International Medicine
type: channel
description: The International Medicine is a distinguished international print publication that is recognized for its rigorous double-blind peer review process, has a focused mission of contributing to the advancement of knowledge in the fields of medicine and surgery. Since the month of September 2025, this journal does not exist in embase list.
language: en
publication name: International Medicine
items: Trichobezoar Causing Small Bowel Obstruction, Perforation, and Meckel's Diverticulum: Rare Case
items: Eﬀectiveness of Triple Saline Washed Leucoreduced Red Cells in Prevention of Post Transfusion Reaction Among Beta- Thalassemia Major Patients
items: Cross Sectional Study on the Pattern of Blood Utilization and Quality Indicators at a Tertiary Care Hospital in Karnataka
items: A Rare Presentation of Hemophagocytic Lymphohistiocytosis Secondary to Dengue Infection in a Sickle Cell Carrier with Concurrent Hyperhemolysis Syndrome
items: Endoscopic Findings and Clinical Outcomes in Adults Following Acidic and Alkaline Caustic Ingestion: A Retrospective Study at a Tertiary Care Hospital
items: A Comparative Study of Local Versus Spinal Anaesthesia in Lichtenstein Inguinal Hernioplasty: A Prospective Randomized Controlled Trial
items: Clinical Profile of Beta Thalassemia and Iron Overload Status with Special Reference to Serum Ferritin - A Cross Sectional Observational Study in a Tertiary Care Hospital
items: Incidence and Risk Factors for Rop Development in Babies Admitted In Nicu Outborn and Inborn In A Tertiary Care Center andAssociation of Anemia in Newborns with ROP
items: A Clinical Study of Hepatic Abscess with Reference to its Management
items: A Comparative Study of Desarda's Technique with Lichtenstein Mesh Repair in Treatment of Inguinal Hernia: A Prospective Randomized Control Study
items: Elastography for the Evaluation of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease: A Systematic Review
items: A Case Of Congenitally Corrected Transposition Of Great Arteries Of Elderly Male: A Rare Event
items: A Prospective Observational Study to Assess the Efficacy of Intrathecal Levobupivacaine versus Bupivacaine in Elderly Patients Undergoing Lower Abdominal Surgeries
items: Assessment of Serum Adenosine Deaminase (ADA) Levels as a Predictive Marker for Diabetes Mellitus in Obese Individuals: A Case–Control Study at a Tertiary Care Center
items: Prevalence of Psychiatric Morbidity and its Associated Risk Factors in Postmenopausal Women-A Cross-Sectional Study
items: Prevalence of Depression in Stroke Survivors and the Relationship between Site of Lesion and Duration of Stroke Onset on Post stroke Depression
items: Induction Chemotherapy Followed by Chemoradiation in Patients of Locally Advanced Laryngeal and Hypopharyngeal Cancers with Intent of Organ Preservation
items: Total Elbow Replacement with Bakshi's Sloppy Hinge Prosthesis in UnsalvageableElbows: A Retrospective Study of Functional Outcomes
items: Impact of Mannequin Based Simulation as Add on Teaching Learning Tool in Pharmacology Training of Undergraduate Medical Students
items: Evaluation of p53 and Ki-67 Expression in Cervical Intraepithelial Neoplasia (CIN) and Invasive Cervical Cancer: A Prospective Observational Study
items: Significance of CT-Derived Sarcopenia Using L3 Skeletal Muscle Index in Lung Cancer Patients: A Prognostic Retrospective Study
items: Can Lymphoma and Multiple Myeloma mimic Radiologically
items: Optical Coherence Tomography in Detecting Subclinical Cystoid Macular Fluid Accumulation Post Nd: YAG Laser Capsulotomy
items: Evaluation of Surgical Outcome in Penetrating Keratoplasty in Adherent Leucoma and Leucoma Grade Corneal Opacity
items: Case Report on a Case of Right Nasolabial Cyst in Young Female with Dental Remnant
items: Diagnostic Utility of MR Spectroscopy in Differentiating Recurrent Brain Tumors from Radiation Necrosis: A Prospective Single-Center Study
items: A Hospital-Based Observational Study on Nutritional Status, Functional Impairment, and Etiological Correlates in Children with Cerebral Palsy at a Tertiary Care Center
items: Pleomorphic Invasive Lobular Carcinoma with Ductal Component: A Rare Mixed Tumour of Breast
items: Diagnostic Utility of P63 in Differentiating Ambiguous Lesions of Prostate
items: Clinical and Pathological Evaluation of Antepartum Stillbirths: A Retrospective Observational Study at a Tertiary Care Center

Trichobezoar Causing Small Bowel Obstruction, Perforation, and Meckel's Diverticulum: Rare Case
type: item
description: Trichobezoars, rare gastrointestinal masses composed of ingested hair, predominantly affect young females with underlying psychiatric conditions such as trichotillomania and trichophagia. Rapunzel syndrome, a severe form of trichobezoar, extends into the small intestine and can lead to complications such as obstruction and perforation. Meckel's diverticulum, an embryological remnant of the vitellointestinal duct, may also serve as a nidus for bezoar impaction, exacerbating the risk of intestinal obstruction. We present a rare case of a 16-year-old male with no prior psychiatric history who developed acute small bowel obstruction and multiple jejunal perforations due to trichobezoars, one of which was lodged within a Meckel's diverticulum. Clinical presentation included abdominal pain, distension, vomiting, and constipation. Imaging suggested small bowel obstruction with intraluminal hyperdense contents. Exploratory laparotomy revealed two trichobezoars, three jejunal perforations, and an inflamed Meckel's diverticulum. Surgical management included resection of the involved ileal segment with primary anastomosis, jejunal repairs, and loop jejunostomy. Postoperative recovery was uneventful. This case highlights the unusual occurrence of trichobezoar in a male adolescent with associated Meckel's diverticulum and jejunal perforation a combination scarcely documented in the literature. Early suspicion, timely imaging, and prompt surgical intervention are essential in preventing morbidity. The presence of Meckel's diverticulum should raise the index of suspicion for bezoar-related complications in unexplained small bowel obstruction, especially in younger patients.
subject: Articles
  topic: section
subject: Trichobezoar Causing Small Bowel Obstruction, Perforation, and Meckel's Diverticulum: Rare Case
  topic: keywords
creator: Dr. Rima Mondal
creator: Dr. Pradeep Saxena
rights: Copyright (c) 2025 International Medicine
date: 2026-04-01
publication date: 2026-04-01

Eﬀectiveness of Triple Saline Washed Leucoreduced Red Cells in Prevention of Post Transfusion Reaction Among Beta- Thalassemia Major Patients
type: item
description: Introduction: Beta-thalassemia major is an inherited hematological disorder characterized by severe anemia, necessitating lifelong regular blood transfusions. Although essential, repeated transfusions are associated with several complications such as febrile non-hemolytic transfusion reactions (FNHTRs), alloimmunization, allergic responses, and iron overload. Triple saline washing, a leukoreduction technique applied to packed red blood cells (PRBCs), significantly decreases residual leukocytes, thereby reducing transfusion-related adverse reactions. This study evaluates the effectiveness of triple saline–washed leukoreduced PRBCs in minimizing post-transfusion complications and enhancing transfusion safety in patients with beta-thalassemia major. Objective: To evaluate the efficacy of triple saline–washed leukoreduced PRBCs in reducing post-transfusion reactions and to analyze the association between the degree of leukoreduction and clinical outcomes. Methods: A cross-sectional study was conducted at a tertiary care center from January 2023 to October 2024. Patients diagnosed with transfusion-dependent beta-thalassemia major were enrolled. Inclusion criteria comprised confirmed diagnosis and regular transfusion requirements. Leukocyte counts were assessed before and after triple saline washing, and post-transfusion reactions were documented. Statistical analysis compared the frequency of transfusion reactions across different levels of leukoreduction. Results: Among the study participants, 68.6% achieved leukoreduction levels below 85%, while 31.4% exceeded this threshold. Patients with higher leukoreduction (>85%) experienced significantly fewer transfusion reactions (6.3%) compared to those with lower leukoreduction rates (40.0%) (p = 0.014). FNHTRs were the most frequently observed reactions (53.3%), followed by allergic reactions (40.0%). Most patients had pre-transfusion hemoglobin levels ranging from 8.5 to 9 g/dL (39.2%), consistent with recommended guideline…
subject: Articles
  topic: section
subject: Beta-thalassemia major Triple saline wash Leukodepletion Post-transfusion reactions Febrile non-hemolytic reactions Packed red blood cells
  topic: keywords
creator: Dr. Vijaysri
creator: Dr. Sharath Kumar Rao
creator: Dr. Zulfikar Ahamed
creator: Dr. Arun M
creator: Dr. Aasha Bhaskar
creator: Dr. Palak Aggarwal
rights: Copyright (c) 2025 International Medicine
date: 2026-01-18
publication date: 2026-01-18

