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   Table of Contents - Current issue
Coverpage
July-December 2022
Volume 12 | Issue 2
Page Nos. 49-96

Online since Wednesday, November 23, 2022

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EDITORIAL  

COVID Immunity Highly accessed article p. 49
Basanta Hazarika
DOI:10.4103/2278-8239.361831  
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ORIGINAL ARTICLES Top

Antibody response to SARS-CoV-2-infected healthcare workers during first wave of Covid-19 pandemic in a tertiary care center of Assam p. 51
Gayatri Gogoi, Mithu Medhi, Reema Nath, Utpal Dutta, Mondita Borgohain, Binod Gohain, Neelakshi Bhattacharyya, Md Ezaz Hussain
DOI:10.4103/ajoim.ajoim_10_22  
Context: Healthcare workers (HCWs) were at the front line of the COVID-19 (corona virus disease-19) pandemic management and were at higher risks of contracting SARS-CoV-2 due to occupational exposure. The objectives of the present study were to estimate the antibody response to SARS-CoV-2 among COVID-19-positive HCWs and its persistence in subsequent follow-up samples and to compare antibody response between rapid antigen/real time polymerase chain reaction (RT-PCR) groups. Settings and Designs: This hospital-based cross-sectional study was carried out in Assam Medical College. Materials and Methods: Inclusion criteria were SARS-CoV-2 test, which was confirmed in HCWs. A total of 127 HCWs were included. The samples were tested for SARS-CoV-2 IgG by qualitative indirect ELISA using InBios SCoV-2 DetectTM IgG kit. First sample was collected from 25th day to 35th day of SARS-CoV-2. First and second follow-up samples were collected in 3 and 6 months, respectively. Statistical Analysis Used: Epi Info version 7 was used. The χ2 test was done. Results: A total of 69% male and 31% female HCWs were included. Most of them were in the 20–29 years age group (48%). About 92% were symptomatic and 20% had comorbidities. Overall seroconversion was 88% (RAT category 98.61% and RT-PCR 74.55%). Symptomatic category showed 90.68% seropositivity. The follow-up at the 3rd and 6th month showed 93.85% and 88.24% seropositivity, respectively. Conclusion: Rapid antigen test-positive symptomatic people have more chances of development of antibodies within a period of 1 month and sustained for more than 6 months in their blood.
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CO-RABS score: A novel bedside scale to predict the severity in COVID patients Highly accessed article p. 58
Merugolu Finny Theo Joseph, Dabboo Patwari, Kishore Kumar Talukdar, Bhaskar Neog, Sunny Kumar Yadav, Nasimur Riaz
DOI:10.4103/ajoim.ajoim_9_22  
Study Objective: To determine the prognostic significance of a new score (CO-RABS), formulated by our Institute to classify the covid patients into mild, moderate, severe cases and also to compare it with the conversion AIIMS based classification. Patients and Methods: This is a retrospective study in which we have collected data from the medical records of patients who were admitted in our Hospital with covid infection during 2nd and 3rd waves of the pandemic. We have taken Comorbidities (CO), Respiratory rate (R), Age (A), Blood pressure (B) and SpO2 (S) of the patients at the time of admission to calculate an overall score (Abbreviated as CO-RABS). Basing on this score, the patients were classified into mild, moderate and severe cases. We then compared our CO-RABS score based classification with AIIMS classification using a statistical software. Results: We studied 727 patients (440 men, 287 women) and 99 patients died due to covid related complications. The ability to predict the prognosis was higher for our newly formulated CO-RABS score when compared to AIIMS classification. (AUC of CO-RABS 0.88 vs 0.82 of AIIMS; p < 0.05). Conclusion: The ability of CO-RABS score to predict the prognosis of covid infection is higher than that of AIIMS/ICMR classification. Hence it can be used as a supportive tool in the covid management protocol along with all the other conversion modes of treatment.
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Clinico-etiological profile of lower respiratory tract infections in HIV-positive patients p. 63
Darpan Rajkhowa, Bipul Chandra Kalita, Malisetty Sreenivas Sai
DOI:10.4103/ajoim.ajoim_8_22  
Background: The type of pathogens responsible for opportunistic infections in human immunodeficiency virus (HIV)-infected persons varies from region to region. Till date, very few studies covering respiratory tract infections in HIV-positive patients have been conducted in this part of the country. This study was conducted in order to get better understanding of the clinical picture of lower respiratory tract infections (LRTIs) in HIV-positive patients in this region. Aim: The aim was to study the LRTIs in HIV-positive patients. Settings and Design: Eighty-one patients were diagnosed as HIV-positive with LRTIs, attending to Department of Medicine at Assam Medical College and Hospital, Dibrugarh, Assam, India. Materials and Methods: Personal and family history was collected with emphasis on the duration of HIV-positive status, any chronic illness, sexually transmitted diseases, history of blood transfusions, or any surgical procedures. A detailed general and systemic examination was done. Statistical Analysis Used: The data collected were tabulated in MS Excel and analyzed using SPSS 20.0. The categorical variables were summarized as frequency and percentages. Results: Mycobacterium tuberculosis was responsible for 18.52% of cases of LRTIs, whereas fungal etiology was found in 7.41% of the cases. The most common bacterial and fungal pathogens isolated were Streptococcus pneumoniae (23.46%) and Candida albicans (7.41%), respectively. Conclusion: Low CD4 cell count is an important indicator for the risk of pulmonary tuberculosis and fungal LRTIs, as shown in our study. Periodic CD cell count in HIV-positive patients is important in this regard.
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Assessment of language proficiency and enhancement among 1st phase MBBS undergraduates p. 70
Dharma Rao Vanamali, Himavathy Kodandarao Gara, Abhay Dadaji Hatekar, Jeneeta Baa, Surekha Pardeshi, Naruttam Sonowal, Sarita Panigrahy, Sachin Mulkutkar, Mamata Sar
DOI:10.4103/ajoim.ajoim_5_22  
Background: Limited language proficiency (LLP) in English and state language may constrain the impetus of a medical undergraduate for effective communication, social interaction, and academic progression. Hence, the study aimed to explore the extent and perceptions pertaining to language barrier among medical undergraduates and to obtain feedback about language and communication skill sessions of foundation course. Materials and Methods: This multi-centric cross-sectional study across five medical colleges in India involved participation of 691 1st phase MBBS undergraduates. The study was conducted in two phases: (a) at the beginning of Foundation course before initiation of language training classes and (b) at the end of training sessions. The questions were either semi-structured or multiple-choice type regarding (a) sociodemographic characteristics, (b) schooling details, and (c) questionnaire regarding proficiency of English and local language and emotional and cognitive responses toward LLP. Results: Out of 691, proficiency for English and respective state language was confirmed by 170 (24.6%) and 318 (46.02%), respectively. Ninety (13.02%) students had no acquaintance for respective state languages. Difficulty in understanding concepts when taught in English and communication breakdown were expressed by 121 (18.22%) and 263 (38.95%) students, respectively. Regarding language and communication skill sessions, improvement in English and state language was expressed by 495 (71.63%) and 521 (75.4%), respectively. The sessions rating was highest for usefulness, followed by quality. Conclusion: Approximately 75% and 50% of MBBS undergraduates of 1st phase expressed LLP for English and state language, respectively, which represents a liability. Language enhancement benefited students in terms of usefulness and better comprehension of medical terminologies and colloquialism. Circumspection of language barrier among medical undergraduates would bridge the gap of linguistic knowledge and communication goal.
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CASE REPORTS Top

