Effect of phototherapy on serum calcium levels in neonates receiving phototherapy for neonatal jaundice

Background: To study the occurrence of hypocalcaemia in neonates with physiological unconjugated hyperbilirubinemia after 48 hours of phototherapy or at the end of phototherapy, in case duration of phototherapy was less than 48 hours.Methods: This prospective study was conducted on 100 term neonates (61 males and 39 females) admitted to Neonatal intensive care unit of Teerthankar Mahaveer Medical College, Moradabad with unconjugated hyperbilirubinemia and requiring phototherapy. Total Serum bilirubin levels and serum calcium levels were checked before and after phototherapy. Neonates were assessed for clinical features of hypocalcemia i.e. jitteriness, irritability/excitability, lethargy and convulsions.Results: After phototherapy, there was hypocalcemia in 35.0% neonates. The difference between pre and post phototherapy serum calcium levels were found to be statistically significant (p <0.001). 2.86% of neonates developed jitteriness among those who had hypocalcemia. Hypocalcemia was more in subjects who received phototherapy for longer duration.Conclusions: Hypocalcaemia is a common complication of phototherapy. Therefore, calcium supplementation should be done in all neonates undergoing phototherapy

Disaster Relief Workers: Health Issues

Introduction: Disaster is defined as any occurrence that causes damage, ecological disruption, loss of human life or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area. Internationally, major disasters occur frequently, but for one country, they are unusual events. It causes severe health damage to that country. In this scenario, our rescue teams/ relief workers risk their own lives to save the life of others. Methods: The concerned topic was searched on internet in different databases with abstract or full free text available in English in previous five years. Results: This group is more vulnerable than general population to various accidents even death in relief process and also health problems such as post traumatic stress disorder, mental health risks, heat disorder, radiation exposure, respiratory problems, skin and mucous membrane problems, digestive problems, eye irritation and fatigue etc. In developed countries, their problems are dealt with great zeal, but unfortunately, in our country, we fail to address the health issue of these workers in spite of having the most important role in disaster management by providing physical and rehabilitative services to survivors. It has been proven that work output of these workers is enhanced if their health issues are taken care of properly. Discussion: We want to acknowledge the health concerns of rescue teams with possible solutions

Clinical and biochemical profile in patients of scrub typhus: an under reported disease-a tertiary care hospital based study in Uttarakhand, India

Background: Scrub typhus is an emerging but neglected infectious diseases that generally results in acute febrile illness, with spectrum of diseases ranging from mild illness to multiorgan dysfunction. Hence we planned this study to know the demographic, clinical and biochemical profile of scrub typhus patients in hilly state of Uttarakhand. Methods: This was a prospective observational study conducted from June 2020 to November 2020 in the Department of Internal Medicine, in a tertiary care institution located in state of Uttarakhand, India. All scrub typhus patients were evaluated by detailed history, examination and laboratory tests. Results: Among 60 cases, the mean age of patients was 38.3±15.43 years, with majority of patients (70.2%) being young adults between the age 18‑40 years. Majority of patients were females (60.0%) with (M:F-1:1.3). 53.3% patients reported from rural and 46.7% patients from urban area. Fever (100%), cough and breathlessness (40.0%), nausea and vomiting (20%), abdominal pain and diarrhoea (16.7%), headache (16.7%) and altered sensorium (8.3%) were the predominant clinical features. Hepatic dysfunction (51; 85.0%) and respiratory dysfunction (25; 41.6%) were the commonest findings followed by renal dysfunction (13; 21.7%). Conclusions: Scrub typhus is often misdiagnosed or diagnosed late due to its wide clinical spectrum overlapping with clinical presentation of other commonly prevalent tropical diseases. An increasing awareness of this disease coupled with prompt management will go a long way in reducing both morbidity and mortality in this disease

Angiomatous nasal polyp: Clinical diagnostic dilemma

Angiomatous polyp (Angiectatic nasal polyps) is rare and its incidence is 4-5% of all nasal polyps. As it occurs with variable clinical features and there is no confirmatory preoperative investigation, clinical diagnosis can be a dilemma. Clinical picture of angiofibroma, simple antrochoanal polyp and inverted papilloma may resemble with each other. As polyps invade surrounding bone, these should be distinguished from a malignant mass. We present an interesting case of an infarcted angiectatic nasal polyp with extensive surrounding bony destruction. Correct preoperative radiological diagnosis is important to avoid unnecessary extensive surgery. Histopathological evaluation of polyps is mandatory since they require different treatment due to difference in the prognosis

Framing Research Question and Formulating Hypothesis for Testing: Critical Step in Research

