https://www.nepjol.info/index.php/AJMS/issue/feed Asian Journal of Medical Sciences 2020-03-02T12:34:36+00:00 Dr Arun Kumar ajmscience@gmail.com Open Journal Systems <p>The inaugural issue of the Asian Journal of Medical Sciences was published in May 2010. Full text articles available.</p> https://www.nepjol.info/index.php/AJMS/article/view/27022 Immunoexpression of p53 and ki-67 correlated with clinicopathological parameters in predicting recurrence of oral squamous cell carcinoma 2020-03-02T08:48:06+00:00 Biji Babu dr.bijibabu@gmail.com Kaveri Hallikeri drcauveri2005@gmail.com Kiran Kumar kirankumarop@gmail.com <p><strong>Background:</strong> Prognosis of oral squamous cell carcinoma (OSCC) can be predicted by evaluating both clinicopathological parameters and molecular markers. Understanding the reasons of recurrence is important to increase the morbidity and mortality of the patient.</p> <p><strong>Objectives:</strong> The objectives are to study the immunoexpression of p53 and Ki-67 in recurrent and non recurrent OSCC. And correlate the clinicopathological parameters among non-recurrent and recurrent OSCC to predict the prognosis of OSCC.</p> <p><strong>Methods:</strong> Clinicopathological and immunoexpression of p53 and Ki-67 at the histologically negative margin (HNM) and invasive tumor front (ITF) were assessed in 50 cases of non-recurrent and recurrent OSCC. Overall survival and disease free survival was estimated. Statistical tests like Mann Whitney U test, t Test, Pearson correlation coefficient, Kaplan Meier curve and Log Rank test were used.</p> <p><strong>Results: </strong>The Labelling Index (LI) of p53 and Ki-67 was marginally higher in recurrent than in non-recurrent OSCC cases. When compared with clinicopathologic parameters, non-recurrent OSCC cases showed no significance with p53 LI in margin and ITF except for site, muscle invasion, pattern of invasion (POI) and muscle invasion, whereas in recurrent OSCC cases p53 LI in HNM and ITF did not show any statistical significance except for duration. In both groups, OS and DFS was higher in patients with lesser LI while higher in the greater LI but more number of deaths occurred in this category respectively.</p> <p><strong>Conclusion: </strong>To conclude p53 and Ki-67 positivity in the HNM and ITF of non-recurrent and recurrent OSCC was seen and thus can be an important marker for identification of high and low risk individuals.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26689 Effect of smoking on visual evoked potential (VEP) and visual reaction time (VRT) 2020-03-02T08:48:09+00:00 Karishma Rajbhandari Pandey karishma@bpkihs.edu Dipesh Raj Panday dipesh.pandey@bpkihs.edu Nirmala Limbu nirmala.limbu@bpkihs.edu Bhupendra Shah doctorbhupen@gmail.com Kopila Agarwal kopila.agarwal@gmail.com <p><strong>Background:</strong> Nicotine in tobacco smoke causes demyelination. Again, hypoxia in long-term smokers is linked to neuropathy. Visual receptors are early sufferer of neuropathy. Visual-Acuity &amp; other ocular tests often fail to detect subtle changes of neuropathy which, however, can be detected by VEP test. Literature review shows that changes in VEP come earlier than PFT changes in smokers. Ironically, smokers claim that smoking improves their reaction time, which can be assessed by VRT.</p> <p><strong>Aims and Objective:</strong> To relate smoking status with VEP and VRT. Materials and Methods: Fifty-six subjects (smoker group = 28 &amp; non-smoker group = 28), whose age &amp; sex were matched, were included in the study. Their PFT, pattern VEP of both eyes &amp; VRT were recorded. The data were compared between the two groups using unpaired t-test, considering statistical significance at p&lt;0.05.</p> <p><strong>Results:</strong> The FVC (4.35±0.83 vs. 5.32+1.18 l, p=0.022), FEF 25% (7.40+2.38 vs. 8.74+3.90 l/s, p=0.019) &amp; FEF 50% (6.11+1.52 vs. 7.74+2.57, p= 0.010) were significantly lower in smokers compared to nonsmokers. There was no significant difference in P100 wave latency of VEP. But, VRT of smokers were significantly shorter (431.69+60.29 vs. 441.14+123.54 ms, p=0.010).</p> <p><strong>Conclusion:</strong> Smokers have shorter visual reaction time and similar visual evoked potential as compared to non-smokers.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26433 The proportion hyperhomocysteinemia in chronic kidney disease patients 2020-03-02T08:48:11+00:00 Rizaldy Taslim Pinzon drpinzon17@gmail.com Rosa De Lima Renita Sanyasi rosasanyasi@gmail.com Esdras Ardi Pramudita drpinzon17@gmail.com <p><strong>Background:</strong> Chronic kidney disease (CKD) patients often have a high homocysteine level Hyperhomocystinemia considered as one of cardiovascular disease risk factor in CKD patients. Studies concern on the proportion of hyperhomocysteinemia in patients with CKD in Indonesia are very limited.</p> <p><strong>Aims and Objectives:</strong> The main objective was to identify the proportion of hyperhomocysteinemia in CKD patients.