Cross Sectional Study on the Pattern of Blood Utilization and Quality Indicators at a Tertiary Care Hospital in Karnataka
type: item
description: Background: Blood transfusion services are vital for medical care but require efficient use to ensure patient safety and optimal resource utilization. Quality indicators such as the crossmatch-to-transfusion ratio (C/T), transfusion probability (%T), and transfusion index (TI) help to monitor and improve utilization efficiency. Aim: To assess the pattern of blood component utilization and assess quality indicators across various departments in a tertiary care hospital in Karnataka. Materials & methods: This retrospective cross-sectional study analyzed transfusion records from January 2023 to December 2024 at the Department of Immunohematology and Blood Transfusion, Victoria Hospital, Bangalore Medical College and Research Institute. Data on patients, units crossmatched, issued and transfused were collected, and C/T ratio, %T, and TI were calculated for each department. Results: A total of 21,156 PRBC units were crossmatched, and 15,692 units were transfused. The overall C/T ratio, %T, and TI were 1.34, 76.76%, and 0.98, respectively. Efficient utilization (C/T ≤2.5, %T ≥30%, TI ≥0.5) was observed in most departments, including Burns, Gastroenterology, Nephro-Urology, and General Medicine. Over-ordering of blood was noted in General Surgery followed by Trauma & Emergency Care Centre. Conclusion: Overall utilization was efficient, but certain departments demonstrated overordering. Implementation of Maximum Surgical Blood Ordering Schedule (MSBOS), Type-and-Screen (T&S) policy, and Institutional transfusion guidelines is recommended to further optimize utilization. Proper communication between the department of Transfusion medicine and other departments as well as regular auditing is necessary to prevent wastage of blood and resources.
subject: Articles
  topic: section
subject: Blood utilization Crossmatch to transfusion ratio Transfusion probability Transfusion index Efficient usage Overordering, MSBOS
  topic: keywords
creator: Dr. Uma Magheswari. C
creator: Dr. Panchakshari Prasanna. P. K
creator: Dr. Akshitha Dave
creator: Dr. Vijayshree Sakpal
creator: Dr. Dheemantha. P
rights: Copyright (c) 2025 International Medicine
date: 2025-12-21
publication date: 2025-12-21

A Rare Presentation of Hemophagocytic Lymphohistiocytosis Secondary to Dengue Infection in a Sickle Cell Carrier with Concurrent Hyperhemolysis Syndrome
type: item
description: Hemophagocytic Lymphohistiocytosis (HLH) is a rare but life-threatening hyperinflammatory syndrome that can be triggered by infections, malignancies, and other immune dysregulations. This report discusses the case of a 27-year-old male with sickle cell disease with Beta thalassemia (heterozygous state) who presented with generalized fatigue, weakness, and fever and subsequently developed hemolysis following blood transfusions. A positive IgM dengue test and immunohematology findings, including negative alloantibody screening and negative Direct and Indirect agglutination tests, guided the diagnosis of HLH secondary to dengue infection, with hyperhemolysis syndrome considered a secondary differential. Early recognition of HLH and prompt use of corticosteroids can significantly improve outcomes in complex sickle cell cases with concurrent viral infections.
subject: Articles
  topic: section
subject: Hemophagocytic lymphohistiocytosis Sickle cell trait Hyperhemolysis syndrome Dengue Immunohematology
  topic: keywords
creator: Dr. Vijaysri
creator: Dr. Sharath Kumar Rao
creator: Dr. Zulfikar Ahamed
creator: Dr. Arun M
creator: Dr. Aasha Bhaskar
creator: Dr. Palak Aggarwal
rights: Copyright (c) 2025 International Medicine
date: 2025-12-08
publication date: 2025-12-08

Endoscopic Findings and Clinical Outcomes in Adults Following Acidic and Alkaline Caustic Ingestion: A Retrospective Study at a Tertiary Care Hospital
type: item
description: Introduction: Caustic ingestion is a critical medical emergency with potential for significant gastrointestinal injury and long-term complications. This retrospective observational study, conducted at KIMS Hospital (Tertiary care hospital), Bangalore Urban, Karnataka compared endoscopic findings and clinical outcomes among adult patients who ingested either acidic or alkaline substances. The study aimed to evaluate differences in demographics, intent of ingestion, mucosal injury severity, treatment approaches, and short-term outcomes. Material and Methods: Adult patients with caustic ingestion who underwent endoscopic evaluation within 96 hours of ingestion at KIMS hospital between April 2022 and April 2025 were included. Data on demographics, type and amount of substance, intent, comorbidities, Zargar grading, treatments, and outcomes were collected. Exclusion criteria included hemodynamic instability, perforation, severe respiratory distress, non-corrosive ingestion, or confounding comorbidities. Descriptive statistics summarized patient characteristics, while Mann-Whitney and Chi-square tests assessed differences between acidic and alkaline groups, with significance set at p<0.05. Results: A total of 88 patients were included. Age and gender distribution were similar across groups. Suicidal ingestion predominated, and most patients had no comorbidities. Sulphuric acid and sodium hydroxide were the most commonly ingested substances in their respective groups. Zargar grading showed comparable mucosal injury severity in the esophagus, stomach, and duodenum. Conservative management was the primary approach for both groups.Although overall recovery was high, the alkaline group had slightly higher mortality and significantly more post-treatment complications (p=0.03). One-month follow-up showed significantly more antral gastritis and fewer complication-free cases in the alkaline group. Conclusion: Both acidic and alkaline ingestions resulted in similar injury severity …
subject: Articles
  topic: section
subject: Caustic ingestion Alkaline vs. Acidic Zargar classification Endoscopy Clinical outcomes
  topic: keywords
creator: Dr. Preethan Nagappa
creator: Dr. Bidarahalli K Prasanna
creator: Dr. Shariq Ahmed Khan
creator: Dr. Preksha V
rights: Copyright (c) 2025 International Medicine
date: 2025-11-21
publication date: 2025-11-21

A Comparative Study of Local Versus Spinal Anaesthesia in Lichtenstein Inguinal Hernioplasty: A Prospective Randomized Controlled Trial
type: item
description: Introduction: Inguinal hernia repair is among the most common surgical procedures globally, with Lichtenstein mesh hernioplasty being the standard technique due to its simplicity and low recurrence rate. However, the choice of anaesthesia—local or spinal—plays a pivotal role in influencing intraoperative and postoperative outcomes. While spinal anaesthesia (SA) is widely used in India, local anaesthesia (LA) is gaining attention for its potential benefits, especially in day-care surgery. Aim and Objective: This study aims to compare the clinical outcomes of Lichtenstein inguinal hernioplasty performed under local versus spinal anaesthesia, focusing on intraoperative difficulties, postoperative pain, complications, hospital stay, and overall recovery. Materials and Methods: A prospective randomized controlled trial at J.A. Group of Hospitals, Gwalior (June 2023–December 2024), included 94 male patients with unilateral, reducible inguinal hernia. They were randomly divided into two groups: local anaesthesia (Group A) and spinal anaesthesia (Group B), with 47 patients each. Key outcomes assessed included intraoperative pain (VAS), operative duration, postoperative pain at various intervals, complications such as urinary retention, headache, infections, and total hospital stay.All data were statistically evaluated for comparison between the groups. Results: Both groups were similar in demographics, hernia type, intraoperative pain, and operative time. Postoperative pain was significantly lower in the local anaesthesia group. Urinary retention and headache were more frequent in the spinal anaesthesia group. Hospital stay was shorter in the local group, indicating faster recovery and improved postoperative outcomes. Conclusion: Local anaesthesia is a safe, effective, and economical alternative to spinal anaesthesia for inguinal hernioplasty, offering superior postoperative recovery, fewer complications, and reduced hospital stay.
subject: Articles
  topic: section
subject: Inguinal Hernia Local Anaesthesia Spinal Anaesthesia Hernioplasty Postoperative Pain
  topic: keywords
creator: Dr.Yogesh Desarda
creator: Dr. Anurag Chauhan
rights: Copyright (c) 2025 International Medicine
date: 2025-11-21
publication date: 2025-11-21

