SRMS JOURNAL OF MEDICAL SCIENCE <p>The SRMS Journal of Medical Sciences (SRMSJMS) is a biomedical journal with national circulation. It publishes original communications of biomedical research that advances or illuminates medical science or that educates the journal readers. It is issued six monthly, in two volumes per year.&nbsp;Manuscripts dealing with clinical aspects will be considered for publication, provided they contain results of original investigations. Articles need to be of general interest - e.g., they cross the boundaries of specialities or are of sufficient novelty and importance that the journal's readers, whatever their speciality, should be made aware of the findings. Research papers reporting original research, review articles, correspondence on published articles will also be considered. Papers of routine nature which are merely records of interesting cases as also those dealing with modifications of routine methodology will not be encouraged.</p> <div class="page-header"> <h1>Article Processing Fee/Open Access Fee</h1> </div> <p><strong>Author Fee</strong></p> <p>Indian Journal of Pharmaceutical and Biological Research is an open access journal, and then Author submission, as well as article processing and publishing, is&nbsp;<strong>free of charge</strong>.</p> <p>Readers can read and download any full-text articles for&nbsp;<strong>free of charge</strong>.</p> MRI Publication Pvt. Ltd en-US SRMS JOURNAL OF MEDICAL SCIENCE 2456-1673 3-Dimensional Conformal Radiotherapy versus Intensity Modulated Radiotherapy in Postoperative Head and Neck Cancers: Comparative Analysis of Dosimetric Parameters and Toxicities <p>Introduction: Post-surgery radiotherapy is an important adjuvant modality in the treatment of locally advanced head and neck cancers. Both 3D-CRT and IMRT represent a significant advance over conventional radiotherapy because they increase dose delivery accuracy while sparing surrounding normal tissues and organs at risk (OAR). India is a developing country that has a heavy burden of head and neck malignancy patients and the radiotherapy facilities are not yet fully developed to provide treatment to every individual by IMRT technique. The aim of this study is to evaluate whether 3DCRT technique is equivalent to IMRT technique in terms of tumor control and sparing of critical normal tissues. Material And Methods: For the present study, 50 postoperative patients of head and neck malignancies were selected and randomized in two groups of 25 each- Group I (3DCRT) and group II (IMRT) from February 2021 to August 2022. The patients were immobilized on base plate in an extended neck position. Contrast enhanced CT (CECT) scan radiotherapy planning (RTP) of 3 mm slice thickness was obtained in a supine position with three radio-opaque fiducial markers. The delineation of various target volumes (gross, clinical and planning) was done along with the delineation of organs at risk. The dose constraints given for the OARs. All the patients were planned either for 3DCRT or IMRT techniques. The total prescription dose was 60 in 30 fractions in 6 weeks. The dosimetric assessment was done for PTV parameters (V95, Dmax, Dmean, D2, D50, D95 conformity index (CI), Homogeneity index (HI)) and various OARs. The patients were assessed for objective tumor response according to WHO criteria and radiation toxicities. Radiation therapy oncology group acute and late morbidity scoring criteria. The statistical analysis was done using standard statistical methods and software to calculate level of significance using p-value with an unpaired T-test. Results: The majority of patients were in the age group of 41 to 50 years with the mean age in groups 1 and 2 being 48.6and 45.6 years, respectively. Male patients were dominant with sex ratio 7.3. The primary sites involved were tongue (42%), buccal mucosa (34%), lower alveolus (10%), gingiva-buccal sulcus (8%), larynx (4%) and retromolar trigone (2%). Early stages (Stage I and II) were little higher in 3DCRT group (44 vs 28%), while advanced cases were more in IMRT group (72 vs 56%). The PTV dose parameters were acceptable in both groups. The homogeneity index was better in IMRT but did not show statistical significance. However, the conformity index was better and statistically significant in IMRT group (1.23 vs 1.46, p = 0.03). Dose constraints were achieved in both groups in PRV brainstem, PRV spinal cord, optic chiasma, optic nerves, and cochlea. The dose constraints was not achieved for parotid glands in either group, though it is lower and statistically significant in IMRT group (33.69 Gy vs 52.41 Gy, p = 0.00). The mandible dose constraints were not achieved in the 3DCRT group (64 Gy) but in the IMRT group (61.6 Gy). Similarly, dose constraints was not achieved for lips in 3DCRT but was significantly lower and achieved in IMRT group ( 27.18 Gy vs 33.02 Gy, p = 0.00) (Table 2). In group I, 21 (84%) patients showed a complete response while in group II 22 (88%) patients showed a complete response. In acute reactions, there were no grade 3 or 4 skin reactions. In chronic reactions, xerostomia and loss of taste was seen in very less patients and almost similar incidences in both groups (xerostomia 16 vs 8%, loss of taste 12 vs 16%) Conclusion: 3DCRT can be given to socio-economically low or middle-class patients who cannot afford IMRT with comparable tumor control. Thus, 3DCRT can be termed as poor man’s IMRT’ as it is cost-effective.