Mahatma Gandhi Memorial Medical College

About: Mahatma Gandhi Memorial Medical College is a education organization based out in Indore, Madhya Pradesh, India. It is known for research contribution in the topics: Dyslipidemia & Lipid profile. The organization has 210 authors who have published 123 publications receiving 1085 citations. The organization is also known as: MGM Medical College.

Clinicopathological Study of Intradural Extramedullary Spinal Tumors and Its Correlation With Functional Outcome.

Abstract: Introduction Intradural extramedullary (IDEM) spinal cord tumors account for approximately two-thirds of largely benign intraspinal neoplasms. These are amenable to gross total excision and usually carry a good functional outcome. Methods In this study, we reviewed the surgical outcomes of 35 patients who underwent excision of intradural extramedullary tumors. Patient demographics, severity and duration of symptoms, and tumor characteristics (anatomical and pathological) in all operated spinal IDEM tumors were collected. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel and Nurick grading. The back pain was assessed with help of the Denis pain scale (DPS). Results The histopathological outcomes of the study were as follows: six patients of neurofibroma, 12 cases of schwannoma, nine cases of meningiomas, three cases of ependymoma, one case of dorsal neurenteric cyst, two cases of epidermoid cyst, one case of cauda equina paraganglioma, and one case of filum terminale dermoid cyst. Paresthesia/numbness were the commonest symptoms (88.6%), weakness of limbs in (80%), sphincter dysfunction in 15 patients (42.9%), and paraplegia was seen in three patients (8.57%). The complications encountered were - one case each of cerebrospinal fluid (CSF) leak, surgical site infection, and pseudomeningocele. The percentage of spinal canal occupied ranged from 71-94%. The mean percentage of the spinal canal occupied by the tumor was 81.8%. In our series, 77.14% of patients (p<0.0001) had good functional outcomes as per improvement in Frankel score. The DPS and Nurick score mean values showed a significant decrease over the follow-up duration as compared to preoperative mean values. Significant functional improvement was noted at the one-week, one-month, and one-year follow-up, with a p-value of <0.0001. Conclusions The IDEM tumors are usually benign and are readily detected by contrast-enhanced MRI scans. These have excellent surgical outcomes with some exceptions. Greater canal occupancy and a longer duration of symptoms are usually seen to correspond with suboptimal functional outcomes.

Depth-Sensitive Raman Spectroscopy of Intact Formalin-Fixed and Paraffin-Embedded Tissue Blocks for Objective Diagnosis of Cancer- An Exploratory Study

Abstract: Histopathology, the current “gold standard”, is prone to human errors as it depends on expert interpretation of the microscopically derived cellular and sub-cellular information for tissue diagnosis. Further, this light microscope based approach requires preparation of appropriately stained specimens of micro-thin tissue sections from the formalin-fixed and paraffin-embedded (FFPE) blocks of tissue samples. We report a method that provides quantitative feedback about tissue diagnosis by measuring depth-sensitive Raman spectra from the intact FFPE tissue blocks without requiring preparation of any thin tissue sections or any other processing. The FFPE blocks of pathologically certified cancerous and normal breast tissues were used for validating the approach. The measured depth-sensitive Raman spectra were mathematically de-paraffinized for retrieving the characteristic tissue Raman signatures using scaled-subtraction. A multivariate analysis of the scaled-subtracted, depth-sensitive Raman spectra employing a probability-based diagnostic algorithm developed using the framework of sparse multinomial logistic regression (SMLR) provided a sensitivity and specificity of up to 100% towards cancer based on leave-one-block-out cross validation. The results of this exploratory study suggest that depth-sensitive Raman spectroscopy along with a multivariate statistical algorithm can provide a valuable alternate diagnostic modality in clinical pathology setting for discriminating cancerous from normal FFPE tissue blocks.

