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  • 1
    Online Resource
    Online Resource
    Diverse presentations of phenytoin toxicity-presenile cataract, encephalopathy and peripheral neuropathy: a case series
    Medip Academy ; 2019
    In:  International Journal of Scientific Reports Vol. 5, No. 8 ( 2019-07-24), p. 222-
    Details
    In: International Journal of Scientific Reports, Medip Academy, Vol. 5, No. 8 ( 2019-07-24), p. 222-
    Abstract: 〈 p class="abstract" 〉 One of the most commonly used antiepileptic drugs, phenytoin, has a narrow therapeutic index, high plasma protein binding, non-linear pharmacokinetics and inter-individual variability. It can also present with adverse drug reactions due to phenytoin toxicity with diverse presentations mimicking symptoms of other diseases thus causing diagnostic predicament. This case series reports three such cases of uncommon presentation of phenytoin toxicity like presenile cataract, fluctuating encephalopathy with diurnal variation and peripheral neuropathy. Monitoring of serum drug levels in such cases aids in confirming drug toxicity. Adverse drug reaction monitoring helps in early detection and appropriate management of drug related morbidity. 〈 /p 〉
    Type of Medium: Online Resource
    ISSN: 2454-2164 , 2454-2156
    URL: Article
    DOI: 10.18203/issn.2454-2156.IntJSciRep20193209
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2019
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  • 2
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    Online Resource
    Uptake of clinical breast examination services at an urban health centre following community-based awareness programme
    Medip Academy ; 2021
    In:  International Journal Of Community Medicine And Public Health Vol. 8, No. 4 ( 2021-03-25), p. 1715-
    Details
    In: International Journal Of Community Medicine And Public Health, Medip Academy, Vol. 8, No. 4 ( 2021-03-25), p. 1715-
    Abstract: Background: A significant proportion of women present in advanced stages of breast cancer due to lack of awareness and non-availability of preventive health checkups. Annual clinical breast examination (CBE) in women aged 40-60 years is estimated to reduce mortality in India comparable to that achieved by biennial mammography at considerably low cost. Aim of the project was to encourage women aged 30-70 years to regularly undergo annual CBE.Methods: The five year project was implemented in Mumbai in an estimated population of 15120 distributed in slums and low income group buildings. The beneficiaries of the project were women aged 30-70 years. Two Interventions, i.e. breast cancer education and screening were implemented by the project. List of women eligible for breast cancer screening, was used to track the utilisation of services.Results: Over the period of five years, 14249 one-one health education interactions took place and fourteen group health education sessions were conducted. 59.7% of the women had received health education at least once. Proportion of women trained in doing SBE was 51%. Proportion of women undergoing at least one CBE was 44.1%. Age was significantly associated with availing of services. Two women were detected with breast cancer.Conclusions: This project demonstrated that it is possible to motivate a large number of women to undergo screening, and such health education programmes will slowly improve the awareness and change health seeking behaviour. 
    Type of Medium: Online Resource
    ISSN: 2394-6040 , 2394-6032
    URL: Article
    DOI: 10.18203/2394-6040.ijcmph20211223
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2021
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  • 3
    Online Resource
    Online Resource
    Young adult with varicosities and recurrent lower gastrointestinal bleeding
    Medip Academy ; 2019
    In:  International Surgery Journal Vol. 6, No. 8 ( 2019-07-25), p. 3012-
    Details
    In: International Surgery Journal, Medip Academy, Vol. 6, No. 8 ( 2019-07-25), p. 3012-
    Abstract: A 30 years gentleman presented with anaemia since last ten years due to recurrent rectal bleeding. He has had multiple admissions with transfusions in the preceding 10 years without a clear clinical diagnosis. His physical examination revealed gross pallor, prominent veins on the lateral side of the left lower limb with minimal hypertrophy and a hemangiomatous patch over the left buttock. Colonoscopy revealed a few dilated tortuous submucosal vessels in the rectum and sigmoid colon. A MR angiogram showed absent left popliteal vein and angiomatous lesions in the rectum and sigmoid colon. He was diagnosed to have Klippel-Trenaunay syndrome with hemangiomata of the lower gastrointestinal tract causing bleeding. He underwent a low anterior resection with stapled anastomosis, which has effectively controlled his bleeding. Adults with gastrointestinal bleeding due to congenital venous malformations commonly have visible external stigmata, which are often pointers of rare syndromes.
