University Medical College Research Articles

Health Related Quality of Life of Thyroid Cancer Patients

Background: Having the longevity of thyroid cancer patients, any impairment in health-related quality of life (HRQOL) during the follow-up period is of great importance.
 Objective: The study was conducted to determine the health related quality of life of thyroid cancer patients. Material and methods: This cross sectional study was conducted among 246thyroid cancer patients. Data were collected by face-to-face interview and reviewing medical records with semi-structured questionnaire and checklist with validated scale. The subjects were purposively selected following specific selection criteria and maintaining ethical issues.
 Place and period of study: The study was conducted during the period from July 2018-June 2019 in two tertiary hospitals of Dhaka city: Bangabandhu Sheikh Mujib Medical University and Dhaka Medical College Hospital, Dhaka.
 Results: This study revealed that majority (74.4%) of respondents was female, married (72%), housewife (61.4%), rural respondent (41.1%) and had primary education (69%). Mean (± SD) age of the respondent was 37.85(±12.20) years (range 14-70 years) and mean (± SD) monthly family income was Tk.17681(±10602). Out of 246 cases, 204 (82.9%) was papillary and 42 (17.1%) was follicular carcinoma. Main presenting features were neck swelling (91.5%), swollen lymph node (41.9%), dysphonia (57.3%) and dysphagia (35.4%). Mean (± SD) of total HRQOL score was 73.7 ± 8.39. HRQOL score of students and higher educated patients were better among the respective groups (p <.001). The study showed the association of HRQOL with clinical condition of thyroid cancer patients (R2=.025). HRQOL revealed the strong prediction with education (β=-0.888, p<.05), family income (β=0.05, p<.05), marital status (β=-0.1.384, p<.05), clinical condition (β=-0.522, p<.05) and perceived stress (β=-0.632, p<.001).
 Conclusion: The overall HRQOL score was considerably good in this study. Timely detection, regular motivation and attending clinical condition may significantly improve the HRQOL of thyroid cancer patients
 JOPSOM 2019; 38(2): 1-8

Study on the Application of A New Type of Anhydrous Thoracic Negative Pressure Drainage Device in Patients after Thoracic Surgery

背景与目的胸外科术后常规会放置胸管行闭式引流排出胸腔内积气、积液促进肺复张，并且可以观察术后是否有活动性出血，是否有肺漏气现象。常规胸腔闭式引流外接水封瓶，通过观察引流情况、水柱波动来判断病情，是非常经典的方法。但是水封瓶有易倾覆、携带不便等缺点，不利于患者早期活动。在加速康复的理念下，本中心应用了新型无水胸腔负压引流装置，并取得了较好的效果。本研究旨在观察新型无水胸腔负压引流装置在胸外科术后患者中的应用效果。方法回顾性分析2018年1月-2019年12月在浙江大学医学院附属第一医院胸外科行肺部手术的患者，分成两组，一组患者使用传统胸腔闭式引流水封瓶作为对照组，另一组使用新型无水负压引流瓶作为实验组。统计患者的性别、年龄、高血压、糖尿病、吸烟史、手术切口和手术方式以及患者在院时间和术后住院时间。结果两组患者在年龄、性别、合并症（高血压、糖尿病、吸烟史）、手术范围、手术时间方面并无统计学差异，但是两组患者在手术使用切口方面存在着统计学差异（P=0.01）。使用新型无水负压引流器的患者无论在术后住院时间以及总住院时间方面都比有水负压引流器的患者短，差异有明显统计学意义（P=0.02, P=0.04）。结论新型无水胸腔负压引流装置对于胸外科术后快速康复推进有较好的作用。