</p> <p><strong>Materials and Methods:</strong> This was a cross sectional study. Subjects in this study were CKD patients with routine hemodyalisis two times per week. Five mililiters venous blood was collected before the first hemodyalisis. The blood was stored into tubes contain clot activator. Homocysteine level higher than 15.39 μmol/L considered as hyperhomocysteine.</p> <p><strong>Results:</strong> Total of 122 subjects included at this study. Subjects dominated by male with mean age of 51.7 years. Anemia (86.9%) and hypertension (86.1%) were the common comorbidities. Co-treatment assessed in this study i.e.: folic acid, calcium carbonat, antihypertensive agent, antidiabetic agent, antiplatelet agent, lipid lowering agent, and hematopoietic agent. The prevalence of hyperhomocysteinemia was high (89.3%) despite of the high consumption of folic acid in subjects (86.1%).</p> <p><strong>Conclusion:</strong> Hyperhomocysteinemia is a common condition among CKD patients with hemodyalisis.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/27308 Drug Interaction analysis-Nigella sativa L.seed (Black Cumin) ethanolicextract on antiseizure activity of Phenobarbitone sodium 2020-03-02T08:48:13+00:00 Lovelyn Joseph lovelynjo@yahoomail.com Rejeesh Edavan Puthillath rejeesh83@gmail.com Sudarshanram Narayan Rao drsnrao2007@rediffmail.com <p><strong>Background: </strong>Multidisciplinary therapy is gaining popularity and drug herb interactions is one of the biggest risk factor contributing to therapeutic failures or toxicities. Apart from analysis of one of such Drug-Herb combinations, this work also aims at emphasizing need for ethnopharmacovigilance practices.</p> <p><strong>Aims and Objectives: </strong>Herb-Drug Interaction analysis between <em>Nigella sativa</em> seed ethanolic extract and Phenobarbitone sodium in maximal electroshock seizure in Swiss albino mice with a modified isobolographic analysis.</p> <p><strong>Materials and Methods: </strong>Experiment model was Maximal electroshock seizure in Swiss albino mice. Dose ratios of the combination tested were NsEE: Phenobarbitone; 3:1(NsEE75%: Pbt25%), 1:1, 1:3. Analysis was done with modified isobolographic analysis.</p> <p><strong>Results: </strong>Nigella sativa seed ethanolic extract exhibit synergistic interaction with Phenobarbitone sodium at 1:1 and 1:3 dose ratios and antagonistic interaction at 3:1 combination. The parameter measured was Hind limb tonic extensor phase in maximal electroshock seizure test in Swiss albino mice.</p> <p><strong>Conclusion: </strong>The study showed that interaction profile of <em>Nigella sativa</em> extract-phenobarbitone combination is dose dependent and requires well designed posological studies in epileptic patients to formulate dose adjustment guidelines for multidisciplinary therapy with the herb and Phenobarbitone, also to avoid food drug interactions.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/27224 Investigation of Borrelia burgdorferi antibodies in patients with multiple sclerosis 2020-03-02T08:48:14+00:00 Nilay Ildız nilaygucluer@yahoo.com İbrahim Halil Özerol ibrahim.ozerol@inonu.edu.tr A. Cemal Özcan abdulcemal.ozcan@inonu.edu.tr Hamit Çelik hamit.celik@inonu.edu.tr <p><strong>Background:</strong> Lyme is a disease that is non-compulsory in our country and whose seroprevalence data is less studied.</p> <p><strong>Aims and Objective:</strong> Recent studies have shown that bacterial and viral infections are risk factor for various neurodegenerative diseases such as multiple sclerosis and Alzheimer’s disease. Herein, we aim to determine the seroprevalence of Lyme in multiple sclerosis (MS) patients. For this purpose, 100 MS patient’s serums were investigated for <em>Borrelia burgdorferi</em> IgM and IgG positivity.</p> <p><strong>Materials and Methods:</strong> The results identified with ELISA as positive antibody was confirmed by Western Blot (WB) test. The correlation between ages, gender, occupation, tick history, existence of erythema chronicum migrans (ECM), antibody positivity, pain, year with MS results were investigated using Kolmogorov-Smirnow and Kruskal-Wallis statistical test.</p> <p><strong>Results:</strong> <em>B. burgdorferi</em> IgM and IgG antibodies were positive in 8% patients when using ELISA method, but that were found to be 2% by WB. ELISA IgM antibody test gave a 5 negative result in WB. These results were considered false positive in the ELISA test. So, altogether 5 patients were positive by WB method. None of syphilis positive samples detected that <em>B. burgdorferi</em> positive serum. A significant difference between the parameters in terms of IgM positivity was not detected (p&gt; 0.05). B. burgdorferi IgG antibodies were found significant differences between the MS disease duration (p = 0.03). MS in the group of less than 10 years had higher titers of IgG antibodies to <em>B. burgdorferi</em>.