Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
  Citation statistics : Table of Contents
   2017| September-October  | Volume 10 | Issue 5  
    Online since November 14, 2017

 
 
  Archives   Previous Issue   Next Issue   Most popular articles   Most cited articles
 
Hide all abstracts  Show selected abstracts  Export selected to
  Cited Viewed PDF
REVIEW ARTICLE
Nanotechnology for health: A new useful technology in medicine
Beuy Joob, Viroj Wiwanitkit
September-October 2017, 10(5):401-405
DOI:10.4103/MJDRDYPU.MJDRDYPU_32_17  
Nanotechnology is accepted as a very useful new technology at present. The impact of new nanotechnology on health is very interesting. Indeed, several usefulness of nanotechnology on animal and human health can be expected. On the other hand, the negative effect of nanotechnology can also be seen. The applied nanotechnologies in public health and medicine already exist. In this short article, the summarization and discussion on nanotechnology and health are presented. It can be seen that the nanotechnology can be applicable in several fields of medicine and can help practitioner in diagnostic, therapeutic, and preventive activities.
  9 16,953 834
ORIGINAL ARTICLES
Measles outbreak in adults: A changing epidemiological pattern
Swati Bajaj, Pranjal Bobdey, Neha Singh
September-October 2017, 10(5):447-452
DOI:10.4103/MJDRDYPU.MJDRDYPU_43_17  
Background: Thirty-one cases of fever with rash were reported among students of a college in Pune, India, from March to May 2014. The clinical profile was similar to that of measles and 7 of them tested positive for measles-specific immunoglobulin M (IgM). An outbreak of measles was declared, and epidemiological investigation was carried out to assess the situation and suggest preventive measures. Methods: An epidemiological case sheet filled for each case to identify the source and likely contacts. Medical and administrative authorities were sensitized about the increase in incidence and clustering of cases. A surveillance system was set up for detection of new cases and follow-up of contacts. Throat swabs and blood samples from 12 cases were tested by ELISA method for commonly occurring viral exanthematous fevers to confirm the diagnosis and 7 were positive for measles-specific IgM antibody. Preventive measures were advised to control the outbreak. Results: A total of 31 cases of fever with rashes were reported among students of a college in Pune, India, during the months of March–May 2014. Most of the students were in the age group of 18–24 years. Samples from 12 cases were sent for testing and 7 tested positive for measles-specific IgM antibodies. Seven cases were epidemiologically linked to a lab-confirmed case. All cases had fever, maculopapular rash, and sore throat and gave a history of vaccination for measles in childhood. Conclusion: An epidemiological investigation was carried out for outbreak of measles in a young adult population of college students from Pune. It is reported that, with increase in overall coverage of vaccination, there is a rise in incidence of measles in vaccinated individuals. The age profile also shifts to higher age groups. Investigation of such outbreaks provides an opportunity to identify high-risk groups, changes in measles epidemiology and weaknesses in the routine immunization programs.
  6 6,190 394
Clinicopathologic study of malignant ovarian tumors: A study of fifty cases
Shirish S Chandanwale, Rahul Jadhav, Ruby Rao, Piyusha Naragude, Sunita Bhamnikar, Jehan Nizam Ansari
September-October 2017, 10(5):430-437
DOI:10.4103/MJDRDYPU.MJDRDYPU_41_17  
Background: Malignant ovarian tumors have worst prognosis among all gynecological malignancies and highest case fatality rate. There is a steady increase in the age-standardized incidence rate in India. Most cases are diagnosed late when the symptoms such as abdominal distension become apparent. Objective: The aim is to study the histomorphological features of malignant tumors of the ovary and to find out the frequency of various malignant ovarian tumors with respect to age and clinical features. Subjects and Methods: Fifty malignant ovarian tumors were included in the study. Clinical and histomorphological features were studied and correlated. Results: Maximum number of malignant ovarian tumors occurred in between 50–60 years and 21–30 years of age. Pain and lump in the abdomen was the most common presenting symptom. Right ovary was commonly involved. CA-125 blood levels were elevated in 54% of cases. Ultrasound and color Doppler examinations showed irregular solid tumor, ascites, papillary structures, large multilocular solid tumor, and high Doppler content. Histopathology diagnosis was aided by immunohistochemistry. Maximum malignant tumors (n = 31) were surface epithelial tumors, and serous cystadenocarcinoma was most common. Conclusion: Malignant ovarian tumors are the leading cause of death from gynecologic malignancy in females. Clinical symptoms, radiological findings, and other ancillary investigations such as CA-125 are the keys in establishing the preoperative diagnosis of malignant ovarian tumors. Malignant surface epithelial tumors are most common, and serous cystadenocarcinoma is the most common histological type.