</p> Abhishek Bhadri Piyush Kumar Pavan Kumar Rashika Sachan Jitendra Nigam Silambarasan N Sivaji Navitha S ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 55 61 10.21761/jms.v8i02.02 The Assessment of Quality of Life Among Pediatric Patients Having Dermatophytosis <p>Introduction: Dermatophytosis constitutes a group of superficial fungus infections of keratinized tissues. Presently, there is not much data on what impact dermatophytosis has on the quality of life among pediatric patients. With the growing prevalence of dermatophytosis, it has become the time to assess the impact of this infection on the quality of life of the children affected. There is a dearth of quality of life (QoL) studies assessing children in dermatophytosis. The aim and objective of this study is to assess the quality of life among pediatric patients suffering from dermatophytosis. Materials and Methods: Pediatric patients with clinically diagnosed dermatophytosis presenting in the Department of Dermatology at Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, from April 2021 to May 2022 were evaluated for inclusion in this study. The questionnaire applied is a validated Hindi version of the children dermatology life quality index (CDLQI). SPSS version 23 was used for statistical analysis. Results: Out of 100 patients, 75 were male and 25 were female. The mean ± SD CDLQI score in our study was13.88 ± 5.3. The majority 66.0% of the cases had very large to extremely large effect on the quality of life due to disease, followed by a moderate effect (33.0%). Most patients belonged to class 2 socio-economic classes (31%) with a mean duration of illness 4.75 ± 1.93 months. Conclusion: Dermatophytosis was found to have a very large effect on the QoL of affected children. The CDLQI score was largely influenced by the patient’s age, the disease duration, the number of lesions, size of the family and the total body surface area involved. It was affected more in females. This study also underscores the feasibility of CDLQI score-based QoL assessment in dermatophytosis.</p> Vasudha Bery Pratik Gahalaut Deepak Charan Madhur K. Rastogi Shikhil Gupta ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 62 66 10.21761/jms.v8i02.03 A Prospective Study to Identify Asymptomatic Bacteriuria: The Causative Organisms, Antibiotic Sensitivity and its Safety in Pregnant Females <p>Introduction: The common procedure of urinary catheterization during childbirth may introduce bacteria that can cause urinary tract infections. Immune function is relatively compromised during pregnancy. The current study was aimed to identify antenatal patients with bacteriuria, the causative organism and its antibiotic sensitivity in patients with bacteriuria. Materials and Methods: The current prospective crosssectional study involved antenatal patients who were being admitted to the delivery room. A clean catch midstream urine sample was collected in a sterile container of which 5 to 10 mL of the sample was obtained in a separate sterile vial (container 1) for screening tests for leucocyte esterase and nitrite, and the remaining sample (container 2) was taken for routine microscopy, culture, and sensitivity. The reports were collected and tabulated, and bacteriuria was confirmed and statistically analyzed. Results: A total of 200 patients were evaluated, and 40 of them had asymptomatic bacteriuria. In this study positive leukocyte esterase test and nitrite test results were considerably higher in the cases than the controls (p &lt; 0.05) at 10.0 and 47.5%, respectively. Escherichia coli was found to be the most prevalent bacteria in this study, followed by, Pseudomonas, Enterococcus faecalis, Candida albicans, and coagulasenegative Streptococcus and Klebsiella. Most of the E. coli isolates (100.0%) were sensitive to amikacin, a category D drug. The majority of Pseudomonas isolates (100.0%) were sensitive to colistin, a category C drug. Amongst category A drugs, Pseudomonas was sensitive to – cefoperazone-sulbactam, meropenem and piperacillin-tazobactam. Conclusion: It is a standard practice to send urine routine and microscopy test in antenatal patients. As most patients are asymptomatic, investigations are required for early diagnosis of significant bacteria like leucocyte esterase, nitrite and culture and sensitivity. This will help us to institute appropriate treatment and improve maternal and fetal outcomes.