Asian Journal of Medical Research and Health Sciences (A-JMRHS)
ISSN: 2583-7761 (Online) Journal indexed in following major databases; Logos are embedded with respective links. Go to the Indexed in page for more indexing information Indexed in: AJMRHS (ISSN: 2583-7761, Online) is an international, peer-reviewed, open-access journal dedicated to advancing knowledge in medicine and healthcare. It welcomes original research, comprehensive reviews, and scholarly articles that highlight recent developments in both clinical and basic medical sciences. Special emphasis is placed on areas such as epidemiology, translational medicine, traditional Chinese medicine, public health, healthcare systems, and health policy. Every manuscript submitted undergoes a meticulous peer-review and editorial evaluation to ensure originality, scientific rigor, and relevance. A-JMRHS serves as a global platform for medical practitioners, researchers, and policymakers to foster dialogue, exchange experiences, and share progress in fields ranging from disease prevention and treatment strategies to healthcare reform and policy-making. By facilitating communication across borders, the journal plays a vital role in promoting better health outcomes and enhancing healthcare delivery worldwide. The journal accepts manuscripts in the following forms: Original research articles Reviews Case reports Short communications Letters to editor Discussion papers Clinical Experience Clinicopathological correlation Book reviews and "How to do it" type articles describing new methods or procedures. Publication Frequency The journal had started in 2023 with three issues per year. Chief in editor A-JMRHS.
PREOPERATIVE NEUTROPHIL TO LYMPHOCYTE RATIO AND PLATELET TO LYMPHOCYTE RATIO FOR PROGNOSIS AFTER EMBOLECTOMY
Introduction: The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are novel parameters that have been associated with inflammation in arterial embolism. This study aimed to evaluate NLR and PLR for the prediction of the prognosis in arterial embolism. Methods:197 patients admitted to the hospital with acute extremity embolism who underwent embolectomy with a Fogarty balloon catheter between February 2019 to March 2022 were included in the study. Receiver Operating Characteristics (ROC) curve analysis was generated for NLR and PLT to predict postoperative mortality and amputation. Patients were divided into two groups according to the NLR cut-off value (Low NLR group; High NLR Group). The Delong Test Was Used To Compare The Area Un-der The Curve (AUC) With Each Of These Parameters. Results: The mean age of the patients was 67.4 ± 15.9 years. The male population was 114 (57.9%). The median neutrophil/lymphocyte ratio was 5.8 (Q1: 3.3- Q3: 10.4), median platelet /lymphocyte ratio was 193.4 (Q1: 128.7- Q3: 298.1). Hospital mortality occurred in 73 patients. ROC curve analysis was performed with NLR to predict hospital mortality. The AUC value was 0.723 (95% CI 0.649 - 0.798, p <0.05). The cut-off for NLR was calculated as 5.97 by predicting hospital mortality (specificity = %66, sensitivity = %70, likelihood ratio: 2.06). Conclusion: High preoperative NLR is an independent mortality predictor for patients who underwent surgical embolectomy. Using NLR as a prognostic indicator for patients undergoing surgical embolec-tomy will be useful and cost-effective. Keywords: Embolism; Embolectomy; Biomarkers
Serkan Mola, Gokay Deniz, Zihni Mert Duman, Muhammed Selim Yasar, Alp Yildirim, Garip Altintas
Copyright (c) 2023 Serkan Mola, Gokay Deniz, Zihni Mert Duman, Muhammed Selim Yasar, Alp Yildirim, Garip Altintas (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
GASTRO INTESTINAL TRACT: THE WORLD OF SECOND BRAIN
Mothers gift not just life but also a microbial profile to their babies, i.e., for vaginally delivered babies, these communities resemble the specific microbial communities found in the mother’s birth canal; for babies delivered by caesarean section, the communities resemble the skin communities of the mother. These gut microbiota, via a complex bidirectional communication system, interact with the Central Nervous System, the enteric nervous system, and the hypothalamo-pituitary-adrenal axis (HPA) (cognitive and emotional centers), referred to as the Gut-Brain axis. Though in contemporary societies microbes have a strong negative connotation and are viewed in a warlike context, not all are harmful but beneficial and indeed crucial for a normal healthy life. As many ongoing research studies link the pathogenesis of various diseases to altered gut microbiota, many studies on the other hand show dramatic recovery with faecal microbiota transplantation, confirming the earlier Keywords: Faecal microbiota transplantation; Gut-brain axis; Gut microbiota; HPA axis.
