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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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1.  ORIGINAL RESEARCH
Prevention of Sudden Cardiac Death in Cricketers
John W Orchard, Rajesh Puranik, Christopher Semsarian, Jessica J Orchard, David Samra, Johan Duflou, Patrick Groenestein, Mark Young, Peter Brukner, Alex Kountouris
[Year:2016] [Month:April-June] [Volume:50 ] [Number:2] [Pages:72] [Pages No:49-58] [No of Hits : 1609]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1193 | FREE

ABSTRACT

Aims: Sudden death in cricketers is rare, with the most common causes being cardiac, neurological (head/neck trauma, mainly from ball impact) and environmental (e.g., lightning strike and heat stroke, the former which usually involves cardiac arrest). The aim of this study was to review possible prevention of sudden cardiac death and make recommendations.

Materials and methods: A literature review of possible causes of sudden cardiac death (SCD) among cricketers was performed, along with evaluation of evidence for existing preventative measures. The method for evaluation was expert panel (cardiology and sports medicine) consensus recommendations based on the published evidence base.

Results: Potential cardiac causes of sudden death while playing cricket can be divided into the following categories: (1) atraumatic-origin preexisting arrhythmias, cardiomyopathies and valve disorders (2) traumatic-origin arrhythmia (commotio cordis) (3) acquired coronary or valvular disease (4) viral myocarditis (5) Lightning strike. Preventive measures can be divided into pre-season (e.g., cardiovascular screening), prematch (e.g., assessment of viral illness), protective equipment (e.g., chest guards) and post-event (presence of first aid response including defibrillators). Our panel agreed that there was strong evidence that (1) trained and planned emergency response particularly with a defibrillator is effective at preventing SCD and (2) ceasing play in the presence of lightning strikes prevents lightning-related death (3) players with symptoms, risk factors or history suggestive of possible cardiac disease should undertake specific individual workup. There are other potential methods to prevent SCD, with expert level recommendations made in the absence of strong evidence.

Discussion and conclusion: The most controversial aspect of prevention of SCD is electrocardiogram (ECG) screening of asymptomatic players and this paper outlines the arguments both in favor and against without fully resolving the debate. The possible increase in early diagnosis of potentially life-threatening cases needs to be balanced against the risk of false positive results which may lead to discussion of exclusion from cricket. Cardiac workup is clearly of net benefit to symptomatic individuals (e.g. history of syncope, chest pain) or any player at higher than usual baseline risk (e.g., positive family history). Basic life support including access to defibrillators should be available with trained personnel wherever they can be afforded, which has strong evidence in favor of improving survival at the time of cardiac arrest.

Keywords: Arrhythmia, Coronary artery disease, Cricket, Defibrillator, Electrocardiograph, Genetics, Prevention, Screening, Sudden cardiac death.

How to cite this article: Orchard JW, Puranik R, Semsarian C, Orchard JJ, Samra D, Duflou J, Groenestein P, Young M, Brukner P, Kountouris A. Prevention of Sudden Cardiac Death in Cricketers. J Postgrad Med Edu Res 2016;50(2):49-58.

Source of support: Nil

Conflict of interest: None

 
2.  REVIEW ARTICLE
Bisphosphonates in Orthopedics: Evidence-based Review of Indications and Adverse Effects
Sameer Aggarwal, Nitesh Gahlot, Uttam Chand Saini, Mandeep Singh Dhillon
[Year:2016] [Month:April-June] [Volume:50 ] [Number:2] [Pages:72] [Pages No:75-85] [No of Hits : 611]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1197 | FREE

ABSTRACT

Bisphosphonates (BPs) are clinically the most important class of antiresorptive agents available to treat diseases characterized by osteoclast-mediated bone resorption. These agents have a potent effect on the skeleton and are in common use for treatment of osteoporosis, Paget’s disease, and metastatic bone disease in adults as well as in the treatment of pediatric disorders such as osteogenesis imperfecta, Perthes’ disease, and fibrous dysplasia. Although initial investigations had demonstrated an acceptable safety profile of bisphosphonate drugs, but recently this has been questioned by some authors. In this article, we review the chemistry, pharmacokinetics, and pharmacodynamics of these agents in brief and the orthopedic applications as well as adverse effects in detail.

Keywords: Adverse effects, Bisphosphonates, Indications, Review.

