MGM Medical College Research Articles

Correlation of foot length and gestational maturity in neonates

Background: Accurate assessment of gestation maturity is not possible in all newborn infants specially when they are sick and need intensive care support . The aim was to study correlation of foot length (FL) with gestational age and other anthropometric measures at birth among preterm, term and post-term neonates. Methods: Prospective observational study was done. 800 babies born at MGM Medical College Aurangabad from December 2012 to November 2014 were enrolled. FL at birth was measured from the center of the back of the heel to the tip of the big toe. Gestational assessment was done using modified Ballard’s scoring on day one. Based on gestational age, babies were grouped as preterm, term and post term babies. All the three groups of babies were categorised into small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) groups using lubchenco intrauterine growth curves. Linear regression analysis was done to investigate the relation of FL to gestational age, birth weight (BW), head circumference (HC) and crown heel length (CHL). Results: There were 52.5% males and 47.5% females. Of the 800 newborns, preterm babies were 124 (15.5%), term babies were 604 (75.5%) and post-term babies were 72 (9%). The mean foot length was 7.42 cm with a range of 4.5-8.8 cm. Foot length correlated significantly (p <0.05) with gestational age, birth weight, head circumference and crown heel length in preterm small for gestational age (SGA), preterm appropriate for gestational age (AGA), term Small for gestational age (SGA) and term appropriate for gestational age (AGA) groups. The correlation coefficient of foot length with gestational age was maximum in preterm AGA (r=0.81) and preterm SGA groups (r=0.75) followed by term SGA (r=0.48) and term AGA (r=0.44). Other groups had no correlation between foot length and gestational age. Post-term AGA and post-term SGA groups had correlation between foot length and birth weight. Conclusions: Foot length correlated significantly with gestational age and other anthropometric parameters in preterm and term infants.

A study of serum ferritin, alanine transaminase and hepatic MRI T2 values in beta-thalassemia major patients

Background: Present transfusion protocols have increased life expectancy of patients with β-thalassemia. Non-invasive T2* MRI is a newer technique in developing countries with promising role in management of thalassemia. Our goal was to assess the hepatic dysfunction in multi-transfused thalassemia patients by estimating iron overload using hepatic MRI T2* values, and correlating the results with serum ferritin and serum alanine transaminase (ALT) values. Methods: This was a cross-sectional study of regularly transfused thalassaemia major patients from Thalassemia Center of Chacha Nehru Bal Chikitsalaya, M. Y. Hospital, a referral thalassaemia centre in Indore, Madhya Pradesh, India. The study was approved by the ethics committee of MGM Medical College, Indore, India. The study was conducted between August 2011 and September 2012. β-thalassaemia major patients who were regularly transfused and between the age of 5 to 15 years, were included. Results: It was fo und that thirty three percent of the patients had hepatic MRI T2* values less than 6.3ms. Serum ALT levels were found to be above three times the normal range in 88% of patients. Significant liver iron deposition starts occurring at an early age leading to liver dysfunction. Serum ferritin levels did not linearly correlate with liver iron load thus it may not be a reliable marker for monitoring of chelation therapy. Conclusions: For better management of thalassaemia patients, hepatic MRI T2* is suggested, instead of relying solely on serum ferritin.

Study of maternal and fetal outcome in elective and emergency caesarean section

Introduction: Caesarean section is one of the most performed surgical procedures all over the world. The present study was conducted to determine the maternal & neonatal outcome and complications in two groups of pregnancy among women with elective and emergency cesarean section. So that measures can be taken to reduce morbidity and mortality in near future. Material & Methods: A prospective observational study carried out in department of Obstetrics and Gynecology, M.G.M Medical College and M.Y. Hospital ,Indore (M.P). All patients who underwent caesarean section are divided into two groups as per the timing of procedure in emergency or electively. The two groups were compared on the basis of age, parity, indication, booking status, intra operative & post op complications, and maternal & fetal outcome. Results: The incidence of caesarean section was 30.25%. The proportion of elective and emergency caesarean was 21.63% and 78.37% respectively. All of the complications were significantly higher in emergency group in terms of both maternal and fetal outcome. Conclusion: The incidence of caesarean section is high in MGM medical college Indore and the overall complication rate is higher in emergency caesarean than elective caesarean section group.