</p> <p><strong>Conclusion:</strong> Although a small number of patients with MS is positive with Lyme antibodies. Lyme disease is a treatable.Also, If the patient is MS, clinician should be considered Lyme in the differential diagnosis. This is the first study that the correlation between Lyme and MS from Turkey.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26924 Role of Vitamin D as an Adjuvant to Oral Hypoglycemic Drugs in Treatment of Type-2 Diabetic Patients 2020-03-02T08:48:16+00:00 Sughandha Garg drsugandhagarg@yahoo.com Debayan Mallik dr.debayanmallik@gmail.com <p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is considered as one of the nonskeletal diseases related with deficiency of vitamin D. Both T2DM and vitamin D deficiency have similar risk factors, such as obesity, aging, and sedentary lifestyle. Cardiovascular diseases (CVDs) and metabolic syndrome disorders are also associated with vitamin D deficiency. Vitamin D plays an important functional role in glucose homeostasis through its effects on insulin secretion and sensitivity. It may reduce insulin resistance (IR) indirectly through its effect on calcium and phosphate metabolism and through upregulation of the insulin receptor gene. Thus, this study was designed to evaluate role of vitamin D as an adjuvant to oral hypoglycemic drugs in treatment of Type 2 diabetic patients.</p> <p><strong>Aims and Objectives :</strong> Vitamin D deficiency appears to be related to the development of diabetes mellitus type 2 and the metabolic syndrome. Vitamin D may affect glucose homeostasis, vitamin D levels having been found to be inversely related to glycosylated hemoglobin levels in diabetes mellitus. The aim of the study was to evaluate role of vitamin D as an adjuvant to oral hypoglycemic drugs in treatment of Type 2 diabetic patients.</p> <p><strong>Materials and Methods:</strong> The study was done on 60 patients diagnosed with T2DM. A total of 60 patients, control group were type 2 Diabetic patients on oral hypoglycemic drugs without vitamin D supplementation (n=30) and study group was type 2 Diabetic patients on oral hypoglycemic drugs with vitamin D supplementation (n=30).</p> <p><strong>Results:</strong> The mean aged of patients was 43.27±8.80 in control group and 47.93±8.39 in study group. The family history of diabetes mellitus was 39 patients. HbA1C, FBG, Postprandial were decreased in study group as compared to control group from baseline (0 day) to 90 days, respectively. Other parameters like hemoglobin, Serum Creatinine serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase were slight changes in study group as compared to control group from baseline (0 day) to 90 days, respectively.</p> <p><strong>Conclusion:&nbsp;</strong>The present study demonstrated that vitamin D as an adjuvant to oral hypoglycemic drugs in treatment in diabetic patients, vitamin D levels being related to&nbsp;glycemic control in diabetes mellitus type 2. These findings may have therapeutic implications as cautious vitamin D supplementation may improve glycemic control in diabetes mellitus type 2.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/27345 Prevalence of dengue virus infection among population of Bhaili visiting tertiary health institution; Chhattisgarh 2020-03-02T08:48:18+00:00 Dhruba Hari Chandi dhrubachandi@gmail.com <p><strong>Background:</strong> Dengue fever, dengue haemorrhagic fever and dengue shock syndrome of infection is distinct clinical forms which is caused by Dengue Virus that belong to a member of the Flaviviridae family. It is most important arthropod borne viral disease that causes morbidity and mortality. Dengue virus infection is a major public health problem growing in worldwide and it is estimated about 2.5 billion people of world are at risk of this infection. In India several parts of the country it is an endemic disease.</p> <p><strong>Aims and Objective:</strong> The current work is an attempt to review current perspectives of dengue infection among population of Bhilai visiting tertiary health institution. In study also we have compared the serological profiles of the dengue cases.</p> <p><strong>Material and Methods:</strong> Samples received were performing retrospective analysis in the department of microbiology and process in the departmental microbiology laboratory obtaining during monsoon season. The duration of fever (in days) and other relevant clinical information were recorded from the requisition form. Rapid test for dengue as NS1Ag, IgG and IgM test were performed in accordance with the manufacturer’s instructions. The dengue NS1Ag, IgG and IgM rapid test is an in vitro immunochromatographic test (ICT) which is a onestep assay designed for the qualitative determination of dengue NS1Ag, IgG and IgM in human serum for the diagnosis dengue infection.