International Journal of Medical Research and Review

Impact of examination stress on response time in first-year medical students

Dr. Inderjit Singh — 2020-08-26

Background: Stress has been seen to deteriorate normal physiological functions as well as the psychological functions of the brain. Medical students face a range of enduring normative stressors in the form of academic demands. This brings upon an amount of stress on the students which is related to the examinations and concerns with achieving high grades consequently referred to as academic-related stress. Thus, it becomes crucial to set upon a tool for measuring this stress in order to present methods for overcoming it. In the present study, one such method is evaluated by assessing the reaction time of first-year medical entrants.

Material and Methods: The effect of stress on response time in 50 normal healthy medical students of Sawai Man Singh Medical College, Jaipur in the age group of 18 to 21 years was explored in the study. Visual Reaction Time was recorded through the computer program.

Results: There was an increase in visual reaction time for the red color in both the sexes during stressful situations as compared to stress-free situations. While a decrease in Visual Reaction Time was seen for green color. A decreased auditory reaction time for both sexes was seen in stressful situations.

Conclusion: The results revealed that stress within a limit facilitates positive feedback to Central Nervous System information processing consequently decreasing the reaction time.

Is there any association between vitamin D deficiency and anti-thyroid peroxidase positive hypothyroidism: A cross-sectional study

Dr. Meenakshi Shankar — 2020-08-26

Background: Vitamin D deficiency is prevalent worldwide and it is believed to have a role as an immune modulator. However, the association between vitamin D levels and anti-thyroid peroxidase positive (TPOAb) hypothyroidism is still controversial.

Aim: To elucidate the association between vitamin D levels and anti-thyroid peroxidase (TPOAb) positive hypothyroidism.

Materials and Methods: Serum Vitamin D, thyroid peroxidase antibody, and thyroid function test were measured in 105 patients, who were sub-grouped into the TPOAb positive and TPOAb negative hypothyroidism category.

Results: Vitamin D level, was found significantly lower in patients with TPOAb positive hypothyroidism as compared to patients TPOAb negative hypothyroidism (13.275.18vs. 17.746.03ng/ml, respectively, P<0.05), as well as between patients with TPOAb positive hypothyroidism and control group (13.275.18vs. 29.669.41 ng/ml, respectively, P<0.05). Within the patients' group, there was a significant negative correlation between serum 25 (OH) vitamin D and TSH (r=−0.438, P<0.05), anti-TPO (r=−0.275, P<0.05). Furthermore, insignificant positive correlations were recorded between serum 25 (OH) vitamin D, and each of T3, T4 (r=–0.056, 0.097, P>0.05).

Conclusion: The current study observed significant low levels of 25(OH)D3 in TPOAb positive hypothyroid patients.

Anesthesia- patient’s apprehension, concerns, and counseling

Dr. Chandra Shekhar Mishra — 2020-08-26

Introduction: To allay anxiety and resolve the patient’s apprehension regarding general anesthesia through counseling. Patients presenting to PAC were asked to participate in a 2-way conversation meant to evaluate and study his apprehension, concerns in relation to anesthesia, and subsequently, a counseling session was given to answer his doubts and resolve his fear.

Material and Methods: In the study, it was found the fear of death was the greatest concern. The other major concerns were fear of paralysis and heart attack.

Results: The level of fear decreased as the severity of surgery decreased. For major surgery, the fear of death differed significantly with age, especially with increasing age came a lessened fear of death. Counseling by anesthesia provider regarding the fear that the patient reported help to reduce the anxiety. It allows for a more personalized approach towards the patient. It helps anesthesia provider to tailor the informed consent process.

Conclusion: In general, the study increases awareness regarding anesthesia among patient and their relatives.

Dosimetric evaluation of 6 MV and 18 MV intensity-modulated radiotherapy plans for treatment of carcinoma of the cervix

Dr. Senthil Manikandan Palaniappan — 2020-08-27

Introduction: Cervical cancer (Ca Cx) is the fourth most frequent cancer in women with an estimated 57000 new cases in 2018 representing 6.6% of all female cancers. Approximately 90% of deaths from cervical cancer occurred in low- and middle-income countries.

Material and Methods: A retrospective radiotherapy treatment planning comparative study conducted at the Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore during June 2018- March 2019.

Result: All the plans were normalized to 100 % at Target mean to achieve a similar target dose for quantitative comparison of DVHs. The results for target coverage, OAR sparing, integral dose, and monitoring units.

Conclusions: The tradeoff of using 6 MV and 18 MV for cervix patients depends on many parameters. Since the same PTV coverage was forced for both energies by having the same optimization constraints, there was little difference in target coverage and conformity index for both energies.

A study to find the utility of MRI in the evaluation of painful hip joints

Dr. Vinay NVP — 2020-08-27

Introduction: Magnetic resonance (MR) imaging is a valuable tool in the evaluation of hip disorders. With these, a study was conducted to assess the role of MRI in the early evaluation of painful hip joints.

Materials and Methods: It was a cross-sectional study conducted in the department of Radiodiagnosis, GSL Medical College, Rajahmundry. The study protocol was approved by the Institutional Ethical Committee. Patients presenting with acute or chronic hip pain pathology of all age groups, both gender who referred for MRI were included in the study. Imaging has been done with 1.5 Tesla Philips Achieva machines using abdominal surface coils and spine coils.

