Assam Medical College Research Articles

Association of maternal determinants with low birth weight babies in tea garden workers of Assam.

This study was aimed to evaluate the association of maternal determinants with birth weight (BW) of babies in tea garden workers (TGW) and housewives (HW). A total of 175 subjects were recruited from Assam Medical College, Dibrugarh, India. In this cross-sectional study, maternal determinants, BW of babies and placental weight were explored in TGW (n = 102) and HW (n = 73). These factors were assessed and correlated by logistic regression models. A higher incidence of low birth weight (LBW) was found in mothers working in the tea garden (48.04%) as compared to HW (10.96%). Activity of plucking of leaves in tea garden by women had a higher risk for LBW babies (adjusted odd ratio [AOR] 4.33, 95% confidence interval [CI] 1.38-13.57, P = 0.012) and decreased placental weight (AOR 11.42, 95% CI 1.18-126.02, P = 0.036) as compared to HW considered as reference group. Women who worked continuously in the tea garden during 9 months of pregnancy also revealed an elevated risk for LBW (AOR 5.32, 95% CI 1.34-21.09, P = 0.017). This study suggests the activity of plucking of tea leaves by women is associated with LBW of babies and decreased placental weight. Particularly, if mothers worked continuously in the tea garden during 9 months of pregnancy, it also increased the risk of delivering LBW babies. This exploratory study provides an important platform for further prospective studies, which could be focused on the potential consequences of maternal occupational exposures during pregnancy on fetal development.

HLA-DQB genetic susceptibility and rheumatic heart disease: a case-control study.

Background Rheumatic heart disease is a major global health concern, especially in low- and middle-income countries. The pathogenesis is attributable to an aberrant immune response, host genetic factors, and socioeconomic status. The objective of this study was to screen HLA-DQB1 alleles as genetic susceptibility markers in rheumatic heart disease patients in Assam, North East India, and to correlate the predominant allele with socioeconomic status and clinical profile. Methods A case-control study of 100 echocardiography-confirmed rheumatic heart disease patients and age- and sex-matched healthy controls from Assam Medical College and Hospital was conducted. Human leukocyte antigen typing was performed using HLA-DQ typing kit. A questionnaire was designed to study the socioeconomic status and clinical profile of rheumatic heart disease patients. Results Among the 9 alleles studied, HLA-DRBQ1*03:01 was found to be the statistically significant predominant allele in this population, especially in the Ahom ethnic group. In the HLA-DRBQ1*03:01-positive population, rural dwelling was found to be a significantly increased risk factor for rheumatic heart disease. Among severe cases, 90% of mitral stenosis, 40% of mitral regurgitation, and 33.3% of aortic regurgitation cases were HLA-DRBQ1*03:01-positive. Also, 50% of aortic valve thickening and 36.8% of mitral valve thickening cases were found in this population. Conclusion Our data suggest that HLA-DRBQ1*03:01 is a significant susceptibility marker in this population, and predominant in the rural population. Furthermore, it may play an important role in determining the pattern of valve damage in rheumatic heart disease patients.

Study the efficacy of platelet rich plasma and local corticosteroid injection for treatment of chronic plantar fasciitis

<p class="abstract"><strong>Background:</strong> Plantar fasciitis is one of the most common causes of heel pain. Various methods of treatment are available but no ideal treatment has been defined in literature. Corticosteroid (CS) injections are being used as a gold standard but studies have shown its short-term effects and various complications. Recently, platelet rich plasma (PRP) has been advocated as a newer treatment option. The main aim and objective of this study is to compare the two modalities of treatment regarding both pain and functional scores and their complications.</p><p class="abstract"><strong>Methods:</strong> This study was a prospective cohort study. Total 90 patients with chronic plantar fasciitis visiting orthopaedic outpatient department of Assam Medical College and Hospital, Dibrugarh from July 2018 to June 2019 were enrolled for the study after clearance from Institutional Ethics Committee and equally divided into two groups. Group A received PRP and Group B received CS injections. They were assessed with visual analogue scale (VAS) and foot and ankle ability measure (FAAM) score at day 0, at 1 month, 3 months and 6 months. Level of significance was set at p<0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> The score on VAS and FAAM improved from baseline for both the groups. CS showed better results at 1 month and 3 months but at 6 months, results of PRP were better. 3 patients had recurrences in CS group.</p><p class="abstract"><strong>Conclusions:</strong> Corticosteroid injections provide immediate and short-term relief but PRP is beneficial with long term effects and without any complications.</p>

Bacteriological pattern and their correlation with complications in culture positive cases of acute bacterial conjunctivitis in a tertiary care hospital of upper Assam: A cross sectional study.

