Issue: Vol 13, Issue 3, Jul-Sep, 2023 :


Year : 2023 – Volume: 13 Issue: 3


Review Article

Are We Doing Enough to Combat Poor Adherence to Pharmacotherapy in Atherosclerotic Cardiovascular Disease?

Sandeep Bansa, Mohanan Padinhare, Jagdish Chander Mohan, Kimi Shetty,Jyoti Juneja, Shreenath Hariharan

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Atherosclerotic Cardiovascular Disease (ASCVD) is a globally prevalent non-communicable disease contributing significantly to Cardiovascular (CV) morbidity and mortality. Approximately, 70% of Cardiovascular Disease (CVD) cases and deaths have been attributed to modifiable risk factors. To overcome the risk factors, therapeutic adherence plays a pivotal role in ASCVD management and is determined by multiple factors. This review highlights the effect of poor adherence on ASCVD events in India, ways to prevent non-adherence and ensure optimum outcomes for patients. Among the major risk factors that cause ASCVD, dyslipidemia is often neglected or inadequately treated. Studies from India have identified varying rates of adherence to lipid lowering therapies in ASCVD. Factors such as lower socioeconomic status, health literacy, asymptomatic nature of disease, forgetfulness and cost of medications contribute towards non-adherence. This has resulted in significantly higher hospitalizations for CVDs and an increased risk of mortality and indirect cost. Further, emphasis is warranted on patient education, enhanced physician-patient relationship and communication, increased access to health care, frequent use of fixed drug combinations, and affordability in improving therapeutic adherence in ASCVD. With innovation in therapeutics, the pharmaceutical sector can contribute significantly to improve adherence. Keywords: Atherosclerotic cardiovascular disease, Adherence, Lipid lowering therapy.

Page No: 86-92 | Full Text


Original Research Article

Comparing the Effectiveness of Otago Exercise Program and Proprioceptive Training on Balance in Knee Osteoarthritis with Genu Varum: A Comparative Study

Divya NSenthil Kumar S, Keerthana R, Keerthana K, Abinaya P

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Background: Patients with knee Osteoarthritis (OA) have balance problems and a higher risk of falling, but it's not apparent whether proprioceptive training or the Otago Exercise Programme (OEP) can help with balance and fall prevention. In order to better understand the benefits of OEP and proprioceptive training on the senior population with OA associated with genu varum deformity, a comparative study was conducted. Patients and Methods: 30 patients with genu varum deformity and knee OA were randomly assigned to groups A (OEP) and B. (proprioceptive training). Both groups received Interferential Therapy (IFT) as a standard form of treatment. Both before and after the intervention, the Time Up and Go test (TUG) and the Knee Osteoarthritis Outcome Score (KOOS) were evaluated as outcome measures. Results: Using a paired t test, demographic data were compared within and between groups with a statistical significance threshold of p<0.05. The pre-post comparison shows a considerable shift. According to the study, there is a statistically significant difference between the two groups in terms of improved balance and decreased fall risk. Conclusion: For older patients with knee OA and genu varum deformity, OEP and proprioceptive training with traditional (IFT) were beneficial in reducing pain, improving balance, and lowering fall risk. Both groups had a significant change between the preand post-test periods, but when the post-test results were compared between the two groups, the OEP group's KOOS and TUG scores showed a more pronounced improvement. Keywords: Osteoarthritis, Genu Varum, Balance, Fall Risk, Elderly Population.

Page No: 93-98 | Full Text


Original Research Article

Exploring Fungal Rhinosinusitis-Epidemiological Profile, Expanding MALDITOF-MS Diagnostic Profiling, Therapeutic Responses, Failures and Learning’s Over a Three-Year Period

Raman Sardana, Hena Butta1,Leena Mendiratta1, Girish Raheja, Vikas Kashyap, Neerav Goyal

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Introduction: Fungal Rhinosinusitis (FRS) is a growing concern in both immunosuppressed and immunocompetent patients and involves a broad spectrum of immune and pathological responses induced by different types of fungi. The aims of this study were to determine the type of fungi causing Rhinosinusitis and to correlate type of FRS with respect to the histopathological findings, causative fungi, immune status, clinical presentation, other co-morbid conditions, treatment and outcome. Materials and Methods: This retrospective study on FRS was done on 92 non-duplicate specimens of suspected cases of FRS over three-year period. Samples from patients of suspected FRS were processed for fungal smear KOH examination and fungal culture. Identification of fungi was done by both conventional and automated methods using MALITOF-MS (Matrix Assisted Laser Desorption Ionization Time of Flight-Mass Spectrometry). Results: Out of 92 non-duplicate specimens of suspected cases of FRS received during study period; fungal smear or histopathological examination for fungal hyphae was positive in 43 cases and fungal culture was positive in 42 cases with 48 fungal isolates. Aspergillus flavus (43.75%) was isolated maximally followed by Rhizopus sp. (20.8%). Mixed infection with two types of fungi was also seen. Aspergillus FRS was mainly Allergic in immunocompetent host and Acute invasive in immunocompromised hosts. Infection with Zygomycetes was largely invasive and was seen in immunocompromised hosts with poor prognosis. Other fungi like Schizophyllum commune, Bipolaris and Paecilomyces were associated with Allergic FRS. Scedosporium apiospermum was associated with chronic non-specific FRS in immunocompetent patient. Fusarium infection was seen both as mere colonization and invasive sinusitis. Candida species were isolated mainly in mixture with mycelial fungi and were associated with invasive FRS. Conclusion: Our study depicts that a variety of fungi may cause FRS and the type of FRS caused by different types of fungi depend upon type of host. So, it is pertinent to monitor and study the types of fungi causing infections in different patient populations. Automated methods like MALDITOF -MS are an excellent tool in the definitive and timely identification of fungi resulting in timely and appropriate management. Keywords: FRS, Immunocompetent, Immunocompromised, Automated.

