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   Table of Contents - Current issue
January-April 2021
Volume 35 | Issue 1
Page Nos. 1-46

Online since Wednesday, August 4, 2021

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Clinicopathological study of papulosquamous skin disorders in a tertiary health-care center p. 1
Rachel Shimray, Sharmila Laishram, Gayatri Pukhrambam, Kh. Ambala Devi, Paramita Rudra Pal
Background: Papulosquamous skin disorder is a group of heterogenous dermatoses with a distinct histomorphological feature. The characteristic primary lesion is a papule, usually erythematous, that has a variable amount of scaling on the surface. The most common papulosquamous dermatoses are psoriasis, lichen planus, and pityriasis rosea. Because all papulosquamous disorders are characterized by scaling papules, clinical confusion may result during their diagnosis. Our study is to evaluate histomorphological findings in various papulosquamous skin disorders encountered at RIMS, Imphal. Materials and Methods: Skin biopsies of clinically diagnosed papulosquamous skin disorders along with their relevant clinical data received during a period of 2 years from September 2017 to August 2019 were included in the study. The diagnosis was confirmed by histopathological examination using hematoxylin and eosin stain. Results: A total of 115 papulosquamous skin disorders were studied with 75 cases of psoriasis (11–80 years), 36 cases of lichen planus (2–70 years), and 4 cases of pityriasis rosea. Age ranges from 2 to 80 years. Maximum cases were seen in the age group of 31–50 (70.6%) with a mean age of 39.18 years. Both genders were almost equally affected with a male: female ratio of 1.13:1. An analysis of the clinical with histopathological diagnosis of these papulosquamous skin lesions revealed a positive correlation in 76 (66.08%) cases and a negative correlation in 39 (2.9%) cases. Conclusion: Because of the varied clinical presentation and histopathological patterns of papulosquamous skin disorder, it is important to characterize the types of papulosquamous lesions as far as possible for definitive treatment.
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Media and suicidality during the surge of Thai student suicides in 2019: A hospital-based study Highly accessed article p. 7
Chonnakarn Jatchavala, Suchawadee Pongthanawisut
Background: During the 2 months of February and March 2019, more than 10 Thai university students were official reported to have committed suicide, which may impact on others' suicidality. Aims: This study aims to examine media and other factors influenced suicidal ideation among Thai university students, during the crisis of suicidal height in March–April 2019. Methods: The study was of a retrospective and cross-sectional design. Patients, who were university students and accessed the psychiatric outpatient clinic in March–April 2019, were recruited. Data collected by the hospital's databased system included patient profiles, perceptions of media influencing suicidality, and the Thai version of the suicide screening test. Results: Of the 68 participants, most participants were female (75.0%). They mostly stated that they were at a high risk of suicide (35.0%); whereas those who reported that the media influenced them were shown to have 3.5 times, higher risk of suicide (P = 0.012). Moreover, the moderate risk of suicide was statistically significantly associated with media, while other variables did not associate with suicidal risk (P = 0.03). Conclusion: During the crisis of copycat suicides, among Thai university students; most of whom were psychiatric outpatients, were at high risk for suicide. In addition, those who reported that the media had influenced them demonstrated a higher risk of suicide. Moreover, those who were at moderate risk for suicide were significantly associated with media.
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A review of rare palatal fractures and their management p. 13
Umesh Kumar, Pradeep Jain
Objective: The objective of this study was to diagnose rare palatal fractures and to subcategories them to formulate a definitive treatment plan depending upon the fracture lines. Materials and Methods: All patients presenting in triage with palatal fractures were classified after computed tomography scan. Thirteen patients diagnosed with complex and transverse palatal fractures were included in the study. Complex fracture was further subdivided into five groups: (a) comminuted, (b) oblique, (c) S shaped, (d) C shaped, and (e) T shaped. The patients were divided into two groups. In Group A, six patients were managed without palatal vault plating, and in Group B, seven patients were managed with palatal vault plating along with anterior alveolar and anterior maxillary buttress plating. Results: Twelve patients presented with complex fracture and one patient presented with transverse fracture. The male-to-female ratio and age range of the study were 5.5:1 and 15–55 years, respectively.Le Fort I and II fracture was present in five patients, isolated Le Fort II fracture in four patients, Le Fort I was present in two, and Le Fort I, II and III fractures was present in two patients. Conclusion: Complex palatal fractures can be subcategorized which simplifies the management and documentation of the fracture. Palatal vault plating should be attempted in cases where there are two large fracture segments to achieve the better stability of fracture and reduce the duration of maxillomandibular fixation in postoperative period.