</p> <p><strong>Result:</strong> During the study period total 1308 serum samples were collected from suspected Dengue fever patients. Among 1308 samples 412(31.5%) samples were found to be positive dengue fever. In the month of August maximum number of sample were received. Out of 1308 patients with dengue suspected patients 792(60.6%) were male and 516(39.4%) were female. Among 60.6% of male 28.2% were positive and out of 39.4% of female 36.6% were positive for dengue. Age between 10-20 years old (55.83%) patients were most affected age group and 70-80 years old (8.77%) age group were least affected. Among the dengue positive patients, dengue parameter associated with thrombocytopenia was also recorded which showed that there was no significant difference between the parameters in relation to thrombocytopenia.</p> <p><strong>Conclusion:</strong> Especially in developing countries like India where there are poor resources for diagnosis of dengue infection, the sensitivity of these tests is more than immunochromatographic Test (ICT). By NS1 assay early detection of dengue infection can help in early confirmation and management of this before its gets complicate. Therefore commercial available dengue NS1 antigen test kits provided additional laboratory diagnostic tool for early detection of dengue.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/27449 Antibacterial activity of ginger extracts on bacteria isolated from digestive tract infection patients attended Muhoza Health Center 2020-03-02T08:48:21+00:00 Callixte Yadufashije cyadufashije@gmail.com Adolyne Niyonkuru adolyneniyonkuru@gmail.com Emanuel Munyeshyaka emmyshya@ines.ac.rw Sibomana Madjidi smadjidi09@gmail.com Joseph Mucumbitsi jephmicro@gmail.com <p><strong>Background: </strong>Ginger (<em>Zingiber officinale</em>) has been used for long time due to its potential antimicrobial activity against diversity of microbial pathogens.</p> <p><strong>Aims and Objectives: </strong>The study was carried out to investigate the bacteria pathogens found in digestive tract infections and assess antimicrobial activities of ginger extract to identified bacteria.</p> <p><strong>Materials and Methods: </strong>Bacteriological studies were carried out on stool samples from 30 patients attending Muhoza health center. Different types of bacteria were isolated from stool samples of digestive tract infection patients by using various methods such culture, biochemical test and antimicrobial activity of ginger extracts was analyzed at INES-Ruhengeri in clinical microbiology laboratory.</p> <p><strong>Results: </strong>Study findings showed isolated bacteria and antibacterial activity of Ginger. Isolated bacteria and their percentages including <em>Escherichia coli </em>(46.6%) which is the predominant isolated bacteria, <em>Salmonella </em>species (33.33%), <em>Enterobacter </em>spp (10.0%), <em>Shigella </em>spp (6.6%) and <em>Citrobacter </em>(3.33%) which is the least isolated bacteria. Antibacterial activity of ginger was seen on isolated bacteria, as ethanol and methanol were used for ginger oil extraction, the antibacterial activity of ginger extracts using ethanol was seen on isolated bacteria such us <em>Citrobacter </em>spp with 14 mm of inhibition zone, <em>Shigella </em>spp with 12 mm, <em>Salmonella </em>with 11.1 mm, <em>E. coli </em>with 9.5 mm and <em>Enterobacter </em>spp which was seen to be resistant to ginger extract using ethanol with 0.66mm of inhibition zone. For methanol extracts antibacterial activity was seen as follows: <em>Citrobacter </em>spp at 12 mm, <em>Shigella </em>spp at 11 mm, <em>E. coli </em>at 8 mm, <em>salmonella </em>spp at 6.1 mm, and <em>Enterobacter </em>spp with 5 mm. <em>Enterobacter </em>spp was seen to be the most resistant bacteria in both extracts.</p> <p><strong>Conclusion: </strong>Ginger has shown to have an antibacterial activity on bacteria isolated from digestive tract infected patients. It can be used as a medicine to treat these infections. Number of researches should be done to be sure on this reality of antibacterial activity of ginger.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/27203 Comparison of liver enzymes and sonological grading in nonalcoholic fatty liver 2020-03-02T08:48:25+00:00 Bishnu Jwarchan jwarchan7@gmail.com Subita Lalchan jwarchan7@gmail.com Anil Dhakal jwarchan7@gmail.com Ramesh R Acharya jwarchan7@gmail.com <p><strong>Background:</strong> Nonalcoholic fatty liver disease (NAFLD) is the leading cause of diffuse liver disease with a global prevalence of 25.24% and progresses to fibrosis and nonalcoholic steatohepatitis (NASH). Diagnosing NAFLD requires demonstration of increased liver fat and ultrasound imaging is widely used for screening. Specific blood tests to diagnose NAFLD and NASH are not yet available and alanine transaminase (ALT) has been used as a marker in population based studies.</p> <p><strong>Aims and Objective:</strong> This study was aimed to compare the liver enzymes and sonological grading in NAFLD.