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   Table of Contents - Current issue
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January-June 2018
Volume 5 | Issue 1
Page Nos. 1-51

Online since Wednesday, May 30, 2018

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EDITORIAL  

Emotional quotient or intelligence quotient? Why not both? p. 1
Sanjeev Kumar Jain, Sanya Jain, Sonika Sharma, Nidhi Sharma
DOI:10.4103/ami.ami_28_18  
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ORIGINAL ARTICLES Top

Morphological and skeletal abnormalities induced by α/β arteether on developing chick embryo p. 2
Vishram Singh, Lavlesh Kumar Mittal, Ram Kumar Ashoka
DOI:10.4103/ami.ami_82_17  
Introduction: Malaria continues to be one of the India's leading public health problem.α/β artether is one of the most common antimalarial drug used worldwide to treat chloroquine resistant malaria and malaria falciparum. The present study was designed to assess the teratogenic effects of α/β artether on developing chick embryo. Material and Methods: The study was performed on 300 fertilized eggs of white leg horn chicken.The eggs were divided in to five experimental groups A, B, C, D, E having 30 eggs each and five control groups a,b,c,d,e one each for every experimental group respectively having 30 eggs each. On 5th day of incubation eggs from experimental groups A, B, C, D and E were exposed to α/β artether with dose of 0.00039 mg, 0.000585 mg, 0.00078 mg, 0.00097 mg and 0.00117 mg whereas the control groups were treated with same amount of normal saline. Results: The results showed growth retardation and some significant morphological abnormalities like scanty feathers, subcutaneous hemorrhage and skeletal abnormalities like poor ossification of the bones, kyphosis and lordosis. Discussion: The drug is toxic specially when used in higher dose and for a long period. At present there is no alternative drug available for the treatment of chloroquine resistant malaria and malaria falciparum except α/β artether. Therefore α/β artether and other artemisinins should be used only after establishment of proper diagnosis in recommended dose only not in higher dose and not for a long duration.
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Effect of aging and lumbar spondylosis on lumbar lordosis p. 14
Francis Osita Okpala
DOI:10.4103/ami.ami_64_17  
Background: Lumbar lordosis (LL), the anterior convexity of the lumbar spine in the mid-sagittal plane, gives the spine some resilience and helps in protecting it from compressive forces because some of the force is taken by the anterior longitudinal ligaments. In aging and lumbar spondylosis, the intervertebral discs undergo the same degenerative changes though at different rates, and in both, while some authors reported a straightening of LL, others reported no significant change. This morphologic information would hopefully influence therapeutic decision-making, particularly in lumbar spondylosis, which though usually asymptomatic, is a common cause of low back pain. Aim: The aim of the study was to investigate the effect of aging and lumbar spondylosis on LL. Subjects and Methods: Lumbosacral joint angle (LSJA), an angular measure of LL, was retrospectively measured in 252 normal and 329 spondylotic adolescent and adult supine lateral lumbosacral spine archival radiographs, and data were analyzed with IBM SPSS Statistics 23.0 (New York, USA). Results: Normal LSJA range was 5°–39°; the mean was 18.7° and showed insignificant variation with gender and aging. Spondylotic range was 5°–40° and the mean (20.8°) differed from the normal mean by about 2°, which probably have inconsequential effect on the lumbar curvature, suggesting that the normal and spondylotic mean values are essentially equal. The spondylotic mean also showed insignificant variation with aging and inconsequential 1° gender difference in favor of females. Conclusion: LL is substantially maintained in aging and lumbar spondylosis.
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Prevalence of sickle cell disease among children attending plateau specialist hospital, Jos, Nigeria p. 20
Nanbur Stephen, Nanyak Nden, Nanle Joseph Gusen, Patience Ringkat Kumzhi, Bonji Gaknung, Dauda Abimiku Auta, Lydia B Bulndi, Champion Mbursa, Vasantha P Kumari, Nannim Nanvyat
DOI:10.4103/ami.ami_60_17  
Background: An estimate of 250,000 children are born annually with sickle cell disease (SCD) worldwide and 75%–85% of the affected children are born in Africa; where mortality rates for those under age 5 years range from 50% to 80%. Objective: The present study was conducted to estimate the prevalence of SCD among children in Plateau State Specialist Hospital (PSSH), Jos, Nigeria. Methodology: Ethical approval was obtained from the Health Research Ethics Committee of the Hospital. Secondary data on age, gender, and region from the case notes of infants, children and/or adolescents; who received medical care in PSSH from 2012 to 2014 were used. Data were analyzed using frequency tables and Chi-square statistics. Results: The findings revealed that the prevalence of SCD in PSSH, Jos from 2012 to 2014 was 26.9/1000 population of pediatric patients. There was a gradual increase in the prevalence rate from 25.8/1000 in 2012 to 26.8/1000 in 2013 and 28.1/1000 in 2014. However, the case fatality rate of SCD gradually decreased from 15.4% in 2012 to 11.1% in 2013 and 10.3% in 2014. Chi-square test shows that the prevalence of the disease in relation to sex, age, and residence was not statistically significant (P > 0.05). Even though the case fatality rate of the disease decreased, its prevalence increased during the study. Conclusion: Therefore, preventive measure for SCD such as premarital genetic screening and counseling should be emphasized, especially in the southern and central geopolitical zones of Plateau state, where the prevalence was found to be higher.