Page No: 99-105 | Full Text


Original Research Article

Unveiling the Shift: Trends in Medical Literature: A Comparative Bibliometric Analysis of ChatGPT vs. Traditional Methods

Mueen Ahmed KK, Chaman Sab M

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has led to transformative changes in research and practice. One such domain that has seen substantial impact is the medical field, where AI-powered tools like ChatGPT have emerged as potential alternatives to traditional methods for generating medical literature. This study presents a comprehensive comparative bibliometric analysis of medical literature generated by ChatGPT and traditional methods, aiming to uncover the emerging trends and potential shifts in the landscape. Materials and Methods: This study collects and analyzes a substantial corpus of articles, reviews, and papers generated by both ChatGPT and traditional methodologies. Bibliometric indicators such as publication frequency, citation counts, collaboration patterns, and keyword usage are examined to discern differences in output and impact. We extract data from Web of Science citation database and selected 18087 publications from the year 2019 to 2023 for our study. The data and descriptive analysis were categorised, collected one at a time, and imported into the Bibliometric R-package programme to produce science maps and statistical graphs. They were exported to MS-Excel for bibliometric analysis and VOSviewer software was used to analyse Co-Occurrence networks. Results and Discussion: A total of 18087 publications on ChatGPT and traditional methodologies from the year 2019 to 2023, namely 12519 (69.29%) original articles, 2836 (15%) reviews, 233 (01.2%) letters, and others. The most productive institution was found to be the Indian Institute of Technology System IIT System (n=1718, 0.09%), followed by National Institute of Technology NIT System (n=1275, 0.07%). the most productive author was found to be the Kumar, Atul, All India Institute of Medical Sciences (AIIMS) New Delhi (n=421, 2.39%), followed by Kumar, Satish, Indian Institute of Management Nagpur (n=405, 2.24%). The most productive journal was found that the IEEE Acess (n=373, 2.063%, TC=6740, ACP=18.06) followed by Multimedia Tools and Applications (n=279, 1.543%, TC=1552, ACP=5.56). The most frequent of authors keywords and occurrences was found that the ‘artificial intelligence’ 1517 occurrences and 1898 total link strength followed by ‘deep learning’ 1156 occurrences and 1764 total link strength. Conclusions: This bibliometric analysis sheds light on the evolving landscape of medical literature production, comparing the outputs of ChatGPT and traditional methods. While ChatGPT shows promise in its ability to quickly generate content on cutting-edge topics, traditional methods maintain their dominance in terms of research depth and impact. The findings have implications for researchers, clinicians, and policymakers, suggesting potential ways to leverage both approaches for a more comprehensive and impactful medical research ecosystem. Further research is warranted to monitor the trajectory of this evolving paradigm shift in medical literature and its long-term implications. Keywords: Artificial Intelligence, Healthcare, Medical Literature, Natural Language Processing, Bibliometric Analysis, Research Productivity.

Page No: 106-117 | Full Text


Original Research Article

Post-Covid-19 Impact on Cognitive Impairment: A Bibliometric Assessment of Global Literature during 2020-23