</p> <p><strong>Materials and Methods:</strong> A prospective hospital based observational study was carried out in 85 patients presenting to medical outpatient department (OPD) with ultrasonogical evidence of nonalcoholic fatty liver (NAFL) from January 2016 to December 2016. The patients were sent for liver enzymes and serum ALT,<br>aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT) were particularly correlated with the grade of NAFL.Data were collected on a preformed proformaand analyzed using the Statistical Package for the Social Sciences (SPSS)20.0 (SPSS Inc., Chicago, IL, USA).</p> <p><strong>Results:</strong> In our study, mean age of the patients was 46.08 years and most of the patients were in age group of 40-60 years. Females (65.88%) were more affected than males (34.12%). There were 71 (83.5%) patients with grade 1 NAFL and 14 (16.5%) patients with grade 2 NAFL. The level of serum ALT increased with higher grades of NAFL. The mean ALT in grade 1 NAFL was 29.14±19.41 and in grade 2 NAFL was 42.19±2157; p= 0.027. Comparison of serum AST and GGT with ultrasonological grading did not show statistical difference.</p> <p><strong>Conclusion:</strong> Serum ALT levels correlated with the ultrasonological grades of NAFLD (p = 0.027) whereas AST and ALT did not show statistical correlation with grades of fatty liver. Our study suggests for large sample size study for AST and GGT values relationship with ultrasonological grades.</p> 2020-02-06T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/27296 Assessment of serum Ferritin level and its correlation with HbA1c in Diabetic Nephropathy 2020-03-02T08:48:28+00:00 Madhura Navule Siddappa madhuramegal@gmail.com Kowsalya Ramprasad r.kowsalya@gmail.com <p><strong>Background:</strong> Serum ferritin levels reflecting the body iron stores, is known to be elevated in type 2 Diabetes Mellitus. However its association with diabetic complications including Diabetic nephropathy (DN), and overall glycemic control needs to be validated.</p> <p><strong>Aims and Objectives:</strong> The aim of this study was to find the Serum Ferritin level abnormalities in DM patients with nephropathy in comparison with DM patients without nephropathy and to find correlation of Serum Ferritin (SF) levels with levels of Glycated Hemoglobin (HbA1c) in patients with diabetic nephropathy.</p> <p><strong>Materials and Methods:</strong> This is a retrospective study, which included eighty five registered patients with Type 2 DM (44 Type II DM without nephropathy cases and 41 cases of Type II DM with nephropathy). SF and HbA1c was estimated in all cases across both the groups and were compared with age and sex matched controls and analysed.</p> <p><strong>Results:</strong> Serum Ferritin levels were higher in diabetics with nephropathy compared to diabetics without nephropathy (p&lt;0.0001). SF levels were higher in diabetic groups compared to control group (p &lt;0.001).The correlation between HbA1c and SF was assessed among all cases of DM with nephropathy group using pearson correlation test and it showed a significantly positive correlation (r=0.431) with a SF (mean = 938±148) and HbA1c (mean = 9.2±2.02).</p> <p><strong>Conclusion:</strong> Serum ferritin levels positively correlate with HbA1c levels in Type II DM cases with nephropathy, which suggests that serum Ferritin levels can be used as a surrogate marker of glycemic control in Type II DM with nephropathy.</p> 2020-02-06T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26580 Standardized low-resolution electromagnetic tomography of preattentive auditory discrimination in accumulative drinker 2020-03-02T08:48:31+00:00 Phakkharawat Sittiprapaporn drwichian.s@gmail.com <p><strong>Background:</strong> The present study proposes a task-dependent hypothesis in which the phonological units of segmental (e.g., consonant and vowel) and suprasegmental (e.g., prosodic) are processed in discrete asymmetry of the human brain. Although the left hemisphere (LH) is selectively employed for processing linguistic information irrespectively of acoustic cues or subtype of phonological unit, the right hemisphere (RH) is employed for prosody-specific cues.Although the left hemisphere is selectively employed for processing linguistic information irrespectively of acoustic cues or subtype of phonological unit, the right hemisphere is employed for prosody-specific cues.</p> <p><strong>Aims and Objective:</strong> As both hemispheres are lateralized for speech and language, the objective of this study is to extend the investigation of how the pre-attentive processing of vowel duration changes of Thai monosyllabic words in alcoholic drinkers.</p> <p><strong>Materials and Methods:</strong> Forty healthy right-handed adults participated in this study.