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.

Relationship of dyslipidemia, insulin resistance, and prostate-specific antigen with prostate cancer

Abstract: Background and Objective: The incidence of prostate cancer is increasing day by day worldwide. Prostate cancer in India is the 10 th most common malignancy affecting men although its incidence is rising in India. This study is designed to the effect of dyslipidemia, altered serum glucose, insulin resistance, and prostate-specific antigen (PSA) on the risk of prostate cancer. Materials and Methods: The study was conducted on a total of 150 patients, in which 75 patients were of prostate cancer considered as cases and 75 were healthy individuals as controls. About 8 ml of blood samples was drawn to determine fasting glucose, lipid profile, serum insulin, and serum PSA. Serum glucose, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were measured using enzymatic kits of auto analyzer. Very low-density lipoprotein-C (VLDL-C) and LDL-C were calculated by Friedwald's formula. Serum insulin and serum PSA were estimated by immunoenzymatic assay. Body mass index (BMI) was calculated as weight in kilograms divided by height in meters squared (kg/m 2 ). Insulin resistance was assessed by homeostasis model assessment insulin resistance index (HOMA-IR) and calculated as follows: fasting glucose (mg/dL) × fasting insulin (mU/mL)/405. Blood pressure was measured in the sitting position after a 10 min resting period. Observation and Results: Clinical variables such as age, BMI, blood pressure, lipid profile, serum glucose, serum insulin, HOMA-IR, and serum PSA in case and control groups were compared using the unpaired Student's t -test. We found that BMI and the level of serum glucose, serum insulin, HOMA-IR, and serum PSA were significantly increased in prostate cancer patients as compared to control. In prostate cancer patients, HDL-C significantly decreased ( P P Conclusion: This study has shown significant association of high BMI, dyslipidemia, insulin resistance, and PSA with prostate cancer.

Antibiotic Prescribing Patterns by Health Care Providers in Pediatric Outpatients: A Prospective Observational Study

Abstract: Objectives: To audit the patterns and quality of antibiotic prescription for children in the outpatient department (OPD). Methods: This prospective observational study was conducted on the tertiary care outpatient department of a teaching hospital. One thousand prescriptions for children between 1 month and 15 years of age, who attended the outpatient department of a tertiary care teaching hospital between April 2018 and May 2019, were included. The quality of prescriptions was assessed based on 12 pretest parameters. One score was given to each correctly written parameter, and total scores were categorized as poor (0 - 4), average (5 - 8), and good (9 - 12). The core prescribing indicators presented by the world health organization (WHO) were used to analyze antibiotic prescribing patterns. The data were analyzed using open-source Epidata software. Results: Out of 1000 prescriptions, quality was average in 490 (49%) and poor in 46 (4.6%) prescriptions. The average number of medicines prescribed per encounter was 3.5 (reference value < 2). The medicines were prescribed by their generic names in 27.3% of the prescriptions (reference value 100%). Antibiotics and injections appeared in 65% (reference value < 30%) and 6% (reference value < 20%) of the prescriptions. The ratio of prescription from a list of essential medicines was 15% (reference value 100%). According to the prescriber profile, the rate of prescribing an antibiotic was 63% by postgraduates in pediatrics, 70% by MBBS, and 90% by AYUSH doctors (reference value < 30%). Conclusions: More than half of the prescriptions could not attain a good score. There is room for improving prescription writing practice. Antibiotic prescription by health care providers, especially AYUSH doctors, needs to be restricted given the high number of antibiotics per prescription. This will limit the indiscriminate use of antibiotics and may be a big step towards achieving the antibiotic stewardship goal.

Diphtheritic Myocarditis: Case Series in the present era of Universal Immunization programme

Abstract: Diphtheria continues to be reported from the developing world and is a major preventable disease of childhood with high morbidity and mortality. It can affect many organ systems but the cardiovascular involvement in the form of myocarditis carries a high mortality. We report a case series of eight children with the diagnosis of diphtheria who presented with arrhythmias or cardiogenic shock suggestive of severe myocardial damage. Out of eight children, five (62.5%) died. Early detection, careful monitoring and aggressive management may result in improved outcomes in these critically sick children. Introduction Diphtheria is an acute infectious disease caused by the exotoxin producing strains of Corynebacterium diphtheria. C. diphtheriae is an aerobic gram-positive pleomorphic bacillus.1 Throughout history, diphtheria has been one of the most dreaded infectious diseases globally causing epidemics and high mortality amongst children. Due to the availability of effective vaccination, diphtheria has shown a declining trend world over.2 However, it remains a significant health concern in countries with poor routine immunization coverage. And it still continues to be reported from the developing countries.3,4,5,6 From 2011-2015, India had the largest number of reported cases (18350) followed by Indonesia and Madagascar (3203 and 1633 respectively).2 Hospital-based surveillance studies, as well as diphtheria outbreaks published in the last 20 years (1996-2016), indicate that diphtheria cases are frequent among school-going children and adolescents.7 As per the national level health surveys, coverage of three doses of diphtheria vaccination was 80% during 2015-2016. Information about coverage of diphtheria boosters is not routinely collected through these surveys but is expected to be low.8 There have been reports of outbreaks of diphtheria from a few states namely Assam (2010), Karnataka (2011), Andhra Pradesh (2014).7 Diphtheria can affect many systems and cardiovascular involvement is a major contributor to mortality. Arrhythmias, heart blocks and cardiogenic shock are the manifestations of severe myocardial damage.9 There is a scarcity of literature describing these manifestations and very few studies have been reported from central India regarding this disease.10 Hence, we did a retrospective study of children admitted with diphtheria who presented with cardiac complications to the pediatric intensive care unit (PICU). Methods & Materials We conducted a retrospective observational study in the Department of Paediatrics at a tertiary care teaching institute from central India. Institutional Ethics committee approval was taken before the commencement of the study. Data was collected from the in-patient records of the patients retrieved from the Medical Records Department. The pediatric cases admitted within the study duration period of 4 months from August 2018 to November 2018 with the diagnosis of diphtheria with myocardial involvement were enrolled in the study. The diagnosis of diphtheria was made clinically on the basis of classic clinical findings of fever, throat pain, white membrane in the throat that bled on touching.11 The diagnosis of myocarditis was made on the basis of symptoms and signs of cardiac failure or arrhythmias or electrocardiographic (ECG) findings in the form of conduction abnormalities (heart block) or arrhythmias.11 ECG was done in all patients; however, echocardiography could be done only in one patient. Children with other causes of myocardial dysfunction were excluded from the study. The details of demography, clinical history and examination findings, immunization status, family history, ECG/ Echocardiography findings, laboratory investigations in the form of complete blood count, renal function tests and throat swab smear examination by Albert’s stain and treatment given were recorded. Leucocytosis was defined as total leucocyte count more than 15,500/cumm (Age: 4-7 years) and 13,500/cumm (Age: 8-13 years). Hypotension was defined as systolic BP <2 SD below normal for age.11 The identity of the patients was not revealed in the study. Data was tabulated and analyzed. Results A total of eight patients were enrolled during the study period of four months. Male to female ratio was CONTACT Dr. Anjali Bharani Email: dr.anjalibharani@gmail.com Address for Correspondence: Dr. Anjali Bharani (Associate Professor), Department of Pediatrics, Mahatma Gandhi Memorial Medical College and M.Y Hospital Indore, Madhya Pradesh, India. ©2020 Pediatric Oncall ARTICLE HISTORY Received 10 February 2020 Accepted 3 June 2020