was seen in 34/40 cases (85%) of intestinal gastric cancer and 9/30 cases (30%) of diffuse intestinal cancer whereas non membranous or absent E-cadherin was seen in 6/40 cases (15%) of intestinal gastric cancer and 21/30 cases (70%) of diffuse gastric cancer. In this study, significant association was found between membranous E-cadherin expression (score 2 or 3) and intestinal histotype and absence of membranous expression (scores 0 or 1) and the diffuse histotype of gastric cancer. Conclusion: Normal gastric mucosa shows strong membranous E-cadherin positivity. There is a change in the pattern of E-cadherin expression from membranous in intestinal type gastric adenocarcinoma to non membranous expression of E-cadherin in diffuse type of gastric carcinoma.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"71 2 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77254274","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":"Outcome Analysis of En-bloc Excision and Endoprosthetic Replacement among the Cases Operated for Distal Femoral and Proximal Tibial Giant Cell Tumour around the Knee: A Retrospective Study","authors":"S. Avasthi, S. Mahapatra, P. Aggarwal, Vineet Kumar, A. Aslam, Prabhat Kumar, Madhusudan Mishra","doi":"10.7860/jcdr/2023/62529.17792","DOIUrl":"https://doi.org/10.7860/jcdr/2023/62529.17792","url":null,"abstract":"Introduction: Giant Cell Tumour (GCT) around the knee joint is the most common site for this locally malignant bone tumour and, in advanced stages, requires excision of the tumour mass. Current recommendations promote joint salvage procedures in allograft or mega prosthetic replacement. Patients undergoing this surgery need massive changes in their lifestyle to cope with their activities of daily living. The psychological and social impact following these procedures has not been extensively studied. Aim: To observe the long term functional results as well as the impact on quality of life in patients undergoing endoprosthetic replacements in GCT around the knee with emphasis on any difference in results among the cases operated for distal femoral and proximal tibial GCT. Materials and Methods: This retrospective study was conducted at Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow from June 2015 to June 2019 with a total sample size of 21 cases. The two groups formed were; one having GCT of distal end femur and the other group with GCT of proximal end tibia. The evaluation was done for outcome measures by Oxford Knee Score (OKS) and Musculo Skeletal Tumour Society score (MSTS) for their functional outcome and Short Form Health Survey (SF12) for their quality of life effect at two years postoperatively. Students unpaired t-test was performed for intergroup analysis and Analysis of Variance (ANOVA) was done for within the group analysis for subsequent follow-up visits. Data was analysed using Statistical Package for Social Sciences (SPSS) version 21. Results: The mean age of study population was 33.67±8.674 years. The male-female distribution was insignificant (p=0.673), providing us with a homogenous study group. Recurrent GCT was found significantly more commonly in the proximal tibia group than in the distal femur group (p=0.031). Comparison of OKS and MSTS preoperatively, at six months, at one year, and two years showed statistically significant improvement in successive follow-ups in both the distal femur and proximal tibia groups (p<0.001 in both groups). Intergroup analysis also showed significantly better scores in the distal femur group compared to the proximal tibia group in the preoperative period and all successive follow-ups. On intergroup analysis at 2 years, both the OKS (p=0.020*) and MSTS score (p<0.0001) were found to be statistically significant. SF-12 mental and physical scores preoperatively also showed statistically significant improvement in all cases (p<0.001 for mental and physical components. Conclusion: Early functional outcomes of en-bloc excision and reconstruction with modular endoprosthesis are good in terms of joint function and the patient’s overall mental and physical well-being.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"52 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79149628","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":"Plasminogen Activator Inhibitor-1 as a Marker of Thrombosis among Prehypertensive Patients: A Cross-sectional Study","authors":"B. Umadevi, OR Anitha, N. Nalina, R. Lavanya","doi":"10.7860/jcdr/2023/63325.18321","DOIUrl":"https://doi.org/10.7860/jcdr/2023/63325.18321","url":null,"abstract":"Introduction: Impaired endogenous fibrinolysis has been shown to play a role in the pathogenesis and complications of hypertension. Plasminogen Activator Inhibitor-1 (PAI-1) is said to be a predictor of impaired fibrinolysis and thrombosis. Prehypertension is a common worldwide condition and is known to be an independent risk factor for Cardiovascular Disease (CVD). Aim: Present study aimed to measure plasma PAI-1 levels in prehypertensive patients and normal subjects and to find the correlation between elevated PAI-1 levels with Blood Pressure (BP), triglycerides, total cholesterol, Low-Density Lipoproteins (LDL) cholesterol, High-Density Lipoproteins (HDL) cholesterol, and urine albumin. Materials and Methods: This cross-sectional analytical study included 100 patients, comprising 50 prehypertensive individuals and 50 controls, aged between 35 and 50 years. The study was conducted at Sapthagiri Institute of Medical Sciences and