Histopathological study of prostatic lesions in a tertiary care hospital

Background: Prostate is an important organ of male reproductive system which surrounds the urethra. Most frequently encountered diseases affecting prostate are the inflammatory lesions, Benign prostatic hyperplasia and Prostatic cancer. Our objective of study was to study various histopathological patterns of prostatic lesions Materials and Methods: It was an observational study conducted in Pathology Department of Bharati Vidyapeeth Deemed to be University Medical College and Hospital, Sangli in the period of December 2016- June 2018. The specimens that we received were of transurethral resection of prostatic (TURP) chips, simple prostatectomy specimens and radical prostatectomy. A questionnaire was to get the necessary details of the patient. Microsoft Word and Excel were used to generate graphs and tables. Results were presented as number and percentage for qualitative data. Results: The present study included 149 prostatic specimens. Total 4394 specimens received in the histopathology section 3.39 % were the prostatic specimens. TURP was done in 144 cases, needle biopsy was done in 3 cases and total prostatectomy was done in 2 cases. Conclusion: Histopathological study of the prostatic lesions plays an important role in diagnosis, treatment and prognosis of the patient. Early diagnosis and treatment help to reduce mortality and morbidity due to prostatic lesions. Along with the screening protocols, immunohistochemistry and molecular genetic analysis should be done and awareness programs should to be carried out. Keywords: Prostate, Transurethral resection of prostate, Benign prostatic hyperplasia, Prostatitis, Carcinoma prostate, Modified Gleason scoring system.

Heat map visualization for electrocardiogram data analysis

BackgroundMost electrocardiogram (ECG) studies still take advantage of traditional statistical functions, and the results are mostly presented in tables, histograms, and curves. Few papers display ECG data by visual means. The aim of this study was to analyze and show data for electrocardiographic left ventricular hypertrophy (LVH) with ST-segment elevation (STE) by a heat map in order to explore the feasibility and clinical value of heat mapping for ECG data visualization.MethodsWe sequentially collected the electrocardiograms of inpatients in the First Affiliated Hospital of Shantou University Medical College from July 2015 to December 2015 in order to screen cases of LVH with STE. HemI 1.0 software was used to draw heat maps to display the STE of each lead of each collected ECG. Cluster analysis was carried out based on the heat map and the results were drawn as tree maps (pedigree maps) in the heat map.ResultsIn total, 60 cases of electrocardiographic LVH with STE were screened and analyzed. STE leads were mainly in the V1, V2 and V3 leads. The ST-segment shifts of each lead of each collected ECG could be conveniently visualized in the heat map. According to cluster analysis in the heat map, STE leads were clustered into two categories, comprising of the right precordial leads (V1, V2, V3) and others (V4, V5, V6, I, II, III, aVF, aVL, aVR). Moreover, the STE amplitude in 40% (24 out of 60) of cases reached the threshold specified in the STEMI guideline. These cases also could be fully displayed and visualized in the heat map. Cluster analysis in the heat map showed that the III, aVF and aVR leads could be clustered together, the V1, V2, V3 and V4 leads could be clustered together, and the V5, V6, I and aVL leads could be clustered together.ConclusionHeat maps and cluster analysis can be used to fully display every lead of each electrocardiogram and provide relatively comprehensive information.

Long-term results of a hearing test in patients operated for chronic otitis media.

<b> Introduction: </b>Chronic otitis media is characterized by tympanic membrane perforation and conductive hearing loss. In the active form of this disease, there will also be periodic or permanent otorrhea. With a number of surgical techniques available depending on intraoperative findings, otosurgery is the treatment of choice in such cases, the extent of which depends on the type and extent of the pathological changes. <br><b>Material and Method:</b> We carried out an analysis of 79 patients with chronic otitis media undergoing surgery at the Department of Otolaryngology, Jagiellonian University Medical College in Kraków between 2005 and 2014. Total audiometry was used as a part of hearing assessment, before the surgery, 6 months after the surgery and in the distant 10-year observation period. In addition, each patient completed the questionnaire and was examined by an otolaryngologist. <br><b> Results:</b> The analysis included 79 patients operated on due to chronic otitis media. The mean bone conduction (for frequencies 500,1000 and 2000 Hz) before surgery was 31.8 dB, it did not differ significantly (p = 0.355) after 6 months after surgery (32.8 dB), while it significantly increased (p < 0.001) in a distant 10-year control of 43.4 dB. The mean air conduction (for frequencies 500, 1000 and 2000 Hz) before the procedure was 57.6 dB, it significantly improved in the early control by 50.5 dB, at p < 0.001. In long-term follow-up it increased again to 61.3 dB and was significantly different from the early postoperative period (p < 0.001). The mean air-bone gap for frequencies 500, 1000 and 2000 Hz before surgery was on average 26.4 dB, it was significantly (p < 0.001) reduced in the postoperative period by 17.6 dB. The level of air-bone gap remained at a similar level in distant control. <br><b>Conclusions:</b> (1) A completely preserved ossicular chain in the absence of active chronic otitis media is the best prognosis for stable hearing improvement over the years with normal inner ear function; (2) Reoperation worsens the long-term results of a hearing test compared to the first operation.