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Knowledge, attitude, and practice toward COVID-19 among the general public in Manipur: A cross-sectional survey p. 18
Shantibala Konjengbam, Madhubala Devi Phurailatpam, Jalina Laishram, Victoria Loukrakpam, Pooja Akoijam, Sushma Khuraijam
Introduction: Various measures have been adopted to control the rapid spread of the ongoing COVID-19 epidemic in the state. Adherence to control measures by the population is influenced by their knowledge, attitudes, and practices (KAP) toward COVID-19. Objective: The objective of this study was to determine KAP toward COVID-19 among the general public of Manipur. Methods: A semi-structured questionnaire was used to interview the study participants. The demographics and KAP of the participants were investigated. Chi-square test and t-test were used for statistical analysis. Results: Out of the total participants (n = 398), 240 (60.3%) were female. One hundred and seventeen (29.4%) participants have adequate knowledge regarding COVID-19. The number of participants who have adequate knowledge was significantly more among males, those residing in plain districts, those residing in rural areas, and among those who studied up to graduate and above. The study also showed that attitude toward practicing more hand hygiene during infectious disease outbreaks was significantly associated with residence, education, religion, and occupation. A significant association was also observed between the preventive practices and knowledge, gender, district, residence, and education. Conclusion: Nearly one-third of the participants have good knowledge and positive attitude. However, when coming to practice, a little more than one-tenth of the study participants practiced preventive behaviors all the time. Knowledge on COVID-19 and practice of preventive behaviors were significantly associated with gender, district, residence, education, and occupation. The results of this study can help to identify the specific target groups with low KAP with well-planned, tailored strategies.
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Platelet function disorder in women with heavy menstrual bleeding in Eastern Uttar Pradesh p. 24
Shuchi Jain, Nisha Rani Agrawal, Vijai Tilak, Ekhlak Mohammad, D Dash, Madhu Jain
Background: Platelet function disorder (PFD) is turning out to be a major cause of heavy menstrual bleeding (HMB) in women. One should suspect for this entity and should look for it in all girls who have this issue since menarche to impart proper management. Objectives: This study was carried out to find the incidence of PFD in Patients with HMB referred to our tertiary care teaching hospital. Materials and Methods: Platelet aggregation in response to ristocetin-induced platelet aggregation (RIPA), Adrenaline, adenosine diphosphate, and Collagen was studied in 50 women with HMB and in the equal number of age-matched healthy women. Bleeding time and Platelet count were also measured. Results: Glanzmann's thrombasthenia (GT) was detected in 5 and Bernard Soulier Syndrome (BSS) in 2 women with HMB. Macrothrombocytopenia was observed in BSS. RIPA was also significantly reduced in BSS but normal in GT. Coagulopathies should always be doubted in the presence of significant anemia. One should carry out the Platelet function studies when screening parameters like prothrombin time, partial thromboplastin time, von Willebrand factor , and factor VIII activity level are normal. Normal platelet count and morphology in addition suggest functional defects in platelets which can be detected by various aggregation studies, electron microscopy, flow cytometry, and thromboelastography. Conclusion: The clinicians treating women with HMB should be aware of PFD as an important etiology and the platelet function should be studied in all women with HMB in a phase-wise manner in order not to miss the diagnosis and also to make it more cost-effective.
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Are donor predonation variables related to the quality of single donor platelets? – A tertiary care center experience p. 30
Priti Chatterjee, Shivali Sehgal, Swati Bhardwaj, Reema Bhushan, Chintamani Pathak, Manjula Jain
Introduction: Platelets are the most common product collected by apheresis. The product obtained is called single donor platelets (SDPs). The quality of the SDP is determined by the platelet yield (that is platelet count of the SDP product), which in turn directly influences the patient recovery. Materials and Methods: In the present study, donor demographic and complete blood count parameters were studied and their influence on the yield of the SDP was analyzed. With such an analysis, a better quality product (with a good platelet yield) can be obtained consequently improving clinical outcome. This would allow prolonging intervals between transfusions. Results: Parameters such as height, weight, and body mass index did not statistically influence the platelet yield in this study, unlike the results obtained by past studies. The most consistent parameter found to influence the platelet yield was platelet count of the donor. Healthy donors with high platelet counts can yield better platelet yield in SDPs in a shorter time and therefore improve the clinical outcome in patients with thrombocytopenia. Conclusion: It is important to consider hematological characteristics of the donors on an individual basis so as to ensure a good quality of the plateletpheresis product.
