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   2018| July-September  | Volume 8 | Issue 3  
    Online since July 27, 2018

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Uterine lipoleiomyoma and lipoma: A rare unique case report with review of literature
Shirish S Chandawale, Kunjal Mukesh Karia, Neekita S Agrawal, Amardeep A Patil, Abhinav B Shetty, Manpreet Kaur
July-September 2018, 8(3):193-195
DOI:10.4103/ijabmr.IJABMR_119_17  PMID:30123754
Uterine lipoleiomyoma and pure lipoma are uncommon and extremely rare benign lipomatous tumors. Reported incidence is 0.03%–0.25%. Pure cervical lipoma is exceptionally rare. These tumors commonly arise in postmenopausal women. Ultrasonography and computed tomography finding may be nonspecific. Although magnetic resonance imaging can be useful in identifying the fatty nature of the lesion preoperatively, most of the cases postoperatively on histopathological examination. Although various theories of histogenesis of these tumors have been proposed, histogenesis remains to be enigma. These lesions may have coexistent malignancy in uterus, ovaries, and fallopian tubes or may have other metabolic disorders and abnormal estrogen status. Immunohistochemical studies have played an integral role in understanding its complex histogenesis. We did not find any case study in medical literature in which uterine lipoleiomyoma and cervical lipoma have been described in hysterectomy specimen. We report a unique case of a 43-year-old premenopausal woman with complaints of irregular vaginal bleeding and lower abdomen pain. Lipoleiomyoma in uterus corpus and cervical lipoma were diagnosed in hysterectomy specimen.
  5 2,214 239
Oral health-related quality of life among patients after complete denture rehabilitation: A 12-month follow-up study
Kiran Kaushik, Pankaj Dhawan, Piyush Tandan, Meena Jain
July-September 2018, 8(3):169-173
DOI:10.4103/ijabmr.IJABMR_171_18  PMID:30123747
Introduction: Complete edentulism is an eventual oral health outcome and results from the combined pathology of dental caries, periodontal disease, or faulty method of rehabilitation due to reduced cost. Complete edentulism has a significant concern and leads to reduced quality of life (QoL) along with impact on general health. However, it has been observed that due to wider and better oral health services globally, edentulism rate is decreasing every decade. Edentulism is directly related to masticatory and nutritional problems, and some authors regard it as a good mortality indicator. Methodology: The sample population consisted of 100 individuals comprising 63 males and 37 females who fulfilled the inclusion criteria. Geriatric oral health assessment index (GOHAI) was administered by a single investigator at baseline (preinsertion) and also 6 and 12 months postdenture insertion. Sociodemographic data, including age and gender, were also collected. Results: It was observed that the overall oral health-related QoL (OHRQoL) scores of the sample improved significantly at 6 and 12 months postinsertion (P < 0.001) when compared to baseline scores. When GOHAI scores were compared individually for males and females (pre- and post-insertion), it was observed that there was statistically significant improvement in OHRQoL (male – pre = 25.02 ± 1.34 and post-12 months = 8.84 ± 1.26, P < 0.001, female – pre = 25.19 ± 0.88 and post-12 months = 9.05 ± 1.20, P < 0.001) postinsertion of denture in both the groups. Conclusion: OHRQoL in patients improved after complete denture rehabilitation. There was an upward shift in score for each item in GOHAI from preinsertion to 6 and 12 months postinsertion of dentures, reflecting improvement in OHRQoL of the sample.
  5 2,654 383
Sleep paralysis, a medical condition with a diverse cultural interpretation
Esther Olunu, Ruth Kimo, Esther Olufunmbi Onigbinde, Mary-Amadeus Uduak Akpanobong, Inyene Ezekiel Enang, Mariam Osanakpo, Ifure Tom Monday, David Adeiza Otohinoyi, Adegbenro Omotuyi John Fakoya
July-September 2018, 8(3):137-142
DOI:10.4103/ijabmr.IJABMR_19_18  PMID:30123741
Sleep paralysis (SP) is a state associated with the inability to move that occurs when an individual is about sleeping or just waking. It could occur in healthy individuals as isolated SP. It has also been linked with other underlying psychiatry, familial, and sleep disorders. Statistics show that 8% of the general population suffers from SP. Although this value has been described inaccurately, there is no standard definition or etiology to diagnose SP. There are several speculations describing SP in the current literature. These descriptions can be viewed as either cultural-based or medical-based. The disparity among cultural or ethnic groups and medical professionals in identifying SP has led to the various approaches to managing the condition. This review aims to medically describe SP and how it is interpreted and managed among various cultural groups.