</p> Saba Sharif Namita Agarwal Shashi Bala Arya Rahul Kumar Goyal Shubhangi Gupta ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 67 71 10.21761/jms.v8i02.04 Neuroimaging in Cerebrovascular Accidents <p>Introduction: The incidence rate and the death rate from stroke increase dramatically with age. The one who survive are usually left with permanent disability. Thus, stroke has become a great medical and social problem. Accurate and early diagnosis may improve the morbidity and mortality rates in the future as newer and more effective therapies are currently being instituted. Neuroimaging in stroke patients, especially in acute ischemic stroke patients, plays an essential role. It helps to differentiate other causes of stroke (i.e., stroke mimics such as migraine headache, tumors, seizure, metabolic disturbance, and peripheral or cranial nerve disorders), early detection of hemorrhagic stroke, distinguish irreversible infarcted tissues from salvageable tissue, identify vascular malformations, treatment planning for intravenous thrombolysis and intra-arterial thrombectomy, and outcomes prediction. The aim of the study is to characterize type of stroke hemorrhagic vs. ischemic on neuroimaging. Radiological evaluation of stroke regarding –site, size, volume and duration. Correlation of neuroimaging findings with clinical findings and patient demographics. Materials and Methods: In 100 patient single-center, prospective observational study was conducted in the department of radiology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly and adult patients with suspected stroke on computed tomography (CT) and magnetic resonance imaging (MRI) and characterization and correlation with clinical findings were done from the study. Infarcts were grouped into hyperacute (0–24 hours), (acute 1–7 days), early subacute (7–10 days), late subacute (10–21 days) Results: Out of 100 patients, the study showed male predominance. The majority of cases had a history of weakness. Comorbidities like diabetes, hypertension, and dyslipidemia increase the risk of stroke On the basis of GCS score the majority of the cases were, having GCS score greater than 10 (72.0%). Cranial nerve palsies and LOC were also common among patients of stroke. Out of a total 69 ischemic stroke cases, CT was positive in 55 patients, while MRI was positive in all the cases. Arterial infarcts (89.8%) are much more common than the venous infarcts 7 cases (10.2%). The majority of cases that reached our department were in the acute stage (56 cases, 81.2%), and the majority had MCA territory involvedThe basal ganglia complex was the most common location for the hemorrhage and was seen in 15 cases (48.3%). The mean volume of bleeding was large in cases of lobar bleeding. There was a strong positive correlation between altered sensorium (Phi value .64) and vomiting (.60), while the symptoms showed a positive correlation. The correlation of cerebrovascular accidents with age was seen more in patients aged &gt; 60 as compared to those age &lt; 60 (Phi value .1). Conclusion: This study depicts the predominance of the older age group (&gt; 40 years). The ischemic stroke was more common than the hemorrhagic stroke, the commonest cause being the MCA territory infarcts. In the cases of hemorrhagic stroke, the ganglion-capsular bleed was the commonest. Stroke imaging has undergone significant advances over last decade. It remains very crucial for the management of hyperacute stroke in the first few hours, where aim is to recognize patients eligible for thrombolytic therapy and expected to have good outcomes. Both CT, and MRI are useful for a comprehensive assessment of acute stroke MRI is sensitive for ischemic infarct detection and can provide important and necessary information for therapy planning. Both clinical examination and early diagnosis of stroke by imaging can lead to better patient outcomes.</p> Eshita Yadav Sameer R Verma Sangeeta Kumari Sharat Johri ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 72 80 10.21761/jms.v8i02.05 A Study to Assess the Knowledge and Attitude regarding Voluntary Blood Donation among College Going Male Students, a Quasi-experimental Study <p>Introduction: Voluntary blood donation in developing countries like India is constrained by misconception, fear, and widespread myths regarding blood donation.(1) Donated blood is an essential component in the management of many diseases. It is the main lifesaving for an individual with loss of large volumes of blood from accidents, hemorrhages or surgery.