MORPHOMETRIC STUDY OF INFERIOR THYROID ARTERY IN CADAVERS

Address for Correspondence: Dr. Roshan S., Assistant Professor, Department of Anatomy, Srinivas Institute of Medical Science & Research Centre (SIMS&RC), Srinivas University, Surathkal, Mangalore-574146, Karnataka, India. PH: +919480077030 E-Mail: kmcroshan@gmail.com Background: Thyroid gland is one of the vital organs in neck region. It is highly vascularized and variations of the thyroid arteries are frequent and have been well documented in literature. This fact increases the significance of being cautious about thyroid gland while performing surgery in neck region. Objective: To study the morphological anatomy of Inferior thyroid artery and to report the origin of the Inferior thyroid artery, to measure the length of the Inferior thyroid artery from its origin to its entry into the gland, to measure the distance from the midline of the neck to the entry of the Inferior thyroid artery into the thyroid gland and to trace its branches. Method: A total of fifty human cadavers were dissected at anatomy department dissection hall of MGM Medical College, Navi Mumbai, Maharashtra and the measurements were taken as per objective of the study. Results: Inferior thyroid artery originated from the thyrocervical trunk in all cases on the left side. On right side in 48 out of 50 cadavers, it originated from thyrocervical trunk (96%) and in rest two cases it originated from the subclavian artery (4%). Statistically significant variation (p<0.001) of mean length of inferior thyroid artery between the right and left side of cadaver was found, indicating mean length was more on left side. Statistically significant variation (p<0.001) of mean distance from midline to entry of inferior thyroid artery into gland between the right and left side of cadaver was found signifying mean distance from midline was more on the right when compared to the left side. Conclusions: Variations of inferior thyroid arteries are well documented in literature. To keep morbidity to minimum, surgeons should have extensive knowledge of the topographic anatomy and its variations.

Prescribing Patterns of Antimicrobial Usage in Ophthalmology Out Patients Department at Tertiary Care Teaching Hospital

Background: Drug utilization provides prescribing behaviors of prescriber. Rational prescribing of antimicrobial drugs plays a crucial role in reducing the antibiotic resistance. The study aim was to analyze the patterns of antimicrobial prescribed ophthalmology outpatient department (OPD) patients. Methods: The study was an observational study completed over a period of 6 months, from July 2014 to December 2014. The study was conducted in Department of Ophthalmology, MGM Medical College, and Hospital Navi Mumbai. A questionnaire was specifically designed factoring patients’ demographical profile, diagnosis of disease, drug regimen. Results: A total 125 prescriptions of patients were analyzed who visited ophthalmology OPD department. Maximum patients belonged to the age group of 41-50 years (27.2%), followed by age group of 31-40 years (25.6%). The proportion of male (59%) patients was more as compared to female patients (41%). Total drug prescribed was 296. Average drug per prescription was 2.36. Among 296 drugs, 144 were antibiotic prescribed. Average antibiotic per prescription was 1.15. Most commonly antibiotic prescribed was moxifloxacin. Most common fixed dose combination (FDC) of antibiotic prescribed was tobramycin plus loteprednol. Among total 125 patients, maximum patients were diagnosed with cataract (25%), followed by meibomitis (12%), conjunctivitis (24%), blephritis (9%), foreign body in eye (12%), psedophakia (10%) and other disease (8%). 96% of antimicrobial were prescribed from essential drug list. The FDC of antimicrobial (40%), fluroquinolone (19%), aminoglycoside (13%), broad spectrum (12%), macrolide (9%), anti-viral (7%) was prescribed. Maximum number of drugs was found in the form eye drops (72%). Conclusion: The present study found that FDC of antibiotic was prescribed maximum. Most common dosage form of prescribed drug was eye drop. Prescription of drugs by brand name was a matter of concern.