Early clinical response to a high consequence infectious disease outbreak: insights from COVID-19.

Early clinical response to a high consequence infectious disease outbreak: insights from COVID-19.

A single center study on antimicrobial use and bacterial resistance in burn ward

Objective: To investigate the effect of antibiotics on bacterial resistance through analyzing the use of common antibiotics and the bacterial prevalence in single-center burn ward. Methods: The epidemiological data of pathogenic bacteria and the use of common antibiotics in burn ward of Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College was investigated in the past 9 years. Bacteria samples were collected from the wounds, catheters, blood, feces, urine and sputum of inpatients in the unit from January 2010 to December 2018. The antibiotics use density was calculated by defined daily doses (DDDs)/(1 000 patient-days). Results: (1) In the proportion of bacteria detected, Staphylococcus aureus was the first and sensitive to glycopeptide antibiotics. Klebsiella pneumonia (19.8%), Pseudomonas aeruginosa (11.9%) and Acinetobacter baumannii (11.5%) were the top three Gram-negative bacteria in 2018; the proportion of Klebsiella pneumoniae was significantly increased (R(2)=0.861, P<0.001). (2) The Pseudomonas aeruginosa resistance rate to ceftazidime (R(2)=0.447, P=0.049) and ciprofloxacin (R(2)=0.663, P=0.008) increased significantly. The Klebsiella pneumoniae resistance rate to piperacillin (R(2)=0.999, P=0.018), meropenem (R(2)=0.999, P=0.023), ciprofloxacin (R(2)=1.000, P=0.010) increased significantly. There was no significant trend in the Acinetobacter baumannii resistance rate. (3) The use density of meropenem increased significantly (R(2)=0.492, P=0.035), and that of ciprofloxacin decreased significantly (R(2)=0.572, P=0.018). (4) Carbapenems use density was positively correlated with resistance rate of Klebsiella pneumoniae to cefoperazone sulbactam (r=0.733, P=0.025), piperacillin tazobactam (r=0.684, P=0.042), cefuroxime (r=0.821, P=0.023), ceftazidime (r=0.741, P=0.022), imipenem (r=0.718, P=0.029), meropenem (r=0.690, P=0.040), amikacin (r=0.750, P=0.020). (5) Ciprofloxacin use density was negatively correlated with the Pseudomonas aeruginosa resistance rate to ceftazidime (r=-0.751, P=0.020), Ciprofloxacin (r=-0.873, P=0.002) and with the Klebsiella pneumoniae resistance rate to cefuroxime (r=-0.767, P=0.044), ceftazidime (r=-0.712, P=0.031), imipenem (r=-0.780, P=0.013), meropenem (r=-0.793, P=0.011), ciprofloxacin (r=-0.871, P=0.002), Sulfamethoxazole/trimethoprim (r=-0.793, P=0.011). Conclusion: Carbapenems can induce Klebsiella pneumoniae to be multiple drug resistance; through the relationship between ciprofloxacin use intensity and drug resistance, the strategy of only restricting a certain antimicrobial agent may not restore the bacterial sensitivity.

Provisional guidelines on autopsy practice for deaths associated with COVID-19

COVID-19 has been included in Category B infectious diseases and is prevented and controlled according to Category A infectious diseases. In order to establish a diagnosis or conduct further research, a post-mortem examination may be desired on a possible COVID-19 death. To guide the personnel engaged in the autopsy to carry out the correct operation, and ensure the safety of the pathologists and disease control staffs during the epidemic, the Chinese Pathological Society, the Chinese Pathologist Association and the Pathology and Pathophysiology national key discipline at Shantou University Medical College, formulated this guidance for the autopsy for deaths associated with COVID-19 during the prevention and control period of COVID-19 in China.