Clinical Profile of Beta Thalassemia and Iron Overload Status with Special Reference to Serum Ferritin - A Cross Sectional Observational Study in a Tertiary Care Hospital
type: item
description: Introduction: Beta-thalassemia is a hereditary blood disorder characterized by defective hemoglobin synthesis, leading to chronic anemia and its associated complications. It is especially prevalent in malaria-endemic regions, including India. Patients often require frequent blood transfusions, predisposing them to iron overload, a significant cause of morbidity and mortality. This study focuses on understanding the clinical presentation of beta-thalassemia and evaluating iron overload status using serum ferritin levels. Objective: To assess the clinical profile of patients diagnosed with beta-thalassemia and determine their iron overload status with special reference to serum ferritin concentrations. Methods: This hospital-based, cross-sectional observational study was conducted in the Department of Medicine at Tezpur Medical College and Hospital from August 2023 to July 2024. A total of 40 patients aged above 12 years, presenting with anemia and diagnosed with thalassemia, were included. Exclusion criteria were applied to rule out confounding causes of anemia. Clinical data were collected using structured questionnaires, and laboratory investigations included hemoglobin analysis via HPLC and serum ferritin estimation. Results: The majority of patients (62.5%) were male, with the highest incidence in the 12–20 year age group. Weakness, pallor, and splenomegaly were the most common symptoms. The frequency of blood transfusion varied widely, with most patients receiving transfusions every 26–30 days. Serum ferritin levels ranged from 251–500 ng/mL in most cases, with 10 patients exhibiting levels >1000 ng/mL, indicating significant iron overload. Conclusion: Thalassemia predominantly affects adolescents and males. Frequent transfusions contribute to iron overload, necessitating regular monitoring of serum ferritin to guide chelation therapy.
subject: Articles
  topic: section
subject: Beta-thalassemia Iron overload Serum ferritin Cross-sectional Tertiary care
  topic: keywords
creator: Dr. Dwijen Das
creator: Dr. Purabi Thaosen
creator: Dr. Subrata Thakur
creator: Dr. Purnakshi Bhattacharyya
creator: Dr. Anaswara Ravi
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-11-13
publication date: 2025-11-13

Incidence and Risk Factors for Rop Development in Babies Admitted In Nicu Outborn and Inborn In A Tertiary Care Center andAssociation of Anemia in Newborns with ROP
type: item
description: Background: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness, particularly in India, where high preterm birth rates and expanding neonatal intensive care services contribute to a growing disease burden. Objectives: To determine the incidence of ROP among neonates admitted to inborn and outborn NICUs of a tertiary care hospital in Assam, and to evaluate risk factors. Methods: A prospective observational study was conducted at Gauhati Medical College and Hospital from October 2022 to August 2023. Neonates with birth weight <2000 g, gestational age <34 weeks, or 34–36 weeks with additional risk factors were included. Ophthalmic screening with indirect ophthalmoscopy was performed at 3–4 weeks of age and classified according to the International Classification of ROP. Clinical data and neonatal morbidities were analyzed using Chi-square test and logistic regression. Results: Of 300 infants screened, 62 developed ROP, giving an incidence of 20.7%. Incidence was higher in males (56.7%) and inversely related to gestational age (80% at 31 weeks vs. 6.1% at ≥37 weeks) and birth weight (77.7% <1000 g vs. 7.7% >2500 g) (p<0.001). Prolonged oxygen exposure (>3 days) markedly increased risk (63.9% vs. 4.1%, p<0.001). Independent predictors included phototherapy (OR 13.79), birth asphyxia (OR 11.28), sepsis (OR 4.80), multiple transfusions (OR 5.73), respiratory distress syndrome (OR 3.62), and multiple births (OR 3.32), while antenatal steroid use was protective (OR 0.19). Most cases (91.3%) regressed spontaneously; 6 infants (9.7%) required treatment. Conclusion: ROP incidence in this cohort was substantial, emphasizing the need for universal screening of high-risk neonates, stringent oxygen monitoring, and judicious transfusion practices to reduce preventable blindness
subject: Articles
  topic: section
subject: Incidence of ROP Neonates Retinopathy Visual impairment Blood vessels
  topic: keywords
creator: Dr Gayatri Bezboruah
creator: Dr Diganta Barman
creator: Dr Swasthik D
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-11-13
publication date: 2025-11-13

A Clinical Study of Hepatic Abscess with Reference to its Management
type: item
description: Background: The aim and objective of our study was to evaluate demographic pattern, various clinical findings, laboratory investigations and different treatment modalities of hepatic abscess. Introduction: Hepatic abscess is a pus-filled mass or lesion in the liver that can arise from liver injury or an intra-abdominal infection spread from the portal circulation. Hepatic abscesses are of various types depending on the aetiology and may be of 2 major types Pyogenic or Parasitic in origin. Hepatic abscesses are a major issue in tropical countries like India, frequently leading to serious consequences and posing difficulties in diagnosis and treatment. Early diagnosis and prompt treatment now improves the prognosis of the disease. Material and Methods: This was a prospective observational study where 35 patients having proven liver abscess admitted in surgery ward from March 2023 to Feb 2024 are included. A predesigned proforma was used to collect data and all data collected were analyzed statistically. Results: Amoebic hepatic abscesses were more common than pyogenic hepatic abscesses. Hepatic abscesses were more common in male than female with sex ratio of 7.7:1 and majority of patients belong to low socioeconomic status (71.4%). Hepatic abscesses were more common in age group of 31-40 years. Alcoholism (68.6%) and diabetes (14.3%) were the most common predisposing factors. Out of 7 aspirate culture positive, 6 (85.7%) were E. Coli and 1 (14.3%) was Klebsiella. Most of the patient (≥80%) showed > 50% of resolution of abscess at 3rd day of treatment with different treatment modalities. Conclusion: The modern-day ultrasound and other minimally invasive imaging techniques had greatly improved the diagnosis and treatment of hepatic abscess. Conservative management with IV antibiotics and ultrasound guided percutaneous catheter drainage or needle aspiration of an abscess are now the most commonly used treatment modalities.
subject: Articles
  topic: section
subject: Hepatic Abscess Liver Abscess Management Treatment of Hepatic Abscess Abscess Drainage Techniques Clinical Outcomes of Hepatic Abscess
  topic: keywords
creator: Prof. Narendra Nath Ganguly
creator: Dr. Arup Deka
creator: Dr. Pirbi Teron
creator: Dr. Richard Barla
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-11-13
publication date: 2025-11-13