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Efficacy of thumb abduction orthosis versus local methylprednisolone acetate injection in De Quervain's tenosynovitis: A randomized controlled trial p. 35
Rakesh Das, Naorem Bimol, Debasish Deb, Shanavas Anoth Meethal, Yumnam Nandabir Singh
Context: De Quervain's disease tenosynovitis is a painful inflammation of tendons on the side of the wrist at the base of the thumb. The most common cause is chronic overuse. It can be self-limited and may resolve without intervention. For those individuals with persistent symptoms, nonsurgical modalities such as rest, massage, cold and heat application, splinting, physical therapy, systemic anti-inflammatory drugs, and corticosteroid injections have been tried with variable success. Aims: The aim of this study was conducted to compare the efficacy of thumb abduction orthosis with local methylprednisolone acetate injection for the management of De Quervain's tenosynovitis. Settings and Design: A randomized controlled study was conducted from September 2017 to August 2019, in the Physical Medicine and Rehabilitation Department of a tertiary hospital in Imphal, Manipur. Subjects and Methods: In Group 1, thumb abduction orthosis was applied, and in Group 2, injection methylprednisolone acetate was given in the first dorsal compartment. Treatment effectiveness was measured by visual analog Scale (VAS) for pain and Quick disabilities score of the Arm, Shoulder, and Hand (quick DASH) for functional assessment. Follow-up assessment was done at 1 month, 3 months, and 6 months. Statistical Analysis: Chi-square test, independent t-test, and paired t-test were used for analysis. Results: Out of the total 60 patients, 51 patients were females and 9 were males. There was a significant improvement in both mean VAS scores and Quick DASH scores in both the groups. At 1-month of follow-up, VAS and Quick DASH score in control group significantly improved compared to study group (P < 0.05). However, there was no statistically significant differences between the two groups at 3 months and 6 months follow-up period (P > 0.05). Conclusions: Although methylprednisolone acetate injection has an excellent outcome, thumb abduction orthosis can be an alternative treatment option for De Quervain's disease.
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Tubular adenoma of the breast: A rare entity p. 40
L Rashil Simon, Moirangthem Henary Singh, Angelica Laiphrakpam, L Sushila Devi
Tubular adenoma is a rare benign neoplasm of the breast. It is commonly seen in premenopausal women and has no association with an increased risk of breast cancer. It is difficult to diagnose tubular adenoma clinically, radiologically, and cytologically. Histopathological examination remains the gold standard in diagnosing tubular adenoma.
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Candida parapsilosis: A rare cause of arthritis and its successful treatment with oral fluconazole p. 42
Ningthoujam Priyolakshmi Devi, Khuraijam Ranjana Devi, K Joy Singh Akoijam, Pukhrambam Pratita Devi, Longjam Nilachandra Singh
Fungal arthritis is a rare condition, often missed and underreported. Among all Candida species, Candida parapsilosis is a rare cause. A 66-year-old male with a history of arthritis on and off for the past 3 years and treated symptomatically presented with acute pain and swelling of the left knee joint for 1 week. Synovial fluid examination revealed yeast-like structures and fungal culture showed growth of Candida spp. VITEK 2 compact identified it as Candida famata but matrix-assisted laser desorption ionization–time of flight mass spectrometry assay confirmed it as C. parapsilosis. This is a rare case of nonalbicans candida arthritis, especially in this part of the country.
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New COVID-19 vaccines and new COVID-19 variants: A long way for COVID-19 containment? p. 45
Rujittika Mungmungpuntipantip, Viroj Wiwanitkit
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Safety of COVID-19 vaccine in the patient with history of drug allergy: An issue to be monitored p. 46
Pathum Sookaromdee, Viroj Wiwanitkit
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