    Type of Medium: Online Resource
    ISSN: 2349-2902 , 2349-3305
    URL: Article
    DOI: 10.18203/2349-2902.isj20193363
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2019
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  • 4
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    Online Resource
    Selective cauterization of supporting ligaments at Non Descent Vaginal Hysterectomy (NDVH)
    Medip Academy ; 2017
    In:  International Journal of Reproduction, Contraception, Obstetrics and Gynecology Vol. 6, No. 11 ( 2017-10-28), p. 5103-
    Details
    In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Medip Academy, Vol. 6, No. 11 ( 2017-10-28), p. 5103-
    Abstract: Background: The objective of the study was to study the use of electrocautery selectively for cardinal uterosacral ligament complex during NDVH.Methods: We performed a series of NDVH where electrocautery was used selectively for the uterosacral cardinal ligament complex. Rest all stumps were clamped, divided and ligated.Results: We did a series of 21 cases using this technique and found this as a very effective method of doing NDVH. There were no major complications.Conclusion: Selective use of electrocautery for uterosacral and cardinal ligament complex makes NDVH easy.
    Type of Medium: Online Resource
    ISSN: 2320-1789 , 2320-1770
    URL: Article
    DOI: 10.18203/2320-1770.ijrcog20175033
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2017
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  • 5
    Online Resource
    Online Resource
    Epithelioid leiomyosarcoma: a rare uterine cancer
    Medip Academy ; 2018
    In:  International Journal of Reproduction, Contraception, Obstetrics and Gynecology Vol. 7, No. 4 ( 2018-03-27), p. 1663-
    Details
    In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Medip Academy, Vol. 7, No. 4 ( 2018-03-27), p. 1663-
    Abstract: A uterine epithelioid leiomyosarcoma is a rare malignant tumour that arises from the smooth muscle lining the walls of the uterus. The exact cause of leiomyosarcoma, including uterine leiomyosarcoma accounting for 5 to 10% is unknown. Leiomyosarcoma is the most common subtype of uterine sarcoma, accounts for 1-2% of uterine malignancies. Malignancy should be suspected in menopausal women with tumour growth who are not on hormonal replacement therapy. A 64-year-old female had attained menopause 16 year back and developed postmenopausal bleeding since 2 months, with palpable mass, of 16 weeks size. Ultrasonography showed whorled mass lesions, endometrium and myometrium could not be seen separately. Uterus with both ovaries removed. Intra-operative findings showed 16 weeks uterine mass with size 15×10.5×10cm and weight 1kg with intramural fibroid. Necrotic and haemorrhagic areas with degenerative changes seen on cut section suggestive of malignancy. Histopathology and immunohistochemistry reported epithelioid leiomyosarcoma.
    Type of Medium: Online Resource
    ISSN: 2320-1789 , 2320-1770
    URL: Article
    DOI: 10.18203/2320-1770.ijrcog20181378
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2018
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  • 6
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    Online Resource
    Sonographic assessment of fetal head deflexion using occiput: spine angle measured during first stage of labour and its role in predicting the mode of delivery among nulliparous women
    Medip Academy ; 2019
    In:  International Journal of Reproduction, Contraception, Obstetrics and Gynecology Vol. 8, No. 8 ( 2019-07-26), p. 3025-
    Details
    In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology, Medip Academy, Vol. 8, No. 8 ( 2019-07-26), p. 3025-
    Abstract: Background: The attitude of the fetal head during labour significantly influences the progress and outcome of delivery and is mainly diagnosed by vaginal examination during labour. The aim of the study was to quantify the extent of deflexion of the fetal head by measuring the fetal occiput spine angle (OSA) through transabdominal ultrasonography in the first stage of labour and to determine whether the fetal OSA can predict the mode of delivery.Methods: We conducted a prospective observational study on 145 nulliparous uncomplicated singleton pregnant women without occiput-posterior position of the fetus during active labour. The OSA was measured as the angle between the two tangential lines to the occipital bone and the vertebral body of the first cervical spine, during active labour and monitored until delivery. Intra- and interobserver reproducibility of the OSA measurement and the correlation between the OSA and mode of delivery were also evaluated.Results: For the study population, the mean value of the OSA measured in the active phase of the first stage was 124.2±11.5⁰. The OSA measurement showed excellent intraobserver agreement (r = 0.82; 95% confidence interval [95% CI] 0.70-0.80) and fair-to-good interobserver agreement (r = 0.62; 95% CI 0.51-0.71).  The mean OSA was significantly less for the group of patients who required conversion to cesarean section due to labour arrest (n=32) as compared to those who had vaginal delivery (n=113) (116.25±9.2⁰ versus 126.53±11.1⁰, P 〈 0.01). An OSA of ≥121° was associated with vaginal delivery in 80.5% (91/113) of women, whereas 87.5% (28/32) of the women who delivered by cesarean section had an OSA 〈 121⁰.Conclusions: Measurement of the OSA, by sonography is feasible, reproducible and an objective tool to assess the degree of fetal head deflexion during labour and to predict the mode of delivery.
