Dr. Ashish Anand

Staff Orthopedics Surgeon, VAMC Jackson, Mississipi, USA.
Associate Professor, Department of Orthopedics, University of Mississipi Med Ctr, Jackson, USA.
Professor, William Carey school of Osteopathic Medicine, Hattiesburg, Mississippi, USA.

ISBN 978-93-5547-825-2 (Print)
ISBN 978-93-5547-826-9 (eBook)
DOI: 10.9734/bpi/cpms/v11

This book covers key areas of Medical Science. The contributions by the authors include COVID-19, global health crisis,  yoga, periodontal health, alternative dentistry,  gastrointestinal cancer, Giant cerebral aneurysm, thrombosis, surgical management, misdiagnosis, analgesic activity, CNS depressant activity, Surgical management, solitary thyroid nodule, nerve damage, Cardiovascular disease,  biomarkers, biochemical markers, Dental practitioners, occupational exposure, transmission risk, Vietnamese traditional medicine,  inflammation, Knee proprioception, Threshold to detect passive motion method, proprioceptive acuity, Cerebral palsy, anterior spinal artery, spastic diplegia, adamkiewicz artery, Cataract surgery, phacoemulsification, pseudophakia, aniseikonia, depth perception, anisometropia, mechanical transmission, experimental infection, leeches,  body mass index, obesity, overweight, and  risk factors. This book contains various materials suitable for students, researchers and academicians in the field of Medical Science.

Media Promotion:


Corona Prevention and Control

M. Johnson, K. Chetty

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 1-19

The coronavirus COVID-19 pandemic is the defining global health crisis of our time and the greatest challenge we have faced since World War Two. Since its emergence in Asia late last year, the virus has spread to every continent except Antarctica. Cases are rising daily in Africa the Americas, and Europe. Countries are racing to slow the spread of the virus by testing and treating patients, carrying out contact tracing, limiting travel, quarantining citizens, and cancelling large gatherings such as sporting events, concerts, and schools. The pandemic is moving like a wave—one that may yet crash on those least able to copeTill date(04/11/2020), the coronavirus disease has spread to 210 countries with over 1.7 million cases and over 106,000 deaths worldwide. There is no vaccine and no definite treatment. The best way to prevent illness is to avoid being exposed to this virus. So prevention is better than cure [1].

Application of Alternative Medicine in Dentistry

Rohma Yusuf

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 20-26

Various types of natural and spiritual healing methods is being practised as Alternative medicine treatments. These treatments can either be practiced individually or in combination with other conventional treatment for the purpose of relaxing mind, body and soul. Alternative medicines are in practice since ancient time and are practiced globally till date. Every country has its own conventional system of health. Presently, Alternative medicine is assimilated in many feilds including dental. Results from few studies conducted has shown significant effect of holistic healing on dental and oral health. This article reviews about impact of alternative medicine in treating dental health and problems associated with it.

Background: Many observational studies has reported the increasing of the loss of follow up rate during our last COVID-19 pandemic since earlier of 2020, especially in the gastrointestinal cancer cases. Not only the patient factor, but also lack of the health facilities which could maintain the multimodality treatment of these patients. Early detection cases also reducing during this pandemic, which could lead to the increasing of the emergency presentation of gastrointestinal cancer patients workup diagnosis and treatment planning. Current data reported the increasing of emergency cases during the last year of pandemic, emergency treatment was correlated with increasing post operative morbidity and mortality.
Methods: This is an observational study on single center hospital which conducted from March until the August of 2020, which will evaluate the gastrointestinal cancer patients whose already been diagnosed and no history of surgery before pandemic. During this period of the study, we will reported elective and emergency cases of gastrointestinal cancer patient, the post operative morbidity will be evaluate also. The exclusion criteria is the recurrence case of gastrointestinal cancer.
Results: During 5 months evaluation, 48 cases of gastrointestinal cancer patients has been included into this observational study. Colorectal adeno carcinoma is the most common GI cancer cases which already diagnosed by histopatology exam, reported in 33 patients, 28 of those had large bowel obstruction and emergency surgery has been done for these obstructive colorectal cancer. The others are malignant biliary obstruction due to advanced stage of the peri ampullary tumor including pancreatic head adeno carcinoma, distal and proximal cholangi carcinoma with sign and symptoms of cholangitis, were reported in 15 cases. Four colorectal cancer patients were not survived, both of them had closed loop perforation associated with the large bowel obstruction before and untreatable sepsis. On the peri ampullary cancer group, palliative surgery has been done in both of cases, delayed biliary obstruction and severe cholangitis were found in 2 patients and had unfavorable outcome after surgery.
Conclusion: The COVID-19 pandemic has a significant impact on the late and delayed presentation which lead to emergency cases of gastrointestinal cancer patients and could increasing the post operative morbidity. Better informed consent should be achieved during treathing the patient especially in this pandemic era.