Sandeep GroverB.M. Gupta, Yogendra Singh, Jivesh Bansal, Rajpal Walke

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Objectives: The characteristic symptom of coronavirus disease 2019 (COVID-19) is respiratory distress, but neurological symptoms are the most frequent extra-pulmonary symptoms. This study aims to explore the current status and hot topics of “Post Covid-19 Impact on Cognitive Impairment”, using bibliometric analysis. The aim was to identify, explore the current trends and present status and hot topics related to this topic, using quantitative and qualitative methods and indicators. Methodology: Publications “Post Covid-19 Impact on Cognitive Impairment” were retrieved from the Scopus database on 4 July 2023. The Advanced search was conducted using the following pre-defined search strategy involving keywords related to “Covid-19” and “Cognitive Impairment”. Microsoft Excel 2010 and VOSviewer were used to characterize the largest contributors, including the authors, journals, institutions, and countries. The hot topics and knowledge network were analyzed by VOSviewer. Results: A total of 467 publications between 2020 and 2023 were identified and retrieved, with a steady increase in annual publications. The USA (n=131), Italy (n=62), and the U.K (n=41) were three key contributors to this field. The U.K. (58.87 and 2.73), Canada (28.38 and 1.32) and USA (27.80 and 1.29) were the countries with highest citation influence, in terms of CPP and RCI. The University of Toronto, Canada (n=17), INSERM, France and AP-HP Assistance Publique - Hopitaux de Paris, France (n=13 each) were the major institutions with the largest publications. The Instituto de Salud Carlos III, Spain (82.67 and 3.84), University of Toronto, Canada (45.35 and 2.11) and King’s College London, U.K. (42.83 and 1.99) were the institutions with highest citation influence (CPP and RCI). The C. Franke (Germany), F. Landi (Italy) and I. Margalit (Israel) (n=4 each) were the most prolific authors. The H.E. Davis (USA) (284.0 and 13.18), P. Dudouet (France) (66.33 and 3.08) and C. Eldin (France) (66.33 and 3.08) were the authors with highest citation influence. International Journal of Environmental Research and Public Health (n=17), Journal of the American Medical Directors Association (n=9) and Frontiers in Immunology (n=8) were the most productive journals, while Alzheimers and Dementia (341.2), EClinical Medicine (236.75) and Brain Behavior and Immunity (68.5) were on top journals in citation impact (CPP and RCI). Covid-19 (n=450), Cognitive defect (n=438), Long Covid (n=346), Fatigue (n=227), Depression (n=169), Dyspnea (n=146) and Headache (n=117) were the central and significant keywords regarding the “Post Covid-19 Impact on Cognitive Impairment” topic. Conclusion: This bibliometric analysis mapped the overall research structure of “Post Covid-19 Impact on Cognitive Impairment” theme and analyzed the current research trends and hotspots for future studies orientation. Key words: ??

Page No: 118-132 | Full Text


Original Research Article

Insights into the Epidemiology of Hepatitis C Virus Infection in Delhi: Findings from a Tertiary Care Hospital

Belinda Jothi J, Pooja Yadav, Arpita Panda, Shilpee Kumar

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Background: The initial stage in the cascade of care for Hepatitis C Virus (HCV) infection involves the identification of infected individuals, which enables the initiation of the care sequence. This study aimed to assess the prevalence of HCV infection and estimate its burden. Study design: This retrospective study was conducted in a hospital setting. Materials and Methods: All consecutive samples received by the Microbiology department between February 2019 and December 2022 were subjected to HCV infection testing using ELISA to detect Ag/Ab, and were included in the study. Results: Out of the 82,614 samples tested for HCV infection, 1,580 were found positive, resulting in a seroprevalence rate of 1.9%. More than half of the seropositive individuals fell within the 19-40-year age group. Conclusion: The implementation of widespread HCV infection screening programs in the community, coupled with awareness initiatives on HCV transmission and prevention, is crucial. Keywords: HCV Infection, HCV prevalence, Hepatitis C.

Page No: 133-136 | Full Text


Case Report

Early Diagnosis of Adverse Effects of PPIs: A Peep into the Eye

Keerthana Sarvanan, Samir Ahuja, Shashi Ahuja

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We describe here a unique presentation of a young female medical graduate, with untreated gastric issues, self-medicating with a proton pump inhibitor leading to chronic and excessive intake. She presented to our Outpatient department with complaints of sudden onset blurred vision. The diagnosis was established in the early stages as toxic optic neuropathy secondary to drug toxicity after ruling out possible etiologies with appropriate investigations. This report highlights the danger of overusing drugs without physician supervision, and the importance of catching such cases early using Optical Coherence Tomography. Keywords: Disc pallor, Glaucoma, Optical coherence Tomography.

Page No: 137-139 | Full Text


Original Research Article


Chalapathy Palemkota, Jayasundaram Eluri, Trinath Kumar Bommisetty, Raghavendra Prasad Saya, Muneer Ahmed Tappa

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Background: Fascia iliaca compartment block (FICB) is a commonly employed technique for providing postoperative analgesia in patients undergoing femur surgery. The study was aimed to compare ultrasonography (USG) guided suprainguinal vs infrainguinal approach for fascia iliaca compartment block in geriatric patients undergoing proximal femur nailing. Material and Methods: 80 patients undergoing proximal femur nailing were randomized to two groups, Group S (suprainguinal FICB) or Group I (infrainguinal FICB). After spinal aanesthesia, patients received USG guided FICB using 40 ml of 0.2% ropivacaine with 8 mg dexamethasone with the approach as per group allocation. Postoperative visual analogue scale (VAS) score was assessed at 2,4,6,8,12,16, 20 and 24 hrs and rescue analgesia consumption (inj. Tramadol) was recorded. Results: VAS score was significantly lower in group S in comparison to group I at 12 hrs. Tramadol consumption was significantly lower in group S. Duration of analgesia was significantly prolonged in group S. Conclusion: Suprainguinal approach to FICB is superior to infrainguinal approach as it provides longer duration of analgesia, decreases rescue analgesia consumption and decreases pain severity. Keywords: Analgesia, fascia iliaca compartment block, suprainguinal approach, infrainguinal approach, proximal femur nailing.

Page No: 140-142 | Full Text