Current Issue Volume 5, Number 2 , April-June 2018

FROM THE EDITORS' DESK
Shibban K Kaul

From the Editors' Desk

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:iv]



World Hepatitis Day was celebrated all over the world on 28th July like every year. In 2015, Viral hepatitis accounted for 1.34 million deaths worldwide. Around 257 million people have chronic hepatitis B virus (HBV) infection and 71 million have hepatitis C virus (HCV) infection. Causes of death are chronic liver disease (cirrhosis) and hepatocellular carcinoma.


GUEST EDITORIAL
CV Raghuveer

Heutagogy: A Paradigm Shift from Pedagogy to Andragogy

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:v-vi]



Heutagogy, a form of self-determined learning with practices and principles noted in andragogy, has resurfaced as a learning method in higher education. In a heutagogical approach, the learner decides what to learn and how to learn and, therefore, exercises control of the learning process while the teacher is only a navigator. In heutagogy, students are highly autonomous and self-determined and emphasis is placed on their capability and capacity with the intention of producing the next-generation professionals well prepared for intricacies of today’s workplace.


ORIGINAL ARTICLE
Shikha Nag, Krishnasastry Musti

TlyA Expression is Necessary for Mycobacterial Susceptibility to Capreomycin: Wild-type Strains are Naturally Resistant

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:51-56]



The human pathogen Mycobacterium tuberculosis has coevolved with humans and uses novel strategies for intracellular survival as well as for drug resistance. In this communication, we have compared the drug resistance of Mycobacterium marinum as well as the H37Ra, an avirulent form of the human pathogen M. tuberculosis against second-generation antibiotic capreomycin. Interestingly, M. marinum and its three mutants are naturally resistant to capreomycin, while the H37Ra showed susceptibility and also it showed surface expression for the TlyA protein since function of TlyA is necessary for susceptibility to capreomycin. It is postulated that the resistance to capreomycin can occur in wild-type strains through suppression of expression of TlyA, while the H37Ra is unable to do the same.

Keywords: Capreomycin, Drug resistance, Drug susceptibility, H37Ra, Mycobacterium marinum, Mycobacterium tuberculosis.

How to cite this article: Nag S, Musti K. TlyA Expression is Necessary for Mycobacterial Susceptibility to Capreomycin: Wild-type Strains are Naturally Resistant. MGM J Med Sci 2018;5(2):51-56.

Source of support: This work was supported by Department of Biotechnology through National Centre for Cell Science as an intramural research support to MVKS SN is a senior fellow of ICMR, India.

Conflict of interest: Nil


ORIGINAL ARTICLE
Nikhil Bhuskute, Ranjeet Shinde

Actinomycosis Mimicking Gynecological Malignancy: Imaging Patterns in Seven Cases

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:57-63]



Pelvic actinomycosis is uncommon and believed to be related to the use of intrauterine devices (IUDs). It may present as a complex gynecological mass either uterine or adnexal with or without local pelvic spread or with peritoneal dissemination, all features which mimic gynecological malignancy. We describe seven women with proven actinomycosis who presented to a single cancer center gynecological cancer multidisciplinary team meeting (MDTM) to illustrate these imaging appearances and highlight discriminant features of actinomycosis. A minority of women had concurrent use of an IUD. Involvement of the pararectal space was a feature of pelvic disease extension. We describe the value of image-guided core biopsy (IGCB) in confirming the diagnosis.

Keywords: Arteriovenous fistula, Fistula, Hemodialysis, Infection, Patency, Primary failure, Rates, Steal syndrome, Thrombosis, Vascular access.

How to cite this article: Bhuskute N, Shinde R. Actinomycosis Mimicking Gynecological Malignancy: Imaging Patterns in Seven Cases. MGM J Med Sci 2018;5(2):57-63.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Rishikesh A Wadke, Padma Ramesh, Haritha K Nimmagadda

Scope and Feasibility of Student-friendly Environmental Sustainability Measures in Educational Institutes: Our Experience in MGM Institute of Health Sciences, Navi Mumbai Campus, Maharashtra, India.

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:64-67]



Introduction: Environmental sustainability is an important component for transforming higher education for a sustainable tomorrow hence, there is a pressing need to step up initiatives for environmental sustainability. Institutes of higher education play a key role in imparting environmental awareness and in employing eco-friendly measures. While institutes have several academic and administrative audits, environmental audit is comparatively neglected. Environmental sustainability includes protecting and restoring ecological systems, optimal utilization of resources, enhancing the well-being of all people, and motivating students to take up environmental educational projects as part of their curriculum.

Objectives: To evaluate environmental initiatives currently being practiced for environmental sustainability in MGM Institute of Health Sciences (MGMIHS) and to assess the scope and feasibility of their implementation and evaluation in educational institutes in a developing country.

