Matrix Science Medica (MSM)

The health science research is an important aspect in the evolution of medical field and hundreds of articles are published in peer-reviewed journals annually. The number of submission is monstrous and the acceptance rate in top journals is low. The journals also need to place a stringent peer-reviewed process so that good research is disseminated to the medical fraternity and public at large. The medical publication field also undergoes changes according to the prevalent fervor of the research milieu and a working knowledge of important changes is essential to keep abreast of things in vogue. The communication of research findings is instrumental for wider readership and citations. The need to “stand out” and be heard is always desirable for any author and use of available avenues or resources helps in the process. A working knowledge of the current trends in the research communication field that is becoming the norm should be of interest to both a novice and an active enthusiast alike. A few notable ones are described below.

Introduction: Prescribing errors account for almost 50% of medication errors and represent the eighth leading cause of death in the US. The current study aimed to evaluate inpatient prescribing practice by assessing adherence to prescription-writing guidelines and identifying the frequency and severity of drug-drug interactions (DDIs) and drug-disease interactions (DDSIs). Methods: An observational-descriptive cross-sectional study was conducted among inpatient wards in Ibrahim Malik teaching hospital, Khartoum, Sudan. Total coverage sampling was performed and the sample size consisted of 132 prescriptions containing a total of 700 prescribed drugs. The data were collected from patients’ files, and the completeness of prescriptions was assessed according to national and international guidelines. Drug interactions were checked by the interaction checker of www.drug.com. Results: The overall prescription completeness was 0%, and the completeness of both prescriber data and medication data were 1.5%, (0.4% for Intravenous [IV] and 0.6% for non‑IV drugs), respectively. The most missing elements of the prescription were duration and qualification. Moreover, only 25% of the prescribed drugs were written in the Prescription and Medication Administration Record or drug chart, but the rest were written elsewhere within the patient’s file. The prescriptions containing DDIs and DDSIs were 49.2% and 46.2%, respectively, ranging from major (9.1%), moderate, (40.9%), and minor (28%) for DDIs, major (30.3%), moderate (33.3%), and minor (0.8%) for DDSIs. The highest percentage of drug interactions was found in the internal medicine ward. Diabetes was significantly associated with both DDIs (P = 0.003) and DDSIs (P = 0.031). Conclusion: The findings of this study reflect a real problem in prescribing practice, as no prescription was considered to be complete, and nearly half of the patients were exposed to DDIs and/or DDSIs.

Virtual teaching mode gets accelerated during the COVID 19 pandemic. Medical educators are looking at virtual classroom teaching rather than classroom teaching owing to the strict restrictions. The pandemic has gifted challenges and glitches given redefining the medical education training to the medical fraternity.

Aims: This study aims to study the clinical profile of patients with acute pyelonephritis(APN), yield of urine culture in APN; common causative agents and their antibiotic sensitivity pattern and to study the outcome of patients with APN in terms of mortality, duration of hospital stay, need of intensive care unit (ICU) care and necessitation of urological intervention. Materials and Methods: This study was a prospective observational study of patients who were admitted to the Postgraduate Department of General Medicine, Shri Maharaja Hari‑Singh Hospital, an associated hospital of Government Medical College Srinagar as clinically suspected cases of APN and then proven radiologically. The study was conducted over a period of 2 years from August 2018 to August 2020 and a total of 200 patients fulfilling the selection criteria were included in the study. Results: Classical triad of fever, dysuria, and flank pain was seen in 55% of our patients with fever as the predominant symptom seen in 92% of patients. In our study, 70% were diabetic, 11% had nephrolithiasis, 8% of patients had obstructive uropathy, 7% were immunosuppressed, 3% had indwelling catheters while as 9% were documented cases of chronic kidney disease. Out of all positive urine cultures, 60% were Escherichia coli, 16.6 were Enterococcus, 13.3% were klebsiella, and 10% were Pseudomonas. Conclusion: Fever is predominant symptom in APN 23. Diabetes is the most common underlying predisposing condition. Yield of urine culture is very low with E. coli is the predominant organism. USG has less sensitivity for diagnosing APN than CT. The outcome of patients in terms of duration of hospital stay and need of ICU care is poor in diabetic patients. In our study, USG underestimated the cases of APN; detected only 132 out of 184 cases of computed tomography‑proven nonemphysematous pyelonephritis and only 8 out of 16 patients of emphysematous pyelonephritis with an overall sensitivity of 70%. In our study, 3% of patients needed ICU care while 46% and 4% develop acute kidney injury and multiple organ dysfunction syndromes, respectively. Eleven percent of patients required urological intervention. Unfortunately, 2 out of 200 patients died during disease in the hospital