A Comparative Study of Desarda's Technique with Lichtenstein Mesh Repair in Treatment of Inguinal Hernia: A Prospective Randomized Control Study
type: item
description: Introduction: Repair of an inguinal hernia is one of the most prevalent types of surgery. Some mesh-based techniques, such as Lichtenstein repair, have become more popular because they have a lower rate of recurrence. However, the difficulties associated with using a mesh have prompted the creation of alternative tissue-based mending techniques, such as the method devised by Desarda. Objective: To assess the efficacy and safety of the Desarda technique of no mesh repair compared to the Lichtenstein mesh repair for the treatment of primary inguinal hernias. Methods: Prospective randomized control trial was done in PSG Institute of Medical Sciences and Research. Sixty patients diagnosed with unilateral primary inguinal hernia were randomly assigned to receive one of two interventions: the Desarda or Lichtenstein repair. The primary outcome of interest was postoperative complications. The secondary endpoints included the duration of surgery, postoperative pain, length of hospital stay, and resumption of regular activities. Findings: The two groups had the same amount of time in surgery and the same level of complications. The patients who had Desarda repair had a lot less pain after surgery and were able to get back to their normal activities much faster. During the follow-up, none of the cases had any recurrences. Conclusion: The Desarda repair is a viable alternative to the Lichtenstein mesh repair, demonstrating similar effectiveness with reduced pain and expedited recovery time. It provides a cost-effective option in situations where mesh is inaccessible or contraindicated.
subject: Articles
  topic: section
subject: Desarda Repair Lichtenstein Repair Mesh Problems Tissue-Based Hernia Repair And Inguinal Hernia
  topic: keywords
creator: Dr. Surendran A
creator: Dr. Vimalraj S.
creator: Dr. G. Sivagnanam MS
creator: Dr. Tracy Rosalin Poulose
creator: Dr. S. Prem Kumar
creator: Naveena Nandhikesan
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-11-13
publication date: 2025-11-13

Elastography for the Evaluation of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease: A Systematic Review
type: item
description: *]:pointer-events-auto [content-visibility:auto] supports-[content-visibility:auto]:[contain-intrinsic-size:auto_100lvh] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" tabindex="-1" data-turn-id="request-WEB:f68bc160-6f39-4684-b7a7-a2b48900c069-2" data-testid="conversation-turn-6" data-scroll-anchor="true" data-turn="assistant"> Background: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide, often progressing to fibrosis, cirrhosis, and liver failure. Liver biopsy, the traditional gold standard for fibrosis assessment, is invasive and impractical for routine monitoring. Elastography, a non-invasive technique measuring liver stiffness, has emerged as a promising alternative. This systematic review evaluates the diagnostic accuracy of transient elastography (TE), point shear wave elastography (pSWE), two-dimensional shear wave elastography (2D-SWE), and magnetic resonance elastography (MRE) for staging liver fibrosis in NAFLD. Methods: Studies were included if they evaluated one or more of elastography techniques and used liver biopsy as the reference standard for fibrosis staging. A comprehensive literature search was conducted in PubMed and Google Scholar to identify studies that assessed elastography techniques to assess liver fibrosis. Five studies met the criteria after screening 4,136 records. Risk of bias was evaluated using the QUADAS-2 tool, and diagnostic accuracy was synthesized narratively. Results: All five studies demonstrated low to moderate risk of bias. SWE and TE showed good diagnostic accuracy (AUC > 0.75) for detecting significant fibrosis (≥F2), with 2D-SWE and MRE excelling in advanced stages (AUC > 0.90). MRE offered superior reproducibility, while SWE correlated strongly with biopsy findings, particularly in the right upper lobe. However, studies included mixed liver disease etiologies, limiting NAFLD-specific conclusions. Conclusion: Elastography, especially MRE and SW…
subject: Articles
  topic: section
subject: Elastography Liver Fibrosis Non-Alcoholic Fatty Liver Disease Systematic Review
  topic: keywords
creator: Dr. Anu Sarah Easo
creator: Dr. Sharon Baisil
creator: Dr. Jeyaseelan Nadarajah
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-11-12
publication date: 2025-11-12

A Case Of Congenitally Corrected Transposition Of Great Arteries Of Elderly Male: A Rare Event
type: item
description: Background:Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital cardiac anomaly, accounting for less than 1% of all congenital heart defects. It features both atrioventricular and ventriculoarterial discordance, resulting in physiologically corrected circulation. Despite this functional correction, the morphologic right ventricle supports systemic circulation, predisposing patients to progressive ventricular dysfunction, tricuspid valve regurgitation, and conduction system abnormalities. While often diagnosed in childhood when associated with other cardiac anomalies, isolated CCTGA may remain clinically silent and undiagnosed until adulthood or even late life. Case Presentation:We report the case of a 53-year-old male who presented with a 7-month history of breathlessness. He was nonhypertensive, nondiabetic, and afebrile with stable vital signs. Clinical examination revealed parasternal heave, a loud second heart sound, and a diastolic murmur at the tricuspid area. Transthoracic echocardiography revealed classic features of CCTGA, including atrioventricular and ventriculoarterial discordance, global left ventricular hypokinesia, moderate systolic dysfunction with an ejection fraction of 35–40%, and severe tricuspid regurgitation. Electrocardiogram findings showed evidence of atrioventricular conduction abnormalities. The patient was managed conservatively with diuretics, ACE inhibitors, beta-blockers, nebulization, and supportive therapy. He responded well to medical management and was discharged in a stable condition with outpatient follow-up. Conclusion:This case emphasizes the importance of considering congenital heart diseases like CCTGA in adult patients presenting with nonspecific cardiac symptoms. Elderly patients with asymptomatic or minimally symptomatic CCTGA may remain undiagnosed for years. Individualized medical management and routine follow-up are essential for optimizing outcomes and monitoring for progressive ventr…
subject: Articles
  topic: section
subject: Congenitally Corrected Transposition Elderly Cardiac Anomaly Tricuspid Regurgitation Ventricular Dysfunction Echocardiography
  topic: keywords
creator: Dr. Sahibjeet Singh
creator: Dr. Harmanjeet Singh Dhillon
creator: Dr. Aneesha Chhibber
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-11-03
publication date: 2025-11-03

A Prospective Observational Study to Assess the Efficacy of Intrathecal Levobupivacaine versus Bupivacaine in Elderly Patients Undergoing Lower Abdominal Surgeries
type: item
description: Introduction: With a growing elderly population, anaesthesia techniques must balance efficacy with safety. Spinal anaesthesia is preferred in geriatric patients due to reduced systemic effects compared to general anaesthesia. However, the choice of local anaesthetic—levobupivacaine or bupivacaine—remains a crucial determinant of perioperative outcomes. Levobupivacaine, the S(-) enantiomer of bupivacaine, is known for lower cardiotoxicity and neurotoxicity. Materials and Methods: This prospective observational study was conducted from September 2022 to September 2024 in the Department of Anaesthesiology at a tertiary care hospital. A total of 70 elderly patients (aged ≥ 65 years) scheduled for lower abdominal surgeries under spinal anaesthesia were enrolled. Patients were divided into two groups: Group L (intrathecal hyperbaric levobupivacaine) and Group B (intrathecal hyperbaric bupivacaine). Parameters recorded included onset of sensory and motor block, time to reach T10 level, maximum block height, haemodynamic changes, total duration of block, regression to L5 level, and complications. Statistical analysis was conducted using SPSS software, with p < 0.05 considered significant. Results:Both groups showed comparable onset of sensory and motor block (p > 0.05). The duration of motor block was significantly shorter in the levobupivacaine group (176.3 ± 14.2 minutes) than in the bupivacaine group (191.7 ± 16.1 minutes) (p < 0.05). Haemodynamic stability was better in the levobupivacaine group, with fewer incidences of hypotension and bradycardia. No major complications were observed in either group. Patient satisfaction and quality of anaesthesia were comparable. Conclusion:Levobupivacaine and bupivacaine provide similar quality of spinal anaesthesia in elderly patients undergoing lower abdominal surgeries. However, levobupivacaine offers better haemodynamic stability and faster motor recovery, making it a safer alternative in geriatric patients
subject: Articles
  topic: section
subject: Levobupivacaine Bupivacaine Spinal Anaesthesia Elderly Patients Lower Abdominal Surgery Haemodynamic Stability
  topic: keywords
creator: Dr. Shital Dalal
creator: Dr. Diksha Sao
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-11-03
publication date: 2025-11-03

