Trends in Clinical and Medical Sciences (TCMS)

Gastric cancer, ranking as the fourth most prevalent cancer and the second leading cause of cancer-related deaths worldwide, poses a significant public health challenge with approximately 800,000 new cases and 650,000 deaths annually, with 60% of cases occurring in developing countries. Regions with the highest incidence rates, exceeding 40/100,000 in males, are Eastern Asia, the Andean regions of South America, and Eastern Europe. Incidence rates are notably higher among socio-economically disadvantaged groups and in developing countries. The aim of this study was to analyze the levels and ratios of pepsinogen-I and pepsinogen-II in gastric dysplasia and malignancy. Conducted at the Pathology Department of MGM Medical College and Maharaja Yashwantrao Hospital in Indore, Madhya Pradesh, the prospective study spanned one year from May 2020 to April 2021 and included a total of 30 cases diagnosed with gastric dysplasia and malignancy through endoscopy and histopathology. The results revealed a significant decrease in serum mean PG-I level and PG I/II ratio in patients with gastric cancer (P=0.00). Moreover, both the mean serum PG-I level and PG I/II ratio were lower in patients with gastric cancer compared to those with dysplastic lesions.

Leukemia, the most common childhood cancer, is predominantly acute, with acute lymphoblastic leukemia (ALL) and acute myelogenous leukemia (AML) being the primary subtypes. The incidence rates for ALL and AML are 1.5 and 2.7 per 100,000 population, respectively. The objective of this study conducted at the Pathology department of M.G.M. Medical College in Indore was two-fold: firstly, to classify acute leukemia into ALL or AML using flow cytometry, and secondly, to assess the diagnostic value of specific markers (Anti-MPO, CD34, HLA-DR, CD45, CD79a, CD3) in acute leukemia diagnosis. The study involved evaluating cases through routine peripheral smear and subsequently analyzing relevant cases on a flow cytometer. The results revealed that 23 cases (77%) were diagnosed as ALL, while 7 cases (23%) were identified as AML. Among the ALL cases, 19 were classified as B-cell ALL (64%), whereas 4 were T-cell ALL (13%). In conclusion, the use of multicolor flow cytometry enables simultaneous assessment of multiple antigens, facilitating more precise categorization of cell populations. Furthermore, flow cytometry plays a crucial role in differentiating AML from ALL and its subtypes.

Infertility, characterized by the failure to conceive after a year of regular unprotected sexual intercourse, affects a significant proportion of couples. Male factors contribute to approximately 40-50% of infertility cases, with around 2% of men exhibiting suboptimal sperm parameters. Semen analysis serves as the primary diagnostic tool for male infertility. Elevated levels of serum follicle-stimulating hormone (FSH) often indicate severe impairment of spermatogenesis. In contrast, inhibin B concentrations are closely associated with sperm concentration and testicular volume, making it a valuable marker for assessing spermatogenesis. This prospective study aimed to investigate the relationship between semen parameters and the levels of serum FSH and inhibin B. The study included 35 cases of male infertility, and their semen samples were subjected to microscopy and comprehensive analysis. Among the cases, 14.3% exhibited a sperm count of =5 million/ml, with a mean serum FSH level of (46.45 \(pm\) 2.68) and a mean serum inhibin B level of (4.34 \(pm\) 2.34). The results revealed a significant negative correlation between inhibin B levels and FSH concentrations (r = 0.919, p < 0.0001). Furthermore, a positive correlation was observed between sperm concentrations and inhibin B (r = 0.945, p < 0.0001), while a negative correlation existed between sperm concentrations and FSH levels (r = -0.980, p < 0.0001). These findings suggest that the degree of male infertility is directly proportional to elevated FSH levels and inversely proportional to serum inhibin B levels. Thus, serum inhibin B emerges as a more sensitive parameter for assessing male infertility.

Background: Advances in all fields of oncology have resulted in five-year survival rate approaching 80% among pediatric /AYA survivors which has led to increased focus on psychosocial relationship care, identification of late effects and improving quality of life. For this growing population of cancer survivors with a whole life ahead of them, more concrete support structures have been directed towards the evaluation and improvement of post-treatment care. Medical care complemented with non-medical (psychosocial relationship) care increases awareness with respect to many psychosocial relationship aspects such as educational, employment, post treatment distress and coping which need to be addressed for the survivor to lead a normal productive life. Recent studies have shown that regular psychosocial relationship follow ups have resulted in timely identification of late effects followed by appropriate rehabilitation services being provided to survivors.
Method: The study is based on project PICASSO (partnership in cancer survivorship optimization) initiated by Indian Cancer Society which aims at providing holistic care for childhood cancer survivors. The qualitative analysis was performed by using the quality-of-life scale (WHOQoL-BREF). Non probability purpose sampling pediatric/AYA oncology survivors were taken from the act clinic and potential survivors participated who have completed the treatment till June 2022. (n=100).
Results: The Significant difference is seen between ACT and non-ACT survivors as far as psychological well-being health and physical health domain is considered and insignificant difference is seen as far as social relationship and environment wellbeing is considered.
Conclusion: The Study revealed that ACT survivors have good psychological well-being and physical health then non-ACT survivor.

This cross-sectional analytical study aimed to investigate the possible association between extended high-frequency hearing and mastoid pneumatization. A total of 206 patients were involved in the study, and a statistically significant difference was found that the patients with higher mean mastoid volume had a response to that particular frequency when compared to patients with lesser mean mastoid volume in both the right and left ear. However, there was no statistically significant association between various age groups and responses and between gender and responses at all frequencies. The study concludes that there is a correlation between mastoid pneumatization and extended high-frequency hearing.