  6 5,501 524
COMMENTARY
Fibrocartilaginous dysplasia: A rare but distinct entity
HL Kishan Prasad
September-October 2017, 10(5):503-504
DOI:10.4103/MJDRDYPU.MJDRDYPU_31_17  
  3 2,557 193
ORIGINAL ARTICLES
Infectious mononucleosis due to epstein-barr virus infection in children: A profile from eastern India
Madhumita Nandi, Avijit Hazra, Mrinal Kanti Das, Subham Bhattacharya, Uttam Kumar Sarkar
September-October 2017, 10(5):438-444
DOI:10.4103/MJDRDYPU.MJDRDYPU_9_17  
Objective: The objective of this study is to delineate the clinical and laboratory profile of infectious mononucleosis due to Epstein-Barr virus (EBV) infection in children admitted to tertiary care teaching hospitals. Materials and Methods: Retrospective observational multicentric analysis of clinical and laboratory features of children between 1 month to 12 years with a diagnosis of infectious mononucleosis due to EBV infection confirmed by positive serology over a 12-month period after seeking approval from the Institutional Ethics Committee. Results: Out of 66 children screened, 53 were included in final analysis. The majority were aged between 5 and 8 years with male: female ratio of 1.2:1. Most presentations were during the monsoon months. The common clinical features were fever (100%), splenomegaly (86.7%), and cervical lymphadenopathy (73.5%) in contrast to the classical triad of fever, sore throat, and generalized lymphadenopathy described in the literature. There were no age differences in clinical findings except for generalized and cervical lymphadenopathy and hepatomegaly which were commoner in 9–12 years age band. Although the incidence of common findings matched with previously published studies, there were some notable differences. While frequencies of upper eyelid edema, epitrochlear lymphadenopathy, and splenomegaly were more, those of rash and sore throat were less. Lymphocytosis and presence of atypical lymphocytes were relatively less common in our series. All children recovered. Conclusions: This multicentric study on profiling childhood infectious mononucleosis, possibly first of its kind from Eastern India, has documented clinical and laboratory features associated with this condition. These data can serve as a reference for future studies.
