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   Table of Contents - Current issue
Coverpage
May-August 2022
Volume 3 | Issue 2
Page Nos. 115-208

Online since Monday, August 29, 2022

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EDITORIALS  

COVID-19: The fourth wave prediction and prevention p. 115
Gagandeep Kang
DOI:10.4103/JME.JME_80_22  
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Discovering true happiness and leadership through medical practice p. 117
Anand Bharathan
DOI:10.4103/JME.JME_93_22  
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ORIGINAL ARTICLES Top

Platelet count estimation on peripheral smear: What should be an acceptable 'multiplication factor'? p. 119
Arnav Tiwari, Shweta Pal, Neha Singh, Michael Leonard Anthony, Nilotpal Chowdhury, Shalinee Rao
DOI:10.4103/JME.JME_36_20  
Context: Automated cell counters have revolutionised laboratory medicine and are being used worldwide. They give accurate results, can run large number of samples and generate accurate results within a short span of time. Quality check procedures in this equipment ensure accuracy of results. However, for platelet counts, the pathologist is still dependent on confirming the results by manual methods, especially in situations of low platelet count and flagging by the electronic counter. Different laboratories use different methods for manual estimation of platelet counts. Aims: This study was done to compare the platelet counts assessed on peripheral smear examination by different multiplication factors, and to identify the multiplication factor which derives the most accurate platelet count. Settings and Design: This was an observational study. Methods: Peripheral smears prepared from 100 ethylenediaminetetraacetic acid-anticoagulated blood samples were manually examined under oil immersion field (OIF) for platelets. Platelet count was further calculated by multiplying the number of platelets per OIF using multiplication factors of 10,000, 15,000 and 20,000. This was compared with platelet (PLT)/red blood cell (RBC) method and automated platelet counts. Accuracy of various manual methods was evaluated by calculating the per cent difference of the methods with automated analyser counts. Statistical Analysis Used: Descriptive statistics was used for statistical analysis. Results: Manual platelet count estimation on peripheral smear employing multiplication factor of 15,000 was found to have comparable accuracy to analyser counts, followed by the PLT/RBC ratio method. Conclusions: This study confirms that for manual estimation of platelet counts on peripheral smear, a standard multiplication factor of 15,000 on OIF gives the most accurate result, which is closest to counts obtained by automated analysers.
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Haematological and biochemical predictors of bone marrow metastases in non-haematological malignancies: A clinico-pathological analysis p. 123
Shruti Agrawal, Rekha Bhandari, Vinay N Gowda, Amit Gupta, Neha Singh, Nilotpal Chowdhury, Shalinee Rao, Sanjeev Kishore, Arvind Kumar Gupta, Harish Chandra
DOI:10.4103/JME.JME_129_20  
Background: Bone marrow metastasis is an uncommon yet significant presentation of many non haematological malignancies. Aims: The present study was conducted with the aim of analysing the clinical, haematological and biochemical parameters of the patients with bone marrow metastases and determines the parameters which could possibly indicate the presence of bone marrow metastases. Patients and Methods: Bone marrow aspirate, imprint and biopsy slides of 22 cases with bone marrow metastases were reviewed and the haematological and biochemical data of all these cases were compared with that of 20 controls without any evidence of metastases. Results: The mean values of mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR) and serum lactate dehydrogenase (LDH) were found to be significantly different (P < 0.001) between the cases and controls. MPV <8.1 fL, NLR >3.5 and LDH >452 U/L showed a high likelihood ratio in predicting bone marrow metastases. Conclusion: Parameters such as MPV, NLR and LDH can be used as efficient and easily available methods to predict bone marrow metastasis for a rapid diagnosis.
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Gallbladder polyps: Is a cancer phobia justified? p. 130
Aaditya Bhatwal, Akshay Bavikatte, Puneet Dhar
DOI:10.4103/JME.JME_95_21  
