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   Table of Contents - Current issue
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July-December 2017
Volume 8 | Issue 2
Page Nos. 65-108

Online since Monday, August 7, 2017

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REVIEW ARTICLE  

Crizotinib in treatment of lung cancer Highly accessed article p. 65
Arpita Singh, Anubhuti Singh, Kislay Kishore, Ajay K Verma, Surya Kant
DOI:10.4103/mjmsr.MJMSR_62_16  
Lung cancer is one of the most common malignancies and is the leading cause of cancer-related mortality throughout the world. Despite advances in surgery and chemotherapy, survival is still poor. Crizotinib is an oral inhibitor of multiple kinases, including anaplastic lymphoma kinase (ALK), and is indicated in the treatment of patients with locally advanced or metastatic? non small cell lung carcinoma (NSCLC) harboring ALK mutation as a targeted therapy. This is short drug review of crizotinib in the treatment of advanced lung cancer.
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ORIGINAL ARTICLES Top

Thyroid hormone status in preeclampsia patients: A case–control study p. 68
Nineetha Muraleedharan, Jessy Sumangala Janardhanan
DOI:10.4103/0975-9727.212415  
Context: Preeclampsia (PE) is a common complication of pregnancy associated with high morbidity. Antiangiogenic factors are raised in PE, which may affect thyroid secretion. Aims: The aim of this study was to determine the association between thyroid hormonal status in PE and the severity of PE and also any correlation between albumin levels and thyroid status. Materials and Methods: Cases include forty women between 30 and 38 weeks of gestation with PE. Forty healthy normotensive pregnant women in third trimester constituted the control group. Thyroid profile (free triiodothyronine [FT3], triiodothyronine [T3], free thyroxine [FT4], thyroxine [T4], and thyroid stimulating hormone [TSH]) was measured by enzyme-linked immunosorbent assay technique. Analysis and Results: Mean, median, standard deviation for quantitative variables were compared by Student's t-test. Percentage values were compared using Chi-square test. ANOVA tests and post hoc analysis were done. Odds ratio was used to assess risk for hypothyroidism. TSH was significantly high in PE (3.76 ± 1.55) than controls (2.30 ± 0.94 mIU/L). Mean FT3 in PE was 2.12 ± 0.55 and in controls was 2.43 ± 0.47 pg/ml. FT4 in cases was 1.16 ± 0.24 and in controls was 1.33 ± 0.27 ng/dL, suggestive of hypothyroidism. The mean serum albumin was significantly lesser (3.11 ± 0.39 g/dL) in PE. Conclusion: Preeclamptics had 11 times, severe preeclamptics 31.5 times while mild preeclamptics had five times more risk for hypothyroidism. Risks for hypothyroidism increase with the severity of PE.
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A clinicomycologic study of onychomycosis at a tertiary health-care center in Chennai p. 74
Chandan Ashokan, Aditya Kumar Bubna, Anandan Sankarasubramaniam, Mahalakshmi Veeraraghavan, Sudha Rangarajan, Adikrishnan Swaminathan
DOI:10.4103/mjmsr.mjmsr_71_16  
Background: Onychomycosis poses to be an important public health problem. There has been a worldwide increase in the prevalence of onychomycosis with factors such as diabetes mellitus, poor peripheral circulation, indulgence in sporting activities, and prolonged antibiotic usage playing major contributory roles. Further, management of fungal infections of nails usually requires a prolonged course with a tendency for relapse. Aim: To study the clinical, epidemiologic, and demographic profile of onychomycosis and determine various organisms responsible for the same. Methods: A cross-sectional study was done over a 1-year period, wherein after patient enrollment, a thorough clinical evaluation was performed, followed by microscopically examining the infected nail specimen under 40% potassium hydroxide, which was succeeded by cultivating the organisms on fungal culture media and identifying the pathogen both by closely studying colony morphology in culture and also microscopically utilizing lactophenol cotton blue staining. Results: Females (67.3%) were more commonly affected than males (32.7%). The most common age group affected was 20-40 years(47%). Majority of patients demonstrated both finger and toe nail involvement (43.6%). Distal and lateral subungual onychomycosis (55.4%) was the most common clinical variant of onychomycosis identified in our study. Out of the 101 patients in our study, 86 demonstrated a positive fungal growth on culture. Non-dermatophyte moulds (NDM) (58.1%) were the most common fungal isolate followed by Candida species (36%) and dermatophytes (5.8%). Conclusion: Unlike most studies, NDM constituted the major pathogen among our participants.
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Correlation of anthropometric indices with rate pressure product in healthy young adults p. 82
Sunil Kumar Jena, Kanhu Charan Purohit, Biswabhusan Mohanty
DOI:10.4103/mjmsr.MJMSR_11_17  
Background: Generalized and abdominal obesity is associated with increased incidence of adverse cardiovascular events. Rate pressure product (RPP) is an indicator of myocardial oxygen consumption, and higher value of RPP indicates myocardial work stress or cardiovascular risk. Thus, RPP can be correlated with anthropometric indices such as body mass index (BMI), waist circumference (WC), and waist–hip ratio (WHR) to evaluate the risk of adiposity on myocardial work stress. Materials and Methods: In this study, 104 young male college students were recruited as subjects. Height, weight, WC, and hip circumference were measured whereas BMI and WHR were derived by specific formula. Heart rate (HR) and blood pressure (BP) were recorded after allowing for 10 min rest and RPP was derived by specific formula. Subjects were distributed into different groups considering BMI, WC, and WHR. The analysis of parameters, i.e., systolic BP, HR, and RPP was done by one-way ANOVA, unpaired t-test, and Pearson correlation. Results: The major findings of this study suggested that obese and overweight subject RPP was more than normal participants. The subjects of WC >90 cm had higher RPP than the subjects of WC ≤90 cm. The subjects of WHR ≥0.90 had higher RPP than WHR <0.90. There was a significant positive correlation (P < 0.05) between RPP and anthropometric indices, i.e., BMI, WC, and WHR. Conclusion: Vital parameters of adiposity or obesity such as BMI, WC, and WHR may be used to evaluate the risk of myocardial work stress or cardiovascular events in correlation with RPP.
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SHORT COMMUNICATION Top