Clinical impact of cardiovascular disease on patients with bronchiectasis

BackgroundPatients with bronchiectasis have a higher cardiovascular risk than their matched controls. However, the effect of cardiovascular (CV) disease on bronchiectasis remains unclear. Thus, we aimed to investigate the clinical impacts of cardiovascular disease on adult patients with bronchiectasis.MethodsThe study cohort comprised 603 consecutive inpatients diagnosed with bronchiectasis in the Affiliated Yancheng Hospital of Southeast University Medical College (Jiangsu, China) from January 2014 to December 2017. Symptoms, bacterial cultures, blood biochemical indicator levels, and chest high-resolution computed tomography scans were assessed during their initial hospitalization for bronchiectasis. Three hundred and thirty five subjects finished 1 year follow-up after their hospital discharge.ResultsThree hundred thirty five patients had at least one bronchiectasis exacerbation during the 1-year follow-up period. Patients with CV comorbidities were more likely to present with symptoms of wheezing (65.3%) and had a higher levels of brain natriuretic peptide (P < 0.001) and D-dimer (P < 0.001) than those without CV comorbidities. Independent risk factors associated with bronchiectasis exacerbations were the presence of comorbidities of cardiovascular diseases (odds ratio [OR] 2.503, 95% confidence interval [CI] 1.298–4.823; P = 0.006), the isolation of Pseudomonas aeruginosa (OR 2.076, 95% CI 1.100–3.919; P = 0.024), and extension to more than two lobes (OR 2.485, 95% CI 1.195–5.168; P = 0.015).ConclusionThe existence of cardiovascular disease was independently associated with increased bronchiectasis exacerbation.

Small for gestational age is a risk factor for thyroid dysfunction in preterm newborns

BackgroundThyroid hormones play an important role in the normal growth and maturation of the central nervous system. However, few publications addressed the altered thyroid hormone levels in preterm small for gestational age (SGA) newborns. We hypothesized preterm SGA infants have higher thyroid-stimulating hormone (TSH) concentrations than appropriate for gestational age (AGA) ones within the normal range and an increased incidence of thyroid dysfunction.MethodsThe study was designed to compare thyroid hormone levels within the normal range and the incidence of thyroid dysfunction in the SGA and AGA groups to test the hypothesis. The medical records of all preterm infants admitted to the neonatal intensive care unit (NICU) at the First Affiliated Hospital of Shantou University Medical College, Shantou, China, between January 1, 2015 and December 31, 2018, were reviewed. Blood samples were collected between 72 and 96 h of life and analyzed with TSH, free thyroxine (FT4) and free triiodothyronine (FT3) assays. Thyroid function test (TFT) results, and neonatal demographic and clinical factors were analyzed to identify the associations between SGA birth and altered thyroid concentrations and thyroid dysfunction.ResultsTSH and FT4 concentrations were significantly higher in the SGA group than the AGA group ((3.74(interquartile range (IQR):2.28 ~ 6.18) vs. 3.01(IQR: 1.81 ~ 5.41) mU/L, p = 0.018), and (17.76 ± 3.94 vs. 17.42 ± 3.71 pmol/L, p = 0.371), respectively). The higher TSH levels were associated with being SGA or Z-score of birth weight (BW) for GA after adjusting for potential confounders ((βSGA = 0.68 (95% confidence interval (CI) 0.15 ~ 1.21), p = 0.013) or (βZ-score = − 0.25 (95%CI -0.48 ~ − 0.03), p = 0.028), respectively). However, we did not find a significant association between SGA birth and altered FT4 concentrations. Furthermore, compared with the AGA group, the SGA group presented an increased incidence of transient hypothyroxinemia with delayed TSH elevation (dTSHe), a higher percentage receiving levothyroxine (L-T4) therapy, and a higher rate of follow-up within the first 6 months of life.ConclusionsPreterm SGA newborns had significantly higher TSH concentrations within the normal range and an increased incidence of thyroid dysfunction. The SGA newborns with these features should be closely followed up with periodical TFTs and endocrinologic evaluation.

The diagnosis and phacoemulsification in combination with intraocular lens implantation for an Axenfeld\u2013Rieger syndrome patient with small cornea: a case report

