International Journal of Medical Science and Clinical invention <p style="text-align: justify;"><strong>International Journal of Medical Science and Clinical&nbsp;invention </strong></p> <p style="text-align: justify;">IJMSCI is an international, peer-reviewed open access journal of medicine published in English. The journal's publisher is the Valley International</p> <p style="text-align: justify;">The Journal aims at publishing evidence-based, scientifically written articles from different disciplines of medical sciences. The Journal welcomes articles of general interest to audiences of medical researchers especially when they contain new information. Articles of clinical evaluation of drugs and other therapies,&nbsp;epidemiology&nbsp;studies in general population, studies on pathogenic organisms and toxic materials, toxicities and adverse effects of therapeutics are welcome.</p> <p style="text-align: justify;">When written in language other than English and has not been propagated in any international information services (abstract journals), secondary publication of the article is negotiable.</p> en-US (Valley International) (Dr. Vivek Dainel) Wed, 01 Aug 2018 15:18:59 +0000 OJS 60 Clınıcopathologıcal Features of Melanoma In Muğla <p><strong>Introduction:</strong> Melanoma<strong><em>, </em></strong>a neoplasm of melanocytes is &nbsp;the most aggressive and life-threatening skin cancer. The incidence of it is higher in fair skinned people as the Ultraviolet-light exposure is the most important risk factor with the malignant transformation of the nevi. So here we aimed to determine the clinical and histopathological findings of our Melanoma cases.</p> <p><strong>Method: </strong>We reviewed the tumors of the patients who received the diagnosis of Melanoma at our Pathology Laboratory, between 2011 and 2018 retrospectively.</p> <p><strong>Results and Discussion: </strong>There were 43 skin Melanoma cases. 21(48.8%) of the patients were female, 22(51.2%) were male. &nbsp;The median-age in females was 68, while 64 in males. 35(81.4%) of the 43 cases were Nodular Melanoma(NM), 3(7%) were Superficial-spreading melanoma(SSM) and 5(11.6%) were Melanoma-in-situ(MIS). None of the SSMs and MISs had metastasis to anywhere.</p> <p>7(20%) of the NMs had lymph-node and 3(8.6%) had soft tissue metastasis at the time of diagnosis. 4 developed lung, brain, stomach and nasopharinx metastases in the following 2 years. The ratio of the Clark Level 2,3,4,5 of NMs were 11.4%, 28.6%, 45.7% and 14.3% respectively. Most of the metastatic cases were Clark Level 3 or 4. This study showed that Melanoma is generally diagnosed at WHO-Stage 2 or 3 and this cause worse prognosis as the cure rates depend greatly on the stage.</p> <p><strong>Conclusion:</strong> As a result it’s very important to self-examine the existing nevi on our skin in order to detect the early malignant transformation to Melanoma and protect our skin from Ultraviolet-light.</p> Özgür İLHAN ÇELİK ##submission.copyrightStatement## Wed, 01 Aug 2018 00:00:00 +0000 Correlates of Men’s Willingness to Undergo Safe Circumcision in the Era of the HIV/AIDS in Botswana <p><strong>Definition and concepts: </strong>&nbsp;Male Circumcision is simply defined as the removal of a fold of loose skin (the foreskin or prepuce) that covers the glans of the flaccid penis. It has been practiced as a religious rite since time immemorial, which has been commonly &nbsp;practiced by all African societies among all religious denominations, especially by the Ethiopian Coptic Church.&nbsp;</p> <p><strong>Motivation and Objectives:</strong>&nbsp; Circumcision is recommended as a global efforts to combat the prevalence of the HIV/AIDS pandemic, for it has been widely believed to be important intervention strategy to tackle the scourge since 2007.&nbsp;</p> <p><strong>Data Sources: </strong>In 2008, Botswana AIDS Impact Survey Programme (BAIS- III) was conducted, based on two stages stratified sampling design.The study covered 8275 households, systematically drawn from selected Primary Sampling Units PSU’s), known as Enumeration Areas (EA’s<strong>).