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  Citation statistics : Table of Contents
   2015| July-September  | Volume 4 | Issue 3  
    Online since September 15, 2015

 
 
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CASE REPORTS
Lipoma in liver: A rare presentation
Onteddoo Joji Reddy, Jamkhana Abdul Gafoor, Balla Suresh, Polysetty Obuleswar Prasad
July-September 2015, 4(3):185-187
DOI:10.4103/2277-8632.165398  
Liver lipoma is an extremely rare tumor. Its nature and behavior is not well-known since available information is based mostly on the individual case reports. This report presents a case of liver lipoma mimicking malignant liver tumor. Patient was a 76-year-old female patient with 5-month history of the right upper abdominal quadrant pain. Diagnostic work-up revealed a large liver tumor mass, suspicious of malignancy. However, histopathological analysis found it to be benign lipoma. Because of extremely low incidence of liver lipoma, especially large ones, appropriate diagnostic work-up is very important for its differentiation from malignant tumors.
  3 4,441 219
ORIGINAL ARTICLES
Perceptions of the introduction of objective structured practical examination (OSPE)/objective structured clinical examination (OSCE): A pilot study carried out in Government Medical College, Ananthapuramu, Andhra Pradesh, India
Gujjala Radhika, Aruna Kumari Dara, Kalyandurg Pujjari Varalaxmi, Chinnappagari Bhavani
July-September 2015, 4(3):145-149
DOI:10.4103/2277-8632.165401  
Background: A uniform and reliable clinical and practical evaluation of medical students is always desirable. The method of objective structured practical examination (OSPE)/objective structured clinical examination (OSCE) tests the students on what they can do rather than what they know. This method is now believed to meet the deficiencies of the conventional system of practical/clinical examination. Aims: The aim of the present study is to take the perceptions and opinions of the medical education training (MET)-trained faculty regarding OSCE/OSPE, and their interest in introducing it as an assessment tool. Materials and Methods: This is a detailed, structured questionnaire study carried out in Government Medical College, Ananthapuramu, Andhra Pradesh, India in the period from May 2014 to July 2014 and was conducted on 50 members of MET-trained faculty. Results: Among the faculty, 96% agreed that it was a good and useful learning methodology; 98% agreed that it was a good assessment tool; 100% agreed that it assessed all the three domains; 80% agreed that it was a transparent, comprehensive, and fair assessment tool, 90% were of the opinion that it was mentally and physically taxing and required additional faculty hours to construct, review, and implement the arrangement of stations initially; 100% agreed that the combination with classical practical examination (CPE) produced good results; and 84% responded that it could partially replace CPE. Conclusion: We conclude that any change must first be thoroughly evaluated before it can uproot a well-defined and time-tested assessment methodology. OSCE/OSPE has several distinct advantages. In the current situation, it may be realistic to expect its inclusion in the evaluation schedule of universities and in day-to-day assessment of students to improve their clinical competence.
  2 5,779 430
A review on cancer incidence in India from 25 population-based cancer registries
Smita Asthana, Preeti S Labani, Satyanarayana Labani
July-September 2015, 4(3):150-154
DOI:10.4103/2277-8632.165397  
Background and Objective: An overview of the update of cancer incidence summary findings will be of help to researchers and clinicians for quick reference of facts in cancer control. To present an overview of cancer incidence available from the recent population-based cancer registries (PBCRs) in India from 2009 to 2011. Materials and Methods: Data on age-adjusted incidence rates and cumulative risks of cancer at various sites were collected for both sexes for six major cancer sites from the first report of the National Cancer Registry Programme (NCRP) on 25 PBCRs in India for the years 2009-2011. Site-specific risks in terms of one out of the total number of persons who develop cancer were computed. The summaries, in the form of ranges, are presented in six regions of the country in which the 20 PBCRs are located. The range of age-adjusted rates (AARs) and one out of the number of persons who develop cancer as a lifetime risk in the age of 0-64 years is presented. Results: In different regions, the highest risks for males for developing cancer in the various major sites studied were as follows: One out of 67 for cancer in the lungs in the Northeast, one out of 27 for cancer in the esophagus in the Northeast, one out of 71 for cancer in the mouth in the western region, one out of 100 cancer in the tongue in the rural western region, one out of 333 for cancer in the prostate in the northern region, and one out of 33 for cancer in the stomach in the northeastern region. The highest risks for the various sites studied were as follows: one out of 36 for cancer in the breast in the south, one out of 59 for cancer in the cervix in the western region, one out of 125 for cancer in the ovary in the northern region, one out of 63 for cancer in the esophagus in the northeastern region, one out of 250 for cancer in the mouth in three regions, and one out of 125 for cancer in the gall bladder in the western and central regions. Overall, for all cancers there is a risk of one out of 8-27 persons and one out of 10-25 persons among males and females, respectively, in the Indian population who are likely to develop cancer of any site in their lifetime during the age of 0-64 years. Conclusion: Female breast cancer in the southern region and esophagus and stomach cancers among males in the northeast region were of the highest magnitudes.
