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   2019| July-September  | Volume 9 | Issue 3  
    Online since July 10, 2019

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Onasemnogene abeparvovec for spinal muscular atrophy: The costlier drug ever
Rajiv Mahajan
July-September 2019, 9(3):127-128
DOI:10.4103/ijabmr.IJABMR_190_19  PMID:31392173
  10 2,821 593
Effect of different finishing and polishing systems on the surface roughness of resin composite and enamel: An In vitro profilometric and scanning electron microscopy study
Karan Bansal, Sachin Gupta, Vineeta Nikhil, Shikha Jaiswal, Akanksha Jain, Neha Aggarwal
July-September 2019, 9(3):154-158
DOI:10.4103/ijabmr.IJABMR_11_19  PMID:31392178
Aim: The aim is to compare and evaluate the different finishing and polishing systems for the change in surface roughness of resin composites and enamel. Materials and Methods: To conduct the study, 30 extracted human maxillary central incisors were selected, decoronated, and molded in self-cure acrylic molds. A box-shaped cavity of dimensions 3 mm × 3 mm × 2 mm was prepared in all the teeth. A nanohybrid composite resin (Filtek Z250) was then used to restore the prepared cavities. Thirty samples were divided into two groups, control group (Group A, n = 10) and experimental group (Group B, n = 20). The samples in Group A were cured through the Mylar matrix. The experimental group, i.e., Group B was divided into two subgroups, i.e., Subgroup BX, n = 10 in which Sof-Lex polishing system was used for polishing the tooth surface and Subgroup BF, n = 10 in which Shofu composite polishing system was used. The mean surface roughness (Ra in μm) of the composite restoration as well as for the enamel surface of all the samples before and after polishing was measured with a contact profilometer, and the values were correlated with scanning electron microscopy. Results: The statistical analysis was carried out using paired t-test. The results exhibited a significant decrease in the surface roughness of the resin composite and enamel surface irrespective of the finishing and polishing system used. The mean surface roughness values demonstrated by Mylar matrix was the lowest followed by Sof-Lex polishing system. Shofu polishing system demonstrated the highest surface roughness values. Conclusion: Finishing and polishing of composite restoration can achieve a surface roughness similar to that of enamel. Involvement of marginal enamel in finishing and polishing procedures carried out for composite restoration results in smoother enamel surface.
  6 3,148 525
Synovial sarcoma of palm masquerading as a neural tumor: A challenging differential diagnosis
Durga Karki, Suvashis Dash, Vamseedharan Muthukumar
July-September 2019, 9(3):176-178
DOI:10.4103/ijabmr.IJABMR_187_18  PMID:31392182
Synovial sarcoma is one of the common soft-tissue tumors of the body and is usually found on the lower extremity, head-and-neck regions. Reports of monophasic variant of synovial sarcoma in the palm are a rare entity. It can present as a challenge for the surgeons mimicking other conditions. Very few cases of this malignancy are reported in the palm. Painful palmar mass is an unusual presentation for this variant of sarcoma. Preoperative suspicion and planned surgical approach pave the way for the proper management. Neoplasm of the hand is very challenging, as it needs surgical resection balancing with resection margin and functionality of the hand. These cases are notorious for late recurrences and metastasis. Long-term follow-up is of utmost importance. We are reporting a case of palmar monophasic synovial sarcoma with its management and follow-up.
  3 3,843 195
Seminal oxidative stress markers, calcium, magnesium, and semen profile of infertile diabetic and nondiabetic Nigerian men
Iya Eze Bassey, Idongesit Kokoabasi Paul Isong, Kaiso Umo Sunday Esiere, Okon Ekwerre Essien, Alphonsus Ekpe Udoh, Uwem Okon Akpan
July-September 2019, 9(3):159-164
DOI:10.4103/ijabmr.IJABMR_152_18  PMID:31392179
Context: Oxidative stress, vitamin, and macroelement deficiencies have been implicated in male infertility. It is unknown if diabetes mellitus with its attendant increased oxidative stress makes the seminal quality of the diabetic infertile men worse compared to their nondiabetic counterparts. Aims: The study investigated semen parameters, seminal plasma calcium, magnesium, Vitamins C and E, and total antioxidant capacity (TAC) in diabetic and nondiabetic infertile men. Settings and Design: This was a cross-sectional study involving 30 infertile men with type 2 diabetes, 30 infertile nondiabetic men and 30 fertile men. Subjects and Methods: Fasting plasma glucose, glycated hemoglobin, seminal plasma calcium, magnesium, TAC, Vitamin C, Vitamin E, semen analysis, and cultures carried out using the standard procedures. Statistical Analysis Used: Data were analyzed by the analysis of variance and Student's t-test; the level of significance was set at P < 0.05. Results: Both infertile groups had significantly lower (P < 0.0001) sperm count, percentage motility, TAC, Vitamin E and C, magnesium and calcium when compared to the fertile group. However, there was no statistically significant difference (P > 0.05) in the mean values of these parameters among the two infertile groups. The infertile men had a significantly higher (P = 0.034) frequency of bacterial isolates compared to the fertile men. Staphylococcus aureus was the most frequent organism isolated. Conclusions: Seminal calcium, magnesium, TAC, and Vitamin E and C were lower in both infertile diabetic and nondiabetic men as compared to that of fertile men, but the levels of these analytes were comparable in the infertile diabetic and nondiabetic men.