Introduction: Tubal and peritoneal pathologies are one of the most common causes responsible for female infertility corresponding to 30%–40% of cases. The use of combined hysteroscopy and laparoscopy (HL) has now become a gold standard in the diagnosis and subsequent treatment of these pathologies. Aim of the Study: (1) Evaluation of infertile females for tubal and uterine pathologies using combined HL as a diagnostic aid. (2) To find out the feasibility of providing therapeutic management concurrently. Materials and Methods: This study was conducted from 2018 to 2019 on 100 married females in the age group of 20–45 years with primary or secondary infertility of > 1‑year duration after ruling out male causes and hormonal causes of infertility. Laparoscopy and hysteroscopy were performed in a single session; methylene blue dye testing was done. Any relevant positive findings on hysterolaparoscopy were noted, and the incidence of different lesions was calculated. Surgical procedures wherever possible were carried out and tabulated accordingly. Results: Out of all patients subjected to combined HL, positive findings were noted in 76% of the cases. The most common hysteroscopic pathology in our patients was intrauterine adhesions (9.2%), followed by polyp (7.9%) and septum (6.6%). Similarly, on laparoscopy, the common findings were adhesions (23.7%), endometriosis (21.1%), myomas (17.1%), and hydrosalpinx (13.2%). Unilateral tubal block was seen in 15.8% and bilateral tubal block in 13.2% of the patients. Hysteroscopic procedures were done in 40.8% of the patients and laparoscopic procedures in 60.5% of the patients. Conclusion: From our study, we concluded that
combined HL serves as an important diagnostic as well as a therapeutic modality in female infertility. Direct visualization of the uterine cavity and the ability to manipulate uterus and adnexa and perform any procedure required l(cannulation, septal resection, adhesiolysis etc.) all in a single session makes combined HL a far more superior tool for evaluation and treatment of infertility.

The nasolabial cyst is a soft-tissue cyst, nonodontogenic in origin that occurs in the sublabial area and anterior maxillary region. The nasolabial cyst is a rare lesion found behind the ala nasi, extending backward into the inferior meatus of the nasal cavity and forward into the labio-gingival sulcus. The patient with nasolabial cyst often presents with painless swelling and sometimes nasal obstruction. The diagnosis of nasolabial cyst is usually diagnosed in an early stage due to cosmetic facial deformity. The final diagnosis of the nasolabial cyst needs a correlation of the clinical presentations, surgical findings, and histopathological information. There are several treatment options described for the treatment of nasolabial cysts. The current treatment of choice for nasolabial cyst is complete excision through sublabial approach. The postoperative complications may include facial/perinasal swelling, facial numbness, and toothache. The postoperative chance of recurrence is rare. The objective of this review article is to familiarize the readers with this uncommon clinical entity such as nasolabial cyst with its prevalence, etiopathology, clinical presentation, diagnosis, and treatment.

The supracondylar process is an uncommon anomaly that presents as a beak-like bony projection from the anteromedial aspect of the humerus. Many of these occurrences are reported as sporadic case reports or small series. While the true incidence cannot be assessed as very few of these have clinical problems like neurovascular compression (brachial artery or median nerve entrapment) due to ligament of Struther’s attached to it. Incidentally, these lesions can be noted in clinical settings while treating some other conditions. We describe a series of four cases that were incidentally seen in our center when radiographs were done for various reasons.

