MAMC Journal of Medical Sciences最新文献

{"title":"False Positive Reaction to VDRL Test with Prozone Phenomenon in a Case of Lepromatous Leprosy","authors":"R. Chawla, P. Thakur, Atul Mohan Kochhar, S. Singla","doi":"10.4103/mamcjms.mamcjms_12_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_12_21","url":null,"abstract":"Abstract The venereal disease research laboratory (VDRL) test, a nontreponemal test for syphilis, may under a certain set of conditions give false positive results in patients who are not infected with Treponema pallidum. A false positive reaction is defined as a positive reaction to nontreponemal tests, and a negative reaction to treponemal tests, in the serum of a patient who has no history or clinical evidence of syphilis or other treponematosis. A prozone phenomenon in nontreponemal tests is seen largely with secondary syphilis due to high-titer samples that show nonreactive results unless the specimens are diluted. We report here perhaps the first case of lepromatous leprosy, which had a false positive reaction to the VDRL test with the prozone phenomenon. The case initially presented to the outpatient clinic with complaints of epistaxis with nasal stuffiness. The finding of septal perforation on nasal endoscopy is what led to the initial suspicion of syphilis and the subsequent syphilis workup. It was only when the false positive reaction to VDRL test with the prozone phenomenon was noted that the search for other causes was made, which eventually lead to the diagnosis of lepromatous leprosy.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41407996","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":"Diaphragmatic Hernia in Pregnancy – A Case Report","authors":"A. Tempe, Vedika Bali, D. Kumar, Chaithanya Guguloth","doi":"10.4103/mamcjms.mamcjms_8_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_8_22","url":null,"abstract":"Background: Maternal diaphragmatic hernias (DH) identified during pregnancy are rare and pose significant management challenges with respect to the timing of delivery, mode of delivery, and hernia repair. Case presentation: We describe a case of traumatic maternal DH, diagnosed at 31 weeks of gestation presenting with multiple episodes of vomiting. Owing to no evidence of visceral compromise and a stable maternal and fetal condition, the patient was conservatively managed allowing further fetal maturation and was delivered by cesarean section at 34 weeks. This was followed by laparoscopic intraperitoneal mesh hernial repair at 6 weeks postpartum. The patient had an uncomplicated recovery. Conclusion: Maternal DH in pregnancy require multidisciplinary care and individualized management for the optimal outcome for mother and fetus.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47884304","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":"Nail Fold Capillary Changes in Diabetes Mellitus and Their Correlation with Diabetic Retinopathy","authors":"Niraj Bohania, S. Singla, S. Pandit, Anuj Achyut Ban, R. Agarwal, P. Jain","doi":"10.4103/mamcjms.mamcjms_5_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_5_22","url":null,"abstract":"Background: Nail fold capillaroscopy (NFC) is mainly used in connective tissue diseases (scleroderma, mixed connective tissue disease, and inflammatory myositis). It is not used routinely in the evaluation of diabetic patients and no specific patterns of nail fold capillary changes have been established in diabetes. We studied morphological patterns of nail fold capillaries by video capillaroscope in diabetic patients and their association with diabetic retinopathy (DR). Methods and Material: Fifty diabetics were recruited after informed consent. The mean age of patients was 49.5 ± 10.6 years. Seventeen patients had DR. Capillary length, capillary density, and various morphological parameters were assessed and these parameters were compared between patients with DR and without DR. Results: The most frequent NFC morphological alterations, among diabetics as a group, were tortuous capillaries (56%), giant capillaries (46%), and cross-linked capillaries (44%). Overall, mean nail fold capillary length was reduced in diabetic patients. When individual morphological alterations were compared in patients with DR versus without DR, statistically significant differences were seen for presence of giant capillaries, tortuous capillaries, and avascular areas. On further analysis, mean nail fold capillary length and mean nail fold capillary density were also significantly lesser in patients with DR versus without DR. Conclusions: The presence of nail fold capillary morphological abnormalities among diabetics and a significant association with microangiopathic changes in the retina suggest that microvascular changes can be detected early using a simple, non-invasive office-based method of NFC. More large-scale studies in the future can establish a characteristic pattern for diabetes as seen in systemic sclerosis so that microvascular changes in diabetics can be detected at the earliest with the simple noninvasive method by using NFC.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49135981","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":"Massive Hemoptysis in Post-Tubercular Sequelae: A Multidisciplinary Critical Care Team in Action","authors":"N. Gupta, Rohit Kumar, P. Garg, P. Ish, V. Aggarwal, Nitesh Gupta","doi":"10.4103/mamcjms.mamcjms_35_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_35_21","url":null,"abstract":"Massive hemoptysis can lead to respiratory failure and life-threatening hypoxia in patients with underlying post-tubercular fibrocavitary disease. In the absence of urgent surgical interventions in a resource-poor country, interventional bronchoscopy and bronchial artery embolization (BAE) can be lifesaving in critical care management of such patients. We present a young male who required mechanical ventilation, emergency bronchoscopic intervention, and BAE, and showed recovery.