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ORIGINAL ARTICLE
Madhuresh Kumar, Santosh Kumar, Tulika Chandra, Vineet Sharma

Clinical Outcome of Intra-articular Injection of Platelet-rich Plasma in Early-stage Knee Osteoarthritis in North Indian Patients

[Year:2018] [Month:April-June] [Volumn:52 ] [Number:2] [Pages:51] [Pages No:56-61][No of Hits : 604]


ABSTRACT

Introduction: With increasing frequency, platelet-rich plasma (PRP) preparations have been used to treat cartilage lesions to regenerate tissue homeostasis and retard the progression of knee osteoarthritis (OA).

Purpose: To determine the effectiveness of intra-articular PRP injections in early-stage OA patients and to evaluate the clinical outcome.

Materials and methods: This prospective study was conducted in the Department of Orthopaedic Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India. The study was conducted on patients with early-stage OA knee enrolled on outpatient department basis during the year 2014 to 2015. The effective sample size was 40 patients with bilateral OA knee in which intra-articular injection was given. And the clinical outcomes and effectiveness were measured in terms of visual analog scale and Western Ontario and McMaster Universities Osteoarthritis Index scores at the end of 6, 12, and 24 weeks. A p-value <0.05 was considered statistically significant.

Results: There was significant improvement in all scores at the end of 6, 12, and 24 weeks.

Conclusions: The PRP treatment showed positive effects in patients with knee OA.

Clinical relevance: There are only a few studies of PRP treatment for cartilage on OA knees. Different PRP products might be more or less appropriate to treat different types of tissues and pathologies. The clinical efficacy of PRP remains under debate, and a standardized protocol has not yet been established.

Keywords: Intra-articular injection, Osteoarthritic knee, Plateletrich plasma.

How to cite this article: Kumar M, Kumar S, Chandra T, Sharma V. Clinical Outcome of Intra-articular Injection of Platelet-rich Plasma in Early-stage Knee Osteoarthritis in North Indian Patients. J Postgrad Med Edu Res 2018;52(2):56-61.

Source of support: Nil

Conflict of interest: None


 
Case Report
Aditya Choudhary, Manoj K Goyal, Manish Modi, Kanchan K Mukherjee, Chirag K Ahuja, Vivek Lal

Froin Syndrome

[Year:2018] [Month:January-March] [Volumn:52 ] [Number:1] [Pages:51] [Pages No:34-35][No of Hits : 567]


ABSTRACT

Introduction: Yellow-colored cerebrospinal fluid (CSF) suggestive of xanthochromia can be due to elevated CSF protein and can be one of the causes of papilledema.

Observation: We observed a 55-year-old lady with papilledema with yellow-colored CSF which was hypercoagulable along with elevated CSF protein and no cells. Her systemic and nervous system examination was unremarkable except for the eye findings. Her contrast-enhanced brain magnetic resonance imaging (MRI) showed multiple meningiomas, and on imaging of the spine, she had multiple contrast-enchancing intradural, extramedullary lesions. Her eye findings were attributed to Froin syndrome found in patients with spinal tumors.

Conclusion: Our case stresses the need to keep the possibility of Froin syndrome in mind while evaluating patients with papilledema and it may be pertinent to perform a spinal imaging, especially when no apparent cause for papilledema is found.

Keywords: Froin, Papilledema, Spinal tumors, Xanthochromia.

How to cite this article: Choudhary A, Goyal MK, Modi M, Mukherjee KK, Ahuja CK, Lal V. Froin Syndrome. J Postgrad Med Edu Res 2018;52(1):34-35.