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CASE REPORTS
Pseudoglucagonoma syndrome secondary to pancreatitis: A case report
Yerrajwala Aruna Kumari, Indukuri Chandrasekhar Reddy, Kalle Gouthami Sree, Mounika Ala
July-September 2015, 4(3):188-191
DOI:10.4103/2277-8632.165396  
Necrolytic migratory erythema (NME) is pathognomonic of glucagonoma syndrome associated with pancreatic neoplasm. Pseudoglucagonoma syndrome, which is extremely rare, refers to NME in the absence of glucagon-secreting tumor. We describe a case of NME in a 22-year-old female who presented with skin rash with scaling, cheilitis, glossitis associated with hair loss, and loss of weight. Serum glucagon, amino acids, and zinc levels were normal. Ultrasonography (USG) and computed tomography (CT) abdomen showed chronic pancreatitis. Resolution of lesions was observed with topical steroids, emollients, and intravenous (IV) protein infusions and other supplements.
  - 2,679 139
Hemangiopericytoma in an 11-year-old patient: Case report and review
Kruthi Nanduri, Rajasekhar Gaddipati, Nandagopal Vura, Krishna Prasad Lingamaneni
July-September 2015, 4(3):192-195
DOI:10.4103/2277-8632.165402  
Hemangiopericytoma (HPC) is a rare vascular neoplasm originating from vascular pericytes. Though they can occur anywhere in the body, their incidence in head and neck region is low and is rare in children. Both benign and malignant variants are present, and they have a tendency to metastasize. We report a case of an HPC of the submandibular region in an 11-year-old female patient. Diagnosis and management are discussed along with a focus on previous literature.
  - 2,012 155
Sepsis presenting as acute hemorrhagic leukoencephalopathy: A rare case report
Om Prakash Lekhra, Pranav Chowdhary
July-September 2015, 4(3):196-198
DOI:10.4103/2277-8632.165408  
Sepsis-associated encephalopathy (SAE) refers to a clinical spectrum of acute neurological dysfunction that arises in the context of sepsis. Although the pathophysiology of SAE is incompletely understood, it is thought to involve endothelial activation, blood — brain barrier leakage, inflammatory cell migration, and neuronal loss with neurotransmitter imbalance. SAE is associated with a high risk of mortality. Imaging studies using MRI and CT have demonstrated changes in the brains of patients with SAE that are also seen in disorders such as stroke.
  - 2,393 166
Spontaneous rupture of the spleen: A case report and review of the literature
Vudutha Srihari, J Jayaram, G Baleswari, S Sabira, M Naveen Kumar, N Mallikarjuna
July-September 2015, 4(3):199-201
DOI:10.4103/2277-8632.165407  
Spontaneous rupture of the normal spleen is a rare clinical entity in the absence of trauma; the diagnosis and treatment of this fatal complication are often delayed. Regardless of the mechanism, patients typically present with upper abdominal pain, classically referred to the left shoulder, with evidence of hemoperitoneum and moderate to severe shock. Here we are presenting a rare case of spontaneous rupture of normal spleen in a young female.
  - 1,845 155
Mucinous cystadenoma of the appendix
Vudutha Srihari, Janga Jayaram, Golla Baleswari, Shaik Sabira, M Naveen Kumar, N Mallikarjuna
July-September 2015, 4(3):182-184
DOI:10.4103/2277-8632.165405  
We present a case of 50-year-old man came with abdominal pain for 3 months who was investigated and found to be suffering from mucinous cystadenoma of the appendix for which who have done appendicectomy and ileotransverse anastomosis. Surgical specimen sent to pathology for histopathological examination revealed mucinous cystadenoma of the appendix.