</strong><strong>&nbsp;</strong></p> <p><strong>Methodolgy: </strong>Using the SPSS Package Programme,&nbsp; the&nbsp; target&nbsp; group&nbsp; was screened to constitute 5647 males within the 10-49 age bracket, consisting of about 622(11%) circumcised&nbsp; and 5025 (89 %) uncircumcised. However, the number of the uncircumcised males who responded willing to undergo Safe Male Circumcision(SMC) were 3046 (61%) and those not willing were 1979(39%).&nbsp;</p> <p><strong>Analytical Approaches:</strong> The appropriate statistical analytical models of analysis include the <em>univariate frequency distribution, bivariate chi-squares (X<sup>2</sup>) technique and the Logistic Regression Model.</em></p> Patrick Seitiso Seitiso, Dr.Hadgu Bariagaber ##submission.copyrightStatement## Wed, 01 Aug 2018 00:00:00 +0000 Impact of pesticide and herbicide on pituitary and gonadal hormone secretion in Heteropneustes fossilis (Bloch) <p>The reproductive toxicity, mainly changes in hormonal status and gonadosomatic index (GSI), of the insecticide chlorpyrifos and herbicide 2, 4- Dichlorophenoxyacetic acid (2, 4-D) was studied in both male and female fish namely<em> Heteropneustes fossilis.</em> Pituitary and gonadal hormone quantification was performed using enzyme- immunoassay (ELISA). Sample of blood and gonads were collected for hormones (testosterone, estradiol, gonadotropin I (GtH I) and gonadotropin II (GtH II)) analysis and determination of GSI respectively. Chlorpyrifos at dose levels of 1.42 ppm and 0.28 ppm and 2, 4-D of 3.00 ppm and 0.60 ppm were exposed to fish population for 30 days. Chlorpyrifos brought about marked reduction in all the studied plasma hormonal level except in GtH I of female fish. Of the two pesticides used in the present experimental setup, 2, 4-D at higher concentration is found to be more potent in declining all the hormonal parameters at the terminal part of the experiment, except estradiol at higher dose of treatment. GSI was significantly reduced in female fish (p&lt;0.01) compared to male during pre-spawning and spawning phases.</p> Nazia Khatun, Rita Mahanta ##submission.copyrightStatement## Sat, 04 Aug 2018 00:00:00 +0000 The Use of Prosthetic Vacuum Socket Suspensions: A Comparison of a Modified Bicycle Pump to Commercially Available Options <p>There are approximately 35-40 million people requiring orthotic and prosthetic services in developing countries (World Health Organization, 2017). Elevated vacuum, as a form of socket suspension, has been documented to decrease limb volume change, improve amputee proprioception, circulation, comfort, gait symmetry, and overall quality of life of amputees (Gholizadeh, Lemaire, Eshraghi, 2016). While these systems may benefit many amputees in developing countries, the high cost, accessibility, and maintenance of current elevated vacuum systems are not a feasible option. The purpose of this study was to evaluate how a simple modified bicycle pump compares to commercially available vacuum pumps. Results from the study show that a modified bicycle pump can achieve a maximum vacuum level of 21.7 inHg (57.6 kPa), comparable to commercially available options, and can achieve 17 inHg (57.6 kPa), significantly faster than commercially available pumps at a price point of $15.00.</p> Ryan Propst, Matthew Buns Ph.D ##submission.copyrightStatement## Wed, 08 Aug 2018 16:20:36 +0000 Assessment of Awareness and Attitudes towards Over the Counter Drugs among Urban Population: An Analytical Questionnaire Study <p>Over-The-Counter drugs are also known as Non prescription drugs. These are safe drugs and can be sold over the counter, by the chemist without prescription. More products have been deregulated for purchase without a prescription<strong>.</strong> Increasing availability of non-prescription medicines may encourage patients to believe that there is a drug treatment for every ailment. Furthermore, the use of such products may delay/mask the diagnosis of serious illness<strong>,</strong> with increased risks of interactions and adverse reactions<strong>.