</p> <p><strong>Results:</strong> This study found that both rising-to-falling and falling-to-rising tone changes perception elicited MMN between 245-297 msec with reference to the standardstimulus ERPs. The long-to-short and short-to-long vowel duration changes elicited a strong MMN for both groups. Source localization was obtained in the Middle Temporal Gyrus (MTG) of the left hemisphere (LH) for both groups.</p> <p><strong>Conclusion:</strong> Automatic detection of changes in contour tones is a useful index of language universal auditory memory traces.</p> 2020-02-06T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26548 A comparative clinical study of intrathecal hyperbaric bupivacaine with and without fentanyl for hysterectomy 2020-03-02T08:48:33+00:00 Hari Poudel haripoudel702@gmail.com Surinder Nath Bawa haripoudel702@gmail.com Surendra Mohan Sharma haripoudel702@gmail.com <p><strong>Background:</strong> Spinal anaesthesia has been widely used for lower abdominal surgeries like hysterectomy.Hyperbaric bupivacaine is the most extensively used local anesthetic. Addition of fentanyl can allow the reduction in the dose of bupivacaine, increase the height and duration of sensory blockade, and reduces complications of spinal anesthesia.</p> <p><strong>Aims and Objective:</strong> The aim of the study was to examine whether adding fentanyl to hyperbaric bupivacaine would increase the height of sensory blockade, accelerate the onset of sensory blockade and increase the duration of the sensory blockade.</p> <p><strong>Material and Methods:</strong> This study was done in Manipal Teaching Hospital, Pokhara, Nepal that included hundred patients who underwent total abdominal hysterectomy. The patients were randomly allocated in two groups; Group I: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus normal saline 0.5 ml. Group II: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus 0.5 ml fentanyl (25 μg). Hemodynamic variables, onset of motor and sensory blockade, duration of sensory and motor blockade and any side effects were observed and recorded.</p> <p><strong>Results:</strong> The highest and lowest sensory block in Group I was T-7 and T-9 whereas in Group II was T-5 and T-9 respectively. In group I, the mean onset till maximum height of sensory blockade was 7.04 min whereas in group II it was 5.96 min (P&lt;0.00).There was no significant statistical difference in the incidence of side effects in both the groups.</p> <p><strong>Conclusion:</strong> Intrathecal fentanyl with hyperbaric bupivacaine for spinal anesthesia significantly accelerated the onset of sensory blockade and increased its maximum height and duration.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26772 Serum vitamin D status and biochemical parameters of asthmatic children in Sokoto Metropolis, North-western Nigeria 2020-03-02T12:34:36+00:00 Mohammed Haruna Yeldu mhyeldu@gmail.com Mohammed Danjuma mhyeldu@gmail.com Mainasara Abdullahi Sulaiman mhyeldu@gmail.com Jiya Nma Muhammad mhyeldu@gmail.com Garba Balkisu Illah mhyeldu@gmail.com Yakubu Ibrahim mhyeldu@gmail.com Buhari Shehu mhyeldu@gmail.com <p><strong>Background:</strong> Asthma is a common chronic disorder of the airways that is complex and characterized by variable and recurring symptoms. It is characterized by the occurrence of bronchial hyper responsiveness, airflow obstruction and an underlying inflammation. Several studies have proposed the association of vitamin D with increased incidence of asthma symptoms.</p> <p><strong>Aims and Objectives:</strong> This study aimed at determining the serum vitamin D status and biochemical parameters among asthmatic children in Sokoto-Nigeria.</p> <p><strong>Materials and Methods:</strong> The study population consisted of 120 subjects including 80 asthmatic children and 40 age-and sex-matched apparently healthy controls from two tertiary Hospitals in Sokoto Metropolis. Serum vitamin D, calcium, parathyroid hormone (PTH), immunoglobulin E (IgE) and magnesium were measured using standard techniques.</p> <p><strong>Results:</strong> Mean serum vitamin D and magnesium were significantly (p ˂ 0.05) lower, while serum PTH and IgE were significantly higher (p˂0.001) in asthmatic children than in controls. Vitamin D insufficiency was found to be prevalent among the asthmatic children. There was no significant relationship between the low level of vitamin D and asthma severity.</p> <p><strong>Conclusion:</strong> This study observed that, hypovitaminosis D and hypomagnesaemia occurred among asthmatic children, and asthma was more prone in the younger children than in their older counterpart. It is recommended that in order to avoid or limit the rate of children having asthmatic episodes, vitamin D and magnesium supplements should be used in the management of asthmatic children.