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Trends in Clinical and Medical Sciences (TCMS)

Trends in Clinical and Medical Sciences (TCMS), ISSN: 2791-0814 (Online), 2791-0806 (Print), is a single-blind, peer-reviewed, Diamond Open Access journal dedicated to publishing scholarly work in medical sciences, dentistry, nursing, and allied health sciences. The journal focuses on transforming scientific hypotheses into evidence-based findings and clinical guidance, while also highlighting recent trends in disease diagnosis, prevention, management, and effective treatment. TCMS accepts original research articles, review articles, case reports, case series, brief reviews, short communications, editorials, and letters to the editor. The journal publishes both print and online versions. Accepted papers are published online in the current issue as soon as they are ready for publication. TCMS publishes one volume containing two issues each year, in June and December.

  • Diamond Open Access: TCMS follows the Diamond Open Access publishing model, under which published articles are freely available online to readers, and authors are not required to pay article processing charges for standard publication.
  • Visibility: The journal publishes both online and print versions, with accepted articles made available online in the current issue as soon as they are ready for publication.
  • Rapid Publication: Accepted papers are published online promptly after final preparation, supporting the timely dissemination of clinical and medical research.
  • Scope: The journal covers research in medical sciences, dentistry, nursing, and allied health sciences, including original research, reviews, case reports, case series, brief reviews, short communications, editorials, and letters to the editor.
  • Publication Frequency: One volume with two issues is published annually, in June and December.
  • Indexing: ICI Journals Master List, Scilit, and Google Scholar.
  • Publisher: Ptolemy Scientific Research Press (PSR Press), part of the Ptolemy Institute of Scientific Research and Technology.

Latest Published Articles

K. F. Zuparov1, N. Ya Fayzullayeva2, A. A. Tursumetov1
1Tashkent Pediatric Medical Institute Tashkent, Uzbekistan.
2Institute of Immunology and Human Genome of the Academy of Sciences of the Republic of Uzbekistan Tashkent, Uzbekistan.
Abstract:

This article discusses the feasibility of using lightweight polypropylene nets for onlay plastic surgery of postoperative ventral hernias (POVH). The study involved 137 patients with POVH, who were divided into two groups: the control group (64 patients) who underwent traditional Esfil-heavy mesh endoprosthesis and the primary group (73 patients) who received Esfil-light endoprostheses. The study investigated the clinical and immunological aspects of using propylene nets in these two groups of patients. Before surgery, the examined patients showed a suppression of the cellular link of immunity, an imbalance of the humoral link, and non-specific factors of protection. The use of polypropylene meshes (Esfil-light and Esfil-heavy) triggered an inflammatory reaction associated with the structural properties of the prostheses. However, the use of Esfil-light PP prosthesis in onlay allogernioplasty caused less inflammation in the alloplasty area compared to Esfil-heavy. Overall, the findings suggest that Esfil-light PP prosthesis can be a suitable alternative to traditional Esfil-heavy mesh endoprosthesis for onlay plastic surgery of postoperative ventral hernias. The reduced inflammatory reaction in the alloplasty area may lead to improved outcomes for patients undergoing this procedure.

Dr. Pratik Mansukhlal Doshi1, Dr. Harshil Mehta2, Dr. Dharmendra M Gohil3
1Associate Professor, Department of Emergency Medicine, P.D.U Government Medical College Rajkot, Gujarat, India.
2Assistant Professor, Department of Emergency Medicine, Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat, India.
3Professor, Department of Emergency Medicine, P.D.U Government Medical College Rajkot, Gujarat, India.
Abstract:

Background: Hypertension affects individuals of all classes and across all groups. The relationship between blood pressure and the risk of cardiovascular disease events is continuous and independent of other risk factors.
Aim and Objectives: The present study aimed to identify various modes of presentation and the clinical profile of hypertensive emergencies in our hospital.
Materials and Methods: Data were collected from 100 patients admitted to this hospital over a period of two years. Patients who presented with an elevated blood pressure of systolic blood pressure >180mmHg or diastolic blood pressure >110mmHg, with a history of acute target organ damage, or with laboratory evidence of acute target organ damage were included in the study.
Results: Of the 100 patients studied, 88 were known hypertensives, among whom 54 had discontinued their antihypertensives before the incident, while the remaining 46 patients continued their medication. Among the 100 patients, 28 had diabetes mellitus and 28 had dyslipidemias. Out of 100 patients with hypertensive emergencies, 12 died before discharge, resulting in a hospital mortality rate of 12%. All expired patients had intracerebral hemorrhage.
Conclusion: Known hypertensives are at a higher risk of presenting with acute target organ damage associated with hypertensive emergency. The presence of diabetes mellitus and dyslipidemia increases the chance of developing hypertensive emergencies.