Medical complications of puerperium: a single center observational study

Abstract: Background: Puerperium is of 6 weeks after delivery, when body reverts back to its original non pregnant state. This period holds its own set of medical issues with frequent occurrence of gynaecological complaints like hematoma, bleeding, painful discharge and many medical issues like pyrexia, mastalgia, coagulation disorders and depression. The management of all these problems is further complicated by consideration of lactation which prohibits use of many drugs. There are many studies available in international communities that analysed women in puerperium but the data from Indian subpopulation where most deliveries are conducted in government funded institutes is lacking. The current study was an observational single center study carried out at gynaecology department along with medicine and surgery department of a tertiary care hospital associated with a medical teaching institute for defining the epidemiological parameters of the puerperal maladies. Methods: 150 randomly selected pregnant subjects with otherwise uncomplicated pregnancies, both booked at our institute or referred at the time of delivery between January to July 2016 were included in the study. Both normal vaginal or assisted deliveries were considered irrespective of booking status. Patient not willing for consent, and patients reporting beyond 2 weeks of delivery were excluded. All patients were observed while in hospital and weekly thereafter till 6th week and detailed gynaecological, medical and psychiatric evaluation was carried out by a multidisciplinary team. Detailed evaluation of cause was carried out in all cases of pyrexia, pain or other objective symptoms and analysis of depression was done. All data were collected and analysed by spss 22.0 at the end of 6 weeks. Results: Of the 150 patients studied, 40% had caesarean delivery while 60% had normal vaginal delivery with or without episiotomy. The most common complications noted during puerperium were wound discharge (10.67%), perineal pain (10%), fever (15%) and Mastalgia & Mastitis (13%). Depression was diagnosed in 6% of the studied cases. Cause of fever was mastitis/breast abscess in 30%, Urinary tract infection in 24%, Malaria in 7% and puerperal sepsis in 12% cases, in rest of the cases the cause of fever could not be found. The puerperal complication rate was more in LSCS 22.95% as compared with vaginal deliveries 14.6%. Conclusions: Puerperium remains an important aspect of pregnancy where the nature of complications differs totally from those seen during antenatal period. Our study suggests that most important complications in puerperium are purulent discharge, perineal pain and pyrexia. Depression is a frequent occurrence in post-partum period and its early identification can benefit both maternal and child health. Fever in puerperium is fairly common Perineal infection, Breast infection, Urinary tract infection and Malaria being common causes. A vigilant multidisciplinary approach is required to optimally manage all these complications.

An observational study of effect on quality of life in perimenopausal females suffering from urinary incontinence

Abstract: Background: Urinary incontinence (UI) affects many older adults. Some of its deleterious consequences include stress, major depression, diminished quality of life, sexual dysfunction, and familial discord. Despite a wealth of research contributions on this topic, the available literature is under representative of ethnic minority older women. Methods: A cross-sectional observational study was conducted by taking a group of 225 females of perimenopausal age group. Patients were assessed clinically for the diagnosis of urinary incontinence and effect on quality of life was assessed. Further testing was done depending on the storage symptoms & voiding symptoms and included residual volume assessment by ultrasound, cystometry, complex urodynamic test and cystoscopy. The data obtained and the socio-demographic data recorded in a structured proforma. The data obtained was assessed, analysed and results were drawn thereafter. Results: In our study the prevalence of UI was found to be 18%. Maximum prevalence was seen in the age group of 61-70 years. Highest numbers were found to have stress incontinence 60.44%, followed by 23.55% of urge, overflow 5.33% and 10.66% mixed symptoms. The impact was equitable over all dimensions measured for QOL, namely activity limitation (28.44%), social interaction limitation (35.11%), sexual activity limitation (16%), financial burden increased (3.55%), emotional upset and distress (16.88%). Conclusions: In the present study, we determined the prevalence of UI among 200 community-dwelling, ethnically diverse older women, discovered that our new UI screener is reliable, and did not find the UI-depression link to be significant.

Pattern of thyroid carcinoma in Gizan region of Saudi Arabia

Abstract: Objective: To study the frequency, clinical features, and histopathological types of thyroid carcinoma in Gizan region of Saudi Arabia. Research Design and Methods: We analyzed the clinical features, laboratory data, histopathological reports, and outcome of 32 patients diagnosed with thyroid carcinoma out of 231 patients who underwent thyroidectomy at King Fahd Central Hospital (KFCH), Gizan and peripheral hospitals over a period of 6 years. Results: The papillary thyroid carcinoma (PTC) was present in 25 patients and follicular thyroid carcinoma (FTC) in 5 cases. Anaplastic cell variety was found in two cases. The mean (±SD) were significantly different ( P = 0.015) when the groups with PTC and FTC were compared (43.1 ± 12.7 vs. 61.3 ± 15.4). Fine needle aspiration cytology (FNAC) was done in all 32 cases; it was negative in 11 cases. Conclusions: In Gizan, incidence of thyroid carcinoma is about 14% among total patients undergoing thyroidectomy. Painless thyroid nodule is the most common clinical feature. PTC is the most common variant. FNAC is a useful tool for diagnosis but it can be false negative also.