Editor(s)

Dr. Barkat Ali Khan
Department of Pharmaceutics, Faculty of Pharmacy, Gomal University, D.I. Khan KPK, Pakistan.

ISBN 978-93-91473-61-7 (Print)
ISBN 978-93-91473-85-3 (eBook)
DOI: 10.9734/bpi/nfmmr/v2

This book covers key areas of medicine and medical research. The contributions by the authors include mind genomics, cartography, burnout, stress, physical exhaustion dentists, papillary thyroid cancer, thyroid swelling, granulomatous thyroid lesions, immunostaining, Birbeck granules, granulocyte macrophage-colony stimulating factor, influenza, periodic acid Schiff, pulmonary alveolar proteinosis, whole lung lavage, manual liquid based cytology, endometrium, cervix, serum vitamin D level, Type 2 diabetes mellitus, Vitamin D deficiency, aortic type A dissection, gender specific risk factors, computed tomography, septoplasty, surgical intervention, deviated septum, total laparoscopic hysterectomy, total abdominal hysterectomy, efficacy, outcome, complications, pyrexia of unknown origin, adult-onset Still’s disease, haemophagocytic lymphohistiocytosis, hyperferritinaemia, leiomyoma, space of retzius, Infertility, benign gynaecological tumour, common carotid artery, common trunk, external carotid artery, facial artery, lingual artery, superior thyroid artery, antimicrobial assay, pediatric, essential medicine, gynaecology, malignancy, acute renal failure, hair dye poisoning, rhabdomyolysis, serum glutamic-oxaloacetic transaminase, risk factors, corticomedullary Junction, proximal convoluted tubules, distal convoluted tubules, loop of Henle, intrauterine growth retardation, eclampsia, magnesium toxicity, maternal mortality, pregnancy induced hypertension. This book contains various materials suitable for students, researchers and academicians in the field of medicine and medical research.

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Chapters

A Mind Genomics Cartography of Insurance for Home Project Contracts: Selling to the ‘Mind’ of the Insurance Prospect

Howard Moskowitz, Attila Gere

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 1-16
https://doi.org/10.9734/bpi/nfmmr/v2/8904D

The paper introduces the science and process of Mind Genomics as a process by which to reveal the mind of prospects regarding the factors surrounding insurance, specifically insurance that the home contractor will complete the project satisfactorily. There are a lot of insurance companies in the world, and, in turn, a great deal of advertising, advertising testing, and an entire world of professional consumer researchers supporting the effort to sell the advertising. The objective is to uncover the existence and nature of groups of people sharing the same point of view about what they want in such insurance. The Mind Genomics process works through experimental design, presenting respondents with vignettes, combinations of messages about insurance, totally different combinations for each respondent. The subsequent analysis by regression reveals which messages make the respondent feel comfortable with the project and the insurance versus which messages make the respondent feel insecure and ready to drop the project. The data suggest three mind-sets of people: project-focused, contractor-focused, and legal/finance-focused, respectively, corresponding to different aspects of the contracting relationship. We introduce the PVI, personal viewpoint identifier, to assign a new person to one of these three mind-sets, to aid sales and client service.

Determination of Occupational Burnout among Private Dental Practioners in Bengaluru, India

Mayur Nandkishor Mishra

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 17-24
https://doi.org/10.9734/bpi/nfmmr/v2/3120F

Introduction: Dentistry is highly rewarding profession, but it’s very demanding job with high degree of concentration and precision in work. Dentists seem to be prone to professional burnout, anxiety disorders and clinical depression because of the variety of sources of stress encountered throughout the professional career.

Objectives: To determine the burnout level and physical exhaustion among private dental practitioners.

Materials and Methods: A cross sectional study was carried out on private dental practitioners in Bengaluru city. A questionnaire containing 22 items Maslach Burnout Inventory and demographic detail, was administered. The response rates were obtained using a likert scale ranging from 0-6. Analysis for p value, cronbach’s $$\alpha$$ for each questions (>0.700 = high consistency), correlation- coefficient, frequency and comparison of variables, were done.

