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REVIEW ARTICLES
Psychogenic dyspnea
Tushar R Sahasrabudhe
January-March 2013, 6(1):14-18
DOI:10.4103/0975-2870.108627  
Dyspnea is a very common presenting complaint of a patient. Though commonly due to an organic disease, dyspnea can be a manifestation of underlying anxiety disorder. Three typical patterns of psychogenic dyspnea, viz. panic attack, psychogenic hyperventilation, and compulsive sighing, have been reviewed in this article. The article also comments on the diagnostic features and treatment of these patterns. The overlap with organic causes of dyspnea such as bronchial asthma and Chronic Obstructive Pulmonary Disease (COPD) has also been discussed. For literature review, a Medline and Pubmed search was conducted using appropriate keywords. Articles were also identified from the authors' own knowledge of the literature as well as reference lists in articles retrieved.
  150,073 1,785 2
Hormone receptor (ER, PR, HER2/neu) status and proliferation index marker (Ki-67) in breast cancers: Their onco-pathological correlation, shortcomings and future trends
Banyameen Mohamad Iqbal, Archana Buch
November-December 2016, 9(6):674-679
DOI:10.4103/0975-2870.194180  
Estrogen receptor (ER) and progesterone receptor (PR) are hormone receptors found on breast cells that pick up hormone signals resulting in cell growth. Similarly, positive human epidermal growth factor receptor-2 (HER2/neu) status of the breast carcinoma means that HER2/neu gene is making too many HER2/neu proteins, which acts as receptors on the cell surface and helps the cells to grow and divide. Hormone receptor studies such as ER, PR, and HER2/neu are routinely done in breast carcinoma. It not only helps in the prognosis of the tumor but also helps in deciding its treatment. The goal of doing this receptor status is to provide right treatment to the right patient. This hormone receptor status is graded using Allred scoring and grading system. Depending on the hormone status, breast carcinomas can be divided into a number of different categories ranging from triple positive through triple negative. Another marker of proliferation (Ki-67) is also being used which is a proliferation index marker. This scoring system has its own limitation and shortcomings, which depends on a lot of pre- and post-analytical factors. Certain new techniques such as genomic assays, PAM50, and HALO screening test are being used nowadays for breast cancer detection.
  128,773 5,070 19
ORIGINAL ARTICLES
Assessment of fetal gestational age by ultrasonic measurement of bi-parietal diameter in the southern part of Rajasthan
Pratima Jaiswal, William F Masih, Sanjay Jaiswal, Dalpat Singh Chowdhary
January-February 2015, 8(1):27-30
DOI:10.4103/0975-2870.148839  
Introduction: Assessment of gestational age (GA) in pregnancy can be carried out by measuring several fetal parameters in ultrasound scans and serial ultrasounds can monitor fetal growth. This study was carried out to assess GA in second and third trimesters with the help of ultrasonography measurements of one of the important fetal parameter that is, the bi-parietal diameter (BPD) in the local population (southern zone) of Rajasthan. Aim: The aim was to provide data for GA estimation by ultrasonic measurement of fetal BPD. Materials and Methods: A total of 200 normal pregnant females were studied with the known last menstrual period in the southern part of Rajasthan. GA determined by measurement of fetal BPD with real time ultrasonography machine. Statistics was applied to correlate GA and BPD. Observation and Results: In this study, fetal mean BPD showed a linear increase from 13 to 36 weeks. Statistically significant correlation was found between GA and BPD (r = 0.38). Mean BPD showed an increase of 2.38 cm in 13-20 weeks, 2.18 cm between 20 and 27 weeks and only 1.72 cm from 27 to 34 weeks. Average growth rate of BPD was found to be 0.31 cm/week from 13 to 28 week, which then later reduced to 0.23 cm/week from 28 to 36 weeks of gestation. Conclusion: Bi-parietal diameter is one of the useful criteria to measure GA and to predict expected date of delivery. Mean measurements of BPD in this study was found to be lower than that of western studies except Hadlock series, which compares well with this study. The mean BPD values of this study compares well with some Indian studies and other found higher results. Variation in predicted values is attributed to anthropometric differences between the two populations due to racial, genetic, nutritional, and socioeconomic factor. Therefore, large scale studies should be done and population-specific tables should be derived to correlate BPD and GA.