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Incidence and medicolegal significance of wormian bones in human skulls in North India Region
Nisha Goyal, Anil Garg, Yogesh Kumar
July-September 2019, 9(3):165-168
DOI:10.4103/ijabmr.IJABMR_89_19  PMID:31392180
Introduction: Wormian bones (Wbs) are small bones located in or near the sutures of the skull which are irregular in size, shape, and number. The present study is to look into the morphological details of such supernumerary bones of skull with regards to their incidence, number, and topography in skulls from the Haryana region. Materials and Methods: This observational study was carried out in the tertiary care hospital, in the region of Haryana and the total of 147 human skulls were examined during routine autopsy procedures with respect to sutures and topographic distribution of Wbs. The data were statistically analyzed. Results: In the present study, the overall incidence of Wbs was seen in 52 skulls (35.3%) with males having 23.8% and females having 11.5%. Conclusion: The knowledge of incidence and distribution of Wbs in the skull could be useful to radiologists, causality medical officers, and autopsy surgeons in successfully differentiating a skull fracture from normal suture with Wbs or exit gunshot wound from fractured small Wb and thus ruling out the possibilities of presence or absence of fractures due to physical abuse, brittle bones, and exit gunshot wounds. It is also helpful to neurosurgeons in timely diagnosis and management of diseases or fractures in relation to the Wbs.
  3 1,444 209
Medication errors: Is it the hidden part of the submerged iceberg in our health-care system?
Sneha Ambwani, Arup Kumar Misra, Rajesh Kumar
July-September 2019, 9(3):135-142
DOI:10.4103/ijabmr.IJABMR_96_19  PMID:31392175
Medication error (ME) is an adverse preventable event which happens due to the inappropriate use of medication that leads to patient harm. Such events may be related to professional practice, health-care products, procedures, and systems including prescribing, communication, product labeling, packaging, and nomenclature, compounding, dispensing, distribution, administration, education, monitoring, and use. A major ME is the one, which results in either permanent harm or transfer to the intensive care units or death. When an error is identified, it shall be reported immediately. It must also be nonpunitive so that staff does not have to be afraid of repercussions. An error shall be reported to the concerned consultant immediately. Continuous monitoring and frequent assessments shall be done for the patient. A root cause analysis shall be done for all serious MEs.
  3 7,846 574
An uncommon case of atraumatic palsy of a branch of the anterior interosseous nerve with a late spontaneous recovery
Vasilios Raoulis, Gregory Tsoucalas, Anastasia Batsiou, Aristeidis H Zibis
July-September 2019, 9(3):182-184
DOI:10.4103/ijabmr.IJABMR_169_18  PMID:31392184
Atraumatic palsy of the anterior interosseous nerve (AIN) is rarely encountered, presenting an uncertain etiology which provokes a weakness of the flexor pollicis longus (FPL), flexor digitorum profundus (FDP), and pronator quadratus, while a lesion of one of the AIN branches is even rarer. In many cases, the diagnosis is based in motor deviations due to nerve's palsy. A palsy of the AIN can be “complete” or “incomplete.” In an incomplete palsy, only the FPL or the FDP of the index finger is paretic or paralyzed. There is a scientific debate concerning the effectiveness between surgical and conservative treatment approaches. Moreover, a patient may have the opportunity to decide whether to be submitted in an interventional procedure or not. The purpose of this paper is to report a case of an AIN's branch palsy and to suggest a possible delay of the surgical exploration, since a late self-recovery may occur.