Results: The study found high level of burnout in 11.3% of participants. It also showed age group of <=25 and 25-35, females were highly influenced. More amount of burnout level found in general practitioners than specialists. Study also indicates that backache 48% and headache 44.7% were main reasons for physical exhaustion followed by neck-ache 34% and hand and wrist disorders 23.7%.

Conclusion: As health care provider the dentists are subjected to interpersonal stress due to the demanding nature of the occupation and close proximity to the patient. Moderate to high level of burnout were detected in the study sample, it’s recommended that attention for burnout risk should be given priority by dental professionals.

Langerhans Cell Histiocytosis Co-existing with Papillary Carcinoma of Thyroid

Jaimanti Bakshi, Atul Kumar Goyal

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 25-30
https://doi.org/10.9734/bpi/nfmmr/v2/2344F

Langerhans cell histiocytosis (LCH) is a rare condition with unknown causes and is characterized by the infiltration of significant numbers of Langerhans cells in the affected tissues leading to formation of granulomas. In this chapter, we have discussed the case of a 31-year-old man with a swollen, diffusely firm, non-tender, non-mobile thyroid swelling presented with Langerhans cell histiocytosis associated with papillary thyroid carcinoma (PTC). The thyroid was shown to be involved by langerhans cell histiocytosis, confirmed with fine needle aspiration cytology. The patient was examined, and no signs of structural intervention were discovered. After ten cycles of vinblastine and etoposide chemotherapy, there was no reduction in the extent of the swelling observed.

A Challenging Case of Influenza H1N1 Pneumonia and Pulmonary Alveolar Protienosis, Comprehensive Discussion of Disease-Disease Relationship in Terms of Causality, Cross-Reactivity, Outcome and Effect of Treatment

Saeed Mishal Albogami, Abdelfattah A. Touman

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 31-38
https://doi.org/10.9734/bpi/nfmmr/v2/3346F

Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by the accumulation of amorphous lipoproteinaceous material in the distal air spaces due to defective surfactant clearance by alveolar macrophages. This leads to impaired gas exchange and arterial hypoxemia of varying degrees. Although autoimmune type of PAP is thought to be idiopathic, this focused report highlights the possible relationship between viral pneumonia and autoimmune PAP (APAP) in terms of causation, superinfection and effect of treatments. We report a newly diagnosed case of APAP with a possible viral causation “trigger” for the confirmed serum anti-granulocyte macrophage-colony stimulating factor (GM-CSF) antibody. To the best of our knowledge, this is the first report that describe and discuss this issue. The patient is a 38-year- old, ex-smoker woman who had had a progressively worsening dyspnea and a persistent, productive cough for more than 4 months. It was thought to be a community acquired pneumonia (CAP) case and was treated with multiple antibiotics which yielded no improvement in her condition. Physical examination revealed mild hypoxemia and minimal bilateral fine crepitations despite marked alveolar filling on chest X-ray (CXR). She underwent a bronchoscopic procedure that revealed PAP. The case also describes an acute flare up of the condition during the course of the disease caused by a confirmed H1N1 influenza infection. APAP should be considered in the differential diagnosis of recurrent pneumonia not responding to treatment. In this case report we suggest the possible role of viral causation “trigger” or cross-reactivity of GM-CSF antibodies that lead to APAP. We also describe the provided management, the response to the antiviral therapy and the diagnostic and management challenges that was encountered during the follow up.