(2) Blood and its product demands is increasing, which can be ensured by increasing awareness and interest in blood donation in different groups of people. Youth is one of those groups. Misconception and low levels of awareness lead to unsatisfactory voluntary blood donation practices among them. The aim is to assess the knowledge and attitude of college students towards voluntary blood. Material and Methods: After prior permission from the College Authority, all the students who were present on the day of the study and who acknowledged their consent for participation were enrolled in the study. A pre-tested, semi-open-ended questionnaire was used as a study tool first as a pre-test to check their prior knowledge and attitude, followed by a health talk. Then, the same questionnaire was used to check their improvement of knowledge about blood donation. Results: As per the Wilcoxon rank test there is a significant improvement in the knowledge of study participants after health talk; out of a total 105 male students, 102 show positive rank (W+). Conclusion: Health education regarding voluntary blood donation is effective in improving the knowledge and attitude of youth. This will further improve the situation of voluntary blood donation by youth.</p> Palak Goyal Amit Kumar Huma Khan Abhinav Pandey Richa Mishra ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 81 85 10.21761/jms.v8i02.06 Evaluation of Immunohistochemical Expression of Cyclin D1 and its Clinicopathological Correlation in Oral Carcinoma <p>Introduction: The present study aimed to evaluate the expression of cyclin D1 in oral carcinoma and to find the association of the expression of cyclin D1 with different histological types, grades and other clinicopathological findings. Materials and Methods: A 50 formalin fixed paraffin embedded tumor sections, stained with haematoxylin &amp; eosin were graded and immunohistochemistry for cyclin D1 evaluated as expression score (ES), intensity score (IS) and total score (TS) was calculated. Results: A significant association was seen between total score of cyclin D1 expression with tumor types squamous cell carcinoma (Grade 1 and Grade 2) and verrucous carcinoma. Conclusion: In the present study for cyclin D1 evaluation, its expression was found in all oral carcinoma cases. A strong association was found between cyclin D1 total score with squamous cell carcinoma (Grade 1 and Grade 2) and verrucous carcinoma. We did not find a significant association between cyclin D1 total score and age, gender, tumor grades, site, laterality, PNI, LVI, pathological and clinical staging.</p> Priya S. Lohchab Hema Pant Nidhi Johri Rohit Sharma Ruchee Khandelwal ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 86 91 10.21761/jms.v8i02.07 Study of Prevalence, Clinical Pattern and Management of Maxillo-Facial Fractures in a Tertiary Care Centre <p>Introduction: Maxillofacial injuries are one of the most common injuries prevailing in society because of the strong reliance on road transportation. Road traffic accidents being the most common cause, affecting more than 20 million people worldwide. Multiple modality treatment is often required for the management of maxillofacial fractures, including clinical examination, radio-diagnosis and surgical intervention. 3-D CT face has helped in the reconstruction and reformation of fractures with some limitations to the same. Surgical management still holds a good approach towards the definitive management of maxillofacial fractures. Material and methods: Prospective observational study from 1st February 2021 to 31st July 2022. The parameters used were age, sex, time of incident, etiology, type of vehicle used with preventive measures, type of fractures, and treatment received. All patients underwent proper history taking, clinical examination, radiographic evaluation, and 3-D CT face reconstruction. Results: About 104 patients of maxillo-facial fractures presented to the emergency room of SRMS-IMS, Bareilly, out of which 63 patients were treated with surgical management Conclusion: The study concluded that RTAs were the major cause of maxillofacial trauma with the mandible being the most common bone fracture. ORIF with mini-plate fixation as treatment. lack of helmet and seat belt use, alcohol abuse, over-speeding and failure to follow traffic rules and regulations were the contributing factors</p> Mohit Singhal Shobhit Sharma Rohit Sharma Sudesh K. Sagar ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 92 95 10.21761/jms.v8i02.08 The Present Study Examined the Functional and Radiological Results of Mid-Shaft Clavicle Fracture Using a Titanium Elastic Screw Nail: A Prospective Study <p>Introduction: Upper extremity fractures, or clavicle fractures, make for 35 to 44% of shoulder girdle fractures and 2 to 5% of adult fractures. They’re one of the most common broken bones in emergency rooms. This study assessed the functional and radiological outcomes of treating a mid-shaft clavicle fracture using a titanium elastic screw nail. Materials and Methods: From February 2021 to July 2022, all patients with middle one-third clavicle fractures were studied at SRMS Institute of Medical Sciences, Bareilly. Written informed permission and institutional ethical committee approval were required to enroll patients. Results: About 44.44% had surgery after 2 to 3 days, 33.33% after 4 to 5 days, and 22.22% after 6 to 8 days. In 83.33% of patients, radiation exposure was 21 to 30 shots, 10 to 20 in 5.56%, and 31 to 40 in 11.11%. Constant score improved significantly from baseline at 2, 6, 12, and 24 weeks (p &lt; 0.05). In 50% (9) of the fracture joined at 24 weeks, 44.40% (8) at 12 weeks, and 6.60% (1) non-union.