A rare malady with a rarer complication

AbstractIsolated ventricular noncompaction (IVNC) is an unclassified cardiomyopathy characterized by prominent intraventricular trabeculations separated by deep intertrabecular recesses. Although microvascular dysfunction is known, myocardial infarction is rare and usually seen as a consequence of coincidental coronary artery disease. We report the case of a 19-year-old male patient who presented to us with symptoms and signs of heart failure. Echocardiography revealed IVNC with severe left ventricular dysfunction. He was put on medical treatment including oral anticoagulants. Six months later, he came to our emergency department with anterior wall STEMI. Coronary angiogram revealed thrombotic occlusion of distal LAD, which resolved completely with tirofiban and heparin. Coronary thromboembolism due to blood stasis in the left ventricular cavity has not been previously documented in IVNC

Comparing WHO C-Model generated C-Section probabilities to actual delivery outcomes in a tertiary care centre

Background: A model which takes into account several relevant factors and gives the probability of C-Section in a woman would have the advantage of preparing for such an event. The identification of women at high risk of C-Section (>50% risk) would provide the opportunity for understanding risks involved in pursuing a vaginal delivery whereas if the risk of C-Section was less (50% probability, giving the model a sensitivity of 14.33%, specificity of 98.8%, positive predictive value of 90% and negative predictive value of 60.56%. Robson’s Groups 5 and 3 demonstrated the greatest overuse of C-Sections.Conclusions: The WHO Model when applied to this centre showed a high positive predictive value for C-Sections but the negative predictive value or the ability to correctly predict a vaginal delivery was much less

Sandifer syndrome: the mis-interpretable disorder

Sandifer syndrome (SS), a movement disorder which is characterised by spasmodic torsional dystonia with back arching and rigid opisthotonic posturing, negatively impacting predominantly the neck, back, and upper extremities. Symptomatic gastro-esophageal reflux disease, esophagitis, or the presence of a hiatal hernia are all associated with Sandifer syndrome. The cause of Sandifer syndrome being uncertain, lifestyle adjustments and modifications highlights as the appropriate mode of treatment. To treat the condition and help relax the baby after feeding, dietary changes or medications can be administered. The case report of a patient with Sandifer Syndrome is considered for observation. Upon arrival, the child was stable, and an Electro-encephalogram (EEG) test revealed nothing abnormal. The child was taking several Anti-epileptic drugs (AED’s), which were stopped in favour of Sodium valproate and Pyridoxine.  An opinion from a Gastro-enterologist was sought in light of the epilepsy and possible Gastro-esophageal reflux disease (GERD), and they suggested a milk scan. Rantac was then started, and breastfeeds were thickened. Milk can indicate mild GERD and a reduction in episode frequency. So, sodium valproate was discontinued. Haemodynamically stable child was discharged from the hospital with Pyridoxine and Carnisure. Studies shows most cases of SS improve over time, within the first 24 months in general.

Premature Hair Greying - Magnitude and Associated Factors: A cross-sectional study in a university in Mysuru

Background: Premature hair greying (PHG) refers to the diffuse loss of hair color at an age earlier than that is generally accepted as physiological. Studies have found that it affects self-esteem and social life. Our efforts were to estimate the prevalence among students <25years and understand the associated factors. Design and Methods: A cross-sectional study using a simple random sampling technique was used to survey 358 students at a university in Mysuru. The data were analyzed using SPSS v22. The association and relationship of PHG with attributed risk factors and various socio-clinical factors have been analyzed using Chi-Square Test, Independent sample t-test, and Mann Whitney U-test. A p-value of less than 0.05 has been considered statistically significant. Results: In this study, the prevalence of PHG was 28.2%. We observed that PHG was associated with male gender, obesity, and positive paternal, maternal, and family history of PHG. The relation of PHG with lower dietary iron intake, tobacco smoking amount, and frequency was also found in this study. However, no association between PHG and psychological stress, alcohol consumption, dietary Vitamin B12, and D intake, shampoo, and oil usage frequency was found. Conclusion: We recommend that further studies should be done to check if weight reduction, smoking cessation, and maintenance of dietary iron adequacy can help in preventing PHG