Completely thrombosed giant cerebral aneurysms are rare lesions that could sometimes be misdiagnosed due to atypical radiographic features. Huge spherical intracerebral masses must be kept in mind in every case as a differential diagnosis to guarantee the best surgical approach and resection of the lesion. In this rare case, we show that even technologically developed imaging could not accurately diagnose this rare entity and enable preoperative surgical planning. This case also reveals how important is the surgical management of these lesions when surgery is performed in a high-volume neurosurgical vascular center by an experienced vascular neurosurgeon.

Determining the Analgesic Activity of Asoka – Saraca asoca (Roxb.) de Wilde

Asha S. Raj, Sara Monsy Oommen

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 42-49

A reverse pharmacological study has been undertaken to validate the analgesic effect of kashaya of stem bark of Asoka - Saraca asoca (Roxb.) de Wilde. The drug, Asoka – Saraca asoca (Roxb.) de Wilde. has been included under Vedanasthapana Mahakashaya mentioned in Shatvirechana shatasriteeya by Acharya Charaka. Drug analgesic action has been referenced in classical literature. It is heavily utilised as arishta in Udavartha to manage diverse anila vedana. Analgesic activity has been assessed using acetic acid induced writhing method in female Wistar Albino rats. The writhing syndrome was established by intra peritoneal injection of 0.25% v/v acetic acid in normal saline (0.4ml/ 200g b.wt.). The test drug and standard drug, will be administered to rats 60 minutes prior to injection of acetic acid. The analgesic activity is expressed as percent inhibition of writhing. Significant differences between the test drug's effective and doubly effective doses and the control were discovered in the analgesic trial. As a result, it supports the kashaya of Asoka's stem bark, Saraca asoca (Roxb.) de Wilde's analgesic properties.

Surgical Management of Solitary Thyroid Nodule

Burkan Nasr Rashed Shaif

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 50-89

Preoperative differentiation between benign and malignant in solitary thyroid nodules is crucial due to the rising incidence of thyroid cancer in these lesions. Additionally, it aids in preventing unnecessary surgery and its side effects, such as hypothyroidism, hypocalcemia, and repeated nerve damage.
In this study ,135 cases of clinically detected solitary thyroid nodules,126 female and 9 male patients, between 14_65 years age, median 41 years and mean 39.76 years, (94, 41)patients respectively Right side thyroid effect more than Left side, Fine needle aspiration cytology (FNAC) sensitivity, specificity and accuracy was (61% , 72% , 64%)respectively. Postoperative histopathology reported 100 (74%) patients as having benign thyroid nodules and 35 patients (26%) as having malignant thyroid nodules. 9 patients (7%) experienced postoperative transitory hypocalcemia, while 3 patients (2%) experienced transient hoarseness.
The incidence of malignancy in solitary thyroid nodules is high and depends on preoperative evaluation, including history, examination, ultrasound, Fine needle aspiration cytology (FNAC) result, and intraoperative assessment of the nodule. Malignant nodules frequently exhibit rapid growth by history, a hard-fixed nodule on physical examination, hypoechoic, micro-calcification, and cervical lymphadenopathy on thyroid ultrasound. Age, the number of nodules, and the size of the nodules are not mentioned as risk factors for thyroid cancer in men. If performed with ultrasound guidance and analysed by histopathologists with experience, fine needle aspiration cytology (FNAC) is more beneficial for diagnosis. When performed by skilled surgeons, thyroid surgery has fewer difficulties.