</p> Shubham Rathee Sanjay Gupta Suresh K. Kaushik ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 96 98 10.21761/jms.v8i02.09 A Comparative Study between Dexmedetomidine, Clonidine and Fentanyl as Adjuvants to Bupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block <p>Introduction: Supraclavicular brachial block is a popular and widely used nerve block technique for perioperative anesthesia and analgesia for upper extremity surgery. The block is performed at level of distal trunks and the origin of divisions, where the brachial plexus is confined to its smallest surface area, thus producing a rapid and reliable block of the plexus. It is the popular technique of anesthesia for upper limb surgeries due to its effectiveness in terms of performance, cost, margin of safety and good post-operative analgesia. It provides rapid onset, dense upper limb anesthesia with a single injection. Materials and Methods: About 90 patients who underwent elective upper limb Orthopaedics surgery during the period of the study were randomly divided into three equal groups of participants each using a computer-based random number generator, i.e., group C, D and F. They were compared for the onset and duration of motor and sensory block and post operative analgesia. Results: Mean onset of sensory and motor block was minimum for fentanyl (7.13 ± 0.94, 9.77 ± 0.82 minutes) followed by dexmedetomidine (7.37 ± 1.06, 11.33 ± 1.61 minutes) and clonidine (8.73 ± 0.98, 12.23 ± 1.57 minutes). Duration of block amongst the three groups showed statistically significant difference, dexmedetomidine (585.13 ± 44.42, 546.07 ± 42.02 minutes) having maximum duration of sensory and motor block followed by clonidine (535.77 ± 32.11, 507.30 ± 33.59 minutes) and minimum for fentanyl (330.03 ± 44.25, 284.67 ± 59.96 minutes). Conclusion: We concluded that adding fentanyl to bupivacaine for supraclavicular brachial plexus block had a faster onset of sensory and motor blockade when compared to dexmedetomidine and clonidine, and dexmedetomidine prolonged the duration of analgesia when compared with clonidine and fentanyl.</p> Pratibha Rawat Geeta Karki Vishwadeep Singh Gaurav Misra ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 99 104 10.21761/jms.v8i02.10 Clinico-demographic Profile of Childhood Encephalitis: A Hospital based Study <p>Introduction: Childhood encephalitis have numerous etiologies, varied presentations and wide outcome ranges, varying from complete recovery to devastating neurological sequele and death. During 2016 nationwide, 11,651 case and 1301 deaths were reported to the National Vector Borne Diseases Control Programme (NVBDCP), with a case fatality rate (CFR) of around 11%. It is a major health problem in the state of Uttar Pradesh, several districts have been experiencing recurrent episodes of encephalitis with different magnitudes. Under this backdrop, the present study was undertaken to know the clinical profile of children admitted with encephalitis. Materials and Methods: The present study was conducted in the Department of Pediatrics , Shri Ram Murti Smarak Institute of Medical Sciences over a period of 13 months (from January 2021 to February 2022). Total 74 cases of AES were included in this study. This was a prospective, observational, hospital based study. We collected relevant data of the encephalitis cases, analyzed and interpreted accordingly. Results: In the present study, total 74 cases of AES were admitted in pediatrics department during the study period. Out of 84 AES patients, majority 45.9% were between one month to five years of age. Male were 59.5% and female cases were 40.5%. The common presenting clinical manifestations were fever with altered sensorium (100%) and seizures in 100% cases. Most common nerve involved was optic nerve in 81% of the cases. Signs of raised ICP was seen in 35.1% of the cases. Laboratory report, CSF analysis revealed 45.9% patients had normal CSF cell count, 51.3% of the patients had normal protein levels. 62.2% had clinical features for 3 to 7 days prior to presentation. 43.2% patients had altered mental status between 0 to 24 hours prior to admission. About 67.6% patients had GCS &lt;8 and required intubation. CT scan head was performed in 13.5% cases and was abnormal in 40% cases. MRI Brain was done in 29.7% cases and most common area involved was thalamus in 36.4% cases. Conclusion: The common clinical features in childhood encephalitis are fever, altered sensorium and seizures, that was seen in 100% of the cases. CSF cell count was found to be normal and abnormal in almost equal number of cases.