Datta Meghe Institute of Medical Sciences University

Review of current global evidences for prevention of coronary heart disease Meenakshi Khapre, Vartika Saxena Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):1-5 India is experiencing epidemiologic transition with sharp increase in coronary heart disease (CHD). Fatality rate of CHD is alarmingly high leading to the most common cause of premature mortality in 2016. There is the growing burden of coronary risk factors owing to rapid urbanization and changes in lifestyle, including diabetes mellitus (DM), hypertension, dyslipidemia, smoking, alcohol consumption, dietary patterns, central obesity physical inactivity, and psychological factors. These risk factors attribute 90% of CHD in population. The global evidences of preventive strategies is being reviewed in this paper with the aim to get the glimpse of study on CHD and find gaps in the research.

To assess the utility of proliferative marker Ki-67 in surface epithelial ovarian tumor Sheronica Laishram, Vivek Gupta, Arvind Bhake, Akanksha Wankhede, Deepika Agrawal Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):6-10 Background: Surface epithelial ovarian tumor (SEOT) accounts for more than 90% of all the ovarian tumors and are the most lethal one. Cellular proliferation plays a significant role in the clinical behavior and aggressiveness of ovarian tumor. Proliferative activity of the tumor can be assessed using the proliferative marker Ki-67, which has both diagnostic and prognostic values. Aim and Objective: The aim and objective of this study was to assess the expression of proliferative marker Ki-67 in various SEOT and correlate its level of expression with clinicopathological parameters including the International Federation of Gynecology and Obstetrics (FIGO) staging and preoperative CA-125 level. Materials and Methods: The study was a cross-sectional and observational study carried out in the Department of Pathology, JNMC, Sawangi, Wardha, over 2 years. It included 74 patients with surgically resected specimen of SEOT. Ki-67 immunohistochemistry was performed in all the 74 cases, and the percentage of immunopositive cells was expressed as Ki-67 labeling index (Ki-67 LI). Results: Out of 74 cases, 54 were benign and 20 were malignant which comprised serous and mucinous histological subtypes. Ki-67 expression was found to be positive only in malignant tumors (Ki-67 LI >1%). High Ki-67 LI was associated with high-grade serous cystadenocarcinoma (48.5%), advanced FIGO staging (40.5%), and high CA-125 levels. However, there was no association between Ki-67 LI and histological subtype. Conclusion: Ki-67 is a cost-effective proliferative marker. Therefore, immunohistochemical assessment of Ki-67 expression can be included in routine histopathological report of SEOT for diagnosis and prognostication which will help in better understanding of the biologic behavior of the tumor and modifying treatment strategies.

To correlate histopathological changes and transvaginal sonography findings in the endometrium of patients with abnormal uterine bleeding Akanksha Wankhade, Sunita Vagha, Samarth Shukla, Arvind Bhake, Sheronica Laishram, Deepika Agrawal, Naincy Rastogi, Madhuri Wankhade Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):11-15 Background: Menstrual ailments are the common manifestation to call for medical visits among women of heavy menstrual bleeding of procreative age. Abnormal uterine bleeding (AUB) affects up to 30% of females in the society. Aim and Objective: The aim of this study was to establish the role of histopathological diagnosis of uterine lesions in patients of AUB and to correlate the transvaginal sonography (TVS) findings with histopathological examination. Materials and Methods: A observational and analytical study was carried out in 120 patients of AUB. All the patients underwent TVS, followed by a histopathological examination of specimens obtained from either D and C or hysterectomy. Results: Menorrhagia was the most common clinical finding. Mean endometrial thickness measured by TVS was 10.15 ± 3.86. Proliferative endometrium (28.33%) was the most frequent finding in histopathological examination, followed by endometrial hyperplasia comprised of 20.83%. Hyperplasia and carcinoma both had a low sensitivity of 36% and 50%, respectively, on TVS compared with histopathology. Conclusion: According to the histopathological diagnosis based on biopsy or D and C, the treatment plan is formulated and the surgery is planned. Hence, even the prognosis depends upon the histopathological examination, TVS is only the initial screening tool for AUB. We advised the clinicians not to rule out these entities only on the basis of TVS.