  121,238 438 5
CASE REPORTS
The 'Milwaukee protocol' (MP) hope does not succeeds for rabies victim
Anil Kumar Agarwal
March-April 2017, 10(2):184-186
DOI:10.4103/0975-2870.202098  
Rabies is caused by the rabies virus, an RNA-based virus in the genus Lyssavirus. Transmission typically occurs when virus-laden saliva from a rabid animal enters a wound or mucous membrane. The Milwaukee protocol, a novel procedure in which the patient was placed in a drug-induced coma and given an antiviral cocktail composed of ketamine, ribavirin, and amantadine. Considering the theory that rabies pathology stems from central nervous system neurotransmitter dysfunction, doctors hypothesized suppressed brain activity would minimize damage while the patient's immune system developed an adequate response.
  99,278 1,193 1
ORIGINAL ARTICLES
Comparative evaluation of prescriptions of MBBS and BAMS doctors using WHO prescribing indicators
Sangeeta Dabhade, Prabodhan Gaikwad, Sanjay Dabhade, BT Rane, Smita Tiwari, BB Ghongane, PT Pandit
October-December 2013, 6(4):411-415
DOI:10.4103/0975-2870.118294  
Background: Irrational prescribing is a global problem. The present study was undertaken to identify the problem of irrational medicine use by Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Ayurvedic Medicine and Surgery (BAMS) doctors in outpatient setting, by using WHO prescribing indicators. Materials and Methods: This study was carried out in Vishrantwadi, Pune, India. 250 prescriptions were collected from MBBS doctors and 250 prescriptions were collected from BAMS doctors and their prescription pattern was analyzed using WHO prescribing indicators. Results: Average number of medicines per prescription was 2.4 for MBBS and 3.04 for BAMS doctors. Percentage of prescriptions with antibiotics and with injections was significantly more in BAMS doctors. Antibiotics, gastrointestinal system related medicines, vitamins and iron preparations were prescribed more by BAMS doctors. Percentage of irrational fixed dose combinations prescribed by BAMS doctors was more (57.2%) as compared to MBBS doctors (28.6%). Conclusions: In the present study, although the prescribing patterns of both MBBS as well as BAMS doctors are not satisfactory; the BAMS doctors seem to prescribe more irrationally as compared to MBBS doctors.
  94,066 1,336 -
A study on knowledge and practices of antenatal care among pregnant women attending antenatal clinic at a Tertiary Care Hospital of Pune, Maharashtra
Barun Bhai Patel, Pranaya Gurmeet, Datttreya Ramkrishna Sinalkar, Kapil H Pandya, Ajoy Mahen, Neha Singh
May-June 2016, 9(3):354-362
DOI:10.4103/0975-2870.182507  
Background: The maternal health status of Indian women was noted to be lower as compared to other developed countries. Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. For sustainable growth and development of country, there is a need to improve MCH Care in the country. Safe motherhood by providing good antenatal care (ANC) is very important to reduce maternal mortality ratio and infant mortality rate and to achieve millennium development goals. Objectives: This study aimed to determine the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic at a Tertiary Care Hospital in Pune and their association with various sociodemographic factors. Materials and Methods: A cross-sectional study was carried out among 384 pregnant women in their 3 rd trimester attending the antenatal clinic in a Tertiary Care Hospital of Pune, Maharashtra during October 2011 to September 2012. Pretested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed using SPSS version 20 and Epi Info Software. Results: Study reveals that about 58% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, education, occupation, parity, type of family, and socioeconomic status (SES) had a significant association with awareness about ANC. 100% women were having a positive attitude toward ANC. Around 70%, women were practicing adequately, and variables such as education and SES had a significant association with practices about ANC. Conclusion: These findings can be used to plan a Health Intervention Program aiming to improve the maternal health practices and eventually improve the health status of the women.