Science is so dynamic that every moment some new advances are happening in each and every field. Medical science is also one of them. To keep pace with the advancements, we always need to update our knowledge to improve our decisions and actions relating to various aspects of medical science. A successful research will largely depend upon how well an investigator frames the research question. To comment upon the research with a degree of certainty, we need to develop a hypothesis, so that, it can be tested statistically by applying required tests of significance

The Relationship Between Maxillary and Mandibular Base Lengths and Dental Crowding in Patients with True Class II Malocclusions

INTRODUCTION: Orthodontists, for a long time have considered that occlusion and facial beauty are so interdependent that they must be equal goals of treatment.AIM: To validate the relationship between maxillary and mandibular effective lengths and dental crowding in patients with Class II malocclusions. MATERIALS AND METHOD: A sample of 40 orthodontic patients with complete bilateral Class II malocclusions in the permanent dentition (25 males, 15 females) who were divided into two groups based on severity of pre-treatment mandibular anterior dental crowding. The maxillary and mandibular effective lengths and tooth-arch size discrepancies were measured on the pre-treatment Lateral cephalograms and initial casts, respectively. Intergroup comparisons of apical base lengths were assessed with independent t-tests. Correlation between effective length and dental crowding was assessed by Pearson's correlation coefficient (P &lt;.05).RESULTS: Subjects with Class II malocclusion and moderate to severe crowding had significantly smaller maxillary and mandibular effective lengths compared with subjects without crowding and with minimal dental crowding. A weak inverse correlation was also found between maxillary and mandibular effective lengths and the severity of dental crowding. CONCLUSION: In patients with complete Class II malocclusion, decreased maxillary and mandibular effective lengths constitute a significant factor associated with dental crowding

Heat-induced proteomic changes in anthers of contrasting rice genotypes under variable stress regimes

Heat stress drastically affects anther tissues resulting in poor plant fertility, necessitating an urgent need to determine the key proteome regulation associated with mature anther in response to heat stress. We identified several genotype - specific protein alterations in rice anthers of Moroberekan (Japonica, heat sensitive), IR64 (Indica, moderately heat tolerant), and Nagina22 (Aus, heat tolerant) in the short-term (ST_HS; one cycle of 42°C, 4 hours before anthesis) and long-term (LT_HS; 6 cycles of 38°C, 6 hours before anthesis) heat stress. The proteins upregulated in long-term heat stress in Nagina22 were enriched in biological processes related to unfolded protein binding and carboxylic acid metabolism, including amino acid metabolism. In short-term heat stress, Nagina22 anthers were enriched in proteins associated with vitamin E biosynthesis and GTPase activator activity. In contrast, downregulated proteins were related to ribosomal proteins. The expression of different Hsp20 and DnaJ was genotype specific. Overall, the heat response in Nagina22 was associated with its capacity for adequate metabolic control and cellular homeostasis, which may be critical for its higher reproductive thermotolerance. This study improves our understanding of thermotolerance mechanisms in rice anthers during anthesis and lays a foundation for breeding thermotolerant varieties via molecular breeding

Management of difficult airway in intratracheal tumor surgery

BACKGROUND: Tracheal malignancies are usual victim of delay in diagnosis by virtue of their symptoms resembling asthma. Sometimes delayed diagnosis may lead to almost total airway obstruction. For difficult airways, not leaving any possibility of manipulation into neck region or endoscopic intervention, femorofemoral cardiopulmonary bypass can be a promising approach. CASE PRESENTATION: We are presenting a case of tracheal adenoid cystic carcinoma (cylindroma) occupying about 90% of the tracheal lumen. It was successfully managed by surgical excision of mass by sternotomy and tracheotomy under femorofemoral cardiopulmonary bypass (CPB). CONCLUSION: Any patient with recurrent respiratory symptoms should be evaluated by radiological and endoscopic means earlier to avoid delay in diagnosis of such conditions. Femorofemoral cardiopulmonary bypass is a relatively safe way of managing certain airway obstructions

Bilateral Ramsay Hunt syndrome in a diabetic patient

BACKGROUND: Herpes zoster oticus accounts for about 10% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in immunocompromised patients, though incidence is very rare. CASE PRESENTATION: Diabetic male, 57 year old presented to us with bilateral facial palsy due to herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural hearing loss. Patient was treated with appropriate metabolic control, anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, glucocorticoids were not used in this patient. Significant improvement in hearing status and facial nerve functions were seen in this patient. CONCLUSIONS: Herpes zoster causes severe infections in diabetic patients and can be a cause of bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in diabetic patients should be treated with appropriate metabolic control, NSAIDS and intravenous acyclovir, which we feel should be started at the earliest. Glucocorticoids should be avoided in diabetic patients