Source of support: Nil

Conflict of interest: None


 
Review Article
Smit Singla, Akhilesh Verma, Snehil Goyal, Itika Singla, Anjali Shetty

Conventional and Advanced Diagnostic Tools in Oral Cancer with Emphasis on Role of Dentist and Early Detection

[Year:2017] [Month:July-September] [Volumn:51 ] [Number:3] [Pages:40] [Pages No:128-133][No of Hits : 4983]


ABSTRACT

The prevalence of oral cancer is increasing worldwide day by day. Those who suffer from oral cancer have low survival rate compared with other cancer, mainly due to delay in the diagnosis, metastases, and presence of secondary tumors. For the dental profession, it is really challenging to diagnose oral precancer or oral cancer, particularly in its early stage of the disease. Early screening and advanced diagnostic tools play an important role in the early diagnosis and treatment planning of patients suffering from oral cancer. The diagnosis method usually includes histopathology and visualization adjuncts, such as toluidine blue, vizilite, etc. This study reviews the development of new upcoming tools for early detection, emphasis on the importance of role of dentist, and early detection of oral cancer.

Keywords: Early detection, Oral cancer, Screening.

How to cite this article: Singla S, Verma A, Goyal S, Singla I, Shetty A. Conventional and Advanced Diagnostic Tools in Oral Cancer with Emphasis on Role of Dentist and Early Detection. J Postgrad Med Edu Res 2017;51(3):128-133.

Source of support: Nil

Conflict of interest: None


 
Original Article
Tvisha Ketan Parikh, S Arumugam

Are Indian Habits of Cross-legged Sitting and Squatting associated with Anterior Knee Pain?

[Year:2017] [Month:January-March] [Volumn:51 ] [Number:1] [Pages:51] [Pages No:1-6][No of Hits : 1700]


ABSTRACT

Aim: To evaluate the association between anterior knee pain (AKP) and traditional Indian habits of cross-legged sitting and squatting which involve deep knee flexion.

Materials and methods: A case control study was carried out in 225 patients and 225 age and sex matched controls at a tertiary care university hospital in South India over 3 years. Males and females between 18 and 55 years were evaluated using a clinical proforma of history and musculoskeletal examination. The details of deep knee flexion habits with quantification of duration were noted and participants were categorized into those who sat and did not sit cross legged, and squatters and nonsquatters. Odds ratios and chi-square tests were calculated for both these categorical variables. A subgroup analysis and stratified analysis were also performed.

Results: The Odds ratios for cross-legged sitting and squatting were not significant at 0.88 and 0.92 respectively. Sixty-nine point three percentage of the AKP cases and 72% of the controls sat cross legged (p = 0.534) and 67.6% of the AKP cases and 69.3% of controls habitually squatted (p = 0.685). Stratified analysis revealed a protective effect of cross legged sitting in AKP cases with quadriceps muscle tightness.

Conclusion: This study did not find an association between AKP and Indian habits of deep knee flexion. More than 65% of all the participants regularly engaged in these habits. Laboratory biomechanical analysis of these positions is suggested in future to understand their effect on knee joint.

Clinical significance: These positions are integral to daily habits of many Indians. The advice to AKP patients to avoid them due to their probable AKP association is not supported by the current study. Clinicians can consider the impact on the patient’s quality of life before advising against these positions.

Keywords: Anterior knee pain, Cross-legged sitting, Indian habits, Squatting,

How to cite this article: Parikh TK, Arumugam S. Are Indian Habits of Cross-legged Sitting and Squatting associated with Anterior Knee Pain? J Postgrad Med Edu Res 2017;51(1):1-6.

Source of support: Nil

Conflict of interest: None


 
Case Report
Nagarajan Doraisamy, Malarvizhi Chandrasekhar, Jim Jebakumar, Sukhdev DB Singh

Tuberculous Compound Palmar Ganglion

[Year:2017] [Month:January-March] [Volumn:51 ] [Number:1] [Pages:51] [Pages No:28-29][No of Hits : 1126]


ABSTRACT

Introduction: Compound palmar ganglion of tuberculous etiology is an infrequent condition, which has an obvious clinical picture, but still overlooked and should be diagnosed earlier before the involvement of underlying bones and nerves.

Case report: We present the case of a 56-year-old male presenting with progressive swelling of the palm and forearm. He was diagnosed to have chronic flexor tenosynovitis without involvement of the underlying bones and was treated by complete excision and antitubercular therapy (ATT).