Ashfaq Ul Hassan1, J.B. Singh1, Neelofer Jan1, Shomalla Jan2
1SKIMS Medical College, Srinagar, J&K, India.
2GMC, Kathua, J&K, India.
Abstract:

In modern education, innovative techniques and updated technology are essential tools for effective teaching. As the medical field advances, new teaching methods and modalities are necessary to generate interest and provide practical learning experiences. Histology is a crucial component of medical education, and a thorough understanding of both the theory and slide recognition is necessary for medical students. This study aimed to investigate the intervention of Basic Pathology into Histology and its impact on First MBBS students’ response. The study involved 81 students from SKIMS Medical College in the Department of Anatomy and Pathology, who were administered a questionnaire. The results showed that students appreciated the integration of pathological perspectives with normal histology and found the combined approach useful and relevant. The study highlights the importance of practical teaching methods and the need for continuous improvement in teaching and assessment methods in medical education.

Vivekanand Satyawali1, Jyoti Rawat2, Nitin Mahrotra2, Vimlesh Sharma2, Shanti Pandey3
1Department of Medicine, Government Medical College, Haldwani Nainital, Uttarakhand, India.
2Department of Ophthalmology, Government Medical College, Haldwani Nainital, Uttarakhand, India.
3Department of Ophthalmology, Government Doon Medical College, Dehradun, Uttarakhand, India.
Abstract:

Background: Diabetes mellitus is a serious public health issue globally, and India is no exception to its growing prevalence in many emerging nations. In the near future, India will emerge as the global capital of diabetes.
Objective: The objective of this study is to investigate ocular surface changes and ocular surface disorders in patients with diabetes mellitus.
Methods: This cross-sectional observational study was conducted among all known cases of diabetes mellitus aged over 40 years, attending the eye outpatient department and diabetic clinic at Dr. Sushila Tiwari Government Hospital, Haldwani, Nainital.
Results: The mean age of diabetic patients was 60.82\(\pm\)10.23 (41-79) years. The majority of cases were female (59.7%), followed by males (40.3%). The rural population (56%) was more affected by ocular surface disorders in patients with type II diabetes mellitus than the urban population (44%). Homemakers (50.2%) were the largest group, followed by outdoor workers (30.8%), office workers (12%), and factory workers (7%). Itching was present in 22.0%, lacrimation in 54.8%, burning in 66.8%, foreign body sensation in 85.6%, and blurring of vision in 53.2%.
Conclusions: This study establishes a causal relationship between ocular surface disorder and diabetes mellitus.

Gautam Medhi1, Amit Bhattacharjee2, Diganta Barman2, Mahibur Rahman2, Sabir Hussain2, Dorothy Hazowary2
1
2Department of Pediatrics, Gauhati Medical College and Hospital, Guwahati, Assam, India.
Abstract:

Background: Beta-thalassemia syndromes are a category of genetic blood disorders defined by reduced or incomplete beta globin chain synthesis, leading to lower hemoglobin levels in red blood cells (RBC), lower RBC output, and anemia.
Aims and objectives: To study the growth pattern in thalassemic children who are on regular chelation therapy and blood transfusion in comparison to normal children and serum ferritin level in these children and its relation to growth pattern and oral chelation therapy.
Methods: The present study was a hospital-based cross-sectional study. One hundred and one transfusion-dependent thalassemic children on oral chelation therapy, attending the pediatric ward in Gauhati Medical College and Hospital, Guwahati, Assam, were enrolled during the study period from 1st May 2021 to 30th April 2022.
Results: This study provides evidence that children suffering from transfusion-dependent thalassemia (TDT) are prone to growth retardation, with underweight, stunting, and wasting being 31.6%, 52.4%, and 27.7%, respectively.
Conclusion: In conclusion, short stature is an important complication in TDT. Growth in patients with TDT is significantly related to age, sex, hemoglobin level, and iron overload status. Management with hypertransfusion and good control of iron overload is important to achieve optimum growth in patients with TDT.