  3 12,312 970
Root canal morphology of maxillary first premolars using the clearing technique in a South Indian population: An In vitro study
Chethana Dinakar, Urvashi A Shetty, Varsha V Salian, Pushparaja Shetty
July-September 2018, 8(3):143-147
DOI:10.4103/ijabmr.IJABMR_46_18  PMID:30123742
Background: The success of root canal therapy requires a good knowledge of root canal morphology. Literature review shows variations in a number of roots and canal morphology in studies done across the globe. Aim: The purpose of this study was to evaluate the root canal morphology in maxillary first premolars using the clearing technique in a South Indian population. Methodology: Two hundred and twenty-five extracted noncarious, nonfractured, sound maxillary first premolars were collected, cleaned, and were injected with India ink to stain the root canals. Teeth were then decalcified and cleared using methyl salicylate. Teeth were then viewed under a stereomicroscope to evaluate the number of roots, root canal morphology based on the Vertucci's classification, variations, and additional features such as accessory root canals, lateral canals, furcation canals, isthmus, and apical delta. Results: Nearly 52.88% of maxillary first premolars were single rooted, 44.88% had two roots, and 2.22% had three roots. Vertucci's Type IV root canal configuration was the most common type in maxillary first premolars and was seen in 66.51% of cases followed by Type II in 13.4%. Type I was seen in 9.76%, Type VI in 6.51%, Type VIII in 2.32%, Type III in 0.46%, Type V in 0.46%, and Type VII in 0% of teeth. Conclusion: The majority of the maxillary first premolars included in our study were single rooted and Vertucci's Type IV was the most common type of root canal configuration.
  3 2,814 464
Lack of awareness of pharmacovigilance among young health-care professionals in India: An issue requiring urgent intervention
Jagjit Singh, Harmanjit Singh, Ravi Rohilla, Rajiv Kumar, CS Gautam
July-September 2018, 8(3):158-163
DOI:10.4103/ijabmr.IJABMR_423_17  PMID:30123745
Background: Young healthcare professionals (HCPs) are the pillar of healthcare system. The objective of the present study was to assess the knowledge, attitude, and practices of young HCPs regarding adverse drug reactions (ADRs) reporting. Methods: This cross-sectional questionnaire-based study was conducted on young HCPs in a tertiary care teaching hospital of North India. The study instrument was semi-structured, prevalidated questionnaire. The responses obtained were compared among doctors and nursing professionals. Results: We obtained response from 84 HCPs (61 doctors and 23 nurses). The mean age of the doctors and nurses was 25.0 ± 2.4 versus 26.3 ± 3.4 years, respectively. No significant difference was observed in questions related to definition of ADR, components of pharmacovigilance (PV), who can report ADRs and medications for which ADRs are to be reported. Only 9.8% doctors and 26.1% nurses were aware of ADR reporting system in India, of which 6 (26%) nurses and none of the doctors were aware of its name. About 16.4% doctors as compared to 61% nurses admitted to have reported an ADR (P < 0.001). The main discouraging factor in ADR reporting was time constraint while lack of knowledge was also highlighted by the HCPs. More nurses as compared to doctors (78.3% vs. 49.2%, P = 0.01) were of the opinion that holding continuing medical education/workshop could encourage reporting. Conclusion: There is an urgent need to increase awareness about PV among young HCPs, and adequate interventions should be instituted to encourage PV practices.
  3 2,612 349
Changes in the internal size of the jugular vein in adult patients with hypovolemia
Aleksandr L Urakov, Aleksei V Shchegolev, Anton A Kasatkin, Anna R Nigmatullina
July-September 2018, 8(3):174-176
DOI:10.4103/ijabmr.IJABMR_277_17  PMID:30123748
The present study is aimed at establishing the values of internal jugular vein (IJV) anterior-posterior and medial-lateral sizes in patients with hypovolemia. A total of 25 adult Intensive Care Unit patients with hypovolemia were studied. It was found that the anterior-posterior vein size in patients with hypovolemia was significantly less than medial-lateral size during inhalation and during exhalation as well (P < 0.05). Besides, the value of the anterior-posterior size (Dmin) <7 mm was recorded in 20 from 25 patients (80%). At the same time, the medial-lateral size (Dmin) <7 mm was recorded only in six patients (24%). In patients with hypovolemia, the medial-lateral diameter of IJV is more than its anterior-posterior diameter. These data might be useful for justifying the benefits of using lateral access for IJV catheterization under ultrasound imaging in patients with hypovolemia.