  84,682 4,753 14
CASE REPORTS
Rare cause of pediatric obesity: Bardet - Biedl Syndrome
Mitul B Kalathia, Yogesh N Parikh, Parin N Parmar, Shyamal S Verma
March-April 2014, 7(2):198-200
DOI:10.4103/0975-2870.126341  
Bardet - Biedl syndrome (BBS) is a rare autosomal recessive disorder, characterized by central obesity, retinal pigmentation, polydactyly, mental retardation, hypogonadism, and renal dysfunction. Other features may include deafness, diabetes mellitus, genitourinary abnormalities, short stature, hormonal abnormalities, developmental defects, and speech problems. We report a case of BBS who presented with night blindness, marked central obesity, polydactyly, syndactyly, hypogonadism, micropenis, and behavioral problems, along with a brief review of the literature.
  77,812 576 1
ORIGINAL ARTICLES
Maternal hydration and L-arginine supplementation improves liquor volume in patients with decreased liquor and prolongs pregnancy
Shripad Hebbar, Lavanya Rai, Prashant Adiga
July-August 2014, 7(4):429-434
DOI:10.4103/0975-2870.135255  
Background: Oligohydramnios (reduced amniotic fluid) may be responsible for the problems of malpresentations, umbilical cord compression, meconium staining of amniotic fluid in the liquor, and difficult or failed external cephalic version. Simple intervention maternal hydration has been reported as a way of increasing amniotic fluid volume in order to reduce some of these problems. Objective: To assess the influence of maternal hydration and l-arginine supplementation in improving liquor volume in patients with decreased liquor. Study Design: Prospective nonrandomized interventional study. Materials and Methods: 50 patients remote from term, with decreased liquor [amniotic fluid index (AFI) < 8] were enrolled in the study. Before the proposed intervention, the antenatal risk factors were studied. Patients with hypertensive disorders of pregnancy were administered l-arginine (one sachet 3 g, two times daily) and others received both arginine and intravenous hydration (500 ml of fructodex which contains 5% dextrose and 5% fructose, and lactated Ringer's solution daily). The treatment was continued till the liquor improved significantly. However, patients were considered for delivery if the liquor remained less than 5. Mean increase in liquor, intervention delivery interval, and neonatal outcome were studied. Results: The mean gestational age at the time of recruitment was 33.4 ΁ 1.9 weeks. The mean AFI at the time of enrolment was 6.9 (SD 0.8). These patients were delivered at 36.3 ΁ 1.3 weeks, and thus, pregnancy could be prolonged by 2.9 weeks. The mean AFI at the end of therapeutic intervention was 9.3 (SD 1.7), and thus, an AFI increase of 2.4 could be obtained. There was no significant neonatal morbidity in these patients. Significant improvement in liquor volume was obtained in these patients after intervention with either or both l-arginine and fructodex infusion (P < 0.0001). The pregnancy could be prolonged from 33.4 weeks to 36.3 weeks. Conclusion: Treatment with l-arginine and fructodex resulted in significant improvement in liquor and prolongation of duration of pregnancy by around 3 weeks, which enabled us to administer steroids for lung maturation (in indicated cases). Thus, treatment with l-arginine and fructodex seems to be promising in improving fetal outcome in pregnancies complicated by decreased liquor.
  73,764 1,143 1
LETTERS TO THE EDITOR
Smegma pearl
Gaurav Sali, Iqbal Ali, Gurjit Singh, Sarang Rathod
January-February 2014, 7(1):98-99
DOI:10.4103/0975-2870.122804  
  69,662 482 1
CASE REPORTS
Supraorbital neuralgia
Vasudha Jadhav, Divakar Patil, Manohar Mane
March-April 2014, 7(2):208-210
DOI:10.4103/0975-2870.126346  
Supraorbital neuralgia is one of the rare types of neuralgias where there is persistent pain in the supraorbital region and forehead with occasional sudden shocklike paresthesia in the distribution of the supraorbital nerve. The primary treatment is identification and removal of anything causing compression over the supraorbital nerve. A brief trial of simple analgesics alone or in combination with gabapentin should be considered for patients who do not respond to the above-mentioned treatments. Supraorbital nerve block using local anesthetics and steroids is the next step.