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Empathy level among the medical students of national defence university of malaysia consuming toronto empathy scale p. 24
Mainul Haque, Siti Nur Najihah Binti Lutfi, Nur Syamirah Aishah Binti Othman, Halyna Lugova, Shahidah Leong Binti Abdullah
DOI:10.4103/ami.ami_73_17  
Background: Multiple research articles were continuously emphasizing that constructive effects of empathy improve patient care. Medical professional bodies often talk that medical doctors need to be competent in clinical skills and empathetic. There was enormous demand from patients that doctors should be empathetic and motivate listeners. Therefore, medical educators became highly concern about the issue whether their students possess empathetic qualities. The Aim of the Study: To measure the empathy level among the medical students and to perform validation and reliability study of the Toronto Empathy Questionnaire (TEQ). Materials and Methods: This was a cross-sectional study among medical students of the Defence University of Malaysia to measure empathy level. The TEQ was utilized to collect data. The data were collected in early second half of 2017. The universal sampling method was adopted, and data were analyzed with IBM SPSS Software. Results: The current study population holds an average level of empathy. Female medical students had statistically significantly (P = 0.001) higher scores than their male friends. There no statistically significant differences observed in the TEQ score between the year of study (P = 0.948) and type of admission (P = 0.065). Conclusion: The current study respondents possess an average level of empathy. Educational intervention can be incorporated to enhance empathy level which sequentially promotes patient care.
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Pondering for the frequency of routine single-lumen tracheostomy tube change for ongoing airway management in adult intensive care unit p. 31
Habib Md Reazaul Karim, Md Yunus
DOI:10.4103/ami.ami_36_17  
Background: Tube blockage in the Intensive Care Unit (ICU) leads to preventable deaths. Routine change of tube for ongoing airway management is one of the indications for tracheostomy tube (TT) changes. However, there are limited data or evidence to recommend the frequency of such change. Aim: The study aims to determine the frequency of routine TT change in adult ICU patients. Subjects and Methods: A retrospective evaluation of ICU records of the patients who had been on TT for >5 days from July 2013 to April 2015 was performed. Data with regard to age, sex, diagnosis, and on tube days (TDs) before the TT was changed with either confirmed/suspicion of blockage and nonblockage were collected. Patients who had blockage and nonblockage were analyzed as individual groups as well as compared using INSTAT software to find the statistical estimates. Results: A total of 62 patients (72.58% males; mean ± standard deviation age: 50.62 ± 18.47 years; mean intubated days of 11.42) with a total of 1022 TT days were evaluated. Fifty-six episodes of tube blockage and 57 episodes (each >5 TT days) of nonblockage were analyzed and compared. The 95% confidence interval (CI) for mean of on TDs for nonblockage and blockage was 7.16–8.27 and 8.08–9.84 days, respectively, in the study population (P = 0.0171). Conclusion: The frequency for routine change of single-lumen TT for ongoing airway management in ICU patient should be 7–10 days taking the lowest 95% CI for nonblockage as the earliest point and the highest 95% CI for blockage as the late point.
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Perceived heart risk factors can predict experienced psychological stress in outpatient cardiac rehabilitation p. 35
Mozhgan Saeidi, Saeid Komasi, Ali Soroush, Behzad Heydarpour
DOI:10.4103/ami.ami_91_17  
Background: The study was done to investigate the role of perceived heart risk factors (PHRFs) in the prediction of psychological symptoms of cardiac rehabilitation (CR) patients. Methods: In this cross-sectional study, 124 CR patients referred to Kermanshah Hospital of Imam Ali were assessed during April–July 2015. PHRFs scale and Depression, Anxiety, and Stress scale-21 used for data collection. The data were analyzed using linear multiple regression analysis. Results: The mean age of samples (69.4% male) was 58.9 ± 9.7 years. The results of regression analysis evidenced that there is no significant relationship between any of the PHRFs with depression and anxiety (P > 0.05); however, biological (P = 0.018) and psychological (P = 0.019) risk factors significantly can predict stress. The model generally can explain 6.4% of the stress variance. Conclusion: PHRFs are included some significant predictors for experienced stress among the CR patients. Given that the biological and psychological risk factors are more effective in experienced stress by the patients, it is recommended that specialists pay more attention to the potential psychological outcomes of this group of patients.