Study of Manual Liquid Based Cytology in Diagnosis of Gynecologic Pathology

Nandini N. Manoli, Nandish S. Manoli, Lopamudra Kakoti, Akshata Kamath, Shweta Kulkarni

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 39-54
https://doi.org/10.9734/bpi/nfmmr/v2/3205F

Abnormal uterine bleeding (AUB) is a commonly encountered complaint in gynecology department. Endometrial cancer is the fourth most common malignancy in women and the most frequent gynecological cancer in developed countries. With 5,28, 000 new cases every year, cervical cancer is the fourth most common cancer affecting women worldwide, after breast, colorectal, and lung cancers. Though the cytological examination has been the mainstay for early detection of cervical cancer, and found to be useful in detection of endometrial cancer, its widespread use has not been possible in the developing countries due to paucity of resources, man power and other facilities Its sensitivity reduces to less than 50% when there is presence of obscuring blood, inflammation or thick areas of overlapping epithelial cells. Manual Liquid Based Cytology (MLBC) is a cost effective technique that enables cells to be suspended in a monolayer and thus improve detection of precursor lesions and specimen adequacy. The residual sample can be used for other tests like Cell block and immunocytochemistry.

Objectives: 1. Toimprove the diagnosis of gynecological cancers by a method called as Manual Liquid Based Cytology (MLBC). 2. To study a cost effective method of studying both endometrial and cervical cancer with help of ancillary techniques like cellblock, immunocytochemistry 3To compare the findings between conventional pap smear (CPS) and MLBC in detection of gynecological conditions of endometrium and cervix.

Methodology: Samples were collected using Ayres spatula by split sample technique from transformation zone of cervix which included outpatients of gynecology dept. The women were aged between 20-60 years, 82 cases with bleeding history were taken to study endometrial pathology, while 100 cases of white discharge per vagina were selected to study the cervix. 60 cases were later subjected to ancillary studies like cellblock with Immunocytochemistry. Histopathological correlation was done for cases wherever possible.

Results: The study on endometruim showed MLBC is more sensitive and specific than CPS in diagnosis of malignant lesions. The contingency coefficient for LBC/Histopathology V/s CPS/Histopathology was 0.572 V/s 0.556. It was observed for cervical lesion that increased detection rate was 150% for low grade intraepithelial lesion. The Positive predictive value for diagnosing neoplastic lesions on cell blocks was 75%, while Concordance Rate of CB/Histopathology Vs CPS/Histopathology was 74% vs. 54%.

Conclusion: MLBC is a cost effective method for detections of cancerous lesions of endometruim andcervix. It has been found to be useful in both Endometrial and cervical cytology in increasing the detection of infection and neoplastic conditions of female genital tract.

Study on Prevalence and Severity of Vitamin D Deficiency in Type 2 Diabetic Patients

Hetal Pandya, Dipesh Patel

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 55-60
https://doi.org/10.9734/bpi/nfmmr/v2/3028F

Background: The current worldwide epidemic of diabetes mellitus is a serious health problem because of the high toll of vascular complications. Vitamin D deficiency as emerging epidemic have effect on pathophysiology of diabetes mellitus by various mechanisms.

Aims: The objectives were to assess the prevalence and severity of vitamin D deficiency in type 2 DM as well as to record the effect of hyperglycaemia on serum vitamin D level.

Methods: In this case-control study 70 type 2 diabetic patients were taken as cases and 70 healthy individuals as controls. All participants included in this study were subjected to complete history taking and clinical examination and routine laboratory Investigations were done for all participants. The data was analyse using appropriate statistical tests.

Results: The prevalence of low vitamin D level (inclusive of insufficiency and deficiency) was 18.57% in healthy controls, while 84.29% in diabetic group. Mean level of vitamin D in cases was 25.73±7.27 while 34.55±5.17 in healthy population (p value <0.05). Vitamin D deficiency is more seen in uncontrolled diabetes patients. Inverse correlation was recorded between HbA1C and serum vitamin D level (r = - 0.281, p value = <0.001).

Conclusions: Vitamin D deficiency is highly prevalent in diabetic patients as compare to normal healthy population. All patients of type 2 Diabetes patients must have screened for serum vitamin D level and if found deficient than it should be treated promptly with vitamin D supplements for better control of hyperglycaemia.