Effect of chemical exposure in induction and evolution of vitiligo: Correlation between duration of exposure and disease, site of exposure and onset, and impact upon avoidance

BackgroundThe exogenous oxidants can trigger and lead to progression and chronicity in idiopathic vitiligo similar to chemical leucoderma and contact vitiligo. AimsThe basic objectives of this study were to study chemical exposure history in vitiligo patients and to correlate this with induction or progression of lesions. MethodsThis prospective observational study with intervention in the form of avoidance of exposure was conducted at MGM Medical College, Bihar at eastern India during the period of September 2010 to April 2012. Detailed record of demographic and clinical features was noted with specific chemical exposure especially duration of exposure, site of exposure, and outcome of the disease upon avoidance of chemicals. ResultsThe proportion of cases coming to the OPD with vitiligo was 1.03% (n=241) among total 23,410 outpatients department's dermatological patients. History of household chemical exposure and industrial (occupational) chemical exposure was found in 94.6% (n=228) and 0.4% (n=1) patients, respectively. The duration of disease and duration of chemical exposure had no correlation (r=+0.1756). Regarding avoidance of chemical exposure on the progression of vitiligo, the difference between fully compliant versus noncompliant was statistically significant (p<0.05) but between partial compliant versus noncompliant was not significant (p>0.05). Correlation of site of chemical exposure with site of onset of disease was found in 64.9% (n=148) patients. ConclusionsChemical triggering factors play very significant role in induction and progression of vitiligo.

Prevalence of insomnia in urban population of West Bengal: A community-based cross-sectional study

International Journal of Medicine and Public Health,2015,5,4,293-296.DOI:10.4103/2230-8598.165953Published:Oct 2015Type:Original ArticlePrevalence of insomnia in urban population of West Bengal: A community-based cross-sectional studySuman Kumar Roy, Anup Kumar Bhattacharjee, Chandrani Chakraborti, and Ritesh Singh Suman Kumar Roy, Anup Kumar Bhattacharjee1, Chandrani Chakraborti2, Ritesh Singh Department of Community Medicine, College of Medicine and JNM Hospital, Kalyani, Nadia, 2Department of Nutrition, Swarupganj Pansila Balika Vidyalaya, Nabadwip, West Bengal,1Department of Medicine, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India Abstract:Background: The complaint of insomnia is one of the most common symptoms a physician encounters in his/her day-to-day practice. Though rarely present as the stand-alone problem, it accompanies other organic or psychological symptoms. Its incidence is on the rise in ever increasing stressful life of present times. Objectives: The objective was to study the prevalence and some sociodemographic factors associated with insomnia among the urban population of Kamarhati municipal area of district 24 Parganas (N) of the state West Bengal. Materials and Methods: The study was carried out at “Kamarhati” municipal area. Ten percent of householders of two randomly selected wards were surveyed. Self-reported sleep questionnaire insomnia symptoms questionnaire (ISQ) was administered to all adult members. Persons with a history of major psychiatric illness, regular shift work, daily alcohol consumption more than four units and on chemotherapy or radiotherapy were excluded from the survey. Results: ISQ identified 15.4% prevalence of insomnia. It was high in persons with co-morbid chronic physical illness (28.1%) compared to persons free from that (10.9%) (P < 0.001). Insomnia was significantly higher among people living in joint families than those living in a nuclear family. The prevalence of insomnia increases significantly with the increasing age (P < 0.05). Conclusion: Findings of this study showed that the prevalence of insomnia in urban India is high. Increased life expectancy, increased burden of chronic illnesses, changing lifestyle, uncertainty of urban life contributes to high prevalence of insomnia that in turn affects quality of life. Keywords:Insomnia, insomnia symptom questionnaire, PrevalenceView:PDF (410.7 KB)

A study on the efficacy of a novel technique envisaged toward improvement of traditional lecture

Background: Lectures are still the main stay of teaching, particularly in medical colleges in view of the fact that the sizes of the classes are increasing day by day, and there is a dearth of teachers to care them in small batches. Therefore, new researches are necessary to improve lecture outcome and to make the lectures more useful. A new method of improving lecture outcome in the Physiology Department of MGM Medical College, Bihar, India, has been studied. In this method, a short questionnaire is given before and after the lecture on the lecture topic. Objective: To identify effective teaching methods for the large class environment. Materials and Methods: The whole class of first-year students was divided into two equal batches randomly. In the first batch, a short multiple choice questionnaire was given at the beginning of the lecture covering the lecture topic. The same questionnaire was given to both the batches at the end of the lecture. Then, the results were compared. Results: The result showed that there was a significant improvement in lecture outcome in the batch that was given a prelecture test. The difference was statistically significant. The average marks obtained by the students in initial examination of all the 6 days of the first batch were only 4.87 � 1.48 of 20. At the end of the class, the marks improved notably in that batch, which was, on average, 15.40 � 2.50 of 20. However, the second batch, which received only one final examination, received average marks 10.10 � 2.12 of 20, which was higher than the initial examination of the first batch but significantly lower than the final examination results of the first batch (p < 0.005). Conclusion: This small experiment within the limited background proves that a short pretest on the lecture topic before lecture improves the lecture outcome. However, more elaborate experiments on a greater number of people with more convincing randomization are required to achieve a definite conclusion.

