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   Table of Contents - Current issue
Coverpage
July-December 2019
Volume 4 | Issue 2
Page Nos. 53-112

Online since Thursday, January 9, 2020

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EDITORIAL  

Hypoxia, Nobel Prize 2019 in Physiology or Medicine and Nanduri R. Prabhakar Highly accessed article p. 53
Kusal K Das, Shashi Bala Singh
DOI:10.4103/bjhs.bjhs_76_19  
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REVIEW ARTICLE Top

Preanalytical requirements: Focus on urine culture p. 55
Sunite A Ganju, Neeraj Kumar Ganju
DOI:10.4103/bjhs.bjhs_26_19  
In a microbiology laboratory, the urine cultures rank among the major tests ordered by doctors. Urine culture using both automated and traditional manual methods are commonly used. The health-care services delivered in India are mainly patient-centered, and laboratory services are under increasing pressure to deliver test results within the stipulated time. Naturally, quality control methods have mainly focused attention only toward analytical aspects of the total testing process (TTP). The TTP includes the preanalytical, analytical, postanalytical phases, and laboratory errors can occur at any stage of the TTP. However, errors in the preanalytical phase are generally overlooked and as many as 46%–68.2% errors can occur. This paper reviews the sources of error in preanalytical phase of urine culture and steps to minimize such errors, which are crucial for laboratory diagnostics and patient safety.
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ORIGINAL ARTICLES Top