</strong> There is also the potential for misuse and abuse of such products<strong>.</strong> In India, the import, manufacture, distribution and sale of drugs and cosmetics are regulated by the Drugs and Cosmetics Act (DCA) and its subordinate legislation, the Drugs and Cosmetics Rules (DCR).This legislation applies to the whole of India and to all sorts of medicines (e.g. allopathic, ayurvedic, homeopathic, etc.) whether imported or made in India. A questionnaire regarding OTC drug was distributed to the 100 persons those coming to the pharmacy for self medication to assess the awareness and attitude towards over-the-counter (OTC) drugs amongst urban population.</p> Akhilesh Kumar, Anubhuti Khare ##submission.copyrightStatement## Thu, 09 Aug 2018 07:04:57 +0000 Evaluation of Practice of Self Medication among Medical and Nursing Students- A Comparative Analytical Study <p>Self-medication is defined as the use of medication, whether modern or traditional, for self treatment. Self care can be defined as primary public health resource in the health care system. It consists of the health activities and health related decision making of individuals, family, friends, colleagues at work and so on. It includes self-medication, non-drug self treatment, social support in illness and first aid in everyday life. Self Medication is practiced in all ages and by both sexes. Self-medication affects both developed as well as developing countries. Previous studies report that there is increase in trend of self-medication globally and so in India as well. In developing countries like India, easy availability of a wide range of drugs coupled with inadequate health services results in increased proportion of drugs used as self· medication compared to prescribed drugs. The present study was a questionnaire based study conducted in Tertiary Health Care Teaching Institute and University of Central India. The study population consists of Second Year Medical and Second Year Nursing Students. A Prevalidated Questionnaire containing questions regarding self medication was distributed to participants who were present on the day of study and showed willingness to participate in the study. Out of total 130 respondents, Medical and Nursing students were 80 and 50 respectively. The practice of self-medication was common in both the groups, with more prevalence in Nursing students. Medical students were found to be more cautious regarding self-medication and preferred seeking consultation as compared to Nursing students, indicating a positive influence of medical knowledge over their practice of self-medication.</p> Prashant Wadagbalkar, Akhilesh Kumar ##submission.copyrightStatement## Thu, 09 Aug 2018 07:09:34 +0000 Colonic diverticulitis in young patients <p><strong>Background:</strong> No consensus exists regarding elective surgery in young patients with diverticulitis. We hypothesized that most young patients with diverticulitis do not require colectomy after the first event.</p> <p><strong>Design:</strong> We conduct a single-institution retrospective study using the hospital records and a phone survey. Fifty-four patients younger than 40 were treated for acute diverticulitis between years 2000-2013. We measure outcome by mean of subsequent hospitalizations after the first attack, continuing symptoms, and the need for emergency or elective colon surgery.</p> <p><strong>Results:</strong> 17 patients had right and 37 left colon diverticulitis. The mean age was of 33.2 and the mean follow-up was of 6.5 years. Most patients with right-sided disease suffered from solitary cecal diverticulitis (n=14), most of them were discovered intra-operatively for suspected appendicitis. Three patients had ascending colon diverticulitis and were successfully managed with antibiotics. 