  68,332 701 -
LETTERS TO THE EDITOR
Split hand sign
Prasanna Venkatesan Eswaradass, Balakrishnan Ramasamy, Ramadoss Kalidoss, Gnanagurusamy Gnanashanmugham
September-October 2015, 8(5):686-687
DOI:10.4103/0975-2870.164966  
  58,333 354 -
ORIGINAL ARTICLES
Effect of benzodiazepines on thyroglobulin, anti-thyroglobulin, anti-thyroid peroxidase, and thyroid stimulating hormone in rat
Mohammad-Hasan Khadem-Ansari, Ali Ahani, Peyman Mikaeili, Yousef Rasmi
July-August 2014, 7(4):447-449
DOI:10.4103/0975-2870.135259  
Background: Benzodiazepines are widely used as psychoactive agents and the side effects of benzodiazepines to the endocrine system are reported. Objective: This study was designed to explore the effects of the benzodiazepines - lorazepam and clonazepam - on thyroglobulin (Tg), anti-thyroglobulin (aTg), anti-thyroid peroxidase (aTPO), and thyroid stimulating hormone (TSH). Materials and Methods: Eighteen male Wistar rats were randomly divided into three groups: control (C), lorazepam-treated, and clonazepam-treated groups. The changes in Tg, aTg, aTPO, and TSH in these three groups were compared after 4 weeks. Results: The levels of Tg and aTg in the lorazepam-treated and clonazepam-treated rats significantly increased compared to the control group. But there was no significant difference in the levels of TSH and aTPO between lorazepam-treated and clonazepam-treated rats in comparison with the control group rats. Conclusion: The thyroid gland is affected by lorazepam and clonazepam, which are used in epilepsy, bruxism, anxiety, insomnia, and other psychic disorders.
  52,768 534 -
CLINICAL IMAGES
Transillumination test: A bedside aid for differentiating meningocele from myelomeningocele: Point of care testing
Aakash Pandita, Deepak Sharma, Sweta Shastri
March-April 2015, 8(2):276-277
DOI:10.4103/0975-2870.153189  
Transillumination test is a bedside and simple technique to illuminate the body cavity by transmission of light through the cavity. Transillumination test is used in a variety of conditions like hydrocele, Hydrocephalus, pneumoperitonium and pneumothorax in neonatology. We describe use of transillumination for differentiating meningocele and myelomeningocele.
  42,969 502 -
ORIGINAL ARTICLES
Cytomorphological study of lymph node lesions: A study of 187 cases
Shruti Vimal, Arpana Dharwadkar, Shrish S Chandanwale, Vidya Vishwanathan, Harsh Kumar
January-February 2016, 9(1):43-50
DOI:10.4103/0975-2870.172428  
Introduction: As components of peripheral or secondary lymphoid organs, lymph nodes are an important part of immune system. Their enlargement is noted in a wide spectrum of diseases, including infections and malignancy, they are a common finding in clinical practice. Therefore, peripheral lymphadenopathy is common in all age groups and management of cases depends on lymph node pathology, which can be studied by collecting material through fine-needle aspiration or excision biopsy. Objectives: The study was undertaken to assess the cytomorphological features and incidence of various lymph node diseases on fine-needle aspiration cytology (FNAC) and to analyze the utility and diagnostic importance of FNAC in lymph node diseases. Materials and Methods: In the study total of 187 patients were selected who had presented with lymph node enlargement at Department of Pathology in our Tertiary Care Centre. Results: Reactive lymphoid lesions comprised the majority (33.69%) followed by tubercular lymphadenitis, metastatic malignancies, acute suppurative lymphadenitis, and lymphomas, respectively. Conclusion: Reactive lymphoid and tubercular lesions were the most common among the lymph node swellings presentations. FNAC is a simple, safe, reliable, and inexpensive method in early detection of lymph node lesions, which has been proven once again in this study.
