MVP Journal of Medical Sciences

MVP Journal of Medical Sciences https://informaticsjournals.co.in/index.php/mvpjms <div id="i-scholarabout"><img class="media-object" style="width: 222px; float: left; margin: 0px 35px 15px 20px;" src="https://www.informaticsjournals.co.in/public/journals/8/coverimage.jpg" /> Editor-in-Chief: Mrs. Dr. Mrunal Suresh Patil Online ISSN: 2348-2648 Print ISSN: 2348-263X Frequency: Biannual Publishers: Informatics Publishing Limited and Dr. Vasantrao Pawar Medical College, Hospitals & Research Centre, Nashik Published Since: 2014 MVP Journal of Medical Sciences is committed to an unbiased, independent, anonymous and confidential review of articles submitted to it. Manuscripts submitted to this Journal, should not have been published or under consideration for publication in any substantial form in any other publication, professionals. All the manuscripts once submitted to and published in the MVP Journal of Medical Sciences will become the property of the journal.</div> MVP Journal of Medical Sciences (MVPJMS) is a Double -Blind Peer Reviewed Journal and is committed to an unbiased, independent, anonymous and confidential review of articles submitted to it. The journal is a bi-annual Publication. The Journal is indexed in Index Copernicus, Google Scholar, SCILIT, CiteFactor, i-Scholar, J-Gate Plus.  Informatics Publishing Limited and Dr. Vasantrao Pawar Medical College, Hospitals & Research Centre, Nashik en-US MVP Journal of Medical Sciences 2348-263X A Study to Evaluate Correlation of C-Reactive Protein and Glycosylated Haemoglobin in Patients of Diabetes Suffering from Acute Coronary Syndrome https://informaticsjournals.co.in/index.php/mvpjms/article/view/43154 Incidence of diabetes is increasing substantially worldwide. Cardiovascular disease is most prevalent cause of mortality and morbidity in diabetic populations. Cardiovascular risk factor including obesity, hypertension, dyslipidemia are common in patients with diabetes mellitus particularly with those of type 2 diabetes. Atherosclerosis has been described as an inflammatory disease. Aim: Study to evaluate correlation of C-Reactive Protein and Glycosylated Haemoglobin in Patients of Diabetes Suffering from Acute Coronary Syndrome. Material and Methods: A descriptive study after satisfying criteria was conducted in 115 patients in medicine department of a medical college and tertiary care hospital over a period of two years that included patients of diabetes suffering from acute coronary syndrome in the age group of 30 to 70 years. Evaluation and correlation was done by clinical profile. Results: Majority of patients were elderly age group of male of 51 to 60 yrs having mean BMI of 24 kg/m2 . CRP level of >3 mg/dl was found in 77.39% and majority of patients had HbA1C >7%. CRP and HbA1C were significantly correlated (p<0.05). Majority of patients with elevated CRP were found in with killip class I. But CRP and killip classification were not significantly correlated in our study. Conclusion: Elevated C Reactive Protein and Glycosylated Haemoglobin are better correlated as poor prognostic marker for cardiovascular event in patients of diabetes suffering from acute coronary syndrome. Mohammad Sultan Chetan Patil Neelima Chafekar Jitendra Kodilkar Copyright (c) 2022-06-01 2022-06-01 1 8 10.18311/mvpjms/2022/v9i1/295 Clinical Profile of Patients with Primary Glaucoma in Tertiary Care Centre https://informaticsjournals.co.in/index.php/mvpjms/article/view/43151 Aim: To study the clinical profile of patients with primary glaucoma in a tertiary care hospital. Method: In a descriptive study of 130 patients, detailed family history, history of systemic illness and previous treatment in past was noted in detailed. Detail ophthalmic examination with visual acuity, anterior segment examination with slit lamp, intraocular pressure measurement with applanation tonometry, fundus examination and perimetry of every patient was done. Result: A total of 130 patients were examined the prevalence of glaucoma was 2.92%. The risk factors and their relevance to open angle glaucoma as compared to narrow angle glaucoma, taking recourse to multiple logistic regression. The Odds Ratio (OR) for age was obtained as 0.978 [95% CI: 0.937, 1.021], indicating that the odds are unchanged with the unit change in the age (p=0.304). For gender, with male as reference, OR for females was 1.676 [95% CI: 0.645, 4.355], indicating that the odds in favour of open angle decreases for females as compared to males (p=0.289). Further, the odds of open angle glaucoma with the presence of hypermetropia decreased with OR 0.098 [95% CI: 0.031, 0.311] (p=0.00). The presence of myopia increased the odds in favour of open angle glaucoma 4.785 [95% CI: 1.497, 15.295] times, which was statistically significant (p=0.008). The presence