</p> 2019-12-30T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26688 Analysis of Limb segment length to the total body height among the undergraduate students in a medical college of Nepal 2020-03-02T08:48:37+00:00 Muna Kadel drmunakadel@gmail.com Shanta Hada muna997@gmail.com Shambhu Nath Pant muna997@gmail.com <p><strong>Background:</strong> Total body height is important for calculating body mass index, drug dosages calculations and other patient care issues. Total height estimation from different body measurements are surrogate measures of stature which is very useful when only fragmentary remains of a human body are found.</p> <p><strong>Aims and Objective:</strong> The aim of this study is to develop the relationship of total body height with arm span, leg length and trunk length in Nepalese Medical students.</p> <p><strong>Materials and Methods:</strong> A descriptive cross-sectional study was conducted in 441 medical students in the Department of Anatomy, KIST Medical College and Teaching Hospital, Lalitpur, Nepal from January to June 2019 after taking ethical approval. Body height, arm span, leg length and trunk length were measured and regression and correlation analysis between them were done.</p> <p><strong>Results:</strong> The mean standing height, arm span, trunk length and leg length were 161.85±9.14, 165.37±10.5, 84.80±4.23, 77.06±6.5 cm respectively. Correlation coefficient of standing height with arm span, trunk length and leg length were 0.87, 0.76 and 0.90 respectively. Regression coefficient for standing height and trunk length, standing height and arm span and standing height and leg length were 1.65, 0.76 and 1.27 respectively. Regression equations for standing height were determined.</p> <p><strong>Conclusions:</strong> Total body height shows strong correlation with arm span, trunk length and leg length.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26364 Macroscopic and microscopic effects of elevated temperatures on unrestored and restored teeth: An in-vitro forensic study 2020-03-02T08:48:40+00:00 Sandeep Sharma sandeepsharma@cmsnepal.edu.np <p><strong>Background:</strong> The present “in vitro” study was done to observe the effects of high temperatures on teeth restored with different restorative materials and unrestored teeth.</p> <p><strong>Aim and Objective:</strong> This study aims to investigate the nature of damage to unrestored and restored teeth subjected to high temperatures. The main objective of the study is to assess whether it could serve as an aid in identification of human dental remains in forensic odontology for cases of incineration by means of comparison between ante-mortem and post-mortem records.</p> <p><strong>Materials and Methods:</strong> The present study was conducted on 125 extracted premolar teeth which were later on divided into five groups (25 premolar teeth each) as control group, group of teeth restored with class I amalgam restorations, group of teeth restored with class I composite/adhesive system restorations, group of teeth restored with glass ionomer restoration and group of teeth restored with metal ceramic crown restored teeth. The restored teeth were placed in a furnace and heated at a rate of 10°C/min. The effects of the predetermined 200°C, 400°C, 600°C, 800°C, 1000°C and 1200°C temperatures were examined macroscopically and then microscopically by means of a stereomicroscope. Data obtained in the present study was subjected to the statistical analysis using SPSS 18 software for one-way ANOVA andindependent t-test (paired).</p> <p><strong>Result:</strong> The class I restorations made of amalgam could be identified till 1200°C because they maintain their shape despite the disintegration of the crowns along with PFM restoration with disintegration of remaining restorations along with tooth. Systematic approach toward the preservation of charred dentition, as at times could prove to be the best evidence for identification of those who are extensively burned.</p> <p><strong>Conclusion:</strong> Pre-planned and systematic approach toward the preservation of charred dentition is important as at times it could act as a potential evidence for the identification of those who are severely burnt.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26515 Comparative study of expandable cage with integrated plate versus non expandable cage in cervical spine corpectomies 2020-03-02T08:48:42+00:00 Nakul Pahwa dl7sad6246@gmail.com Suniti Kumar Saha dl7sad6246@gmail.com Kaushik Roy dl7sad6246@gmail.com Debajyoti Pathak dl7sad6246@gmail.com Shuvayu Bandyopadhyay dl7sad6245@gmail.com <p><strong>Background:</strong> The use of expandable cages in cervical spine has gained popularity over the last decade. They have been used in dorsal spine since long but were rarely used in cervical spine due to their high cost. Now, with more insight into their mechanics, many advantages have been noted over the fixed cages along with similar efficacy and with no added complications.</p> <p><strong>Aims and Objectives:</strong> To study the benefits of expandable cage with incorporated anterior cervical plate over non expandable cage in cervical spine corpectomies.