  2 1,577 135
An unexpected encounter with foreign body in the primary teeth and its management
Chinta Mahesh, Dwitha Animireddy, Shanthan Mettu, Manasi Kulkarni
July-September 2018, 8(3):181-183
DOI:10.4103/ijabmr.IJABMR_264_17  PMID:30123750
Clinicians may come across strange situations when they accidentally notice foreign bodies in the root canals of the teeth. This foreign body entrapment is more common in children because of the habit of placing various objects into the tooth, particularly in the cases of open carious lesions. Sometimes, these foreign objects may act as an impending source for pain and infection. Even though accidental insertion is the main etiological factor, there are other possibilities such as self-injurious habits and dental neglect which should be ruled out by thorough history. The present article describes two cases of typical etiology for foreign body lodgment and its management in the primary teeth.
  2 1,751 210
Pharmacokinetics and oxidation parameters in volunteers supplemented with microencapsulated docosahexaenoic acid
Ivan M Petyaev, Natalya E Chalyk, Victor A Klochkov, Dmitry V Pristensky, Marina P Chernyshova, Nigel H Kyle, Yuriy K Bashmakov
July-September 2018, 8(3):148-154
DOI:10.4103/ijabmr.IJABMR_367_17  PMID:30123743
Context: Docosahexaenoic acid (DHA) is an omega-3 fatty acid essential for cardiovascular health, brain development, and reproductive function. Due to hydrophobicity and low DHA bioavailability, new microencapsulated DHA formulations are under development. Aim: This study aims to evaluate DHA pharmacokinetics (PKs) and biological oxidation parameters in volunteers ingesting a newly developed lutein-containing lycosomal formulation of DHA (LF-DHA). Materials and Methods: A total of 32 healthy volunteers (40–65 years old) with signs of oxidative stress (OS) and subclinical hypoxia were orally supplemented for a month with 250 mg of regular DHA (1st group) or a combination of lutein (7.0 mg) and zeaxanthin (1.4 mg) (2nd group). The third group received regular DHA (250 mg) co-ingested with lutein/zeaxanthin (7.0/1.4 mg), whereas the 4th group was given LF-DHA containing lutein/zeaxanthin (7.0/1.4 mg). PK, OS, and oxygenation parameters were analyzed. Results: LF-DHA improved the PKs of DHA enhancing its serum concentrations time dependently by 34.6% and 94.1% after 2nd and 4th weeks, respectively. DHA and lutein ingested either alone or simultaneously as two separate formulations reduced the levels of OS markers. However, LF-DHA inhibited the malonicdialdehyde (MDA) and oxidized low-density lipoprotein values were better than other formulations. LF-DHA also enhanced the plasma oxygen and tissue oxygen saturation. This effect was significantly higher than in other groups. Conclusion: LF-DHA eliminates the need in high-dose DHA supplementation protocols and confers a higher DHA bioavailability, thereby improving the parameters of biological oxidation and tissue respiration in affected individuals.
  2 6,018 380
“Collateral damage:” Horner's syndrome following excision of a cervical vagal schwannoma
K V Praveen Kumar, Md Shahid Alam
July-September 2018, 8(3):190-192
DOI:10.4103/ijabmr.IJABMR_439_16  PMID:30123753
Horner's syndrome is characterized by triad of blepharoptosis, miosis, and anhydrosis on the lateral part of the face. Incidence of iatrogenic Horner syndrome resulting from neck surgeries has been reported between 10% to 18.5%. Iatrogenic Horner syndrome resulting from excision of cervical vagal nerve schwannoma is uncommon, and has rarely been mentioned in literature. We report a rare case of iatrogenic preganglionic Horner's syndrome resulting from excision of a cervical vagal schwannoma. An 18 years old female presented with the complaints of sudden drooping of right upper lid associated with reduced sweating on right side of face for the past 3 months. There was history of excision of a right cervical vagal schwannoma. Ocular examination revealed mild ptosis, miosis with anisocoria more in scotopic illumination. Photographs of the patient prior to surgery showed no evidence of ptosis. Preoperative Magnetic resonance imaging revealed a mass suggesting a vagal nerve schwanomma. A diagnosis of iatrogenic preganglionic Horner's syndrome was made and the patient was kept under follow up. Horner's syndrome is an uncommon sequelae of cervical vagal schwannoma excision that results from injury of the cervical sympathetic chain intraoperatively and hence should be discussed with the patient during pre-operative counseling.