  2 1,019 193
Postpolio syndrome: A review of lived experiences of patients
Oluwaseyi Jacob Oluwasanmi, Devaunna Andrene Mckenzie, Idowu Oluwasegun Adewole, Christian O Aluka, James Iyasse, Esther Olunu, Adegbenro Omotuyi Fakoya
July-September 2019, 9(3):129-134
DOI:10.4103/ijabmr.IJABMR_333_18  PMID:31392174
Postpolio syndrome (PPS) refers to a group of conditions that are present in patients, years after recovery from initial acute paralytic poliomyelitis. About 15%–80% of 20 million polio survivors worldwide will experience exacerbation of symptoms which typically appear 15–30 years after the resolution of initial poliomyelitis. Symptoms include new muscle weakness, fatigue, myalgia, joint pain, dysphagia, and difficulty breathing. Other reported symptoms include cold intolerance, sleep disorder, dysphonia, loss of stamina, musculoskeletal deformities, cardiovascular disorders, psychosocial problems, and restless legs syndrome. These symptoms are attributed to the superimposed neuronal loss of aging with inflammatory mechanisms, but without any convincing evidence of viral reactivation. Risk factors include female gender, respiratory symptoms, normal aging, permanent disability caused by motor neuron damage, muscle overuse and disuse, aging, and immunologic mechanisms. Hypothyroidism-induced myopathy and fibromyalgia are a differential diagnosis for PPS, and exclusion diagnosis is required as confirmatory criteria for PPS. The symptoms of PPS presented determine the course of management.
  2 3,224 350
A prospective multicentric postmarketing observational study to characterize the patient population with reduced gastrointestinal motility among indian diabetic patients receiving itopride: The progress study
Ramesh Roop Rai, Chittaranjan C Choubal, Mukesh Agarwal, Abdul M Khaliq, Faraz J Farishta, Yogesh P Harwani, Sanjay Y Kumar
July-September 2019, 9(3):148-153
DOI:10.4103/ijabmr.IJABMR_351_18  PMID:31392177
Aims: This study was intended to assess the clinical profile of Indian diabetic patients with reduced gastrointestinal (GI) motility and to understand the role of itopride in addressing reduced GI motility (gastroparesis) symptoms and maintaining glycemic control. Material and Methods: Patients with established reduced GI motility (scintigraphy), with varying degree of GI symptoms, receiving itopride 150 mg as per physicians' discretion were enrolled. Clinical profile, changes in symptom severity, glycemic indices, tolerability, and quality of life (QoL) after 8-week therapy (Patient assessment of upper GI disorders-QoL [PAGI-QoL]) were assessed. Results: Mean ± standard deviation age of enrolled population (n = 41) was 51.8 ± 12.39 years. Average duration of gastroparesis since underlying etiology was 67.7 ± 59.76 months. Common symptoms reported at baseline were bloating (68.3%), postprandial fullness (61.0%), nausea (51.2%), early satiety (41.5%), heartburn (39.0%), and vomiting (9.8%). Itopride therapy resulted in significant improvement in all symptoms (P < 0.001), which correlated with improved QoL (PAGI-QoL score reduction: 13.8 ± 11.48; P < 0.0001). Moreover, significant improvement in glycemic indicators was also evident (mean change from baseline hemoglobinA1c –0.5 ± 1.18; fasting plasma glucose –15.3 ± 43.61; postprandial plasma glucose –24.6 ± 57.20). Conclusions: Itopride showed effectiveness in addressing symptoms of reduced GI motility in diabetics, with improved QoL. Significant improvement in glycemic indices was also evident posttreatment with itopride. This study sheds light on the role of prokinetics, not only for symptom relief but also for improving glycemic control in diabetic patients with reduced GI motility, thus providing a holistic approach for the management of these patients.
  2 1,883 351
Steroid cell tumor of the ovary – A rare case report and review of literature
Vijayalaxmi S Patil, Poojitha Ram VemiReddy, Afra Taqdees, Surekha U Arakeri
July-September 2019, 9(3):185-187
DOI:10.4103/ijabmr.IJABMR_299_18  PMID:31392185
Steroid cell tumors of the ovary are extremely rare, accounting for only 0.1% of all ovarian tumors. Most steroid cell tumors secrete steroid hormones, and only about 10%–15% of patients are asymptomatic. The clinical presentation may take many forms, including abdominal pain, distention, irregular menstrual cycles, and hirsutism. Here, we present a case of a 60-year-old postmenopausal patient who presented with complaints of bleeding per vagina and abdominal pain for 4 months. Ultrasonography (USG) revealed a hypoechoic left adnexal mass measuring 65 mm × 40 mm × 30 mm. Based on these USG findings, the diagnosis of cystic lesion of the left ovary was made. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done, and the specimen was sent for histopathological analysis. On histopathology, diagnosis of steroid cell tumor-not otherwise specified was offered. This case is reported due to its rarity and its unusual presentation, together with a brief review of the literature of the same.
  1 1,861 274
Regenerative surgical flap to maintain interdental papilla around dental implant
Abdul Habeeb Bin Mohsin, KV Sheethi, M Priyanka, Dhanalaxmi Karre, Mohammed Qusroo Ahmed
July-September 2019, 9(3):188-190
DOI:10.4103/ijabmr.IJABMR_140_18  PMID:31392186
The modified surgical flap technique for placement of implant in the anterior maxilla has been described. The flap design has been used to achieve optimal soft-tissue contour for implant restoration. A modification in the surgical technique has been employed with the intention to preserve the interdental papilla, which is the key to the maintenance of hygiene and esthetics around anterior implants. This, in turn, prevents black triangles and improves soft-tissue contours. The modified surgical flap method maintains both functional and esthetic values.
