Gujarat Medical Journal https://nicpd.ac.in/ojs-/index.php/gmj <p>Gujarat Medical Journal (pISSN: 0971-9342) is an official publication of Indian Medical Association, Gujarat State Branch. It provides the platform to share the research works of the doctors &amp; students from all the fields of modern medical sciences.</p> en-US gujaratmedicaljournal@gmail.com (Dr. Kamlesh Saini) cjshah79@yahoo.co.in (Dr Chinmay shah) Tue, 26 Apr 2022 18:16:29 +0000 OJS 3.3.0.13 http://blogs.law.harvard.edu/tech/rss 60 Diagnostic Features Of Tuberculous Meningitis: A Cross Sectional Study https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3424 <p>Background: Tuberculous meningitis (TBM) is a common central nervous system infection however it is difficult<br>to diagnose as findings are non-specific. Hence we decided to determine if, among patients with chronic meningitis<br>syndrome, the following are associated with the diagnosis, new-onset seizures, focal neurologic deficit;<br>pulmonary tuberculosis (PTB) on chest X-ray, cerebrospinal fluid (CSF), pleocytosis with lymphocytic<br>predominance; decreased CSF glucose; increased CSF protein.<br>Methods : Adult patients with suspected TBM were enrolled after informed consent was obtained. Baseline<br>physical examination and diagnostic tests including CT scan of the head with contrast and CSF analysis for acid fast<br>bacilli (AFB) smear, TB culture and cryptococcal antigen detection were done and results collected. Definite TBM<br>was defined as positive AFB smear or positive TB culture or positive basal meningeal enhancement on CT contrast<br>study. Logistic regression was done to determine which were associated with a diagnosis of TBM.<br>Results : 91 patients were included. Using the gold standard criteria mentioned above, 44 had definite TBM; but if<br>subsequent clinical course and response to anti-Koch's therapy are considered, 68 had a final diagnosis of TBM.<br>After logistic regression was performed, only abnormal CSF (the combination of CSF pleocytosis with lymphocytic<br>predominance, decreased CSF glucose, and increased CSF protein) was associated with the diagnosis of TBM.<br>Conclusion : In patients with chronic meningitis syndrome, only abnormal CSF was associated with the<br>diagnosisof TBM.</p> Dr. Moin Sheth*, Dr. Bhupendra Shah**, Dr. Manisha Panchal*** Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3424 Thu, 07 Apr 2022 00:00:00 +0000 Study of Effect of Ferrous Carboxymaltose on Postpartum Anemia https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3425 <p>Background: The incidence of post-partum anemia (PPA) is 14-24%. Treatment of PPA with injectable iron<br>replenishes the iron store. Ferric carboxy-maltose complex (FCM) is an intravenous iron agent designed to be<br>administered in large doses in a short period of time. This study aims to find the efficacy and safety of FCM in<br>treating postpartum anemia. Materials And Methods : The present study is a Prospective interventional hospital<br>based therapeutic trial conducted on postpartum anemic women of more than 18 years of age with HB &lt;10gm.<br>Intravenous ferric carboxy-maltose (FCM) was given to the anemic women who has just delivered. Total 500<br>mg/10 ml in 250 ml of 0.9% normal saline was given over 15-20 min. Result : Mean hemoglobin level before<br>intravenous ferric carboxy maltose was 8.1+/-0.4gm% while it was 10.05+/-0.6 gm% after treatment. Hb level,<br>Serum ferritin, MCV and MCHC improved after 2 weeks of treatment. Conclusion : FCM was well tolerated and<br>effectively increased mean hemoglobin levels in postpartum women. The duration of hospital stay also shortened<br>and their were no serious side effects noted with the use of FCM.</p> Dr. Samrudhi Jain*, Dr. Hardi Shukla*, Dr. Ajesh N. Desai** Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3425 Thu, 07 Apr 2022 00:00:00 +0000 “Coronary Atherosclerosis”- A Post-Mortem Histopathological study of 7 years https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3426 <p>Background : The incidence of coronary heart disease has markedly increased in India over the past few years.<br>Coronary atherosclerosis, the largest cause of morbidity &amp; mortality in developed and developing country.<br>Aim : To study the prevalence of coronary atherosclerosis cases on histopathology. To study different morphology<br>of coronary atherosclerosis on histopathology.To assess cases according to gender, age and socioeconomic<br>profile.<br>Material and Methods : Prospective and retrospective study of 7 years was designed to evaluate common<br>coronary atherosclerosis reported on autopsy viscera at histopathology department from August 2014 to August<br>2021.