Acute conjunctivitis is inflammation of conjunctiva of less than 3 to 4 weeks duration, characterized by cellular infiltration and exudation. It may also result into corneal, lid or orbital involvement which may lead to various complications.A hospital based prospective study was conducted in Assam Medical College and Hospital with 110 culture proven acute bacterial conjunctivitis cases. Primary objective was to evaluate the bacteriological pattern and secondary objectives were to evaluate seasonal variation, association of different organisms with various complications and antibiotic sensitivity pattern of the isolates.Maximum frequency of bacterial conjunctivitis observed from May to September. SA was the predominant organism isolated throughout the year (32.1%). Commonest single organism isolates were SE (26.1%) and SA (21.6%). True membrane formation was significantly associated with CD (P < .05), whereas pseudo-membrane formation was associated with SA and STBH isolation (P < .05). Isolation of SE, SA, and PA was associated with corneal involvement (P < .05). Lid involvement was seen with SA and Diphtheroid, whereas SP isolation was associated with concomitant dacryocystitis (P < .05). All the major organisms were (SE, SA, D, STBH, SP) highly sensitive to amino-glycosides, cephalosporins, chloromphenicol, vancomycin and linezolid, whereas high level of resistance was seen towards fluroquinolones (ciprofloxacin and moxifloxacin).All acute bacterial conjunctivitis cases don’t require antibiotic therapy. In case if required, periodical culture and sensitivity may guide initial pre-emptive antibiotic therapy. Further choice of antibiotic should be govern by culture and sensitivity status.

Treatment of displaced intra capsular fracture neck of femur by proximal femur locking compression plate (PFLCP): A case series evaluation

Introduction: Treatment of choice for fracture neck of femur has always been a matter of debate since time immemorial. Till date there is no definite consensus regarding best implant for fixation of unstable intracapsular fracture neck of femur. We conducted this study to assess the results of fixation in such femoral neck fractures using proximal femur locking compression plate (PFLCP). Materials & Methods: The present study includes 10 cases of acute unstable fracture neck of femur in the age group of 18 to 65 years irrespective of sex treated by CRIF using PFLCP in our unit of Orthopedics department, Assam medical college and Hospital. Results: Six cases showed unfavorable results which later got converted to hip replacement in subsequent follow up. Four cases showed clinic-radiological union. Intra-articular penetration of screws was a common complication encountered in this study. Discussion & Conclusion: We conclude from our study that though this implant provides a rigid fixation at proximal femur but definitely requires some modifications during process of fixation while dealing with fracture neck of femur. Initially the results were encouraging but with subsequent follow up we encountered a higher failure rate with conventional sequence of fixation using PFLCP.

Exploration of life events and perceived stress in female patients admitted in the psychiatry Department of a Tertiary Care Hospital

Background: Research in past four decades show that recent life events do contribute to the onset of psychiatric illness but exact relationship between stress and psychiatric illness is still unclear and studies on life events are relatively less in North Eastern region of India. Aim: To examine the nature of life events, perceived stress, their association with various psychiatric illness and impact on duration of hospital stay in admitted female patients. Method: It is a cross-sectional study on 100 female patients admitted in psychiatry ward in Assam Medical College & Hospital, Dibrugarh, Assam, India, over a period of one year. Life events were examined using the Presumptive Stressful Life Events Scale (PSLES) and perceived stress was assessed by 14-item questionnaire, the Perceived Stress Scale (PSS). Result: Four most common stressful life events were financial problem/loss, death of a close family member, excessive alcohol use, and illness of a family member. Patients of schizophrenia perceived more stress than mood disorder followed by conversion disorder. Similarly, duration of hospitalisation was also higher in patients with higher perceived stress. Conclusion: The results of current research suggest that higher levels of perceived stress and negative life events are encountered in patients with schizophrenia. Life events in manic patients are usually related to social life while in depressive patients, role of loss is found more important like bereavement, loss of job.