Materials and methods: The key components of eco-friendly initiatives include carbon footprint reduction, water management, waste recycling, sustainable buildings, energy conservation, and environmental hygiene. Methods to achieve environmental sustainability also include using academic resources, such as faculty and students for campus education initiatives in order to produce awareness, motivation, and behavioral change. These methods are studied and assessed with a view to implementation in our local setting. In addition, environmental indicators for auditing the beneficial effects of these methods are examined.

Results: A campus score measuring physical qualities of university campuses like Urbanism, Greenness, and On-Campus Living is suggested to be included in accreditation process like National Assessment and Accreditation Council (NAAC). Various student- and faculty-friendly environmental initiatives were taken by MGMIHS to make the campus eco-friendly. At policy level the Institute became committed to a plastic bag-free zone. Pooling of cars and vehicles was promoted. There was a felt need to test the feasibility of implementing a completely paperless system of functioning for university and constituent institutions. The recently introduced enterprise resource planning (ERP) software can be considered as a starting point for going paperless. Energy conservation by using renewable energy in order to reduce carbon footprints was promoted along with water conservation efforts. Increasing the green cover of MGMIHS university campuses was given highest priority. Advocacy, communication, and social mobilization for environmental awareness was achieved by arranging regular lectures for motivation of students and faculties to maintain eco-friendly campus. Constitution of a Campus Environmental and Sanitation Committee was a step in the right direction.

Conclusion: This article discusses the measures that can be easily and effectively adopted in educational institutes in a developing country for contributing toward environmental preservation. In addition the article discusses the importance of auditing environmental sustainability in educational institutes using various indicators like the campus index. United Nations Environmental Programme (UNEP) Greening Universities Toolkit in 2013 can be a starting point to make MGMIHS more environmental friendly.

Keywords: Environmental audit, Environmental indicators, Environmental sustainability, Student-friendly environmental initiatives.

How to cite this article: Wadke RA, Ramesh P, Nimmagadda HK. Scope and Feasibility of Student-friendly Environmental Sustainability Measures in Educational Institutes: Our Experience in MGM Institute of Health Sciences, Navi Mumbai Campus, Maharashtra, India. MGM J Med Sci 2018;5(2):64-67.

Source of support: MGMIHS

Conflict of interest: None


ORIGINAL ARTICLE
Pooja Agrawal, Hemangi R Jerajani, Saurabh Jindal

Intralesional Platelet-rich Plasma Therapy vs Intralesional Triamcinolone Acetonide for the Treatment of Alopecia Areata

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:68-75]



Introduction: Alopecia areata (AA) is a common autoimmune condition causing hair loss. Platelet-rich plasma (PRP) has emerged as a new treatment modality in dermatology, and preliminary evidence has suggested that it might have a beneficial role in hair growth.

Aims and objectives: To compare the efficacy of intralesional PRP therapy vs intralesional triamcinolone acetonide (TrA) for the treatment of AA in a randomized, single-blinded, placeboand active-controlled parallel study.

Materials and methods: Thirty AA patients were randomized into two groups to receive intralesional injections of PRP or TrA. Half the number of patches in each patient were treated and other half were injected with placebo (normal saline). A total of three treatments were given for each patient at one month intervals. The evaluation was done by severity of alopecia tool (SALT) scoring, dermoscopic evaluation of dystrophic hair, and patient satisfaction. Patients were followed up for 6 months.

Observations and results: Intralesional TrA was found to give better results as compared with intralesional PRP.

Conclusion: Intralesional TrA gives superior results in AA as compared with intralesional PRP.

Keywords: Alopecia areata, Intralesional triamcinolone acetonide, Platelet-rich plasma therapy.

How to cite this article: Agrawal P, Jerajani HR, Jindal S. Intralesional Platelet-rich Plasma Therapy vs Intralesional Triamcinolone Acetonide for the Treatment of Alopecia Areata. MGM J Med Sci 2018;5(2):68-75.

Source of support: Nil

Conflict of interest: None


ORIGINAL ARTICLE
Gauri M Vaishnav, Swati S Shiradkar, Shubhangi A Mande

A Study of Factors affecting the Knowledge and Awareness about Effective Breastfeeding

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:76-80]



Aim: To study the knowledge and awareness about breastfeeding in women attending a tertiary care medical center, and correlate it with sociodemographic factors.

Materials and methods: A total of 331 participants were selected and interviewed with a prevalidated questionnaire. Their answers about essentiality and advantages of breastfeeding were evaluated as “wrong,” “don’t know,” and “correct.” Spearman’s correlation coefficient graph was used to analyze the association of their answers with different sociodemographic factors.