Assessment of Serum Adenosine Deaminase (ADA) Levels as a Predictive Marker for Diabetes Mellitus in Obese Individuals: A Case–Control Study at a Tertiary Care Center
type: item
description: Background: This study investigated serum adenosine deaminase (ADA) as a potential biomarker for metabolic dysfunction in obesity and type 2 diabetes mellitus (T2DM). Methods: A case-control study was conducted with 160 participants (40 per group): Group 1:- non-obese T2DM (BMI <25 kg/m²), Group 2:- obese non-diabetic (BMI ≥25 kg/m²), Group 3:- non-obese healthy controls (BMI <25 kg/m²), and Group 4:- obese T2DM (BMI ≥25 kg/m²). ADA levels and glycemic parameters (FBS, PPBS, HbA1c) were analyzed using ANOVA with Tukey's post-hoc test. Results: ADA levels were significantly elevated in obese groups (Group 2: 22.33±16.09 U/L; Group 4: 27.15±20.73 U/L) versus non-obese groups (Group 1: 13.71±6.18 U/L; Group 3: 10.41±4.71 U/L; p<0.01). Obese T2DM showed highest ADA (p<0.001 vs all groups). Notably, obese non-diabetics had higher ADA than healthy controls (p<0.01), while glycemic parameters remained normal. Conclusion: Elevated ADA in obese individuals, particularly before diabetes onset, suggests its potential as an early metabolic dysfunction marker. These findings support ADA's role in obesity-related inflammation and insulin resistance.
subject: Articles
  topic: section
subject: Adenosine deaminase Obesity Type 2 diabetes Insulin resistance Early biomarker
  topic: keywords
creator: Dr. Rohith Srinivas
creator: Dr. Meghana B S
creator: Dr. Balachandra G
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-11-03
publication date: 2025-11-03

Prevalence of Psychiatric Morbidity and its Associated Risk Factors in Postmenopausal Women-A Cross-Sectional Study
type: item
description: Background- Post-menopausal period is affected by hormonal changes leading to a woman showing variety of post-menopausal symptoms and these are associated with various social factors which collectively affect the mental health and quality of life. Comprehensive research in this direction is required and remedial measures need to be suggested. So, this study was done with objective to know the prevalence of psychiatric morbidity and its associated risk factors in postmenopausal women. Methods- A cross-sectional observational study was done on 100 postmenopausal women. Socio-demographic characteristics were noted, depression was measured by Beck Depression Inventory, menopausal symptoms rated by menopausal rating scale (MRS) and perceived social support was measured by Multidimensional scale of perceived social support (MSPSS) and then their relationship was assessed. Results:- Depression was prevalent in 56% of the postmenopausal women and it was associated significantly with low MSPSS and higher MRS value (p<0.001). Other factors such as low education, lower SES, being widowed and unmarried, history of physical abuse, chronic illness and lower age of menopause and menarche were also significantly associated with depression in postmenopausal women. Conclusion- Multiple social and medical factors along with low social support and postmenopausal symptoms affect the mental health of postmenopausal women and must be taken care of along with hormonal treatment.
subject: Articles
  topic: section
subject: Postmenopausal Women Depression Perceived Social Support Social Factors
  topic: keywords
creator: Dr. Priyanka Singh
creator: Dr Borsha Banerjee
creator: Dr Divya Singh
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-10-09
publication date: 2025-10-09

Prevalence of Depression in Stroke Survivors and the Relationship between Site of Lesion and Duration of Stroke Onset on Post stroke Depression
type: item
description: Introduction: Poststroke depression (PSD) is a common psychological complication, affecting about one-third of stroke survivors. It can negatively impact rehabilitation efforts, quality of life, and overall recovery outcomes. Factors such as brain lesion location, stroke severity, and time since onset are critical in the development of PSD. Understanding the prevalence and contributing factors of PSD is essential for improving comprehensive care for stroke survivors. Objective: This study aims to estimate the prevalence of depression in stroke survivors and investigate the relationship between lesion site and duration of stroke onset with PSD. Methods: A cross-sectional study was conducted with 200 stroke survivors at a neurology outpatient clinic. Depression was assessed using the PHQ-9 scale, with a score of 10 or above indicating significant depression. Brain imaging identified lesion locations, and stroke duration was categorized into specific time groups. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression, with a significance level of p < 0.05. Results: The prevalence of Post-Stroke Depression (PSD) was 31.49%, with the highest occurrence observed in individuals aged 61-70 (41.67%). Males were disproportionately affected, accounting for 69% of cases. A significant association was noted between PSD and left cortical lesions (p < 0.001). Furthermore, PSD prevalence increased with stroke duration, reaching its peak between 6 months and 2 years post-stroke (p < 0.001). Conclusion: The study underscores the high prevalence of PSD in stroke survivors, particularly those with left cortical lesions and those 6 months to 2 years post-stroke. Early detection and continuous mental health support are crucial in enhancing recovery and quality of life for stroke survivors.
subject: Articles
  topic: section
subject: Poststroke Depression Stroke Survivors Brain Lesion Stroke Duration Prevalence Mental Health
  topic: keywords
creator: Dr. Jesna T J
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-10-09
publication date: 2025-10-09

Induction Chemotherapy Followed by Chemoradiation in Patients of Locally Advanced Laryngeal and Hypopharyngeal Cancers with Intent of Organ Preservation
type: item
description: Laryngeal and hypopharyngeal cancers are among the most common malignancies of the head and neck region. Traditionally, these cancers have been managed with surgery, but the advent of organ-preserving treatments has revolutionized their management. Induction chemotherapy followed by chemoradiation is an emerging approach for patients with locally advanced laryngeal and hypopharyngeal cancers, with the primary intent of organ preservation while ensuring optimal oncological outcomes. Induction chemotherapy, typically consisting of platinum-based agents such as cisplatin and taxanes, is utilized to reduce tumor size and assess tumor response. This initial treatment phase offers a chance for organ preservation, with the aim to downstage tumors and make them amenable to subsequent chemoradiation. The subsequent chemoradiation phase involves combining chemotherapy with radiation therapy, which intensifies tumor control while allowing for the preservation of the larynx and hypopharynx. This approach aims to avoid total laryngectomy, which can have significant functional and psychological impacts on patients. Studies have demonstrated that induction chemotherapy followed by chemoradiation can offer comparable survival outcomes to surgery, with the added benefit of preserving critical organ function, particularly speech and swallowing. However, careful patient selection and monitoring of treatment toxicity are crucial to optimize the benefits of this regimen. Long-term outcomes, including survival, recurrence, and quality of life, are pivotal in evaluating the success of this organ-preserving strategy. The integration of induction chemotherapy with chemoradiation represents a promising alternative to surgery in the management of locally advanced laryngeal and hypopharyngeal cancers. Further prospective studies are needed to refine patient selection criteria and determine the long-term efficacy and safety of this approach in preserving both organ function and survival.
subject: Articles
  topic: section
subject: Laryngeal cancer Hypopharyngeal cancer Organ preservation Induction chemotherapy Chemoradiation Cisplatin Chemotherapy Radiation therapy Head and neck cancer
  topic: keywords
creator: Dr. Hemalatha
creator: Dr. Kapil Suri
creator: Dr. Akhilesh Mishra
creator: Dr. Vikas Yadav
creator: Dr. Jaspreet Kaur
creator: Dr. Anu Agrawal
creator: Dr. Navaudhyam
creator: Dr. Simran Suri
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-09-30
publication date: 2025-09-30

