The aims of the present study were to determine the prevalence of hypothyroidism, both subclinical hypothyroidism (SH) and overt hypothyroidism (OH), its correlation with dyslipidemia, and whether replacement therapy with levothyroxine has an effect on plasma lipid profile, i.e., total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) of hypothyroid patients.

A prospective, open-label, observational, clinical study was conducted by the Department of Pharmacology in collaboration with the Department of Medicine, Rohilkhand Medical College & Hospital, for a period of 10 months. A total of 50 patients, age 18 to 65 years, of both genders, who were newly diagnosed cases of hypothyroidism with dyslipidemia (Adult Treatment Panel III National Cholesterol Education Program guidelines) were recruited for the study. Levothyroxine replacement therapy was administered and the patients were reassessed at 6 and 36 weeks for an effect on lipid profile and body mass index.

In cases of OH, baseline TC, TG, LDL, and HDL were 231.01 ± 27.84, 148.18 ± 10.72, 149.07 ± 12.38, and 35.42 ± 6.73 mg/dL, which was reduced to 177.33 ± 23.17, 123.15 ± 29.50, 118.44 ± 29.85, and 47.86 ± 8.53 mg/dL after 36 weeks of levothyroxine therapy (p < 0.05).

In cases of OH associated with dyslipidemia, levothyroxine therapy achieved a favorable lipid profile in significant number of cases.

Shekhar A, Singh HK, Chandra S, Shaifali I, Mehra D. Effect of Levothyroxine Therapy on Hypothyroidism-induced Dyslipidemia. Int J Adv Integ Med Sci 2017;2(3):107-110.

Blindness due to cataract presents an enormous problem especially in developing countries like India, not only in terms of human morbidity but also in terms of economic loss and social burden. The cataract surgeon of today is challenged to control the sphere as well as the cylinder of the refraction after surgery. Small incision cataract surgery (SICS) is now the method of choice in many parts of the world. This present study has been carried out with the aim to compare the postoperative corneal astigmatism between the two groups of patients undergoing SICS with posterior chamber intraocular lens (PCIOL) implantation with two difference types of incisions, i.e., frown and straight.

A prospective study was carried out in 60 patients enrolled from the Department of Ophthalmology of Pondicherry Institute of Medical Sciences who underwent SICS with superiorly placed straight and frown incision with PCIOL (each group consisting of 30 patients) during the period from May 2005 to October 2006.

In this study, 60 patients having senile cataract in the age group of 50 to 75 years were studied. Out of these, the majority were in the age group of 60 to 64 (28.33%) years and only 26.66% were more than 70 years. The male:female ratio was 1:1. In our study, we found that frown incision had significantly better (p < 0.001) mean net astigmatism as compared with the straight incision.

We conclude that small incision size and absence of suture are the most important factors that contribute to less astigmatism and faster stabilization of SICS, where phacoemulsification cannot be performed. The duration for stabilization of postoperative astigmatism in straight incision group is 6 weeks, whereas it is 3 weeks in frown incision. Frown superior incision has got added advantage of early wound stabilization than straight incision, allowing the patient to resume their daily activities at an early stage. Superior incision group (both frown and straight) had increased amount of with-the-rule (WTR) astigmatism which later shifted to against-the-rule. There was a significant difference in net astigmatism between frown and straight. Postoperative astigmatism also depends on preoperative astigmatism. Patients with preoperative WTR benefited from superior incision cataract surgery.

Tripathi S, Srinivasan M, Gupta S. Astigmatism in Straight and Frown Incision in Small Incision Cataract Surgery: A Comparative Study. Int J Adv Integ Med Sci 2017;2(3):111-116.

The objective of our study was to evaluate the role of ultrasound in the evaluation of patients with first trimester bleeding and to prognosticate and predict the status of abnormal pregnancies.

