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2022 | January-December | Volume 5 | Issue 1-2

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EDITORIAL

Charu Mohan, Shaifaly M Rustagi

Self-directed Learning: How to Do It?

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:2] [Pages No:1 - 2]

   DOI: 10.5005/jp-journals-11003-0120  |  Open Access |  How to cite  | 

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RESEARCH ARTICLE

Samar R Hossain, Nidhi Budh, Priya Arora

Perception of WhatsApp-based Learning among Medical Students in Delhi, India

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:3] [Pages No:3 - 5]

Keywords: Community medicine, Mobile learning, Smartphone, Teaching program, WhatsApp

   DOI: 10.5005/jp-journals-11003-0116  |  Open Access |  How to cite  | 

Abstract

Background: Mobile (M) learning is an emerging platform for students to learn through smartphones. The widespread use of smartphones on medical college campuses among the students and the faculty has now emerged as an interesting and immediate tool for acquiring knowledge. The smartphone can also become an efficient method in teaching and learning programs. Review results: Out of the 100 students who participated in the study, 83 of them liked the WhatsApp-based M-learning program (83%). Conclusion: This study found immediate acceptance of a new learning mode, that is, the M-learning WhatsApp mode, thus serving as an eye-opener that students are open to newer learning methods. Newer learning methods should be introduced in the curriculum. Academic significance: A large number of students used smartphones for communication, education, entertainment, navigation, and gaming purpose, so this method would help channelize the proper and effective use of the electronic gadget. Moreover, the WhatsApp application supports free voice and video calls so teachers and students can stay in touch, even outside the stipulated periods.

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RESEARCH ARTICLE

Anjali Singh, Suraj Prakash, Shaifaly Madan Rustagi

Anatomical Description of the Duct System of the Pancreas: A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:6] [Pages No:6 - 11]

Keywords: Cadaveric, Ductal anatomy, Magnetic resonance cholangiopancreatography, Major pancreatic duct, Pancreatitis, Retrospective study

   DOI: 10.5005/jp-journals-11003-0119  |  Open Access |  How to cite  | 

Abstract

Introduction: Variations in the duct system of the pancreas lead to anomalies that predispose to diseases like acute or chronic pancreatitis or impairment of the pancreatic exocrine function. Pancreas divisum is the most common ductal anomaly leading to chronic pancreatitis. Objectives: This study was aimed at observing, understanding, and analyzing recorded variations of the ductal anatomy of the pancreas with the purpose of reviewing the literature on pancreatic duct anatomy, and underlining its importance in daily invasive endoscopic and surgical practice. Methods: A total of 10 cadaveric pancreas and duodenum were obtained en bloc from the abdomen. Following the injection of eosin dye for better visualization of the ducts, piecemeal dissection of the parenchyma of the gland was carried out to expose the duct system of the pancreas. A total of 10 outpatient department (OPD) cases of pancreatitis from the department of radiology in whom MRCP had been performed were chosen at random. The findings were interpreted, tabulated, compared with outcomes of previous studies, and analyzed. Result: Our findings from the cross-sectional observational study suggest that out of twenty pancreas, 75% of cases showed the presence of major pancreatic ducts, and 25% of cases showed the presence of both main and accessory pancreatic ducts. MRCPs of patients with acute/chronic pancreatitis obtained from the Department of Radiology showed the presence of a single duct, suggesting that presence of single duct anatomy might be a predisposing condition for the occurrence of pancreatitis. Conclusion: This knowledge is significant for planning diagnostic procedures and procedure-related complications. Magnetic resonance cholangiopancreatography (MRCP) is the investigation of choice for visualizing the pancreatic and biliary ductal anatomy as it is noninvasive and safe. Hence, based upon findings of the pancreatic ductal system using cadaveric pancreas and MRCP, associations between the patterns and anomalies with pancreaticobiliary diseases were assessed.

219

REVIEW ARTICLE

Yancarlos Ramos-Villegas, Loraine Quintana-Pájaro, Christian Meza-Valle, Mario Contreras-Arrieta, Huber Padilla-Zambrano, Tariq Janjua, Willem G Calderon-Miranda, Yelson A Picon-Jaimes, Julio Castillo-Blandino, Luis R Moscote-Salazar, Natalia Guevara-Moriones

Neuroradiological Characteristics in Patients with Mucopolysaccharidosis Type II: A Systematic Review

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:8] [Pages No:12 - 19]