A retrospective study of Adverse Drug Reactions in a tertiary care centre

Background: Adverse drug reactions (ADRs) are a major concern in present day clinical practice. They are inevitable consequences of drug therapy; as no pharmacotherapeutic agent is completely free from noxious and unintended effects. They are major contributors for morbidity, mortality and hospitalization of the patients increasing the economic burden on the society and uncertainty in clinical outcomes.Methods: This was a retrospective observational study, extending over 6 months (September 2016 to February 2017). A total of 290 cases were studied, excluding the geriatric age group. The data was collected using CDSCO ADR reporting form. A comparison of ADR between males and females was made; based on the organ system affected and the category of drug using “proportion test”.Results: The study showed the ADR incidence was equal in both sexes (≈50%). It was observed that majority ADRs were from gastro intestinal system (39%) followed by CNS (20%) and skin and soft tissue (14%). Constipation was found to be the most common of the reported ADRs (18%) followed by vomiting (9%) and diarrhoea (8%).Conclusions: ADRs are a major cause of morbidity worldwide. Several studies; including the present one, has shown GIT to be the most common system affected. Frequency of ADRs can be reduced by careful follow up and a robust hospital based pharmacovigilance setup

Aspect of sleep quality amid undergraduate medical students in correlation with BMI.

Purpose: This study aimed to assess the quality of sleep among medical undergraduates from different phases of the medical program using the Pittsburgh Sleep Quality Index (PSQI) and to study the association of body mass index (BMI) with the quality of sleep among them. Material and Methods: Sleep quality was assessed among 482 medical undergraduates using the PSQI. Students undergoing treatment for psychiatric illness, diabetes or hypertension, history of alcohol consumption, and smoking were excluded from the study. Obesity was ascertained by calculating the BMI and categorized into 2 groups of23.0 according to the World Health Organization (WHO) guidelines for the Asian population. The chi-square test was utilized to compare seven components of PSQI and sleep quality for different phases and BMI groups and SPSS 24 was used to compare the components and the global score. Results: Only 0.8% of the total sample classified their sleep as very bad whereas 69.5% classified themselves as fairly good sleepers. The study participants had an average sleep time of 7.06±1.26 hours. The sleep duration (p23 had daytime dysfunction every day. Conclusions: It is necessary to create awareness among medical undergraduates about the importance of good sleep hygiene which will help them to improve their academic performance

Association of Physical Activity and Screen Time Usage of Adolescents in Rural Areas of Mysore.

Introduction: In these changing times there have been increased usage of screen device due to more accessibility to both device and the internet and a greater number of children are having reduced physical activity. The purpose of the current study was to determine if screen usage among adolescents (11-17yrs) who live in supportive environments is associated with decreased levels of moderate to vigorous physical activity. Methods & materials: A school-based cross-sectional study was conducted in two rural schools of Mysore, Karnataka in February 2023, in 176 students between the age group of 11 – 17yrs. Physical activity and screen time was evaluated using a questionnaire. School sports, Leisure Time Physical Activity (LTPA), and mode of transportation to school was evaluated for their physical activity pattern and the amount of time spent on each type of screen device – TV, Computers, video games, mobile phones, and tablets was measured in hours per day. Results: Prevalence of excessive screen time usage was 36%and physical activity \u3e1hr./day was found to be 57% in study subjects. However, there is no correlation between physical exercise and screen time found in rural adolescents. Conclusion: Prevalence of excessive screen time with 57% of adolescents having physical activity more than 1hr/day. A tighter control of screen usage was also shown by 77% of adolescents, being role models for appropriate screen time, all are factors for an improved lifestyle