This study aimed to compare the efficacy of Midazolam and Dexmedetomidine as premedication agents in pediatric patients administered via the intranasal route. 100 children in ASA physical status I and II, aged 2-8 years, planned for surgery under general anesthesia, were randomly assigned to Group D, which received 1 mcg/kg of Intranasal dexmedetomidine, or Group M, which received 0.2 mcg/kg of Intranasal midazolam for premedication. The patients’ sedation status, separation anxiety, and mask acceptance were evaluated using UMSS, PSAS, and MAS, respectively, along with hemodynamic parameters and side effects. The mean sedation score was higher in Group D than Group M, and the mean parental separation anxiety score and mean mask acceptance score were also higher in Group D than Group M. All hemodynamic parameters were comparable and stable in both groups. In conclusion, intranasal dexmedetomidine was found to provide better sedation, relieve preoperative anxiety, make parental separation easier, and promote better mask acceptance, without any significant side effects.

The study aimed to compare the analgesic efficacy of USG-guided versus landmark-based transversus abdominis plane (TAP) block using 0.25% bupivacaine in abdominal surgeries. A total of 100 patients undergoing elective abdominal surgery were included in the study, with 50 patients receiving USG-guided TAP block and the other 50 patients receiving landmark-guided TAP block. The patients were evaluated post-operatively for up to 24 hours for their VAS score, amount of analgesic required, and time for the first rescue analgesia. The results showed that the USG-guided TAP block group had a significant decrease in pain at 4 and 8 hours following surgery compared to the landmark group, with a lower total analgesic demand in the postoperative period. The study concluded that USG-guided TAP block is an efficient and safe addition to multimodal post-surgical analgesia compared to landmark-guided block. The study was conducted at the Department of Anesthesiology of the M. G. M. Medical College and M. Y. Hospital in Indore, Madhya Pradesh, and was approved by the Institutional Ethical and Scientific Review Committee.

Preoperative anxiety is a common occurrence in patients undergoing surgery, and it can lead to a range of negative effects, including an increased requirement for anesthetic agents, hemodynamic instability, and delayed recovery. Melatonin has been shown to have an anxiolytic and hypnotic effect with fewer side effects. This study aimed to explore the potential of oral melatonin to reduce preoperative anxiety levels and the dose requirement of propofol for the induction of general anesthesia. The study included 150 patients who were equally divided into two groups: Group M and Group C. Group M received oral melatonin 6mg and vitamin B complex tablets, while Group C received a sip of water and vitamin B complex tablets 90 minutes before the surgery. Anxiety levels were measured using the VAS score preoperatively and 90 minutes after drug administration. Propofol was given until the BIS value was sustained for 1 min at 48\(\pm\), and the total dose was measured in both groups. Postoperative pain was assessed using the VAS score just after extubation and every hour for the next 4 hours, with Inj. Diclofenac given if the score was \(\geq\)4. The time of first rescue analgesia was noted. Results showed that Group M had a significantly reduced VAS score and required a lower dose of propofol for induction compared to Group C (p\(\leq\)0.0001). The time of first rescue analgesia was also prolonged in Group M compared to Group C (p\(\leq\)0.0001). Therefore, oral melatonin is an effective premedicant that reduces preoperative anxiety, the required induction dose of propofol, and provides postoperative analgesia.

This prospective observational study aimed to assess the role of transvaginal ultrasound (TVS) in diagnosing the cause of abnormal uterine bleeding (AUB) and characterizing benign and malignant lesions. 130 patients were included and underwent TVS and histopathological examination. TVS showed sensitivity of 59%, specificity of 93%, positive predictive value of 81%, negative predictive value of 82%, and accuracy of 58% for diagnosing malignant lesions. The study provided TVS imaging features for early identification, characterization, and extent of uterine pathologies, as well as relevant information for clinicians to make reasonable decisions. TVS is a good primary imaging modality due to its non-invasiveness, low cost, and wide availability.

Introduction: Cytomegalovirus (CMV), a double-stranded DNA virus belongs to a family called herpesviridae or human herpesviruses (HHVs). CMV is spread by direct contact with infectious body fluids such as nasal secretions, saliva, tears, urine, genital secretion or breast milk. After contamination, the virus initially replicates in the epithelial cells at the site of entry, followed by hematogenous spread to numerous organs and cell types.
Aims: to estimate prevalence of CMV in a population of male partners of infertile couples attending a tertiary care hospital of Kolkata and also to determine the impact of CMV infection on sperm parameters.
Materials and method: The proposed study is an observational and descriptive study of cross-sectional study was conducted in department of Physiology, R.G. Kar Medical College & Hospital, Kolkata. The study period was One year January 2021 – January 2022. 56 patients were included in this study.
Result: We showed that, lower number of patients had Normal Morphology in with Cytomegalovirus [4 (100.0%)] this was not statistically significant (p=0.6895). Association of Addiction with Cytomegalovirus was statistically significant (p=0.0059) and Infertility DX with Cytomegalovirus was not statistically significant (p=0.6088). It was found that, higher number of patients had Height in without Needed Mechanical Ventilation [29 (65.9%)] compared to with Needed Mechanical Ventilation [4 (44.4%)] It was not statistically significant (p=0.0504).
Conclusion: we concluded that cytomegalovirus was associated with in male partner of infertile couple and its impact on seminal analysis a tertiary care hospital.