  2 8,496 402
Serum superoxide dismutase activity: A predictor of disease severity in nigerian sickle cell anemia patients in steady state
E Chide Okocha, O Patrick Manafa, C John Aneke, E Chizoba Onwuzuruike, C Nancy Ibeh, O George Chukwuma
September-October 2017, 10(5):406-411
DOI:10.4103/MJDRDYPU.MJDRDYPU_90_17  
Background: Sickle cell anemia (SCA) is associated with intense oxidative stress; optimal antioxidant levels are essential to prevent oxidant tissue damage. Objective: The objective of this study was to evaluate superoxide dismutase (SOD) activity and Vitamin C levels in individuals with SCA, heterozygous sickle cell (heterozygous hemoglobin AS [HbAS]), and normal (hemoglobin AA [HbAA]) hemoglobin phenotypes in comparison with objective scores of disease severity (in those with SCA). Subjects and Methods: A total of ninety participants were recruited, including thirty SCA (in steady state), thirty HbAS, and thirty HbAA. From each participant, 5 ml of venous blood was collected; 3 ml was dispensed into plain tubes and serum was extracted for the estimation of SOD activity and Vitamin C level. Serum SOD activity was measured using a semi-automated spectrophotometric procedure, while serum Vitamin C level was estimated by the enzyme-linked immunosorbent assay technique. The remaining 2 ml was used for hemoglobin electrophoresis and full blood count estimation. Objective score of disease severity was calculated for SCA individuals using a scoring system. Results: The mean serum activity of SOD was significantly lower in SCA compared with HbAS and HbAA participants (9.45 ± 3.39 U/ml vs. 12.87 ± 2.17 U/ml and 13.24 ± 2.10 U/ml, P < 0.001, respectively). No significant differences were observed between the mean serum Vitamin C levels of SCA, HbAS, and HbAA participants (1922.59 ± 771.56 ng/ml vs. 1631.10 ± 526.57 ng/ml and 2029.17 ± 902.99 ng/ml P > 0.05, respectively). Serum SOD activity was significantly correlated with objective score of disease severity in SCA participants, while Vitamin C level was not (r = −0.529, P = 0.02 and r = −0.349, P = 0.14, respectively). Conclusion: Serum SOD activity is a predictor of disease severity in Nigerian individuals with SCA.
  2 9,129 409
CASE SERIES
Musculoskeletal manifestations in sickle cell anemia
Reddy Ravikanth, Manu Jacob Abraham, Ashok Alapati
September-October 2017, 10(5):453-457
DOI:10.4103/0975-2870.218182  
Sickle cell anemia is an inherited hemoglobin disorder characterized by substitution of glutamic acid by valine at the sixth position of the beta globin chain. The sequence of events leads to pain crisis. Ischemia of the tissues resulting from decreased blood flow is believed to occur in pain crisis. Repeated or prolonged sickling causes red cell death in the form of hemolytic anemia. The majority of hospital admissions are due to painful crisis. These patients are at increased risk for both osteomyelitis and infarction of the long bones. Magnetic resonance imaging has been shown to be helpful in the diagnosis of early osteomyelitis and its differentiation from infarction in sickle cell disease patients with acute bone crisis. Others findings include dactylitis, medullary infarcts, diploic space widening, fish mouth vertebrae, and avascular necrosis. We present a case series on the various musculoskeletal manifestations of sickle cell disease.
  1 8,517 478
COMMENTARY
Obstructive sleep apnea and endocrine disorders
M Vishnu Sharma
September-October 2017, 10(5):467-469
DOI:10.4103/MJDRDYPU.MJDRDYPU_17_17  
  1 4,003 240
CASE REPORTS
Partial prune belly syndrome: A rare case report
Aditya Pratap Singh, Vinay Mathur, Ramesh Tanger, Arun Kumar Gupta
September-October 2017, 10(5):470-472
DOI:10.4103/MJDRDYPU.MJDRDYPU_280_16  
Prune belly syndrome (PBS) is characterized by deficient development of abdominal muscles that causes the skin of the abdomen to wrinkle like a prune, bilateral cryptorchidism, abnormalities of the urinary tract. The etiology of PBS is unclear and possible familial genetic inheritance was reported in some of the studies. We are presenting here a case with the absence of the muscle in the right side of the abdomen as hernia, thinning of the muscle on left side with bilateral cryptorchidism, and abnormalities of the urinary tract. It is the partial presentation of the PBS.
  - 3,558 186
A seizuring alagille syndrome
Jomon Mathew John
September-October 2017, 10(5):473-475
DOI:10.4103/MJDRDYPU.MJDRDYPU_248_16  
Alagille syndrome is a rare autosomal dominant inherited disorder with incidence of one in 100,000 live births. This syndrome with seizure as a presentation has been rarely reported in Indian studies. We present a 3-month-old infant who presented to us with seizures was found to have a dysmorphic face, jaundice, hepatomegaly, and soft systolic murmur. Infant was stabilized and remained seizure free. A detailed clinical evaluation of a common presentation may reveal a rare syndrome.