BackgroundAxenfeld-Rieger syndrome (ARS) is a congenital disease with a series of developmental abnormalities, and no case of ARS with cataract and small cornea has been reported in previous studies. In the present report, we aimed to describe the diagnosis and phacoemulsification of an ARS patient with small cornea.Case presentationA 58-year-old Han Chinese male patient who was referred to Eye Center of the Second Affiliated Hospital of Zhejiang University Medical College was diagnosed with ARS. Systemic and ophthalmic examination and genetic testing were performed. The slit-lamp microscopic examination of anterior segment showed obvious nuclear cataract, iris lesions, and the abnormal cornea of both eyes with small transversal and longitudinal diameters. ARS with bilateral complicated cataract and small cornea was diagnosed. Microincision-phacoemulsification in combination with intraocular lens implantation was performed on his left eye. After successful surgery of his left eye, the best-corrected visual acuity (BCVA) was obviously improved from 2 to 0.5 (LogMAR). A transient elevation of intraocular pressure (IOP) was controlled with medication.ConclusionsThrough genetic testing, a known pathogenic mutation NM_153427.2:c.272G > A was detected on the PITX2 gene; and an unknown mutation NM_001453.2:c.1063C > T was detected on FOXC1 gene. For the ARS patient with complicated cataract, the visual acuity was increased by phacoemulsificasion in combination with microincision.

Factors Influencing Cervical Spondylosis

Background: Cervical spondylosis is a degenerative disorder of cervical spine prevalent in our population. The disease advances insidiously resulting in worsening with time. This study aims to highlight the factors influencing cervical spondylosis. Methods: The present case control study was conducted at orthopedic OPD (Out Patient Department) and Radiology department of the Patel hospital from September 2018 to February 2019 after acquiring ethical approval from Ethical Review Committee (ERC) of Bahria University Medical and Dental College and Patel Hospital. The study enrolled 88 cases suffering from cervical spondylosis based on history and clinical examination and 88 controls i.e., healthy attendants. The radiography of cervical spine was used to assess degenerative changes of cervical spine. They were asked basic history entailing age, gender, working hours, nature of job, use of computers, mobiles. The independent t-test was used for comparison between these variables, and Fischer exact test and Chi square test was employed to find association between them. Results: The study revealed a significant preponderance of females (56.8%) with shorter stature (159.14±8.88) in patients. There was a predilection for cases in outdoor workers (44.3%) and homemakers (43.2%) as well as increased working hours (73.9%). The mobile use had a significant impact (59.1%) on disease. Conclusion: Considering factors like Middle Ages, females, short stature, obesity, outdoor workers and house workers with increased working hours and use of mobiles for more than 4 hours can influence development of cervical spondylosis. One can intervene in the progression of disease by adopting healthy lifestyle to prevent it.

Effect of ABO Blood Groups on the Response to Warfarin

BackgroundNumerous studies have demonstrated that patients with non-O blood groups have a higher risk for venous thromboembolism than those with the O blood group. However, the effect of ABO blood groups on warfarin dose requirements in patients receiving anticoagulation in the Chinese Han population remains unknown. This study aimed to investigate the influence of ABO blood groups on warfarin dose requirements in a Chinese Han population. Material and MethodsA retrospective study was conducted in the First Affiliated Hospital of Shantou University Medical College in South China. Three hundred and fifty-eight patients with a confirmed diagnosis of deep vein thrombosis or atrial fibrillation were included. The frequency of blood groups and warfarin dose requirements were determined. ResultsOf 358 patients with deep vein thrombosis or atrial fibrillation, 111 patients had blood group A (31.01%), 104 patients had blood group B (29.05%), 20 patients had blood group AB (5.59%) and 123 patients had blood group O (34.36%). The patients in the O blood group had lower warfarin dose requirements than those in the A, B and AB blood groups. ConclusionsOur study showed that patients with non-O blood groups require higher doses of warfarin.

Meet the First Author.

Meet the First Author.

3D Printing Technology Improves Medical Interns' Understanding of Anatomy of Gastrocolic Trunk