Improvement in school absence after factor replacement in students with haemophilia in Upper Assam, India

Abstract Background Patients with haemophilia who are not adequately treated experience a lifetime burden of joint complications and loss of functional ability due to repeated bleeding episodes caused by low levels of clotting factor VIII or IX in the blood. These complications can significantly impact day-to-day life, including active participation in school and academic study in children with haemophilia (CwH). Treatment with factor replacement therapy can help to prevent this, but access to factor has been challenging in low-resource settings such as Northeast India. This study shows the impact of factor replacement therapy on bleeding episodes, joint complications and school absence among CwH in this setting. Methods A retrospective observational study was undertaken to examine the impact of receiving regular factor replacement therapy (prophylaxis or on demand) on school absences among CwH registered with the haemophilia treatment centre at Assam Medical College and Hospital. Annual bleed rate (ABR), Haemophilia Joint Health Score (HJHS) and Functional Independence Score in Haemophilia (FISH) were also assessed. Results Thirty-eight CwH were eligible for the study; 26 (68.4%) were on prophylaxis therapy and 12 (31.5%) received on-demand therapy. In the year before starting regular treatment, the mean ABR was 37.8 (+20.0), HJHS was 31.1 (+18.1) and mean FISH score was 21.1 (+4.2). At the end of the study period the mean (+SD) ABR in prophylactic therapy was significantly lower at 5.8 (+4.6) (p&lt;0.001) and the HJHS was significantly lower at 4.7 (+4.6). FISH score significantly improved to 27.9 (+3.3) (p&lt;0.001). Prophylaxis showed better (but not significant) results in comparison to on-demand therapy. Conclusions Treatment with factor replacement significantly reduces school absence in CwH and correlates strongly with joint health and functional improvement, with the effect slightly better with prophylaxis than on-demand therapy. Low dose prophylaxis is a good treatment option in low-resource settings, but improvements are also needed in rates of diagnosis.

Haemostatic action of a topical foam-based patch (VELSEAL-T) in haemophiliac patients with external bleeding

Abstract Introduction Haemophilia is an X-linked congenital bleeding disorder due to deficiency of coagulation factor VIII (in haemophilia A) or factor IX (in haemophilia B) caused by mutations of the respective clotting factor genes. Treatment involves the administration of an appropriate dose of factor concentrate, as soon as possible, in the event of any bleeding episode. In low-resource settings, such as Northeast India, where factor concentrates are not widely available, people with haemophilia (PwH) may bleed profusely even from trivial external injuries, warranting transfusion of blood or blood products. We previously reported on the use of a low cost, foam-based haemostatic patch to treat an external bleed in a single patient. In this study, we investigated its use to treat a range of external injuries in PwH presenting at Assam Medical College and Hospital. Method Over 24 months, eligible PwH with external injuries attending our haemophilia clinic were treated with a topical haemostatic patch (VELSEAL-T) at the target bleeding site. The time to cessation of bleeding was recorded and the wound sites evaluated after haemostasis to monitor efficacy and safety. Results Out of 72 individuals with bleeding disorders who volunteered to participate, 59 cases of external bleeding in 48 PwH were eligible for inclusion in the study. Nine (15.3%) had aberration wounds, 24 (40.7%) cut wounds, 21 (35.6%) tooth and/or gum bleeding and five (8.4%) bleeding from puncture wounds. The average time required for achievement of haemostasis was 9.9 (±4.7) minutes. Aberration wounds required the least amount of time for haemostasis at 7.3 (±4.4) minutes. Cut wounds required a mean time of 8.5 (±2.9) minutes; puncture wounds required 9.0 (±3.1) minutes; gum bleeding required the longest time to achieve haemostasis with a mean of 12.7 (±5.6) minutes. Conclusion The use of this topical haemostatic patch has been shown to be beneficial in the treatment of external injuries in PwH, and provides a good treatment option in resource-constrained areas. A larger controlled study would be helpful to further investigate its efficacy and safety.