<br>Result : The study comprises the cases in the age group between 10 to 90 years. Both side coronary vessels<br>involvement is more common than single vessels involvement. The most common type of atherosclerosis seen was<br>Grade 2.<br>Conclusion : coronary atherosclerosis was most commonly diagnosed in the age group of 41 – 50 years and have<br>a male preponderance. Urban population more affected than rural. Most common observed complication is<br>myocardial infraction.</p> Dr. Amit Agravat*, Dr. Mahesh Vatkiya**, Dr. Kruti Soria***, Dr. Gauravi Dhruva**** Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3426 Thu, 07 Apr 2022 00:00:00 +0000 Study of Medical Disease Affecting Pregnancy other than Pregnancy induced and its Effect on Outcome https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3427 <p>Total 100 antenatal patients were selected on basis of history, clinical examination and investigation who came in<br>OPD of department of Obstetrics and Gynaecology B.J. Medical College, Ahmedabad, with various medical<br>conditions between May 2020 to september 2020And observed till the termination of pregnancy. This s t u d y d o e s<br>not include those medical conditions which are pregnancy Induced like pregnancy induced hypertention,<br>Gestational diabetes mellitus, Physiological anaemia etc. Study includes those medical conditions which are<br>already presents before pregnancy or not directly related to the pregnancy. Study shows that highest chances<br>of neonatal mortalityamong studied diseases is seen in pregnancy with jaundice, HIV, HBsAg, Asthma, Heart<br>disease, epilepsy, TB, UTI, influenza, Typhoid, Dengue, thyroid dysfunction in pregnancy. Highest chances of<br>Maternalmortality among studied diseases is seen in pregnancy withjaundice in pregnancy followed by<br>Heartdisease, epilepsy, tuberculosis, influenza and dengue in pregnancy. Where chances of Medically terminated<br>abortion inearly pregnancy is seen highest with heart disease in pregnancy followed by and thalassemia minor in<br>pregnancy. Highest chances of Spontaneous Abortion. Aims and Objectives : Aim is to study the various medical<br>condition which affects pregnancy and its outcome. Material and methods : Total 100 Random antenatal<br>patients were selected on basis of history, clinical examination and investigation who came in OPD of department<br>of Obstetrics and Gynecology B. J. Medical College, Ahmedabad, with various medical conditions between May<br>2020 to September 2020. Exclusion Criteria : this study does not involve those medical conditions which are<br>directly related to the pregnancy which occurs or exaggerates because of pregnancy, for example Pregnancy<br>induced hypertension, Gestational diabetes mellitus, Physiological anemia etc. Inclusion Criteria : This study<br>includes medical disorders that women had before they became pregnant (preexisting disorders), such<br>as diabetes or chronic high blood pressure and Disorders that develop during the pregnancy but are not<br>directly related to the pregnancy. 14 cases of cardiac disease, 10 cases of jaundice (viral hepatitis), 8 cases of<br>HbsAg, 8 cases of HIV, 8 cases of urinary tract infections, 8 cases of typhoid, 6 cases of epilepsy, 6 cases of dengue,<br>5 cases of thyroid disease, 5 cases of asthma, 5 cases of influenza, 5 cases of tuberculosis, 4 cases of renal<br>disease, 4 cases of malaria, 4 cases of chronic hypertension.</p> Dr . Tushar M. Shah*, Dr. Janki B. Shingadia**, Dr. Bhakti Modi*** Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3427 Thu, 07 Apr 2022 00:00:00 +0000 A Comparative study on visual outcomes in Myopic Astigmatic Refractive error correction by Customized Femtosecond Laser and Mechanical Microkeratome. https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3428 <p>To compare the visual outcomes in myopic astigmatic refractive error correction by Customized femtosecond laser<br>and Mechanical Microkeratome LASIK.This was aprospective observational study, performed on 200 eyes of 100<br>patients treated between 2016 to 2020 for myopia and astigmatism (sphere ≤ -6.00 Diopters; cylinder ≤ -6.00<br>Diopters). The first 100 consecutive eyes that had LASIK flaps created with a femtosecond laser were compared<br>with the first 100 consecutive eyes that had flaps created with a mechanical microkeratome. All eyes received<br>wavefront-guided LASIK treatments performed with a VISX S4 IR Advanced CustomVueexcimer laser (AMO).