of systemic illness like hypertension and diabetes increased the risk of open angle glaucoma with OR of 1.694 [95% CI: 0.608, 4.719] and 1.017 [95% CI: 0.288, 3.592] respectively. The correlation of pretreatment IOP and visual field defect was statistically significant for PACG and not with POAG the correlation of VCDR and visual field defect was statistically significant for both POAG and PACG.9 eyes were blind in POAG and 17 eyes were blind in PACG. Conclusion: Patient with family history of glaucoma; history of DM, HTN, myopia, hypermetropia; and patient above 40 years of age should be screened for glaucoma for early detection and prompt treatment. Awareness of glaucoma is needed in the country as it is one of the leading causes of blindness . Pranjali Pawar Shweta Bandopadhyay Dhiraj Balwir Copyright (c) 2022-07-01 2022-07-01 9 17 10.18311/mvpjms/2022/v9i1/284 Clinical Study of Local Application of Insulin on Diabetic Foot Ulcer Healing https://informaticsjournals.co.in/index.php/mvpjms/article/view/43148 Introduction: Foot complications are a major cause of hospitalization in patients with Diabetes Mellitus (DM), which consumes a high number of hospital days because of multiple surgical procedures and prolonged length of stay. Patients with DM have up to a 25% lifetime risk of developing a foot ulcer, which precedes amputation in up to 85% of cases. A mainstay of Diabetic Foot Ulcer (DFU) therapy is debridement of all necrotic, callus, and fibrous tissue, with a primary goal to obtain wound closure. Materials and Methods: Cases with diabetic foot ulcer presenting to our OPD/IPD and signing the informed consent form before study as well as fulfilling the inclusion criteria mentioned along with detailed clinical examination of the patient as well as laboratory workup the study was an open labelled randomised control trial. Results: The study was carried out with 64 patients selected randomly and sorted into two groups, i.e. the control and test subjects. No difference was observed in two groups with respect to wound depth after debridement (p-0.85). However, the depth of wound was significantly less in insulin group at week 1, 2 and 3 as compared to control group. The percentage decrease in wound depth was more in insulin group than control group by the end of 3rd week. Primary closure was observed in 62.5% and 84.4% patients while STSG was required in 37.5% and 15.6% cases of control and insulin group respectively. Sudhir Bhamre Yash R. Godbole Copyright (c) 2022-06-01 2022-06-01 18 23 10.18311/mvpjms/2022/v9i1/287 Comparative Outcome Study between Resolved and Unresolved St Segment in St Segment Elevation Acutemyocardial Infarction (STEMI) after Thrombolytic Therapy https://informaticsjournals.co.in/index.php/mvpjms/article/view/43145 Background: To study the comparative outcome between resolved an unresolved ST segment in ST Segment Elevation Acute Myocardial Infarction (STEMI), after thrombolytic therapy. Method: A study was carried out on patients admitted with 1st episode of ST elevated myocardial infarction in MICU of a tertiary health care center of a teaching hospital. On admission detailed history was taken and a complete clinical examination was done. Thrombolysis was done using streptokinase, 2D ECHOs were performed before and after thrombolytic therapy. Result: Most of the study population in both the group (Unresolved STEMI and Successful thrombolysis), belonged to the age group of 41 to 50 years. Co-morbidities like hypertension were present in 83% of Unresolved STEMI and 53% of Resolved STEMI. Comorbidities like diabetes were present in 66.7% of Unresolved STEMI and 52.6% of Resolved STEMI. RWMA on 2D-Echo before thrombolysis was present in 58.3% of Unresolved STEMI and 47.4% of Resolved STEMI. RWMA on 2D-Echo after thrombolysis was present in 66.7% of Unresolved STEMI and 18.5% of Resolved STEMI. Conclusion: Symptom to needle time is an important predictor of whether thrombolysis will be successful or not in acute myocardial infarction patients. Hence it is important to educate the public about prompt recognition of symptoms and seeking medical help urgently. As the rate of unsuccessful thrombolysis is higher in patients with old age, diabetes, hypertension and dyslipidemia, such patients should be monitored and treated aggressively. Satish Kamthe Deodatta Chafekar Neelima Chafekar Copyright (c) 2022-07-01 2022-07-01 24 29 10.18311/mvpjms/2022/v9i1/294 Functional Outcome of Bone Patellar Tendon Bone Graft in Anterior Cruciate Ligament Reconstruction https://informaticsjournals.co.in/index.php/mvpjms/article/view/43142 Background: Anterior Cruciate Ligament (ACL) tear is the one of the common among ligamentous injury to the knee joint. Various surgical methods have been advised for the anterior cruciate ligament reconstruction with different