Complex vascular anatomy has always been a difficult point for medical students. Gastrocolic trunk (Henle trunk) has many branches and variations, involving the venous reflux of the stomach, right colon, and pancreas. This study investigated the effects of 3 dimensional (3D) printing technology on medical interns' understanding of Henle trunk's variation, by comparing 2 dimensional (2D) images. Henle trunk modes were manufactured using 3D-CT angiography and 3D-printing technology. Forty-seven interns from 2 medical schools (Nanjing Medical University and Medical College of Nantong University) participated in the study. The interns were divided randomly allocated into 2 groups, where group 1 was the control group with a 2D image of Henle trunk plus surgical video (named 2D image group), and group 2 was the study group with a 3D printed model of Henle trunk plus surgical video (named 3D-printing group). Knowledge of interns on the Henle trunk was compared between 2 groups using a question test before and after the teaching intervention. All interns had an improved overall assessment score as a result of attending the seminar, whether in the 2D image group or the 3D-printing group. The score of the 2D image group increased 32.57 ± 13.86, and the 3D-printing group increased 47.04 ± 12.99, showing significant difference (p = 0.001). There was no significant difference observed between postseminar scores between 2 medical schools (p = 0.975). There was a significant improvement in satisfaction among the 3D-printing group for education depth, novel and inspiring of teaching method, except for the interaction between teacher and interns (p = 0.215). Interns hope to have more teaching time for 3D printing, and not satisfied with the time of 3D printing teaching compared with those in the 2D image group (p = 0.021). The 3-D printed Henle trunk model is a very effective teaching tool, which can help interns understand the anatomy of Henle trunk. The application of 3D printing technology in the teaching of interns of complex vascular anatomy is worth popularizing in teaching hospitals.

Assessment of Knowledge and Attitude towards Hepatitis B Infection Among Dental Students in two Teaching Hospitals of Punjab, Pakistan

Objective: To evaluate the knowledge and attitude of dental students towards hepatitis B infection. Study Design: A Cross Sectional Study (survey). Settings: University Medical & Dental College Faisalabad and FMH College of Medicine and Dentistry Lahore. Duration: Two months from February 1 to March 31, 2018. Methodology: A structured questionnaire consisted of total 27 open and closed ended questions were distributed among 200 first year and final year BDS students. The aim of questionnaire was to assess knowledge and attitude towards hepatitis B infection. The questions were divided into three different sections; Section A: Demographic Detail; Section B: Knowledge Questions and Section C: Attitude Questions. Results: Out of 200 distributed questionnaires 191 (95.5%) were collected and analyzed. The most of the participants were females 149 (78%) students and the number of male students was only 42 (22%) with male to female ratio 1:3.5. The age of the participants ranged from 17-25 years (mean age: 21.4 years). Among 191 participants 99 (52%) students were from first year BDS class and 92 (48%) from final year BDS class. The majority of study participants (73%) had adequate knowledge on hepatitis B infection and its mode of transmission. However, results revealed that there are still misinterpretations regarding the attitudes of participants towards hepatitis B infected patients and only 44% participants have adequate concept regarding this. Conclusion: The results of this study showed that the overall level of knowledge about hepatitis B infection among the first year and final year BDS students is fairly satisfactory. However, there are still misconceptions regarding the attitudes, which reflect the wrong impression of the disease among students. This calls for well-structured health education programs stressing on such misconceptions.

THE RELATIONSHIP BETWEEN SERUM RHOA AND MIR-133B IN ACUTE ISCHEMIC STROKE

02Mar 2020 THE RELATIONSHIP BETWEEN SERUM RHOA AND MIR-133B IN ACUTE ISCHEMIC STROKE Yong-Peng Yu , Ya-Li Zheng , Ting-Hong Yu , Jia-He Bai and Ting-Ting Jiang Yongpeng Yu Innovation Studio and Department of Neurology, the Affiliated Weihai Central Hospital of Qingdao University and Weifang Medical College, Weihai, Shandong, 264400.

Prevalence and Perceived benefits of energy drink Consumption in medical students

Background: To assess the energy drink consumption patterns and perceived risks and benefits among medical students. The present study was carried out on 332 medical students from Foundation University Medical College. All the students enrolled in foundation university medical college were invited to participate. 332 students, who gave their consent were enrolled in the study. Data was collected by distributing a preformed structured questionnaire among medical students present in their classes. Data was entered and analyzed on SPSS version 17. Results: Out of 332 students 307 (92.5%) said that they were familiar with energy drinks whereas 212 (63.9%) admitted to consuming energy drinks. sting and the red bull came out to be the most popular brands. 78 (36.7%) students said mental awareness to be the main motivator for energy drink consumption. The majority (94.3%) of the study population were aware of the untoward effects of energy drinks experienced. The most common of them was insomnia, students (49.05%) experienced it. 91 (42.92%) of the students said that their parents don’t object to their taking of these drinks. Conclusion: Although the consumption of energy drinks was common among medical students, the knowledge of ingredients and health risks of energy drinks among them was unsatisfactory. Keywords: Energy drink, Medical students, Caffeine, Frequency of consumption.