Comparison of lower limit of normal values with a fixed ratio assessed by spirometry in obstructive and restrictive lung diseases in Indian population

Background and Aim: Spirometric parameters are approximated by the normal distribution and using lower limit of normal (LLN) minimize the misclassification with fixed-ratio protocol in interpretation of spirometry results. This study investigates prevalence and characterization of obstructive and restrictive lung function impairments, and dissimilarities between two guidelines interpreting spirometry. Methods: This study was conducted to assess the lung function in students and patients ( n = 74) of MGM Medical College, Kishanganj, Bihar, between September 2012 and May 2014, using computerized Spirometer. Results: Forced vital capacity (FVC), forced expiratory volume in the 1st s (FEV1)/FVC, forced expiratory flow25-75% (FEF25-75%), peak expiratory flow rate (PEFR) were normally distributed with inflection at their mean ± standard deviation. FEF25-75%, and PEFR were higher in normal individuals compared to individuals with respiratory disease. FEV1/FVC were lower, and FVC were higher in obstructive disease while the reverse results were obtained in restrictive disease category. Restrictive disease by fixed-ratio was found with 55% negative predictive value (NPV) and 5% positive predictive value (PPV), while the normal cases by fixed-ratio criteria was found with 91% NPV and 15% PPV versus LLN criteria. There were 58 individuals with normal spirometries under the LLN method but a discrepant of only 12 fixed-ratio normal results. Concordance analysis by kappa statistics yielded a κ = 0.017. Conclusion: Older adults are more pulmonary susceptible. The performance of LLN criteria in differentiating respiratory diseases is better than the fixed-ratio criteria. Poor agreement exist between the fixed-ratio and LLN protocols in interpreting spirometric results. There is the difference between the LLN and fixed-ratio criteria which need to be redressed with population-specific reference values.

Comparative Study of Tricortical versus Quadricortical Syndesmosis Fixation in Ankle Fractures

Objective: To assess short-term functional results in 2 types of syndesmotic fixation, comparing the traditional rigid quadricortical syndesmotic screw fixation with a more dynamic tricortical screw fixation. Method: PATIENTS: Thirty nine patients (Age group: 20 to 50 yr) with closed ankle fractures in which the syndesmosis was found to be unstable clinically, radiographic and confirmed intra operatively. INTERVENTION: The unstable syndesmoses were fixed with either one cortical screw through both tibial cortices (n = 18) QSF or two cortical screws engaging only 1 cortex of the tibia (n = 21) TSF. The quadricortical and the tricortical screws were removed only in the case of discomfort. However, all quadricortical screws were removed at 6 month follow up. Rehabilitation was the same in both groups. DESIGN: Prospective, randomized single blinded clinical study. SETTING: Department of orthopaedics and traumatology MGM Medical College & M Y Hospital Indore. And G.R. Medical College & Jayarogya Hospital, Gwalior. Results: At the end of three months mean OM score was 65.35 (55 to75) For TSF group as compared to59.58 (55 to65) in QSF group. Mean values were similar between the two groups with respect to pain, swelling, support, running and jumping. The overall difference noted in two groups was due to difference in Mean value for functional parameter like stair climbing, Squatting and activities of daily living. At six months there was no significant difference in any parameter of OM score. Hence the overall scores were with non-significant difference {TSF76.42 (70 To 80) and QSF72.42 (65 to 80). A three months DID was 12.07 (9to17) in TSF and 9.75 (6to13) in QSF with significant difference in two groups. At six months difference was non significant 4.75 for TSF and 4.42 for QSF Group. The one set of tricortical screws and two Quadricortical were removed in patients due to infection. Quadricortical group was re-operated in 3 (16.66 %) cases for screw removal in case of

English

Objectives: To report the case of a huge benign ovarian tumour (Mucinous cystadenoma) in MGM medical college, Aurngabad. Patients: 19 years old female admitted in surgery. METHODS: The information was collected through Clinical examination, Ultrasonography, CT scan, blood investigations & Histopathological study of the specimen. RESULTS: The outcome was large ovarian mucinous cystadenoma. CONCLUSIONS: This case report gives information that although the condition is extremely rare, it is harmful when it's huge if not diagnosed and managed properly. Thogh the tumour is huge it is observed that excion of huge benign ovarian tumour gives good quality outcome to the patient.

