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  Citation statistics : Table of Contents
   2017| May-August  | Volume 4 | Issue 2  
    Online since June 15, 2017

 
 
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ORIGINAL ARTICLES
Increased role of nonalbicans Candida, potential risk factors, and attributable mortality in hospitalized patients
Raminder Sandhu, Shalley Dahiya, Pallavi Sayal, Diksha Budhani
May-August 2017, 4(2):78-83
DOI:10.4103/2394-2010.208115  
Aim: The aim of this study was to evaluate the distribution of nonalbicans Candida (NAC) along with their associated risk factors, clinical outcome, and antifungal susceptibility pattern among inpatients. Materials and Methods: Retrospective descriptive study comprising 94 isolates of Candida species obtained from various clinical specimens of hospitalized patients. The clinical charts of patients were reviewed retrospectively who stayed in the hospital for more than 7 days irrespective of their diagnosis. Statistical Analysis: Descriptive statistics was used which involves the use of simple percentage and bar chart to analyze the data. In addition, Chi-square test was performed and P value was calculated. Results: NAC was identified in 72 (77%) patients and Candida albicans in 22 (23%). Factors associated with Candida krusei were stay in hospital ≥15 days (78%), broad-spectrum antimicrobial therapy (72%), prophylactic fluconazole therapy (67%), preterm newborn with low birth weight (LBW) (67%), stay in the Intensive Care Unit (ICU) ≥10 days (67%), indwelling devices (67%), and mechanical ventilation (67%); Candida glabrata infection as broad-spectrum antimicrobial therapy (69%), preterm newborn with LBW (62%), stay in ICU ≥10 days (62%), and indwelling devices (62%); Candida tropicalis as indwelling devices (86%), broad-spectrum antimicrobial therapy (71%), stay in ICU ≥10 days (71%), stay in hospital ≥15 days (71%), pulmonary tuberculosis (71%), neutropenia (71%). Amphotericin B was effective against both C. albicans as well as NAC with susceptibility of 91% and 89%, respectively. Mortality was similar in patients infected with C. albicans and nonalbicans species (27.27% vs. 27.77%). Conclusion: The study concludes higher prevalence of NAC with majority of patients having multiple underlying illnesses and other associated risk factors. Continued surveillance of Candida infections will be required to document changes in epidemiology and antifungal susceptibilities.
  4 1,878 221
Interventions in the management of blood viscosity for idiopathic sudden sensorineural hearing loss: A meta-analysis
Yike Li
May-August 2017, 4(2):50-61
DOI:10.4103/jhrr.jhrr_125_16  
Aims and Objectives: To estimate the efficacy of interventions in the management of blood viscosity for idiopathic sudden sensorineural hearing loss (ISSNHL) using meta-analysis method. Materials and Methods: An extensive search for literature was performed to identify publications from 1966 to 2016 in Cochrane controlled clinical trials register online, Medline, EMBASE, BIOSIS Preview, Web of Science, China Knowledge Resource Integrated Database and Wanfang. Only randomized control trials (RCTs) with valid control groups were included in this study. Each trial was graded for methodological quality using a 6-point standard. Meta-analysis was performed to assess the efficacy of intervention in managing blood viscosity on hearing improvement (primary outcome), relief of tinnitus and vertigo (secondary outcomes) for ISSNHL. Tests for sensitivity, heterogeneity as well as publication bias were also performed to evaluate the validity of results. Results: Forty-nine RCTs with a total of 4978 patients were included in this meta-analysis. The overall odds ratio of all interventions was 3.12 (P < 0.01). Significant effect sizes were shown on fibrinogen reduction, plasmapheresis, and anticoagulation as well as hemodilution. The mean methodological score was 3.0. There was great homogeneity between studies. No evidence of publication bias was found. Sensitivity test showed reliability and robustness of the results. Conclusion: This meta-analysis provided evidence to support the effect of interventions that manage blood viscosity in the treatment of ISSNHL. There is a need for more high-quality RCTs in the future, especially for hemodilution, anticoagulation as well as plasmapheresis.
  1 1,913 177
REVIEW ARTICLES
The role of exfoliative cytology and molecular biology in oral potentially malignant disorders
Ravi Teja Chitturi, Elanagai Rathinam, Rochard Santo, Thukanayakanpalayam Ragunathan Yoithapprabhunath
May-August 2017, 4(2):43-46
DOI:10.4103/jhrr.jhrr_22_17  
According to the latest statistics, oral squamous cell carcinoma is the 9th most common cancer to diagnose worldwide, especially in males and in the developing countries and cause for high mortality and morbidity. Oral potentially malignant disorders (OPMD's) are an important entity associated as precusors for most of these cases which are reversible. Hence, early detection of OPMD's can be very useful. Exfoliative cytology is a practically very easy and patient-friendly method to collect cells from these lesions. They can be subjected to a variety of analysis to help us detect oral cancer in advance. This review describes all the techniques have been used in early detection right from the conventional techniques to molecular diagnostics.