K G Somashekara1, Ravikeerthi G1, Vibha B2, Norma Thomas3
1Department of ENT H & N, Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.
2Department of ENT H & N, Government Hospital, Bangalore North, Karnataka, India.
3Department of ENT H & N Government Hospital, Kanakapura, Ramanagar District, Karnataka, India.
Abstract:

Background: Hoarseness of voice is a common manifestation of structural or functional anomalies affecting the glottis. A detailed examination is necessary to ensure accurate diagnosis and management. Patients from rural areas often present with the condition at a later stage, emphasizing the need for creating awareness to facilitate early diagnosis and treatment. Indirect or video laryngoscopy (IDL/VDL) is the preferred method for evaluating hoarseness.

Objectives: The objectives of this study were to determine the socio-demographic profile of patients with hoarseness of voice and identify common predisposing factors for the condition.
Methods: We conducted a study of 100 cases of hoarseness of voice at the Department of Otorhinolaryngology, Bangalore, Karnataka, over 18 months. Detailed histories, including habits and socio-demographic information, were obtained. We documented information on the onset, duration, precipitating factors, aggravating and relieving factors, and socio-economic status. All patients underwent general clinical and otorhinolaryngological, head, and neck examinations, as well as IDL/VDL.
Results: In our study, the most commonly affected age group was 50-60 years (21%), and males were more affected than females in a ratio of 1.2:1. The majority of patients were from urban areas, with most belonging to class 3 (36%). Agricultural workers and manual laborers had the highest incidence. The majority of patients presented within 15 days of symptom onset, and vocal abuse (32%) was the most common predisposing factor. All patients presented with a change in voice (100%), with associated symptoms including difficulty in swallowing (34%), voice fatigue (26%), weight loss, and loss of appetite.
Conclusion: Due to the prevailing COVID-19 situation, most patients in our study presented at a later stage, with significant changes in voice or associated symptoms. This was a major limitation of our study. We emphasize that any change in voice can have varied etiologies, and therefore requires appropriate investigation, screening, and early management. Awareness of the ill-effects of smoking, alcohol, tobacco, and vocal abuse is crucial in preventing various laryngeal pathologies.

Satish R Gawali1, Yogesh Teke1, Abhay Kawedial1
1Department of Orthopaedics, Government Medical College and Hospital, Aurangabad, Maharashtra, India.
Abstract:

Background: Pilon fractures are complex fractures of the lower limb in adults that can be managed by various modalities, including open reduction and internal fixation (ORIF), external fixation, and conservative management.
Materials and Methodology: In this study, 30 patients with pilon fractures were treated with external fixation at a tertiary care center. The patients were followed up for 12 months, and their functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Score.
Results: The results showed that the use of external fixation led to a significant improvement in functional outcome in patients with pilon fractures, including range of motion, pain, and anatomical reduction.
Conclusion: External fixation is a less invasive and less time-consuming surgical modality for the treatment of pilon fractures. This technique has a favourable functional outcome and can be considered as an effective option for managing this complex fracture in adults.

Satish R Gawali1, Abhay Kawedia1, Yogesh Teke1, Swapnilkumar Patil1
1Department of Orthopaedics, Government Medical College and Hospital, Aurangabad, Maharashtra, India.
Abstract:

Background: Proximal humerus fractures are one of the most common fractures of the upper limb in older individuals and can be managed by multiple modalities, from ORIF to K-wire fixation, and can even be managed conservatively.
Materials and Methodology: Thirty patients with proximal humerus fractures were treated with K-wire fixation at a tertiary care center and followed up for six months to evaluate the functional outcome using the Neer scoring system.
Results: The patients who underwent K-wire fixation had a significant functional outcome in terms of range of motion, pain relief, and anatomical reduction.
Conclusion: K-wire fixation is a simpler, less invasive, and less time-consuming surgical modality of treatment with a favorable functional outcome for proximal humerus fractures.