</p> Animesh C Pathak Sandhya Chauhan Sharat Johri Neeraj Prajapati ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 105 109 10.21761/jms.v8i02.11 Functional and Radiological Outcomes of Total Knee Arthroplasty in Osteoarthritis with Varus Deformity of Knee: A Prospective Study <p>Introduction: Total knee replacement (TKR) is the most commonly performed orthopedic surgical procedure for treating severe arthritis of the knee joint either due to osteoarthritis or due to inflammatory arthropathy. There was cartilage damage in either the medial or patella femoral joint/lateral compartment. Severe pain through deformity develops, subsequently necessitating a total joint replacement. This study assessed the Functional and radiological outcomes of total knee arthroplasty in osteoarthritis with varus deformity of the knee. Materials and Methods: From February 2021 to July 2022, all patients with osteoarthritis with varus deformity of knee were subjected to total knee arthroplasty after obtaining approval from the Institutional Ethics Committee were required to enroll patients. Results: The age of the patients in our study was 63.58 years ranging from 52 to 79 years. In 72.09% of the patients were females while the remaining 27.91% were females. In our study, 45% of the patients were overweight while the remaining 59.48% were overweight. In our study, 55.81% of the patients get their left knee operated first while the remaining 44.19% of the patients get their right knee operated first. In 25.58% patella resurfacing was done. The p-value was found to be significant between the pre- and post-oper knee society scores. In our study, 5 patients had complications out of which 4.65% of the patients had superficial wound infection, 4.65% of them patient had anterior knee pain and 2.33% had popliteal artery thromboembolism. Conclusion: Total knee arthroplasty is a relatively safe procedure. Treatment with total knee arthroplasty resulted in greater pain relief and functional improvement after 6 months. It improves the functional ability of the patient and the ability of the patient to get back to pre-disease state, which is to have a pain-free mobile joint, There was a significant association between the knee clinical score and knee functional score at six months follow-up.</p> Shubhanshu Saini Suresh K Kaushik Sanjay Gupta Shubham Rathee ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 110 114 10.21761/jms.v8i02.12 Correlation of Perfusion MRI of Brain Tumors with their Histopathological Grade <p>Introduction: Gliomas are the most common primary neoplasms of the central nervous system, histologically varying from low grade (benign) to high grade (malignant). Their grade can be underestimated even on histopathology because even a single lesion may be histologically heterogeneous. For planning the optimal treatment strategy and assessing prognosis, accurate histologic grading is essential because treatment options are different for high-grade and low-grade gliomas as high grades are usually treated with adjuvant and neoadjuvant radiation or chemotherapy, whereas low-grade gliomas are not. The study aims to differentiate glioma grades by using perfusion MRI and to correlate findings of brain tumors on perfusion MRI with histopathological grading. Materials and Methods: We investigated 50 consecutive patients with brain tumors who had undergone both conventional and perfusion MR imaging during a period of one and half year period. Dynamic contrast-enhanced T2*-weighted and conventional T1- and T2-weighted imaging. rCBV maps were obtained by fitting a gamma-variate function to the contrast material concentration versus time curve. rCBV ratios between tumor and normal white matter (maximum rCBV of tumor/rCBV of contralateral white matter) were calculated and compared between four grades of glioma. Results: Mean rCBV ratios were 1.00 ± 0.35 for grade 1 gliomas, 2.6 ± 1.17 for grade 2 gliomas, 4.98 ± 0.76 for grade 3 gliomas and 6.54 ± 1.47 for grade 4 gliomas, and were thus significantly different. Lymphomas have less vascularity than other tumors, with a mean rCBV of 1.85 ± 0.77. Metastasis is a relatively high vascular tumor with a mean rCBV of 4.57 ± 0.67, which is near to grade 3 gliomas. High-grade gliomas can be differentiated from low-grade gliomas with cut-off value of mean rCBV of 2.86 with a sensitivity of 93%. Conclusion: Perfusion MRI is a useful and dependable means of noninvasively preoperative diagnosis and assessing the histologic grade of brain tumors, especially gliomas and determining the appropriate treatment according to the vascularity of the tumor and respective grade of glioma</p> Vishal R Rana Neeraj Prajapati Vinod K Mogha Shashank Sah Namrata Singh ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 