Inverted follicular keratosis: A rare lesion revisited p. 86
Anubhav Chauhan, Neeraj Sharma, Lalit Gupta
DOI:10.4103/mjmsr.MJMSR_1_17  
Inverted follicular keratosis is a rare lesion of the follicular infundibulum with characteristic signs and histopathological features. It may mimic malignant lesions, especially squamous cell carcinoma and hence a high degree of suspicion is warranted whenever any patient presents with such growths.
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CASE REPORTS Top

An atypical presentation of hemophilia in an infant: A diagnostic dilemma in a resource-constrained setting p. 88
Ibrahim Aliyu, Zainab F Ibrahim
DOI:10.4103/mjmsr.MJMSR_63_16  
Hemophilia is one of the most common inherited disorders. There are mainly two types: hemophilia A and B. They are both X-linked disorders; therefore, they are mostly expressed in male patients. Common forms of presentation are bleeding from trauma site, following circumcision, and into joints. However, a case of a 7-month-old male child who presented with severe anemia and febrile illness that was treated for severe malaria is reported, but further review revealed a right axillary hematoma, and his clotting studies showed prolonged activated partial thromboplastin time, and therefore the diagnosis of hemophilia was made.
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Lupus miliaris disseminatus faciei: An uncommon dermatologic entity p. 91
Anjali Madan, Vineet Rehlan, Vijay Kumar Garg, Nidhi Mahajan
DOI:10.4103/0975-9727.212411  
Lupus miliaris disseminatus faciei (LMDF) first described in 1878 is an uncommon dermatosis of unknown etiology with characteristic clinicopathological features. It mainly affecting the central area of the face showing a characteristic tendency to involve the lower eyelids. Various treatments have been tried with tetracyclines, isotretinoin, dapsone, prednisolone, clofazimine, isoniazid and corticosteroids, with variable results. We present the case of a 30 year old patient with characteristic complaints of eruption of multiple, discrete reddish raised asymptomatic lesion all over face with histopathology suggestive of Lupus miliaris disseminatus faciei
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Valsalva retinopathy following an aborted attack of destructive self-harm by strangulation p. 94
Padma B Prabhu, Nellikka Parambil Amitha, Balan Reshma, Suma Unnikrishnan
DOI:10.4103/mjmsr.MJMSR_53_16  
We describe a case of Valsalva retinopathy that occurred after near hanging. A 23-year-old female presented 5 days after destructive self-harm by attempted hanging, complaining of defective vision in the right eye which started immediately after she regained consciousness after resuscitation. The vision was counting fingers close to face. Fundus examination showed a large preretinal hemorrhage at the macular region. She failed to respond to conservative management and was successfully treated with neodymium-doped yttrium aluminum garnet hyaloidotomy. Hanging can cause Valsalva-like retinopathy.
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Optic nerve avulsion: A rare presentation of blunt trauma p. 97
Valiyaveettil Babitha, Chellappan Prasannakumary, ECK Ramesan, Kuzhippally Vlluon Raju
DOI:10.4103/mjmsr.mjmsr_23_17  
Optic nerve avulsion is one of the severe complications of blunt ocular trauma. Although a rare entity, optic nerve avulsion should be suspected in all blunt trauma cases presenting with sudden marked visual loss accompanied with dense vitreous hemorrhage.
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MEDICAL HISTORY PAGE Top

Evolution of refractive surgeries p. 100
Madhurima K Nayak
DOI:10.4103/mjmsr.MJMSR_5_17  
The use of surgical procedures to correct refractive errors of the eye has come a long way. The two main types are corneal procedures and intraocular procedures. Corneal procedures have evolved from thermokeratoplasty, keratotomies, epikeratoplasty, laser ablation, conductive keratoplasty, and collagen cross-linking. Intraocular procedures involve phakic intraocular lens (IOL), toric IOL, refractive lens exchange, and accommodating IOLs. Various physicists and ophthalmologists have played a role in this saga. From the idea of using thermal energy to shrink corneal tissue to using femtosecond laser, this article highlights the important landmarks in the history of evolution of refractive surgeries. Refractive surgeries form an ever-growing specialty of ophthalmology with addition of novel techniques with every quantum of time.
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LETTERS TO EDITOR Top

Synbone®: An effective tool in undergraduate teaching of fracture pattern and management p. 104
Ganesh Singh Dharmshaktu
DOI:10.4103/mjmsr.mjmsr_49_16  
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Acral gangrene following diarrhea disease p. 105
Ibrahim Aliyu
DOI:10.4103/mjmsr.mjmsr_18_17  
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Promotion of physical activity: A crucial strategy to delay the onset of noncommunicable diseases p. 106
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
DOI:10.4103/mjmsr.mjmsr_12_17  
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Pyoderma gangrenosum: Different perspective p. 108
Shveta Chauhan
DOI:10.4103/mjmsr.mjmsr_7_17  
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