  1 1,774 128
Failure of eruption of permanent tooth
J Bhuvaneswarri, SC Chandrasekaran
July-September 2018, 8(3):196-198
DOI:10.4103/ijabmr.IJABMR_366_17  PMID:30123755
Primary failure of eruption (PFE) is a rare condition that can lead to posterior open bites. It is difficult to diagnose and difficult to treat. PFE appears to be a condition that predominantly affects the molar dentition. The increased frequency of hypodontia in affected individuals and common findings of a family history regarding tooth eruption problems suggests a significant genetic component to the etiology of this rare condition.
  1 2,195 296
Simple mortality predictive models for improving critical care in resource-limited settings: An insight on the modified early warning score and rapid emergency medical score
Mazou Ngou Temgoua, Joel Nouktadie Tochie, Valirie Ndip Agbor, Frank-Leonel Tianyi, Ronni Tankeu, Celestin Danwang
July-September 2018, 8(3):199-201
DOI:10.4103/ijabmr.IJABMR_15_18  PMID:30123756
Mortality rate among critically ill patients admitted to the Intensive Care Unit is high, particularly in low-income countries (LIC). Many scores have been developed to predict these fatal outcomes. In LIC, the applicability of scoring systems is precluded by the unavailability of resources to compile all the parameters of these scores. Herein, we highlight the advantages of two models: the Modified Early Warning Score (MEWS) and the Rapid Emergency Medical Score (REMS). The REMS and the MEWS have the advantage of being accurate, simple, inexpensive, and practical for LIC.
  1 1,992 239
Assessment of differences in pupil size following phacoemulsification surgery
Ibrahim Sahbaz
July-September 2018, 8(3):155-157
DOI:10.4103/ijabmr.IJABMR_211_17  PMID:30123744
Purpose: The purpose of this study is to detect the changes in pupil size developing after phacoemulsification surgery. Methods: Seventy-five eyes of a total of 49 patients (32 males and 17 females) were included in this prospective clinical trial. Routine preoperative ophthalmological examinations of the patients were performed. The presence of any systemic diseases, the presence or history of ocular trauma, uveitis, optic neuropathy or anisocoria, using ocular or systemic medications, and also the presence of any other serious ocular diseases except cataract was considered as criteria for exclusion. The age range of patients included in the study is 48–81 years. Patients who developed surgical complications were excluded from the study. Pupil measurements were made after each patient waited in a dark room for 5 min preoperatively and were repeated 1 month after the operation. The Oasis brand of pupillometer was used for pupil measurement. Results: The mean, standard deviation, median, minimum-maximum, ratio, and frequency were used for the descriptive statistics of the data. Postoperative pupil size was seen to significantly decrease compared to the preoperative period (P < 0.05). The mean value of preoperative pupil size decreased from 4.9 ± 1.0 to 4.1 ± 0.9 mm 1 month after operation. Conclusion: The pupil size is important in phacoemulsification especially combination with phacoemulsification and multifocal intraocular lens implantation. It should be considered that better postoperative visual outcomes would be obtained by accompanying postoperative pupil size reduction into preoperative measurements. Thus, we recommend MIOLs that function independent of pupil size as appropriate for cataract surgeries in elderly patients.
  1 0 0
Immunoglobulin a myeloma in a newly diagnosed sickle cell disease patient
John Ayodele Olaniyi, Khadijah Bolanle Shonde-Adebola
July-September 2018, 8(3):177-180
DOI:10.4103/ijabmr.IJABMR_107_17  PMID:30123749
Several neoplasms including hematological malignancies occurring in very few patients with sickle cell syndromes have been reported in literature, particularly as survival among these patients and diagnostic accuracy have continued to improve. Multiple myeloma (MM) has rarely been reported in patients with hemoglobin (Hb) S + C. We report a 65-year-old retired banker who was recently diagnosed with HbS + C. This patient developed MM with markedly elevated erythrocyte sedimentation rate, mild anemia, 80% bone marrow plasmacytosis, and elevated serum immunoglobulin A level, while plain X-ray of the lumbosacral spine showed multilevel vertebral collapse.