  - 1,761 125
ORIGINAL ARTICLES
In vitro effect of aspirin on Helicobacter pylori on upper gastrointestinal tract
Madhurima Kothapalli, Kolli Rama Lakshmi Surya Kirani
July-September 2015, 4(3):155-158
DOI:10.4103/2277-8632.165409  
The role of Helicobacter pylori in aspirin-associated gastroduodenal ulcer disease is a subject of controversy. Aspirin use is widespread, especially in elderly patients, leading to the increased incidence of gastrointestinal (GI) bleeding. Endoscopy-guided biopsy is diagnostic. H. pylori fecal antigen detection in stool samples by enzyme-linked immunosorbent assay (ELISA) is also an option. Aim: The aims of this study were to assess the in vitro action of aspirin on H. pylori and to determine whether this effect has a role in different gastroduodenal lesions. Materials and Methods: The study group consisted of 100 symptomatic cases with different upper GI tract disorders, the patients aged 20-60 years and of either sex. Ten (10) asymptomatic, apparently healthy individuals were also included as the control group, after their consent was obtained for endoscopy. Biopsy material obtained by endoscopy was subjected to rapid urease test and culture, and aspirin sensitivity was determined by incorporating 400 ug/mL of aspirin in the medium. Results and Discussion: Out of the 41 culture-positive cases, 27 isolates were aspirin-sensitive. Among the various GI disorders analyzed, aspirin-sensitive H. pylori was found mostly in cases of gastritis (7) and duodenal ulcer (7). Two of five strains from duodenitis cases, one of four from esophagitis, all four from carcinoma, five isolated from symptomatic patients without visible lesions, and only one isolated from those asymptomatic with lesion were sensitive. The aspirin-sensitive organisms may or may not be associated with lesions, but the resistant strains were definitely associated with lesions. Although these findings do not change the current clinical approach, they do emphasize the need for screening. The Helicobacter pylori stool antigen (HpSA) test is sensitive and specific for planning eradication programs of H. pylori in colonized but presymptomatic cases.
  - 1,659 171
Impact of smoking on erythrocyte indices and oxidative stress in acute myocardial infarction
Sandhya Metta, Satyanarayana Uppala, Doddamani R Basalingappa, Srinivasa Rao Badeti, Saiprasad S Gunti
July-September 2015, 4(3):159-164
DOI:10.4103/2277-8632.165400  
Context: The free radicals generated by cigarette smoke are responsible for the production of excessive oxidative stress, causing damage to the cellular and subcellular components in acute myocardial infarction (AMI). Aims: The present study is aimed to evaluate the impact of smoking on erythrocytic oxidative stress and erythrocyte indices in patients with AMI. Materials and Methods: Two hundred consecutively admitted male patients with AMI were enrolled in our study and were subsequently divided into two groups, smokers and nonsmokers. All the subjects were evaluated for lipid profile, red blood cell (RBC) indices and the antioxidant enzyme activities-catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPX) were studied. Statistical Analysis Used: The independent sample t-test was used, and P values were calculated. Results: We found significantly high (P < 0.001) hematocrit, hemoglobin (Hb) concentration, mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) in smokers. While evaluating the antioxidant enzymes, we observed a reduction in GPX activity in the erythrocytes of smokers in comparison to nonsmokers and this was found to be highly significant (P < 0.001) whereas, CAT and SOD activities even though were reduced, they were not as highly significant (P = 0.023, P = 0.006 respectively) as GPX activity. Conclusions: Along with altered RBC indices, the erythrocyte GPX activity is more reliable and sensitive indicator of oxidative stress than CAT and SOD activities for the assessment of oxidative stress in AMI patients who are smokers.
  - 3,652 321
Establishment of cephalometric norms for four sagittal skeletal discrepancy indicators in Andhra population
Venkata S Polina, Adusumilli S Prakash, Sudhakar Paturi, Bhaskar Mummidi, Praveen K Varma, B Shyam Kumar
July-September 2015, 4(3):165-169
DOI:10.4103/2277-8632.165404  
Background: In orthodontic diagnosis assessment of sagittal skeletal discrepancy has greater importance and it aids in treatment planning. Aim: To establish cephalometric norms for sagittal dysplasia using four parameters WITS, ANB, Beta and YEN in Andhra population. Materials and Methods: Sample consisted of 90 pretreatment conventional lateral cephalograms and WITS, ANB, Beta, YEN were measured. Statistical analysis included mean, standard deviation, reciever operative characteristic (ROC) analysis. Results: ROC analysis shows range for WITS: −3 mm to +2.5 mm; ANB: 0° to 4.5°; Beta: 27° to 37° and YEN: 120° to 127°. Conclusion: Subjects with straight profile and class I occlusion showed higher range of values for all the four parameters. These values can be considered while assessing sagittal skeletal discrepancies which help in better orthodontic diagnosis and treatment plan of subjects residing in Andhra.