Research Centre in Bangalore, India. Anthropometric measurements, PAI-1 levels, total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and urine albumin were measured using standard procedures. The data were statistically analysed using the Statistical Package for Social Sciences (SPSS) version 10.0, applying Student t-test and Chisquare test. Correlation analysis was performed to assess the relationship between PAI-1 and various parameters. Results: A total of 100 patients were included in the study which had 64 men and 36 women with a mean age of 46±7 years. PAI-1 levels were significantly higher in the prehypertensive group compared to the control group (p-value=0.013). Participants with higher plasma PAI-1 levels had significantly elevated BP (p-value=0.001) compared to those with lower PAI-1 levels. Total cholesterol, triglycerides, and LDL cholesterol were significantly increased in prehypertensive individuals (p-value=0.001), whereas HDL cholesterol was significantly lower (p-value=0.001). The study also observed a significant increase in urine albumin in the prehypertensive group with elevated PAI-1 levels compared to the controls (p-value=0.001). The study revealed that elevated plasma PAI-1 levels did not show a significant positive correlation with SBP and DBP (r=0.138 and 0.660, p-value of 0.338 and 0.648, respectively). Plasma PAI-1 levels were weakly correlated with total cholesterol (r=0.145, p-value 0.315), LDL cholesterol (r=-0.068, p-value 0.640), HDL cholesterol (r=0.21, p-value 0.882), and triglycerides (r=0.207, p-value 0.150). There was no significant correlation between increased PAI-1 levels and urine albumin (r=-0.225, p-value of 0.117). Conclusion: Present study demonstrated that plasma PAI-1, total cholesterol, triglycerides, LDL cholesterol, and urine albumin were significantly elevated in prehypertensive individuals, suggesting vascular damage and inflammation. As prehypertension is often asymptomatic, patients with p","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"41 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79301160","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":"Stability of Midline Diastema Closure by Frenectomy and Orthodontic Treatment: A Systematic Review","authors":"S. Siva, S. Kishore, J. Ravi","doi":"10.7860/jcdr/2023/60342.17958","DOIUrl":"https://doi.org/10.7860/jcdr/2023/60342.17958","url":null,"abstract":"Introduction: Midline diastema is one of the most common aesthetic complaints in mixed and sometimes in permanent dentition stage. High frenal attachment is the major aetiological factor causing midline spacing. Combined frenectomy and orthodontic treatment can be done to close the midline diastema which may also increase the stability and reduce relapse. Aim: To assess the stability of midline diastema closure by using frenectomy and orthodontic treatment. Materials and Methods: A systematic review was conducted about clinical trials showing the stability of midline diastema closure by using frenectomy and orthodontic treatment, articles were searched from 1995 to 2022. A total of 521 articles were retrieved. Among these 433 articles were screened. The risk of bias was assessed for all the studies included in this review. Results: A total of five studies were included in the systematic review which has clinical trials showing the stability of midline diastema closure in patients having midline diastema of at least 0.5 mm. Four studies using orthodontic treatment has shown some amount of relapse and one study using orthodontic treatment and frenectomy has shown prominent closure of median diastema. Conclusion: Closure of maxillary median diastema is more prominent when it is performed by using combined frenectomy and orthodontic treatment than orthodontic treatment alone and the risk of relapse is minimal. However, furthermore clinical studies are required to confirm the stability of midline diastema closure by using orthodontic treatment and frenectomy.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"81 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79329359","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":"Limberg Transposition Flap in Primary Pilonidal Sinus- A Case Series","authors":"T. Jeyalaksmi, E. S. S. Priya","doi":"10.7860/jcdr/2023/63105.17759","DOIUrl":"https://doi.org/10.7860/jcdr/2023/63105.17759","url":null,"abstract":"Sacrococcygeal Pilonidal Sinus (PS) is common among the young male adult population. There are multiple treatment options available ranging from non medical and surgical procedures. Medical management is not in vogue. This case series is about 10 patients with a common manifestation of serous discharge from the sinus in the sacrococcygeal region. The patients warranted a definitive cure for their condition. Though not life-threatening, it is socially embarrassing and adversely affects the quality of life in terms of education and livelihood among the young. The Limberg flap technique was advocated in all these patients, only one out of 10 patients showed wound infection. All the patients were satisfied with the surgical outcome. The surgical choices varied from simple excision to flap procedures. Overall the Limberg (rhomboid) flap technique has fewer postoperative complications and low recurrence rate and has a shorter learning curve, and is emerging as the standard of care.