LDH (Lactate Dehydrogenase): A Biochemical Marker for the Prediction of Adverse Outcomes in Pre-eclampsia and Eclampsia.

The aim of the study was to find out the role of Serum lactate dehydrogenase in prediction of adverse outcomes of PE & E i.e., severity of disease and occurrence of complications. This study was conducted in the Department of Obstetrics and Gynaecology, MGM Medical College, Indore. A total of 200 women were studied; they were divided into control (n=100), severe pre-eclampsia (n=32), eclampsia (n=68). Demographic and hematological parameters were studied including LDH levels. The incidence of severe pre-eclampsia-1.2% & Eclampsia 2.7%, PE & E patients were significantly younger, with low gravidity and parity. They had significantly increased systolic and diastolic pressure, liver enzymes, uric acid, urine albumin, and LDH levels. Serum urea and creatinine were normal in majority of cases. The symptoms and complications of PE along with perinatal mortality were increased significantly in patients with LDH >800IU/l compared with those who had lower levels. Complications like Retinopathy, ARF, Abruptio, DIC, CVA, MODS, Shock were also associated with high level of serum LDH >800IU/L. Low birth weight of babies was also associated with high level of serum LDH levels in PE & E patients. The incidence of poor perinatal outcome was higher in PE & E patients with high serum LDH level (>600IU/L). LDH is the earliest marker seen in blood during hypoxia and oxidative stress. It is a useful biochemical marker that reflects the severity of and the occurrence of complications of PE & E; these are preventable if identified at an earlier stage and adequately managed at a higher center. Test is easily available, so screening of all cases of PE & E with LDH levels must be made mandatory.

Study of diameter, length, tortuosity of splenic artery and its branches with its clinical implications

Background: Systematic knowledge of the splenic arterial vasculature would provide greater safeguards in the design of the surgical techniques but there are surprisingly few studies on the subject. For this reason, we studied morphological anatomy of splenic artery. Aims: To study morphological anatomy of splenic artery and clinical implications. The present study aims to report length, tortuosity, diameter of splenic artery and its branches. Material and Method: The measurements were taken on 50 donated embalmed cadavers irrespective of the sex in the Department of Anatomy, MGM Medical College, Navi Mumbai, Maharashtra. The findings were noted after dissection. The study was carried out between May 2009 to December 2012. Results: The mean length of splenic artery with tortuosity was 9.52 cm. The mean length of splenic artery without tortuosity was 12.76 cm. The splenic artery shows numerous tortuosities. The tortuosity decreases as the diameter increases. We found that superior polar branch was slender and thin can be easily damaged. To avoid this operation should start from inferior pole. The mean diameter of splenic artery was 5.144 mm that of superior ramus was 4.340 mm and inferior ramus was 3.760 mm. So we found weak inferior ramus supplying the lower pole of spleen. Due to which inferior pole was also supplied by additional branches. Conclusion: Knowledge of splenic artery has the clinical significance in planning and conducting procedures such as partial or total splenectomy, splenic aneurysm, splenic embolisation, splenography, surgical and radiological procedures of upper abdominal region to avoid any complications. Key words: splenic artery, length, diameter, tortuosity

Prediction of Stature Based on Foot Length

Background Estimation of body height from its segments or dismember parts has important considerations for identifications of living or dead human body or remains recovered from mass disaster or other similar conditions. Objective Stature is an important consideration in determining the identity. Our aim of the study was to investigate the relationship between foot length and body height and to derive a regression equation for stature estimation from foot length and to find out the correlation between body height and foot length. Methods The present study was conducted on 200 medical students of age group 18 to 23 years studying in MGM Medical College, Navi Mumbai, Maharashtra. India. Body height and foot length were measured in centimeter. All the measurements were taken by using standard measuring devices and standard anthropometric techniques. Results Correlation coefficients between stature and foot dimensions were found to be positive and statistically highly significant. Prediction of stature was found to be most accurate by multiple regression analysis. Conclusions In population similar to our subjects, stature and gender estimation can be done by using foot measurements and it will be helpful for Anatomists, Anthropologists and forensic experts to calculate stature based on foot length. DOI: http://dx.doi.org/10.3126/jonmc.v3i1.10058 Journal of Nobel Medical College Vol.3(1) 2014; 66-70