An Analysis of Perioperative Risk Factors for Long Term Survival after Surgery for Acute Type A Dissection Focusing on Gender-specific Differences

Frank Harig, Anna Engel, Johannes Rösch, Michael Weyand

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 61-74
https://doi.org/10.9734/bpi/nfmmr/v2/3404F

We focused on gender specific perioperative risk factors for the survival of an acute Stanford type A aortic dissection.

A cohort of 147 patients undergoing surgery since 2004 was studied in a 9 year follow-up. Analysis was performed using Cox-proportional hazard model focusing on 36 variables.

Survival after 1y (5, 10y) was 98% (88%, 50%). Early mortality was 25%, 27% female, with a higher age (+10y, mean, 64±10y) than men. In the 7th decade, percentage of women was as twofold higher and threefold higher in the 8th decade. Survival probability (Log rank test) for the first postoperative year was 0.82/0.77 (female/male) for 5 years 0.70/0.71, and 0.46/ 0.50 for 10 years. Risk factor analysis showed women having a high hazard ratio for death in case of resternotomy (16.543), bleeding (8.1), and renal insufficiency (3.4).

Only EURO-Score (1.103, p=0.038) and length of hospital stay (0.849, p=0.015) were significant risk factors for death.

The survival curve declines between 5 and 10 years (88% to 50%). In male patients, age and resternotomy had a significant influence on survival. Women had a higher incidence for aortic type a dissection in the 7th and 8th decades. Gender did not influence survival.

Determining the Impact of Pre-Operative Computed Tomography Scan in Patients Underwent Septoplasty on the Postoperative Complications

Abdulwahid S. AlQahtani, Ramzi M. Dagriri, Radeif E. Shamakhi, Ahmad M. Alrasheed, Ahmed A. Etwadi, Khalid A. AlQahtani

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 75-80
https://doi.org/10.9734/bpi/nfmmr/v2/2818F

Background: One of the most common causes of nasal obstruction in adults is a deviated nasal septum (DNS). Anterior rhinoscopy (AR), which is generally the first diagnostic procedure in the evaluation of obstructive nasal pathologies, is frequently insufficient in the assessment of the posterior nasal cavity, and paranasal sinus computed tomography(PNS CT) is the gold standard method for the evaluation of paranasal anatomy and inflammatory paranasal sinus pathologies .The goal was to prove that a pre-operative computed tomography scan was helpful in reducing post-septoplasty complications.

Methods: All patients with clinically confirmed DNS who had surgical intervention at Khamis Mushayet General Hospital were included in a retrospective record-based analysis. Patients' demographic information, as well as post-operative problems and the history of a preoperative CT scan for evaluating and grading DNS, were all collected.

Results: For DNS, a total of 60 patients underwent septoplasty. The average age of the patients who had a preoperative CT scan was 30.The remaining 30 patients did not get a pre-operative CT scan to rule out DNS. Nasal obstruction was the most common problem (28.3%), followed by external nose deformity (20 percent).

A total of 47% of patients with postoperative nasal obstruction did not have a pre-operative CT scan.

About 42% of patients with postoperative nasal deformity did not have a CT scan, whereas 33% of patients with postoperative bleeding and septal perforation did not have a CT scan.

Conclusions: In conclusion, the study found that preoperative CT had insignificant efficacy in relieving nasal obstruction or minimising postoperative complications.

A Comparative Overview of Total Laparoscopic Hysterectomy and Total Abdominal Hysterectomy

Anju Dogra, Vinay Kumar

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 81-88
https://doi.org/10.9734/bpi/nfmmr/v2/3327F