Stability study of Kumari (Aloe vera [L.] burm.) Swarasa (juice) with respect to baseline microbial diagnostic modalities p. 60
Pravin Jawanjal, MS Cholera, Prashant Bedarkar, BJ Patgiri
DOI:10.4103/bjhs.bjhs_50_19  
BACKGROUND: Swarasa, one of the most popular Kalpana among five basic Kalpana, is widely used therapeutically as well as pharmaceutically. A clear description of Swarasa is available in all Samhitas regarding its preparation, and utility. AIMS: This study aims to carry out the stability of Kumari Swarasa with respect to its microbial profile. MATERIALS AND METHODS: Sample of Kumari Swarasa was prepared and studied to check microbial contamination at regular intervals. RESULTS: Five samples were subjected to the microbiological study from the date of the preparation to the date of last microbiological study. No, any contaminations were found in the microbiological study in the range of minimum of one day and a maximum of three days after preparation of sample. DISCUSSION: Hence, the present study was carried out to observe the stability study of Kumari Swarasa with respect to microbial contamination of samples prepared and preserved in different climatic and temperature conditions. Thus, a baseline microbial profile was studied at regular intervals. At the end of the study, it was found that shelf life of Aloe vera juice was varied as per humidity and temperature. CONCLUSION: The microbiological study of Kumari Swarasa shows its stability in the range of a minimum of one day and maximum of three days after the preparation of the sample.
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Anthropometric and Biochemical Profile of young adults of age group 20-45 years diagnosed newly with type 2 diabetes mellitus at Dr. Prabhakhar Kore Hospital and Medical Research Centre, Belagavi p. 66
Harpreet Kour, VA Kothiwale, Shivaprasad S Goudar
DOI:10.4103/bjhs.bjhs_25_19  
BACKGROUND AND OBJECTIVES: Diabetes mellitus, the most common endocrine disorder is characterized by metabolic abnormalities Indiais the second most populated country and presently has the largest share of the adult population in the world. The batteries of papers have reported the increased prevalence of obesity and type 2 diabetes mellitus in the adult population. So it is important to know more about this population, as the early diagnosis will help to develop better strategies for the prevention and management of a disease. Thus the present study has been undertaken to evaluate anthropometric and biochemical parameters in young adults diagnosed newly with type 2 diabetes mellitus. METHODS: A total of 148 patients of age group 20-45 years with newly diagnosed T2DM were enrolled in the study as per eligibility criteria. The normal healthy controls (n-=74) were also enrolled to see the baseline difference. Socio-demographic, Anthropometric and Biochemical parameters were evaluated. RESULTS: The study population consisted of adult subjects aged 20-45 years newly diagnosed with T2DM In the present study, most of the diabetics belonged to the overweight and obese category with impaired biochemical parameters.
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Sociodemographic and clinical profile of children with autism spectrum disorders – An observational study from a tertiary care hospital p. 72
Bilal Ahmad Bhat, Arshad Hussain, Wasim Qadir, Shabir Ahmad Dar
DOI:10.4103/bjhs.bjhs_18_19  
BACKGROUND: In spite of advances in assessment and management of patients with autism spectrum disorders (ASDs) in the west, developing countries including India are lagging far behind in child psychiatry, let alone ASDs. The aims of our study were to find the sociodemographic and clinical profile of children with ASDs in a child psychiatry clinic of a tertiary care hospital. MATERIALS AND METHODS: A semi-structured questionnaire was used to record the sociodemographic status. The diagnosis of ASDs was made on the basis of both 4th Edition, Text Revision and 5th Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR and DSM-V), after a thorough clinical assessment. Intelligence quotient was assessed by a clinical psychologist. Descriptive statistical analysis was done and presented as frequencies and percentages. RESULTS: A total of 55 patients were diagnosed with ASDs. Most of the patients were <9 years with 52.73% in 4–7 years' age group and 21.82% in 7–9 years' age group. Males (78.18%) outnumbered females. About 52.73% belonged to nuclear family, and 63.63% were from rural background. Nearly 70.91% were staying at home. About 87.27% with ASDs as per DSM-IV-TR met the DSM-V symptom criteria for ASDs, whereas 12.73% met DSM-V symptom criteria for social communication disorder. CONCLUSION: Almost 10.4% of children and adolescents with psychiatric disorders were having ASDs. Only 3% of our cases were receiving inclusive education, and about 70% of cases were staying at home. Nearly 87.27% of DSM-IV-diagnosed ASDs retained the DSM-V diagnosis of ASDs. Comorbid intellectual disability was frequently seen in children with ASDs.
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Work-related musculoskeletal disorders of tribal female Sal leaf platemakers: An unperceived issue p. 78
Sasangbaha Mandi, Piya Majumdar, Subhashis Sahu,
DOI:10.4103/bjhs.bjhs_38_19  
BACKGROUND: Industrialization and globalization produce a threat to the traditional livelihood of the indigenous population. A large number of tribal people in Asia are engaged in small-scale forest-based industries. Sal leaf platemaking is a common occupation among most tribal women in the Eastern part of India. However, occupational health problems of the women engaged in this job are hardly reported so far. MATERIALS AND METHODS: This study was carried out on 400 female workers engaged in Sal leaf platemaking units and 100 tribal female homemakers were considered as a referent. Modified Nordic Questionnaire and body part discomfort rating scale were applied for finding reported pain. The working postures were evaluated by rapid entire body assessment, rapid upper limb assessment, and Ovako Working Posture Analysis System (OWAS) methods. RESULTS: The findings emphasize that the Sal leaf platemakers complaints about different musculoskeletal problems. They have to go to the nearby forest (2–3 km far) by foot for 3–4 days per week for collecting the Sal leaves and carry it to their home for making of plates. They spend 4–6 hour daily in making Sal leaf artifacts. The maximum discomforts felt were reported in the lower back, hips, neck, leg, and hand during working hours and also some after the work. The postural analysis shows that most of the posture adopted during Sal leaf platemaking requires corrective measures. CONCLUSION: Postural stress is a causative agent for work-related musculoskeletal disorders. Therefore, to reduce the problems faced by them, some low-cost ergonomic interventions such as working bench, proper work-rest cycle, and back support should be formulated and implemented for the betterment of their daily livings.
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Quantification of retinal nerve fiber layer changes in optical coherence tomography images reveals differential progression of glaucomas p. 85
Saumyadipta Pyne, Mohammad Hasnat Ali, Meghana Aruru, Harsha L Rao
DOI:10.4103/bjhs.bjhs_74_19  
BACKGROUND: For monitoring the progression of glaucoma, a major cause of irreversible blindness, clinicians measure retinal nerve fiber layer (RNFL) changes in the eye. MATERIALS AND METHODS: Based on a clinical cohort of patients, we computed the temporal differences in the RNFL patterns in their glaucomatous eyes using optical coherence tomography (OCT) images. To gain insights into disease progression, we quantified the precise changes in the RNFL clock-hour sector phenotypes in each glaucomatous eye between the first and second clinical visits. CONCLUSION: Further, we identified 2 groups of patients using unsupervised clustering based only on their initial RNFL phenotypes, which may be investigated further to develop clinically useful models for prediction of glaucoma progression.
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MEDICAL EDUCATION TEACHING NOTE Top