  - 1,590 319
Andersen–Tawil syndrome and hypothyroidism: A case report with an unusual association
Mohd Saalim, Freny R Karjodkar, Kaustubh P Sansare, Sneha R Sharma
July-September 2019, 9(3):179-181
DOI:10.4103/ijabmr.IJABMR_164_18  PMID:31392183
Andersen–Tawil syndrome (ATS) is an autosomal dominant disorder, characterized by the triad of muscular paralysis, skeletal, and craniofacial anomalies and prolonged QT interval on echocardiogram with a tendency toward malignant ventricular arrhythmia. Although the patient may express one or two of the three components of triad, hypothyroidism is an endocrine disorder resulting in the delayed eruption of teeth, defective mineralization of bone and teeth, and speech and hearing deformity. Here, we report a case of ATS with hypothyroidism. To the best of authors' knowledge, no such association has been reported in the literature.
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Prevalence of hypertension and its determinants among policemen in a City of Haryana, India
Jai Parkash, Meenakshi Kalhan, Komal Singhania, Anita Punia, Brijesh Kumar, Pankaj Kaushal
July-September 2019, 9(3):143-147
DOI:10.4103/ijabmr.IJABMR_356_18  PMID:31392176
Introduction: Noncommunicable diseases (NCDs) kill 40 million people each year, equivalent to 70% of all deaths globally. Cardiovascular diseases account for most NCD deaths or 17.7 million people annually. Police work has been regarded by some researchers as one of the most stressful occupations in the world, and coronary heart disease has been identified as a major cause of mortality in this population. Materials and Methods: A cross-sectional study was carried out during July 2016–June 2017 among 450 policemen posted in Rohtak city of Haryana selected randomly. The investigator made two measurements of blood pressure. Data were collected using predesigned, pretested, semi-structured interview schedule, and analyzed using the Statistical Package for the Social Sciences version 20.0. Results: Of 450 participants, 164 (36.4%) participants were found to be hypertensive. Age of study participants, duration of service, rank, and education are significantly associated with the prevalence of hypertension (HTN) among policemen. Conclusion: HTN in policemen has emerged as an important public health problem. Knowledge of risk factors for HTN may give tracks for prevention in this population. Therefore, it is the need of hour to devise a sound screening strategy to diagnose HTN among policemen and devise a comprehensive strategy for the management of HTN.
  - 1,750 393
Histopathological spectrum and immunohistochemical profile of lung carcinomas: A 9-year study from a tertiary hospital in North India
Vandana Bhatti, Kanwardeep Singh Kwatra, Shivani Puri, Nalini Calton
July-September 2019, 9(3):169-175
DOI:10.4103/ijabmr.IJABMR_66_19  PMID:31392181
Background: Lung cancer is the most common cancer worldwide and the leading cause of cancer-related death. Diagnostic bronchoscopic or percutaneous biopsies are usually small. However, judicious use of immunohistochemistry (IHC) helps in accurate subtyping, which forms the basis for molecular tests and treatment. Aim: The aim was to study the role of IHC in the diagnosis of various histological subtypes of lung cancer. Methods: This 9-year study from 2009 to 2017 included all cases diagnosed as lung carcinoma on tissue biopsies. IHC markers were selected based on histopathology, from a panel comprising CK7, CK20, CK5/6, p63, thyroid transcription factor 1 (TTF-1), napsin A, synaptophysin, chromogranin A, neuron-specific enolase, CD56, and CDX2. Metastatic cancers to the lung were excluded from the study. Results: There were 199 cases of lung carcinoma comprising squamous cell carcinoma (37.7% [n = 75]), adenocarcinoma (26.1% [n = 52]), small cell carcinoma (20.6% [n = 41]), non-small cell lung carcinoma-unclassified (10.1% [n = 20]), adenosquamous carcinoma (2.5% [n = 5]), and others (3% [n = 6]). IHC was done on 47.7% (95/199) of cases. Squamous cell carcinomas showed CK5/6 and p63 positivity in 13/13 (100%) and 12/13 (92.3%) cases, respectively. Adenocarcinomas were positive for napsin A in 12/13 (92.3%) and TTF-1 in 35/41 (85.4%) cases. Neuroendocrine markers were positive in all small cell carcinomas. Conclusion: Squamous cell carcinoma was the most common primary lung malignancy in the North Indian population, followed by adenocarcinoma and small cell carcinoma. IHC panel of TTF-1, napsin A, CK5/6, and p63 is very helpful to classify most non-small cell lung carcinomas.
  - 2,514 325