Total Elbow Replacement with Bakshi's Sloppy Hinge Prosthesis in UnsalvageableElbows: A Retrospective Study of Functional Outcomes
type: item
description: Background: Distal humerus intra-articular fractures in elderly patients often lead to poor outcomes due to osteoporosis and complex joint mechanics. Total elbow arthroplasty (TEA) with constrained implants like Bakshi's sloppy hinge prosthesis offers a viable salvage option. This study evaluates the functional outcomes and complications of TEAin unsalvageable elbows. Methods: A retrospective analysis of 10 patients (2019–2022) undergoing primary or secondary TEA was conducted with a follow-up period of 3 years. Data included demographics, surgical details, range of motion, stability, and Mayo Elbow Performance Score (MEPS). Results: The cohort comprised 60% females, with a mean age of 63.6 years. Secondary TEA (70%) was more common than primary (30%). Non-union (40%) and infection (30%) were leading causes for surgery. Postoperatively, 100% achieved stable elbows, 90% reported no pain, and 80% scored 'excellent' result on MEPS. Stability and arc of motion >100° (p=0.04) significantly correlated with better MEPS. Conclusion: TEA with Bakshi's prosthesis effectively restores function in complex elbow injuries, particularly in elderly patients with comorbidities. Outcomes of secondary TEA outperformed compared to primary procedures, emphasizing its role in salvaging failed prior interventions.
subject: Articles
  topic: section
subject: Total elbow arthroplasty Bakshi's sloppy hinge Unsalvageable elbow MEPS score Elbow arthritis
  topic: keywords
creator: Dr. Anil Kumar S V
creator: Dr. Diwakar P
creator: Dr. Sarhan Ali Khan Zai
creator: Dr. Vishnuprasad S H
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-09-29
publication date: 2025-09-29

Impact of Mannequin Based Simulation as Add on Teaching Learning Tool in Pharmacology Training of Undergraduate Medical Students
type: item
description: Background: Traditional didactic methods in pharmacology education often fail to actively engage undergraduate medical students or foster clinical application of theoretical knowledge. To bridge this gap, mannequin-based simulation has emerged as a promising educational strategy, offering hands-on, experiential learning in a controlled environment. This study aimed to assess the effectiveness of mannequin-based simulation as an adjunct teaching tool in pharmacology training for second-year MBBS students. Materials & Methods: A prospective observational study was conducted among 100 second-year MBBS students at Saraswati Medical College, Unnao. Participants underwent mannequin-based simulation training on intravenous (IV), intramuscular (IM), and subcutaneous(SC)drug administration. Student perceptions were evaluated using structured questionnaires, and practical competencies were assessed using pre- and post-simulation Objective Structured Practical Examinations (OSPE). Statistical analysis included paired t-tests, Wilcoxon signed-rank tests, and chi-square tests with a significance threshold of p < 0.05.Results: A strong majority of students (over 85%) expressed favorable perceptions of mannequin based learning, particularly in enhancin gattention span, theoretical integration, procedural skills, and confidence. The post-simulation OSPE scores showed statisticallysignificantimprovementsinproceduralcompetenciesacrossallthree administration routes. For IV training, the paired t-test (p < 0.001) and Wilcoxon test (p < 0.001) indicated a highly significant improvement. Similarly, significant gains were observed for IM(p<0.001;p=0.0156) and SC(p=0.00014;p=0.0313)routes. Conclusion: Mannequin-based simulation significantly enhanced student’s pharmacological skill proficiency, confidence, and engagement. Its positive reception and measurable impact on learning outcomes support its integration into routine pharmacology curricula to bridge the gap between theory and clinica…
subject: Articles
  topic: section
subject: Mannequin-based simulation Pharmacology education OSPE Clinical skills Undergraduate medical training
  topic: keywords
creator: Dr. Divya Singh
creator: Dr. Amit Kumar
creator: Dr. Harendra Kumar
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-09-29
publication date: 2025-09-29

Evaluation of p53 and Ki-67 Expression in Cervical Intraepithelial Neoplasia (CIN) and Invasive Cervical Cancer: A Prospective Observational Study
type: item
description: Introduction: Cervical cancer is the fourth most common malignancy among women worldwide, predominantly affecting those in low- and middle-income countries due to inadequate screening and preventive measures. High-risk Human Papillomavirus (HPV) infection, particularly types 16 and 18, is a critical etiological factor in cervical carcinogenesis. Molecular markers like p53 and Ki-67 have emerged as valuable indicators of disease progression and prognosis, given their roles in cell cycle regulation and proliferation. Aim and Objective: To evaluate the expression of p53 and Ki-67 in cervical intraepithelial neoplasia (CIN) and invasive cervical carcinoma, and to correlate their expression with histopathological grades. Materials and Methods: This 15-month prospective observational study at GSVM Medical College, Kanpur, and J.K. Cancer Institute included histologically confirmed cases of CIN (I, II, III) and invasive cervical carcinoma in women aged 18 and above. Immunohistochemistry (IHC) assessed p53 and Ki-67 expression, with chi-square tests and p-values used to analyze associations between biomarker expression and histological grading. Results: The study included 100 participants with a mean age of 41.66 ± 12.00 years. Squamous cell carcinoma (SCC) was the most common (40%), followed by CIN3 (30%), CIN2 (20%), and CIN1 (10%). High Ki-67 expression was mainly seen in SCC and CIN3 (p < 0.0001).Aberrant p53 expression was rare (1.6% in SCC), while mild reduction was common in CIN3 (19.4%). Conclusion: The findings suggest that high Ki-67 expression and reduced p53 levels are associated with greater histological severity in cervical lesions. These markers hold significant prognostic value and could enhance early diagnosis and targeted therapeutic strategies in cervical cancer.
subject: Articles
  topic: section
subject: Cervical cancer p53 Ki-67 Immunohistochemistry CIN
  topic: keywords
creator: Dr. Sunaina Singh
creator: Dr. Mahendra Singh
creator: Dr. Chayanika Kala
creator: Dr. Lubna Khan
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-09-17
publication date: 2025-09-17

Significance of CT-Derived Sarcopenia Using L3 Skeletal Muscle Index in Lung Cancer Patients: A Prognostic Retrospective Study
type: item
description: Introduction: Sarcopenia, a progressive loss of skeletal muscle mass and strength, is increasingly recognized as a negative prognostic factor in cancer patients. In lung carcinoma, sarcopenia often coexists with cachexia and systemic inflammation, contributing to reduced treatment tolerance and poor survival outcomes. Computed tomography (CT)-based measurement of the skeletal muscle index (SMI) at the L3 vertebral level is a validated and non invasive method for assessing sarcopenia. Aim and Objective: To evaluate the prognostic significance of CT-derived sarcopenia using L3 skeletal muscle index (L3SMI) and its correlation with survival in lung cancer patients. Materials & Methods: This retrospective cohort study was conducted in the Department of Radiodiagnosis, Govt. Kilpauk Medical College Hospital, from October 2020 to September 2021. Fifty lung cancer patients aged over 18 years who underwent CT including the L3 level within two months of diagnosis were included. Sarcopenia was defined as L3SMI <41 cm2/m2 in females and <53 cm2/m2 in males. Clinical and laboratory data were collected and survival outcomes were analyzed using Pearson correlation and ANOVA. Results: Out of 50 patients, 29 (58%) were sarcopenic, and 23 of them died during a follow-up period of 6–12 months. A strong positive correlation was observed between low L3SMI and mortality (r = 0.726, p < 0.001). Sarcopenia also showed a strong negative correlation with ECOG performance status (r = –0.824). Advanced cancer stage and low serum albumin levels were significantly associated with increased mortality. Conclusion: CT-derived L3SMI is an effective predictor of mortality in lung cancer patients. Early identification of sarcopenia allows for timely interventions to improve clinical outcomes and survival.
subject: Articles
  topic: section
subject: Sarcopenia Lung cancer L3 skeletal muscle Index Computed Tomography Prognosis
  topic: keywords
creator: Dr. Indhumathi Salivaganan
creator: Dr. Usha Nandhini Ganesan
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-09-17
publication date: 2025-09-17