How to cite this article: Aggarwal S, Gahlot N, Saini UC, Dhillon MS. Bisphosphonates in Orthopedics: Evidence-based Review of Indications and Adverse Effects. J Postgrad Med Edu Res 2016;50(2):75-85.

Source of support: Nil

Conflict of interest: None

 
3.  Original Article
Risk Factors of Congenital Malformations in North India: A Case Control Study
Amarjeet Singh, Smita Sinha
[Year:2016] [Month:January-March] [Volume:50 ] [Number:1] [Pages:47] [Pages No:22-27] [No of Hits : 605]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1186 | FREE

ABSTRACT

An increasing incidence of congenital malformations (CMF) has been reported in India.

Objective: To ascertain the determinants of CMF.

Methodology: This hospital based age-sex matched pair case control study was done at advanced pediatric center (APC), obstetrics and gynecology department (ANC clinic, maternity ward, labor room, etc.) and special clinics, PGIMER, Chandigarh, India in 2008. The mothers were interviewed to collect information about risk factors.

Results: Two hundred three CMF (under five children and gestational CMF) cases and same number of controls were studied. Significant association of CMF was observed with the use of sex selection drugs by mothers (OR = 4.35), habits of fathers like taking alcohol (OR = 3), smoking (OR = 4.5) and using tobacco (OR = 2.7). Mother’s age at marriage < 18 years and history of abortion were also important predictors of CMF.

Conclusion: Most of the risk factors for CMF were avoidable viz. addiction, early marriage and use of sex selection drugs. People need to be educated about this.

Keywords: Antenatal care, Child health, Congenital malformations, Reproductive health, Sex selection.

How to cite this article: Singh A, Sinha S. Risk Factors of Congenital Malformations in North India: A Case Control Study. J Postgrad Med Edu Res 2016;50(1):22-27.

Source of support: Nil

Conflict of interest: None

 
4.  Original Research
Mean Platelet Volume and Platelet Distribution Width as Markers of Vascular Thrombosis in Type 2 Diabetes Mellitus
M Bhanukumar, Prasanna KH Ramaswamy, Naveen K Peddi, Vineetha B Menon
[Year:2016] [Month:July-September] [Volume:50 ] [Number:3] [Pages:49] [Pages No:127-131] [No of Hits : 528]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1204 | FREE

ABSTRACT

Aims: The objective of the study was to determine the mean platelet volume (MPV) and platelet distribution width (PDW) in subjects with type 2 diabetes mellitus (type 2 DM) compared to subjects without type 2 DM and their correlation with fasting blood glucose, glycosylated hemoglobin (HbA1c), and duration of type 2 DM respectively.

Materials and methods: A prospective analytical case-control study was conducted involving 50 subjects with type 2 DM and 50 subjects without type 2 DM. The mean and standard deviation were estimated for both the groups separately and independent Student’s “t”-test was used for evaluating the significant difference. The statistical evaluation was carried out at 95% confidence level.

Results: Mean MPV and PDW in case group was significantly higher compared to control group (p < 0.005). Fasting blood glucose, HbA1c, and duration of type 2 DM did not significantly alter MPV or PDW.

Conclusion: The study concludes that MPV and PDW are significantly increased in patients with type 2 DM compared to patients without type 2 DM. Platelet volume indices are an important, simple, and cost-effective tool that should be used and explored extensively, especially in countries, such as India, for predicting the possibility of impending acute vascular events in patients with type 2 DM.

Clinical significance: This analytical method helps us to use MPV and PDW as early markers of vascular thrombosis.

Keywords: Case-control study, Mean platelet volume, Platelet distribution width, Type 2 diabetes mellitus, Vascular thrombosis.

How to cite this article: Bhanukumar M, Ramaswamy PKH, Peddi NK, Menon VB. Mean Platelet Volume and Platelet Distribution Width as Markers of Vascular Thrombosis in Type 2 Diabetes Mellitus. J Postgrad Med Edu Res 2016;50(3):127-131.