  - 2,331 246
A study on isolation, identification, and antifungal susceptibility of various oral candidal species in renal transplant patients
Muddana Keerthi, Gontu Sridhar Reddy, Poosarla Chandra Shekar, Kantheti Lalith Prakash Chandra, Kattapagari Kiran Kumar, Baddam Venkat Ramana Reddy
July-September 2015, 4(3):170-175
DOI:10.4103/2277-8632.165399  
Background: The rationale of this study was to know the prevalence of candidal colonization in renal transplant individuals and to isolate and identify the various species and determine their antifungal susceptibility. Materials and Methods: The study population was divided into Group I (renal transplant individuals, n =30) and Group II (healthy individuals, n =50) from whom oral rinse samples were collected in a container with sterile phosphate-buffered saline (PBS). All the collected samples were transported immediately and subjected to various mycological investigations. Statistical analysis was performed using Mann–Whitney U and Chi-square test. Results: In Group I, 11 (36.67%) and in Group II, 9 (18%) showed positivity for Candida. Candida albicans formed the major species and it showed sensitivity to Fluconazole and Ketoconazole. Conclusion: Prevalence of Candida species in the oral cavity of renal transplant recipients was higher than in immunocompetent control subjects. Administration of immunosuppressive drugs predisposes the development of an increased density of candidal colonies.
  - 1,928 166
A study on association and correlation of lip and finger print pattern analysis for gender identification
Surapaneni Ratheesh Kumar Nandan, Brijesh Krishna Bandaru, Arvind Babu Rajendra Santosh, Prasanth Thankappan, Naga Sirisha Venkata Chundru, Rajesh Amudala
July-September 2015, 4(3):176-181
DOI:10.4103/2277-8632.165406  
Background: The lip print pattern is a unique among individuals and thus helps in the identification during the forensic investigation. Lip print analysis in the forensic scene may help in the personal identification. Thus, correlating the lip print with the finger print and gender will create a new room in forensic dentistry investigation. Aim: This study aims to identify the lip and finger print pattern and to correlate lip and finger print pattern for gender identification. Materials and Methods: A total of 100 students from dental institution were included in this study. Of which, 50 were male and 50 were female.. Their aged range between 18 and 28 years with a mean age of 21.3 years. The physiological rest position of the lip print was recorded by the application of red or dark pink colored lipstick over the lips and the imprint was transferred over a white chart sheet through a transparent tape. The imprint of the finger was taken directly on a white chart sheet. The lip and finger print pattern was examined with magnifying lens. The results were analyzed using SPSS software 19.0 (Armonk, NY, USA) and presented as a descriptive statistics. A correlation of lip print with finger print and gender variation was analyzed by Pearson correlation test. Results: The study identified higher prevalence of Type II (34%) lip print pattern in the overall study population. In males, Type I lip print (42%) and plain loop finger print pattern (44%) was frequent in the study. In males, the correlation of lip and finger print patter showed weaker correlation and statistically insignificant (P = 0.436). In females, Type II lip print (34%) and plain loop finger print pattern (42%) was frequent in the study. In females, the correlation of the lip and finger print pattern showed weaker correlation with approachable statistical significance (P = 0.083). The correlation of lip and finger print with gender showed weaker correlation and approachable significance (P = 0.07). The association of lip and finger print in the study showed statistically insignificant. However, the association of Type III lip print pattern with loop finger print pattern showed statistical significant association (P = 0.05) by Chi-square analysis. Conclusion: Lip print analysis is a challenging area in the personal identification during forensic dentistry examination. The study revealed the weaker correlation and approachable significance of lip and finger print pattern in gender identification. Future studies should be encouraged in the direction of software based identification for lip and finger print analysis in gender identification. Such studies may benefit this study pattern in more accurate way.
  - 4,477 894
REVIEW ARTICLE
Oral field cancerization: An update of evidences
Balkuntla Krishnamurthy Ashwini, Prakash Sharada, Kyadala Nagaraja Hema, Srinivas Murthy Chitra
July-September 2015, 4(3):141-144
DOI:10.4103/2277-8632.165403  
Patients with head and neck squamous cell carcinoma often develop multiple premalignant lesions; this led to the concept of field-effect in cancer which was originated by Slaughter et al. in the year 1953. Though this was based on histopathological observations, the development of modern molecular technologies has extended the field effect concept by exploring the molecular abnormalities in tissues that appear histologically normal. In this update, we discuss in detail about the origin, principle, various theories used to explain this effect, molecular findings and therapeutic implications related to oral field cancerization.
  - 4,367 629
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