A comparative study to find out emotional quotient in students of MGM Medical College, Indore MP, India

Background: Emotional intelligence/Quotient (EI/EQ) is a concept including perception, expression and control of emotions, self-control and empathy, communication, conflict resolution process, conscience. Nowadays there is an increasing incident of patient complaints about doctor’s behaviour, care, interaction. This situation can easily be improved by increasing emotional intelligence. Aims & Objective: To assess emotional intelligence, to study the level of anger and correlating level of anger with EI and empathy in medical postgraduates. Materials and Methods: A cross sectional study was done on medical graduates & post graduates of various departments in the MGM Medical College & MY Hospital Indore using a pretested semi structured questionnaire. Data was analyzed using SPSS version 20. Results: 53.3% of P.G. students, 43.3% of pre-final students and 58.3% 1st prof students adjust their behaviour according to whom they are interacting with. 43.3% P.G. Students and 48.3% of 1st prof students gets nervous sometimes while 51.7% of pre-final students don’t get nervous without any reason. 9.6% of P.G. students, 10.4% of Pre-final students and 10.9% of 1st prof students had poor social awareness. 48.3% don’t get their thoughts never get negative further, while 41.7% of pre-final and 46.7% of 1stprof students disagree of getting negative thoughts. Conclusion: According to our study social awareness was found to be least in 1st prof students. P.G. students were found to have lowest self-awareness and lowest self-management.

Study of imprint smears of various lesions with histological correlation

Background: Imprint smear is simple and rapid technique for tissue diagnosis. Imprint is a touch preparation in which tissue is touched on the slide and it leaves behind its imprint in the form of cells on glass slide; studies are made after proper staining. Aims & Objective: (1) To evaluate utility of imprint smears as diagnostic modality; (2) To study the merits and pitfalls of imprint smears techniques in the diagnosis; (3) To correlate the findings of imprint smears with histopathological findings. Materials and Methods: This was a prospective study of 100 surgical specimens submitted in Department of Pathology, MGM Medical College, Indore. Smears obtained were stained with Papanicolaou Stain & studied. Results: Out of total 35 benign lesions, 32(91.4%) were diagnosed correctly and 03(8.6) was false negative. Out of total 65 malignant lesions 58 (89.2%) were diagnosed correctly, 07 (10.8%) were false negative. Conclusion: Imprint smear is rapid technique for diagnosis & can be utilized for adjuvant to histological diagnosis.

Role of scrape cytopathology in early diagnosis of neoplastic lesions and its histopathological correlation

Background: Scrape cytology is quick method to know difference between benign & malignant lesions hence aid in early diagnosis. This can in turn lead to quick management even intra operatively. This diagnostic discipline has arisen in parallel but much before contemporary histology. Aims & Objective: (1) To establish scrape cytology techniques as a routine procedure for diagnosis of surgical specimen; (2) To evaluate the diagnostic accuracy of scrape cytological techniques in the diagnosis; (3) To study the merits and pitfalls of scrape cytological techniques in the diagnosis; (4) Correlations of findings of scrape cytology with histopathological findings. Materials and Methods: This was a prospective study of 100 surgical specimens submitted in Department of Pathology, MGM Medical College, Indore. Smears obtained were stained with Papanicolaou Stain & studied. Results: Out of total 33 benign lesions, 31 (94%) were diagnosed correctly and 1 (3%) was false negative & 1 (3%) was not correlating well with histology. Out of total 67 malignant lesions 60 (89.6%) were diagnosed correctly, 2 (3.0%) were false negative and 5 (7.4%) did not correlated with histology. Conclusion: Scrape cytology is rapid technique for diagnosis & can be utilized in place of frozen section as well as adjuvant to histological diagnosis.