Background: With better imaging technologies, the frequency of detecting GB polyps has increased, however, their effective management remains a clinical dilemma. Aims: This study was aimed to assess the true outcome of lesions suspected or diagnosed as gallbladder (GB) 'polyp' on ultrasound. Patients and Methods: Computerised hospital-based medical records between June 2008 and June 2014 at a medical sciences institute in Kerala were accessed to identify and review the follow-up of all cases identified as GB polyp on ultrasound. Results: Ultrasound examination was performed in 108 cases. Of these 46% had symptoms suggestive of gall bladder disease, 20% had nonspecific abdominal symptoms and for the remaining 34% it was part of routine health check-up. The mean polyp size was 4.7 mm. During follow-up, 20 (18.5%) patients underwent cholecystectomy and none of them came as true polyps on histopathology, 25 (23%) patients were lost to follow-up after primary ultrasonography and 10 (9.25%) patients died due to reasons unrelated to GB disease. Conclusion: Radiologists tend to over diagnose GB polyps due to the risk of malignant transformation of GB polyps and increased usage of imaging modalities. It is observed in this study that higher imaging modalities do not add significant specificity in the diagnosis of the true polyp. However, there is a need for a large cohort study to confirm the outcome.
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Evaluation of birth preparedness and complication readiness index among women of central India: A community-based survey of slums p. 134
Tripti Chandrakar, Nirmal Verma, Shubhra A Gupta, Diwakar Dhurandhar
DOI:10.4103/JME.JME_59_22  
Background: Chhattisgarh is one of the worst performing states of India in terms of maternal mortality ratio figures. Slums carry the unfortunate burden of maximum maternal deaths. Birth Preparedness and Complication Readiness(BPCR) advocates planning of birth and being ready for any obstetric complications. Aim: To evaluate the BPCR index among first and second trimester pregnant women and those delivered within 6 months living in urban slums of Raipur city. Methods: A population-based, cross-sectional descriptive study was conducted among 160 pregnant and 70 recently delivered women residing in urban slums of Raipur city selected by multistage random sampling using an interview method. BPCR index was calculated using Johns Hopkins Program for International Education in Gynaecology and Obstetrics guidelines. BPCR components were correlated for any association with sociodemographic variables of the participants using Z test. Results: BPCR index came out to be 34.1%, which was very low. Factors associated with ≥4 antenatal care visits were general category women (P = 0.0375) and homemakers (P = 0.0057). Identifying skilled provider was higher in educated women (P = 0.0001), those with educated husbands (P = 0.0085), working (P = 0.0167) and with higher socioeconomic status (P = 0.0013). Saving money for childbirth was more among general category (P = 0.0067), educated (P = 0.0094) and women with low socioeconomic status (P = 0.0004). Conclusions: BPCR index of the study area was found to be very low.
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Patterns of haematological malignancies on bone marrow examination: A 3-year institutional experience p. 141
Harish Chandra, Arathi Kunnumbrath, Vandana Bharati, Neha Singh, Uttam Kumar Nath, Arvind Kumar Gupta
DOI:10.4103/JME.JME_127_20  
Aims and Objectives: Haematological malignancy may show varied presentation in different regions of world, however, Uttarakhand lacks any recent data about them. The present study was therefore conducted to study the pattern of haematological malignancies on bone marrow examination in institute of Uttarakhand. Materials and Methods: This study was conducted at All India Institute of Medical Sciences, Rishikesh, Uttarakhand, over a period of 3 years. It included patients of haematological malignancies diagnosed on bone marrow examination. Patient's age, sex, clinical history and bone marrow diagnosis were noted for every case. All the data were entered into the excel sheet and statistically analysed. Results: The study included total 256 cases of haematological malignancies with male:female ratio of 1.13:1 and mean age of 39.3 years. Chronic myeloproliferative neoplasm (CMPN) was the most common haematological malignancy (49%) with chronic myeloid leukaemia (CML) being its most common type (40%). All the haematological malignancies showed male preponderance except for non-Hodgkin's lymphoma. Mean age of CMPN was 45.81 years and of acute myeloid leukaemia was 36.92 years. Bone marrow aspirate (BMA) and trephine biopsy (BMT) together were able to diagnose 81.3% of cases of haematological malignancies. Conclusion: The study concludes that haematological malignancies present at lesser age with male preponderance in Uttarakhand. CML is the most common haematological malignancy followed by acute lymphoblastic leukaemia. BMA and BMT are complimentary to each other for diagnosis of haematological malignancies and should be used together to avoid missing of any case.
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REVIEW ARTICLES Top