Can Lymphoma and Multiple Myeloma mimic Radiologically
type: item
description: Lymphoma and multiple myeloma are distinct hematologic malignancies that can present with overlapping clinical and radiological features, making diagnosis challenging. Accurate differentiation between these two diseases is critical due to their differing treatment protocols and prognosis. In this case, an 80 year old male presented with persistent abdominal pain, hypodense liver lesions, splenomegaly, and lytic bone lesions findings initially suggestive of multiple myeloma. However, further imaging revealed a heterogeneously enhancing testicular mass and retroperitoneal lymphadenopathy, which raised suspicion for lymphoma. A biopsy of the testicular mass and retroperitoneal lymph nodes confirmed the diagnosis of non-Hodgkin lymphoma, ruling out multiple myeloma. While lytic bone lesions and extramedullary involvement are characteristic of multiple myeloma, the atypical findings of testicular involvement and lymphadenopathy in this patient underscored the diagnostic complexity. This case emphasizes the necessity of integrating clinical, radiological, and pathological data to reach an accurate diagnosis. Despite imaging that suggested multiple myeloma, the histopathological confirmation of lymphoma underscores the importance of biopsy in cases with ambiguous radiological findings. Clinically, this case highlights the need for a multidisciplinary approach, as misdiagnosis could result in inappropriate treatment. Accurate and timely diagnosis is essential to guide the proper therapeutic strategy and improve patient outcomes.
subject: Articles
  topic: section
subject: Lymphoma Multiple myeloma Radiology lytic lesions Differential diagnosis Extramedullary involvement.
  topic: keywords
creator: Dr. Ajay Saini
creator: Dr. Vivek Setia
creator: Dr. Himanshu Gupta
creator: Dr. Jitendra Kumar Meena
rights: Copyright (c) 2024 International Medicine ISSN:2667-7008
date: 2025-09-03
publication date: 2025-09-03

Optical Coherence Tomography in Detecting Subclinical Cystoid Macular Fluid Accumulation Post Nd: YAG Laser Capsulotomy
type: item
description: Purpose: To evaluate the efficacy of optical coherence tomography (OCT) in identifying subclinical cystoid macular edema (CME) following Nd: YAG laser capsulotomy for posterior capsular opacification (PCO). Study Design: Descriptive case series. Methods: Seventy-five eyes with visually significant PCO after uncomplicated cataract surgery were included. Exclusion criteria included corneal opacities, glaucoma, retinopathy, maculopathy, optic neuropathy, or high refractive errors (±6.0 diopters). Bestcorrected visual acuity (BCVA), slit-lamp examination, posterior segment evaluation, and macular thickness via spectral-domain OCT (TOPCON 3D OCT) were assessed pre-laser, at 1 week, and 1 month post-laser. Results: Mean age was 56.12 ± 5.40 years (95% CI: 55.30–56.94). Of the 75 patients, 42 (56%) were male, and 33 (44%) were female. Subclinical CME was detected in 12 (16%) eyes. Of these, 4 were aged 40–55 years, and 8 were aged 56–70 years (P=0.042). Conclusion: OCT is an effective, non-invasive tool for early detection of subclinical CME post Nd:YAG laser capsulotomy, facilitating timely management to prevent macular damage.
subject: Articles
  topic: section
subject: Cystoid macular edema Nd: YAG Laser Posterior capsular opacification Optical coherence tomography
  topic: keywords
creator: Dr. Ankit Raj
creator: Dr. Raj Kumar Singh
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-09-03
publication date: 2025-09-03

Evaluation of Surgical Outcome in Penetrating Keratoplasty in Adherent Leucoma and Leucoma Grade Corneal Opacity
type: item
description: Introduction: Penetrating keratoplasty (PK) is a full-thickness corneal transplant where a diseased cornea is replaced with a donor graft. The outcome is influenced by multiple factors including donor-host compatibility, surgical precision, and follow-up care. In India, low literacy and socioeconomic barriers often hinder consistent postoperative monitoring. Materials and Methods: This prospective observational study was conducted over 18 months at a tertiary care center. Thirty patients with unilateral corneal opacity were enrolled—15 with adherent leucoma and 15 with leucomatous corneal opacity. Both genders were included. Detailed clinical histories were taken, and comprehensive ocular evaluations, including visual acuity testing with Snellen's chart, slit-lamp biomicroscopy, and ophthalmoscopy, were conducted. Additional imaging, such as orbital X-rays and B-scan ultrasound, was used when needed. Patients were followed up regularly to assess visual improvement and monitor for complications. Results: Of the 30 patients, 12 (40%) were male and 18 (60%) female, with mean ages of 52.8 years for leucomatous opacity and 55 years for adherent leucoma. Postoperative complications included corneal edema in 24 (80%) patients, epithelial defects in 4 (13.3%), anterior chamber reaction in 10 (33.3%), hyphema in 2 (6.6%), glaucoma in 3 (10%), loose sutures in 1 (3.3%), corneal vascularization in 3 (10%), and graft failure in 3 (10%). Conclusion: Penetrating keratoplasty is an effective treatment for restoring vision and anatomical integrity in corneal blindness, particularly in post-traumatic and post-ulcerative cases, thereby significantly contributing to visual rehabilitation.
subject: Articles
  topic: section
subject: Penetrating keratoplasty Corneal opacity Adherent leucoma Visual outcome Graft complications
  topic: keywords
creator: Dr. Arati Shankar Mule
creator: Dr. Tejaswini Gondane
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-09-03
publication date: 2025-09-03

Case Report on a Case of Right Nasolabial Cyst in Young Female with Dental Remnant
type: item
description: Background: Nasolabial cyst also known as klesatd's cyst is a rarenono dontogenic cyst that arises from the soft tissues of the maxillofacial region. Previous review of literature of nasolabial cyst include it as an asymptomatic swelling located beneath the ala of the nose, along with a distinctive swelling of the lip. The presentation of patient is usually asymptomatic and the patient usually presents when it enlarges in size leading to cosmetic deformities. It is quite often more common in age group 40-50 years, bit in our case it was seen in young female. Usually it might be confused as an odontogenic lesion. If infected it leads to infective cyst and can be mistaken for facial cellulitis. We are describing in our case a surgically managed case report and also discussing the etiopathogenesis and management. Case report: The article presents a case of nasolabial cyst in a young female who presented with swelling on right side of nasolabial region, resulting in cosmetic deformity, which was excised and follow up of the patient was done. Conclusion: Nasolabial cyst is a rare cyst of maxillofacial region that result in deranged cosmetic appearance and if infected leads to cellulitis. For evaluation generally radiological investigations as CT scan is done. This helps us easily diagnose and plan surgical management of the case.
subject: Articles
  topic: section
subject: Nasolabial cyst Nonodontogenic cyst Management Nasal obstruction
  topic: keywords
creator: Dr. Asmita Sharma
creator: Dr. Linadri Kalita
creator: Dr. Ananya Phukon
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-09-03
publication date: 2025-09-03

Diagnostic Utility of MR Spectroscopy in Differentiating Recurrent Brain Tumors from Radiation Necrosis: A Prospective Single-Center Study
type: item
description: Introduction: Magnetic Resonance Spectroscopy (MRS) is a non-invasive imaging technique that provides valuable metabolic insights, supplementing conventional MRI. Differentiating between recurrent brain tumors and radiation necrosis is challenging, as both may appear similar radiologically. Accurate identification is essential for guiding appropriate treatment, avoiding unnecessary interventions, and improving patient outcomes by distinguishing viable tumor tissue from post-therapeutic necrotic changes. Aim and Objective: To evaluate the diagnostic utility of MRS in distinguishing recurrent brain tumors from radiation necrosis in post-treatment patients, specifically using Cho/NAA, Cho/Cr and NAA/Cr metabolite ratios, and to assess its potential in reducing invasive procedures. Materials and Methods: A prospective single-center study was conducted between November 2023 and January 2025 at Tamil Nadu Government Multi Super Specialty Hospital, Chennai. Thirty four patients aged 10–70 years with previously treated primary brain tumors and new or worsening contrast-enhancing MRI lesions were included. Multivoxel MRS was performed using a 1.5T scanner. Patients with chronic renal failure, extreme ages, or incomplete follow-up were excluded. ROC curve analysis of metabolite ratios was performed using MedCalc version 23.2.1.Results: Cho/NAA ratio showed the highest diagnostic performance with an AUC of 0.965, sensitivity of 93%, and specificity of 100%, achieving 96.5% overall accuracy. The Cho/Cr ratio had an AUC of 0.820 and good diagnostic value, while NAA/Cr showed lower sensitivity but high specificity, supporting its limited standalone utility. Conclusion: MRS is a highly accurate tool in differentiating recurrent brain tumors from radiation necrosis, with Cho/NAA emerging as the most reliable marker. Routine incorporation of MRS into post-treatment imaging protocols can improve diagnostic accuracy, reduce invasive procedures, and guide clinical decision-making.
subject: Articles
  topic: section
subject: Magnetic resonance spectroscopy Recurrent brain tumor Radiation necrosis Cho/NAA ratio ROC curve
  topic: keywords
creator: Dr. Usha Nandhini Ganesan
creator: Dr. Sumeena Shanmugam
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-08-09
publication date: 2025-08-09