  42,348 1,006 7
ORIGINAL ARTICLE
Magnetic resonance imaging of cerebellopontine angle lesions
Pratiksha Yadav, Mansi Jantre, Dhaval Thakkar
November-December 2015, 8(6):751-759
DOI:10.4103/0975-2870.169917  
Background: Cerebellopontine angle (CPA) tumors are usually benign, and they are divided into extra-axial, intra-axial, extradural, and petrous axis tumors. CPA pathologies can be asymptomatic or it may present with vertigo, tinnitus, or unilateral hearing loss depending upon the site of tumor origin and displacement of the neurovascular structure. Aim and Objectives: To evaluate the role of magnetic resonance imaging (MRI) aided with contrast-enhanced MRI as an imaging modality for diagnosis of CPA lesions. Materials and Methods: Analysis of 36 patients of CPA lesions over a period of 2 years was done. MRI was performed on Siemens 1.5 Tesla MAGNETOM Avanto Machine. Conclusion: There are spectrums of pathologies, which can present with these symptoms, which includes tumors, vascular malformations, and vascular loop compressing vestibulocochlear nerve or mastoid pathology so it is important to investigate the patient by MRI. Contrast-enhanced MRI is the most sensitive investigation in the evaluation of the CPA lesions, its characteristic, and its extent.
  41,215 1,877 7
Introducing integrated teaching and comparison with traditional teaching in undergraduate medical curriculum: A pilot study
Mausumi Basu, Palash Das, Gagori Chowdhury
July-August 2015, 8(4):431-438
DOI:10.4103/0975-2870.160778  
Background: Medical colleges in India usually follow a traditional curriculum, characterized by "discipline wise model" which compelled Medical Council of India to recommend a teaching approach characterized by maximal efforts to encourage integrated teaching (IT) between traditional subject areas. Objectives: To assess the feasibility of IT; to compare IT with traditional teaching (TT) and to analyze the student's feedback and faculty feedback about perception of IT. Materials and Methods: An interventional study was conducted among fifth semester students using pre- and post-test questionnaire and student and faculty feedback forms. Students were divided randomly into two groups. IT was introduced to Group I on the topic of tuberculosis (TB) by faculties of different disciplines; using methods of didactic lectures, seminars, role play, clinical case presentation, demonstration of Ziehl-Neelsen stain, Bacillus Calmette-Guerin vaccination and visit to Directly Observed Treatment Centre. Group II were exposed to TT on TB by faculties of Community Medicine using method of didactic lectures. Paired and un-paired t-test and effect size were used as statistical tests. Results : Statistically significant results were obtained using pre- and post-test questionnaire of IT. Similarly, statistically significant results were obtained using posttest results of IT and TT. Effect size that is: Cohen's d and Pearson correlation revealed large effect which indicates high influence on student achievement. The students and faculty showed a positive attitude about IT. Conclusion: The introduction of IT was found to be feasible and to be more effective and acceptable than TT.
  40,828 1,368 4
CASE REPORTS
Anemia with jaundice: An unusual cause
K. V. S. Hari Kumar, AK Gupta
January-February 2015, 8(1):95-97
DOI:10.4103/0975-2870.148865  
Anemia and jaundice are two important clinical signs in medicine. Occurrence of these two signs together in a patient suggests hemolytic disorders. Hemochromatosis is a disease characterized by hyperpigmentation, arthralgia and diabetes. The disease usually presents in elderly individuals and is rare in menstruating females. We present a case of a young lady with anemia and unexplained jaundice with extensive work-up leading to the diagnosis of hereditary hemochromatosis with megaloblastic anemia. We present the case to highlight the unusual presentation of anemia and jaundice in a case of hemochromatosis.
  36,011 473 -
REVIEW ARTICLE
Anesthesia for day-care surgeries: Current perspectives
Sukhminder Jit Singh Bajwa, Veenita Sharma, Ridhima Sharma, Arvinder Pal Singh
July-August 2017, 10(4):327-333
DOI:10.4103/MJDRDYPU.MJDRDYPU_24_17  
Day-care surgery has become a popular modality of surgical intervention throughout the globe. Numerous factors including the economic and financial issues are driving this therapeutic modality to a widespread acceptance among surgeons and anesthesiologists. Advancements in anesthesia and surgical techniques as well as availability of newer drugs are largely responsible for the progress of day-care surgeries. Numerous challenges are still faced by anesthesiologists and surgeons in carrying out day-care surgeries, especially in spite of these advancements, at resource-limited setups. The first right step in successfully delivering the day-care surgical services includes proper selection of the patients. The preanesthetic evaluation is highly essential in determining the suitability of the patient for day-care anesthesia and surgery as well as the formulation of various anesthetic plans and strategies. The current review is intended to highlight inherent challenges and probable solutions to them for this rapidly progressing anesthesia.