Hysterectomy is one of the gynecological operations performed due to benign indications such as uterine leiomyoma, dysfunctional uterine bleeding, endometrial hyperplasia, dysmenorrhea, dyspareunia, and severe endometriosis refractory to medical or conservative surgical management and malignant conditions like cervical, endometrial and ovarian cancer. Hysterectomy can be performed by abdominal, vaginal and laparoscopic method. Abdominal hysterectomy has been the most popular method but it is more invasive and is associated with more blood loss, delayed recovery and longer hospital stay. Since Reich's introduction of laparoscopic hysterectomy in 1989, it has become a widely accepted technique around the world. Laparoscopic hysterectomy was reported to have lower post operative morbidity, improved quality of life, shorter hospital stay and less blood loss when compared to laparotomy. The aim and objectives of the study was to compare the surgical results and intra- operative and post-operative complications between Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH). A retrospective study was conducted at SMGS hospital, GMC Jammu between October 2016 and September 2018 and a total of 252 patients were recruited in the study. Patients were divided into two groups of 126 patients each- Group A consists of patients who underwent TLH and Group B comprises of patients who underwent TAH. We observed that there was no significant difference between the two groups in respect to patient’s age (45.16±4.58 versus 45.23±6.44), parity (4.32±2.08 versus 4.77±3.08) and indication of surgery. Duration of surgery was found to be longer in TLH (116.02±16.38) than TAH (83.18±21.40). The length of hospital stay was significantly less in TLH than TAH ( p value <0.0001). Hb drop was more in TAH group as compared to TLH (1.46±0.64 versus 1.83±0.68). 25(19.8%) patients of TAH were given post op blood transfusion but only 9(7.14%) patients of TLH were given post op blood transfusion and this difference was again statistically significant (p value<0.0001). The time to ambulation in patients of TLH was much shorter than TAH (9.94±4.29 versus 23.03±1.28). Wound infection was more prevalent in TAH than in TLH; 5 patients had wound infection, and 4 patients had wound dehiscence that required resuturing. Laparoscopy was converted to laparotomy in 8 patients due to adhesions, vascular injury, and bowel injury in one case.  This study found that TLH can be performed safely as an alternative to abdominal hysterectomy by an experienced surgeon.It has various advantages over TAH, including a smaller incision, earlier ambulation, a shorter hospital stay, and a faster recovery time, as well as the absence of more serious complications.

Refractory Adult-Onset Still’s Disease: A Case Report

Wahinuddin Sulaiman, Aris Chandran Abdullah, Jerome Tan Tsen Chuen, Shaffie Baba, Norain Karim

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 89-96
https://doi.org/10.9734/bpi/nfmmr/v2/1803C

It is often a challenge and a dilemma for clinicians encountering patients with pyrexia of unknown origin. Numerous tests performed to determine the underlying cause often give inconclusive results. We present a 52-year-old man with undulating fever for more than ten months consistent with diagnosis of pyrexia of unknown origin (PUO).  It was associated with persistent hyperferritinaemia, elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), leukocytosis, thrombocytopaenia, hepatosplenomegaly, hypertrigyceridaemia, raised fibrinogen index and arthritis of the ankle joints. Serological markers, repeated septic workout, cerebrospinal fluid and bone marrow and trephine biopsy (BMT) studies were all negative otherwise.  The imaging studies (computed tomography scan of whole body) apart from findings of mild hepatosplenomegaly, was otherwise normal. The positron-emission tomography (PET) scan shows evidence of polyarthritis. Based on these findings, diagnosis of refractory adult-onset Still’s disease complicated by haemophagocytic lymphohistiocytosis was made although the BMT findings was inconclusive. Despite corticosteroids, disease modifying anti-rheumatic agents (DMARD) and immune-modulator therapy, he succumbed to the illness.  This case history illustrates the diagnostic complexity of adult-onset Still’s disease with protean manifestation.

Study on Leiomyoma in the Space of Retzius

. Shweta, Shaheen Anjum, Zehra Mohsin, Afzal Anees

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 97-102
https://doi.org/10.9734/bpi/nfmmr/v2/3221F

Leiomyoma although are the most common benign tumour of reproductive age group females, their clinical diagnosis poses a huge problem to the clinician especially extrauterine leiomyomas. Space of retzius is one such location where they usually remain asymptomatic. These may sometimes present with minor complaints like pain lower abdomen, urinary complaints, pelvic mass and rarely infertility. Till now in the literature so far, only few cases of extrauterine leiomyoma have been reported making their management difficult.