115 121 10.21761/jms.v8i02.13 Acne Vulgaris Triggering Factors in Females at Nangarhar University Teaching Hospital <p>Background: Acne vulgaris is a common disease in teenagers. It is a chronic inflammatory condition of the pilosebaceous units. Objective: To see the effect of different factors like age, skin type, diet, cosmetics, family history and pornographic material on acne. Methods: This case-control study was conducted in the Dermatology Department of Nangarhar University Teaching Hospital, Nangarhar from August 2021 to March 2021. The study consisted on a sample of 120 subjects including 60 cases of acne and 60 controls. The data was entered in a structured close-ended questionnaire. Univariate and multivariate logistic regression was used to see the effect of different factors on acne. Results: Age was below 20 years in 68 percent of patients and 38% of controls. Amongst patients 12% and amongst controls 7% were married. Logistic regression analysis showed that age (p = 0.001), odds ratio (0.288), Confidence interval (0.136–0.612) siblings history (p = 0.007), odds ratio (2.786), confidence interval (1.329–5.841), skin type (p = 0.000), dry skin (p = 0.173), odds ratio (0.449), confidence interval (0.142–1.422), oily skin (p = 0.002), odds ratio (3.925), confidence interval (1.684 9.146), cola drinks (p = 0.048), daily drinks (p = 0.023), odds ratio (2.975), confidence interval (1.159–7.636), cosmetic used (p = 0.004), odds ratio (4.219), confidence interval (1.577–11.285) and frequency of application of cosmetics (p = 0.010), odds ratio (3.509), confidence interval (1.347–9.1)had significant effect on acne. Conclusion: Acne is a more common disease in teenagers; age greater than twenty plays a protective role against acne. Carbonated drinks, positive sibling history, cosmetic treatment and frequent use of cosmetics have a significant relationship with acne. It is more common in oily skin than dry and normal skin</p> Zwaak Raihanullah Imamzai I Shah Kamawal N Khah ##submission.copyrightStatement## 2024-05-07 2024-05-07 8 02 122 125 10.21761/ms.v8i02.01 Determining Perception and Predilection for Ayurveda versus Allopathy amongst Educated Individuals Studying and Practising Allopathy at Different Levels <p>Background: Ayurveda is an alternative medicine system with historical roots in the Indian subcontinent. Ayurvedic preparations are typically based on complex herbal compounds, minerals, and metal substances. Up to 80% people in India use Ayurveda exclusively or combined with conventional Western medicine. The COVID-19 pandemic, also known as the coronavirus pandemic, is a recent global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On 5th May 2023, WHO declared end of COVID-19 as PHEIC. As of 24th May 2023, the pandemic had caused more than 766 million confirmed cases and over 6.9 million deaths globally, making it one of the deadliest in history. It is necessary that the scientific community must draw on pluralistic knowledge systems available globally to strengthen the immune system and reduce dependence on any one system of medicine. It is time for us to strengthen our trust and belief in our age-old tradition and knowledge of Ayurveda. This study was planned to determine use of Ayurvedic medicines and associated beliefs of educated individuals studying and practicing allopathy at different levels. Materials and Methods: Descriptive cross-sectional study amongst students pursuing a Bachelor of Pharmacy and Medical and Paramedical staff using an online questionnaire created using Google Forms. A total 229 respondent data were included in the study. The obtained information was summarised using Microsoft Excel and presented as percentages. The parameters that were studied were gender and age distribution of study subjects; preferred system of medicine for major ailments; reason for preferring allopathic medicine over ayurvedic medicine, rationale for rising credence of Ayurveda in COVID and post-COVID era; common perceptions regarding Ayurvedic medicines.Results: Most of our subjects were 18 to 35 years of age (176, 76.9%). One-third of the study subjects (77, 33.6%) preferred Ayurveda as the science for medical treatment. Ayurvedic treatment was preferred for gastro-intestinal and liver diseases. The rationale sought by study subjects for rising credence of Ayurveda during the COVID and post-COVID era were fewer side effects, ease of availability, and cost-effectiveness. Conclusion: COVID-19 has rekindled the belief and knowledge of people in Ayurveda. Predilection is to use ayurvedic and allopathic medicines together rather than Ayurveda alone and still people resort to allopathy to tide over acute conditions and immediate crisis.</p> Dipali Gupta Nipun Agrawal Pragati Khare Namrata Singh Manoj Gupta Lalit Singh Anamta Mirza ##submission.copyrightStatement## 2023-12-31 2023-12-31 8 02 126 130 10.21761/jms.v8i02.14