Significance of Body Mass Index in the Classification of PCOS: A Comparative Study in Northeast India

ABSTRACTAimTo compare the clinical and biochemical characteristics of obese and lean women with polycystic ovary syndrome (PCOS). To confirm the significance of body mass index (BMI) in classifying PCOS.Materials and methodsThis was a comparative cross-sectional study done at Assam Medical College Hospital, Dibrugarh, Assam, in 1 year. Women who attended the hospital diagnosed to have PCOS based on Rotterdam's criteria were divided into lean and obese with BMI cut-off of 23. Clinical, anthropometric, and biochemical characteristics of both were compared. Body fat percentage was calculated using Harpenden skinfold calipers, and based on it, the lean group was found to have a normal weight, and obese subgroup with body fat percentage more than the cut-off.ResultThere was a significant difference in age, hirsutism score, and family history of diabetes and PCOS between the groups. The systolic blood pressure, serum cholesterol, and serum low-density lipoprotein (S.LDL) were statistically higher in the obese group. The normal weight obese group had features of the lean group, except for hyperandrogenism.ConclusionThe lean and obese PCOS are two discrete groups. Obese patients have a more androgenic and atherogenic lipid profile, but both groups should be screened. Body mass index is the easily available method, but it has a chance of missing out on the normal weight obese PCOS.Clinical significanceFollow-up is needed in both the groups, and the normal weight obese group behaves as the lean PCOS group; hence, BMI can be continued to be used as the differentiating factor.How to cite this articlePillai SS, Phukan PK, Dihingia P. Significance of Body Mass Index in the Classification of PCOS: A Comparative Study in Northeast India. J South Asian Feder Obst Gynae 2020;12(3):145–149.

A study on knowledge, attitude and practice about rabies among pharmacy students in a tertiary care hospital

Background: Rabies, a disease of antiquity, continues to be a major public health problem in India and itis 100% fatal. Objective: To assess the knowledge, attitude and practice about rabies among pharmacy students of Assam Medical College and Hospital, to assess whether there is any difference of knowledge, attitude and practice among male and female students and study the socio-demographic profile of the students. Materials &amp;Methods: A cross sectional study was conducted among 156 pharmacy students by purposive sampling using pre designed structured close ended questionnaire. Knowledge and attitude was assessed by a scoring system. Statistical analysis was done by percentage and chi square test. Results: The mean age of the students was 20.64 ± 1.42 years. Most (63.5%) of the students were males and most (46.7%) of them belong to the Hindu religion. Almost all (97.4%) the students had heard the word rabies. Conclusion: Most (61.2%) of the students had average knowledge, 38.8 % had good knowledge, 48.7 % had negative attitude and 51.3 % had positive attitude about rabies.

Spot Urinary Albumin-to-Creatinine Ratio: A Novel Marker for Detecting Fetomaternal Outcomes and Complications in Preeclamptic Women.

Preeclampsia is a multisystem endothelial disease leading to glomeruloendotheliosis with endothelial leak causing significant proteinuria. It is associated with high maternal and fetal risks and fetomaternal morbidity and mortality. Spot urinary albumin-to-creatinine ratio (ACR) leads to earlier detection of glomerular damage leading to prompt management of preeclamptic patients. To study the correlation between fetomaternal outcomes of preeclamptic patients with spot urinary ACR. Spot urinary ACR was measured in 70 consecutive patients with preeclampsia in Assam Medical College, Dibrugarh. The best cutoff value to differentiate between significant and insignificant proteinuria was calculated. Mean spot urinary ACR was calculated in all maternal outcomes (mode of onset of labor and mode of delivery), and maternal complications (elevated liver enzymes, renal insufficiency, severe hypertension, coagulation disturbances and thrombocytopenia, antepartum and postpartum hemorrhage) and fetal complications and outcomes (birth weight, Apgar score, IUGR, need for resuscitation, NICU requirement, neonatal sepsis, jaundice and mortality) and the correlation were studied. The best cutoff value to differentiate significant and insignificant proteinuria was calculated as 291.9mg/g beyond which adverse fetomaternal outcomes and complications were seen. All maternal and fetal outcomes and complications had high mean spot urinary ACR and were found to be significant (p < 0.05). Mode of delivery and birth weight of babies showed no statistical significance though low-birth-weight babies had high mean spot ACR. Compared with 24-h urinary protein excretion, spot urinary ACR is a simple and accurate indicator of significant proteinuria and helps to detect fetomaternal outcomes in preeclamptic women which may lead to prompt management to reduce fetomaternal complications.