Study of Clinical Implications of Variable Patterns of Major Arteries of Neck with Their Ontological Basis

Preeti Sonje, Neelesh Kanasker, P. Vatsalaswamy

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 103-114
https://doi.org/10.9734/bpi/nfmmr/v2/3357F

Objective: As arterial variations are very commonly seen in different arteries of body, study of External carotid artery was carried out to know the variability in it. The main artery supplying the structures of the neck and face is the external carotid artery. From the standpoint of surgeries performed in that location, variations in the branching pattern of the external carotid artery are essential surgically and radiologically. The goal of this research was to look into the branching pattern of the external carotid artery.

Methods: The external carotid artery was studied by dissecting the carotid triangle of the neck and the infra temporal fossa.

Results: The common carotid artery usually splits near the upper boundary of the thyroid cartilage lamina.

The level of bifurcation of the common carotid artery can vary; it might develop at a lower or higher level than its normal origin, as seen in this study.

The superior thyroid artery, the facial artery, and the lingual artery are some of the branches of the external carotid artery that have different origins. These include the superior thyroid artery's origin from the common carotid artery, a common trunk for the facial and lingual arteries, and a variety of other variations. These were found in this study.

Conclusion: The different sources of the branches of the external carotid artery are significant in thyroid, parotid gland, and tongue surgeries, as well as in head, neck, and face diagnostic procedures.

Determination of Prescribing Pattern of Drugs in Acute Respiratory Tract Infection in Children at Tertiary Care Teaching Hospital, India

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 115-125
https://doi.org/10.9734/bpi/nfmmr/v2/10804D

Acute respiratory tract infections (ARTI) are very common in all age groups. Childhood respiratory tract infections are responsible for considerable morbidity and mortality. It is significant health problem in India also. The World Health Organization (WHO) estimates that 2 million children under five years of age die due to pneumonia. Majority of ARTIs have viral etiology. Rhinoviruses, respiratory syncytial viruses, parainfluenza and influenza viruses, human metapneumovirus, and adenoviruses are main causative agents. Among bacteria, group A streptococci, Corynebacterium diphtheriae, N. meningitides, H. influenzae, pneumococcus and Staphylococcus aureus are responsible for ARTIs. Drug utilization studies help to understand the pattern of prescription in that particular area for specific conditions. Our aim was to study the prescribing pattern of drugs and to evaluate the rationality of this pattern in acute respiratory tract infection in children aged 1 to 5 years.

We evaluated 298 prescriptions given to these children. Analysis of these prescriptions was done as well as they are compared with WHO prescription indicators. Cough (96%), fever (93%) and rhinitis (82.5%) were common symptoms observed, but sore throat, earache and breathlessness were also present in these children. Average number of drugs prescribed was 4.1/patient. Following drugs were prescribed, Antipyretics 98.3%, antimicrobials 91.3%, antihistaminics and cough syrups in 75.2%, Leukotriene antagonist in 25.1% patients, Vitamin B complex 11% and glucocorticoids 4.6%. All drugs were prescribed by brand names and not by generic name. 97.3% prescribed drugs were from national list of essential medicine. We found overuse of antimicrobials in our study. Educational programs are needed in order to bring rational use of antimicrobials. At the same time awareness in parents also should be done regarding antimicrobial use.

Study on Gynaecological Malignant Tumours at a University Teaching Hospital in Imo State South-Eastern Nigeria

J. C. Umeobika, E. C. Ojiyi

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 126-132
https://doi.org/10.9734/bpi/nfmmr/v2/10889D

Background: Gynecological malignancies are significant contributors to morbidity and mortality in women and are key components of reproductive health. They are found all across the world, though their distribution varies by region.

Objectives: To assess the frequency and pattern of Gynaecological malignancies at a University Teaching Hospital in South Eastern Nigeria.

Methodology: From January 1, 2004 to December 31, 2013, all patients with histologically proven genital tract cancers in the Department of Obstetrics and Gynecology of a University Teaching Hospital in South Eastern Nigeria were analysed retrospectively.