kinds of grafts which have own merits and demerits. Bone patellar tendon bone is one of the commonly used autograft for ACL reconstruction. Aim of this study was to analyze the functional outcome following arthroscopic ACL reconstruction using Bone patellar Tendon Bone graft (BTB). Materials and Methods: Between 2017 and 2019, 32 patients with an average age of 27 years (range: 19-51 years) participated in a prospective study. The patients were arthroscopically treated with a bone-patellar tendon-bone graft. Physiotherapy and appropriate post-operative care were provided. The patientâ€™s functional status was assessed at three-month, six-month, and one-year intervals. We assess knee joint stability and normal knee function using clinical tests. To evaluate the findings, we used the Tegner Lysholm knee score as well as the VAS score. Results: In terms of clinical outcomes, 93 percent of patients had normal or near-normal knee function. According to the Tegner-Lysholm knee rating system, 88 percent of the patients received an excellent score. At the end of one year, 27 out of 32 patients have no pain on the VAS score. Anterior knee discomfort (10%) and numbness above the graft donor site were the most common consequences (8 percent). Conclusion: Based on objective and subjective assessments, ACL reconstruction employing the bone-patellar tendon-bone approach could produce a very satisfactory functional outcome. Improved knee stability and function allow for a quicker return to everyday activities. Nitin Wagh Chinmay Salunkhe Sandip Pangavane Brijbhushan Mahajan Sameer Shelar Copyright (c) 2022-06-01 2022-06-01 30 36 10.18311/mvpjms/2022/v9i1/266 Magnetic Resonance Imaging Evaluation of Various Neoplastic Lesions of Ankle and Foot at a Tertiary Health Care Centre https://informaticsjournals.co.in/index.php/mvpjms/article/view/43138 Introduction: Magnetic Resonance (MR) Imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot and is useful to confirm the presence and extent of a soft tissue mass and to determine the precise anatomic location, which aids in surgery; in some cases, the appearance is specific for a particular lesion. Purpose of Study: Our aim was to study various Magnetic Resonance Imaging findings of various neoplastic lesions of ankle and foot. Results: Total 49 patients (Male - 27, Female - 22) were studied with various neoplastic conditions involving the ankle and foot. Amongst the neoplastic lesions involving the bones, 62.5% of neoplasms were benign lesions while 37.5% were malignant. Amongst the neoplastic lesions involving the soft tissue, 36.7% of neoplasms were benign lesions while 63.3% were malignant. On MRI, 84% of study population with neoplastic lesions showed hyperintense signal on T1WI while 16% showed hyperintense signal. Although 26.7% of study population with neoplastic lesions showed hypointense signal on T2WI, while 73.3% showed hyperintense signal. Conclusion: According to our study, MRI in combination with other radiologic images is very helpful in appropriate diagnostic imaging for neoplastic lesions involving the bone and soft tissue of the ankle and foot. Prerit J. Sharma Priti Komatwar Arvind K. Takle Copyright (c) 2022-07-01 2022-07-01 37 45 10.18311/mvpjms/2022/v9i1/293 Modifiable Risk Factor in Acute Lower Respiratory Tract Infection in under 5 Children https://informaticsjournals.co.in/index.php/mvpjms/article/view/43135 Objective: Acute lower respiratory tract infections are leading cause of morbidity and mortality in under five children in developing countries. Hence presence study was undertaken to study various modifiable risk factor for acute lower respiratory tract infection in under five children. Study Design: Data collected from a observational study of eighty Acute Lower Respiratory Tract Infection (ALRTI) cases of age group from 2 month to 5 year fulfilling WHO criteria of pneumonia to study various modifiable risk factor. Eighty healthy control of same age group also interrogated. Result: The significant modifiable risk factor were parental illiteracy, low socioeconomic status, overcrowding, partial immunization, pre lacteal feed, early weaning, malnutrition, parental smoking, history of respiratory infection in family and rickets. Conclusion: The present study has identified various modifiable risk factors for acute lower respiratory tract infection which can be tackled by effective education of community . Nilesh Ahire Shripad Dakhane Ravindra Sonawane Suhas Patil Sagar Sonawane Copyright (c) 2022-06-01 2022-06-01 46 50 10.18311/mvpjms/2022/v9i1/279 MRI Evaluation of Ligament Injuries of the Knee Joint https://informaticsjournals.co.in/index.php/mvpjms/article/view/43132 Background and Objective: Knee joint is the complex joint. It is much frequently injured joint due to trauma. The principle intra