Impact of COVID-19 pandemic on the mental health of the younger generation: A review p. 145
Pradnya V Kakodkar, Rishav Narayan Singh, Sameer Agarwal
DOI:10.4103/JME.JME_109_21  
The World Health Organization declared COVID-19 outbreak as a pandemic in March 2020. It had opened doors to several issues that were never envisaged. The global economy and the health equilibrium were disturbed. This review systematically assesses and compiles the literature describing the influence of COVID-19 on the psychological or mental health of the younger generation. Databases such as PubMed, SCOPUS and Google Scholar were searched electronically for relevant data. The results indicate that the mental health of the younger generation was affected to a large extent. The school and college students had to adapt to the new way of online education. COVID-19 had affected childhood, family dynamics and students' lives in schools and colleges. It increased the number of domestic violence cases, which had severe effects on the mental health status of the younger generation.
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Post and long-COVID conditions: Epidemiology, clinical symptoms and the prevention and treatment p. 149
Pooja Chauhan, Vineet Kumar Pathak, Dewesh Kumar, Anita Upadhyay, Anirban Chatterjee, Chandrakant Lahariya
DOI:10.4103/JME.JME_83_22  
A proportion of individuals affected with severe acute respiratory syndrome coronavirus 2 continue to have COVID-19 symptoms even after recovering from illness. These are termed as post-COVID condition (PCC)/long-COVID. Evidence suggests that symptoms of COVID-19 along with other generalised sequelae may persist in some patients with severe and very severe disease, as well as in patients who had mild or no symptoms. The management of PCC is a challenge as there is limited understanding about the issue even in healthcare professionals. Then, there is not enough documentation of post-COVID and long-COVID in India. From public health perspective, the health services and facilities have not been re-designed to tackle the situation. This review article aims to explore PCC and compilation of current international and national public health response along with recommendations to identify and manage the PCC at the primary. The article concludes the urgent need to document the burden of PCCs in India, develop standard case definition and equip primary healthcare facilities and providers with the requisite skills to manage the PCC. The governments, health care providers and facilities and public health bodies should also encourage and foster continuing country specific data, analysis and research into the determinants, duration and probable treatment modalities of PCC. The post and long-COVID conditions would require sustained policy and programmatic attention in all countries with special focus in low and middle income country settings.
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CASE REPORTS Top

Synchronous renal cell carcinoma and urothelial carcinoma in a female: A rare case p. 155
Srilata Chitti, Arvind Ahuja, Sumit Gahlawat, Ravi Hari Phulware
DOI:10.4103/JME.JME_197_20  
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Early adhesive colonic obstruction post-radical gastrectomy – Do not forget the pancreas p. 158
Karthik Chandra Vallam, Vamsikrishna Alluri, Muralikrishna Voonna
DOI:10.4103/JME.JME_141_20  
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Axillary giant lipoma with brachial plexus compression: Rare presentation with diagnostic dilemma and review literature p. 161
Satya Prakash Meena, Ashok Puranik, Pawan Kumar Garg, Meenakshi Rao
DOI:10.4103/JME.JME_119_20  
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Necrotic rectal prolapse with perforation and herniation of small bowel, treated with abdominoperineal resection p. 164
Melissa M Gabriel, Nicholas S V. Philippson, Charlotte N Horrigan, Adeline Rankin, Irshad A Shaikh
DOI:10.4103/JME.JME_183_20  
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MEDICINE AND SOCIETY Top

