MGM Journal of Medical Sciences

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2017 | December | Volume 4 | Issue 4

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ORIGINAL ARTICLE

Arun V Marwale, Sana A Quadri, Aziz A Quadri

Prevalence of Disability and Family Burden in Patients with Obsessive Compulsive Disorder: An Observational Study

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:5] [Pages No:155 - 159]

   DOI: 10.5005/jp-journals-10036-1162  |  Open Access |  How to cite  | 

Abstract

Introduction: Obsessive compulsive disorder (OCD) is a common psychiatric disorder with significant disability Aim: To study the prevalence and extent of family burden and disability in patients with OCD and its correlates. Materials and methods: A cross-sectional study involving 75 consecutive patients with OCD was done. Family burden was assessed using the family burden schedule (FBS). Disability was calculated using the World Health Organization's (WHOs) disability assessment schedule (DAS). Various variables were analyzed and significance of correlation was assessed using chi-squared test of significance. Results: Prevalence of family burden was 13.33% and that of disability was 42.67%. These were significantly associated with low socioeconomic status, single marital status, early age of onset, and severity of disease. There was significant association between severity of disability and family burden. Conclusion: Patients with OCD have significant disability and burden on family

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ORIGINAL ARTICLE

Diagnostic Value of Fine Needle Aspiration Cytology in Enlarged Cervical Lymph Nodes in a Tertiary Care Hospital in Navi Mumbai, Maharashtra, India

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:4] [Pages No:160 - 163]

   DOI: 10.5005/jp-journals-10036-1163  |  Open Access |  How to cite  | 

Abstract

A retrospective study of 362 patients with cervical lymphadenopathy, who underwent fine needle aspiration cytology (FNAC) at Mahatma Gandhi Mission (MGM) Medical College & Hospital, Navi Mumbai, Maharashtra, India, is presented. Tuberculosis was the commonest pathology (42%). Other causes were reactive lymphadenitis, granulomatous lymphadenitis, metastases, chronic nonspecific lymphadenitis, acute suppurative lymphadenitis, and lymphoma. Histopathological examination of lymph node biopsy specimens was carried out in 26 cases

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ORIGINAL ARTICLE

Seema Anjenaya, Prasad Waingankar, Sunila Sanjeev, Virendra J Mahadik, Kiran Mali

Cross-sectional Study of Health Status of Auto Rickshaw Drivers in Vashi, Navi Mumbai, India

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:7] [Pages No:164 - 170]

   DOI: 10.5005/jp-journals-10036-1164  |  Open Access |  How to cite  | 

Abstract

Introduction: It is observed that auto rickshaw drivers are prone to musculoskeletal, respiratory, and gastrointestinal disorders and also to injuries and substance abuse. Objective: To study the health status, disease profile, and substance abuse among auto rickshaw drivers in Navi Mumbai, Maharashtra, India. Materials and methods: Participants in this cross-sectional observational study were drivers plying rickshaws registered at Regional Transport Office (RTO), Vashi, Navi Mumbai, India. Considering 1,500 registered auto rickshaws, a 10% random sample was planned. Questionnaire was designed to collect data by trained doctors including sociodemographic factors, occupational details, perceived stress scale, Nordic Musculoskeletal Questionnaire (NMSQ), addiction details, current symptoms, and significant history of past illness as well as general and systemic examination findings. Bone mass density (BMD) testing and random blood glucose levels were done. Data were analyzed using Microsoft Excel and Epi Info. Results: Totally, 159 drivers participated. Majority [82 (51.6%)] belonged to socioeconomic class III, 37 (23.3%) to class IV, while 40 (25.1%) to class II. Among those, 54 (33.9%) drivers were in the profession for 10 to 19 years, while 36 (22.7%) were driving for 20 years or more. Only 19 (11.9%) drivers were asymptomatic, while 140 (88.1%) had one or more complaints. The commonest complaint was musculoskeletal pain in 95 (59.9%) of the study participants. Generalized fatigue, acidity, and headache were other common complaints. Ninety seven (61.1%) drivers had osteopenia. This had significant association with age and the number of years in profession. Substance abuse was found in 95 (59.7%) of the study participants. Conclusion: Auto rickshaw drivers are very susceptible to health-related problems and there is need for monitoring on an ongoing basis and institutionalization of measures to prevent it.

