National Journal of Integrated Research in Medicine

Idiopathic Intracranial Hypertension In Background Of Empty Sella Syndrome

Dr. Neha Vaghela — 2024-09-16

Background: Empty sella syndrome is a rare disorder characterized by enlargement or malformation of a structure in the skull known as the sella turcica. Most individuals with empty sella syndrome do not have any associated symptoms, but the finding raises concerns about hormone deficiencies. Empty sella syndrome may occur as a primary disorder (idiopathic) or as a secondary disorder in which it occurs due to an underlying condition or disorder such as a treated pituitary tumor, head trauma, or a condition known as idiopathic intracranial hypertension (also called pseudotumor cerebri) during which elevated intracranial pressure causes empty sella syndrome. Here we present a case of 25 year married female having symptoms and signs of raised ICP and decreased secondary sexual characters with blood investigations showing hypothyroidism. Her MRI Brain showed features of raised intracranial pressure (ICP) suggestive of Idiopathic Intracranial Hypertension with partially empty sella. Patient was diagnosed as Idiopathic Intracranial Hypertension with partial empty Sella with hypothyroidism and hypogonadotrophic normogonadism secondary to raised ICP. Patient was treated with IV Mannitol, thyroxine was started according to weight and other supportive treatment. Patient consciousness improved and got better. Patient was discharged with follow up on oral acetazolamide, thyroxine and hormone replacement therapy. [Vaghela N Natl J Integr Res Med, 2024; 15(1): 54-56, Published on Dated: 26/01/2024]

Non-Familial Hereditary Hemorrhagic Telangiectasia In A Middle-Aged South Asian Male- A Case Report

Dr. Sanket Bharadwaj — 2024-09-16

Background: Hereditary Hemorrhagic Telangiectasia (HHT) also known as Osler-Weber-Rendu
syndrome is an autosomal dominant disease with a prevalence of 1 in 5000 to 10,000. It is characterized by
mucocutaneous and visceral telangiectasias with multiorgan involvement- resulting in anemia causing a
continuous blood transfusion requirement. Case Description: A 45-year-old diabetic male with a history of
recurrent epistaxis since 6 years of age presented with anemic heart failure. Upper GI endoscopy and
contrast-enhanced CT abdomen were suggestive of multiple telangiectasias in the oral cavity, oropharynx,
and jejunal angiodysplasias with duodenal erosions. The patient was diagnosed with HHT based on three
out of four Curacao criteria- Recurrent spontaneous epistaxis, Telangiectasias, and Visceral lesions. The
patient was treated with oral Thalidomide and Packed Red Cell transfusions. Epistaxis was conservatively
managed with topical medications while the patient underwent Argon Plasma Coagulation for
gastrointestinal bleeding. According to hematological opinion, Bevacizumab therapy was planned but due
to non-affordability, the family decided to continue with the existing treatment and the patient succumbed
a month later. Early diagnosis with a low threshold of suspicion is important to improve the quality of life
and life expectancy for this disease. [Bharadwaj S Natl J Integr Res Med, 2024; 15(1):45-48, Published on
Dated: 26/01/2024]`

Assessment Of Knowledge, Attitude And Practice Regarding Interocclusal Record Materials And Techniques Among Dental Practitioners With Different Training Levels: A Survey Based Study

Dr. Rutu Shah — 2024-01-26

Objective: This study was designed to evaluate the knowledge, attitude and practice
regarding interocclusal record materials and techniques among dental practitioners with different training
levels like undergraduate and postgraduate and those undergoing post graduation training. Material And
Methods: In this survey based study total 152 dentist participated via Google forms. Survey questions were
framed aiming to collect general information and knowledge, attitude and practice towards interocclusal
record materials. The results obtained from the survey Google forms were analysed. Result: The results
show that majority of the participants in the study were PG students (53.3%) followed by BDS (34.2%) and
MDS (12.5%). Most of the participants (94.7%) possessed knowledge about interocclusal record materials
and 96.7% participants believed that it is necessary for fabrication of prosthesis. Among all participants
75.7% used interocclusal record materials routinely in their practice and having the knowledge of various
materials available in market. Conclusion: Within the limitations of the study, it was concluded that most of
the practitioners(94.7%) having knowledge about interocclusal record material but not having a knowledge
about recently available material like polyether / polyvinylsiloxane and digital intraoral scanner / T scan.
Most of the practitioners used wax in their clinical practice routinely. This survey shows that MDS and PG
student have greater overall understanding regarding interocclusal record material than BDS. Hence,
providing more extensive training related to this topic during undergraduate curriculum will be beneficial.
[Shah R Natl J Integr Res Med, 2024; 15(1): 04-11, Published on Dated: 26/01/2024]

