Journal of Postgraduate Medicine, Education and Research

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Volume 55, Number 4, October-December 2021

EDITORIAL

Samir Malhotra

Lessons from a Vaccine Contract

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:2] [Pages No:153 - 154]

PDF  |  DOI: 10.5005/jp-journals-10028-1454  |  Open Access |  How to cite  | 

RESEARCH ARTICLE

Divya Sharma, Amarjeet Singh

Determinants of Use of Health and Wellness Products by People in Chandigarh and Shimla

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:5] [Pages No:155 - 159]

Keywords: Fitness, Health, Wellness, Wellness products

PDF  |  DOI: 10.5005/jp-journals-10028-1452  |  Open Access |  How to cite  | 

Abstract

Background: Health has always been given importance in all cultures. Various new dimensions have been added to the concept of health with time. This in turn has led to change of perception and beliefs regarding health among people. Aim and objective: To analyze the determinants of use of health and wellness products by people in Chandigarh and Shimla. Materials and methods: This quantitative cross-sectional study was conducted on a total of 150 individuals from Chandigarh and Shimla (H.P) using semi-structured interview schedules. The sample was further divided in a ratio of 2:1 because of the difference in area and population of Chandigarh and Shimla. A health and wellness score was calculated. The data were analyzed statistically by calculating frequencies, percentages, and using the Chi-square test. Results: The mean health and wellness product usage score was 51 with a standard deviation of 11.8. There was a significant relation of gender with product usage. Being physically fit was the main definition of health and wellness for the majority of participants. A proper and healthy diet was the main focus of a large number of participants to stay healthy. The most commonly used source of information to learn about health and wellness by participants was the Internet. The most important criterion for purchasing health and wellness products reported by the majority of participants was their perceived effectiveness. Conclusion: The use of products was seen among all age-groups. The factor that affected the use of these products was gender. Females were using more health and wellness products than males.

RESEARCH ARTICLE

Lixiao Chen, Xinjiang Ying, Bin Shen, Xinwei Chen, Pin Dong

Integrated Data Analysis Implicates PLAU, SERPINE1, SPP1, and MMP1 as Prognostic Factors in Head and Neck Squamous Cell Carcinoma

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:11] [Pages No:160 - 170]

Keywords: Differentially expressed gene, Gene expression omnibus, Head and neck squamous cell carcinoma, Prognostic factor, The cancer genome atlas

PDF  |  DOI: 10.5005/jp-journals-10028-1411  |  Open Access |  How to cite  | 

Abstract

Aim: Head and neck squamous cell carcinoma (HNSCC) ranks seventh in incidence among the most common types of cancer worldwide. Although smoking and drinking are risk factors for HNSCC, the specific causes of, and molecular mechanisms underlying, of HNSCC have not been identified. Despite improvements in tumor treatment technology over the last 40 years, the prognosis of patients with HNSCC has not changed significantly. Therefore, to improve HNSCC treatment strategies and for early diagnosis, it is important to study its pathogenesis, and to identify prognostic markers for it. Materials and methods: We used an integrated bioinformatics approach to identify key pathogenic and prognostic genes involved in HNSCC and to reveal the potential underlying molecular mechanisms. The expression profiles of the GSE6631 and GSE107591 datasets were downloaded from the Gene Expression Omnibus (GEO) database, and the tertiary RNA-sequencing dataset of HNSCC and corresponding clinical information were downloaded from The Cancer Genome Atlas (TCGA). These three datasets were integrated to identify differentially expressed genes (DEGs), and DEGs were analyzed using bioinformatic tools, including R packages. Results: We identified 83 DEGs among these datasets. Gene Ontology analysis showed that the biological functions of the identified DEGs are primarily associated with regulating extracellular signal cascades, epidermis development, adhesion, and other tumor cytology behaviors. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that these DEGs were mainly involved in the PI3K-Akt, human papillomavirus infection, and IL-17 signaling pathways. A protein–protein interaction network was constructed to reveal the 20 most closely related genes among the DEGs. Conclusion: Four key genes in the network (PLAU, SERPINE1, SPP1, and MMP1) were demonstrated to have prognostic relevance based on their significant associations with survival in patients with HNSCC. We verified the high expression of SERRPINE1 in hypopharyngeal carcinoma cell lines by qRT-PCR and Western blotting. Clinical significance: Our findings would help elucidate the molecular mechanisms underlying the development and provide the possibility to improve the prognosis of HNSCC.