Keywords: Diagnostic imaging, Hunter syndrome, Mucopolysaccharidosis II

   DOI: 10.5005/jp-journals-11003-0118  |  Open Access |  How to cite  | 

Abstract

Introduction: Mucopolysaccharidosis (MPS) is an inherited metabolic disorder that is part of the lysosomal disorders; the main characteristic is the deficiency of lysosomal enzymes responsible for the degradation of glycosaminoglycans except for type II or Hunter syndrome, which is X-linked recessive inheritance. Neurological symptoms are Down syndrome, carpal tunnel, communicating hydrocephalus, spinal cord compression, and hearing loss. Neuroimaging plays a fundamental role in the diagnosis of central nervous system (CNS) involvement, as well as the assessment of complications such as hydrocephalus and spinal cord compression. Objective: To determine the characteristic findings of neuroimaging diagnostic aids in patients with MPS type II or Hunter's disease. Methodology: The recommendations of the Cochrane Collaboration [Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)] were followed. The bibliographic search was carried out in PubMed, Embase, Scopus, and ScienceDirect. Considering all the publications made up to 13th May 2018. Results and discussion: A total of 19 articles of the 723 results obtained were considered. Neuroradiological studies in patients with MPS type II still do not report clear and specific patterns of this pathology. Decreased contrast between the cortex and the underlying white matter has been reported; however, another study stated that these changes were secondary to demyelination or gliosis, manifestations that are not pathognomonic of MPS II. Ventricular dilatation is also a constant in patients with MPS II, which seems to be related to a cognitive disability; larger studies are still needed to confirm this association. Conclusion: Patients with MPS type II have a variety of abnormalities that are reflected in neuroradiological manifestations. The most significant findings of these patients included changes in gray and white matter signaling, cerebral atrophy, ventriculomegaly, increased perivascular space, increased subarachnoid space, and changes in the craniocervical junction. These characteristics must be strictly monitored both in the routine review and in the evaluation of responses to new therapeutic strategies.

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CASE REPORT

Sumit Arora, Abhinav Kumar, Kuldeep K Ashta, Atul Gogia, Atul Kakar

Pulmonary Nocardiosis—A Mimicker of Tuberculosis in Human Immunodeficiency Virus Patients: Two Case Reports

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:3] [Pages No:20 - 22]

Keywords: Human immunodeficiency virus and acquired immunodeficiency syndrome, Nocardiosis, Pneumonia

   DOI: 10.5005/jp-journals-11003-0112  |  Open Access |  How to cite  | 

Abstract

Background: Nocardia is a gram-positive weakly acid-fast bacterium causing atypical pneumonia in an immunocompromised setting. A mimicker of pulmonary tuberculosis, presenting as cavitating lesions of the lung. It presents with suppurative disease localized to skin and subcutaneous tissue in immunocompetent individuals. It is a rare opportunistic infection in HIV patients with CD4 < 50, on prolonged steroids, at extreme ages, and haematological malignancies presenting with severe disseminated disease. Diagnosis of Nocardia requires the isolation of the organism from invaded tissue and can be stained on the Gram and modified acid-fast stains. Case Description: We report two cases of severe pulmonary nocardiosis diagnosed to have HIV infection on presentation with CD4 counts <50 cell/cmm3. Conslusion: We conclude that for patients presenting with subacute cavitating or interstitial pneumonia with immunocompromised status and HIV patients with low CD4 counts, a diagnosis of nocardiosis should be suspected along with tuberculosis and fungal infections.

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CASE REPORT

Sharmila Dudani, Sridhar Mangalesh, Archna Rautela, Rajendra Maskara

Tuberculous Mastitis Masquerading as an Inflammatory Cellulitis: Case Report

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:2] [Pages No:23 - 24]

Keywords: Abscess, Breast, Cellulitis, Tuberculosis

   DOI: 10.5005/jp-journals-11003-0113  |  Open Access |  How to cite  | 

Abstract

Introduction Tuberculosis mastitis is a rare manifestation of tuberculosis. Clinical manifestations can be variable and unusual. Routine laboratory and imaging tests may yield nonspecific results making diagnosis challenging. Clinical details A 33-year-old, healthy, nonlactating, female presented with a 15-day history of high fever, pain, and swelling of the left (Lt) breast. Examination revealed tender breast swelling with erythema of overlying skin. No breast lump/axillary lymphadenopathy was palpable. Nipple and areola were normal. No sinus/ulcer present. X-ray chest was normal. No tuberculous focus is present. Differential diagnosis includes breast abscess, mastitis, fungal infections, and granulomatous diseases. Mammography and ultrasound are not diagnostic of breast tuberculosis. Fine needle aspiration cytology (FNAC) is useful only in presence of a breast lump. Open biopsy/surgical debridement may be required for confirmation. Conclusion A high index of clinical suspicion with appropriate diagnostic tests and a standard antitubercular drug regimen is needed for a complete cure.