The Assessment Of Pharyngeal Airways In Skeletal Class I And Class Ii Malocclusion With Different Growth Patterns In Bhavnagar Population

Dr. Prinsi Seth — 2024-01-26

Background: Aim: To evaluate the width of the pharyngeal airways and to ascertain any
correlations in skeletal Class I and Class II malocclusion with different growth patterns. Materials and
Methods: The sample size 90, divided into 6 groups based on class I and II skeletal relationship with Normal,
Horizontal and Vertical growth patterns. Result: Tukey test revealed that the mean upper airway width of
hyper divergent group was significantly different to hypo divergent and norm divergent group (P < 0.05),
whereas for lower airway width of hyper divergent group was significantly lower as compared to hypo
divergent group (P < 0.05). Conclusion: Upper airway is influenced by only growth pattern and not
malocclusion type. Lower airway is not influenced by growth pattern or malocclusion type. [Seth P Natl J
Integr Res Med, 2024; 15(1): 12-18, Published on Dated: 26/01/2024

Biofilm Production And Antifungal Resistance Among Candida Species In Patients With Vulvovaginitis: A Cross Sectional Study

Aastha Garg — 2024-09-16

Background: Vulvovaginal candidiasis (VVC), one of the commonest fungal infections in women of
reproductive age group, can become recurrent if not managed appropriately. Recently, production of
biofilm, which reduces the susceptibility to anti-fungal agents, has also been implicated in its pathogenesis.
Hence, the study was planned to determine the prevalence of VVC in cases of vulvovaginitis, identify the
pre-dominant candida species, and find out their antifungal susceptibility pattern and to detect biofilm
production in the candida isolates. Material And Methods: In this cross-sectional study, all isolates were
identified and confirmed by various basic microbiological methods followed by the VITEK-2 system. Biofilm
formation was detected by Congo red agar method and Tube method. Descriptive statistical methods were
used to evaluate the data collected. Result: Out of total 25 patients, 7 were positive with VVC out of which
2 cases were caused by C.albicans and 5 by Candida Non Albicans (3 by C.glabrata and 2 by C.tropicalis). As
compared to NAC, C. albicans is still partially sensitive to fluconazole. Fortunately, both C. albicans and C.
tropicalis are still 100% sensitive to voriconazole although resistance has developed partially in C. glabrata.
Biofilm production was observed in 3 cases. Conclusion: Majority of cases of VVC were due to NAC
predominantly C. glabrata which has grave therapeutic implications as they show decreased susceptibility
to all antifungals. Voriconazole is still effective but needs to be used rationally to avoid developing
resistance to it also. The evidence of biofilm production could be an important contributor towards
increased incidence of antifungal drug resistance. [Garg A Natl J Integr Res Med, 2024; 15(1): 19-25,
Published on Dated: 26/01/2024]

Descriptive Prospective Epidemiological Study In Thyroid Eye Disease In Tertiary Eye Care Hospital

Dr. Mayur Damor — 2024-09-16

Background: Thyroid eye disease can have a social and psychological well being, epidemiological
evidence of thyroid eye disease is lacking in Gujarat. Material And Methods: The epidemiological
prospective epidemiological study in 32 thyroid patients in Tertiary care hospital from year 2011 to 2013.
Result: In our study female are more affected with diplopia and inferior rectus muscle restriction
Conclusion: The prevalence of Thyroid eye disease now a say increasing in state of Gujarat so the robust
result of this study add valuable evidence on Thyroid eye disease in City. [Damor M Natl J Integr Res Med,
2024; 15(1): 23-27, Published on Dated: 26/01/2024]

Development And Validation Of ‘Awareness About Physiotherapy In Stroke’ (APIS) Scale

Dr. Suvarna Ganvir — 2024-09-16

Background: Aim: To develop and validate a scale for assessing awareness about role of
Physiotherapy in Stroke, among general public. Material And Methods: A 2 step approach with test
construction and validation of the scale was adopted. The 32 item scale was developed using the specific
literature and validated through expert review. It was administered on 50 voluntary Stroke Survivors,
divided in 2 groups receiving general Physiotherapy information and Physiotherapy in Stroke information.
The effect of education was measured to determine sensitivity and test retest reliability of the scale. Result:
Items of the scale revealed good content coverage, positive expert review ratings, and acceptable item
properties. It had good test retest reliability and internal consistency. Construct validity was strong specially
after providing exposure of Physiotherapy in Stroke information among the sample participants.
Conclusion: APIS is a robust tool with preliminary strong psychometric properties which can be used to
measure awareness about Physiotherapy in Stroke among general public which can be used as an outcome
measure in observational and experimental studies. [Ganvir S Natl J Integr Res Med, 2024; 15(1): 31-35,
Published on Dated: 26/01/2024]