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ORIGINAL ARTICLE

Namrata Khanna, Manish Raj Kulshrestha, Pradeep Kumar Maurya, Sajjan Lal Verma, Ajai Kumar Singh, Anup Kumar Thacker

Cognitive Decline due to Impaired Homocysteine Metabolism in Adults on Antiepileptic Monotherapy: A Prospective Study

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:6] [Pages No:171 - 176]

   DOI: 10.5005/jp-journals-10036-1165  |  Open Access |  How to cite  | 

Abstract

Aim: Long-term antiepileptic therapy is associated with hyperhomocysteinemia (HHcy), causing cardiovascular risk and subsequent cerebrovascular and cognitive disorders. Objective of our study is to assess the effects of old and new generation drugs on homocysteine (Hcy), folate, and B12 levels in serum and to relate HHcy with cognitive decline. Materials and methods: Drug-naïve patients recently diagnosed with epilepsy in the age group 18 to 40 years (n = 124) were recruited and grouped according to the drug prescribed: conventional drugs, like phenytoin, carbamazepine, valproate, and newer drugs, like oxcarbazepine and levetiracetam. A pretreatment analysis of Hcy, folate, and B12 was done. Mini- Mental State Examination (MMSE) was used to assess cognitive impairment, if any. After 6 months of continuous monotherapy, the analyses were repeated. Results: Homocysteine levels were raised significantly in all the groups (p < 0.05 in all groups) after 6 months of therapy. Hyperhomocysteinemia (>15.1 ìmoles/L) was found in 64 out of 124 patients, of which 42 were on conventional drugs. Folate and B12 registered a significant decrease in patients on phenytoin, carbamazepine, and oxcarbazepine. Cognitive decline was evaluated as drop of a point or more in MMSE score after 6 months of therapy. A significant positive relation between Hcy and cognitive decline was seen in groups on monotherapy of phenytoin [relative risk (RR) = 4.667; confidence interval (CI) = 0.7663, 28.42], carbamazepine (RR = 2.778; CI = 1.042, 7.403), and oxcarbazepine (RR = 3.316; CI = 0.9483, 11.59). An insignificant positive correlation was observed in sodium valproate and levetiracetam groups. Conclusion: Both conventional and newer antiepileptic drugs (AEDs) may cause HHcy, leading to cardiovascularcomplications and cognitive decline. Subjects on sodium valproate and levetiracetam are less likely to show a decline in cognition, regardless of a rise in Hcy levels. Clinical significance: Folate and B12 deficiency causes HHcy, which correlates positively with cognitive decline.

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REVIEW ARTICLE

Raman P Yadav, Rinkey R Shahu, Sveeta Mhatre, Priyanka Rathod, Chandana Kulkarni

Pancreatic Lipase Inhibitors from Plant Sources for Possible use as Antiobesity Drugs

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:8] [Pages No:177 - 184]

   DOI: 10.5005/jp-journals-10036-1166  |  Open Access |  How to cite  | 

Abstract

Pancreatic lipase inhibitors prevent the breakdown of dietary fat into fatty acids, thereby reducing their absorption in the gut. This action makes them attractive for use as antiobesity drugs. Currently, a few drugs have been approved by the Food and Drug Administration (FDA) for long-term use in the management of obesity. Over the last decades, studies have shown that many plants exhibit pancreatic lipase inhibitor activity in their extracts. The present review highlights the current status of our knowledge about lipase inhibitory activity in molecules derived from plant sources. We could possibly have a range of natural products derived from plants that could be of use in the treatment of obesity.

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CASE REPORT

Anup Kapse

Medical Management of Cervical Ectopic Pregnancy

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:2] [Pages No:185 - 186]

   DOI: 10.5005/jp-journals-10036-1167  |  Open Access |  How to cite  | 

Abstract

A 27-year-old woman, primigravida, presented with a history of 8 weeks of amenorrhea and painless vaginal bleeding. Pelvic examination revealed ballooned-up cervix smeared with blood. The urine pregnancy test was positive. Ultrasonography showed a gestational sac of approximately 0.6 cm implanted in the anterior wall of cervix but the uterus was empty. The patient was diagnosed as a case of cervical ectopic pregnancy based on clinical and sonographic findings. As this was her first pregnancy, it was decided to follow a conservative approach. She was treated with methotrexate (MTX) six doses on alternate days with folinic acid, administered intramuscularly. The patient made a remarkable recovery. She stopped bleeding after 1 week of MTX therapy, the gestational sac was not seen after 30 days, and the beta human chorionic gonadotropin (hCG) level decreased continuously and was undetectable after 55 days of MTX therapy.

