GAIMS Journal of Medical Sciences 2021-11-30T00:00:00+0530 Editor-in-Chief Open Journal Systems <p>An official publication of Gujarat Adani Institute of Medical Sciences</p> <p> </p> <p><strong>Published by:</strong><br />Gujarat Adani Institute of Medical Sciences<br />G K General Hospital<br />Opposite Lotus Colony<br />Bhuj, Kachchh, Gujarat – 370001</p> <p> </p> <p> </p> Time to shift from authorship to contributorship 2021-10-15T22:27:22+0530 Chinmay Shah <p>-</p> 2021-11-30T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences Severe generalized junctional epidermolysis bullosa in a newborn 2021-09-23T18:18:58+0530 Rekha Thaddanee Kinjal Patel Aishwarya Ramani <p>Epidermolysis Bullosa (EB) is a group of inherited skin fragility disorders. It characteristically presents as blisters formation over skin and mucosa. Epidermolysis bullosa simplex, junctional epidermolysis bullosa and dystrophic epidermolysis bullosa are three major subtypes of EB depending on the level of skin cleavage. Present case report describes a rare junctional epidermolysis bullosa in a newborn. Clinical manifestations vary from mild local blisters formation to severe one with multisystem involvement. Protection of skin, prevention of complications and supportive care are the only current treatment options.</p> 2021-10-20T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences Bilateral anterior lenticonus associated with Alport syndrome 2021-09-30T21:56:56+0530 Naurin Memon Divyang Patel Kavita Shah <p>Anterior Lenticonus is a rare congenital anomaly of the eye characterized by a conical protrusion of the crystalline lens capsule and the underlying cortex in anterior chamber leading to high axial myopia; most cases are associated with Alport syndrome. Alport syndrome (AS) is an inherited disorder of many forms, most commonly X-linked. The main abnormality is deficient synthesis of type IV collagen, the main component of basement membranes. It typically presents with the classic triad of progressive glomerulonephritis, progressive high tone hearing loss, and several ocular signs; the most pathognomonic of which is the presence of anterior lenticonus.We reported a 21 year old female of alport syndrome presenting with gradual, progressive diminished vision in both eyes associated with anterior lenticonus and dot and fleck retinopathy with progressive sensorineural hearing loss.</p> 2021-10-20T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences Cavernous hemangioma of uterus – Report of two cases and review of literature 2021-09-22T13:16:35+0530 Arohi Parekh Bhawana Sharma Keval Patel Kinalee Chothani Dhaneshwar Lanjewar <p>Uterine hemangioma is a rare benign tumour and can be congenital or acquired. Acquired is associated with physical changes such as tissue injury, hypoxia, endometrial curettage, increased blood volume during pregnancy and hormonal alterations. Uterine hemangiomas are found incidentally, remain asymptomatic and may present with bleeding per vaginum. Only 73 cases of uterine, cervical, vaginal and fallopian tube hemangiomas are described in the literature. In this report we describe additional two cases of uterine hemangioma.</p> 2021-11-30T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences Role of Ultrasound in Female Infertility 2021-09-28T20:05:15+0530 Meet Chavda Raj Patel <p>Ultrasound has became an important tool for the diagnosis of female infertility by demonstrating pelvic organs ,growing ovarian follicles and cyclical changes in the endometrium during the menstrual cycle .Ultrasound particularly can demonstrate ovarian flow and resistance of flow and many other parameters affecting the follicular growth .In assisted reproductive technology(ART) ultrasound is indispensable tool for the monitoring of ovarian follicles after hormone stimulation ,ovum pick up ,embryo transfer and also thereafter.The average diameter of follicles is measured. Among the study conducted it is found that ovulation induction will be successful if preovulatory follicular diameter was between 18 to 24 mm.The risk of overstimulation can be assessed with ultrasound.The detection of ovulation is the most important step in management of infertility . Ultrasound is more important for determining the time of ovulation than other methods like basal body temperature or hormonal studies. Ultrasound is also important for visualisation of uterine size-position,fallopian tubes and any congenital anomalies of genitourinary system.In the uterus it has very important role for endometrium ,the physiological changes occurring in endometrium during the menstrual cycle.Female infertility is multifactorial in origin ,ultrasound plays an important role in female infertility work up with hysterosalpingography(HSG) ,sonohysterography and MRI ,each playing a complimentary role in screening ,diagnosis and management of female infertility</p> 2021-11-30T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences A Case of Autosomal Dominant Bilateral Familial Aniridia 2021-10-04T16:15:29+0530 Kinjal Mehta Nikhil Rupala Kavita Shah <p>&nbsp;&nbsp;Aniridia is a familial or sporadic disorder affecting not only the iris but also the cornea, angle &nbsp;structures, lens, optic nerve, and fovea. This disorder may be associated with many other systemic abnormalities such as urogenital malignancies. We report a family of aniridia with different clinical spectrum of features.