A Clinico-Etiopathological Study Of Leg Ulcers At Tertiary Care Center

Dr. Nimish Kyada — 2024-09-16

Background: A leg ulcer is a disruption in the epithelial integrity of the skin, typically located
between the knee and malleoli, characterized by partial or complete loss of the epidermis and dermis,
occasionally extending into the subcutaneous adipose tissue. The incidence of leg ulceration is increasing,
due to risk factors such as advancing age and increasing prevalence of risk factors like smoking, obesity,
hypertension, and diabetes mellitus. Without timely intervention, these ulcers may recur and precipitate
severe complications, imposing substantial economic burdens on patients. Material And Methods: In this
observational study, 32 patients with leg ulcer attending the dermatology OPD at P.D.U. medical college,
Rajkot, Gujarat were enrolled after obtaining their consent. Detailed history of each patient was recorded.
Routine investigations and biopsy were done to detect associated risk factors and histopathological
correlation. Result: Among the 32 patients,21 (65.62%) were male and 11 (34.38%) were female,
predominantly in the age group of >50 years , trophic ulcers(31.25%) was predominant followed by by
pyoderma gangrenosum (25%), venous ulcers (18.75%), vasculitic ulcers (15.62%), diabetic ulcers (6.25%),
and malignancy-related ulcers (3.12%). History of sensory neuropathy due to leprosy (33.33%), obesity
(21.88%), hypertension (18.75%), diabetes (18.75%), and malignancy (3.12%) were the common risk factors
in leg ulcer patients. Conclusion: Due to the complex nature of these ulcers, a thorough diagnostic
approach and adherence to treatment plans are essential for successful management. [Kyada N Natl J
Integr Res Med, 2024; 15(1): 36-41, Published on Dated: 26/01/2024]

Utility Of Homoeopathic Management In Root Canal Treatment With Relation Of Homoeopathic Posology

Dr. Divya Darji — 2024-09-16

Background: Root canal treatment saves teeth that would otherwise need to be extracted. It
involves removing the damaged or dead nerve tissues and pus in the root canals of teeth that have become
infected. The infected or dead tissue is cleaned away and the residual canal space is also cleaned and
disinfected, and the root canal is prepared so that it can be sealed with a filling. The tooth can then be
restored and can remain in function for many years provided there is sufficient sound tooth structure to
support a new filling or crown. Material And Methods: Homoeopathic management in root canal treatment
with relation of Homoeopathic posology through case study after defining, analysing then further testing
data for accuracy. Selection of medicine was depending on the concept of the individualization. Selection
of potency and repetition was based on Homoeopathic posology which describe in Organon of medicine.
Result: In study mostly in chronic cases low or medium potency gives good result and In acute cases higher
potency with single dose. Conclusion: Our study has concluded that Homoeopathic management has
shown utility in root canal treatment.[Darji D Natl J Integr Res Med, 2024; 15(1): 42-49, Published on Dated:
26/01/2024]

Impact On The Quality Of Life Among Acne Patients Attending A Tertiary Care Hospital In The Southwestern Part (Saurashtra Region) Of Gujarat

Dr. Mona R. Purohit — 2024-09-16

: Background: Acne vulgaris is a common, chronic disorder resulting from the inflammation of
pilosebaceous unit, present with clinically various forms. It is usually prevalent in adolescent may persist in
adulthood. This study was conducted to evaluate the quality of life (QoL) in patients suffering from the acne
vulgaris. Material And Methods: Hospital based cross sectional study was conducted in 100 patients
attending outpatient department of dermatology at a tertiary care hospital in south western part
(Saurashtra region) of Gujrat. Dermatology life quality index (DLQI) questionnaire was used to observe the
effect of acne among patients.Result And Conclusion: Total numbers of patients enrolled were 100(71
females.29 males). Maximum patients were of the age group 21-30 years with the 52(52%) individuals,
followed by 25 (25%) in the age group older than 31 years, and 23 (23%) in the age group younger than 20
years. In general, grade 2 acne was the most common kind of acne. The vast majority had a “very large
effect’’ on QoL. [Purohit M Natl J Integr Res Med, 2024; 15(1): 50-53, Published on Dated: 26/01/2024]