A Case Study on Psychiatric Patient in Assam Medical College, India

A Case Study on Psychiatric Patient in Assam Medical College, India

Histopathological Spectrum of Testicular Tumors in a Tertiary Care Centre

Background&#x0D; Testicular tumors are rare type of tumors affecting adolescents and young adults. However, in many western countries, its incidence has been increasing. These tumors contribute for 1–2% of all malignant tumors and most malignancy in men in the age-group of 15–25 years. This study was undertaken to analyse the histopathological pattern of testicular tumors at the tertiary level hospital in Assam Medical College, Dibrugarh highlighting pathological findings, diagnostic evaluation and laterality.&#x0D; Objective&#x0D; The purpose of the study was to analyse the histopathological pattern, age-wise distribution and laterality of testicular tumors.&#x0D; Materials and Method&#x0D; This one year study was performed in the Department of Pathology, Assam Medical College, Dibrugarh, India from January 2018 to December 2018. For the study, the orchidectomy specimens received in Pathology department were subjected to routine histopathological processing followed by a detailed gross and microscopic examination. Tumor typing and subtyping were done according to WHO classification (2004).&#x0D; Results&#x0D; A total of 12 cases of testicular tumors were included in the present study. Out of these 12 cases, right testis was affected in 58.4% of cases whereas left testis was affected in 41.6% cases. Germ cell tumor was the most common type accounting for 91.5% of tumors followed by Sex cord stromal tumor (8.5%). Most tumors were seen between the age-group of 21–30 years.&#x0D; Conclusion&#x0D; Testicular tumors are uncommon in our population. Study of testicular tumor is important for pathologist because grossly identifiable benign pathology may harbour focus of malignancy. At the end, we conclude that despite new technique in imaging and tumour marker assay, the diagnosis of testicular tumor is dependent on HPE only.

Profile of intractable epilepsy in a tertiary referral center in upper Assam

Introduction: Epilepsy is a common and diverse disorder with many different causes.Outcomes are varied with 60—70% of newly diagnosed people rapidly entering remission after starting treatment, and 20—30% developing a drug-resistant epilepsy with consequent clinical and psychosocial distress. Methods: It is a Descriptive Cross-sectional study which was conducted in Assam Medical College and Hospital, Dibrugarh from April 2014 to April 2016. A total of 42 patients of IE attending the neurology, paediatrics and medicine department were included in the study. Results: Forty-two patients (males 24, females 18) with intractable epilepsy were included for the study. Maximum patients were in between 20-40 years of age (42.9%) and their mean duration of epilepsy was13.2 ± 7.13 years. The seizure frequency varied from once every month to more than 200 per (mean 26.2 ± 24.17) month. Twenty-six patients (61.9%) had partial seizures, 8 (19.1%) patients had generalized seizures and 8(19.1%) had multiple seizure semiology. Thirty-six patients had risk factors of intractable epilepsy. Seven (16.6%) patients were having family history of epilepsy and 4(9.5%) patients had history of febrile seizures. Mesial temporal lobe sclerosis (MTLS) and birth hypoxia are the two major risk factors for intractable epilepsy. EEG was abnormal in 66.7% cases, with generalized background slowing in 19.1%, focal slowing in 14.2%, generalized epileptiform discharges in 9.5% and focal epileptiform discharges in 23.8%. CT brain was abnormal in 18(42.9%) patients. MRI brains were abnormal in 25 out-off 36 patients (69.4%). Carbamazepine was the most commonly used drug (57.1%) followed by clobazam (47.6%). Phenytoin, levetiracetum, Phenobarbitone, oxcarbazepine, zonisemide, lacosemide are the other AEDs used in combination. Conclusion: This study showed, patients with partial seizures, birth hypoxia, history of febrile seizures, family history of seizures, structural brain abnormalities and background EEG abnormalities were the most common risk factors for development of intractable epilepsy.

A study of growth pattern in regularly transfused thalassaemic children of age group of 2 years to 12 years