</p> 2021-11-30T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences A clinico-pathological and clinico-radiological study of anterior neck swellings 2021-09-18T11:35:22+0530 Hetal Joshi Ajeet Kumar Khilnani Narendra Hirani Rashmi Sorathiya Riddhi Bhimajiani Nisarg Desai Ronak Bodat <p><strong>Introduction</strong></p> <p><strong> </strong>Swelling in anterior neck is a common cause of visit to ENT OPD. Most of the times it is easy to diagnose an anterior neck swelling by clinical, radiological, cytological and histo-pathological examinations. However, if there is any discrepancy or doubt, then there should be a clinico-pathological and clinico-radiological inter-departmental discussion to finalize a diagnosis.</p> <p><strong>Methodology</strong></p> <p><strong> </strong>The present study was a prospective longitudinal study conducted in ENT Department of Gujarat Adani Institute of Medical Sciences, Bhuj, from October 2018 to September 2020. The evaluation of patients included clinical, radiological, cytological and histo-pathological examinations. All the data was tabulated in Microsoft excel sheet and analyzed using descriptive statistics.</p> <p><strong>Results</strong></p> <p><strong> </strong>In our study, the youngest patient was 4 years old and the eldest patient was of 84 years. The mean age of patients was 40±18.4 years. Out of 150 patients studied, there were 46 males (31%) and 104 females (69%) with female to male ratio is 2.2: 1. Out of 150 cases, 87 (58%) cases were thyroid swellings. Considering histopathology data as gold standard, we found that sensitivity of USG was 79.48 %, that of FNAC was 92.31% and clinical was 92.31% with respect to thyroid swellings, while for non-thyroid swellings, the sensitivity of USG was 50 %, FNAC was 62.5% and clinical was 50%.</p> <p><strong>Conclusions</strong></p> <p> In our study, thyroid swelling was the most common anterior neck swelling, more common in females. Discrepancy in clinico-radio-cyto-histological diagnosis was higher in cases of malignant anterior neck swellings.</p> 2021-10-20T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences Correlation of vitamin D levels with left ventricular ejection fraction in patients with dilated cardiomyopathy 2021-10-01T12:13:20+0530 Avinash Tiwari Amit Kamleshbhai Mistry Shaktisinh R Zala <p>Vitamin D deficiency is highly prevalent and has been shown to be associated with cardiovascular diseases, including coronary<br />artery disease, left ventricular (LV) hypertrophy and systolic heart failure. Vitamin D is an important hormone whose receptors are<br />found in many tissues including cardiac myocytes, and plays a significant role in the autocrine and paracrine regulation of cellular<br />function, growth and differentiation in various organs. Although there is a substantial published literature on Vitamin D deficiency<br />and cardiovascular diseases, there is a little data on Vitamin D deficiency and diastolic dysfunction or diastolic heart failure. Since<br />diastolic dysfunction is an early manifestation of LV hypertrophy and ventricular dysfunction, it may reflect the effects of Vitamin<br />D deficiency on the cardiovascular system. As a result, the present study examines if there is any association between Vitamin D<br />levels and diastolic dysfunction as measured by comprehensive two-dimensional (2D) Doppler echocardiography.</p> 2021-10-20T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences Prevalence of neonatal septicemia at a tertiary care level district hospital 2021-09-30T16:08:58+0530 Vandana Patel Hitesh Assudani <p><strong>Introduction</strong></p> <p>Neonatal sepsis is a major cause of neonatal mortality, the clinical outcome of which depends on early diagnosis and initiation of appropriate antibiotics. The emergence of multi-drug resistant strains has limited the choice of available antibiotics. Thus, antibiotic resistance pattern of pathogens is critical for both therapy and infection control.