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MGM Journal of Medical Sciences
Current Issue : Volume 4, Issue 1, January-March 2017
 
 
1.  From the Editors’ Desk
From the Editors’ Desk
Shibban K Kaul, Chander P Puri
[Pages No:iv]
Full Text PDF | Abstract | FREE

ABSTRACT

Increasing resistance of microorganisms to antibiotics is becoming a cause of great concern globally. We are already witnessing increase in morbidity, mortality, longer hospital stays and greater health care costs of treating patients suffering from infections.

 
2.  ORIGINAL ARTICLE
Prospective Study of Percutaneous Nephrolithotomy in the Management of Renal Calculi
Nandkishor Raut, Piyush Singhania, Nitin Joshi, Sanish Shringarpure, Saket Sathe, Niraj Tiwari
[Pages No:1-5]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1128 | FREE

ABSTRACT

Introduction: Kidney stones are a common problem affecting all population groups across the globe. Percutaneous extraction of renal stone - properly termed percutaneous nephrolithotomy (PCNL) which was invented over three decades ago - has become a standard, well-established procedure for the management of renal stones. This study will evaluate the role of PCNL in the management of renal calculi.

Materials and methods: A total of 107 cases of renal calculi who underwent PCNL from May 1, 2014 to April 30, 2016 were studied. Intraoperative findings and immediate postoperative complications were noted. They were followed up for 1 month after the surgical procedure.

Results: Mean age of cases was 43.64 years. Multiple calculi were seen in 43.9%, while a staghorn calculus was seen in 16.8%. Stone clearance was done through a single tract in 78.5%. Additional tracts were made in 21.5%. Tubeless PCNL was done in 45%; 12.1% of the cases had urinary tract infection. Pulmonary complications were noted in 4.67% in the form of hydrothorax. Urinary leak was noted in 4.6%; 70% of the cases were left stone free, with an overall success rate of 85.98%.

Conclusion: This study reveals that PCNL is a safe procedure with less complications and higher stone-free rates without compromising patient safety in a short period.

Keywords: Minimally invasive, Nephroscopy, Percutaneous nephrolithotomy, Renal calculi.

How to cite this article: Raut N, Singhania P, Joshi N, Shringarpure S, Sathe S, Tiwari N. Prospective Study of Percutaneous Nephrolithotomy in the Management of Renal Calculi. MGM J Med Sci 2017;4(1):1-5.

Source of support: MGMIHS

Conflict of interest: None

 
3.  ORIGINAL ARTICLE
Utility of GeneXpert Mycobacterium tuberculosis/Rifampin Assay for Extrapulmonary Tuberculosis Samples
Shamma Shetye, Pratiksha Chheda, Ashish Lad, Sunmeet Matkar, Priyanka Yadav
[Pages No:6-9]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1129 | FREE

ABSTRACT

A total of 3,806 samples from suspected cases of extrapulmonary tuberculosis (EPTB) were subjected to GeneXpert Mycobacterium tuberculosis (MTB)/rifampin (RIF) assay. Samples consisted of body fluids, pleural fluids, pus and aspirates, lymph node (LN) tissues, and others. Mycobacterium tuberculosis positivity was detected in 18.10% and RIF positivity in 2.73% samples. The MTB/RIF positivity was found highest in pus and aspirates (40.38%). In this study, assay failure rate for GeneXpert MTB/RIF assay was very low (1.99%). It is concluded from this study that GeneXpert MTB/RIF is an efficient, reliable, simple, and fast technique for rapid diagnosis of EPTB in our country where incidence of tuberculosis remains high.

Keywords: Assay failure rate, Extrapulmonary tuberculosis, GeneXpert MTB/RIF assay, Positivity rate.

How to cite this article: Shetye S, Chheda P, Lad A, Matkar S, Yadav P. Utility of GeneXpert Mycobacterium tuberculosis/ Rifampin Assay for Extrapulmonary Tuberculosis Samples. MGM J Med Sci 2017;4(1):6-9.