Results: Over 80% participants had correct knowledge about early initiation of breastfeeding within 1 hour, exclusive breastfeeding for 6 months, and importance of colostrums in normally delivered babies; 58% showed lack of knowledge about hazards of prelacteals and initiation of breastfeeding after cesarean section. Advantages of breastfeeding for mothers were known to only 60 to 65% of participants. Our study did not establish any positive or negative correlation between age, parity, education, address, place of delivery, and information providers with knowledge about breastfeeding.

Conclusion: In this study, urban living, higher education, multiparity (i/v/o breastfeeding experience), and hospital delivery of women did not show positive correlation with higher degree of knowledge and awareness about breastfeeding, thus highlighting the need for specifically designed and focused training for the antenatal and postnatal women as well as the society.

Clinical significance: There is an urgent need for prompt and active action to be taken at health care system, community, and policy levels for strategic planning of different programs to improve effective breastfeeding rates. These plans should focus on clearing social myths and taboos and in accordance with local needs of the women.

Keywords: Awareness, Breastfeeding knowledge, Education relationship, Information provide.

How to cite this article: Vaishnav GM, Shiradkar SS, Mande SA. A Study of Factors affecting the Knowledge and Awareness about Effective Breastfeeding. MGM J Med Sci 2018;5(2):76-80.

Source of support: MGMIHS

Conflict of interest: None


ORIGINAL ARTICLE
Rita Abbi

Effects of Diet Pattern on Nutritional Status of Schoolchildren: A Study in One Township of Navi Mumbai, Maharashtra, India

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:81-84]



Diet pattern plays a key role in determining the nutritional status of children. The study was conducted to find the impact of diet pattern on the nutritional status of 105 school-going children in Navi Mumbai. Data were collected using survey questionnaire including observation and interview technique.
Food frequency questionnaires were administered to assess dietary intake. To assess growth status of children, z-scores [weight-for-height (WHZ), height-for-age (HAZ), and weight-for-age (WAZ)] were used. The objectives of the study were to determine diet variety and frequency of food intake, to find the nutritional status using food mean score for anthropometric parameters. The article further reveals the relationship between diet pattern and WAZ, WHZ, and HAZ of primary schoolchildren.
Results from the study revealed that there is a variation in the nutritional status of children. The children who eat less dietary variety may be related to malnutrition, while the large variety is related to heavyweight or obesity. The food variety should include all kinds of foodstuff from each category of major group.

Keywords: Diet pattern, Nutritional Status, Primary schools, z-score.

How to cite this article: Abbi R. Effects of Diet Pattern on Nutritional Status of Schoolchildren: A Study in One Township of Navi Mumbai, Maharashtra, India. MGM J Med Sci 2018; 5(2):81-84.

Source of support: MGMIHS

Conflict of interest: None


REVIEW ARTICLE
Alaka Deshpande

Diabetic Autonomic Neuropathy

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:85-87]



Neuropathy is a debilitating complication of diabetes. Neuropathy can be motor, sensory, and autonomic. There is a wide variation in the prevalence of diabetic autonomic neuropathy (DAN), depending upon the definition and criteria used for diagnosis. The sympathetic and parasympathetic nerves supply various organ systems modulating their functions. Therefore, DAN has wide spectrum of clinical presentation.
The clinical manifestations differ depending upon the systemic involvement. The management consists of lifestyle modifications, control of hyperglycemia, and simple physical measures along with supportive care.

Keywords:Diabetes mellitus, Diabetic neuropathies, Hyperglycemia.

How to cite this article: Deshpande A. Diabetic Autonomic Neuropathy. MGM J Med Sci 2018;5(2):85-87.

Source of support: Nil

Conflict of interest: None


CASE REPORT
Anith N Riduan, Narasimman Sathiamurthy

Hybrid Laparoscopic and Video-assisted Thoracoscopic Surgery Repair of Recurrent Traumatic Diaphragmatic Hernia: A Case Report and Literature Review

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:88-90]



Introduction: A case of recurrent traumatic diaphragmatic hernia (TDH) is presented in whom hybrid laparoscopic and video-assisted thoracoscopic surgery (VATS) was carried out.

Case report: A 38-year-old male with a history of emergency laparotomy for repair of traumatic diaphragmatic injury and left thoracotomy and repair of dissected descending thoracic aorta with plication and interposition graft repair presented to us 1-year postsurgery with chronic vomiting, electrolyte imbalance, and malnourishment. Diagnosis was established with contrast-enhanced computed tomography (CECT) of thorax and abdomen which showed a left hemi-diaphragm mid-part defect, measuring 5.1 cm in diameter, with stomach herniation. He underwent laparoscopic and left VATS repair of diaphragmatic hernia. Herniated stomach was adherent to the lower lobe of left lung and descending thoracic aorta.