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48952365","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":"Seroprevalence of Sexually Transmitted Infections (Hepatitis B Virus, Hepatitis C virus, Syphilis, and HIV) in Pregnant Women and Evaluation of Sociodemographic Characteristics and Awareness Regarding STIs in North Indian Population","authors":"R. Bhatia, G. Mehta, Sukhbir Pal Sidhu, T. Arora, Renuka Raina","doi":"10.4103/mamcjms.mamcjms_98_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_98_21","url":null,"abstract":"Context: Sexually transmitted infections (STIs) are a problem of increasing concern among men and women. They can affect fertility, increase maternal and neonatal morbidity, and can become a burden on both physical and emotional health. Owing to lack of awareness and partly due to the social stigma attached, couples do not come forward for screening. Antenatal testing for STIs is an effective strategy recommended to detect STIs in this subset of the population. Aims: To estimate the seroprevalence of four STIs (hepatitis B, hepatitis C virus, HIV, and syphilis) in pregnant women, to evaluate its correlation with sociodemographic characteristics and sexual behavior, and to check awareness regarding STIs. Settings and Design: It was an observational study on 500 pregnant women attending an antenatal clinic at a tertiary care hospital in rural Haryana, India. Methods and Material: Pregnant women were screened for four STIs – hepatitis B, hepatitis C virus, HIV, and syphilis. Statistical Analysis Used: The sample size was calculated considering the mean reported seroprevalence of infections in pregnant women in previous studies. The power of the study was kept 80% and the alpha error was 0.05. Results: Seroprevalence for STIs in pregnancy was 5.2% – hepatitis C virus (2.6%), hepatitis B (2.4%), and syphilis (0.4%). Conclusions: Viral STIs are more prevalent among pregnant women. Antenatal screening is an effective strategy for the detection of STIs in pregnant women.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47250292","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":"Spontaneous Resolution of Type 1 Macrocystic Congenital Cystic Adenomatoid Malformation: A Rare Presentation","authors":"Shishir Kumar, S. Panda, S. Neogi, S. Ratan","doi":"10.4103/mamcjms.mamcjms_79_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_79_21","url":null,"abstract":"Abstract We present a case of 6-month-old boy who presented with respiratory distress due to empyema, which was initially managed by the intercostal drain. Computed tomography scan confirmed the diagnosis of type 1 congenital cystic adenomatoid malformation (CCAM). Subsequently, there was the spontaneous resolution of empyema and CCAM prior to surgical intervention. Our case illustrates the postnatal spontaneous resolution of CCAM, which is rare.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45555925","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":"Prevalence and Determinants of Exclusive Breastfeeding Among Children Less Than Two Years of Age in a Rural Area of Delhi, India","authors":"Pallavi Singh, Rajesh Kumar, G. Meena, P. Lal","doi":"10.4103/mamcjms.mamcjms_133_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_133_21","url":null,"abstract":"Context: Exclusive breastfeeding for the first 6 months of life is highly beneficial to the child. Unfortunately, it is frequently not practiced among women due to a lack of knowledge. Aims: The study aims to to find the prevalence of exclusive breastfeeding among children aged less than 2 years of age and to study the factors influencing the practice of exclusive breastfeeding among the mothers of the study participants. Methods and Material: The design was a community-based cross-sectional study. Between January 2019 and January 2020, we enrolled 190 children aged less than 2 years of age and their mothers residing in a rural area of Delhi, India. We collected baseline sociodemographic data and details of feeding practices followed using a pretested semi-structured questionnaire. To measure association, the chi-square test or Fischer exact test was used. Statistical analysis used: Collected data was entered into MS-Excel and analyzed using IBM Statistical Package for the Social Sciences – 25 for descriptive and inferential statistics. Results: Of the 190 participants with complete information, 74 were under 6 months of age and it was found that 57 (77.0%) of those were exclusively breastfed till their present age. The remaining 116 children were aged between 6 and 23 months and the prevalence of exclusive breastfeeding in these children was found to be 55.2% (64). The mean duration of exclusive breastfeeding was 5.75 ± 1.79 months. The age of the child was found to be statistically significant with the practice of exclusive breastfeeding (P = 0.01). Conclusions: The exclusive breastfeeding up to 6 months of age was practiced only by approximately half of the mothers.