Source of support: Nil

Conflict of interest: None

 
4.  ORIGINAL ARTICLE
Spectrum of Microbial Isolates from Wound Infections in Patients admitted in a Tertiary Care Hospital, Kolkata
Ashis K Saha, Suman Nandi, Payodhi Dhar
[Pages No:10-18]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1130 | FREE

ABSTRACT

Increasing emergence of drug-resistant bacteria is becoming a major problem globally. A retrospective study of 790 culture and sensitivity reports on microbial isolates, from infected wounds was carried out in KPC Medical College and Hospital, Jadavpur, Kolkata, India. 504 patients were males and 286 females. Gram negative organisms were isolated in 561 and gram positive in 229. Among the gram negative organisms, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli were the most common, whereas Staph aureus was the only gram positive organism isolated. Antibiotic sensitivity tests revealed most gram negative organisms susceptible to carbapenems, polymyxin and colistin. Staphylococci showed sensitivity to tigecycline, clindamycin, vancomycin, teicoplanin and linezolid. Interesting differences in the type of organisms isolated in male and female patients were noted. For example Enterococcus faecalis was found only in female patients. Increasing resistance of microorganisms cultured from infected wounds to first line and even second line antibiotics is a matter of great concern and can be attributed to indiscriminate and irrational use of broad spectrum antibiotics. This has to stop forthwith if we want to prevent resistance to antibiotics; otherwise morbidity, mortality and health care costs in treating patients with wound infections are going to increase exponentially

Keywords: Blood culture, Gram-negative bacteria, Grampositive bacteria, Sensitivity, Tertiary hospital.

How to cite this article: Saha AK, Nandi S, Dhar P. Spectrum of Microbial Isolates from Wound Infections in Patients admitted in a Tertiary Care Hospital, Kolkata. MGM J Med Sci 2017;4(1):10-18.

Source of support: Nil

Conflict of interest: None

 
5.  ORIGINAL ARTICLE
Early Results of Total Condylar Knee Arthroplasty using Indian-designed Prostheses
Kuldip R Salgotra, Sarabjeet Kohli, Nilesh Vishwakarma, Shaival Chavan
[Pages No:19-22]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1131 | FREE

ABSTRACT

The present study was undertaken to evaluate the results of 50 total knee replacements performed at Military Hospital Kirkee, Pune, India, using Indian-manufactured prostheses, from November 2001 to November 2005. The study group consisted of 18 males and 28 females in the mean age of 63 years for osteoarthritis and 48 years for rheumatoid arthritis (RA): 41 knees of osteoarthritis and RA in 9 knees. The followup period was 6 months to 2 years, with a mean of 14 months. Good correction of deformities was achieved for all the knees. Postoperatively, there was improvement in Knee Society Score by 69 points for osteoarthritic knees and 65 points for rheumatoid knees. Excellent results were achieved in 88% of the cases. Average postoperative range of movements achieved was 90°. The results are comparable with those following use of far costlier imported prostheses.

Keywords: Osteoarthritis, Total condylar knee, Total knee replacement.

How to cite this article: Salgotra KR, Kohli S, Vishwakarma N, Chavan S. Early Results of Total Condylar Knee Arthroplasty using Indian-designed Prostheses. MGM J Med Sci 2017; 4(1):19-22.

Source of support: MGMIHS

Conflict of interest: None

 
6.  ORIGINAL ARTICLE
Ultrasound Evaluation of Difference in Endometrial Thickness in Infertile and Fertile Females
Shishir Kumar, Priti Kapoor, Satish Nawre
[Pages No:23-25]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1132 | FREE

ABSTRACT

Endometrium has an important role in the success of a pregnancy, providing the site for implantation and supporting the pregnancy to fruition. There is a correlation noted between the thickness of the endometrium and the accomplishment of implantation. Endometrial thickness was measured on ultrasound examination of 50 women, who were being investigated for primary infertility and 50 age-matched healthy fertile women serving as control group, in all the three phases of the menstrual cycle. The endometrium of infertile women was found to be thinner during all the three phases of the menstrual cycle as compared with that of the fertile women in the control group. Difference in the thickness was found to be statistically significant in each phase of the menstrual cycle.

Keywords: Endometrial thickness, Infertility, Intracyclic endometrial response.

How to cite this article: Kumar S, Kapoor P, Nawre S. Ultrasound Evaluation of Difference in Endometrial Thickness in Infertile and Fertile Females. MGM J Med Sci 2017;4(1):23-25.

Source of support: MGMIHS

Conflict of interest: None

 
7.  REVIEW ARTICLE
Epithelial-mesenchymal Transition of Glomerular Podocytes: Implications in Proteinuria
Rajkishor Nishad, Krishnamurthy Nakuluri, Manga Motrapu, Anil K Pasupulati
[Pages No:26-34]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1133 | FREE

ABSTRACT

The kidneys play an essential role in filtration of blood plasma, regulation of water, electrolyte, and acid/base balance of the body, and thus maintain overall homeostasis. The glomerular filtration barrier serves as a size, shape, and charge barrier to ensue glomerular permselectivity, so that kidneys excrete almost protein-free urine. Podocytes are glomerular visceral epithelial cells and significantly contribute to the glomerular permeability owing to their unique structure and specialized function. Nevertheless, podocytes are susceptible to various insults, including altered metabolites, aberrant signaling molecules, and mutations to critical proteins that otherwise ensue normal function. Podocyte injury is a predominant indicator of several glomerular diseases that are manifested by proteinuria. Epithelial-mesenchymal transition (EMT) is considered as one of the responses of podocytes to the noxious stimuli, which consequently results in podocyte depletion and proteinuria. This review discusses the importance of podocytes in normal renal filtration and details the molecular and cellular events that lead to EMT of podocytes vis-é-vis impaired glomerular filtration.