REVIEW ARTICLE

Venkatesh Babu Subbiah

Safe Spine Surgery

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:6] [Pages No:171 - 176]

Keywords: Injury, Safe, Spine, Surgery, Trauma

PDF  |  DOI: 10.5005/jp-journals-10028-1407  |  Open Access |  How to cite  | 

Abstract

Presently, the surgical treatment is prescribed for most of the spine diseases and fractures. The complications after spine surgery are also increasing. This review piece of writing updates the applied anatomical knowledge and operative skills necessary for the surgeon who intends to surgically treat the spine in a safe manner.

CASE REPORT

Vignesh Subramanu, Renu Suthar, Lokesh Saini, Venkataseshan Sundaram

Peripheral Limb Gangrene in Neonates

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:3] [Pages No:177 - 179]

Keywords: Auto-amputation, Low-molecular-weight heparin, Neonates, Peripheral gangrene

PDF  |  DOI: 10.5005/jp-journals-10028-1402  |  Open Access |  How to cite  | 

Abstract

Peripheral limb gangrene in neonates presenting soon after birth is rare and exact etiology could not be ascertained in majority. In order to make an important contribution to the limited literature on this topic, we report rare and unique presentation of peripheral limb gangrene in two neonates soon after birth (on day 1 of life) involving lower limbs. The etiology could not be ascertained, despite extensive workup. Both cases were managed with supportive care and low-molecular-weight heparin and developed auto-amputation of toes.

CASE REPORT

Mary Henry, Kanwaljit Singh, Sowjanya Potturu

Lemierre's Syndrome: Not Just a Sore Throat

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:3] [Pages No:180 - 182]

Keywords: Dysphagia, Lemierre\'s syndrome, Oropharyngeal infection, Septic phlebitis, Septicemia, Thrombosis

PDF  |  DOI: 10.5005/jp-journals-10028-1447  |  Open Access |  How to cite  | 

Abstract

Lemierre\'s syndrome is a rare condition, sharing a symptom spectrum with some other viral diseases which can sometimes mask the diagnosis of the syndrome. It is important to keep a low threshold of the possibility of the syndrome, especially in someone who develops features of systemic upset after a sore throat. If undiagnosed and left untreated the syndrome can be fatal and can have severe multiorgan complications requiring various forms of medical and surgical interventions. We present the case of Lemierre\'s syndrome in a 32-year-old man who was successfully treated during an inpatient stay involving intensive care unit, followed by a community-based course of antimicrobial therapy for several weeks.

CASE REPORT

Nilofar Noor, Vidushi Kulshrestha, Kallol Kumar Roy, Kandala Aparna Sharma

Pregnancy in Post-splenectomized Myasthenia Gravis: A Case Report

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:3] [Pages No:183 - 185]

Keywords: Myasthenia crisis, Myasthenia gravis, Pregnancy, Pyridostigmine

PDF  |  DOI: 10.5005/jp-journals-10028-1443  |  Open Access |  How to cite  | 

Abstract

Aim and objective: We aim to emphasize the principles of management of pregnant women with a complex medical condition such as myasthenia gravis. Background: Myasthenia gravis is an autoimmune disorder affecting neuromuscular transmission resulting in fatigable weakness of skeletal muscles. Case description: We report a case of pregnancy with myasthenia gravis with a history of splenectomy. The patient was on oral pyridostigmine and prednisolone, which were continued in pregnancy. The patient received multidisciplinary care involving obstetrician, neurologist, anesthetist, and had an uneventful antenatal course. She had a normal vaginal delivery and her postpartum period was uneventful with neonate not developing any signs of myasthenia. Conclusion: This case highlights the importance of a multidisciplinary approach in managing pregnancy with myasthenia gravis for optimum maternal and neonatal outcomes. The patient should continue the drugs for myasthenia throughout pregnancy. Vaginal delivery is not contraindicated, with preparedness for intubation to tackle myasthenia crisis. Instrumental delivery may be needed for inadequate bearing-down efforts. Neonates should be monitored for 48 hours for transient neonatal myasthenia symptoms and may need pyridostigmine till symptoms resolve. Clinical significance: Autoimmune conditions like myasthenia gravis are not uncommon in women in the reproductive age-group. Hence, obstetricians need to acquaint themselves with the knowledge to ensure early diagnosis and appropriate management for a safe pregnancy outcome.