Source of support: Nil

Conflict of interest: None

 
5.  Research Article
Effectiveness of Isokinetic Exercises in Preoperative Anterior Cruciate Ligament Tears Rehabilitation
Amita Aggarwal, Bibek Adhya, Mandeep S Dhillon
[Year:2016] [Month:January-March] [Volume:50 ] [Number:1] [Pages:47] [Pages No:5-8] [No of Hits : 526]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1183 | FREE

ABSTRACT

The present study compared the effectiveness of adding isokinetic exercise program to conventional rehabilitation protocol in preoperated patients with anterior cruciate ligament (ACL) tear. The subjects were randomly assigned into two groups (n = 10 each). Group A followed conventional rehabilitation protocol. In group B, isokinetic exercise for quadriceps and hamstring were advised. These consisted of 3 set of 10 repetitions at velocity of 60 and 120° sec. with 1 minute rest interval between the sets. The exercise protocol was performed 6 days a week for 4 weeks. Student t-test was used for analysis. Also subjects were evaluated for pain using visual analog scale (VAS). For the assessment of symptoms and functions Cincinnati knee rating system and Lysholm scoring scale were used. The effectiveness of isokinetic exercise was significantly better only with knee extension peak torque and peak work in case of quadriceps (p < 0.05). Hamstring testing showed no significant difference with isokinetic training in intragroup as well as intergroup comparison for any measured parameters. Also no significant differences were found with use of functional scales.

Conclusion: Isokinetic exercises are effective in improving quadriceps peak torque and peak work in patients with ACL tear.

Keywords: Anterior cruciate ligament tear, Isokinetic exercise, Rehabilitation.

How to cite this article: Aggarwal A, Adhya B, Dhillon MS. Effectiveness of Isokinetic Exercises in Preoperative Anterior Cruciate Ligament Tears Rehabilitation. J Postgrad Med Edu Res 2016;50(1):5-8.

Source of support: Nil

Conflict of interest: None

 
6.  Review Article
Appendicular Histology and Its Clinical Significance in Patients with Ulcerative Colitis: A Prospective Study from North India
Nadeem Parvez, Surinder S Rana, Ritambhra Nada, Vishal Sharma, Ravi Sharma, Puneet Chhabra, Deepak Gunjan, Lovneet Dhalaria, Rajesh Gupta, Deepak K Bhasin
[Year:2016] [Month:July-September] [Volume:50 ] [Number:3] [Pages:49] [Pages No:141-147] [No of Hits : 504]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1207 | FREE

ABSTRACT

Background and aims: The appendix may be involved in ulcerative colitis (UC) to variable extent. Clinical significance of appendicular involvement is not clear and it has long been considered an innocent bystander. This study prospectively investigated appendiceal histology and its clinical significance in patients with UC.

Materials and methods: Colonoscopy was performed in 60 patients and biopsies were taken from appendiceal orifice, cecum, and colon. Appendiceal histology was classified as active if there was presence of neutrophils with crypt distortion. Inactive inflammation was defined as positive for crypt distortion and negative for neutrophils. Otherwise the histology was reported as normal or nonspecific changes. The patients were followed for a minimum period of 6 months.

Results: In patients evaluated endoscopically, 63% patients had histological involvement of the appendiceal orifice. Pancolitis was seen more commonly in patients with appendicular orifice inflammation than in patients with normal appendicular histology (44.7 vs 9%, p = 0.001). Most patients with appendiceal orifice inflammation had involvement of the cecum. Skip lesion of the appendix without cecum involvement was seen in 37% of the patients. The patients with appendiceal orifice inflammation had a significantly higher grade of endoscopic colitis compared to patients with normal histology (p = 0.006). Relapse rate was higher in patients with appendiceal orifice inflammation than in patients with normal appendiceal histology (18.4 vs 9%), although the difference was insignificant (p = 0.329).

Conclusion: Appendicular involvement in ulcerative colitis is not uncommon. Its involvement may predict the course, extent, and severity of colitis.

Keywords: Appendix, Colonoscopy, Inflammation, Ulcerative colitis.

How to cite this article: Parvez N, Rana SS, Nada R, Sharma V, Sharma R, Chhabra P, Gunjan D, Dhalaria L, Gupta R, Bhasin DK. Appendicular Histology and Its Clinical Significance in Patients with Ulcerative Colitis: A Prospective Study from North India. J Postgrad Med Edu Res 2016;50(3):141-147.