  - 3,572 215
Accidental strangulation by electric rickshaw
Alka Chandra, Anshu Mali, Shubham Narayan, Amitabh Sharma
September-October 2017, 10(5):476-478
DOI:10.4103/MJDRDYPU.MJDRDYPU_55_17  
The dupatta and sari are the traditional Indian wear. The loose end of both makes the females prone to sustain grievous injuries while traveling in an electric (E) rickshaw which has become a very popular means of transport on the streets of capital and national capital region. We report here a case of accidental strangulation with a dupatta sustaining airway trauma with a serious consequence leading to significant morbidity.
  - 2,635 185
Unilateral multicystic dysplastic kidney with ipsilateral grade V vesicoureteral reflux: A case report of a rare association
Savita Agarwal, Bhawana A Badhe, Pinki Pandey, Megha Ralli
September-October 2017, 10(5):479-481
DOI:10.4103/0975-2870.218185  
Multicystic renal dysplasia is a common cause of childhood end-stage renal failure and is categorized under the entity known as congenital anomalies of kidney and urinary tract. With the increasing knowledge about their natural history, it is now known that most of the cases of unilateral multicystic dysplastic kidney undergo spontaneous involution; thus, most of the pediatric urologists now prefer conservative management with long-term nephrological and urological observation. However, the presence of recurrent urinary tract infection as in the present case report due to associated ipsilateral Grade V vesicoureteral reflux, a rare associated finding mandates nephrectomy.
  - 3,040 202
Topiramate-induced angle closure glaucoma in a case of chronic migraine
VA Arun, YS Sirohi, Yatharth Dixit
September-October 2017, 10(5):482-484
DOI:10.4103/MJDRDYPU.MJDRDYPU_288_16  
Topiramate is an oral sulfamate medication used primarily for epilepsy and migraine. The tolerability profile with its lack of significant metabolic side effects makes it a favorable drug for patients with comorbid lifestyle illnesses. Topiramate-induced angle closure is an idiosyncratic reaction and can occur in otherwise normal eyes with normal anterior chamber angles. Ocular examination before starting topiramate cannot identify eyes at risk. Prompt cessation of therapy alone can result in rapid resolution of most of these adverse effects, whereas failure to recognize can lead to permanent visual problems. The internists should be aware of the documented side effects of topiramate, particularly when presented with simultaneous bilateral acute angle-closure glaucoma. Neurologists initiating therapy with topiramate should also educate the patients of its potential side effects and importance of reporting back immediately in case of any visual disturbance. Prompt cessation of topiramate is the mainstay of treatment. Supportive treatment in the form of oral and topical antiglaucoma drugs to reduce the intraocular pressure (IOP), topical steroids to bring down the inflammation, and topical cycloplegics to retract the ciliary processes thus bringing down the IOP has been recommended, but a few would warrant laser iridotomy or surgical iridectomy. We report a case of topiramate-induced angle closure glaucoma in a young female being managed as a case of chronic migraine, highlighting the importance of increasing the awareness of this rare, idiosyncratic adverse effect of topiramate and the need for timely intervention to avoid irreversible visual loss.
  - 2,617 179
Osteosarcoma of first metacarpal with bilateral lung metastasis: A rare case report
Rajeev Saxena, Mamta Jain, Harshvardhan Singh, RP Meena
September-October 2017, 10(5):485-487
DOI:10.4103/0975-2870.218179  
Osteosarcomas of hands are rare, (<1%) and these cases differ in presentation and behavior compared to those in usual locations. Histological grade was the only significant single prognostic variable for risk of death. High-grade osteosarcoma of the hand should be treated similar to those in conventional sites with ablative surgery and neoadjuvant chemotherapy. Here, we report a case of high-grade osteosarcoma of the first metacarpal. World literature shows occasionally reported case of this site. Rarity of the lesion and creating awareness among surgeons about existence of such a lesion in smaller bones is our motto. This would prompt them for an early effort for proper diagnostic procedure and subsequent early treatment so that prognosis of this grave disease can be improved. In the present case, diagnosis was delayed and pulmonary metastasis was present at time of diagnosis. The patient is presently undergoing chemotherapy and under regular follow-up.