<br>Refractive predictability, change in mean spherical equivalent refraction, postoperative uncorrected visual acuity<br>(UCVA), and best spectacle-corrected visual acuity (BSCVA) were compared at 1 day, 1 week and 1 month<br>following surgery. The refractive accuracy was the same for both groups. At allfollow-up, the percentage of eyes that<br>achieved a postoperative UCVA of 20/20 or better was significantly higher in the femtosecond laser group than in the<br>mechanical keratome group. In addition, a higher percentage of eyes in the femtosecond laser group achieved a<br>postoperative UCVA of 20/16 at 1months. Creating LASIK flaps with the femtosecond laser resulted in faster visual<br>recovery and better UCVA.</p> Ankit S. Varshney*, Dr. Mahendrasinh D. Chauhan** Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3428 Thu, 07 Apr 2022 00:00:00 +0000 Correlation of Clinically & Sonographically estimated Fetal Birth Weight with Actual Birth Weight in Cephalic Presentation https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3429 <p>Introduction : Knowledge of the weight of the fetus in utero is important for obstetrician to decide whether to deliver<br>or not to deliver the fetus. And also to decide the mode of delivery. Accurate estimation of fetal weight is of<br>paramount importance in the management of labor and delivery. High rate of perinatal mortality in developing<br>countries makes estimation of fetal weight (EFW) antenatally pivotal to obstetricians. Objective : EBW was<br>estimated by clinical method using Johnson’s formula, Dare’s formula &amp; by USG with Hadlock’s formula. All EBW<br>derived from these 3 methods were compared with the actual birth weight, to find out EBW by which formula has<br>closest resemblance with actual birth weight. Results : In this analysis using paired t-test, the reissignificant<br>statistical difference found between actual birth weight &amp; Johnson’s method ( p-value &lt; .00001) and between actual<br>birth weight &amp; Hadlock’s method ( p-value &lt; .00001). There is no statistically significant difference found between<br>actual birth weight &amp; Dare’s method ( p-value0.32725) Conclusion : The assessment of fetal weight using Dare’s<br>formula is more accurate for predicting birth weight at term which is easy and cost-effective, amongst all 3 methods.</p> *Dr. Sugandha Patel, Dr. Akash Makwana** *Assistant Professor, ** Senior Resident Department Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3429 Thu, 07 Apr 2022 00:00:00 +0000 “Short term functional outcomes of single Stage Surgically treated Multiligamentous Knee injuries in cases of Knee Dislocation” https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3430 <p>Introduction: Knee dislocation is a disastrous injury with significant displacement of tibia over femur leading to<br>disruption of multiple ligaments of knee and other surrounding soft tissue structures. Open wounds and<br>neurovascular insult can put the limb in jeopardy. The complexity of injury and varied treatment makes this MLKI<br>challenging.<br>Purpose : This review article describes multiligament knee injuries (MLKI) in depth, with a focus on associated<br>injuries, operative management, outcomes, and complications.<br>Materials and Methods : We conducted a retrospective observational study of all patients who underwent MLKI<br>surgeries between 2014 to 2020 in a dedicated Arthoscopy and sports injury Center (Deliwala Hospital in<br>Bhavnagar). Over the past 7 years, we have treated many cases and have taken 30 cases for this article. The<br>Schenck knee dislocation classification was used to classify the ligament injury patterns.<br>Results : The male of age group 36-50 yrs most commonly involved. High Velocity flexion injury is most common<br>mechanism. Medial sided bicruciate injuries most common pattern. 3 patients develops knee stiffness, 2 superficial<br>wound infection and 1 had popliteal artery injury. Early surgeries (3-6 weeks) is always preferred over delayed<br>one.Repair had higher failure rate and lower return to sports activities compared to reconstructions. Surgical<br>treatment has higher mean Lysholm score96.3.<br>Conclusions : This review suggests that the best treatment guidelines for MLKI is still awaited due to<br>heterogeneous nature of the injuries themselves and the many treatment strategies available, but better functional<br>outcomes havebeen achieved with reconstruction rather than repair. Surgery must be performed early within 6<br>weeks for better results.When feasibleACL reconstruction can be delayed thereby reducing rate of<br>arthrofibrosis.High-quality research efforts needed to investigate best modality of treatment of MLKI.