</p> <p><strong>Objectives</strong></p> <ul> <li>To find out prevalence neonatal septicemia at tertiary care level hospital</li> <li>To find out gender wise distribution of prevalence of neonatal septicemia at tertiary care level hospital</li> <li>To find out common associated factor, clinical symptoms of prevalence of neonatal septicemia at tertiary care level hospital</li> <li>To identify common bacterial pathogen responsible for neonatal septicemia at tertiary care level hospital</li> <li>To determine antibiotic susceptibility pattern of Bacterial pathogen responsible for neonatal septicemia<strong style="font-size: 0.875rem;"> </strong></li> </ul> <p><strong>Materials and Methods</strong></p> <p>This observational study was conducted in the Microbiology department of Tertiary care level hospital affiliated with medical college. Venous blood collected aseptically before initiation of antibiotic therapy. For neonates 2 ml of blood &amp; for older children 5 ml of blood was collected from peripheral vein with aseptic precaution. The blood culture bottles were sent to laboratory, where they incubated in BACTEC (FX40) if bottle was positive then it sub-culture were made on MacConkey &amp; Blood agar &amp; incubated in appropriate temperature &amp; further identification was done according to standard guidelines.Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method and interpretation was done according to CLSI guidelines.</p> <p><br /><strong>Results</strong></p> <p>Among 100 blood samples processed from clinically suspected neonatal septicemia cases, 28 (28 %) samples showed growth. Among 28 isolates, 15 were from early onset septicemia (EOS) and 13 were from Late Onset Septicemia (LOS). Among 28 culture positives, 20 (71.4%) were from males and 8(28.6%) were from females, thus showing a male preponderance.Gram-positive bacteria were responsible for most cases of neonatal sepsis. Coagulase negative staphylococci (CoNS) were the most frequent<br />isolated pathogens in EOS and LOS, followed by Klebsiella pneumoniae, Staphylococcus aureus, Enterococcus spp and Escherichia coli. The antibiotic sensitivity showed that most of the Gram negative bacteria were highly resistant to the commonly used antibiotics like Ampicillin and Gentamicin.</p> <p><strong>Conclusion</strong></p> <p>Neonatal sepsis is a medical emergency and empirically treatment is started without microbiology report. If local microbiological databases are available with information regarding the commonly isolated organisms and their drug resistance patterns, it can help the clinicians in planning of therapy which in turn reduces neonatal mortality and morbidity.</p> <p><strong>Keywords: </strong>Neonatal septicemia, Blood culture, Antibiotic resistance</p> 2021-11-30T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences Study of Correlation between Chronic Renal Failure and Thyroid Hormones 2021-09-28T13:48:02+0530 Amitkumar Kamleshbhai Mistry Avinash Tiwari Shaktisinh R Zala <p>The interactions between kidney and thyroid functions are known for years. Thyroid hormones are necessary for growth and development of the kidney and for the maintenance of water and electrolyte homeostasis. Kidney on the other hand, is involved in the metabolism and elimination of thyroid hormone.<br />The prevalence of hypothyroidism is increased in patients with chronic renal failure while primary hyperthyroidism is extremely rare. Hyperthyroidism, hypothyroidism &amp; euthyroid state have all been reported in various studies.<br />The kidney plays an important role in the metabolism, degradation, and excretion of thyroid hormones. So, any impairment in kidney function leads to disturbed thyroid physiology including hypothalamic-pituitary-thyroid axis, leading to alterations in hormone production, distribution, and excretion.<br />Epidemiologic data suggests that reduced kidney function is associated with prevalent subclinical and clinical hypothyroidism. Though the thyroid function has been extensively studied in patients with chronic renal failure; the results are variable.</p> 2021-11-30T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences Pelvic retroperitoneal masses in children: what does the radiologist need to know? 2021-09-30T14:57:15+0530 Devanshee Jadeja Bhaven Shah Jignesh Shah Shivam Kotak <p>Pelvic retroperitoneal tumors pose a diagnostic and therapeutic challenge due to their rarity, late presentation, and complex anatomical location in the retroperitoneum. This article reviews the diagnosis and management of retroperitoneal tumors in the pelvis, and highlights the implications of imaging on management. This study was conducted in a tertiary care hospital of western Gujarat over a period of 2 years. We reviewed the various retroperitoneal masses in pelvis in pediatric age group and then discuss potential diagnostic and therapeutic challenges.</p> 2021-11-30T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences Pediatric Lines and Tubes: What Radiologists must Know 2021-10-01T11:53:11+0530 Kishan Patel Shivam Kotak Bhaven Shah Jignesh Shah <p>Radiographs are very useful for evaluation of various support and monitoring devices in pediatric patients. This review article focuses on the ideal locations of the tips of these tubes and catheters, as well as the consequences of malpositioning. Clinical outcome of patients can be affected by the placement of these support devices. Thus the radiologist has animportant role in detecting such malpositioned devices for prompt revisions or removal.</p> 2021-11-30T00:00:00+0530 Copyright (c) 2021 GAIMS Journal of Medical Sciences