  - 2,968 184
Gastrointestinal stromal tumor of the anal canal: An unusual presentation
Chhanda Das, Madhumita Mukhopadhyay, Madhu Kumari, Bikram Halder
September-October 2017, 10(5):488-491
DOI:10.4103/MJDRDYPU.MJDRDYPU_293_16  
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of the gastrointestinal tract. The most common site is stomach, followed by small intestine, colon, and esophagus. However, GIST from the anal canal is an extremely rare tumor. Here, we report an extremely rare case of GIST of the anal canal in a 40-year-old female with a history of irregular bowel habits mixed with blood and constipation for 4 months. Diagnosis was made on the basis of histopathological and immunohistochemical examination.
  - 3,893 160
Ecthyma gangrenosum like lesions in disseminated mycobacterial tuberculosis infection in a renal transplant recipient
Navjyot Kaur, Aditya Vikram Pachisia, Puneet Saxena, VK Sashindran, Pankaj Puri
September-October 2017, 10(5):492-496
DOI:10.4103/MJDRDYPU.MJDRDYPU_260_16  
Ecthyma gangrenosum (EG) is a relatively rare skin manifestation that is most commonly described in Pseudomonas aeruginosa bacteremia. It is more frequently seen in immunocompromised individuals. We report a case of 60-year-old renal transplant recipient on triple immunosuppressants and diabetes mellitus type 2 on insulin therapy who developed EG-like lesions due to disseminated mycobacterial tuberculosis (MTB) infection. To the best of our knowledge, this is the first case report of EG-like lesions associated with disseminated kochs.
  - 3,519 201
Giant brenner tumor of ovary
Rupali Bavikar, Sunita Bamanikar, Harsh Kumar, Megha Jha, Yamini Ingale
September-October 2017, 10(5):497-499
DOI:10.4103/MJDRDYPU.MJDRDYPU_261_16  
Brenner tumor is a rare ovarian tumor that is a part of the surface epithelial group of ovarian neoplasm. It is usually asymptomatic, and most of the times, it is an incidental pathological finding. They can be subdivided into benign, borderline or proliferative, and malignant neoplasms. The majority of Brenner tumors are benign in nature. Tumors of borderline malignancy are less frequent, and only about 1% of tumors are borderline. Here, we present a rare case of giant Brenner tumor of ovary measuring 28 cm in diameter. This is the case is presented because the giant size of Brenner tumor, although rare gynecologist should be aware of this rare entity.
  - 3,731 186
Aggressive angiomyxoma of scrotum in a young male: A rare entity
Krishna Tadepalli, Vijaya Gattu
September-October 2017, 10(5):458-460
DOI:10.4103/MJDRDYPU.MJDRDYPU_297_16  
Aggressive angiomyxoma (AAM) is a rare mesenchymal benign myxoid tumor of the pelvis and perineum which occurs almost exclusively in adult females. It rarely occurs in males and involves scrotum. Here, we report a case of aggressive angiomyxoma in a 15-year-old male presented with a slow-growing scrotal swelling for 6 months. About 150 cases were reported worldwide (few cases were reported in males). AAM in the scrotal region may present as a scrotal mass, often mistaken for a hernia or hydrocele.
  - 3,040 228
Pornographic addiction: Is it a distinct entity?
Adnan Kadiani, Ekram Goyal, Spandana Devabhaktuni, Brig Daniel Saldanha, Bhushan Chaudhari
September-October 2017, 10(5):461-464
DOI:10.4103/MJDRDYPU.MJDRDYPU_303_16  
Among all the different types of behavioral addictions, the one related to sexual activity is probably the most difficult to treat as we are reluctant to discuss issues related to sex. From innocuous viewing of pornographic content in adolescence, a 34-year-old married male for 6 years becomes addicted to it. The case highlights the importance of recognizing pornographic addiction as a disorder and the difficulties encountered in its management.