Association of serum Interlukin-6 and glycolysis in sickle cell disease patients

Background: Glycolysis, a major cytosolic oxidative pathway of glucose, is intended for the supply of energy in RBC and, moreover, for the production of 2,3 Bisphsophoglycerate through the Rapaport-Lubering shunt, which delivers oxygen more readily to the tissues. Interleukin 6 (IL-6) is a pro-inflammatory cytokine, playing a pivotal role in the inflammation process and mediating the acute phase process. Aim: This study aimed to investigate the association of the inflammatory parameter, serum IL-6, and glycolytic metabolism in the erythrocytes of sickle cell disease patients. Materials and Methods: This cross-sectional study was performed using a cohort of patients (90 sickle cell disease patients and 60 healthy age-matched controls) followed at the General Medicine Department of MGM Medical College, Indore. Glucose uptake, Hexokinase-2, pyruvate, lactate and 2,3 Bisphosphoglycerate levels were estimated in the RBC by relevant chemical kit methods on an autoanalyzer and enzyme-linked immunosorbent assay (ELISA), respectively. Serum IL-6 is estimated through the ELISA kit method. Statistical analysis was performed by using the Student's unpaired t test and Pearson's correlation test. P < 0.05 was considered statistically significant. Results: All glycolytic parameters were elevated along with IL-6 in sickle cell disease when compared with controls. A positive correlation was observed between the IL-6 level and glucose uptake (r = 0.345, P < 0.001), pyruvate (r = 0.512, P < 0.001) and lactate of RBC. Conclusion: This study shows that increased levels of plasma IL-6 might enhance the rate of glycolysis in RBC through the STAT3 pathway in sickle cell disease patients.

Dengue fever triggering systemic lupus erythematosus and lupus nephritis: a case report

We report a rare case of dengue fever triggering systemic lupus erythematosus and lupus nephritis. The patient presented herself during a large outbreak of dengue fever in December 2012 in Maharashtra, India. The diagnosis of dengue fever was confirmed by the presence of NS-1 antigen during the first few days of febrile illness. Eight weeks later, kidney tissue biopsy studies revealed evidence of lupus nephritis on microscopic examination and immunofluorescence. The report interpreted it as focal proliferative glomerulonephritis and segmental sclerosis (Stage IIIC). The case was also found positive for perinuclear antineutrophil cytoplasmic antibodies by indirect immunofluorescence assay. An active and effective management of a case essentially calls for clear perception of differentiating dengue-induced lupus flare, antineutrophil cytoplasmic antibody-related nephropathy, and/or dengue-induced de-novo lupus disease. Dengue viremia may be the trigger for immune complex formation in patients who are predisposed to developing autoimmune diseases. The present case explains the importance of considering the diagnosis of dengue-related lupus nephritis as an atypical occurrence in appropriate situations, as in this case. It would not be improper to regard this escalating disease as an expanded feature of dengue.

Weight does Matter! A Study of Effect of Obesity on Pregnancy and its Outcome

ABSTRACT Objectives To analyze the significant risk associated with obesity and its consequences on obstetrics management and perinatal outcome. Materials and methods A prospective study was carried out in the Department of Obstetric and Gynecology, MGM Medical College and My Hospital, Indore. The study enrolled 200 pregnant women with body mass index (BMI) &gt;25 and equal number of women with normal BMI (18-24.9) as control. Results A total of 76 (38%) out of 200 pregnant women were overweight, 70 (35%) were obese type 1 (BMI: 30-34.9), 44 (22%) had BMI (35-39.9) and 10 (5%) had BMI &gt;40. In comparison to normal BMI pregnant women, women with BMI &gt;25 had significant risk of gestation hypertension (p = 0.004), pre-eclampsia (p = 0.04) gestational diabetes mellitus and shoulder dystocia (p = 0.021), cesarean section (0.0001), induced labor (0.0001) and decreased incidence of VBAC (p = 0.037) with postoperative wound infection. Neonates of these women were mostly macrosomic (p = 0.021) and had high incidence of shoulder dystocia. Conclusion High maternal BMI at booking is associated with increased risk of pregnancy complications. Achieving a normal BMI prior to conception with the institution of healthy eating and exercise regimens may represent an ideal option. How to cite this article Dave A, Maru L, Daksha S, Natu N. Weight does Matter! A Study of Effect of Obesity on Pregnancy and its Outcome. J South Asian Feder Obst Gynae 2013;5(3): 107-110.