Conclusion: Tuberculous palmar ganglion is a condition that can be managed by excision and chemotherapy. However, it presents as a challenge to rural surgeons where the patients present late. Hence, early identification and treatment are the main goals of this article.

Keywords: Antitubercular therapy, Chronic flexor tenosynovitis, Compound palmar ganglion, Melon-seed bodies.

How to cite this article: Doraisamy N, Chandrasekhar M, Jebakumar J, Singh SDB. Tuberculous Compound Palmar Ganglion. J Postgrad Med Edu Res 2017;51(1):28-29.

Source of support: Nil

Conflict of interest: None


 
Review Article
Vinay Jasani

Congenital Scoliosis

[Year:2017] [Month:April-June] [Volumn:51 ] [Number:2] [Pages:61] [Pages No:95-102][No of Hits : 883]


ABSTRACT

Congenital scoliosis is a scoliosis that occurs as a result of bony abnormalities that arise between 4 to 16 weeks of gestation. There are genetic and environmental factors involved in etiology. The majority of congenital vertebral anomalies are in the thoracic spine (64%).
The patients often have associated skeletal anomalies and can also be part of a syndrome. Skeletal, cardiac, genitourinary intraspinal abnormalities are most commonly found in association with congenital scoliosis.
The natural history seems to be related to the morphology of the bony the site in the spine, and the patient’s age. Congenital scoliosis usually progresses and often requires intervention. The aim of intervention is to achieve a flexible and balanced spine with normal truncal height and space available for lung ratio. Early intervention for scoliosis seems to be instrumental in trying to achieve these goals.

Keywords: Congenital, Hemivertebra, Scoliosis, Segmentation.

How to cite this article: Jasani V. Congenital Scoliosis. J Postgrad Med Edu Res 2017;51(2):95-102.

Source of support: Nil

Conflict of interest: None


 
Review Article
Mushtaq A Shaikh

Intraoperative Neurophysiological Monitoring in Spine Surgery

[Year:2017] [Month:April-June] [Volumn:51 ] [Number:2] [Pages:61] [Pages No:89-94][No of Hits : 870]


ABSTRACT

Intraoperative neurophysiological monitoring (IONM) encompasses a variety of neurological testing modalities used during surgery to monitor, identify, and potentially prevent iatrogenic complications to the nervous system and the blood supply to it or adjacent tissue. It has been used to monitor integrity of the neural pathway during spinal, neurological, cranial, and vascular procedures. Specific tests are designed to the clinical need of the surgery. Modalities may include: Somatosensory evoked potentials, motor evoked potentials, spontaneous or triggered electromyography, brainstem auditory evoked potentials, visual evoked potentials, electroencephalogram, and electrocorticography. During spinal surgery, a wide variety of procedures are utilized in which the spinal cord, nerve roots, and key blood vessels are frequently placed at risk from iatrogenic injury. Multimodal IONM relies on the strengths of different types of neurophysiological modalities to maximize the diagnostic efficacy in regard to sensitivity and specificity in the detection of impending neural injury. Thorough knowledge of the benefits and limitations of each modality helps in optimizing the diagnostic value of IONM during spinal procedures. As spinal surgeries continue to evolve, the value of neuromonitoring will also continue to become more prominent.

Keywords: Electroencephalography, Electromyography, Motor evoked potentials, Sensory evoked potentials.

How to cite this article: Shaikh MA. Intraoperative Neurophysiological Monitoring in Spine Surgery. J Postgrad Med Edu Res 2017;51(2):89-94.

Source of support: Nil

Conflict of interest: None


 
Original Article
Dhaval Ranjitbhai Lekhadia, Rohan Rai, Niveditha Hegde, Gautham Hegde, Abhinay Sorake, Anil Kumar

Assessment of Vertical Skeletal Patterns using a New Cephalometric Parameter: The Dhaval Rohan Angle

[Year:2017] [Month:January-March] [Volumn:51 ] [Number:1] [Pages:51] [Pages No:7-11][No of Hits : 865]


ABSTRACT

Introduction: The aim of this study was to establish a new cephalometric parameter, named the Dhaval–Rohan angle (DR), to assess the vertical skeletal patterns on a lateral cephalogram with accuracy and reproducibility.