</p> Dr. Ujjval Deliwala*, Dr. Sumit Jain Sethia**, Dr. Akshay Patel*** Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3430 Thu, 07 Apr 2022 00:00:00 +0000 A Retrospective Cross Sectional Study on Ectopic Pregnancy: A Two Year Study https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3431 <p>BACKGROUND : Ectopic pregnancy is a life threatening condition. It is importance to diagnose it early to prevent<br>complications. This study aims to understand the risk factors, common group age of presentation, signs , symptoms<br>and management. This study was conducted for 2 years in Civil Hospital, Ahmedabad.<br>AIM : To determine the incidence, clinical features, risk factors and morbidity and mortality associated with ectopic<br>pregnancy in a tertiary care hospital.<br>METHOD : A retrosceptive cross sectional study was done for years in Obstetrics and Gynecology Department,<br>Civil Hospital, Ahmedabad from August 2019 to July 2021 for the period of 2 years.<br>RESULTS : 82 cases of suspected ectopic gestation were observed during the study period of two years at our<br>institution. Total no. of delivery during the same period were 12660. The incidence of ectopic pregnancy was 0.64%.<br>Amenorrhoea was present in 79.2% cases,pallor was seen in 81.7% of cases. Ultrsonography reported 47.2 % of<br>them as ruptured, 24.3% unruptured.<br>CONCLUSION : Early diagnosis of ectopic is very crucial for appropriate conservative medical management.<br>Clinicians should be suspicious of ectopic pregnancy in any woman of reproductive age presenting with abdominal<br>or pelvic symptoms.</p> Dr. Sneha*, Dr. A.U. Mehta**, Dr. Prerak Modi***, Dr. Rinky Agrawal**** Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3431 Thu, 07 Apr 2022 00:00:00 +0000 Acute ischemic stroke during the convalescent phase of asymptomatic COVID-2019 infection in young male https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3432 <p>Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) initially most appreciated for its pulmonary<br>symptoms, is now increasingly recognized for causing multi-organ disease and stroke in the setting of a hypercoagulable<br>state. Acute ischemic stroke (AIS) has not been described as late sequelae in patients without<br>respiratory symptoms of COVID-19. Here we report a case of 15 year old male with post COVID-19 status who<br>developed acute malignant middle cerebral artery infarction due to occlusion of left terminal internal carotid artery,<br>left middle cerebral artery stem and A1 segment of left anterior cerebral artery who undergone successful<br>intravenous thrombolysis followed by mechanical thrombectomy and decompressive craniectomy.</p> Dr. Zubin Shah*, Dr. Meet Raval* ,Dr.Heli Shah **,Dr. Sudhir V. Shah *** Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3432 Thu, 07 Apr 2022 00:00:00 +0000 A 30 Weeks, Impending Rupture Ectopic Pregnancy in Rudimentary Horn https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3433 <p>Rudimentary horn is one of the rarest congenital uterine anomalies. Pregnancy in a rudimentary horn of the uterus is<br>a rare clinical condition with a reported incidence of 1 in 100,000 to 140,000 pregnancies. It is difficult to diagnose<br>before surgery and hazardous to maternal life as rupture of pregnant horn result in severe hemoperitoneum. The<br>standard treatment is the surgical excision of the horn.</p> Dr. Seema Patel*, Dr. Rakesh Patel**, Dr. Jignasha Ram***, Dr. Harsh Patel***, Dr. Hetul Patel*** Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3433 Thu, 07 Apr 2022 00:00:00 +0000 A rare case of Cavernous Hemangioma inLateral Rectus Muscle https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3434 <p>Cavernous hemangioma is the commonest benign tumour of orbit. It is slow-growing and mostly asymptomatic.<br>Its presence in muscle tissue is very uncommon.A case of 23 year old woman presented with a cavernous<br>hemangioma in lateral retcus muscle in orbit. It was treated by surgical excision by Lateral orbitotomy.</p> Dr. Nitin Trivedi, Dr. Stuti Trivedi Copyright (c) 0 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3434 Thu, 07 Apr 2022 00:00:00 +0000 Neonatal Chikungunya Infection with Perioral Hyperpigmentation https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3435 <p>Background : During outbreak of Chikungunya, Neonatal Chikungunya Infection is not that uncommon and should<br>be suspected as closest differential diagnosis of sepsis<br>Case characteristics : Both babies had postnatal infection, one presented as signs and symptoms similar to<br>sepsis, both had hyperbilirubinemia and typical perioral hyperpigmented rash after phototherapy.<br>Message- : Perioral Hyperpigmentation is consistent with Neonatal Chikungunya Infection</p> Dr. Chitra Prakashkar* Dr. Nirav Patel**, Dr. Meet Patel**, Nidhay Prakashkar*** Copyright (c) 2022 https://nicpd.ac.in/ojs-/index.php/gmj/article/view/3435 Thu, 07 Apr 2022 00:00:00 +0000