    Type of Medium: Online Resource
    ISSN: 2320-1789 , 2320-1770
    URL: Article
    DOI: 10.18203/2320-1770.ijrcog20193147
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2019
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  • 7
    Online Resource
    Online Resource
    Five year trend of aerobic bacteria isolated from patients with neonatal sepsis in a tertiary care centre, North Kerala, India
    Medip Academy ; 2020
    In:  International Journal of Contemporary Pediatrics Vol. 7, No. 6 ( 2020-05-22), p. 1269-
    Details
    In: International Journal of Contemporary Pediatrics, Medip Academy, Vol. 7, No. 6 ( 2020-05-22), p. 1269-
    Abstract: Background: Antimicrobial resistance has reached to a significant proportion globally. This antimicrobial resistance increases the cost of health care in addition to the existing burden of the prevalence of infectious disease in developing countries. We need to have institutional protocols based on the standard guidelines. It is important for the clinician to use antibiotics only when it is necessary. Thus, the present study was undertaken to know the bacteriological profile and antibiogram of aerobic pathogens isolated from blood samples of patients in NICU during 2012 -2016.Methods: This retrospective study was conducted at Clinical Microbiology and Paediatric department, MES Medical College, Perinthalmanna, between January 2012 to December 2016. All blood samples from suspected Neonatal sepsis were included in the study. The positive samples were cultured as per standard microbiological procedure and antimicrobial susceptibility was done as per CLSI guidelines.Results: During the study period of 5 years, out of 2022 blood samples received from NICU 251 (12.41%) were positive. During the study period, male patients (146, 58.17%) were more than the female. The Gram-positive isolates accounted for 135 (53.78%) isolates compared to Gram negative isolates 115 (45.81%). Authors had a single isolate of Candida species in 2014. Among the Gram positive isolates, Staphylococcus aureus (77/135) was the commonest and Klebsiella pneumoniae (51/115) among the Gram negative isolates. There was a steady rise in MRSA isolation rate in five years. The commonly used antibiotic in neonatal sepsis i.e., Ampicillin and Gentamicin, was observed to have high level of resistance. No resistance was observed against Vancomycin, Teicoplanin, Linezolid among Gram positive and against Carbapenems among Gram negative pathogens.Conclusions: As Gram positive organisms were the most common pathogen isolated in patients with neonatal septicaemia in our study population. The Staphylococcus aureus and Klebsiella pneumoniae were the common isolates. Following this study, Piperacillin tazobactum is considered as the drug for empirical therapy. Vancomycin and carbapenems are considered as reserve drug and escalated only following the report from microbiology report.
    Type of Medium: Online Resource
    ISSN: 2349-3291 , 2349-3283
    URL: Article
    DOI: 10.18203/2349-3291.ijcp20202132
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2020
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  • 8
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    Online Resource
    Retrospective analysis of disability evaluation and work fitness reports issued in occupational therapy training school and centre, Mumbai, Maharashtra, India
    Medip Academy ; 2020
    In:  International Journal of Advances in Medicine Vol. 7, No. 6 ( 2020-05-22), p. 958-
    Details
    In: International Journal of Advances in Medicine, Medip Academy, Vol. 7, No. 6 ( 2020-05-22), p. 958-
    Abstract: Background: Patients from medicine, neurology and neurosurgery are referred to occupational therapy for disability calculation and if applicable work fitness. The patients who were referred from other units are not analysed here. Objectives of this study were to find the total number of patients referred for disability evaluation and certification from neuro-medicine and neuro-surgery units. To find the number of patients referred according to the different diagnosis. To find the patient distribution according to the percentage of disability. To find number of patients who were given work fitness (unfit, fit, light duty).Methods: A total 84 patients were given disability certificate in 2018 whereas 79 patients in 2019. In 2018, out of 84 patients, 1 received disability 〈 40%, 64 got disability between 40-70% and 19 got disability 〉 70%. In 2019, out of 79 patients, 2 got disability 〈 40%, 58 got disability between 40-70% and 19 got disability 〉 70%. In 2018, out of 84 patients, 33 patients were referred for work fitness in which 27 got unfit, 1 patient was given fit and 5 got light duty after work simulation. In 2019, out of 79 patients, 21 were referred for work fitness in which 18 were given unfit, 1 patient was given fit and 2 got light duty after work simulation.Results: A total 144 participants included in the study, 75 (52%) were females and rest were males 48%. Out of these 111 (77%) were aware about dog bite causes disease and among these 52 (46.8%) were aware that dog bite causes rabies. Among the participants, 138 (95.8%) were aware about the vaccine availability and 125 (90.5%) knew vaccine is available in Government Hospital. In the study 88% of dog bite victims received treatment.Conclusions: The patients were analysed based on age, gender, type of diseases, percentage of disability, type of work and work fitness (fit, unfit, light duty).