Background: ß-thalassemia is an autosomal recessive single gene disorder. Physical growth failure is one of the most important complications of thalassemia. Very few data regarding growth pattern of thalassemic children is available from India especially North East part. Keeping this in mind, present study was undertaken. To study the growth pattern of transfusion dependent thalassaemic children and to compare growth pattern between regularly and irregularly transfused children.Methods: A cross-sectional observational study was done on 38 thalassaemic patients (aged 2 years-12 years) who attended Department of Pediatrics, Assam Medical College Dibrugarh. History, physical examination and investigations were done and filled in predesigned proforma. Anthropometric measurements like weight and height were taken from all patients. Sexual maturity rating was done in girls ≥10 years and boys ≥11 years. Lab parameters included pre-transfusion hemoglobin (Hb), serum ferritin, LFT, RFT, Thyroid profile. Percentile for weight, height and body mass index were calculated using WHO (2007) reference data. Collected data were compared with age and sex matched normal children.Results: About 34.21% transfusion dependent children had under-nutrition and 50% had stunting. 42% had thinness. Stunting was more in irregularly transfused children (81.25%) as compared to regularly transfused children which was highly significant (p&lt;0.001). Under-nutrition among irregularly transfused children was more (40%) compared to regularly transfused children (28.57%). Pubertal spurt was delayed in 66% children. Those who had Hb &lt;5 gm/dl had 100% stunting and under-nutrition.Conclusions: Regular blood transfusion with growth monitoring and appropriate iron chelation (Sr. Ferritin &gt;1000 ng/ml) is of utmost importance in transfusion dependent thalassaemic children.

Histopathological Spectrum of Testicular Tumors in a Tertiary Care Centre

Background Testicular tumors are rare type of tumors affecting adolescents and young adults. However, in many western countries, its incidence has been increasing. These tumors contribute for 1–2% of all malignant tumors and most malignancy in men in the age-group of 15–25 years. This study was undertaken to analyse the histopathological pattern of testicular tumors at the tertiary level hospital in Assam Medical College, Dibrugarh highlighting pathological findings, diagnostic evaluation and laterality. Objective The purpose of the study was to analyse the histopathological pattern, age-wise distribution and laterality of testicular tumors. Materials and Method This one year study was performed in the Department of Pathology, Assam Medical College, Dibrugarh, India from January 2018 to December 2018. For the study, the orchidectomy specimens received in Pathology department were subjected to routine histopathological processing followed by a detailed gross and microscopic examination. Tumor typing and subtyping were done according to WHO classification (2004). Results A total of 12 cases of testicular tumors were included in the present study. Out of these 12 cases, right testis was affected in 58.4% of cases whereas left testis was affected in 41.6% cases. Germ cell tumor was the most common type accounting for 91.5% of tumors followed by Sex cord stromal tumor (8.5%). Most tumors were seen between the age-group of 21–30 years. Conclusion Testicular tumors are uncommon in our population. Study of testicular tumor is important for pathologist because grossly identifiable benign pathology may harbour focus of malignancy. At the end, we conclude that despite new technique in imaging and tumour marker assay, the diagnosis of testicular tumor is dependent on HPE only.

A clinical study of pneumonia with special reference to hyponatremia among children aged 1–5 years admitted in teaching hospital

Introduction: Pneumonia probably is one of the oldest diseases, as old as antiquity known to human kind and has always remained a subject of challenge to medical science, despite extensive research. Hyponatremia is the most common electrolyte disorder among hospitalized patients and has been associated with increase in mortality. Objectives: 1) To study clinical profile of pneumonia among children aged 1-5 years. 2) To determine the frequency of hyponatremia in pneumonia. Methodology: This was a hospital based cross sectional study of pneumonia with special reference to hyponatremia conducted among children aged 1-5 years who were admitted in pediatric wards of Assam Medical College Dibrugarh, Assam, during the period April 2012 to March 2013. Results: In the present study, outof 300 cases of pneumonia, 78 (26%) cases were hyponatremic. Among them 9 (11.5%) cases were pneumonia, 51 (65.4%) cases were severe pneumonia and 18 (23.1%) cases were very severe pneumonia. Mean duration of hospital stay of patient with hyponatremia with pneumonia was 9.54 ± 2.63 and those with normonatremia with pneumonia were 6.43 ± 1.16. Conclusion: Incidence of hyponatremia in pneumonia is common and its incidence is more common in cases of very severe pneumonia. Mean duration of hospital stay of patient with hyponatremia with pneumonia is more compared to those with normonatremia with pneumonia.

A hospital-based study of socioeconomic status and clinical spectrum of rheumatic heart disease patients of Assam, North-East India.