</p> <p><strong>Materials and Methods:</strong> Ten cases of two level corpectomy were operated in each group and compared for intraoperative time, postoperative fusion rates and complications.</p> <p><strong>Results:</strong> Intraoperative time was less in the expandable cage group. Fusion rates were comparable at 6 month follow up. No reported long term complication in both groups.</p> <p><strong>Conclusion:</strong> Expandable cages are less frequently used in cervical spine due to their significantly higher cost but there are advantages such as decreased intraoperative manipulation and operative time, less damage to end plates and also useful in cases of poor bone quality.</p> 2020-02-06T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26205 Role of tranexamic acid to reduce blood loss and transfusion of allogeneic blood in the field of surgery 2020-03-02T08:48:02+00:00 Indra K. Shrestha indrashresthakmu2017@hotmail.com Yong Yu Si indrashresthakmu2017@hotmail.com Jian Ping Tao indrashresthakmu2017@hotmail.com <p>Tranexamic acid is widely used as an antifibrinolytic drug to reduce blood loss intraoperative and postoperative time periods as well as to reduce transfusion of allogeneic blood. After releasing in the market, multidisciplinary surgeries have wide use of tranexamic acid due to its antifibrinolytic effect to reduce bleeding and transfusion of blood. In literature, there were mentioned a few adverse effects like thromboembolism, seizure, anaphylactic reaction, etc which are still unsolved questions to date. The aim of this review to minimize the blood loss from acute bleeding in different situations by updating the doses used in a different clinical scenario,since the release of tranexamic acid. It also gives an idea about appropriate doses&nbsp;to reduce blood loss, need for blood transfusion, minimize adverse effects and to understand the wide scope of application of TXA to date.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/26465 Phytotherapeutic antioxidants 2020-03-02T08:48:08+00:00 Tulika Mishra anand1025@gmail.com Ananda Kumar Kondepati anand1025@gmail.com Shalini Devaprasad Pasumarthi anand1025@gmail.com Gurmit Singh Chilana anand1025@gmail.com Suresh Devabhaktuni anand1025@gmail.com Pratik Kumar Singh anand1025@gmail.com <p>Plants have always been an integrated part of human life, whether we discuss about providing food or we about their medicinal value. Ethnomedicines have led to the discovery of many valuable drugs against various diseases. It has been postulated that most of the disease are related to immune system which is affected by imbalance balance between antioxidants and prooxidants or free radicals. Free radicals are the chemical entities capable of independent existence that contain one/more unpaired electrons and can be balanced by antioxidants. Antioxidants maintain the integrity and function of membrane lipids, cellular proteins, and nucleic acids and the control of signal transduction of gene expression in immune cells. For this reason, the immune cells are particularly sensitive to changes in their antioxidant status. Whenever there is imbalance between prooxidant and antioxidants they can lead to many diseases and even ameliorate the severity of disease like Alzheimer, cardiovascular disorder, cancer etc. There are evidences showing usage of plants as a potent source of antioxidants has provided a lot of support in combating various diseases, without any side effect. Various Bioflavonoids, Carotenoids, Hydroxycinnamates etc helps in scavenging the free radicals and thus proved to be immunostimulant. There are various mechanisms through which these Phyto antioxidants assisted against various disease. The present review is an attempt showing the relationship of free radicals with various diseases and immune system and the role of Phyto antioxidants against various health related conditions.</p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/AJMS/article/view/27477 Initial presentation of Hodgkin’s Lymphoma as Extradural Spinal Cord Compression: A case report 2020-03-02T08:48:05+00:00 Rishav Mukherjee mukherjeerishav@gmail.com Sampurna Chowdhury sampurna21@icloud.com <p class="p1"><span class="s1">A 23 year old female presented with acute onset paraparesis. She denied any history of fever, weight loss or drenching night sweats. Neither did she have any obvious lymphadenopathy on general examination. Chest Xray was however suggestive of mediastinal widening and her MRI spine showed metastases with superior mediastinal SOL. Biopsy of this SOL ultimately revealed classical Hodgkin lymphoma. Thus this was a very unusual initial presentation of Hodgkin lymphoma presenting as Epidural Spinal Cord Compression. Hasenclever IPS score was 2. Patient was treated with radiotherapy followed by ABVD chemotherapy and achieved remission in 3months.</span></p> 2020-02-29T00:00:00+00:00 ##submission.copyrightStatement##