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76159623","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":"Middle Ear Function Changes due to the Combined Effect of Pressure along with Fluid in Middle Ear Pressure Regulation- A Review","authors":"P. D. Lanjekar, Sagar Gaurkar","doi":"10.7860/jcdr/2023/60719.17632","DOIUrl":"https://doi.org/10.7860/jcdr/2023/60719.17632","url":null,"abstract":"The pressure changes in Middle Ear (ME) are due to the effect of both fluid and pressure, which can be detected by tympanometry. In this review article, the mathematical and formal model of regulation of ME pressure is discussed. The air pressure in the ME chamber and the surrounding environment are the same. The auditory tube is a common connection between the ME chamber and the nasopharynx. The main functional role of the auditory tube is the ventilation of ME. When a person breathes air through an auditory tube, it enters into the ME and ventilates it. The ossicles in the ME collect sound from the tympanic membrane and transfer it to the inner ear, which requires proper ventilation of the ME. The auditory tube maintains ME pressure, the same as the external auditory canal and outside pressure. If an auditory tube is blocked, it leads to failure to ventilate ME, leading to changes in ME pressure. Swallowing and yawning allow the passive opening of the auditory tube and thus results in air flow out of the chamber. Easy and passive air exchange is allowed from the ME to the pharynx if, the pressure in the ME is higher than in the surrounding environment. ME pressure is highly variable and can change in many conditions. ME pressures increase when the body rotates from a vertical to a horizontal position because it increases the effusion of the ME mucosa due to an increase in hydrostatic pressure, which leads to an increase in the perfusion rate. Therefore, pressure increases in the case of sleeping and drowsiness. Regulation of ME pressure is a physiological process in which pressure between ME and the surrounding environment is maintained at equilibrium. The mechanism of pressure regulation is possible because of the complex sensory neural reflex pathway. A laser doppler vibrometer measures displacement of the tympanic membrane in response to sound and ME compliance is calculated by tympanometry. The movement of the tympanic membrane reduces due to the combined effect of fluid and pressure on the ME. The ME functions are altered due to the negative pressure of the fluid rather than the positive pressure.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"108 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76238926","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":"An Outcome Analysis of Asymptomatic COVID-19 Patients Presenting with Angina- A Retrospective Study","authors":"D. Dastidar, Rakhi Sanyal, N. Dastidar, Tirna Halder","doi":"10.7860/jcdr/2023/59103.17577","DOIUrl":"https://doi.org/10.7860/jcdr/2023/59103.17577","url":null,"abstract":"Introduction: Cardiovascular disorders have long been considered as one of the leading causes of mortality in India, which when presented with concurrent Coronavirus Disease (COVID-19) infection becomes even more fatal. Evidence suggests that COVID-19 affects the cardiovascular system by causing exuberant cytokinaemia, which results in endothelial inflammation and microvascular thrombosis, leading to multiorgan failure. Aim: To analyse the outcome of the asymptomatic COVID-19 patients presenting with cardiac angina during the second wave of COVID-19 in India. Materials and Methods: This is a retrospective data analysis of asymptomatic COVID-19 patients hospitalised with angina was conducted between April 2021 to June 2021 at Bardhhaman Medical College and Hospital located at Bardhdhaman district of West Bengal, India. A total of 1235 patients underwent all regular biochemical, haematological and cardiac investigations after undergoing test for COVID-19 test. Data was retrospectively collected. The outcome of these patients was analysed. Estimation of mean, standard deviation, percentage, p-value (from Pearson’s correlation) was performed to establish the aim of the study. Results: Seventy six out of 1235 patients tested positive for asymptomatic COVID-19. The mean age of this study population was 55.075±10.95 years, of which were 55 male and 21 female. Hypertension was the most prevalent co-morbidity followed by diabetes, 73 (96%) presented with chest pain. A total of 47(62%) of these 76 patients had ST Elevated Myocardial Infarction (STEMI). Eleven (14.4%) underwent Percutaneous Coronary Intervention (PCI) whereas 36 (47.3%) underwent fibrinolytic therapy with tenecteplase, followed by secondary PCI in 27 (75%) of them. Rest 29 (38%) were medically managed for unstable angina. Mortality rate was as low as 6.5%. Age and comorbidity were the contributing factors for STEMI among asymptomatic COVID-19 patients. Conclusion: The results indicate that age and comorbidity are the factors, which lead to death or increases the life risk among patients with asymptomatic COVID-19. In this study, we have established that for the current patient population STEMI and age are negatively corelated. Medical management with thrombolytic agent became a lot more accepted in this scenario. PCI still remains the gold standard to treat myocardial infarction. It is recommended that there should be an ICMR guided protocol for the management of such cases with the concurrent COVID-19.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"2680 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86592650","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}