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CASE REPORT

Dorab Daruwalla

Attitude of Parents to Carrier Screening for Genetically Transmitted Diseases in India

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:4] [Pages No:187 - 190]

   DOI: 10.5005/jp-journals-10036-1168  |  Open Access |  How to cite  | 

Abstract

Carrier screening plays a pivotal role in controlling transmission of genetic abnormalities through generations. Irreparable genetic aberrations are preventable by understanding the nature of alterations and nurturing prenatal/pre-implantation diagnosis. Retrospective carrier screening of blood-linked relatives not only prevents transmission to future generations but also helps in understanding the impact on future health. However, lack of cooperation of the parents/family members posts barriers for carrier screening, and thus, abnormalities occur in recurrent pregnancies. Parental attitude toward carrier screening has been discussed in this paper based on a case having unbalanced karyotypic abnormality with a chimeric extra chromosome (47,XX,+mar). This female baby was born with choanal atresia (CA), anteposed anus, and atrial septal defect to nonconsanguineous parents as second child. Owing to common problem of difficulty in breathing in father and the elder son, it could have been speculated that the father was the carrier of some genetic condition, which contributed to clinical expression; however, the parents were reluctant to undergo screening. Since there was aneuploidy with a rearranged chromosome, the possibility of normal karyotype in the parents cannot be expected, and thus, karyotyping was essential for the other child too. That was also refused. Refusal of screening by the family will necessarily put future generations of the family at risk of inheriting CA.

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CASE REPORT

Prajay J Lunia, Unnati D Desai

Spontaneous Chylothorax

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:4] [Pages No:191 - 194]

   DOI: 10.5005/jp-journals-10036-1169  |  Open Access |  How to cite  | 

Abstract

Chylothorax is the occurrence of chyle (lymph) in the pleural cavity due to damage to the thoracic duct. Leakage of chyle and lymph leads to significant loss of essential proteins, immunoglobulins, fat, vitamins, electrolytes, and water. The presence of chylomicrons and a triglyceride level >110 mg/dL in the aspirated pleural fluid confirms the diagnosis of chylothorax. Identifying the etiology using different diagnostic tests is important in planning treatment. Definitive therapy consists of obliteration and prevention of recurrence of chylothorax. We report a case of chylothorax which resolved spontaneously with conservative management.

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CASE REPORT

Kalpana R Kumar, Suman P Rao, Priyank D Talati, Padma Ramesh

Unsafe Chronic Suppurative Otitis Media with Cerebellar Abscess

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:5] [Pages No:195 - 199]

   DOI: 10.5005/jp-journals-10036-1170  |  Open Access |  How to cite  | 

Abstract

A 30-year-old female patient presented with fever, altered sensorium, vomiting, and right-sided ear discharge. She was diagnosed as right-sided squamosal chronic suppurative otitis media (CSOM) with cerebellar abscess for which she underwent modified radical mastoidectomy with transmastoid cerebellar abscess drainage. After surgery, the patient made an uneventful recovery. Brain abscess due to suppurative otitis media is a potentially fatal complication and needs to be treated aggressively.

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CASE REPORT

Darpan Kaur, Rahul Mishra, Shubhangi Dere

Selective Mutism with Social Anxiety Disorder and Sibling Rivalry Disorder

[Year:2017] [Month:] [Volume:4] [Number:4] [Pages:2] [Pages No:200 - 201]

   DOI: 10.5005/jp-journals-10036-1171  |  Open Access |  How to cite  | 

Abstract

A rare case of selective mutism, social anxiety disorder, sibling rivalry disorder, and temperamental difficulties in an 8-year-old girl has been reported. The relevant literature about clinical assessment and management of this disorder has been reviewed.

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