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CASE REPORT

Sharmila Dudani, Archna Rautela, Sridhar Mangalesh

Capillary Hemangioma of Toe in an Adult: Clinically Mistaken as a Pyogenic Granuloma

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:2] [Pages No:25 - 26]

Keywords: Adults, Capillary hemangioma, Pyogenic granuloma, Toe

   DOI: 10.5005/jp-journals-11003-0114  |  Open Access |  How to cite  | 

Abstract

Introduction: Capillary hemangiomas are benign vascular neoplasms seen in the head, face, and neck regions of infants and children. Pyogenic granulomas commonly occur in the oral cavity in adults. Clinical details: We report a case of a 46-year-old male who presented with a rapidly growing mass on the toe which was clinically diagnosed as pyogenic granuloma but was confirmed to be capillary hemangioma on histopathology. Conclusion: A high index of clinical suspicion for lesions at unusual sites along with caution is required during surgery of these neoplasms due to the risk of excessive bleeding.

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CASE REPORT

Rohit Bhardwaj, Ashwani Sethi, Biswajit Das, Shubhankar Tiwari, Manjeera Pathri

Isolated Sternocleidomastoid Cysticercosis—Insights of Diagnosis and Treatment Planning: A Case Report

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:3] [Pages No:27 - 29]

Keywords: Helminthic diseases, Myocysticercosis, Neurocysticercosis, Sternocleidomastoid, Taenia saginata

   DOI: 10.5005/jp-journals-11003-0117  |  Open Access |  How to cite  | 

Abstract

Introduction: Taeniasis is a condition when humans (definitive host) are infected with adult tapeworms in the intestine whereas cysticercosis is infection with larval forms (i.e., Cysticercus cellulosae). Case description: We present a rare case of isolated sternocleidomastoid muscle cysticercosis which was diagnosed with help of USG and treated successfully by pharmacotherapy (albendazole and steroids). Discussion: The cysticercous larva enters the circulatory system by penetrating and crossing the bowl wall. Through blood stream these larvae migrate to sites of lodgement which includes brain (most common), skeletal muscles, eyes, liver and subcutaneous tissues. Conclusion: Isolated muscle involvement is not common and thus often presenting as isolated asymptomatic swelling, it poses challenges in diagnosis.

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BRIEF RESEARCH COMMUNICATION

Abdul Nasser

Identification of Multiple “Space Cohorts” Based on Ventilation Parameters: A Novel Strategy to Combat Airborne Pathogens on Naval Warships

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:4] [Pages No:30 - 33]

Keywords: Airborne pathogens, Air recirculation, Space cohort, Ventilation, Warships

   DOI: 10.5005/jp-journals-11003-0115  |  Open Access |  How to cite  | 

Abstract

Introduction: Warships have unique built environment with an ideal setting for rapid transmission of several air-borne pathogens. A study of SARS-CoV-2 behavior on board ships achieved through high rates of testing with combinations of epidemiology, transmission, ventilation, and accommodation parameters suggests inevitability of outbreaks. Materials and methods: We propose a model based on the study of ventilation patterns and air-conditioning systems on warships which permits division of ship's crew into multiple small cohorts, named as `Space Cohorts’. Such an approach will allow segregation of crew into smaller groups permitting early detection of asymptomatic and pre-symptomatic carriers of virus. The proposed labeling of `Space Cohorts’ expands on the definition of primary contacts for a more effective control of virus transmission. Use of these cohorts as isolation/ quarantine facility offers several operational advantages and can be considered as an option in response to the threat of air-borne pathogens. Conclusion: It is essential that a warships’ integrity and operational efficiency is maintained. Bases on the proposed model, each ship may need to work out a submodel based on its design, size, crew manning philosophy and operational imperatives. The fresh perspective is recommended for implementation and further validation.

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VIEWPOINT

Tariq Janjua, Masood Kisana, Luis Rafael Moscote-Salazar

Mechanical Medical Devices in Intensive Care and End-of-life: Unanswered Questions

[Year:2022] [Month:January-December] [Volume:5] [Number:1-2] [Pages:3] [Pages No:34 - 36]

Keywords: Critical Care, Ethics, Medical device

   DOI: 10.5005/jp-journals-11003-0111  |  Open Access |  How to cite  | 

Abstract

End-of-life can be at different locations. Intensive care admission and progression to the terminal stage is one of these locations. The condition progresses to an unfortunate state where finally it is decided to initiate comfort care, terminal extubation, or change the status to no further therapy. Modern advancements in health care include the application of an extensive list of medical devices to continue functional life in an outpatient setting or support critical care conditions. Both of these situations can have periods where medical device function makes critical decisions difficult. Patients, families, and sometimes healthcare providers discuss and do their best what has to be done to deal with these devices as the end-of-life approaches. Here we bring up some questions, not clearly defined in medical practice and suggest some options. As medical care gets more complex, there will be newer editions to these devices and further questions will arise. To make the point more clear, the below-mentioned case may help with the questions to follow.

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