  34,089 1,770 5
CASE REPORTS
A case of recurrent pleural effusion: Can we think beyond tuberculosis and malignancy?
Bhumika Vaishnav
March-April 2014, 7(2):215-217
DOI:10.4103/0975-2870.126351  
Pleural effusion can occur due to a variety of causes such as infectious, neoplastic, inflammatory, autoimmune, traumatic, etc. Recurrent pleural effusions have always been a diagnostic challenge. Here, we present a case of recurrent exudative pleural effusion in a male patient, which was the first clinical manifestation of rheumatoid arthritis. Of note was the absence of articular involvement at the onset of the disease. The low glucose concentration, low pH and low C4 level in the pleural fluid were the most valuable findings to distinguish it from tuberculous and malignant pleural effusions. Pleural biopsy also helped in making such a distinction. Thus, in a patient with recurrent pleural effusion, rheumatoid etiology should also be kept in mind as a differential diagnosis.
  34,733 706 -
Magnetic resonance imaging in pseudotumor cerebri: A case report
Dhaval K Thakkar, Abhijit Patil, Dolly Thakkar, Parag Patil, Mansi N Jantre
November-December 2014, 7(6):802-805
DOI:10.4103/0975-2870.144894  
Idiopathic intracranial hypertension (IIH) is characterized by symptoms of raised intracranial tension (ICT) as headache and visual disturbances due to raised cerebrospinal fluid pressure, however without any ventricular enlargement or space occupying lesion. The characteristic findings include papilledema which is usually bilateral, however which may be unilateral or asymmetrical. We report a case of 35-year-old female patient who came with complaints of headache and diplopia. She underwent magnetic resonance imaging of the brain which showed changes in bilateral globes, optic nerves and sella, which were suggestive of increased ICT. The ventricles and basal cisterns were normal. No other abnormality was seen. The magnetic resonance venogram was also normal. Thus, we concluded the diagnosis of IIH. The patient underwent therapeutic lumbar puncture after which she showed significant improvement in symptoms.
  33,763 660 2
COMMENTARY
Elevated troponin levels and typical chest pain: Is always acute coronary syndrome?
Anil Kumar
July-August 2016, 9(4):505-506
DOI:10.4103/0975-2870.186073  
  33,989 285 -
Differentiating primary and secondary dengue infections: Why and how?
Harshal S Mandavdhare, Vishal Sharma
Sep-Oct 2016, 9(5):594-595
DOI:10.4103/0975-2870.192145  
  33,226 843 3
ORIGINAL ARTICLES
Comparison of modified Petroff's and N-acetyl-L-cysteine-sodium hydroxide methods for sputum decontamination in tertiary care hospital in India
Mukesh Sharma, Rabindra Nath Misra, Nageswari Rajesh Gandham, Savita Vivek Jadhav, Kalpana Angadi, Vivian Wilson
July-December 2012, 5(2):97-100
DOI:10.4103/0975-2870.103323  
Background : Tuberculosis is the second leading cause of death worldwide, killing nearly two million people each year. Sputum decontamination with N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH) is expected to improve detection of Mycobacterium tuberculosis (M. tb) by culture better than that with modified Petroff's; which is widely used in laboratories. In this study, sputum samples collected from suspected cases of pulmonary tuberculosis (TB) were cultured directly on Lowenstein-Jensen (LJ) medium and after decontamination by both the methods and the results of smear and culture positivity were evaluated to assess whether the NALC-NaOH treatment method improves smear and culture. Materials and Methods : For each decontamination method, 30 samples were obtained from suspected cases of Pulmonary TB, from Pad. Dr. D.Y. Patil Medical College and Hospital. Two sputum samples from each patient were collected on day 1 and 2. These samples then underwent decontamination process by performing the 4% NaOH, NALC-2% NaOH treatment methods and direct inoculation. After each process a smear was made and culture was done on LJ medium. Results: The modified Petroff's and NALC-NaOH treatment methods did not significantly affect the AFB smear positivity of the sputum samples (66% and 72.3%, respectively). (However, the culture positivity for M. tb on LJ medium was significantly different by the three processes. With NALC-NaOH and modified Petroff's it was 63% and 46%, respectively, while with direct culture it was 23%. Conclusion: NALC-NaOH treatment is better than modified Petroff's treatment for the detection of M. tb by culture. However, AFB microscopy does not seem to be significantly different by either process.