  - 1,648 146
Combined ST elevation in a case of acute myocardial infarction: How to identify the infarct-related artery?
Kavitha Balasubramanian, Balasubramanian Ramachandran, Anandaraja Subramanian, Kandan Balamurugesan
July-September 2018, 8(3):184-186
DOI:10.4103/ijabmr.IJABMR_365_16  PMID:30123751
Combined ST elevation in anterior and inferior ECG leads in acute myocardial infarction is not a rarity. It is both interesting and challenging to indentify the infarct related culprit artery. We report the case of a middle aged male with acute myocardial infarction whose admission ECG shows ST elevation in lead II, III, aVF as well as from V1-V3. 90% of such cases are due to single vessel occlusion - majority due to proximal RCA occlusion and the remaining due to mid to distal LAD occlusion. ECG features to differentiate between these two vascular occlusions are discussed. In this case at hand, lead III ST elevation of 2.5 mm and V2/V3≥ 1 indicates proximal RCA as the IRA and the same has been confirmed by pre-discharge coronary angiogram .
  - 1,605 177
Breast lump: A rare presentation of tuberculosis
Ravish M Kumar, Santosh Laxman, Prashant Parandekar
July-September 2018, 8(3):187-189
DOI:10.4103/ijabmr.IJABMR_238_17  PMID:30123752
Tuberculosis presenting as breast lump is a rare disease. This condition usually occurs in females who are in the reproductive age group. Diagnosis is quite difficult unless prompt investigations are meticulously done. They are often mistaken for malignancy. We report a 19-year-old girl with tubercular breast abscess. The abscess was incised and drained based on fine-needle aspiration cytology and ultrasonography revealed it as pyogenic abscess. Ziehl–Neelsen stain (ZN stain) of the pus sample showed acid-fast bacilli. Now, she has been started on antitubercular treatment.
  - 1,703 240
Novel lipid-lowering agents proprotein convertase subtilisin-kexin type 9 inhibitors: Do they show mortality benefits?
Rajiv Mahajan
July-September 2018, 8(3):135-136
DOI:10.4103/ijabmr.IJABMR_217_18  PMID:30123740
  - 2,124 302
The role of cilia in the setting of isomerism and why isomerism is not a subset of heterotaxy
Rohit S Loomba, Robert H Anderson
July-September 2018, 8(3):202-202
DOI:10.4103/ijabmr.IJABMR_71_18  PMID:30123757
  - 1,350 162
Effect of lidocaine on olfactory perception in humans
Churunal Hari, Ben Grimshaw, Tim Jacob
July-September 2018, 8(3):164-168
DOI:10.4103/ijabmr.IJABMR_2_18  PMID:30123746
Objective: The effect of local anesthesia to the nasal mucosa on olfactory acuity is the subject of some debate. This study was aimed to investigate the effect of local anesthesia on olfactory perception. Materials and Methods: Six healthy participants, five males and one female, were chosen from the academic population of Cardiff University. Olfactory perception was monitored at intervals following administration of 4% lidocaine to the nasal mucosa in the volunteers. Lidocaine was administered using a nasal spray as used in routine otolaryngological investigations. The olfactory stimulus (amyl acetate) was delivered directly to the nostril using an olfactometer. Olfactory perception was determined by the use of a 13 trial, forced choice scoring task. Results: Lidocaine caused a small, transient reduction in olfactory perception. The maximum reduction in olfactory perception (35%) was achieved by 60 mg lidocaine 15 min following administration, but perception could be increased to almost normal levels by increasing the odor stimulus dose. Detection of the lowest stimulus strength returned to normal levels after 30 min. Conclusions: Intranasal application of lidocaine, caused a reduction in olfactory perception, however, did not abolish the olfactory function 15 min following administration. Physiological/psychometric olfactory testing would not be precluded under these circumstances, and the effects of anesthesia could be overcome by increasing the stimulus strength.
  - 1,697 205