Suvvari Jagadeeswari1, Tutta Kishore Kumar1, Thatipakala Ramya Durga1, Hanumanthu Lakshmi Vasavi2, Vijaya Bharathi1
1Department of Pathology, Government Medical College, Balaga Road Srikakulam-532001, Andhra Pradesh, India.
2Department of Pathology, Andhra Medical College, Visakhapatnam -530002, India.
Abstract:

Background: Oral squamous cell carcinoma is a carcinoma with squamous differentiation arising from the mucosal epithelium. The pathogenesis of oral cancers is multifactorial. P53, guardian of the genome regulates cell cycle progression, DNA repair, cellular senescence and apoptosis. Ki-67 is a cell cycle associated nuclear protein used as a proliferation marker to measure the growth fraction of cells in human tumours.
Aims and Objectives: To compare demographic factors like age, sex and predisposing factors. To evaluate grade of differentiation, expression of p53, Ki67 and their comparison in various grades of differentiation in oral squamous cell carcinomas.
Materials and Methods: This study comprises of 35 cases of oral squamous cell carcinoma After processing of representative tissue block, H\&E and IHC stain with Ki-67 and p53 immunomarkers were carried out.
Results: Out of 35 cases of oral squamous cell carcinoma,20(57%) were well differentiated, 14(40%) moderately differentiated, 1(3%) was poorly differentiated. The age range was 26-85 years. Sex ratio was 2:1. The most common risk factor for development of cancer was found to be smoking (57%) followed by betel quid chewing (43%). The most common clinical presentation was non healing ulcer (80%). Sensitivity of Ki67 and P53 is 100% and 63% respectively.
Conclusion: P53 positivity was demonstrated in majority of cases indicating that it is most common genetic mutations in oral cancers. The present study showed an inverse correlation between the degree of tumour differentiation and the rate of cell proliferation obtained by the expression of Ki-67.

Babita Lahkar1, Vikramjit Baruah2, Nilotpal Das3, Rishov Hazarika4
1Department of Anaesthesiology and Critical Care, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam–781301, India.
2Department of Anaesthesiology, Jorhat Medical College and Hospital, Jorhat, Assam- 785001, India.
3Department of Anaesthesiology, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam–781301, India.
4Department of Anaesthesiology, Diphu Medical College and Hospital, Assam, India.
Abstract:

Background: Thoracic epidural analgesia (TEA) remains a critical tool for anaesthesiologists to use in acute pain management. Present study was aimed to investigate the analgesic effect of buprenorphine and fentanyl as adjuvant with bupivacaine in thoracic epidural anaesthesia in patients undergoing open cholecystectomy.
Material and Methods: Present study was prospective, randomized, blinded study, conducted patients 18-50 years, of either sex, ASA physical status I and II, posted for elective open cholecystectomy under thoracic epidural anaesthesia. The patients were randomly allocated into 2 groups, A (buprenorphine) or B (fentanyl) of 30 each.
Results: Onset of analgesia in group A was 5.97 min while that of group B is 5.43 min at T10 level. There was no difference in the onset of analgesia between the two groups. Mean duration of analgesia of group A is 701.53 min while that of group B is 477.17 min, which is statistically significant with p value <0.0001. So, duration of analgesia is higher in buprenorphine compared to fentanyl as an adjuvant with bupivacaine in thoracic epidural anaesthesia. Mean two segment regression time of group A is 129.96 min while that of group B is 120.7 min, which is statistically significant with p value 0.0057. VAS is statistically significant in group B at 6th ,12th and 20th hrs. In the Group A, 20 % patients show nausea and 10% shows vomiting, while in the group B, 10% complained of nausea and 36.67% complained of pruritus.
Conclusion: Open cholecystectomy cases can be done under thoracic epidural anaesthesia with 0.5% bupivacaine and buprenorphine or fentanyl as an adjuvant. Buprenorphine having prolong duration of analgesia can be better than fentanyl even in postoperative period.

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