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Distribution of ABO and rh blood group in myeloproliferative diseases p. 39
Sushil Yadav, Jagveer Chaudhary, Nilesh Kumar, Pankaj Kumar Kannauje, Kailash Kumar, Ranjan Bhattnagar, Rvindu Tiwari
DOI:10.4103/ami.ami_30_17  
Background: The aim of this study was to investigate the distribution of ABO and Rh blood group in myeloproliferative disease and if association, if any exists can be used as a preclinical marker for cancer development and risk; hence, we can modify other modifiable risks for myeloproliferative diseases (MPDs). Materials and Methods: This was a cross-sectional study which included 252 cases who were diagnosed as a patient with lymphoid malignancies of any age group of both gender, 350 controls were taken as healthy people who have donated blood. Cases and controls were collected between January 1, 2016 and May 30, 2017. Blood group sampling of all cases and controls was performed. The obtained information regarding the presence or absence of myeloproliferative disorder, blood group type, age group, and type of myeloproliferative disorder analyzed, the statistical analysis was performed using SPSS for windows version 16.0 software. The findings were present in number and percentage analyzed using frequency, percentage, and Chi-squared test. Results: Of 266 cases of MPDs, majority of cases were of blood Group B (35.34%), followed by O (27.81%), A (26.69%), and AB (10.16%). Majority of cases were Rh positive (85.33%). Of 266 cases of MPDs, the most common was chronic myeloid leukemia (CML) (53.38%), polycythemia vera (16.55%), essential thrombocytosis (15.78%), primary myelofibrosis (11.28%), mastocytosis (1.5%), chronic neutrophil leukemia (1.13%), and the least common chronic eosinophilia leukemia (0.38%). In CML, primary myelofibrosis, mastocytosis, chronic neutrophilic leukemia, and chronic eosinophilic leukemia blood Group B was the most common, while blood Group O was more common in polycythemia vera and essential thrombocytosis. In control group, the most common blood group was O (36%), followed by B (32.67%), A (21.33%), and AB (10%), respectively. Majority of control groups (94.33%) were Rh positive and (5.67%) were Rh negative. Conclusions: The present study revealed that there are significant associations between ABO blood group and patients with MPDs. Male gender and blood group B and Rh factor positive are more prone for the development of myeloproliferative disorder. These findings also raise the possibility of using blood groups as an epidemiological marker for identifying population subgroups who are at high risk of these MPDs.
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Self-medication practices in patients attending a Tertiary Care Teaching Hospital in Urban North-West India p. 44
Shilpa Patrick, Dinesh Badyal
DOI:10.4103/ami.ami_65_17  
Background: This study was designed to determine the frequency, reasons, and the association of self-medication with demographic and other factors reported by participants. Materials and Methods: This study was conducted in 500 patients visiting a tertiary hospital in Ludhiana, North Western India. Participants were interviewed with a preset questionnaire. Data were entered into Microsoft Excel and analysis was performed using SPSS software version 16. Frequencies and proportions were calculated. Results: Of 500 study participants, 93.8% reported self-medication with no gender difference. The participants who took self-medication were of the opinion that self-medication resulted in quick cure of illness 50.75%, saved their time 17.46%, and gave them a sense of independence in 17.06%, respectively. The common reasons self-medication 45.84% for fever, 18.34% for pain, and 10.87% for headache with nonsteroidal anti-inflammatory drugs 49.4% followed by antibiotics (11.6%) be the common medication. The most common source of information is local chemists/pharmacy 39%. Conclusions: Self-medication is described as a double-edged sword in India, and regulation of over-the-counter sale of antibiotics prescription medication is necessary to safeguard the populace.
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CASE REPORTS Top

Isolated psoas schwannoma: A rare retroperitoneal tumor p. 48
Mohd Ilyas, Zubair Ahmad, Irshad Ahmad Banday, Suhail Rafiq, Naseer Choh
DOI:10.4103/ami.ami_15_18  
Retroperitoneal neurogenic tumors are very rare. Isolated or primary psoas schwannoma is one of the rarest tumors of retroperitoneum. The images of such a case are presented in this report.
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Placental adherence to small bowel: An uncommon appearance of placenta percreta; Managed without intestinal resection p. 50
Cimona Lyn Saldanha, Insha Khan, Mohd Ilyas
DOI:10.4103/ami.ami_72_17  
Placenta percreta is an uncommon and potentially fatal condition in pregnancy. It can invade the adjacent structures of uterus including the urinary bladder, rectum, and small bowel. The invasion of bladder is common but that of small bowel is extremely rare. This report presents a case of placenta percreta with small bowel invasion which was managed without intestinal resection.
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