  - 11,247 515
Acromegaly presenting as obstructive sleep apnea syndrome
Deepthi Laldayal, Unnati Desai, Jyotsna M Joshi
September-October 2017, 10(5):465-467
DOI:10.4103/MJDRDYPU.MJDRDYPU_254_16  
A 52-year-old female presented with a history of snoring and excessive daytime sleepiness for 3 years. On evaluation with polysomnography, she was confirmed as a case of severe obstructive sleep apnea syndrome (OSAS). Macroglossia and enlargement of fingers and toes aroused suspicion; extending the evaluation to be ultimately confirmed as a case of acromegaly; changing the management protocols. Acromegaly, though a rare endocrine disorder which results from excessive secretion of growth hormone in adults, has a high prevalence of OSAS. We report one such rare case of acromegaly which initially presented to us as a case of OSAS.
  - 2,932 220
COMMENTARY
Is infectious mononucleosis a pediatric disease?
Jennifer Grimm
September-October 2017, 10(5):445-446
DOI:10.4103/MJDRDYPU.MJDRDYPU_66_17  
  - 2,299 209
EDITORIAL
Medical research in India: Spirit is unwilling and the flesh is weak
Amitav Banerjee
September-October 2017, 10(5):399-400
DOI:10.4103/MJDRDYPU.MJDRDYPU_138_17  
  - 3,105 336
LETTERS TO THE EDITOR
Chloroma in a child with T-cell acute lymphoblastic leukemia
Anirban Mandal, Amitabh Singh, Vijay Gnanaguru, Rachna Seth
September-October 2017, 10(5):500-501
DOI:10.4103/MJDRDYPU.MJDRDYPU_7_17  
  - 3,244 207
Polyostotic fibrocartilaginous dysplasia
Naveen Basavaraj Manibanakar, Manoj Gopal Madakshira
September-October 2017, 10(5):502-503
DOI:10.4103/MJDRDYPU.MJDRDYPU_301_16  
  - 1,865 155
ORIGINAL ARTICLES
Phenytoin-induced changes in the bone mineral metabolism in young males
Shalesh Rohatgi, Abhay Inderjit Ahluwalia
September-October 2017, 10(5):412-416
DOI:10.4103/MJDRDYPU.MJDRDYPU_56_17  
Background: Antiepileptic drugs (AEDs) have an adverse effect on the bone mineral metabolism. Patients and Methods: The objective of the study was to determine the bone loss and change in bone mineral parameters in patients treated with phenytoin sodium. We prospectively studied 36 young males aged 20–30 years, with new-onset epilepsy, and treated with phenytoin. Patients were clinically examined and subjected to determination of the bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) at the femur neck, spine, and lower third of radius. We also assessed Vitamin 25-OH-Vitamin D3, parathyroid hormone (PTH), and osteocalcin at the onset and after 1 year of treatment. Results: There were no significant changes noted in the 25-OH-Vitamin D3, (20.7 ± 10 ng/dl before and 18.5 ± 7.3 ng/dl after therapy, P = 0.198), and serum parathyroid levels (8.8 ± 6.8 pg/ml before and 14.2 ± 11.5 pg/ml, P = 0.114) at the end of 1-year therapy. There was declines in BMD at all the three sites; the spine (0.943 ± 0.11 vs. 0.943 ± 0.12 g/cm2, P = 0.15), femur neck (0.912 ± 0.0.12 vs. 0.896 ± 0.124 g/cm2, P = 0.093), and a statistically significant decline lower third of radius (0.659 ± 0.07 vs. 0.644 ± 0.073 g/cm2, P ≤ 0.001). We did not find any significant change in levels of 25-OH-Vitamin D3, PTH, and serum alkaline phosphatase, but found significant elevation in levels of osteocalcin. Conclusions: Phenytoin therapy in young male patients for 1-year causes a bone loss at femur and spine in the absence of Vitamin D deficiency and significant bone loss in the cortical bone radius. DXA should be done in patients during the treatment with AEDs to identify patients who are susceptible to increased risk of fractures.