Risk factors for gestational diabetes mellitus: A prospective case-control study from coastal Karnataka

BackgroundIdentification of gestational diabetes mellitus (GDM) risk factors is pertinent, for it can be an effective intervention for its prevention. As previous information regarding GDM risk factors from India were mostly descriptive and scarce from coastal Karnataka, a current prospective case-control study was designed to identify GDM risk factors among pregnant women seeking antenatal care. MethodsA hospital-based prospective matched case–control study was carried among antenatal subjects seeking routine antenatal care at two secondary-level care private hospitals, affiliated to a University Medical College in coastal Karnataka. It comprised of 100 incident GDM cases and 273 frequency-matched controls. Data was collected by personal interviews using a pretested questionnaire. Data was entered and analyzed using Statistical Package for Social Sciences(SPSS), version 15.0. ResultsRisk factors using Carpenter and Coustan criteria and DIPSI criteria were found similar. Pooled data identified following significant GDM risk factors: marital age (25–29 years)(adjusted OR:18.2; 95% CI:1.9–177.6; p= 0.012), delayed menarche (adjusted OR:11.4; 95% CI:1.1–124.6; p=0.045), multiparity (adjusted OR:14.1; 95% CI:1.8–109.8; p=0.011), family history of DM (adjusted OR:66.6; 95% CI:6.9–645.2; p < 0.001), high maternal perceived stress (adjusted OR:21.6; 95% CI:1.9–248.8; p=0.014, less physical activity (adjusted OR:21.0; 95% CI: 2.8–158.8; p=0.003), and low intake of green leafy vegetables (GLV)(adjusted OR:41.7; 95% CI:3.7–472.4; p=0.003). Positive current polyhydramnios and recurrent vaginal infections were also identified as significant risk factors (p<0.05). ConclusionsModifiable risk factors identified were low physical activity, high antenatal perceived stress, multiparity, marital age ≥25 years, and low pre-pregnancy intake of GLV, which were also comparable using two criteria in vogue for GDM diagnosis. Pre-conception advice on healthy lifestyle may prove beneficial.

Evaluation of pre-operative clinical finding and per-operative assessment of carcinoma stomach in tertiary settings of Bangladesh

Background: Carcinoma stomach, a major killer cancer all over the world, is still presenting late in developing countries due to delay in early diagnosis, lack of awareness, infrastructure etc.&#x0D; Objectives: To establish the importance of preoperative evaluation on operability of carcinoma stomach.&#x0D; Methods: Sixty clinically and histopathologically diagnosed ca stomach cases who underwent surgery in department of Bangabandhu Sheikh Mujib Medical University, Dhaka, and Dhaka Medical College Hospital, Dhaka in 2011 were assessed with clinical picture, investigations, preoperative evaluation and peroperative findings were recorded. Z test for proportion was used to assess clinical decision predictability with a p value of :s;0.05 as significant.&#x0D; Results: Male (73.33%) predominant with 2.75:1 male:female ratio was observed. Mobility, fixity and abdominal lymphadenopathy were not well detected through clinical assessment (p=0.001) while ascites, metastasis and Shelf of Slummer were similar in both clinical and operative finding. The endoscopy of upper GIT finding gave a unique picture as the findings were almost same as were found during operation. USG detected a lesser proportion of the clinical condition compared to peroperative condition whereas CT performed better than the USG except for the lesion detection. Though Computed Tomography (CT) detected higher percentage of lesion, metastasis, ascites and lymph node involvement compared to ultrasonogram (USG), it was significantly higher only for lesion detection (p=0.002) and lymph node involvement (p=&lt;0.001). In the similar manner USG assessment of lesion detection (p=&lt;0.001) and lymph node involvement (p=0.003) was significantly low compared to operative finding. When we looked between CT and operative finding only lesion detection was significantly low (p=0.01) indicating CT to be most effective predictor of clinical picture for operative decision. Preoperative plan were mostly not in accordance with peroperative decision except for total gastrectomy.&#x0D; Conclusion: The study indicates weakness in clinical detection and pre-operative plan compared to per-operative finding. Hence combination of clinical feature and investigation tools especially endoscopy of upper GIT combined with CT is recommended to predict a better operative decision.&#x0D; Journal of Surgical Sciences (2018) Vol. 22 (1): 43-46