Source of support: Nil

Conflict of interest: None

 
7.  Original Article
Knowledge and Attitude of Medical and Dental Postgraduate Students toward Practice of Biostatistics
Medha Wadhwa, Pulkit Kalyan, Thanveer Kalantharakath
[Year:2015] [Month:January-March] [Volume:49 ] [Number:1] [Pages:58] [Pages No:1-4] [No of Hits : 2310]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1134 | FREE

ABSTRACT

Purpose: Evidence-based medicine (EBM) has appropriately focused attention on critical appraisal of clinical research. A result of this movement is that medical specialists must improve their grasp of epidemiological and statistical principles. This process necessitates a substantial level of expertise of the reader to appraise the design, methodology, data analysis, and interpretation of findings of relevant studies to arrive at conclusions. The foregoing requirements, together with the progressively increasing complexity of statistical methods, make information processing a complex task. This ‘gap’ between health science researchers and the understanding of mathematics and the statistical methods could justify the disinterest of a considerable part of clinical researchers and postgraduate students.

Materials and methods: A cross-sectional and descriptive study was conducted on all the enrolled medical and dental postgraduate students of 3 years belonging to the Sumandeep Vidyapeeth. The study subjects were distributed questionnaire that consisted of 2 parts which had questions related to the attitude and knowledge regarding the practice of biostatistics among the study subjects.

Results: The level of knowledge among the postgraduates was moderate and the attitude was found to be highly positive. Significant results were obtained that showed that the knowledge and attitude toward practice of biostatistics are strongly associated with each other with correlation coefficient to be 0.82.

Conclusion: The knowledge and attitude of medical and dental postgraduate students was found to be highly correlated indicating that with higher level of attitude increased knowledge can be acquired for practice of biostatistics among them. Biostatistics is perceived as an important element of EBM and incorporating it into EBM practice and curriculum would pave new ways into research field.

Keywords: Knowledge, Attitude, Biostatistics, Practice, Postgraduate students.

How to cite this article: Wadhwa M, Kalyan P, Kalantharakath T. Knowledge and Attitude of Medical and Dental Postgraduate Students toward Practice of Biostatistics. J Postgrad Med Edu Res 2015;49(1):1-4.

Source of support: Nil

conflict of interest:None

 
8.  Original Article
Knowledge, Attitude and Perception Regarding Organ Donation among the Nursing Students
Sukhpal Kaur, Sandhya Ghai, Nadiya Krishnan, Deepika Rana, Dimple Kathania, Gagandeep Kaur, Godawari Thakur, Gurinder Kaur
[Year:2015] [Month:July-September] [Volume:49 ] [Number:3] [Pages:53] [Pages No:105-110] [No of Hits : 1752]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1157 | FREE

ABSTRACT

A descriptive cross-sectional study was undertaken to assess the knowledge, attitude and perception regarding organ donation among the nursing students. The study was conducted at National Institute of Nursing Education, Postgraduate Institute of Medical Education and Research, Chandigarh. Using stratified systematic random sampling technique, 200 nursing student undergoing graduation and postgraduation courses were enrolled in the study. The tool used for data collection was a self-administered structured questionnaire consisting of three parts, i.e. information profile, assessment of knowledge, and assessment of attitude and perception regarding organ donation. For the assessment of knowledge, 17 multiple choice questions with one correct answer was used. The maximum attainable score was 18. One question had two right answers and was given a score of two. A five point Likert scale consisting of 15 questions was used for assessment of both attitude and perception of subjects regarding organ donation. Maximum attainable score was 65. Data collected was analyzed using descriptive and inferential statistics. The results of study revealed that 74.5% of the subjects had average knowledge, 22% had poor knowledge and only 3.5% had good level of knowledge regarding organ donation. The mean knowledge score of the subjects was 10.56 ± 2.01 with the range of 5 to 17. Regarding attitude and perception toward organ donation, 55.5% had neutral attitude and perception, 43.5% had positive attitude and perception and only 1% had negative attitude and perception.
It was concluded that majority of students had average knowledge about organ donation with neutral or positive attitude and perception. There is need to organize separate educational programs on organ donation for the nursing students other than their classroom teaching.

Keywords: Attitude, Knowledge, Nursing students, Organ donation, Perception.

How to cite this article: Kaur S, Ghai S, Krishnan N, Rana D, Kathania D, Kaur G, Thakur G, Kaur G. Knowledge, Attitude and Perception Regarding Organ Donation among the Nursing Students. J Postgrad Med Edu Res 2015;49(3):105-110.