Recent Biochemical Markers for Cardiovascular Diseases: Diagnostic and Prognostic Implications

Deepika Dalal, Ashish Kumar Malik, Anjali Dhama, Veena Singh Ghalaut

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 90-97

Cardiovascular diseases are the leading cause of mortality and morbidity worldwide. Early identification of a potential CVD risk and early intervention can contribute to a better prognosis. Cardiac biomarkers are very important in the early diagnosis in golden period so that early intervention can be done and possibly myocardial damage can be reversed. Various studies have highlighted the potential biochemical markers associated with cardiac tissue, inflammation and underlying metabolic processes that may aid in the clinical assessment of the vulnerable or high-risk population. This chapter provides an overview of cardiac biomarkers being widely used as diagnostic and prognostic tools for CVD risk assessment.

Evaluating the Knowledge and Practice of Sharps Safety and Management among Dental Practitioners

Shuchi Tripathi, Raghuwar Dayal Singh, Rameshwari Singhal, Richa Khanna, Deeksha Arya, Swapnil Parlani

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 98-109

The purpose of this study was to assess dentists' knowledge and practise of sharps use and disposal in the public and private sectors, as well as to provide correct methods and procedures for sharps use and disposal in order to raise awareness. A questionnaire of 20 self-administered questions about sharps knowledge, use, and disposal methods in dentistry was created. The questionnaire was distributed to 220 dentists in Lucknow and the surrounding area. 86 dentists from government teaching institutes and hospitals, 45 dentists from private teaching institutes and hospitals, and 29 dentists from private clinics responded. The collected information was compared and statistically analysed.
Only 11% of dentists were completely knowledgeable about the types of sharps used in dentistry. 79 percent of dentists prefer to always use gloves when injecting. Although 81 percent of dentists agreed on the use of mechanical needle cutters and electrical needle destroyers to destroy needle tips, only 37 percent actually used these methods. Incineration is the best method of final disposal of sharps, according to 66 percent of respondents.
Conclusion: Awareness Programs resources regarding the usage of sharps and their maintenance is specifically required as many of the dentists are not even aware with sharp disposal methods.

Anti-inflammatory and Antioxidant Effects of HV Prostate Capsule (HVPC) in Rats with Induced Benign Prostatic Hyperplasia

Ngoc Bich Son Le, Thi Thanh Nhan Le, Van Hung Nguyen, Tu Bui, Thao Phuong Thi Nguyen, Hoang Ngan Nguyen, Viet Van Chau, Dao Cuong To

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 110-131

HV prostate capsules (HVPCs) are a Vietnamese herbal prescription drug used to treat benign prostatic hyperplasia (BPH), but its anti-inflammatory and antioxidant mechanisms are not fully understood. This study examined the anti-inflammatory and antioxidant activities of HVPC in white rats with induced BPH. The anti-inflammatory and antioxidant effects of HVPC were tested in a rat model of BPH. The inflammatory cytokines interleukin-8 (IL-8) and tumor necrosis factor \(\alpha\) (TNF-\(\alpha\)) were measured in serum and prostate tissue using an enzyme-linked immunosorbent assay (ELISA) kit. The antioxidant effect of HVPC was evaluated based on the identification of superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels in the blood and the prostate gland. HVPCs at 700 mg/kg/day and 1400 mg/kg/day provided good anti-inflammatory effects in a rat model of BPH and reduced inflammatory cytokines IL-8 and TNF-\(\alpha\) in serum and prostate tissue. This capsule also exhibited antioxidant effects on rats causing BPH by increasing the SOD activity in serum and reducing the MDA content in serum and prostate tissue. HVPC was found to reduce the absolute and relative prostatic weight and improve prostate histopathology. HVPC  reduced inflammation of the prostate gland, proliferation of ductal cells, and compression of the gland parenchyma.