    Type of Medium: Online Resource
    ISSN: 2349-3933 , 2349-3925
    URL: Article
    DOI: 10.18203/2349-3933.ijam20202111
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2020
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  • 9
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    Online Resource
    Cognitive rehabilitation using occupational therapy models for adults with cognitive impairment: a case series
    Medip Academy ; 2020
    In:  International Journal of Advances in Medicine Vol. 7, No. 7 ( 2020-06-22), p. 1173-
    Details
    In: International Journal of Advances in Medicine, Medip Academy, Vol. 7, No. 7 ( 2020-06-22), p. 1173-
    Abstract: Occupational Therapy is one of the primary professions with knowledge and skills to address the consequences of cognitive decline. Cognitive decline is caused by traumatic brain injury, non-traumatic neurological diseases, Ageing, Chronic psychiatry diseases. Recent thinking on cognitive rehabilitation places various approaches to a continuum, from restorative/ remedial approaches to cognitive compensatory approaches with four models within OT, and functional environmental approach with three models of intervention. Before using any of the above models, it is necessary to assess the needs of the patient, the demands of the environment and his cognitive ability. The issues faced by persons with cognitive dysfunctions demand interdisciplinary work to link the brain, behaviour and performance in everyday life. A 36-year-old male, 4years post-traumatic brain injury with anosognosia, disorientation and anomia was treated using a dynamic interactional model of cognitive retraining and showed dramatic recovery after 8 weeks’ therapy. A 65-year-old female diagnosed as Alzheimer's Dementia since two years with memory problems, neglect of ADL and visual hallucinations, disinhibited behaviour was treated for 8 weeks using Cognitive Disabilities model of 2011 and showed moderate recovery. A 73-year-old male diagnosed as Alzheimer's Dementia with forgetfulness, difficulty in money handling, disorientation and dependent in ADL was treated using Cognitive Disability Reconsidered model showed slight recovery. Each individual with cognitive problems due to disease, trauma and ageing behaves separately. Occupational therapy aims at maintaining independence in ADL and achieving the maximum level of performance in work and leisure.
    Type of Medium: Online Resource
    ISSN: 2349-3933 , 2349-3925
    URL: Article
    DOI: 10.18203/2349-3933.ijam20202575
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2020
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  • 10
    Online Resource
    Online Resource
    Can idiosyncratic drug reactions occur in quick succession? a case of cross sensitivity between levetiracetam and phenytoin
    Medip Academy ; 2017
    In:  International Journal of Basic & Clinical Pharmacology Vol. 6, No. 8 ( 2017-07-22), p. 2098-
    Details
    In: International Journal of Basic & Clinical Pharmacology, Medip Academy, Vol. 6, No. 8 ( 2017-07-22), p. 2098-
    Abstract: The occurrence of adverse drug reactions (ADRs) to more than one drug in quick succession can cause diagnostic dilemma to the doctor and increased burden of suffering to the patient. We present a single case report of a 23 year old female who developed rash and agranulocytosis in quick succession as ADRs to phenytoin and levetiracetam respectively. These antiepileptic drugs (AEDs) were prescribed as prophylaxis against post traumatic seizures (PTS). Hence a proper rationale for the prophylactic treatment of PTS and pharmacovigilance for early detection of adverse drug reactions is the need of the hour.
    Type of Medium: Online Resource
    ISSN: 2279-0780 , 2319-2003
    URL: Article
    DOI: 10.18203/2319-2003.ijbcp20173304
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2017
    detail.hit.zdb_id: 2681376-2
    SSG: 15,3
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