We studied 50 cases of pregnant women who presented with bleeding per vaginum during the first trimester between November 2015 and August 2016. The main sources of data for this study are patients from teaching hospitals attached to Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India. All patients referred to the Department of Radiodiagnosis with clinically suspected first trimester bleeding were evaluated with clinical history, clinical examination, and ultrasonography (USG). Ultrasonographic examination of patients was done using the following machines: (1) Phillips 350, (2) G.E. logiq V3, and (3) Toshiba 1000.

Of the 50 cases of first trimester bleeding, 26 cases were diagnosed as threatened abortion clinically, out of which only 12 cases were confirmed. Ultrasound examination confirmed 12 cases of clinically suspected threatened abortions and aids in correctly diagnosing 8 cases that were missed on clinical examination. A total of 12 cases out of 18 threatened abortions continue to term gestation with a successful outcome of 66%. All cases of threatened abortion (n = 18), incomplete abortion (n = 10), missed abortion (n = 4), ectopic pregnancy (n = 4), inevitable abortion (n = 4), blighted ovum (n = 2), and hydatidiform mole (n = 2) were correctly diagnosed on USG. A total of 48 out of 50 cases were correctly diagnosed on ultrasound compared with 18 out of 50 cases on clinical diagnosis, with a disparity of 64%. Four out of five proved ectopic pregnancies were correctly diagnosed both on ultrasound and on clinical examination.

Ultrasound is noninvasive, nonionizing, without any proved harmful effects on the developing fetus and easily available method of investigation to assess the patients with first trimester bleeding, which is highly accurate in diagnosing the actual causes of bleeding and guides the clinician in choosing the appropriate line of management and prevents mismanagement of the cases. In the present study, 48 out of 50 cases were correctly diagnosed on ultrasound compared with 18 out of 50 cases on clinical diagnosis, with a disparity of 64%.

Kumar P, Mehrotra A, Gupta D, Mukharjee S, Saket R, Sinha P. First Trimester Bleeding: A Diagnostic Dilemma—Probing It with Ultrasound. Int J Adv Integ Med Sci 2017;2(3):117-124.

To study the clinical spectrum of nail disorders including congenital, developmental, infectious, neoplastic, degenerative, dermatological, and systemic diseases affecting the nail unit.

A total of 100 consecutive cases of nail disorders reporting to the dermatology outpatient department in Rohilkhand Medical College & Hospital were examined.

Complete dermatological, systemic, hematological examinations, Gram staining, scraping for fungus, nail clipping for potassium hydroxide mount, fungal culture, biopsy from nail bed were undertaken in doubtful cases.

Among 100 cases, the most common was onychomycosis — 28 cases, followed by nail psoriasis — 13 cases, pitting — 10 cases, paronychia — 9 cases, trachyonychia — 5 cases, onycholysis — 4 cases, clubbing — 3 cases, koilonychia — 3 cases, ingrow toenail — 3 cases, pterygium — 3 cases, onychogryphosis — 2 cases, subungual wart — 2 cases, half and half nail — 2 cases, anonychia — 2 cases, longitudinal grooves — 2 cases, clubbing with resorption of fingers — 2 cases, onychomadesis — 1 case, nail discoloration — 1 case, melanonychia — 1 case, pachyonychia congenita — 1 case, beau's line — 1 case, racket nail — 1 case, transverse groove — 1 case.

Among examined cases, onychomycosis was most common followed by another nail disorders.

Garg P, Kumar A, Rathore PK, Goyal S. Clinical Study of various Nail Disorders presenting to Dermatology Outpatient Department. Int J Adv Integ Med Sci 2017;2(3):125-129.