  1 2,749 343
ORIGINAL ARTICLES
The effects of maxillomandibular fixation on ventilatory functions in adult Nigerians
Benjamin Idemudia Akhiwu, Dauda Birch Saheeb, Helen Oluwadamilola Akhiwu, Daniel Otasowie Osunde, Basil Ojukwu, Musa Babashani
May-August 2017, 4(2):84-87
DOI:10.4103/jhrr.jhrr_102_16  
Background: Maxillomandibular fixation (MMF) is a routine procedure in maxillofacial surgery in developing countries. Aim: The aim of this study was to determine the pulmonary functions (forced expiratory volume in 1 min [FEV1], forced vital capacity [FVC], and peak expiratory flow rate [PEFR]) of adult Nigerian patients who had MMF and to find the associated changes in pulmonary functions in the postoperative period vis-à -vis pulmonary function tests among healthy adult Nigerians. Settings and Design: The study setting was the Oral and Maxillofacial Surgery Department of a Teaching Hospital in Northern Nigeria, and the study design was prospective hospital based. Materials and Methods: One hundred and six patients and 106 controls were recruited between January 2011 and December 2012. Information was obtained using a questionnaire. All study participants had their baseline lung functions measured; the treatment group in addition had their postoperative daily lung function parameters measured for the 1st week and then weekly for the next 5 weeks. Statistical Analysis: Statistical analyses were performed using the Statistical Package for Social Sciences (version 16, SPSS Inc., Chicago, IL, USA). The mean and standard deviation values of physical characteristics and ventilatory functions were determined in both men and women. The mean values were compared using Student's t-test. Statistical significance was inferred at P ≤ 0.05. Results: One hundred and seventy males and 42 females participated in the study. The control group had a mean age of 30.25 ± 9.05, weight 64.08 ± 9.90, height 1.67 ± 0.10, body mass index (BMI) 23.32 ± 3.07, basal FVC 3.70 ± 0.71, basal FEV13.16 ± 0.54, and basal PEFR8.35 ± 1.62. For the treatment group, the mean age was 30.68 ± 8.23, weight 64.91 ± 9.96, height 1.66 ± 0.10, BMI 23.21 ± 3.14, basal FVC 3.72 ± 0.69, basal FEV13.14 ± 0.51, and the basal PEFR8.18 ± 1.61. Conclusion: The postoperative mean FVC, FEV1, and PEFRvalues drop significantly by more than 50% when compared to the preoperative values in the first postoperative week with the nadir on the second postoperative day in the patients with MMF.
  - 1,595 133
Correlation of waist circumference and waist-to-height ratio with maximal aerobic capacity in young adults
Himel Mondal, Snigdha Prava Mishra
May-August 2017, 4(2):62-65
DOI:10.4103/jhrr.jhrr_5_17  
Background: Central obesity or abdominal obesity doubles the risk of cardiovascular disease when compared to gynoid pattern of fat distribution. Maximal oxygen consumption (V.O2max) is an index of aerobic capacity and low level of V.O2maxis an established risk factor for cardiovascular diseases. Aim: This study aimed to evaluate the effect of central obesity on V.O2maxin young adults. Materials and Methods: A cross-sectional study with 133 apparently healthy subjects (male = 83, female = 50) in the age group of 17–25 years was carried out. Waist circumference (WC) was measured by fiberglass measuring tape to nearest 0.1 cm. V.O2maxwas measured by submaximal treadmill exercise test by first two stages of Bruce protocol. Data were analyzed using unpaired t-test and Pearson correlation according to necessity. Results: Male subjects (n = 83) had statistically significant (P < 0.0001) higher V.O2max(mean ± standard deviation) (38.024 ± 6.243) than the female subjects (n = 50) (33.611 ± 3.470). WC showed negative correlation with V.O2max(r = −0.629, P < 0.0001). Waist-to-height ratio (WHtR) showed more negative correlation (r = −0.728, P < 0.0001) with V.O2max. Conclusions: Male has more aerobic capacity than female. Increase in WC and WHtR are associated with decreases in V.O2max. When compared to WC, WHtR is better predictor variable for V.O2max.