Materials and methods: One hundred and twenty pretreatment lateral cephalograms of the patients visiting the department of orthodontics and dentofacial orthopedics for treatment were obtained and divided into three groups. i.e., horizontal growth pattern, average growth pattern, and vertical growth pattern cases based on the routinely used cephalometric parameters; FMA, SN-GoGn, Y-axis angle and Jarabak ratio. This angle uses three skeletal landmarks, the point C (center of the condyle), point M (midpoint of premaxilla), and point G (center of the largest circle that is tangent to the internal inferior, anterior, and posterior surfaces of the mandibular symphysis).

Results: The one-way analysis of variance (ANOVA) test showed that the three groups studied were not the same for DR angle and the post hoc Tukey test found the groups to be significantly different. According to the Student’s t-test, there was no statistically significant difference in mean values of DR angle between males and females.

Conclusion: Cephalometric evaluation of young adults shows that the DR angle below 28.5° indicates a horizontal growth pattern, between 28.5 and 32.5° indicate an average growth pattern and above 32.5° indicate a vertical growth pattern.

Keywords: Growth pattern, Point C, Point G, Point M.

How to cite this article: Lekhadia DR, Rai R, Hegde N, Hegde G, Sorake A, Kumar A. Assessment of Vertical Skeletal Patterns using a New Cephalometric Parameter: The Dhaval–Rohan Angle. J Postgrad Med Edu Res 2017;51(1):7-11.

Source of support: Nil

Conflict of interest: None


 
Review Article
Amrut U Borade, Filippo Familiari, Kyubo Choi, Jacob Joseph, Edward G McFarland

Comparison of Reverse Total Shoulder Arthroplasty vs Hemiarthroplasty for Acute Fractures of the Proximal Humerus: Systematic Review

[Year:2017] [Month:October-December] [Volumn:51 ] [Number:4] [Pages:51] [Pages No:182-187][No of Hits : 763]


ABSTRACT

The optimal treatment of proximal humerus fractures is debated; however, reverse total shoulder arthroplasty (RTSA) has become increasingly popular as the primary treatment. We systematically reviewed the PubMed, EMBASE, and Scopus databases to identify English-language clinical studies (evidence levels I through IV) comparing the results of RTSA with those of hemiarthroplasty (HA) for the treatment of acute proximal humerus fractures. We evaluated the following outcomes: Range of motion, patient-reported outcome measures (including pain relief), and complications. We identified eight published studies comparing RTSA with HA for treatment of acute proximal humerus fractures. The RTSA group (180 patients) showed significantly better postoperative pain relief, active anterior elevation, Constant-Murley scores, and American Shoulder and Elbow Surgeons (ASES) scores compared with the HA group (439 patients; all p < 0.05). There were no significant differences between the two groups for overall complications (RTSA, 11.8% vs HA, 20.8%), infections (2% for both groups), dislocations (RTSA, 0% vs HA, 2.5%), or nerve injury (RTSA, 1% vs HA, 2.8%). Scapular notching occurred in 15.8% of RTSA cases (grade I, 53%; grade II, 32%; grade III, 16%; and grade IV, 0%). In the treatment of acute proximal humerus fractures, RTSA provided better pain relief, postoperative anterior elevation, and outcome scores after surgery compared with HA and had similar complication rates.

Keywords: Complications, Outcomes, Pain, Reverse total shoulder, Shoulder hemiarthroplasty, Surgery, Systematic review.

How to cite this article: Borade AU, Familiari F, Choi K, Joseph J, McFarland EG. Comparison of Reverse Total Shoulder Arthroplasty vs Hemiarthroplasty for Acute Fractures of the Proximal Humerus: Systematic Review. J Postgrad Med Edu Res 2017;51(4):182-187.