78% of the patients with left sided diverticulitis (n=29) didn't had recurrence but 2 patients ultimately underwent elective sigmoidectomy because of continuing symptoms. There were 6 patients with one or two recurrences, 2 of them underwent elective colectomy. One of the two patients with three or more recurrences required emergent sigmoidectomy during the 3<sup>rd</sup> attack. No patient with left sided diverticulitis required an emergent operation during the first episode. The first attack was more severe and hospital stay was longer in the group with recurrent disease than in the group without recurrence.</p> <p align="LEFT"><strong>Conclusions:</strong> Colonic diverticulitis in young people is usually a mild disease and few patients suffer recurrent disease. We recommend elective segmental colectomy for patients with continuing symptoms in the ambulatory setting and for the group of patients with a more severe first attack who suffer from recurrent episodes.</p> Raphael Fedidat MD, Amram Hadary MD, Igor Waksman MD ##submission.copyrightStatement## Tue, 14 Aug 2018 15:12:15 +0000 Safety Measures and Health Issues among Pesticide Applicators in Foumbot Agricultural Area, West Region, Cameroon <p>Several reports have raised the misuse of pesticides in the protection of crops in the Foumbot agricultural area. This study aims at evaluating the health status of pesticide operators in the said area. 127 farmers were interviewed out of which 30 were selected for medical check-up. A diagnostic was done on the liver status and a physical checkup on the eyes, the respiratory system and the skin of 30 selected pesticide applicators following the medical laboratory routine examination. The skin of users was diagnosed for itching, prickling, irritation and burns;&nbsp; the eyes for sight troubles, stinging, wateriness; the respiratory system for catarrh, cough , difficulties in breathing and chest constriction; the liver status was estimated using two enzymes: Aspartate Amino-Transferase (ASAT) and Alanine Amino-Transferase (ALT).&nbsp; As results: pesticides used are from three main classes and belong to classes II and III toxicity: insecticides (cypermethrin, most used), fungicides (ethylenebisdithiocarbamates) and herbicides (paraquat and glyphosate).&nbsp; 40% of workers showed liver alteration, the skin of workers was affected and revealed itching, prickling, irritation and burns; the eyes showed sight troubles, stinging and wet eyes; the respiratory system was affected with catarrh, cough, difficulties in breathing and chest constriction; 40% of workers showed liver alteration.&nbsp; The poor safety measures observed affects the health of workers. Pesticide users in the Foumbot agricultural area manifested symptoms and signs related to pesticide effects on human beings. A study is now needed to do a follow-up on a particular group of people for a long term toxicity study.</p> Sonchieu Jean, Fotsing Stephano Franklin, Akono Edouard Nantia, Ngassoum Martin Benoit ##submission.copyrightStatement## Tue, 14 Aug 2018 15:42:27 +0000 Safety and Efficacy of a Zinc Gluconate Solution in Management of Paediatric Diarrhoea <p><strong>Introduction:</strong> Diarrhoea is worldwide health problem in paediatric patients. It is the second leading and primary cause of morbidity and mortality in childhood in India. Zinc deficiency is prevalent among children in developing countries and is one of the reasons which cause diarrhoea. WHO, UNICEF, IAP and NRHM have advocated the use of Zinc for the treatment of paediatric diarrhoea. This study was conducted to evaluate the safety and efficacy of Zinc gluconate in Indian paediatric diarrhoea patients.</p> <p><strong>Methodology:</strong> Study was planned in 200 patients. The duration of the study was 5 days. There were 3 visits (Baseline, Day 3 and Day 5) planned. Efficacy assessment was made by studying the change in stool consistency (hard/soft/semisolid/ watery) and reduction in average stool frequency. Safety assessment was made by analysing the adverse events during the clinical trial. All the patients received Zinc gluconate solution (20mg/day) with ORS.</p> <p><strong>Results:</strong> Out of 200 patients, 182 patients completed the study. Efficacy assessment was made by analysis of change in stool consistency and frequency. As compared to baseline visit, it was found that in conclusion visit the patients with watery stools are shifted to soft and semisolid stool and some patients were found with hard stools. The average stool frequency at baseline visit was 7.07 which reduced to 3.5 in conclusion visit.