  - 3,614 279
Quantification of vulnerability to Type 2 diabetes: A study among shopkeepers in Kolkata
Aparajita Dasgupta, Bijit Biswas, Bobby Paul, Lina Bandyopadhyay, Ayon Ghosh, Sembagamuthu Sembiah
September-October 2017, 10(5):417-423
DOI:10.4103/MJDRDYPU.MJDRDYPU_63_17  
Context: Urban people are more prone to develop diabetes due to their sedentary lifestyle and high-calorie food intake. Shopkeepers with their long sitting hours, unhealthy food habits, and lack of regular physical activity are one of the high-risk groups for developing diabetes. Hence, it is necessary to detect this large pool of undiagnosed people with diabetes to offer them early treatment. Aims: The present study aimed at assessing people with a high risk of developing type 2 diabetes and its correlation with some known risk factors. Materials and Methods: The study was a cross-sectional community-based study conducted from May to July among 152 shopkeepers in a permanent market with a structured schedule. Statistical Analysis Used: Data were analyzed using appropriate statistical methods by SPSS software (version 16). Results: Thirty-five (23.02%) out of 152 shopkeepers were found having high blood sugar (>140 mg/dl). In univariate analysis, the study participants with higher age, perceived stress score, Indian Diabetic Risk Score (IDRS), body weight, centrally obese, and less physically active had shown significantly greater odds of having high blood sugar level. In multivariable model, PSS (adjusted odds ratio [AOR]-1.90), waist circumference (AOR-3.34), and physical activity (AOR-3.09) remained significantly adjusted with other significant variables in univariate analysis excepting IDRS. Sensitivity and specificity of IDRS were 68.6% and 65.8%, respectively, with diagnostic accuracy of 72.3% calculated using receiver operating characteristic curve. Conclusions: The study revealed that shopkeepers are indeed at high risk of developing diabetes. There is an urgent need for increasing awareness regarding diabetes among them.
  - 2,577 317
Spectrum of monoclonal light-chain gammopathy in a tertiary care hospital
Mir Sadaqat Hassan Zafar, Swasti Sinha, Shyam Aggarwal, Manorama Bhargava
September-October 2017, 10(5):424-429
DOI:10.4103/MJDRDYPU.MJDRDYPU_39_17  
Background: Monoclonal light chain gammopathies are uncommon subsets of plasma cell disorders which usually present as diagnostic challenge. Materials and Methods: Twenty cases of monoclonal light-chain gammopathy were identified after screening 150 plasma cell disorders at a tertiary care referral center of North India and were analyzed for clinical profile and treatment outcomes. Results: Out of 20 cases of monoclonal light-chain gammopathy, 65% (13/20) were light-chain multiple myeloma (LCMM) type, 20% (4/20) were light-chain deposition disease (LCDD) type, and 15% (3/20) had primary amyloidosis (AL). Renal failure (65% of cases) was the most common presentation. All the patients with LCDD presented with renal failure (4/4) while as 61% of LCMM (8/13) and 33% of AL (1/3) presented with renal failure. Five patients presented with anemia and all were LCMM type. Two patients presented with lytic bone lesions (LCMM type) and one patient presented with plasmacytoma (LCMM). Overall response rate after 4 cycles of induction therapy was 92.3% in LCMM group, 100% in LCDD group, and 33.33% in AL group (excluding one patient who expired before the start of treatment). LCMM showed 23% partial remission (PR), 30.77% very good PR, 38.46% complete response (CR), and 5% no response (NR). LCDD showed PR 75% and CR 25%. AL showed PR 33.33% and NR 5%. Conclusions: Renal failure is a common presentation of monoclonal light chain gammopathies, and it should alert the treating physician for the underlying uncommon plasma cell disorder.
  - 2,593 192