Source of support: Nil

Conflict of interest: None


 
Invited Article
Rajat Verma

Blood Conservation in Scoliosis Surgery

[Year:2017] [Month:April-June] [Volumn:51 ] [Number:2] [Pages:61] [Pages No:68-73][No of Hits : 657]


ABSTRACT

Spinal deformity correction surgery can result in significant blood loss. Historically, large volumes of allogeneic blood transfusion were used in these patients. There is now an increasing awareness of the need to reduce allogeneic transfusion as there are reported adverse effects. Reducing blood loss during scoliosis surgery is a multipronged approach. This study reviews current strategies to reduce requirements for allogeneic blood transfusion for scoliosis corrective surgery.

Keywords: Blood loss, Blood salvage, Blood transfusion, Scoliosis, Spine surgery.

How to cite this article: Verma R. Blood Conservation in Scoliosis Surgery. J Postgrad Med Edu Res 2017;51(2):68-73.

Source of support: Nil

Conflict of interest: None


 
Invited Article
Jayesh Trivedi

Adolescent Idiopathic Scoliosis

[Year:2017] [Month:April-June] [Volumn:51 ] [Number:2] [Pages:61] [Pages No:58-67][No of Hits : 624]


ABSTRACT

Traditionally idiopathic scoliosis is divided into three categories according to the age of onset: Infantile (0-3 years), juvenile (4-9 years), and adolescent (10 years to skeletal maturity).

How to cite this article: Trivedi J. Adolescent Idiopathic Scoliosis. J Postgrad Med Edu Res 2017;51(2):58-67.

Source of support: Nil

Conflict of interest: None


 
Research Article
Georgy J Eralil

Role of Structured Feedback of Direct Observation of Procedural Skills in improving Clinical Skill of Interns

[Year:2017] [Month:January-March] [Volumn:51 ] [Number:1] [Pages:51] [Pages No:22-27][No of Hits : 620]


ABSTRACT

Objectives:

• To assess clinical skills of interns in selected procedures using direct observation of procedural skills (DOPS)
• To assess the change in procedural skills among students who received a structured feedback on DOPS.

Materials and methods: The study was interventional and conducted between December 2015 and February 2016 at the Department of Obstetrics and Gynaecology of Sree Narayana Institute of Medical Sciences, Ernakulam, Kerala, India. In the study, investigator observed the trainee performing a practical procedure within the workplace and recorded a rating for each competency on the assessment form. Feedback was given expanding on the reasons for any ratings of development required and makes practical suggestions for any remedial steps. The intern is reassessed for the same procedure at a later stage and the impact on skills is scored. Then the structured feedback is provided, and later on again the score on skills obtained by DOPS are compared between pre- and post-values by Wilcoxon-signed rank test.

Results: The average of pre- and post-feedback values were compared by Wilcoxon signed rank test. The p-value calculated was <0.001, which is significant. None of the interns were competent to perform the procedure before feedback; 80% of them needed more practice and 20% needed supervision. After feedback, 53.3% achieved competency and 46.7% achieved competency needing supervision; 93.3% of interns regarded feedback as superior quality, while 6.7% regarded as satisfactory.

Conclusion: Direct observation of procedural skills can be used to assess clinical skills of interns in selected procedures and it brings changes in procedural skills among students who received a structured feedback on DOPS.

Keywords: Direct observation of procedural skills, Feedback, Internship, Medical education, Skill assessment, Workplacebased assessment.

How to cite this article: Eralil GJ. Role of Structured Feedback of Direct Observation of Procedural Skills in improving Clinical Skill of Interns. J Postgrad Med Edu Res 2017;51(1):22-27.

Source of support: Harsha CH, Statistician, Sree Narayana Institute of Medical Sciences, Ernakulam, Kerala, India

Conflict of interest: None


 
Review Article
Vibhu K Viswanathan, Nirmal R Gopinathan

Resurgence of Serial Casting in Early-onset Scoliosis: Is It “Old Wine served in a New Bottle”?