Background and objective: Spinal cord compression is the most important cause of neuropathy and disability. Many spinal cord diseases are reversible if recognized early. They are definitely among the most critical of neurologic emergencies. Plain radiographs have a low sensitivity for identifying traumatic/neoplastic spinal lesions. The role of magnetic resonance imaging (MRI) is to distinguish the compressive from noncompressive causes of myelopathy, localize the spinal tumors as being extradural/intradural, and assess the integrity of spinal cord, intervertebral disks, and ligaments after acute spinal trauma. Mateirals and methods: It is a descriptive study with 90 cases carried out in the Department of Radiodiagnosis and Imaging at Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India. The patients with a suspected clinical history of compressive myelopathy were subjected to MRI scanning. Acquired images were evaluated based on severity of cord compression, location in the extradural/intradural, level of lesion (cervical, thoracic, and lumbar), signal intensities of the neoplasms, vertebral fracture with epidural hematoma, ligamentous injury, and cord edema/contusion. The patients were chosen for the study by a process of purposive sampling, and data were analyzed by descriptive analysis. Results: In our study of 90 cases of compressive myelopathy we found various different causes for compression. Among these are trauma (39), infectious causes (21), Metastasis (15), primary neoplasm (meningioma (06) + neurofibroma (09). Conclusion: The MRI is the definitive modality in assessing soft tissues of the spine and spinal cord abnormalities. In our study, with the help of MRI, we could successfully characterize the spinal cord after trauma, identify spinal tumors based on extradural/intradural locations, and assess the integrity of spinal cord, intervertebral disks, and ligaments. Thus, in the end, we can conclude that in cases of RTA and other causes, which lead to compressive myelopathy, MRI is the definitive and accurate answer to the clinical question.

Chronic disease like chronic obstructive pulmonary disease (COPD) is associated with various comorbidities. Anxiety and depression are among the common comorbidities and have significant impact on socioeconomic status of the person as well as the course of disease. In our study, we screened COPD patients attending the outpatient department (OPD) of pulmonary medicine for anxiety and depression, using different scales that include questionnaires. About 46.2 and 34.6% cases were found to have depression and anxiety respectively, among all COPD patients (n = 156). Incidence of anxiety and depression was directly proportional to severity of disease. Age, gender, locality, educational, marital, and socioeconomic statuses are some factors that play important roles in the development of these psychiatric comorbidities. Hence, mental assessment of COPD patients should be mandatory with every visit to the OPD.

Jaiswal A, Kumar A, Rathi H, Sharma CS, Sharma P, Arya V. Assessment of Depression and Anxiety in Chronic Obstructive Pulmonary Disease Patients attending Pulmonary Medicine Department of Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India. Int J Adv Integ Med Sci 2017;2(3):137-139.

This study has been undertaken to study the effect of type II diabetes mellitus (T2DM) and its duration on hearing.

The present study was conducted on 100 persons of age group 20 to 45 years. All subjects included in the study were divided into two groups. Group I: 50 patients suffering from T2DM (fasting blood sugar ≥ 126 mg/dL and postprandial ≥ 200 mg/dL) of either sex, in the age group of 20 to 45 years. Group II: 50 healthy volunteers in the age group of 20 to 45 years, of either sex were included in control group. Hearing assessment was done by using pure tone audiometry (PTA).

In diabetic patients, the mean threshold in the PTA was higher at all frequencies as compared with healthy controls, and there was a positive correlation between the duration of diabetes and hearing loss.

Various audiological investigations have revealed that there is a strong association of diabetes with sensorineural part. The prevalence of sensorineural hearing loss (SNHL) in type II diabetics observed was 64%. In the majority of the patients, the hearing loss was bilateral, affecting mid and higher frequencies from 2 to 8 kHz. Hence, to conclude, we can say that the high prevalence of hearing loss in T2DM supports the importance of audiometric evaluation in such patients.

Gulati A, Kakkar V, Aggarwal S, Sharma C, Panchal V, Pareek M, Bishnoi S. To Study the Effect of Type II Diabetes Mellitus and Its Duration on Hearing. Int J Adv Integ Med Sci 2017;2(3):140-143.