Results: Cervical cancer accounted for 60.1 percent (131/218) of the 218 cases, ovarian cancer 20.6 percent (45/218), corpus uteri cancer 10.6 percent (23/218), vulval cancer 8.2 percent (18/218), and vaginal cancer 0.5 percent (1/218). Overall, the age distribution was primarily between the ages of 30-69, with a high in the 40-49 age group. Cervical and ovarian cancers were most common in people aged 40 to 49, accounting for 39.7% and 24.5 percent of all cancers, respectively. The Gynaecological malignancies appear to occur less at the extremes of age (<20 years and $$\ge$$70 years).

Conclusion: The most common type of gynaecological cancer in this study was cervical cancer. Despite the fact that it is the most preventable of all gynaecological cancers and a leading source of morbidity and mortality in Nigeria, it continues to be a major cause of morbidity and mortality. Health education, awareness creation and good government policies are key to curbing this ugly trend.

Clinical Profile and Incidence of Acute Kidney Injury Due to Hair Dye Poisoning: A Prospective Study

P. Ramulu, P. Amruth Rao, K. Kanthi Swaroop, K. Paul Marx, Ch. Venkata Ramana Devi

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 133-141
https://doi.org/10.9734/bpi/nfmmr/v2/11001D

Background: Suicides have been increasing at an alarming rate around the world in recent decades, claiming the most productive age group in society. India, like other developing countries, is not immune to this unnecessarily rising toll.

Methods: Between November 2011 and October 2013, 31 patients were enrolled at Osmania General Hospital for this prospective observational study. After the exclusion criteria were ruled out, patients admitted to MICU for claimed hair dye consumption were enrolled in the study. Every patient or the patient's relatives gave their informed consent. From the time of hospital admission until discharge or death, all routine laboratory investigations were performed according to normal clinical procedures and protocols, and patient-related clinical information was documented on the produced proforma. RIFLE criteria were used to define and rate the existence of AKI.

Results: The current study looks at 31 cases of suicidal hair dye consumption, with males accounting for 6 (19.35 percent) and females accounting for 25 (80.64 percent). Males (30%) and females (30%) were found to have a higher probability to commit suicide in the age range 21-30 years (70 percent). Acute Kidney Injury necessitating hemodialysis developed in 19% of all patients who ingested more than 50 mL of dye. Following treatment, approximately 58 percent of patients were discharged from the hospital in good general health. Four patients died as a result of respiratory complications such as pneumonia, ARDS, sepsis, and ARF.

Conclusions: Hence, in the current situation of emerging hair dye poisoning, it is critical for a timely intervention by reducing the time of admission in hospital and also early management by clinicians is the need of an hour.

Diabetes Mellitus and Myocardial Infarction: Correlation Among Based on a Study in a Tertiary Care Centre, India

Debananda Sahoo, Lalatendu Mohanty

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 142-148
https://doi.org/10.9734/bpi/nfmmr/v2/2923F

Background: Diabetics have a higher mortality rate during the acute phase of a myocardial infarction (MI) and a higher morbidity rate during the post-infarction period. The purpose of this study was to determine the prevalence of diabetes as a risk factor for acute myocardial infarction.

Methods: For each patient, detailed demographic information such as age, gender, weight, BMI, blood pressure, smoking and alcohol history, and previous clinical and medical history were recorded. Blood was drawn from the patients to determine random blood glucose levels and HbA1c levels. Fasting blood glucose levels were measured on the second and fifth days of admission.

Results: The average age of the patients was roughly 66 years, and 63.5 percent were males and just 36.5 percent were females. The majority of MI patients admitted to hospitals were obese or overweight, with high cholesterol and triglyceride levels. 59 (56.7%) of the 104 patients did not have diabetes, while 29 (27.9%) were diabetics. During their hospitalisation, 11 (10.6 percent) of them were diagnosed as diabetic.