</p> <p><strong>Conclusion:</strong> Zinc gluconate with ORS therapy is safe and efficacious in treatment of diarrhoea in Indian paediatric patients. &nbsp;</p> Dr. Mayuresh Dilip Kiran, Shaheen Naseem Sheikh, Lalit Jeevan Pawaskar ##submission.copyrightStatement## Sun, 19 Aug 2018 07:38:47 +0000 Assessment of Pregnancy Induced Hypertension by Urine Analysis <p><strong>Bac</strong><strong>k</strong><strong>gro</strong><strong>und</strong>: Proteinuria is a major component of preeclampsia. Urine protein measurement after 24 hour urine collection is the traditional standard method for the detection of proteinuria. It is time consuming. As an alternative, random spot sampling for a urine protein to creatinine ratio has been investigated.</p> <p><strong>Objective</strong>: Screening for preeclampsia by urine albumin to creatinine ratio.</p> <p><strong>Methods</strong>: The study was conducted on 190 antenatal women with gestational age 16-18 weeks. Specimens for measuring protein to creatinine ratio are obtained. Urine albumin was estimated by Bromocresol green assay and urine creatinine level was estimated by modified Jaff’s reaction. Urinary albumin to creatinine ratio of 0.2 or more was considered to be abnormal.</p> <p><strong>Results</strong>: Out of 190 women 30 women had urine albumin creatinine ratio &gt; 0.2 and 12 (40%) developed preeclampsia while out of 160 women with urine albumin to creatinine ratio &lt;0.2 only 4 (2.5%) developed preeclampsia. The sensitivity, specificity, positive predictive value and negative predictive value of the test were 75%, 89.6%, 40% and 97.5% respectively.</p> <p><strong>Conclusion</strong>: Spot urinary albumin to creatinine ratio is a reasonable rule out test for significant proteinuria. The Albumin to creatinine ratio is highly predictive to detect proteinuria and can be used as a rapid alternative test.</p> Bachaspati Dash ##submission.copyrightStatement## Sun, 19 Aug 2018 07:44:57 +0000 Study Profile of Patients Attending Dog Bite Clinic of A Tertiary Care Hospital Of Nagpur <p><strong>INTRODUCTION: Dog attacks</strong>, by street or domestic dogs, with injuries from very minor to significant and severe to fatal, are not uncommon. Attacks on the serious end of the spectrum have become the focus of increasing media and public attention.To study the epidemiological characteristics of dog bite injuries and the knowledge, attitude &amp; practices of the subjects regarding dog bite.</p> <p><strong>MATERIAL &amp; METHOD: </strong>A cross-sectional study of 422 dog bite victims reported at ARV Clinic of NKPSIMS&amp;RC, Nagpur for medical advice and post exposure immunization against rabies during past one year has been done.&nbsp; Statistical analysis was done by Epi Info software.</p> <p><strong>RESULT &amp; DISCUSSION: </strong>422 victims of dog bite comprised of 75.8%&nbsp; males, 31.5 %&nbsp; in 21 - 30 years age-group and&nbsp; 73.93%&nbsp; class III exposures victims and unprovoked bite in majority of victims. Extremities were involved in 89.33% victims.&nbsp; Maximum bites occurred during May-June. 80.8% were bitten by a stray dog. Only 52.1% of the victims reported for treatment within 24 hours .Majority of patients did not take any treatment till the time of reporting. Half of the subjects mentioned that a person could go mad after being bitten.&nbsp; 84.1% did nothing to control freely roaming dogs that had bitten.</p> <p><strong>RECOMMENDATIONS: </strong>The type, nature, site, geographical distribution &amp; seasonal variations in dog bite victims show a definite interactive trend.</p> <p><strong>CONCLUSION: </strong>Wisely developed intervention model, based on epidemiological triad, for causation of rabies shall be quite helpful in prevention and control of the rabies victims.</p> Dr. MohdJunaid, Dr. Sachin Patil ##submission.copyrightStatement## Sun, 19 Aug 2018 07:50:27 +0000