Various Methods to Assess Knee Proprioception

Jaykumar Soni

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 132-140

Proprioception is an important part of motor control that, when impaired or eliminated, can have a significant influence on function in a variety of clinical groups. The purpose of this systematic review was to find clinically relevant techniques for measuring proprioceptive acuity. Proprioception can be elaborated as the sensory feedback contributing to muscle sense, postural equilibrium, and joint stability. The primary goal of this systematic review was to identify and categorise the methods that have been developed and used to measure proprioceptive accuracy. The databases used were PubMed, Scopus, and Web of Science, as well as the following search engines/databases: Cochrane database / SCIRE / PEDro / CINAHL/ EMBASE, and ERIC. The TTDPM technique has lower relative ecological validity but higher conceptual purity. Although JPR tests have lower relative test validity but are more therapeutically viable, the AMEDA approach looks to have better ecological validity as well as relatively higher test and data validity.

Hypoxic – Ishemic Spinal Cord Lesions in Cerebral Palsy: A Case Report

Belenky Vadim, Kozireva Elena, Plakhotina Nadezhda, Skoromets Alexander, Dugaev Pavel, Leontiev Oleg

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 141-154

Objective: To challenge the dominant conception of cerebral palsy as pathology restricted by the brain, by testing alternative hypothesis, that perinatal hypoxia – ischemia affects brain circulation just to the same extent, as it affects spinal circulation.
Presentation of Case: We present the case of a 4-year-old male with lower paraplegia and delayed speech. Clinical examination revealed that the muscle tonus in the gastrocnemius and thigh adductors was increased bilaterally. The iliopsoas' muscle tonus was reduced bilaterally. Electrophysiological testing revealed evidence of decreased excitability of motoneurons at the L 2 - S 2 level. In addition to brain lesions, MRI has revealed spinal cord lesions at that level. A tortuous anterior spinal artery was discovered using MRI spinal angiography. The patient benefited from theophyllinum electrophoresis on the lower thoracic and first lumbar vertebrae, which improved his leg motor function.
Discussion and Conclusion: Dr. Little, the first explorer of cerebral palsy, based his theory on a thorough postmortem examination performed by himself and his colleagues. According to the data obtained from the section, he reported the cerebral palsy to be caused by perinatal injury to either the brain or the spinal cord. However, the next explorer of this disorder, Dr. Freud, limited his pathlogoanatomic research to brain cuts only, diverting neurologists' attention away from the spinal cord. Nonetheless, our presentation demonstrates the involvement of the spinal cord in the pathogenesis of Cerebral Palsy, as well as the benefits of spinal therapy, and thus confirms Little's point of view.

A Comparative Study on Stereopsis, Aniseikonia, and Associated Symptoms in Patients with Bilateral Pseudophakia with and without Anisometropia

Marcelo Tannous, Daniel Dantas, Paulo Roberto de Arruda Zantut, David Tayah, Pedro Carricondo, Amaryllis Avakian, Milton Ruiz Alves