articular structures in the knee are the 2 cruciate ligaments, 2 menisci and the 2 collateral ligaments. The main objective is to study the MRI findings in ligament injuries of knee joint. Materials and Methods: MRI knee of 110 patients with suspected ligament injuries of knee joint was performed on 1.5-T MR system using flexible surface knee coil. Results: A total of 110 patients in a period of 2 years were collected and analysed comprising of either single ligament or combination of ligament tears. Anterior Cruciate Ligament (ACL) tear was most common and seen in 61 patients followed by Medial Collateral Ligament (MCL) in 31, Lateral Collateral Ligament (LCL) in 22 and Posterior Cruciate Ligament (PCL) in 16 patients. Majority of the patients belonged to age group 18-30 years with right knee involvement. Males dominated in this study constituting 63.64% of total population. Conclusion: MRI is non-invasive prime imaging modality with nonionizing radiation and multi planar capabilities. It accurately detects, localizes and characterizes various ligament injuries of the knee joint and help in arriving at accurate final diagnosis thereby guiding further management of the patient. Sumit Baviskar Nilesh Chaudhari Ajit Patil Priti Komatwar Akshit Gangwal Ashu Dixit Sujay Saxena Copyright (c) 2022-07-01 2022-07-01 51 56 10.18311/mvpjms/2022/v9i1/297 Psychiatric Co-Morbidity in Patients Presenting with Primary Headache https://informaticsjournals.co.in/index.php/mvpjms/article/view/43129 Background: Headache is a common neurological disorder and most disabling conditions in the worldwide. Psychiatric disorders can occur with at least two to three-fold greater frequencies among the patients presenting with headache than among general population. The presence of psychiatric co-morbidity further complicates headache management and portends a poorer prognosis. Therefore, the present study of psychiatric co-morbidity in patients presenting with primary headache and to know the nature and extent of psychiatric co-morbidity associated with headache among the patients was undertaken. Methods: Present sample consists of 62 patients who presented with the complaints of headache to the department of Psychiatry and Neuropsychiatry from August 2016 to June 2018 was included in the study. MINI 7.0.0 was applied to elicit the presence of any Psychiatric disorder. Results: In this study 65% of the patients presenting with headache had co-morbid psychiatric disorders. Out of 65% of the psychiatric illnesses; 43.55% had MDD, 14.52% had GAD, 3.23% had Panic disorder and 3.23%had Social phobia among the patients presenting with headache. Conclusions: Patients presenting with headache have high levels of co-morbid psychiatric disorders. In view of the present findings, the management of patients presenting with headache should include the detail assessment of coexisting psychopathology and treatment of both coexisting conditions. Shuchi Pande Sunil G. Gupte Yogesh Pawar Copyright (c) 2022-06-01 2022-06-01 57 61 10.18311/mvpjms/2022/v9i1/280 Study of Clinical Profile, Radiological Findings and Risk Factors in Patients with Cerebral Venous Thrombosis in Tertiary Care Hospital https://informaticsjournals.co.in/index.php/mvpjms/article/view/43127 Background: Cerebral venous thrombosis is a rare cause of stroke in adults especially in the young. It is a diagnostic and therapeutic challenge for the physician, given the wide spectrum of its clinical presentation. The purpose of the present study is to describe the clinical features, risk factors, radiological findings and outcome in a patient of Cerebral venous thrombosis. Objective: To study clinical profile, radiological findings and risk factors in patients with cerebral venous thrombosis amongst study participants. Material and Method: The prospective observational study was conducted on 60 patients admitted in department of General Medicine at tertiary health care institute at Nashik. Written informed consent was taken from all the study participants, and those who gave consent and satisfy eligibility criteria were enrolled in the present study between August 2017 to December 2019 with a radiologically confirmed diagnosis of cerebral venous thrombosis. Detailed history, clinical examination, laboratory investigations were carried out in all the cases and followed until discharge from the hospital or death. All the data will be analysed by applying appropriate statistical tests Microsoft Excel 2010. Results: Majority of incidence was seen in 18-30 age group comprising 50% of the cases, with equal sex distribution. Mean age of patient was found to be 37.3 years. Most patient had subacute onset with headache (76.67%) being the commonest presenting symptoms followed by convulsions and focal deficit in 46.67%. Hemiparesis 43.67% followed by papilloedema 33% were the most common neurological signs. Hyperhomocystinemia 33.67% and Protein S deficiency 20% were the most common risk factors identified in males whereas anemia 60% and puerperium 26.67% were most common in females. Transverse sinus (66.33%) was most common sinus involved radiologically followed by superior sagittal sinus in 43.67%. In 90% of the cases Low Molecular Weight Heparin [LMWH] was given and remaining 10% were given intravenous unfractionated heparin. 