Keywords: Epithelial-mesenchymal transition, Glomerulus, Kidney, Nephron, Podocytes, Proteinuria.

How to cite this article: Nishad R, Nakuluri K, Motrapu M, Pasupulati AK. Epithelial-mesenchymal Transition of Glomerular Podocytes: Implications in Proteinuria. MGM J Med Sci 2017;4(1):26-34.

Source of support: The work is funded by a grant from SERB, India (EMR/2015/002076) and DST-INSPIRE Faculty Scheme to AKP.

Conflict of interest: None

 
8.  REVIEW ARTICLE
Fetal Surgery: A Basic Overview and a Glimpse into Its Future
Sushil Kumar, Mayuri More, Sunil Sharma
[Pages No:35-38]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1134 | FREE

ABSTRACT

The routine antenatal screening for congenital disorders in the fetus has made a sea change the way we look at the fetus. With the availability of high-resolution ultrasound machines, we have technology to diagnose fetal structural defects, with high degree of certainty. Some of these babies can go through the entire pregnancy and can be operated upon after delivery without additional morbidity and mortality. Fetus with diaphragmatic hernia needs fetal surgery for better survival, while the fetus with myelomeningocele can be operated upon postnatally, but neurological outcome for the baby is better if operated upon in utero. Fetal surgery is performed in the second trimester of pregnancy either by open route or by endoscopy. Endoscopy route is still evolving and generally used to coagulate the communicating vessels in cases of twin-twin transfusion syndrome. Open fetal surgery involves hysterotomy, control of hemorrhage from edges of hysterotomy wound, aspiration of amniotic fluid, delivery of effected fetal part to the hysterotomy wound, corrective surgery, closure of uterine incision, and instillation of aspirated amniotic fluid back to uterus. Postoperatively, the patient is given tocolytics and antibiotics to avoid preterm labor and infection respectively. At appropriate date, the baby is delivered by cesarean section. Despite several benefits, fetal surgery cannot be considered safe for the mother and the fetus. It is associated with considerable maternal morbidity like hemorrhage, preterm delivery, chorioamnionitis, and so forth. It also needs coordinated team effort with a dedicated team of obstetrician, anesthetist, pediatrician, and other specialized surgeons of concerned deformity in the fetus. Currently, fetal surgery is a new frontier of fetomaternal medicine and may be labeled as evolving science, and the facility should be limited to highly specialized tertiary care centers to gain more experience. However, the future of fetal surgery as an effective tool to correct the congenital defects for the fetus is promising.

Keywords: Fetal surgery, Minimally invasive fetal surgery, Open fetal surgery.

How to cite this article: Kumar S, More M, Sharma S. Fetal Surgery: A Basic Overview and a Glimpse into Its Future. MGM J Med Sci 2017;4(1):35-38.

Source of support: MGMIHS

Conflict of interest: None

 
9.  CASE REPORT
Undiagnosed Cesarean Scar Pregnancy: A Nightmare
Shubhangi A Mande, Gauri A Dank, Swati S Shiradkar
[Pages No:39-42]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1135 | FREE

ABSTRACT

Ectopic pregnancy is one of the leading causes of morbidity and mortality among fertile women. Cesarean scar pregnancy (CSP) is the rarest type of ectopic pregnancy. It is a lifethreatening abnormal form of implantation of a gestational sac in the myometrium at the site of a previous cesarean scar. A case of 23-year-old woman with previous cesarean section, torrential hemorrhage during dilatation, and evacuation carried out for retained products of conception is being reported. The patient finally required hysterectomy to stop the hemorrhage. The provisional diagnosis of CSP was made during laparotomy and later confirmed by histopathological examination.

Keywords: Cesarean scar pregnancy, Methotrexate, Myometrium, Obstetric hysterectomy.

How to cite this article: Mande SA, Dank GA, Shiradkar SS. Undiagnosed Cesarean Scar Pregnancy: A Nightmare. MGM J Med Sci 2017;4(1):39-42.