  - 2,717 246
Is glucose dysregulation an inflammatory process?
Yakubu Lawal, Felicia Ehusani Anumah, Adamu Girei Bakari
May-August 2017, 4(2):66-70
DOI:10.4103/2394-2010.208120  
Aim: To determine the relationship between glucose dysregulation and high-sensitive C-reactive protein (hsCRP). Settings and Design: Zaria is a major city located on the high plains of Northern Nigeria, 652.6 m above the sea level, some 950 km away from the coast. Its location is latitude 112°31 N and longitude 7°42 E. This was a cross-sectional observational study. Participants not previously known to have diabetes mellitus (DM) who satisfied the inclusion criteria were enrolled after cluster random sampling. The study was carried out over a period of 12 months. Materials and Methods: Four hundred apparently healthy participants were recruited through cluster sampling from their respective communities after due consent. Relevant biodata were documented, and appropriate examinations including anthropometric measurements were carried out. Plasma glucose and hsCRP levels were subsequently measured. Statistical Analysis Used: Microsoft excel was used for data entry while SPSS software version 19 was used for data analysis. Pearson's Correlation was used to test for association between plasma glucose levels and body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and hsCRP. Multiple logistic regression was used to determine whether BMI, WC, WHR, and hsCRP were significant determinants of glucose dysregulation. Significance level was considered P < 0.05. Results and Conclusions: BMI, WC, WHR, and hsCRP were shown to be significant determinants of glucose dysregulation. Therefore, a chronic low-grade inflammation may contribute to the etiopathogenesis of DM.
  - 1,722 166
Quantifying variation in blood pressure measurement through different arm cuffs and estimating its impact on diagnosis of hypertension at community level
Badrinarayan Mishra, Nidhi Dinesh Sinha, Habib Ur Rehman
May-August 2017, 4(2):71-77
DOI:10.4103/2394-2010.208121  
Aims: The aim of this study was to analyze does the difference in blood pressure (BP) measured by different arm cuffs has a clinical/diagnostic implication? Settings and Design: This study was a cross-sectional evaluation of sample rural population from Central India. Materials and Methods: Three different adult arm cuffs were used on a selected 394 rural population from 35 to 65 years age group to estimate BP. Their BP was taken on three different times of the day on three different occasions/days. Statistical Analysis: Basic sociodemographic profiles were expressed in frequency and percentages; relationships of hypertension (HTN) with sociodemographic and other risk factors were calculated by Chi-square test; variability in BP by different arm cuffs was expressed by mean, standard deviations, and ANOVA; and prevalence difference of HTN by different arm cuffs was expressed by frequency, percentage, paired t- test, and Chi-square test. Results and Conclusions: The routinely used small adult cuff was found appropriate in only 3.8% of cases studied, thereby highlighting the prevalence of under cuffing at 96.2%. The mean variation in systolic and diastolic BP recorded by using small adult arm cuff vs. medium arm cuff and small arm cuff vs. large arm cuffs were 5.9mm Hg/4.4mm Hg and 9mmHg/7.2mmHg respectively. These observations were both clinically and statistically significant. Our study reported an overestimation of 4.8% systolic and 15% diastolic HTN by the exclusive use of small adult arm cuff. The prevalence of systolic, diastolic, and both systolic and diastolic HTN in selected age group using the correct arm cuff was found to be 20.8%, 29.6%, and 37.5%, respectively. Thus, arm cuff mismatch was a prevalent cause in misdiagnosis of primary HTN in our study population.
  - 1,856 136
REVIEW ARTICLES
Health supplements, patient behavior, concordance-does anybody bother?
Nagesh Kamat
May-August 2017, 4(2):47-49
DOI:10.4103/jhrr.jhrr_19_17  
Naturally available fruits and vegetables along with a healthy diet does provide all required nutrients to the body. Then why do people go behind the so-called “health supplements” - vitamins, minerals, herbal immune booster, probiotics, tonics, etc? Do you really need them? Patients in India are desperate to grab the shortcut to good health. They buy products which are unnecessary and which do not have any beneficial effect. On the other hand, health of the patient is undermined as he skips essential drugs which doctors would have prescribed according to the health of a patient. Misconceptions that herbal medicines are safe and without side effects need to be addressed. Patients need to be educated regarding health supplements, its consequences, costs and its implications, and nonadherence. The need of the hour is educating patients to be the guardian of their own health. Numerous reviews exist on health supplementation; however, many facts remain unexplored. This review focuses on what needs to be done for optimal health care.
  - 1,482 139