14% cases underwent decompressive surgery. Mortality was found to be 6.33% in the present study. Conclusion: High index of suspicion required for diagnosis of Cerebral venous thrombosis. The clinical presentation is nonspecific, can vary significantly and often makes the diagnosis of quite puzzling. MRI brain and MR Venogram are necessary for establishing a diagnosis. Patients are treated with anticoagulants, antiepileptics and antiedema measures and surgical decompression in case of continuing deterioration, in spite of maximum medical management. Cerebral venous thrombosis has a good prognosis unlike arterial ischemic stroke if the acute stage of illness has been survived. Vivek Lade Neelima Chafekar Copyright (c) 2022-07-01 2022-07-01 62 67 10.18311/mvpjms/2022/v9i1/264 Study of Psychiatric Morbidity among Patients with Chronic Obstructive Pulmonary Disease in a Tertiary Health Care Institute https://informaticsjournals.co.in/index.php/mvpjms/article/view/43124 Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible. COPD is a progressive airway disease associated with psychological distress Screening the psychiatric disorders in COPD patients will be helpful in better management of the disease by assuring compliance as well as will help to improve quality of life of these patients leading to overall improvement in patientsâ€™ health, by helping in starting early psychiatry management whenever necessary. Methods: A single-center, cross-sectional, observational study performed at a tertiary care hospital between august 2016 and June 2018 to study psychiatric morbidity among patients with chronic obstructive pulmonary disease in a tertiary health care institute. A total of 68 clinically stable patients with COPD were screened for psychiatric morbidity by using Mini International Neuropsychiatric Interview (MINI) version 6.0.0. The clinical diagnosis was confirmed using DSM-5 and by qualified psychiatrist of the Department of Psychiatry. Result: Generalized anxiety disorder, Major depressive disorder, major depressive disorder with Anxiety, Panic attack, Phobia and Substance Abuse Disorder was present in 8.8%, 13.2%, 5.9%, 7.4%, 1.5% and 7.4% of study population respectively. Conclusions: We found that patients with COPD had high prevalence of depressive and anxious symptoms. Therefore, screening and treatment of these psychiatric comorbidities in patients with COPD may lead to significant improvements in patientsâ€™ quality of life. Amandeep Singh Mahesh Bhirud Copyright (c) 2022-06-01 2022-06-01 68 72 10.18311/mvpjms/2022/v9i1/282 Study of Schatzker Type V and VI Proximal Tibial Fractures Functional Outcome, Treated with Bicondylar Plating at Tertiary Care Centre https://informaticsjournals.co.in/index.php/mvpjms/article/view/43121 Background: The treatment of complex fractures of Tibial plateau is challenging even for the most experienced surgeons. These injuries, affecting mainly the younger population during their most productive years causes a socioeconomic impact. A retrospective study was performed to evaluate the of Schatzker type V and VI, functional outcome, managed through internal fixation and open reduction was thus evaluated in this retrospective study. Materials and Methods: In our study, we used Rasmussen et al., score to evaluate patients. A simple and valid score, it helps the patientâ€™s to access their own perspective regarding surgical outcome. We have attempted to present Type V/VI Schatzkerâ€™s proximal tibia fractures in our tertiary care centre. With the increase in population, intern giving rise to increase in automobiles, has resulted in more vehicle accidents. Results: The study was conducted on 30 cases of surgically treated closed proximal tibia fractures and was analysed under the criterias of - sex, age, cause of injury, fracture type, range of motion, time taken for union, and occurrence of complications. Conclusions: The results of this study thus show an excellent functional outcome, with the open reduction and internal fixation surgery as there is minimal soft tissue complication with it. The rigid fixation with bicondylar plating helps in stability for early mobilisation and the range of motion thus ensuring optimal functional recovery and patient satisfaction. Sandeep Pangavane Mayur Pekhale Akshaj Sharma Copyright (c) 2022-07-01 2022-07-01 73 79