Objective The aim of this study was to assess the impact of socioeconomic factors in increased prevalence of rheumatic heart disease and its clinical spectrum in Assam, North-East India. Method A case-control questionnaire-based study of 100 echocardiography confirmed rheumatic heart disease cases with age- and sex-matched healthy controls from Assam medical college and hospital in Dibrugarh, Assam was conducted. Results There was a trend toward increased risk of rheumatic heart disease and its clinical spectrum with respect to low socioeconomic status. Three parameters were found to be statistically significant in posing increased risk towards rheumatic heart disease: rural dwelling location ( p < 0.0001, odds ratio (OR) 4.1, 95% confidence interval (CI = 2.29-7.45), low monthly income ( p < 0.001, OR=9.5, 95% CI = 4.99-18.1) and education status ( p < 0.05, OR=9.5, 95% CI = 1.866). Out of the severe cases of mitral stenosis, mitral regurgitation and aortic regurgitation, 69.6%, 58.3% and 34% patients were of low socioeconomic status. Conclusion Socioeconomic factors can be of significant importance in increased prevalence of rheumatic heart disease and might also influence the clinical spectrum of the disease. Increased awareness and up-gradation of socioeconomic status might ameliorate the prevalence of rheumatic heart disease.

Significance of mucin stains in the diagnosis of carcinoma of cervix

Background: As many as 25-35% of carcinoma cervix without clearly defined glandular structure on histopathological examination by Hematoxylin and Eosin stains have intracellular mucin demonstrable by using mucin stains which may redefine the classification of cervical carcinomas which becomes important as mucus secreting neoplasms resembling pure squamous cell carcinomas are more aggressive and have worse prognosis than their purely squamous counterparts.Methods: Our study conducted at Assam Medical College Dibrugarh for a period of one year. 54 cases of carcinoma cervix diagnosed on Hematoxylin and Eosin stain were subjected to mucin stains i.e. Periodic acid Schiff and Alcian blue at pH 2.5 and the results were compared with each other.Result: Out of the total 54 cases, 47 cases were squamous cell carcinoma(SCC,87.03%) which were further graded as well differentiated type(12/47)SCC, moderately differentiated(31/47)SCC, poorly differentiated(4/47)SCC and only 3 cases were adenosquamous carcinoma( 3/54; 5.5%) and adenocarcinoma( 4/54; 7.41%) by conventional H& E stain. On subjecting to specific mucin stains, however 21.2% (10 cases)of the SCC(47 cases) contained intracellular mucin with varying percentage, along with adenocarcinoma and adenosquamous carcinomas . Revised diagnosis after application of mucins stains showed pure squamous cell carcinomas (37/54) i.e. 68.51%, adenocarcinomas remained same at 7.41% (4/54) and adenosquamous carcinoma increased(13/54) to 24.07%.Conclusion: Identifying adenosquamous carcinomas after application of mucin stains which were not detectable by H&E stained sections has sparked academic interest because of its prognostic significance as it has been found in various studies that adenosquamous carcinomas often pursue an aggressive course and are associated with worse prognosis than their pure adeno- and squamous – counterparts as most of them are poorly differentiated. So recognition of this type of carcinomas can help to predict prognosis and to plan management.DOI:10.21276/APALM.1583

A hospital-based clinical study of childhood psoriasis in a tertiary care center of Northeast India

Background: Childhood psoriasis has been reported to differ from that among adults. There are a limited number of studies on childhood psoriasis and none from the north-eastern part of India. A detailed clinical study will help to understand better the disease profile in children, thereby assisting in better diagnosis and treatment. Objective: The objective of this study was the clinical profile of childhood psoriasis. Materials and Methods: The present observational study was conducted in the Dermatology Outpatient Department of Assam Medical College and Hospital, Dibrugarh, during 12 months from June 2014 to May 2015. All children up to 13 years presenting with psoriasis during 1 year were taken as study participants after obtaining the written consent from the sole guardian. A detailed examination and relevant investigations were done, whenever necessary. The findings were recorded in a pro forma for the analysis and interpretation of data. Results: A total of 26 cases of childhood psoriasis were recorded during the study. The prevalence of childhood psoriasis in our outpatient pediatric population was 1.24%. Female cases (19; 73.08%) outnumbered male cases (7; 26.92%). A maximum number of cases were noted in 9–13 years of age group. The lower extremities (11; 42.31%) were the most common site of onset. Plaque type (14; 53.85%) was found to be the most common type. About 7.69% cases had a positive family history. Conclusion: Frequent involvement of soles was noted in childhood psoriasis similar to other parts of India but unlike other parts of the world. Pediatric patients had significantly more involvement of the trunk, face, and groin than did adult patients.