Impact of Living (Surface) Anatomy module as continuous professional development program for practicing physiotherapists Bincy M George, Satheesha B Nayak, Prem Venketesan, Sapna Marpalli, Mohandas K. G Rao Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):16-21 Background: It is often presumed that physiotherapists need to be thorough in their knowledge in gross anatomy prior to learning new skills or therapeutic techniques. We implemented a Living (Surface) Anatomy module for physiotherapists, prior to the teaching of therapeutic techniques, in one of the continuous professional development (CPD) programs as a supportive venture for their clinical practice. The present study intended to evaluate the impact of a CPD program on reinforcing practicing physiotherapists' knowledge, skills, and attitude for their clinical practice. Methods: A 1-day workshop was conducted on living (surface) anatomy for practicing physiotherapists (n = 27) through a CPD program. This training included manual muscle testing and body painting of selected muscles of trunk and limbs. Pre- and post-tests were conducted to analyze the impact of the module on improvement in participants' knowledge and skills. In addition, participants were requested to respond to a questionnaire (15 items) on a 5-point Likert scale. Results: Analysis of the pre- and post-test scores revealed a significant increase (34.6%) in surface anatomy knowledge. Majority of the participants opined that the workshop was organized effectively (100%) and the modules helped them to become aware of the lacunae in their knowledge (100%). They also echoed that they realized the need for continuous self-directed learning (100%) and responded that they would attempt to apply whatever they learned through the workshop in their clinical practice (96%). The overall satisfaction score reported by the participants was 9, on a rating scale ranging from 1 to 10 (1 = very poor; 10 = excellent). Conclusion: The CPD was well received by the participants, as evident from their feedback. The present study results demonstrated that the CPD had a positive impact on the participants' knowledge, skills, and attitude.

Profile of urinary tract infection in a rural tertiary care hospital: Two-year cross-sectional study Priyansh Bhayani, Rajendra Rawekar, Shilpa Bawankule, Sunil Kumar, Sourya Acharya, Abhay Gaidhane, Mahalaqua Nazli Khatib Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):22-26 Aim: The aim of this study was to study the profile of urinary tract infection (UTI) in patients admitted to the medicine department. Settings and Design: This was a cross-sectional study done in a rural tertiary care hospital conducted for a period of 2 years from September 2016 to September 2018. Materials and Methods: All the patients who were admitted (irrespective of the diagnosis at the time of admission) with onset of fever after 48 h of admission, and patients with catheter-associated UTI (CAUTI) and non-CAUTI were defined using the Centers for Disease Control and Prevention guidelines. Statistical Analysis: Statistical analysis was done using descriptive and inferential statistics using Chi-square test and Student's unpaired t-test, and software used in the analysis were SPSS 22.0 version (IBM, USA) and GraphPad Prism 6.0 version (Graphpad software, Inc. California, USA) and P < 0.05 is considered as level of significance. Results: Eighty-four patients developed UTI, the most common organism causing UTI was Escherichia coli. The risk factors associated with CAUTI were higher age, prolonged duration of catheterization, diabetes, and chronic kidney disease. The risk factors associated with non-CAUTI were higher age and benign prostate hyperplasia. The risk factors associated with mortality were prolonged duration of catheterization and diabetes. Twelve patients (14.28%) with CAUTI succumbed in the ICU to their primary illness. Conclusions: Diabetic and elderly patients are at high risk of developing UTI and patients with CAUTI had higher mortality and morbidity.

Dermatoglyphics: A prediction tool for malocclusion Smitha Sammith Shetty, Gloria Su Mi Li, Nurul Ashiqin Binti Babji, Liyana Syatrah Binti Mohd Yusof, Nicholas Ngieng Jiun Yang, Teong Dun Jun, Kuhan Magandran Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):27-30 Introduction: Dermatoglyphics has proved to have a potential role in predicting the anomalies related to orofacial regions. Aim: The aim of the present study was to explore an association if any, between the dermatoglyphic patterns and type of malocclusion among the Malaysian dental and medical students. Materials and Methods: A total of 104 Malaysian dental and medical students were included in the study. The fingerprints and palm prints were recorded to analyze the type of pattern. Occlusion status was clinically assessed using Angle's classification of malocclusion. Results: Statistically significant association was seen between the left thumb ridge pattern and type of malocclusion. Individuals with loop ridge pattern on their left thumb showed high frequency of Class I normal occlusion and Class III malocclusion, and those with whorl ridge pattern were witnessed to have Class I malocclusion. Conclusion: Dermatoglyphics serves to strengthen the diagnostic impression of malocclusion at an early age and hence can aid in predicting malocclusion and plan preventive and interceptive orthodontics in pediatric patients.