Source of support: Nil

Conflict of interest: None

 
9.  Original Article
Direct Immunofluorescence of Renal Biopsy: Perspective of an Immunopathologist
Ranjana Walker Minz, Seema Chhabra, Kusum Joshi, N Khirwadkar, Vinay Sakhuja, Neelam Pasricha, Ranjit Bhardwaj
[Year:2015] [Month:January-March] [Volume:49 ] [Number:1] [Pages:58] [Pages No:10-17] [No of Hits : 1512]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1136 | FREE

ABSTRACT

Aims: This study was undertaken to analyze the strength of direct immunofluorescence microscopy in the diagnoses of renal diseases vis-à-vis histopathology. An attempt was also made to present advantages and pitfalls of this age old technique.

Settings and design: A total of 250 consecutive renal biopsies received over a period of 1 year were analyzed. The histopatholgy and direct immunofluorescence slides were reported by two separate pathologists and later compared to reach a final diagnosis.

Results: Two cores examined by histopatholgy and direct immunofluorescence microscopy yielded a final diagnosis in 98% cases. In 2% of renal biopsies (4 biopsies with a ‘descriptive’ label and 1 case of amyloid like nephropathy), additional diagnostic aids like electron microscopy were required to clinch a conclusive diagnosis. No case of anti-glomerular basement membrane glomerulonephritis or hereditary glomerular disease was observed over 1 year period under review.

Conclusion: Direct immunofluorescence helped to detect IgA nephropathy (5% cases), it incresed the sensitivity of detection of focal segmental glomeulosclerosis (23 more cases) and membranous glomerulopathy (2 more cases). It helped in detection as well as grading of glomerulonephritis in lupus nephritis. Crescentic glomerulonephritis could be further categorized into immune complex and pauci-immune subtypes. Immunofluorescent dye thioflavin T proved out to be a very sensitive dye for detection of amyloidosis. Membranoproliferative glomerulonephritis/ diffuse proliferative glomerulonephritis cases were less well discriminated by direct immunofluorescence than histopathology. Two percent of renal biopsies (2 cases of membranoproliferative glomerulonephritis, 1 case of membranous glomerulopathy, 1 case of mesangioproliferative glomerulonephritis) were false negative on direct immunofluorescence implying technical errors. Thus, correct diagnosis of glomerulonephritis requires direct immunofluorescence microscopy in parallel with light microscopic examination and also correlation with clinical features, serological as well as biochemical parameters. In less than 2% of patients, electron microscopy might be essential.

Keywords: Biopsy, DIF, Kidney.

How to cite this article: Minz RW, Chhabra S, Joshi K, Khirwadkar N, Sakhuja V, Pasricha N, Bhardwaj R. Direct Immunofluorescence of Renal Biopsy: Perspective of an Immunopathologist. J Postgrad Med Edu Res 2015;49(1):10-17.

Source of support: Nil

conflict of interest:None

 
10.  Original Article
Prevalence of Knee Osteoarthritis and its Correlation in Women of Rural and Urban Parts of Hoshiarpur (Punjab)
Rajvir Kaur, Vijay Lakshami Sharma, Amarjeet Singh
[Year:2015] [Month:January-March] [Volume:49 ] [Number:1] [Pages:58] [Pages No:32-36] [No of Hits : 1399]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10028-1139 | FREE

ABSTRACT

Osteoarthritis (OA) is a major cause of enormous disability in both the developed and developing world. The worldwide prevalence estimate for symptomatic OA is 9.6% among men and 18% among women. The present study was undertaken with the objectives: To estimate the prevalence of Knee Osteoarthritis (KOA) in women of rural and urban Hoshiarpur and to elucidate the correlates of KOA in women of rural and urban Hoshiarpur. The study was conducted in the rural and urban areas of district Hoshiarpur, Punjab (India) between August 2012-May 2013. The sample comprised of urban (200) and rural (200) females. A semi structured interview schedule was used to interview the study subjects. The prevalence was found to be high in urban area (21.5%). The prevalence of KOA was found to be increased with age and was also significantly associated with educational level and menopause.

Keywords: Knee osteoarthritis, Prevalence, Women.

How to cite this article: Kaur R, Sharma VL, Singh A. Prevalence of Knee Osteoarthritis and its Correlation in Women of Rural and Urban Parts of Hoshiarpur (Punjab). J Postgrad Med Edu Res 2015;49(1):32-36.

Source of support: Nil

conflict of interest:None

 
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