  31,417 1,605 8
A study of megakaryocyte morphology in bone marrow aspiration smears of cases of thrombocytopenia
Shashikala Vinayakamurthy, Rojaramani Potluri, Prathima Shivajirao, Rekha Singh, Rajalaxmi Pujahari, Indu Maniketh
January-February 2017, 10(1):51-57
DOI:10.4103/0975-2870.197922  
Background: Thrombocytopenia may be encountered in various hematological and nonhematological conditions and may be associated with dysplastic megakaryocytes which is a feature of myelodysplastic syndrome (MDS), even though they can be observed in non-MDS hematological conditions. Objective: To study the morphological variations of megakaryocytes on bone marrow aspiration smears in non-MDS-related thrombocytopenia in a Medical College in Bengaluru, Karnataka. Materials and Methods: It was a prospective study of 86 cases of non-MDS thrombocytopenia whose bone marrow aspirates were studied morphologically. Results: The most common cause of thrombocytopenia was acute leukemia followed by other systemic malignancies, megaloblastic anemia, and idiopathic thrombocytopenic purpura. Both dysplastic and nondysplastic features were observed in the above-mentioned conditions. The most common dysplastic feature was nuclear segmentation followed by micromegakaryocytes and hypogranular forms. Among nondysplastic features, the most common were immature forms, bare nuclei, and hypolobation. Emperipolesis and cytoplasmic vacuoles were noted in a case of pyrexia of unknown origin. Conclusion: Dysplastic megakaryocytes are common in non-MDS-related thrombocytopenia and their mere presence should not lead to the diagnosis of MDS. Hence, proper diagnosis should be made on megakaryocyte morphology, patient's clinical findings, and other hematological parameters. This understanding can improve the diagnostic accuracy for wide range of hematological disorders.
  31,528 1,047 2
A rapid appraisal of traffic policemen about auditory effects of traffic noise pollution from Ambala city
Abhishek Singh, Ashish Bansal, Shewtank Goel, Pawan Kumar Goel, Pankaj Chhikara, Nand Kishore Singh
January-February 2015, 8(1):12-15
DOI:10.4103/0975-2870.148826  
Context: Traffic policemen are at an increased risk of suffering from hazards of noise pollution because they are engaged in controlling traffic noise, particularly at heavy traffic junctions. The effect is more in this subgroup because they are continuously exposed to it. Aim: The present study was aimed at assessing the knowledge, attitude and practices of traffic policemen regarding auditory effects of traffic noise pollution in Ambala city. Settings and Design: Cross-sectional workplace survey. Materials and Methods: The present descriptive study was carried out in different traffic zones of Ambala city during April-June 2013. The study population consisted of 100 traffic policemen working in different traffic intersections of Ambala city. Statistical Analysis Used: Structured interview schedule was used to collect the data. SPSS version 17.0 was used for analysis. Interpretation of data was performed using percentages and proportions. Results: Majority (75%) of the study subjects were exposed to traffic noise pollution for more than 5 years. Of the total subjects, 5% of respondents reported below-average hearing on self-assessment of hearing ability. Seventeen percent of the study population accepted that while hearing over phone they do miss some conversation. Most (98%) of the traffic police did not use any personal protective equipment (PPEs) like earplugs/earmuffs, and the non-availability of these PPEs (90%) is the common reason for the hearing loss. Conclusions: The study concludes that traffic policemen are not much aware regarding impending auditory effects of traffic noise pollution. Duty rotation, duty scheduling and other forms of preventive modalities for exposure limitation are suggested.
  31,381 1,004 1