[Year:2017] [Month:April-June] [Volumn:51 ] [Number:2] [Pages:61] [Pages No:79-83][No of Hits : 605]


ABSTRACT

Casting as a treatment of scoliosis has been practiced since 1800s. However, the practice fell into disfavor following the serious chest deformities and thoracic constrictions secondary to casting, as well as tremendous improvements in the surgical modalities. Recently, there has been a resurgence of this technique in early-onset scoliosis (EOS) and it has been considered to be a definitive treatment modality and a delaying tactic prior to the inevitable surgery. It carries the triple advantages including correction of the spinal deformity, allowing spinal growth uninterruptedly as well as low complication rates. The current article elaborately discusses the role of serial casting in EOS.

Keywords: Early-onset scoliosis, Nonsurgical treatment, Serial casting.

How to cite this article: Viswanathan VK, Gopinathan NR. Resurgence of Serial Casting in Early-onset Scoliosis: Is It “Old Wine served in a New Bottle”? J Postgrad Med Edu Res 2017;51(2):79-83.

Source of support: Nil

Conflict of interest: None


 
Review Article
Nusrat Shafiq, M Praveen Kumar, Gautam Kumar, Rachna Rohilla, Shruti Saha, Vikas Gautam, Ritesh Agarwal, Pallab Ray, Gurpreet Singh, Jayashree Muralidharan, Pankaj Arora

Antimicrobial Stewardship Program of Postgraduate Institute of Medical Education and Research, Chandigarh: Running Fast to catch the Missed Bus

[Year:2017] [Month:July-September] [Volumn:51 ] [Number:3] [Pages:40] [Pages No:123-127][No of Hits : 563]


ABSTRACT

Antimicrobial stewardship is a coordinated multidisciplinary effort directed at judicious use of antimicrobials. While antimicrobial stewardship is a routine activity in the developed world, the concept has evolved only of late in the developing countries including India. Started initially as a research project, a formal antimicrobial stewardship committee was constituted in the institute. The present article highlights the work done so far, problems faced, and the future of antimicrobial stewardship related activities in the institute.

Keywords: Antimicrobial stewardship, Rationale, Tertiary care hospital.

How to cite this article: Shafiq N, Kumar MP, Kumar G, Rohilla R, Saha S, Gautam V, Agarwal R, Ray P, Singh G, Muralidharan J, Arora P. Antimicrobial Stewardship Program of Postgraduate Institute of Medical Education and Research, Chandigarh: Running Fast to catch the Missed Bus. J Postgrad Med Edu Res 2017;51(3):123-127.

Source of support: Nil

Conflict of interest: None


 
Clinicopathological Conference Report (CPC)
Ritambhra Nada

Looking beyond Allergic Bronchopulmonary Aspergillosis in a 10-year-old Boy

[Year:2017] [Month:April-June] [Volumn:51 ] [Number:2] [Pages:61] [Pages No:103-113][No of Hits : 513]


ABSTRACT

A 10-year-old male child presented with chief complaints of cough, breathing difficulty, and fever for 15 days.


 
ORIGINAL RESEARCH
John W Orchard, Rajesh Puranik, Christopher Semsarian, Jessica J Orchard, David Samra, Johan Duflou, Patrick Groenestein, Mark Young, Peter Brukner, Alex Kountouris

Prevention of Sudden Cardiac Death in Cricketers

[Year:2016] [Month:April-June] [Volumn:50 ] [Number:2] [Pages:72] [Pages No:49-58][No of Hits : 1986]


ABSTRACT

Aims: Sudden death in cricketers is rare, with the most common causes being cardiac, neurological (head/neck trauma, mainly from ball impact) and environmental (e.g., lightning strike and heat stroke, the former which usually involves cardiac arrest). The aim of this study was to review possible prevention of sudden cardiac death and make recommendations.