Background: The coronavirus disease 2019 (COVID‑19) is a highly contagious acute respiratory disease caused by a novel virus called severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). COVID‑19 infection presents with respiratory illness and even respiratory failure and death. Olfactory dysfunction is an important clinical manifestation that has an impact on quality of life. Objective: This study is designed to analyze the role of the topical nasal corticosteroid in post-COVID olfactory dysfunction. Materials and Methods: This is a prospective and descriptive study on 72 COVID‑19 patients who were administered topical intranasal corticosteroids and olfactory training. All of them were diagnosed with COVID‑19 infection by reverse transcription–polymerase chain reaction of the nasopharyngeal swab. The detailed clinical examination and treatment with intranasal corticosteroid and its outcome were analyzed. Results: In this study, 46 (63.88%) patients were male and 26 (36.11%) were female with a male‑to‑female ratio of 1.76:1. The age ranges from 18 to 58 years. There were 30 (41.66%) patients in the age range of 18–30 years and 42 (58.33%) patients in the age range of 31–58 years. Out of 72 patients, 11 (15.27%) patients recovered after 2 weeks, 34 (47.22%) patients recovered after 3 weeks, and 20 (27.77%) recovered after 4 weeks. Three patients lost to follow-up during the treatment period. Conclusion: COVID‑19 infection is spreading quickly all the continents of the world. Olfactory dysfunction is an important symptom of the COVID‑19 infection. Intranasal mometasone spray and olfactory training are useful treatment options for post-COVID olfactory dysfunction.

Background: Sphenoid sinus mucocele is a benign expansile mucus‑filled cystic lesion as a result of chronic obstruction of the sinus ostium. Because of its expansile, growth may affect nearby vital structures and result in the involvement of optic nerve and intracranial structures. Objective: This study aims to evaluate the details of patients with sphenoid sinus mucocele. Materials and Methods: In 5 years, we reported eight patients with mucocele in the sphenoid sinus. The detailed clinical presentations of these patients were documented. All the patients with sphenoid sinus mucocele were investigated with diagnostic nasal endoscopy and imaging such as computed tomography scan and magnetic resonance imaging (MRI) of the nose, paranasal sinuses, and brain. All underwent transnasal endoscopic transsphenoidal marsupialization of the mucocele in the sphenoid sinus. Results: There were eight patients diagnosed with sphenoid sinus mucocele. Out of eight patients, five (62.5%) were male and three (37.5%) were female with a male‑to‑female ratio of 1.66:1. The mean age of enrolled patients was 48.37 years. Out of eight patients with sphenoid sinus mucocele, three (37.5%) patients had allergic rhinitis, two (25%) patients had chronic sinusitis, and one (12.5%) patient had a history of radiation therapy for nasopharyngeal carcinoma. Conclusion: Sphenoid sinus mucocele is a rare clinical condition. In this study, headache was the most common symptom. Allergic rhinitis, sinusitis, and radiation to the head-and-neck region are important predisposing factors for causing sphenoid sinus mucocele. Orbital symptoms are indicators for prompt surgical intervention. Endoscopic sinus surgery is an effective and safe treatment option for sphenoid sinus mucocele.

Objective: The objective of this study is to study the morphological changes in hepatic parenchyma, to characterize the intra and extrahepatic ductal changes and to study the morphological changes in vasculature of the liver in patients with oriental cholangiohepatitits (OCH). Materials and Methods: All documented or newly diagnosed cases of OCH, referred to the department of radiodiagnosis and imaging from Departments of Surgical Gastroenterology and Medical Gastroenterology were evaluated by ultrasonography (USG) and color Doppler study. The dilatation of the intrahepatic as well as extra-hepatic ducts was noted. The morphological changes in the liver parenchyma as well as hepatic vasculature were studied. Results: USG showed calculi in 53 (98.1%) cases, ductal dilatation in 52 (96.3%), and worms within biliary ducts in 10 cases(18.5%). Among parenchymal changes, atrophy was seen in 9 cases(16.6%), space‑occupying lesion was seen in seven cases(12.9%), and peri‑portal echogenicity in 10 cases (18.5%). Significant association was found between atrophic segments and reduced/absent blood flow in the affected segmental portal venous branches. Conclusion: USG is the preferred primary examination. Further imaging depends on the USG findings, the patient’s symptomatology, the clinical problems, and the intended mode of treatment. Advances in Knowledge: USG plays a pivotal role in the evaluation of oriental cholangiohepatitis in the low resource settings where higher modalities like MRI are not available, especially in the remote areas of developing countries, as it has high degree of accuracy in the diagnosis of OCH