Priapism as the initial presentation in chronic myeloid leukemia is a red flag sign: A case report p. 79
Aritra Saha, Salitteeswaran Visvesvaran, Sudem Narzari, Krishnangshu Das, Ajit Kumar Pegu, Rajesh Kumar Dhanowar
DOI:10.4103/ajoim.ajoim_13_22  
Chronic myeloid leukemia (CML) is a myeloproliferative disorder of the hemopoietic stem cells, which may occasionally present with symptoms of leukostasis secondary to hyperleukocytosis, which includes headache, priapism, and dreaded ones such as stroke and myocardial infarction. This is a case of a 23-year-old man who presented with priapism and was subsequently found to have CML. The patient later developed stroke and succumbed to it. This case demonstrates that the importance of treating CML patients presenting with signs of hyperleukocytosis promptly and cautiously to prevent the impending grievous complications.
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UGI bleed- A rare presentation of carcinoma gall bladder with cholecystoduodenal fistula p. 85
Karishma Das, Swarup Kar, Usha Rani Pegu, Liza Hazarika
DOI:10.4103/ajoim.ajoim_11_22  
Upper GI bleeding(UGIB) is defined as bleeding derived from a source proximal to the ligament of Treitz. It is a life threatening condition. Bilioenteric fistulas are abnormal communication between the bile duct system and the gastrointestinal tract that occurs spontaneously and usually occurs as a rare complication of untreated gallstone in majority of cases. Cholecystoduodenal fistula(CDF) as a cause of upper GI bleeding is an extremely rare event. It has been theorized that a cholecystoduodenal fistula may lead to development of carcinoma gall bladder due to chronic reflux of duodenal contents. High index of clinical suspicion is required to make a diagnosis.
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“BABOON” syndrome: A case report p. 88
Dipankar Das, Anupam Dutta, Bidisha Dangoria, Chetan Damani, Imdadul Hussain
DOI:10.4103/ajoim.ajoim_14_22  
Symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), previously known as Baboon syndrome, is a symmetrical erythematous rash on the gluteal and intertriginous areas observed after exposure to systemic drugs. This was the case of a 35-year-old woman who presented to medicine OPD (outpatient department) of Assam Medical College and Hospital (AMCH), Dibrugarh with a history of a macular rash over the right and left armpit and right upper back, buttocks and inner aspect of the left thigh.
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SHORT COMMUNICATIONS Top

Referencing in scientific writing and research p. 91
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/ajoim.ajoim_6_22  
In general, research activities are essential, but it is equally important to ensure that the research findings are shared with different researchers across the world. In simple terms, referencing refers to giving credit to the intellectual work of a person/s or the source of information. Referencing is a strategy that tends to provide support to the statements made by the researchers in their own work. It is one of the most effective strategies to reduce the incidence of plagiarism, as it gives an opportunity for the authors to let the readers know about the ideas which are theirs and those which are contributions of other researchers. To conclude, referencing is an important aspect of the research writing and has been linked with multiple benefits to the authors, readers, and other researchers. Thus, it is our responsibility to envisage citation of appropriate references in the research work, so that more people become aware of the similar kind of works and replicate them in their individual settings.
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A study of malaria in Bangladesh p. 93
Arvind Nath
DOI:10.4103/ajoim.ajoim_12_22  
Background: Malaria still occurs in Bangladesh which is one of the countries of the South-east Asia region. Materials and Methods: The study design included an online search of all data pertaining to Malaria in Bangladesh from the year 2020 onwards. Results: During 2020, 90% of Malaria cases in Bangladesh occurred in just 3 districts of the country. Conclusion: The number of imported cases of Malaria from Bangladesh to India and vice versa would decrease if anti-Malaria measures are stepped up in the respective countries’ border districts.
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MEDICAL QUIZ Top

Medical quiz p. 95
Dibyajyoti Borah
DOI:10.4103/2278-8239.361832  
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