Source of support: MGMIHS

Conflict of interest: None

 
10.  CASE REPORT
Severe Metabolic Alkalosis in an Infant: Bartter Syndrome
Jeetendra Gavhane, Karan Markanda, Surabhi Dogra, Neha Jafri
[Pages No:43-45]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1136 | FREE

ABSTRACT

Metabolic alkalosis is an uncommon acid/base disorder in children in which serum bicarbonate concentration is increased. Two most important causes of metabolic alkalosis are emesis and diuretic use. However, in the absence of these two etiologies, a thorough investigative workup is of paramount importance to reach a definitive diagnosis. A case having severe metabolic alkalosis diagnosed as a case of Bartter syndrome is being reported.

Keywords: Bartter syndrome, Hypokalemia, Metabolic alkalosis.

How to cite this article: Gavhane J, Markanda K, Dogra S, Jafri N. Severe Metabolic Alkalosis in an Infant: Bartter Syndrome. MGM J Med Sci 2017;4(1):43-45.

Source of support: MGMIHS

Conflict of interest: None

 
11.  CASE REPORT
Hyperhomocysteinemia with Anticoagulant-related Acute Kidney Injury
Kshitija G Gadekar, Nilrohit Paike, Nilesh Bhange, Sudhir Kulkarni
[Pages No:46-48]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1137 | FREE

ABSTRACT

A case of 40-year-old young woman with an extensive, acute thrombosis of left distal brachial artery following an elective laparoscopic cholecystectomy was reported. The patient underwent urgent surgical intervention for brachial artery thrombosis and was started on oral anticoagulant. Within a week, the patient presented with bleeding diathesis and acute renal insufficiency with sepsis. She was found to have markedly increased serum homocysteine level. No other thrombophilic factors could be found. On investigation, a genetic defect of homocysteine metabolism was found to be the underlying cause. The patient recovered completely on treatment with pyridoxine, cyanocobalamin, and folate.

Keywords: Acute kidney injury, Anticoagulant, Heterozygous methylenetetrahydrofolate reductase gene mutation, Thromboembolic event.

How to cite this article: Gadekar KG, Paike N, Bhange N, Kulkarni S. Hyperhomocysteinemia with Anticoagulant-related Acute Kidney Injury. MGM J Med Sci 2017;4(1):46-48.

Source of support: MGMIHS

Conflict of interest: None

 
12.  CASE REPORT
Pediatric Catatonia in Early-onset Schizophrenia and Treatment Implications
Chetan D Vispute, Ajita S Nayak, Jahnavi S Kedare, Nakul A Vanjari
[Pages No:49-51]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1138 | FREE

ABSTRACT

A 13-year-old girl presented with symptoms of catatonia during second episode of early-onset schizophrenia. Catatonic features seen were motoric immobility, extreme negativism, mutism, ambitendency, and refusal to take food. She was initially treated with antipsychotic drugs but developed side effects. In view of life-threatening situation and absence of improvement, she was treated with electroconvulsive therapies (ECTs). Nine adequately spaced ECTs were given using propofol as the anesthetic agent. She showed significant response to ECTs with respect to her symptoms of catatonia and activities of daily living.

Keywords: Catatonic symptom, Electroconvulsive therapy, Pediatric catatonia, Schizophrenia.

How to cite this article: Vispute CD, Nayak AS, Kedare JS, Vanjari NA. Pediatric Catatonia in Early-onset Schizophrenia and Treatment Implications. MGM J Med Sci 2017;4(1):49-51.

Source of support: MGMIHS

Conflict of interest: None

 
13.  CASE REPORT
Kyrle’s Disease: A Rare Presentation in Diabetic and Hypertensive Patients
Reeta Dhar, Ajay S Wani, Shilpi Sahu, DB Borkar, Manisha Tambekar, Priyanka Jadhav, Puja I Ambrish, Shonit Agarwal
[Pages No:52-53]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10036-1139 | FREE

ABSTRACT

Two rare cases of Kyrle’s disease in diabetic patients who presented with papules on legs, back and abdomen, are reported. Pathology of this disease and management are described in detail. Importance of treating the underlying condition associated with this disease is highlighted.

Keywords: Diabetes, Hyperkeratosis follicularis, Kyrle’s disease.

How to cite this article: Dhar R, Wani AS, Sahu S, Borkar DB, Tambekar M, Jadhav P, Ambrish PI, Agarwal S. Kyrle’s Disease: A Rare Presentation in Diabetic and Hypertensive Patients. MGM J Med Sci 2017;4(1):52-53.

Source of support: MGMIHS

Conflict of interest: None

 
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