Conclusion: In the age of minimally invasive surgery, hybrid laparoscopic and thoracoscopic surgery is an innovative, safe, and feasible option in managing recurrent diaphragmatic hernia.

Keywords: Recurrent diaphragmatic hernia, Thoracic surgery, Traumatic diaphragmatic hernia, Video-assisted thoracoscopic surgery.

How to cite this article: Riduan AN, Sathiamurthy N. Hybrid Laparoscopic and Video-assisted Thoracoscopic Surgery Repair of Recurrent Traumatic Diaphragmatic Hernia: A Case Report and Literature Review. MGM J Med Sci 2018;5(2):88-90.

Source of support: Nil

Conflict of interest: None


CASE REPORT
Kuldip Salgotra, Sarabjeet Kohli, Nilesh Vishwakarma, Shaival Chauhan

Acute Total Hip Arthroplasty in Unreconstructable Acetabular Fractures: Three Case Reports

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:91-94]



The indications of acute total hip arthroplasty (THA) in acetabular fractures are limited and well defined. The reinforcement antiprotrusio cage offers an opportunity to conduct the THA in select unreconstructable acetabular fractures. The need to open-reduce the posterior column and dome fracture is not necessary and the fracture need not be aligned as the Bursch–Schneider’s cage with flange can compensate for significant bone loss. Three patients in this study with unreconstructable acetabular fractures underwent acute THA. They were followed up for 3 years. The mean Harris hip score was 72.7. Two patients returned to their preexisting activity level. The short-term result in terms of Harris hip score is good and preinjury level can be achieved. There were no cases with complications of cage subsidence or osteolysis during the 3-year follow-up.

Keywords: Acetabulum fractures, Acute total hip arthroplasty, Bursch–Schneider’s cage.

How to cite this article: Salgotra K, Kohli S, Vishwakarma N, Chauhan S. Acute Total Hip Arthroplasty in Unreconstructable Acetabular Fractures: Three Case Reports. MGM J Med Sci 2018;5(2):91-94.

Source of support: MGMIHS

Conflict of interest: None


SHORT COMMUNICATION
Shridhar Dwivedi, Harshita Mangla

Accelerated Atherosclerosis: A Clinical Report

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:95-97]



Aim: The present study was conducted to determine the major risk factors for accelerated atherosclerosis.

Materials and methods: Patients between 50 and 70 years who had documented evidence of atherosclerotic vascular disease at three or more than three arterial sites in a short span of time were included in this study.

Results: Majority (83%) had diabetes for over 15 years mostly with poor control and most common dyslipidemia was low high-density lipoprotein (HDL). Evidence of coronary artery disease (CAD) was noted in all cases. Next common site for atherosclerosis was observed in carotid and lower limb arteries. Three amputation were done which showed evidence of inflammatory arthritis.

Conclusion: Accelerated atherosclerosis is an important complication of long-standing uncontrolled diabetes. Dyslipidemia characterized by low HDL and other inflammatory arthritic conditions also contribute to accelerated atherosclerosis.

Clinical significance: Intermittent claudication or pain in leg in long-standing diabetic cases particularly associated with CAD should arouse suspicion of peripheral arterial diseases. Early detection and management of peripheral arterial disease can save the involved limb from amputation.

Keywords: Accelerated atherosclerosis, Amputation, Cerebrovascular disease, Coronary artery disease, Diabetes mellitus, Intermittent claudication, Peripheral artery disease.

How to cite this article: Dwivedi S, Mangla H. Accelerated Atherosclerosis: A Clinical Report. MGM J Med Sci 2018;5(2):95-97.

Source of Support: Nil

Conflict of Interest: None


LETTER TO THE EDITOR
Shivali Sehgal, Priti Chatterjee, Swati Bharadwaj, Chintamani Pathak

Hemolytic Disease of the Newborn due to Anti-c Antibodies

[Year:2018] [Month:April-June] [Volumn:5 ] [Number:2] [Pages:48] [Pages No:98]



Sir,
Our blood bank received samples of a newborn male child and his mother for blood group and cross match. The neonate developed jaundice on the 3rd day after birth (bilirubin = 27.5 mg/dL, indirect bilirubin = 24 mg/dL), which progressed further on days 4 and 5. Double volume exchange transfusion was planned and the demand was of 520 mL of fresh whole blood.

How to cite this article: Sehgal S, Chatterjee P, Bharadwaj S, Pathak C. Hemolytic Disease of the Newborn due to Anti-C Antibodies. MGM J Med Sci 2018;5(2):98.

Source of support: Nil

Conflict of interest: None


© JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD.