Journal of Research in Applied and Basic Medical Sciences
Volume:10 Issue: 2, Spring 2024

 The collimator angle significantly impacts radiation leakage between the multi-leaf collimator (MLCs) leaves. This study aims to examine dose-volume evaluation in planning target volume (PTV) and organs at risk (OARs) for Head & Neck patients undergoing volumetric-modulated arc therapy (VMAT) with 2.5 arcs and varying collimator angles.

 In this experimental study, five patients with nasopharyngeal cancer were selected for treatment with the VMAT method. CT images were prepared using a CT simulator and transferred to the treatment planning system. For optimizing VMAT plans, volume and dose constraints were applied to OARs and PTVs by the algorithm. Then, the doses were calculated using the AAA algorithm.

 Although no significant differences were observed in DVH curves across different collimator angles, other parameters exhibited variations. Notably, in Head & Neck cancer patients, optimal values for dose conformity, homogeneity, MUs, and gradient index were found at collimator angles of 20° and 30°. Additionally, OAR sparing was favorable at these angles. Based on target coverage, homogeneity, and MUs, the collimator angles were optimized for VMAT planning.

 Our findings offer valuable guidance to clinical medical physicists in making informed decisions regarding collimator angles. The dosimetric analysis underscores the importance of selecting the optimal collimator angle for accurate PTV coverage.

Several studies were conducted earlier to find the association between serum Vitamin- D and Anti-Müllerian hormone (AMH) levels among women with Polycystic Ovary Syndrome (PCOS). The results from the existing studies were inconsistent. The objective of the present study was to find out the association between serum Vitamin D and AMH levels among women with PCOS.  

 A cross-sectional study was conducted in a Tertiary Care Teaching hospital in South India, 120 PCOS and 60 controls were included in the study. Age, Body Mass Index (BMI), Follicular Stimulating Hormone (FSH), Luteinizing hormone (LH), Estradiol (E2), Antral Follicular Count (AFC), Anti-Müllerian hormone (AMH), and 25-hydroxyvitamin D (25(OH)D) were analyzed among PCOS and control groups and comparisons were made.

 There was no significant difference (P =0.925) in the Vitamin D levels among PCOS and control groups. There was a positive correlation (r = 0.392; p = 0.002) between Vitamin D levels and AMH levels among PCOS group.

 The present study revealed that there was no significant difference between Vitamin D levels among PCOS and control groups. There was weak positive correlation between Vitamin D levels and AMH levels among PCOS group. Multilinear regression analysis with AMH as dependent variable and other parameters as dependent variables in PCOS group revealed that AMH levels were independently correlated with age but not with Vitamin D.

Urinary Tract Infections (UTIs) are one of the most commonly occurring infections in medical practice despite the widespread availability of antibiotics. The emergence of antimicrobial resistance in uropathogens may lead to poor treatment outcomes in individuals with UTIs. The knowledge of the microorganism involves and antibiograms are important for the empirical treatment of UTIs.

This study was undertaken to evaluate the bacteriological profile of UTI patients and to know their antimicrobial susceptibility pattern.

A cross-sectional study was carried out over 6 months (from July 2021 to December 2021) with a focus on the identification of bacterial pathogens causing UTI and the evaluation of their antibiogram. Mid-stream urine samples were collected from a total of 2825 subjects with clinically suspected acute UTI. Urine samples were aseptically collected in sterile containers and inoculated aseptically on to Hi-Chrome UTI agar. Isolation and identification of the bacterial strains were performed using standard microbiological protocols. Antibiotic susceptibility was carried out following CLSI recommended guidelines. Only culture proven cases, were included in this study. 

 A total of 2825 urine samples were processed for urine culture and sensitivity out of which 804 samples were found to be positive for bacterial infection (amounting to 28.46% positivity). Gram -negative bacteria accounted for 58.5 % (471/804) and Gram -positive 33% (267/804) of the positive results. Among Gram -negative isolates, E. coli(33.8%) and K. pneumoniae (10.8%) were the most prevalent microorganisms while as Enterococcus sp (26.3%) was the most common Gram -positive organism isolated followed by Staphylococcus aureus. Gram negative bacteria on the whole showed a high degree of resistance to cephalosporins and quinolones while as nitrofurantoin was the most effective antibiotic against E. coli and K. pneumoniae. In case of Gram-positive bacteria linezolid and vancomycin were the most effective antibiotics.

The results of this study revealed a great concern for emerging UTI‑related multidrug‑resistant strains of bacteria causing UTI. The need of the hour is continuous monitoring of susceptibility patterns of specific pathogens to commonly used antimicrobial agents before initiation of antibiotic therapy.

Amiodarone is a purposive medicine useful in restoring sinus rhythm (SR) after cardiac surgery. The aim of the study was to evaluate the effect of prophylactic intraoperative single-dose intravenous amiodarone and to convert atrial fibrillation (AF) into normal sinus rhythm (NSR) in the patients undergoing valve replacement surgery.

In this prospective and interventional study, 180 patients of ASA III (American Society of Anesthesiologist) classification between the ages of 18-60 years, posted for Rheumatic Mitral Valve Replacement were allocated randomly to two equal groups (Group-1 and Group-2). Their hemodynamics parameters, Pre and post pulse rate, ECG findings and incidence of AF and VT/VF and ICU, Hospital stay were noted. Data was analysed with SPSS v26 using chi-square test. A two-tailed P value of 0.05 or less was regarded as statistically significant.

In our study, we found that there was suggestive significance between both groups as regard to mean pulse rate changes after 5 and 10 minutes of induction (P value >0.05). At the end of surgery, there was developing atrial fibrillation in few patients and sinus rhythm in more (P value >0.05). Postoperative arrhythmias in the first 24 hrs, AF was seen in 9(10%) patients in the Group 1 compare to Group 2 49 (54.4%) (P <0.001). In both groups as regard to Mechanical ventilation & ICU stay was of suggestive significance in amiodarone group (P value <0.0001).

The incidence of post-operative AF among high-risk patients was significantly reduced by a prophylactic amiodarone treatment resulting in a shorter time of intensive care unit and hospital stay.

 There are different types of drugs to shorten prolonged labor. Spasmolytic drugs are used frequently in the delivery section to overcome cervical spasms and reduce the duration of labor. The study's objective was to evaluate the therapeutic efficacy of hyoscine N-butyl bromide (HBB) and Promethazine on the duration of the active phase of labor.

We searched the Science Direct, PubMed Scopus, Google Scholar, MEDLINE, Web of Science, Cochrane Library, PsycINFO, and ProQuest databases, and reviewed the literature and reference lists of retrieved articles. We included reports of quantitative studies published in all Persian and English articles from 2000 to 2021 that focused on Promethazine or Hyoscine during. Two authors independently screened titles and abstracts and assessed articles in full text against the inclusion criteria. These criteria included vertex presentation, no previous uterine surgery, intact membranes, and spontaneous labor, with mothers having no contraindications for normal vaginal delivery.   

 Out of a total of 170 records initially screened, we included 44 articles in our review, and other studies were excluded. The results showed that 10, 20, 40 mg of HBB decreased the first stage of labor duration by 147.02 min, 58.95 min, and 71.60 min, respectively. Additionally, HBB decreased the first stage of labor duration by 100.61 min in multiparous women and 66.04 min in primipara women. To evaluate the Promethazine effect on labor duration, the results showed that the combined MD was not significant (p=0.67, 0.85, and 0.44 in the first, second, and third stages, respectively).

 HBB is more effective in multiparous women compared to primiparous women. On the other hand, Promethazine has no effect on reducing total labor duration and any stages of labor, so its use is not recommended.

 Glaucoma usually undiagnosed in general population. People usually ignores the symptoms and came late when disease already get worsened. This study aimed to compare intraocular pressures in general population having inclusion criteria with different types of tonometers and its correlation with central corneal thickness in patients presenting in OPD at Ophthalmology Department of Sir T hospital, Bhavnagar, Gujarat.

In this Hospital based cross-sectional observational study with 9-month duration, 72 patients between the ages of 30–75 years were evaluated, after taking into consideration the inclusion and exclusion criteria. Detailed history taken including chief complaints, past history, family history, personal history followed by general and systemic examination. 72 patients having inclusion exclusion criteria were analyzed with three different tonometers (Goldmann applanation, Non-contact tonometer (NCT), Schiotz tonometer), and the correlation between each other were measured. Then central corneal thickness is measured with OCT Tomography, and the results were compared to intraocular pressure (IOP).

 When compared to the non-contact tonometer, we found that the Schiotz tonometer had the highest correlation. These associations were also seen in people with diabetes and hypertension. Nonetheless, as patients age, there is a corresponding rise in the correlation between the gold standard approach and the tonometer.

 All the tonometer showed significant correlation with the gold standard technique (Goldmann applanation tonometer), over a range of intra ocular pressure, between the ages of 30 -75 years, in diabetics and hypertensive patients, and in the patients with different CCT values.

This study investigated the effect of fludrocortisone treatment on the expression of genes and proteins involved in the implantation process in mice.

The study involved four groups of mice, and mRNA and protein expression were measured using real-time PCR and western blotting.

The results showed that fludrocortisone treatment slightly downregulated the expression of SGK1, ENaC-α, miR-145, and miR-200a, while slightly upregulating the expression of HAND2, miR-451, mTOR, and 4E-BP1 in the endometrial epithelium. mTOR kinase inhibitor PP242 treatment resulted in the upregulation of miR-145 and miR-200a, while partially downregulating the expression of p-4E-BP1, mTOR, SGK1, ENaC-α, HAND2, and miR-451 expression. Combination therapy of fludrocortisone and PP242 resulted in slightly decreased expression of ENaC, SGK1, miR-200a, miR-145, and 4E-BP1, while slightly upregulating the expression of miR-451 and HAND2 in the epithelial endometrium.

The findings indicated that fludrocortisone did not disrupt endometrial receptivity and may even enhance it by modulating gene expression through the activation of the mTOR signaling pathway. Overall, the study suggests that fludrocortisone treatment can modulate the expression of genes and proteins involved in the implantation process in mice. The activation of the mTOR signaling pathway was also increased during the treatment. The findings indicate that fludrocortisone may increase endometrial receptivity without disrupting it, which could have implications for fertility treatment.

 Type 2 diabetes mellitus is the most prevalent form of diabetes seen worldwide. Neuropathy is one of the most common micro-vascular complications of type 2 diabetes mellitus. DPN is considered a main risk factor for diabetic foot leading to amputation, and hence a significant cause of morbidity in diabetes mellitus. Increasing age, longer duration of diabetes and poor glycemic control are well recognized risk factors for DPN. Influence of oxidative stress and corresponding inflammatory changes in tissues in chronic diabetes can be evaluated by certain biochemical parameters. The aim of the present study was to evaluate these biochemical parameters in predicting risk for neuropathy.

 This is a randomized case control study. This study was done in a tertiary care hospital in Andhra Pradesh. The study was conducted for a period of 4 months from the month of June to October 2022. All the subjects were the patents attending medical OPD and demographic characters were noted. The patients were asked for an overnight fast for collecting blood samples for analyzing parameters like fasting plasma glucose, glycosylated hemoglobin, renal and lipid profile. Institutional ethical committee clearance was taken before starting the study. The study includes a total of 200 subjects with 100 cases of diabetic patients with neuropathies compared with 100 controls of diabetic patients without neuropathy for various biochemical parameters. Statistical analysis was done using graph pad prism software for unpaired t- test and p-value.

 There was a significant increase in the levels of fasting plasma glucose (p< 0.0002) glycosylated hemoglobin (p <0.0006), Total Cholesterol (p<0.0017), triglycerides (p <0.0232), creatinine (p<0.0001) and Low-density Lipoprotein cholesterol (LDL-C) (p< 0.0080) in patients with diabetic neuropathy when compared to diabetic patients without neuropathy. And there is significant correlation with duration of diabetes (p<0.0320) and other associated risk factors like hypertension systolic blood pressure (SBP) (p< 0.003) diastolic blood pressure (DBP) (p<0.0001) and Body Mass Index BMI (p<0.002).

 From this study it can be seen that regular screening of diabetic patients using biochemical parameters like glycosylated hemoglobin, lipid profile and creatinine and considering the duration of diabetes and other associated risk factors helps in the prediction and prevention of development of neuropathy at an early stage.

Anatomical variations in the branching pattern of arch of aorta are significant for diagnostic, surgical, and interventional procedures of the thorax and neck, and failure to recognize these patterns may have fatal outcome. Hence the present study aims to determine the percentage and type of aortic arch variations.

This cross-sectional study was conducted on 30 formalin-fixed stillborn human fetuses of 35 weeks gestational age and above, in the Department of Anatomy, RIMS, Imphal, Manipur from 2018 to 2020. stillborn human fetuses were collected from the Obstetrics and Gynecology Department of RIMS, Imphal, Manipur, after taking due consent from parent. Fetus with gross abnormality and weighing less than 2.5 kg were excluded. whereas above 2.5 kg weight fetuses were included. The variations in the branching pattern of aortic arch were observed, noted and photographed. The variations were according to the classification by vicurevic et al., 2012.

The classical pattern of three branches of the arch of aorta were seen in 23 (76.66%) cases in the present study. In the remaining 7 (23.33%) cases, two different types of variations were observed with four and two branches arising in five and two cases respectively.

Knowledge of normal anatomy and frequency in the variations in the branching pattern of the arch of aorta in the present study can be of significance for clinicians.

 Otalgia is a very common symptom induced by a wide variety of diseases. Depending on the location of the pathology, otalgia is categorized into primary and secondary types. In primary otalgia, the main source of the pain is located within the ear. On the contrary, secondary or referred otalgia is defined as a disorder which the underlying pathology is outside of the ear complex giving rise to the sensation of pain in the ear. Multiple etiologies have been reported to produce secondary otalgia including temporomandibular joint dysfunctions, cervical spine pathologies, laryngitis, pharyngitis and tonsillitis.

  In this study, we present a 57-year-old man with referred otalgia, associated to rotator cuff tendon tear and acromioclavicular joint osteoarthritis, which is uncommon and atypical.

Shoulder pathologies like rotator cuff tendon tear and acromioclavicular joint osteoarthritis can be considered as a possible but rare cause of referred otalgia

 Heart diseases stand out as a leading cause of death. Specific enzymes are active eliminators of toxic substances from the body. One of the crucial enzymes in this process is Glutathione S-Transferase (GST). In this study, GST activities were determined in individuals with and without coronary artery, and the relationship between some biochemistry tests and GST activity was examined.

This case-control study was conducted on 54 patients with CAD and 54 people without CAD with matched age and sex as control group. Biochemical parameters were measured on an autoanalyzer, and GST enzyme activity was measured on a spectrophotometer. All parameters were examined statistically in line with the data obtained. Data were analyzed by SPSS v.20. A p-value less than 0.05 was considered statistically significant

Accordingly, while there was a statistically significant difference in the GST enzyme activity and HDL-C levels, there was no statistically significant difference in total cholesterol, triglycerides, LDL-C, urea, creatinine and CRP levels. GST enzyme activity level, total cholesterol, triglycerideç LDL-C and CRP levels were found to be higher in thr patient group than the control group, while HDL-C, urea and creatinine levels were found to be higher in the control group than the patient group (Ps <0.05).  

The results obtained indicate that determining the GST enzyme activity level, in addition to routine cardiac markers for the diagnosis of CAD, is important in the diagnosis of CAD-related conditionsç Also ıt will elucidate the mechanisms that constitute the main cause of these diseases.

 One of the most popular Anabolic Androgenic Steroids (AAS) among athletes and teenagers is Nandrolone Decanoate (ND), a synthetic testosterone analog. Chronic AAS consumption raises the risk of cardiovascular problems in athletes, however the mechanism causing such changes is not known. This experimental research aims to investigate the impact of nandrolone decanoate administration on heart in white male albino rats.

Twenty male Albino rats, split into two groups, were used in the study. Group A served as a control, getting peanut oil injections, while Group B received decanoate injections at a dose of 10 mg/kg body weight weekly for eight weeks. After the eighth week, the rats were sacrificed under anesthesia in accordance with the recommendations issued by the Ethical Committee. Following sacrifice, the rats were dissected and their tissues processed using normal histology procedures. Sections were stained with hematoxylin and eosin, and microscopic observations were recorded in groups. In order to properly label and analyze the photos, photographic microscopy was used.

 After Eighth week, the control group's heart showed no obvious changes under microscopic examination, whereas the ND treated group showed intermuscular hemorrhages, congested myocardial vessels, widely separated cardiomyocytes, fragmented muscle fibers, and cardiomyocytes showing vesicular nuclei and few degenerative changes. These results suggest that ND treatment may cause particular cardiac structural changes in white male albino rats.

 The study suggests that Nandrolone abuse can lead to cardiac problems such as severe degeneration, myocardial vascular congestion, and intermuscular hemorrhages. The study emphasizes the significance of investigating the long-term effects of these medications, as well as the importance of well-designed studies and proper dosage considerations.