COMMENTARY

Neeraj Singla, Deba P Dhibar, Vikas Suri, Navneet Sharma

Low-cost Modifications in the COVID-19 Screening Outpatient Department in a Tertiary Care Hospital in North India in the Rational Use of Personal Protective Equipment

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:2] [Pages No:186 - 187]

Keywords: COVID-19, Healthcare workers, Preventive health, Rationale

PDF  |  DOI: 10.5005/jp-journals-10028-1433  |  Open Access |  How to cite  | 

Abstract

In the COVID-19 pandemic, infection control measures in a hospital setting are mainly aimed to reduce transmission of COVID-19 among healthcare workers working both in the COVID-19/non-COVID-19 areas. These include complete source control (covering the nose and mouth with appropriate masks to contain respiratory secretions), early identification (by widespread testing), isolation of patients with suspected disease, the use of appropriate personal protective equipment (PPE) while caring for patients with COVID-19, and ensuring proper disinfection of biomedical waste as per the standard hospital guidelines. At our institute, the screening outpatient department (OPD) room was separated for patients by a roof to floor fully covered with transparent glass partition with aluminum borders (Fig. 1). Communication with patients was established with mike (microphones) and speakers placed on both sides of the interphase for better audibility. It was sanitized with 1% Na hypochlorite solution three times a day.

CLINICAL TECHNIQUE

Monica Chhabra, Sharad Prabhakar, Devendra K Chouhan, Mandeep S Dhillon

Technical Note: Three-dimensional Gait Analysis

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:4] [Pages No:188 - 191]

Keywords: Gait, Gait analysis, Kinematics, Kinetics, Knee joint, Three-dimensional

PDF  |  DOI: 10.5005/jp-journals-10028-1445  |  Open Access |  How to cite  | 

Abstract

Quantitative gait analysis is the systematic measurement, description, and assessment of those quantities thought to characterize human locomotion. Optoelectronic motion capture system is a tool to conduct three-dimensional gait analysis and it helps us to acquire kinematic data, i.e., the angles and the kinetic data, i.e., forces along with spatiotemporal data which describe the fundamental gait characteristics. These are ultimately interpreted by the clinician(s) to form an assessment1 which helps in identifying the pathology and developing rehabilitation strategies to restore normalcy of gait. Keeping in view the above evidence and the paucity of Indian normative gait data, our study was designed to create a gender-specific, region-specific, normative spatiotemporal, kinematic, and kinetic dataset. We present a technical note on our method of three-dimensional gait analysis. The gait lab at PGIMER is equipped with BTS SmartTM (BTS Bioengineering, Milan, Italy) Optoelectric system which was used to record and measure spatiotemporal, kinematic, and kinetic data. The gait lab has a walkway embedded with 16 force platforms with sufficient space for acceleration and deceleration coupled with 6 infrared cameras and two real-time cameras, enabling the recordings of left and right feet to be made simultaneously with each trial recording at least three complete gait cycles at a self-selected pace. The data were captured, processed, and analyzed with strict adherence to a standardized protocol. The data were recorded for transverse, sagittal, and axial planes.

BIOSTATISTICS SERIES

Kamal Kishore, Vidushi Jaswal

Statistics Corner: Introduction to R and R Commander (Rcmdr)

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:5] [Pages No:192 - 196]

PDF  |  DOI: 10.5005/jp-journals-10028-1453  |  Open Access |  How to cite  | 

Abstract

Data collection and analysis is an integral component of medical research. Still, many medical students feel anxious while taking statistics courses—these are perceived as dry, dull, technical, and non-useful for clinical practice by medical students. Medical institutes struggle to motivate students to take statistics seriously—despite being, the same is necessary to capture, analyze, interpret, and understand patient data. The interest in statistics drops further when PowerPoint presentations full of notations and equations are used to teach. It is challenging for students to connect clinical practices with the utility of statistics. The time for rote teaching and training are the things of the past. 21st century problems demand 21st century solutions. It is better to teach statistics in a computer lab loaded with statistical software and actual medical data. Many institutes and departments have computer labs, but purchasing and renewing commercial statistical software is costly. Therefore, the question arises, is there any non-commercial easy-to-use reliable statistical software? A quick google search can display a long list of packages. However, almost all softwares restrict users in one way or the other. Of late, the adoption and popularity of R-software in the academic world have grown exponentially. R can be used, shared, and modified without any restriction. However, few doubts need clarification before adopting R in routine teaching and training. • What are R and Rcmdr? • Why use R and Rcmdr? • How to install R and Rcmdr? • Whom to contact for R and Rcmdr help?

Clinicopathological Conference Report

Ritambhra Nada, Dr Amber Parwaiz, Prof Krishnan Lal Gupta, Prof Subhash Varma

IgA Nephropathy Presenting as Reno-pulmonary Syndrome

[Year:2021] [Month:October-December] [Volume:55] [Number:4] [Pages:8] [Pages No:197 - 204]

PDF  |  DOI: 10.5005/jp-journals-10028-1455  |  Open Access |  How to cite  | 

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