Materials and methods: A literature review of possible causes of sudden cardiac death (SCD) among cricketers was performed, along with evaluation of evidence for existing preventative measures. The method for evaluation was expert panel (cardiology and sports medicine) consensus recommendations based on the published evidence base.

Results: Potential cardiac causes of sudden death while playing cricket can be divided into the following categories: (1) atraumatic-origin preexisting arrhythmias, cardiomyopathies and valve disorders (2) traumatic-origin arrhythmia (commotio cordis) (3) acquired coronary or valvular disease (4) viral myocarditis (5) Lightning strike. Preventive measures can be divided into pre-season (e.g., cardiovascular screening), prematch (e.g., assessment of viral illness), protective equipment (e.g., chest guards) and post-event (presence of first aid response including defibrillators). Our panel agreed that there was strong evidence that (1) trained and planned emergency response particularly with a defibrillator is effective at preventing SCD and (2) ceasing play in the presence of lightning strikes prevents lightning-related death (3) players with symptoms, risk factors or history suggestive of possible cardiac disease should undertake specific individual workup. There are other potential methods to prevent SCD, with expert level recommendations made in the absence of strong evidence.

Discussion and conclusion: The most controversial aspect of prevention of SCD is electrocardiogram (ECG) screening of asymptomatic players and this paper outlines the arguments both in favor and against without fully resolving the debate. The possible increase in early diagnosis of potentially life-threatening cases needs to be balanced against the risk of false positive results which may lead to discussion of exclusion from cricket. Cardiac workup is clearly of net benefit to symptomatic individuals (e.g. history of syncope, chest pain) or any player at higher than usual baseline risk (e.g., positive family history). Basic life support including access to defibrillators should be available with trained personnel wherever they can be afforded, which has strong evidence in favor of improving survival at the time of cardiac arrest.

Keywords: Arrhythmia, Coronary artery disease, Cricket, Defibrillator, Electrocardiograph, Genetics, Prevention, Screening, Sudden cardiac death.

How to cite this article: Orchard JW, Puranik R, Semsarian C, Orchard JJ, Samra D, Duflou J, Groenestein P, Young M, Brukner P, Kountouris A. Prevention of Sudden Cardiac Death in Cricketers. J Postgrad Med Edu Res 2016;50(2):49-58.

Source of support: Nil

Conflict of interest: None


 
Original Research
Jyoti Rattan

Biotechnological Inventions and Patent Law: National and International Perspective

[Year:2016] [Month:July-September] [Volumn:50 ] [Number:3] [Pages:49] [Pages No:132-135][No of Hits : 1566]


ABSTRACT

In the knowledge society of 21st century, intellectual property rights (IPRs) are real assets and much more valuable and important than are materialistic assets like house, motor car, and so on. Patents are given for inventions which fulfill few important conditions, such as novelty, inventiveness, industrial application, and written description. Significantly, biotechnological invention involves monopoly over life or living beings or living processes, and morally and ethically these are considered to involve tinkering with life or nature. However, today, biotechnological inventions are patentable because of their benefits and utility to the industry. This article is a humble attempt to examine international and national law and judicial decisions relating to patents and biotechnological inventions from a theoretical perspective.

Keywords: Intellectual property rights, Nonnatural living beings, Novelty, Patent, World intellectual property organization.

How to cite this article: Rattan J. Biotechnological Inventions and Patent Law: National and International Perspective. J Postgrad Med Edu Res 2016;50(3):132-135.