Radiological protection and safety: Putting patients first p. 90
Reddy Ravikanth
DOI:10.4103/bjhs.bjhs_22_19  
The concept of radiation safety has always been a hot topic, especially with the late reports pointing to increased hazards with chronic radiation exposure for patients and medical personnel alike. Appropriate use of equipment include collimation, optimizing beam-on time, minimizing distances between image intensifier and patient, ensuring sufficient distance between patient and x-ray tube, and optimizing exposure rates for image quality and dose. Present day diagnostic radiology relies on three radiation protection principles - Justification of practice safety, optimization of radiation exposure ALARA, and dose limitation. General practitioners need a working knowledge of radiation safety as to adequately inform their patients of the risks-benefit ratio of diagnostic imaging procedures
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Selection of an appropriate data collection tool to conduct a sensitization session on competency-based medical education p. 94
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/bjhs.bjhs_15_19  
Research work essentially involves the collection of data or facts unknown or untouched till date. To collect these data, a wide range of tools or instruments can be used based on the study objectives or the settings in which they have to be used. For conducting a sensitization session for faculty and postgraduate students about competency-based medical education, entrustable professional activities, use of appropriate assessment tools for the certification of EPAs to produce a competent postgraduate, and roles and responsibilities of the stakeholders, a number of tools can be employed, such as questionnaire, checklist, rating scale, attitude scale, and observation. To conclude, planned utilization of appropriate data collection tool can play a crucial part in the successful outcome of a project or a session. Thus, it is very much important that the researcher should be aware of the merits and demerits of each tool and the settings under which they should be employed.
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Reading physiology slowly p. 97
Hwee-Ming Cheng, See-Ziau Hoe
DOI:10.4103/bjhs.bjhs_51_19  
Learning physiology requires unhurried time to understand and deepen the appreciation for whole-body homeostatic mechanisms. To read slowly is to read thinkingly, to read and imagine conceptually, the integrative workings of multiorgan physiology. It is reading beyond descriptive facts, to see the priorities of diverse organ responses during adaptation to challenges to maintain homeostasis. Teachers have a key role to inculcate slow physiologic reading in their classes with students.
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CASE REPORTS Top

A rare case of insulinoma presenting as cardiac arrest p. 101
Varun Suresh
DOI:10.4103/bjhs.bjhs_17_19  
Insulinomas are rare neuroendocrine tumours of pancreas arising from the Islets of Langerhans cells with an incidence estimated at 1 to 4 new cases per million persons per year. Patients with insulinomas usually develop neuroglycopenic symptoms presenting as recurrent headache, lethargy, diplopia, and blurred vision, particularly with exercise or fasting. We report a case of young female patient presenting with unwitnessed cardiac arrest later diagnosed as Insulinoma.
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Osteopoikilosis of the axial skeleton and pelvis: A rare cause of back pain p. 104
Reddy Ravikanth, Kanagasabai Kamalasekar
DOI:10.4103/bjhs.bjhs_2_19  
Osteopoikilosis (OPK) is an autosomal dominant and rare skeletal condition characterized by discrete ovoid or round, multiple radiodense lesions scattered predominantly in the appendicular skeleton. On radiographs, bone metastases and sclerotic bone dysplasias may mimic OPK. However, OPK is an incidental diagnosis. OPK is an asymptomatic condition but rarely may present with slight joint pains and effusions. Radionuclide bone scans have the propensity to distinguish OPK from osteoblastic bone metastases. Here, we present a 49-year-old female with chronic backache, and imaging revealed OPK of the axial skeleton and pelvis.
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LETTERS TO EDITOR Top

What can go wrong while flipping a preclinical class? – Viewing the potential pitfalls of student-centered instruction method under pragmatic lens p. 108
V Dinesh Kumar, R Rajprasath, Magi Murugan
DOI:10.4103/bjhs.bjhs_36_19  
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Hyponatremia and traumatic brain injury: An overview p. 110
Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
DOI:10.4103/bjhs.bjhs_49_19  
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An exploratory study to assess the prevalence and risk factors of malnutrition among under-five children residing in selected rural areas of district Sirmaur, Himachal Pradesh p. 112
Mahmood Dhahir Al-Mendalawi
DOI:10.4103/bjhs.bjhs_29_19  
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