Rural indemnity bond – Audacity in austerity or bonded labour? p. 167
Vasu Bansal
DOI:10.4103/JME.JME_56_22  
The recommendation of a Rural Indemnity Bond after MBBS aims to address the rural-urban disparity in the Indian healthcare system. It is a radical reform in medical education curriculum and generates searching questions: How to affect the attitudes of medical graduates? Are there other successful models we can learn from? Do the healthcare challenges need a more integrated action? A policy enforcing the shunting of doctors needs to take the apprehensions of all the stakeholders into consideration. The broader issue of Rural Health Iniquity, that plagues the country requires interventions at multiple levels with a properly financed healthcare system at its foundation.
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Career opportunities in rural healthcare for young doctors: Opportunities and challenges p. 170
Royson Dsouza, Nandakumar Menon
DOI:10.4103/JME.JME_89_22  
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Why and when did i decide to become a doctor p. 174
Surendra Kumar Mathur
DOI:10.4103/JME.JME_87_22  
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CLINICAL IMAGE Top

Successful resection of an advanced renal carcinoma by a multidisciplinary team consisting of a urologist, liver transplant and cardiac surgeons p. 177
Bhabani Sankar Sahoo, Naimish N Mehta, Ganesh Shivnani, Sudhir Khanna, Samiran Nundy
DOI:10.4103/JME.JME_71_22  
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CONTROVERSIES IN MEDICINE Top

Videoconferencing: Necessity is the mother of (Re) invention p. 180
Rajeev Jayadevan
DOI:10.4103/JME.JME_91_22  
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Webinars/Online seminars – Against p. 182
Ayesha Parveen, Ashok Rijhwani
DOI:10.4103/JME.JME_82_22  
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HOW TO DO IT Top

Research data collection in field locations situated at high altitude p. 184
Jayanti Pant, Rashmi Malhotra, S Srikant, Latika Mohan
DOI:10.4103/JME.JME_79_22  
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STUDENTíS SECTION Top

Spirituality and Health Care in Contemporary World p. 187
Prerna Anand, Asha Kumari Kiran, Vidya Sagar, Dewesh Kumar, Tanya Tanu
DOI:10.4103/JME.JME_68_21  
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NURSESí SECTION Top

My experience as a registered nurse in a middle Eastern Country p. 190
Lovely Simon, Rajini Peter
DOI:10.4103/JME.JME_86_22  
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CONFERENCE REPORT Top

The seventh annual national conference of association of physiologists of India p. 193
Ashok Nair, Hasmukh Shah, Archana Nimbalkar, Tejas Prajapati, Shalini Ranjan, Minal Patel, Puja Dulloo, Wasim Shaikh
DOI:10.4103/JME.JME_72_22  
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JOURNAL SCAN Top

The birth of a healthy baby 9 years after a surgically successful deceased donor uterus transplant p. 195
Tanvi Jain, Samiran Nundy
DOI:10.4103/JME.JME_74_22  
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LETTER TO EDITOR Top

Living in 'Digital India' p. 197
Harish Gupta
DOI:10.4103/JME.JME_11_22  
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MEDICAL EDUCATION Top

Role of quizzing in medical education p. 199
Unnikrishnan K Menon
DOI:10.4103/JME.JME_53_22  
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OBITUARY Top

A legend in oncology: Professor Devendra D Patel (15/9/1932 – 5/4/2022) p. 201
Rajkumar Kottayasamy Seenivasagam, Ajeet Singh Bhadoria, Ravi Kant
DOI:10.4103/JME.JME_95_22  
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BOOK REVIEW Top

Fact and fun in surgery: A companion to surgical study by Dr C. S. Rajan p. 203
Ramanuj Mukherjee
DOI:10.4103/JME.JME_98_22  
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PEOPLE WE ADMIRE Top

Broken strings can still make a symphony p. 204
Puneet Dhar
DOI:10.4103/JME.JME_94_22  
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MOVIE REVIEW Top

Influence of cinema on public perception of disability p. 207
Latika Mohan, Rituparna Barooah, Rashmi Malhotra
DOI:10.4103/JME.JME_75_22  
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KNOW YOUR INDIAN MASTERS Top

Theme: ABSTRACT THEMES IN INDIAN CONTEMPORARY ART  
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