Source of support: Nil

Conflict of interest: None


 
Research Article
Ruchi Saini, Sukhpal Kaur, Karobi Das

Stress, Stress Reactions, Job Stressors and Coping among Nurses Working in Intensive Care Units and General Wards of a Tertiary Care Hospital: A Comparative Study

[Year:2016] [Month:January-March] [Volumn:50 ] [Number:1] [Pages:47] [Pages No:9-17][No of Hits : 1524]


ABSTRACT

Literature has presented nursing as a stressful profession. The present study was conducted to compare stress level and job stressors operating in two different units, i.e. intensive care units (ICU) and general wards of a tertiary care hospital of North India. This is a cross-sectional study involving 285 nurses (general wards = 176; ICU = 109). The nurses were selected conveniently. Demographic profile sheet, modified workplace stress scale (WSS), workplace stress symptom scale (WSSS) and coping checklist (CCL) of Rao, Subbakrishna and Prabhu (1989) was used in the study. Findings of the study revealed moderate to high stress level among general wards and ICU nurses with young female nurses experiencing more stress. Further, workload, role ambiguity and lesser social support accounted for significant amount stress among nurses working on both the units while external factors, such as physical environment and resources hardly contributed to stress. It was also found that the ICU nurses experienced stress more in the form of exhaustion (11.9%); irritation (11.9%) and reduced self-confidence (0.9%) that those working in general wards. However, the nurses on both the units use distraction, positive coping, problem-solving and religious strategies to manage and handle their stress. The findings of the study give insight into stress and stressors related to job which can be buffered using various stress management strategies by the nurse managers.

Keywords: Coping, Job stressors, Nurses, Stress.

How to cite this article: Saini R, Kaur S, Das K. Stress, Stress Reactions, Job Stressors and Coping among Nurses Working in Intensive Care Units and General Wards of a Tertiary Care Hospital: A Comparative Study. J Postgrad Med Edu Res 2016; 50(1):9-17.

Source of support: Nil

Conflict of interest: None


 
Review Article
Nadeem Parvez, Surinder S Rana, Ritambhra Nada, Vishal Sharma, Ravi Sharma, Puneet Chhabra, Deepak Gunjan, Lovneet Dhalaria, Rajesh Gupta, Deepak K Bhasin

Appendicular Histology and Its Clinical Significance in Patients with Ulcerative Colitis: A Prospective Study from North India

[Year:2016] [Month:July-September] [Volumn:50 ] [Number:3] [Pages:49] [Pages No:141-147][No of Hits : 1460]


ABSTRACT

Background and aims: The appendix may be involved in ulcerative colitis (UC) to variable extent. Clinical significance of appendicular involvement is not clear and it has long been considered an innocent bystander. This study prospectively investigated appendiceal histology and its clinical significance in patients with UC.

Materials and methods: Colonoscopy was performed in 60 patients and biopsies were taken from appendiceal orifice, cecum, and colon. Appendiceal histology was classified as active if there was presence of neutrophils with crypt distortion. Inactive inflammation was defined as positive for crypt distortion and negative for neutrophils. Otherwise the histology was reported as normal or nonspecific changes. The patients were followed for a minimum period of 6 months.

Results: In patients evaluated endoscopically, 63% patients had histological involvement of the appendiceal orifice. Pancolitis was seen more commonly in patients with appendicular orifice inflammation than in patients with normal appendicular histology (44.7 vs 9%, p = 0.001). Most patients with appendiceal orifice inflammation had involvement of the cecum. Skip lesion of the appendix without cecum involvement was seen in 37% of the patients. The patients with appendiceal orifice inflammation had a significantly higher grade of endoscopic colitis compared to patients with normal histology (p = 0.006). Relapse rate was higher in patients with appendiceal orifice inflammation than in patients with normal appendiceal histology (18.4 vs 9%), although the difference was insignificant (p = 0.329).

Conclusion: Appendicular involvement in ulcerative colitis is not uncommon. Its involvement may predict the course, extent, and severity of colitis.

Keywords: Appendix, Colonoscopy, Inflammation, Ulcerative colitis.

How to cite this article: Parvez N, Rana SS, Nada R, Sharma V, Sharma R, Chhabra P, Gunjan D, Dhalaria L, Gupta R, Bhasin DK. Appendicular Histology and Its Clinical Significance in Patients with Ulcerative Colitis: A Prospective Study from North India. J Postgrad Med Edu Res 2016;50(3):141-147.

Source of support: Nil

Conflict of interest: None