Conclusions: Chronic and acute hyperglycemia associated with acute coronary syndromes, most notably acute myocardial infarction, is an independent and determinant factor in outcome for patients with and without diabetes mellitus.

Determination of Histogenesis of Human Kidney in Spontaneously Aborted Human Fetuses from 14 Weeks to 36 Weeks

Divya Jain Pokarna, Kasturi Kshitija, Seethamsetty Saritha

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 149-157
https://doi.org/10.9734/bpi/nfmmr/v2/2963F

Aims and Objectives: The development of Kidney is a complex process having two parts the collecting & excretory part. Due to recent advances in the medical field it is now possible for premature babies to survive successfully. The original conception of   human fetal Kidney morphology and developmental anatomy is very important for prenatal diagnosis of normal and congenital disorders such as Wilm’s tumor, Hydronephrosis, Multicystic dysplastic kidney, Autosomal recessive polycystic kidney disease, Megacystis, Renal dysplasia etc.

Histogenesis of Kidney according to its gestational age gives overview  of  these congenital anomalies that are important for a developmental Anatomist , in diagnosing the Genetics aspects, Radiological   and Histopathological diagnosis & finally  improvising antenatal screening and forecasting the route of treatment.

Methods: The study used 40 kidneys obtained from 20 spontaneously aborted foetuses [11 males and 9 females] ranging in gestation from 14 weeks to 36 weeks. After confirming their age with CRL, they were grouped and then processed to form slides stained with hematoxylin and eosin. The stained slides were seen under light microscope.

Results: At an early gestational age, all kidneys were lobulated and fused by 36 weeks. By 18 weeks, the corticomedullary junction and preformed collecting tubules were plainly visible. By 19 to 23 weeks, well-differentiated PCT and DCT had formed. Well formed pyramids by 28 weeks and medullary rays by 29 weeks were clearly distinguished. Loop of Henle developed and distinguished by 28 weeks. Increased vascularity was seen by 32 weeks to 36 weeks. Nephrogenic zone and undifferentiated mesenchyme decreased and matured glomeruli increased by 36 weeks.

Conclusion: This present study may help us in understanding various renal disorders. This study can also emphasizes on the development of each component in medulla and cortex of Kidney, regarding histological maturity & functional status according to gestational age & gives us an overall panoramic view.

Study on Cases of Eclampsia: A Clinical Approach

Bipin Kanani, Nirav J. Garala

New Frontiers in Medicine and Medical Research Vol. 2, 27 July 2021, Page 158-163
https://doi.org/10.9734/bpi/nfmmr/v2/2993F

Background: Eclampsia is a life-threatening illness that is one of the most leading causes of maternal death around the world. Acute renal failure, DIC, postpartum haemorrhage, and other problems, as well as adverse foetal outcomes, are all linked to it.

Aims: This study aimed to highlights fetomaternal outcomes in cases of Eclampsia.

Methods: From January 1, 2016, to June 30, 2017, a total of 75 cases of eclampsia were assessed at RZ Hospital, a government tertiary referral centre. The complications of pregnancy, the efficiency of magnesium sulphate treatment, the foetal outcome, and the route of delivery were all investigated.

Results: Eclampsia had a 0.55 percent incidence rate, with 62.66 percent of all cases being primigravida, 76 percent of cases being between the ages of 21 and 26, 84 percent of cases being from lower socioeconomic position, and maternal mortality occurring in two of every 75 cases. 66.67 percent of patients were pregnant to term (37 to 42 weeks).71 percent (53) of patients delivered vaginally, with 9 spontaneous deliveries and 44 induced vaginal deliveries. 22 patients required caesarean section.

Conclusions: Early detection and prevention of pregnancy-induced hypertension and pre-eclampsia, as well as other eclampsia risk factors, may assist to lower the occurrence of the condition. Magnesium toxicity, acute renal failure (ARF), disseminated intravascular coagulation (DIC), and postpartum haemorrhage (PPH) were the maternal unfavourable events in this trial, with 92 percent of women having no problems.