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42262066","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 Audit of Antibiotic Prescribing Pattern Among Children in Emergency Settings of a Tertiary Medical College and Hospital","authors":"V. Manchanda, Urvashi Suman, U. Jhamb, Rincy Shaji","doi":"10.4103/mamcjms.mamcjms_4_22","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_4_22","url":null,"abstract":"Background: Resistance to antimicrobials is increasing, which leads to a significant increase in mortality, morbidity, and health care costs. In order to promote rational antibiotic uses, standard policies must be set and can be done only after the current antibiotic prescription has been audited. Objective: The aim of the study was to describe the antibiotic prescribing patterns in the pediatric emergency of a tertiary care hospital. Methods: The data were collected from the pediatric emergency over the period of 6 consecutive days from August 6, 2018 to August 11, 2018. The methodology recommended by the World Health Organization (WHO) for the investigation of drug use in a health facility was followed. The data were analyzed for the percentage of antibiotics prescribed by generic name, prescribed from essential medicine list of government, drugs with fixed-dose combination, and percentage of broad- and narrow-spectrum antibiotics used. Result: A total of 600 prescriptions were analyzed in the study. Most of the children were less than 1 year of age (30.8%). Combination of three antibiotics were prescribed in 8.8 % of patients. A 100% of antibiotics were prescribed from the essential drug list. Antimicrobials prescribed by generic name were 52%. Injection ceftriaxone was the commonest antibiotic prescribed (43.3%), followed by amikacin (25.2%). The broad- and narrow-spectrum antibiotics prescribed were 86.6% and 13.4 %, respectively. Conclusion: The antibiotics are used cautiously in the paediatrics emergency department of this institute. Among those who were prescribed antibiotics, all prescriptions were from the essential drug formulary. Our findings provide support for investigating antibiotic utilization in other settings and work toward developing a national rational prescribing strategy.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41569063","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":"A Possible Cause of Incorrect Dose Administration of Insulin in ICU","authors":"S. Bloria, Jetinder Singh","doi":"10.4103/mamcjms.mamcjms_129_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_129_21","url":null,"abstract":"","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44696921","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":"Perception of Medical Faculty and Students about Online Teaching during the COVID-19 Pandemic in a Tertiary Care Teaching Institute","authors":"N. Maheshwari, B. Kalra, V. Roy","doi":"10.4103/mamcjms.mamcjms_121_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_121_21","url":null,"abstract":"Background: Classroom teaching has been found to be the most common modality used for teaching. The unusual situation of the coronavirus disease 2019 (COVID-19) pandemic led to the shutdown of all educational institutions across the country. To limit the spread of the coronavirus, classroom teaching had to be abandoned and online teaching was sought for to continue the learning process. The study was conducted with the aim of assessing the perception of faculty as well as undergraduate medical students toward online teaching and learning methodology. Methods: A cross-sectional observational study using two separate pretested, structured questionnaires for faculty and students was conducted. The questionnaire had a total of 45 questions for collecting data on demographic information, awareness, perception and knowledge toward online teaching, perception about establishing connect between teachers and students through online portal, and operational and technical aspects. These questionnaires were mailed to faculty and students using Google forms (Google Survey platform). Results: A total of 47 teaching faculty and 386 students responded to the questionnaires. More than 70% faculty availed the training and guidance provided for online teaching. The move to switch over to online mode of teaching during lockdown was appreciated by majority (95%) of respondents. The faculty members made use of online polls, surveys, and educational videos for making online lectures interesting. In addition, online assessments (72%) and use of an interactive software (70%) were found worthy and useful. Majority of (80%) students missed direct and in person contact with instructor. Majority of the students (60%) felt isolated and alone during online teaching sessions. One-third of the students believed that instructors were able to generate interest in the topic and 63% of students were satisfied with the explanations delivered with regard to queries during online lectures. The major disadvantages that surfaced were limited options for two-way communication (55%), technical glitches (70%), social isolation (63%), eye strain, and other health-related issues (62%). Internet connectivity emerged as the biggest limitation by faculty members. Conclusion: Overall, the respondents were of the opinion that online teaching was a useful modality during COVID-19 and can be used as a complementary aid to regular teaching in. Adequate infrastructure and uninterrupted internet connectivity is vital for smooth conduct of online teaching.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48820745","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}