Role of sonoelastography in diagnosing endometrial lesions: Our initial experience Gulam Marfani, Suresh Vasant Phatak, Kaustubh Anil Madurwar, Samida Samad Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):31-35 Context: Real-time elastography is a novel and dynamic imaging technique that is based on the softness or hardness of tissues or organs of interest under the appropriate compression and can be used with conventional ultrasonography (USG) probes after performing grayscale imaging and Doppler USG. Aims: The aim was to analyze the role of sonoelastography in diagnosing endometrial lesions. Subjects and Methods: A prospective study was conducted from August 2016 to 2018. 30 females were included who underwent sonographic examination. Diagnoses were made and later elastograms were obtained. Strain ratios were calculated and the final diagnosis was compared to histopathological diagnoses to evaluate the role of sonoelastography in diagnosing endometrial pathologies. Statistical Analysis Used: Statistical analysis was done be using descriptive and inferential statistic's using chi square test, students unpaired test, sensitivity and specificity and software used in the analysis were SPSS 22.0 version and graft pad prism 6.0 version. Results: Of the total 30 patients, 5 cases were misdiagnosed on USG compared to 1 on elastography which was of atypical endometrial hyperplasia. Sensitivity, specificity, and diagnostic accuracy of ultrasound were found to be 90.28%, 80%, and 88.5%, respectively. Sensitivity, specificity, and diagnostic accuracy of sonography with elastography were 93.06%, 86.67%, and 91.95%, respectively, showing better results. Conclusions: Sonography coupled with elastography showed better results and can be used to avoid dependency on computed tomography and magnetic resonance imaging avoiding radiation exposures and high cost, especially in a developing country like India, or unnecessary surgical interventions can also be avoided.

Awareness of tuberculosis control program among health-care workers in a tertiary hospital, South India Satyavamsi Gadde, T Jaya Chandra Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):36-38 Objectives: The objective of the study is to access the awareness of tuberculosis control program (TCP) among health-care workers (HCWs) in a tertiary hospital and to compare the knowledge on TCP between HCWs and the public. Materials and Methods: The participants were provided with printed, multiple-choice questionnaire, containing 28 questions and options to mark the correct answer. All the questions were provided with “not aware” option also. The results were tabulated and analyzed by giving 1 for correct answer, −1 for wrong answer, and 0 for not aware option. The Mann–ANOVA test was used to find the statistical difference. Results: The mean average of scores was 18.52 in the test group and − 0.12 in the control group. Statistical mean significant difference was observed between the groups (P < 0.05). Conclusion: Awareness among the public and HCWs is important for the success of Revised National Tuberculosis Control Programme (RNTCP). To create the awareness in the public, it has to get advertised in cinema theaters, local channels, and newspapers. For awareness among HCWs, scientific updates should be advertised frequently in the journals and symposiums/seminars should be organized regularly by RNTCP.

A rare case of bilateral multiple ovarian dermoids with uterine fibroid and ectopic kidney Suvarna Satish Deshpande, Suresh Vasant Phatak Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):39-41 Ovarian dermoid cysts are made up of solid, cystic, and fat tissue arising from two of the three germ layers. The incidence of they being bilateral is rare and accounts for 10%–15%. A 42-year-old female came with chief complaints of increased bleeding during menses and pain in the abdomen. Ultrasonography revealed echogenic lesion with heterogeneous echotexture in both the ovaries with internal echogenic strands within which was s/o bilateral dermoid cyst. The patient had a left ectopic renal kidney on contrast-enhanced computed tomography of the abdomen; there was well–defined, rounded, mixed-density mass lesion seen in the pelvis showing fat density, areas of calcification (Rokitansky protuberance), soft tissue, and fluid components. After postoperative and histopathological correlation, it was found to be bilateral dermoid.

Plexiform unicystic ameloblastoma with adenoid differentiation: An unusual finding Monal Yuwanati, Ravi Dande, Amol Ramchandra Gadbail, Shailesh Gondivkar Journal of Datta Meghe Institute of Medical Sciences University 2019 14(1):42-44 Unicystic ameloblastoma (UA) shows clinical and radiologic characteristics of an odontogenic cyst, but histologically shows a typical ameloblastomatous epithelial lining part of the cyst cavity, with or without luminal and/or mural tumor proliferation. Very few cases were reported with variation in histological pattern but rarely with adenoid differentiation. Keeping this in mind, we here report a case report of plexiform UA with adenoid differentiation in maxilla.

Alexandros Sfakianakis
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