Spinal block is a preferred technique for most lower abdominal and lower limb surgeries. Lignocaine had been the local anesthetic of choice for decades in such surgeries. With the advent of adjuvants, now it has become possible to enhance the duration of spinal anesthesia. These adjuvants can be given intravenously or intrathecally. Intravenous clonidine and dexmedetomidine have been used in recent studies as adjuvant in spinal anesthesia with promising results. Dexmedetomidine is a more suitable adjuvant compared with clonidine due to its more selective alpha-2A receptor agonist activity.

To evaluate the effect of intravenous dexmedetomidine on spinal anesthesia with 0.5% bupivacaine in lower abdominal surgeries in terms of onset and duration of sensory and motor blockade and sensory regression.

Sixty patients of American Society of Anesthesiologists grades I and II, 25 to 60 years of age, posted for elective lower abdominal surgeries under spinal anesthesia were included in the study and randomly allocated into computer-generated two groups. Group IV received intrathecal 0.5% bupivacaine heavy and intravenous infusion of dexmedetomidine 1 μg/kg over 20 minutes followed by 0.5 μg/kg/hour till the end of surgery. Patients in group III (control group) received intrathecal 0.5% bupivacaine heavy and intravenous normal saline as placebo.

In groups IV and III, mean duration of analgesia was 209 ± 29.93 and 150.20 ± 3.46 minutes respectively. This increase in duration of analgesia in dexmedetomidine group was statistically significant. The mean duration of motor blockade was 189.48 ± 1.34 and 158.18 ± 3.27 minutes respectively. Injection diclofenac sodium 75 mg intramuscularly was used as rescue analgesic.

Sharma YK, Agrawal M. Intravenous Dexmedetomidine enhances the Duration of Spinal Anesthesia with 0.5% Hyperbaric Bupivacaine in Lower Abdominal Surgeries. Int J Adv Integ Med Sci 2017;2(3):144-148.

Gene therapy is an emerging field of biomedicine that has gained significant attention in dentistry too. Various research programs are being carried out to understand the cellular and molecular bases of every disease. Since most of the conventional therapeutic approaches are not so satisfactory in treating a disease completely, currently there is an increasing focus on gene therapy to treat a wide variety of inherited and acquired diseases. This new era of gene therapy can be accomplished in the medicine field primarily to replace or cure defective genes and treat a wide variety of gene disorders, whether the disease is due to single or multiple defective genes. It has a variety of applications in the field of dentistry like salivary gland disorders, autoimmune conditions, potentially malignant disorders, etc. The sites, such as minor salivary glands present in the labial and buccal mucosa and also mucosal keratinocytes are potential targets for gene therapy, since these structures are superficial and offer minimal hindrance to the gene therapy procedure. The present article discusses the basic principles of gene therapy, its applications in the field of dentistry, limitations, and disadvantages.

Gupta P, Thakur J. Gene Therapy as a Management Tool in Dentistry. Int J Adv Integ Med Sci 2017;2(3):149-154.

Oral cancer is a potentially fatal disease, which constitutes an important portion of tumors of the head and neck region. Among head and neck cancers, oral squamous cell carcinomas (OSCCs) constitute 90% of total cancers. Regardless of the fact that the oral cavity is easily accessible to the accumulation of carcinogens, most oral cancers are typically detected at an advanced stage leading to lower survival rate among subjects. Abnormal cellular products elucidated from malignant cells can be detected and measured in various body fluids including saliva, which constitute tumor markers. Saliva, an aqueous biological fluid, is in direct contact with the oral cancer lesion. Hence, the saliva in any stage of oral cancer constitutes abnormal deoxyribonucleic acid (DNA), acid (RNA), and protein molecules. Saliva, being a noninvasive diagnostic aid, can be an alternative to serum for early detection, status of chemotherapy regime, and also patient prognosis. This article aims at providing a brief overview of various salivary biomarkers and their implications in oral cancer.

Gupta P. Role of Salivary Biomarkers for Early Detection of Oral Squamous Cell Carcinoma. Int J Adv Integ Med Sci 2017;2(3):155-160.