Results: Out of the 30 participants, avascular necrosis was diagnosed in 46.6% (14) participants, joint effusion in 10% (3) cases, osteoarthritis (OA) in 4 (13.3%) cases, tuberculosis (TB) in 10% (3), 6.6% (2) each was diagnosed to be Perthe’s, developmental dysplasia of the hip (DDH) and metastasis, respectively. All the pathological findings were diagnosed using MRI also.

Conclusion: MRI helps in the evaluation of the involvement of articular cartilage in the form of T2W hyperintensity. It also helps in the evaluation of soft tissue involvement along with the detection of bone marrow edema.

Vitamin D3 effect on Albuminuria in Type 2 Diabetes Mellitus patients in Northern Andhra Pradesh, India

Dr. P. Sreedevi — 2020-08-31

Introduction: Vitamin D deficiency is a common disorder in diabetic patients and may be a risk factor for the progression of diabetic nephropathy. The present study aimed to assess the effects of a large dose of parenteral. Vitamin D on 24 hours albuminuria in T2DM patients.

Methods: This prospective single-center study included 80 vitamin D deficient [25(OH) D <50 nmol/l] T2DM patients with an adequate glycemic control (HbA1c< 7.0%). Without any changes in anti-hyperglycemic or antihypertensive drugs, these patients were given a single high dose (600000 IU) of parenteral Vitamin D3. Then the changes in Vitamin D levels and 24 hours albuminuria were seen on follow up at 3 months.

Results: Vitamin D3 supplementation improved 24 hours albuminuria. In the present study, Twenty-four-hour urinary albumin excretion decreased from 210.4 ± 101.2 to 204.6 ± 104.5. In males, it changed from 221.8 ± 99.7 to 216.1 ± 100.3 and in females, it changed from 192.3 ± 108.5 to 186.7 ± 113.1. There was a negative association of albuminuria with Vit D levels in the present study.

Conclusion: Vitamin D3 supplementation significantly reduces 24-hour urinary albumin excretion in T2DM patients with Vitamin D3 deficiency.

Changes in Cardiovascular system among smokeless tobacco users attending tertiary care hospital in Andhra Pradesh, India

Dr. B Annaji — 2020-08-31

Background: Tobacco can be consumed as cigarettes and also as smokeless tobacco. Smokeless tobacco is a harmful tobacco product that contains over 3,000 chemicals, 7 including 28 known carcinogens (cancer-causing agents). Various forms of smokeless tobacco (mainly snuff and chewing tobacco) cause an immediate increase in heart rate and blood pressure. However, the relationship between smokeless tobacco uses on blood pressure remains unknown, especially in tertiary level hospitals. Our aim is to find out the smokeless tobacco use influence on cardiovascular parameters, for instance, pulse rate and blood pressure.

Methods: This cross-sectional study was carried out to assess cardiovascular changes among adult male smokeless tobacco (ST) users. For this purpose, 50 male respondents were selected. The participants were selected from the medicine outpatient department of Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh. Pulse rate and blood pressure were measured and ST uses behavior was assessed using self-reports. Statistical analysis was done by SPSS20.

Results: In this study, the mean (±SD) of pulse rate was 83.2±12.3 beats/min. The mean (±SD) of systolic blood pressure was 158.72±24.84 mm of Hg and the mean (±SD) of diastolic blood pressure was 98.78±9.87 mm of Hg in smokeless tobacco users.

Conclusion: Mean systolic and diastolic blood pressures were higher in smokeless tobacco users in the tertiary level hospital. However, the mean pulse rate was within the normal range.

Clinical and functional profile of 6-12-year-old children with attention deficit hyperactivity disorder referred to a tertiary care center in South India

Dr. Arpita Gupta — 2020-08-31

Objective: To describe the clinical, socio-demographic, and functional profile of children with Attention Deficit Hyperactivity Disorder (ADHD) referred to a tertiary care center in Kerala, India.

Methods: A retrospective descriptive study was conducted from records of developmental evaluation clinic over a period of one year. All-consecutive cases the first time diagnosed as ADHD were enrolled. Autism Spectrum Disorder, genetic disorders, and children with sensory impairments were excluded. Clinical profile was based on presenting symptoms, gender, and socio-demographic characteristics; functional status assessed by Conner’s 3 Parent Scale and cognitive status by Intelligence Quotient.

Results: ADHD prevalence in a clinically referred sample was 12.7%. Boy to girl ratio was 6:1. The mean age of presentation was 8.2 years (SD 6.09). The most common presenting symptom was hyperactivity and behavioral problems followed by poor scholastic performance and poor memory. The functional status assessment showed major concerns in all six domains - Inattention, Hyperactivity, Learning Problem, Executive Functioning, Aggression, and Peer relation, in the majority of children. Children presenting with ADHD symptoms at a later age (9-12 years) had lower IQ scores than those diagnosed at a younger age.

Conclusion: Course of childhood ADHD shows a consistent clinical and functional pattern. Early diagnosis and quantification of difficulties at the outset is suggested, which can help in providing early intervention and is likely to improve long-term outcome in these children.