A Hospital-Based Observational Study on Nutritional Status, Functional Impairment, and Etiological Correlates in Children with Cerebral Palsy at a Tertiary Care Center
type: item
description: Introduction: Cerebral palsy (CP) is a non-progressive neurodevelopmental disorder manifesting in early childhood with variable motor and functional impairments. Nutritional deficiencies frequently coexist due to feeding difficulties, oral-motor incoordination, and comorbid conditions, exacerbating disability and compromising quality of life. Aim and Objective: This study aimed to assess the nutritional status, functional impairment, and etiological correlations in children with cerebral palsy. The objectives were to: 1) evaluate the prevalence of undernutrition, stunting, and wasting across age and gender; and 2) examine associations between nutritional status, GMFCS grading, and etiological factors. Materials & Methods: A hospital-based observational study was conducted from May 2020 to April 2021 at Gauhati Medical College and Hospital. Children aged ≤10 years with clinically diagnosed CP attending pediatric OPD/IPD were included. Exclusion criteria involved motor deficits due to non-central causes or progressive/chronic illnesses. Ethical clearance and informed consent were obtained. Data on nutritional status, functional grading (GMFCS), and etiological factors were collected and analyzed using descriptive statistics and chi-square tests. Results: Among 100 children, 59% were male and 49% were aged 0-4 years. Birth asphyxia (59%) was the leading etiology, followed by neonatal hyperbilirubinemia (26%). Undernutrition was observed in 56%, stunting in 43%, and wasting in 45%. Higher GMFCS grades (IV–V) were significantly associated with worse nutritional indices (p<0.001). Birth asphyxia correlated with severe motor impairment (p=0.017), while milder etiologies were linked to better functional grades. Conclusion: Birth asphyxia, neonatal jaundice, and prematurity are major contributors to CP. Nutritional deficits worsen with increasing motor disability. Early perinatal care and comprehensive nutritional and rehabilitative support are essential for improving health…
subject: Articles
  topic: section
subject: Cerebral palsy Nutrition Birth asphyxia GMFCS Pediatric disability
  topic: keywords
creator: Dr. Gayatri Bezboruah
creator: Dr. Manjunatha
creator: Dr. Swasthik D
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-08-06
publication date: 2025-08-06

Pleomorphic Invasive Lobular Carcinoma with Ductal Component: A Rare Mixed Tumour of Breast
type: item
description: Introduction: Due to its uncommon nature, there exists a limited understanding of optimal treatment strategies and long-term prognosis for MDPLC. This report contributes to the existing knowledge base by presenting a unique case and potentially informing future treatment decisions. Aim: Among women globally, breast cancer stands as the most prevalent form of malignancy. Invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) dominate the diagnostic landscape. However, a rarer variant emerges where both these histological features intermingle within a single tumour, forming mixed ductal and pleomorphic lobular carcinoma (MDPLC). This case report delves into the experience of a patient diagnosed with MDPLC. This case report aims to present an unusual case of pleomorphic invasive lobular carcinoma with a ductal component, focusing on its distinctive histopathological features. It also seeks to explore the diagnostic challenges and treatment considerations involved in managing this rare mixed tumor in clinical practice
subject: Articles
  topic: section
subject: Pleomorphic Invasive lobular carcinoma Ductal
  topic: keywords
creator: Dr. Ishika Godara
creator: Dr. Tanika Mishra
creator: Dr. Anku Alisha
creator: Dr. Rajeev Sen
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-08-06
publication date: 2025-08-06

Diagnostic Utility of P63 in Differentiating Ambiguous Lesions of Prostate
type: item
description: The proper identification of prostate cancer stands essential for effective treatment because it remains among the primary cancers affecting male patients. The p63 marker undergoes immunohistochemical evaluation to detect basal cells in ambiguous prostatic lesions which aids diagnosis. The research initiative evaluates p63 immunohistochemistry as a diagnostic tool for prostatic lesion discrimination through assessment of histopathological attributes as well as PSA quantities and Gleason rating. Research activities took place at GSVM Medical College, Kanpur with 75 prostate disease patients who received clinical diagnoses. The tissue samples from core biopsies and TURP and prostatectomy underwent both histopathological analysis and p63 immunohistochemical examination. The research team used SPSS version 20 for statistical analysis through chi-square tests together with ROC curve analysis. The expression level of p63 protein was strong in benign tissue while it was moderate in premalignant lesions but completely absent in malignant pathology. The intensity of p63 protein expression showed a negative connection to PSA values but cases without p63 protein together with high Gleason scores were observed. Immunochemistry analysis on the p63 marker produced exceptional results with 100% diagnostic accuracy based on an area under the curve of 1.00. This indicates nearly perfect diagnostic capabilities combined with 100% sensitivity and specificity. Utilization of p63 testing within standard diagnostic protocols will generate improved diagnostic accuracy that benefits medical treatment of patients.
subject: Articles
  topic: section
subject: P63 Prostate cancer Immunohistochemistry Basal cell marker PSA levels Gleason score Diagnostic biomarker
  topic: keywords
creator: Dr. Neera Yadav
creator: Dr. Sunita
creator: Dr. Mahendra Singh
creator: Dr. Lubna Khan
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-08-01
publication date: 2025-08-01

Clinical and Pathological Evaluation of Antepartum Stillbirths: A Retrospective Observational Study at a Tertiary Care Center
type: item
description: Introduction: Stillbirth, defined as fetal death beyond 20 weeks of gestation, remains a major public health issue, particularly in low- and middle-income countries like India. Despite improvements in obstetric care, stillbirths continue to cause significant physical, emotional, and psychological trauma. Identifying maternal, fetal, and placental factors associated with stillbirth can inform preventive strategies and improve outcomes in future pregnancies. Aim and Objectives: The study aimed to determine the proportion of stillbirths with identifiable etiologies and evaluate associated maternal, fetal, and placental factors. Objectives included categorizing stillbirths into known and idiopathic etiologies and analyzing the relationship of anemia, abnormal ultrasound findings, and placental pathology with stillbirths. Materials and Methods: A retrospective observational study was conducted at a tertiary care hospital on 124 antepartum stillbirths beyond 20 weeks of gestation. Maternal records, antenatal data, and ultrasonographic findings were reviewed. Placental specimens were examined histopathologically. Stillbirths were classified as idiopathic or having a probable etiology, and statistical analysis was conducted to identify associations with clinical variables. Results: Out of 124 stillbirths, 91.9% had an identifiable etiology while 8.1% were idiopathic. Significant associations were found between stillbirths of known etiology and the presence of maternal anemia (n=74) and abnormal ultrasonographic findings (n=44) (p < 0.05). No significant associations were found with maternal age, parity, socioeconomic status, or fetal gender. Histopathological placental abnormalities were present in 18.5% of cases. Conclusion: Most stillbirths were linked to identifiable maternal or fetal factors, especially anemia and abnormal ultrasound findings. Placental examination proved valuable in determining etiology. Routine antenatal care and placental histopathology in unexplaine…
subject: Articles
  topic: section
subject: Stillbirth Etiology Anemia Placental Pathology Antenatal care
  topic: keywords
creator: Dr. V. S. Umamaheswary
creator: Dr. Shruti Bhavi Patil
creator: Dr. S Susmitha
rights: Copyright (c) 2025 International Medicine ISSN:2667-7008
date: 2025-07-31
publication date: 2025-07-31