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 155-170

The study compared bilateral pseudophakia with and without anisometropia in order to examine stereopsis, aniseikonia, and related symptoms. This cross-sectional study comprised patients with senile cataracts who had previously been scheduled for phacoemulsification with an IOL implant in both eyes. Patients were divided into two groups: control group (n = 69) with an interocular post-surgical refraction difference in Spherical Equivalent (SE) <1.0 D and anisometropia group (n = 42) with an interocular post-surgical difference in SE \(\geq\) 1.00 D. Univariate, multivariate, and regression analysis models were used in the statistical evaluation of the data. Cataract surgery-induced aniseikonia was 0.64% \(\pm\) 1.41% in control group and 0.62%\(\pm\) 1.76% in anisometropia group with an insignificant difference (p = 0.766). Measured stereoacuity was 1.95 \(\pm\) 0.17 log10 seconds of arc in the control group and 2.12 \(\pm\) 0.22 log10 seconds of arc in the anisometropia group with a sig- nificant difference (p < 0.0001). The mean score of symptoms associated with aniseikonia was 1.41 \(\pm\) 0.46 in the control group and 1.47 \(\pm\) 0.45 in the aniso- metropia group, with an insignificant difference (p = 0.387). In the anisometropia group, the following independent variables contributed to stereopsis prediction: axial length difference (18.06 percent), refractive error difference (44.53 percent), aniseikonia (25.71 percent), and IOL power difference (11.71 percent). The study demonstrated that bilateral pseudo-dophakia with anisometropia smaller than 3D did not significantly suffer from stereopsis, aniseikonia, or associated symptoms.

Haementeria lutzi Pinto (Hirudinea: Glossiphoniidae) as a Putative Vector of Trypanosoma evansi (Kinetoplastida: Trypanosomatidae) in the Pantanal Matogrossense

João Carlos Araujo Carreira, Bianca dos Santos Carvalho, Reginaldo Peçanha Brazil, Alba Valéria Machado da Silva

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 171-186

The aim of this study was to demonstrate under experimental conditions that Trypanosoma evansi can be mechanically transmitted to Rattus norvegicus by leeches of the species Haementeria lutzi). We also discuss some aspects of Trypanosoma evansi behaviour in leeches following an infectious blood meal, including: a) the parasites quickly moved to the coelomic cavity 10 minutes after ingestion. b) After roughly 10 to 30 minutes in the intestine, trypomastigotes with stumpy and slender shapes and rounded shapes displayed a random dispersion. c) Trypanosomes also infiltrated the salivary glands and proboscis cells 24 hours later. Our findings imply that Haementeria lutzi may play a role as a potential substitute vector for Trypanosoma evansi in Brazilian wetlands.

Determination of Obesity and Overweight among Urban Adolescents in India

Ansh Chaudhary, Aarati Pokale, A. P. S. Narula, Bhupendra Chaudhary, Ankita Misra, Ayush Jain

Current Practice in Medical Science Vol. 11, 24 August 2022, Page 187-200

The present study was conducted with aims to access the prevalence of overweight and obesity among urban adolescents and to study various factors associated with overweight and obesity. Obesity is defined as the abnormal expansion of adipose tissue brought on by a rise in the size, the quantity, or both of fat cells. Given their increasing nutritional needs, eating habits, lifestyle, and vulnerability to external factors, adolescents are a particularly sensitive age group in terms of nutrition.
A community based cross sectional study of 872 adolescents of both sexes in urban population of Pune, Maharashtra, India was conducted to assess prevalence and various factors influencing overweight and obesity, especially type of diet, frequency of junk foods, physical activity and sleeping habits. The Body Mass Index (BMI) and Waist-Hip Ratio (WHR) were used to define overweight and obesity as per WHO growth standards.
The prevalence of overweight and obesity in urban adolescents according to BMI were 17.4% and 6.9% respectively with overall prevalence being 24.3% but with Waist-Hip Ratio (WHR) it was 43.1%. Risk factors in urban areas were consumption of fast/junk food, carbonated drink, physical inactivity while afternoon sleep was not a significant factor.
According to this study, there is a higher prevalence of overweight and obesity among urban adolescents, particularly among those who consume more fast food and carbonated beverages and who engage in less than 30 minutes of physical activity each day. . Large scale nationwide campaigns targeted at more specific groups are required to check the growing epidemic of childhood obesity in developing countries.