Prajwal Toragal, Seema Sankeshwari, Nagaraja Puranik
Copyright (c) 2023 Prajwal Toragal, Seema Sankeshwari, Nagaraja Puranik (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
DETECTION OF PANTON–VALENTINE LEUKOCIDIN GENE IN METHICILLIN RESISTANCE STAPHYLOCOCCUS AUREUS: CLINICAL AND EPIDEMIOLOGICAL ASPECTS
Introduction: The role of PVL in the disease process and severity of Staphylococcus aureus till now is a debate matter. The data provide substantial evidence that the high virulence potential of CA-MRSA isolates is associated with the expression of PVL. PVL genes carried by HA-MRSA strains have also been recently described in cutaneous and invasive infections. Epidemiology of MRSA strains is constantly changing and is known to vary between hospitals. This study aimed to analyze the prevalence of PVL in MRSA isolates from patients using multiplex PCR. Material and Methods: Staphylococcus aureus were isolated from various clinical samples received in Bacteriology Laboratory using standard protocol. Antibiotic susceptibility testing was performed by Kirby – Bauer disc diffusion method. Detection of PVL genes by multiplex PCR. Results: The highest prevalence of MRSA PVL positive isolates was from pus sample (74.5%) followed by blood (16.3%). The results of antimicrobial susceptibility testing revealed almost similar pattern of antibiotics resistance among PVL negative MRSA isolates as compared to PVL positive MRSA isolates. Conclusion: The detection of PVL-producing MRSA will help us in framing and planning the infection control measures against the MRSA infections. Keywords: Panton–valentine leukocidin gene; PCR; Antibiotics
Sneha Mohan, Tarana Sarwat, Satendra Pal Singh, Dalip K. Kakru
Copyright (c) 2023 Sneha Mohan, Tarana Sarwat, Satendra Pal Singh, Dalip K. Kakru (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
PARTIAL HYDATIDIFORM MOLE AND COEXISTENT LIVE FETUS WITH ANENCEPHALY: A CASE REPORT
Ultrasound Partial molar pregnancy is a rare entity in which there is usually a triploid abnormal fetus associated with a large placenta with cystic changes. The fetus is usually not compatible due to multiple abnormalities. Here we present a case of a 24-year-old pregnant woman who came for routine first trimester scan and was diagnosed with partial mole and a live fetus with anencephaly and multiple spinal anomalies. Keywords: Partial mole; Live fetus; Anencephaly
Neha Anjum, Sowmya Uppalapati, Sriya Gudavarthi, Anthapu Keerthi Reddy, Kalla Mounica
Copyright (c) 2023 Neha Anjum, Sowmya Uppalapati, Sriya Gudavarthi, Anthapu Keerthi Reddy, Kalla Mounica (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
PREHOSPITAL POINT-OF-CARE ULTRASOUND (POCUS)
POCUS is instrumental in improving patient outcomes and person-centered care. It is performed as a bedside test and it is interpreted by the attending physicians. It is highly important in emergency medicine to use as a rapid diagnostic tool. Training Requiremen Formal ultrasound training is a requirement for prehospital physicians. It is an added advantage if the paramedics and nurses can learn POCUS programs that include both practical and instructive training. After the formal training, it is necessary to get educated in various courses, unit- level in-services, and medical education. Applications of POCUS in Prehospital settings Several applications such as enhancing various medical and traumatic pathologies can be achieved through the correct administration of POCUS. POCUS plays a very important role in the termination of resuscitation (JEMS 2018). Quality Assurance of POCUS in Prehospital Settings For better quality assurance, skill retention is very important for a better application of prehospital ultrasound. Limitations of POCUS in Prehospital Settings There are a few limitations of POCUS such as the response time of the emergency care professionals. Conclusion Thus, the impact of the prehospital point-of-care of ultrasound is quite important to determine and identifying patient outcomes and patient-centered care. the technological advancements help to address several factors in education, quality assurance, and feasibility of POCUS. POCUS is standard care in several prehospital settings used to reduce morbidity and mortality. Keywords: emergency medicine, diagnostic tool, resuscitation, ultrasound, quality assurance
Copyright (c) 2023 Murdhi Alanazi (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Pre-donation Hydration and Muscle Tensing exercises to Reduce Donor adverse Reactions due to Blood Donation.
Blood Donors are the backbone of a Blood Transfusion service.Since blood donors are considerate volunteers, they should be encouraged , motivated and should be safe without any adverse reactions. As the quote says , people who have not donated have never been asked for .Post donation well being and donors being fine fettle will definitely have implications on blood donor return rate .voluntary repeat donations should be encouraged. If the donors are ensured of a pleasant experience, they will be motivated to become regular repeat donors. This can be accomplished by preventing adverse reactions during and post donation. Objectives: 1.To study the frequency of occurrence of adverse reactions in voluntary whole blood donors. 2. To evaluate the efficacy of pre dontion hydration and muscle tensing exercises in preventing Adverse donar reactions 3. To look for associated factors like age, sex,mental status in the causation of donor adverse reactions Methodology: Study duration : 3 months . Total of 800 donors will be included in the present study , of which 200 will in the standard group and 600 ( 200 each) in intervention group. Randomly donors were assigned to one of four groups: 1) standard donation, 2) Leg exercise prior to Donation (venipuncture/Phlebotomy) 3) Pre-donation water (500 ml of bottled water consumed 20 to 30 minutes before donation), 4) Pre-donation water combined with leg exercise during donation Statistical analysis: Analysis :using SPSS 19.0 software. All data will be entered in Excel and further analysed. Results : There was significant reduction in the VVR in group 3 and 4 when compared to group 1 and 2.Anxiety was more in group 1 and 2.we found that pre donation exercise was not acceptable/ tolerated by many donors and they became more restless / showed anxiety when compared to group 3 .there was no much difference between group 3 and group 4 with respect to VVR.Pre donation hydration and muscle exercise were associated with significantly lower VVR. Implications : Pre Donation Hydration ( 500 ml of water 15 to 20 minute before donating) and leg exercises will help reduce vasovagal reactions specially in Novice donors, thus adding them to the Donor Pool. Hilights : Pre donation Hydration and Muscle tensing exercise to reduce the Adverse donor reactions Increase the Donor Pool
Predonation Hydration, Muscle tensing exercise, donor adverse reaction.
Veena Shivamurthy, Thotadamane Nagaraja Chandrasekhar, Shweta Ghatapanadi, Pradeep Kumar Lalyanaik, Kalagara Devi Samyuktha, Namratha Girish.
Copyright (c) 2024 Veena Shivamurthy, Thotadamane Nagaraja Chandrasekhar, Shweta Ghatapanadi, Pradeep Kumar Lalyanaik, Kalagara Devi Samyuktha, Namratha Girish. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Bilateral middle cranial fossa arachnoid cysts with temporal lobe agenesis. Case report in adult.
The temporal lobe agenesis syndrome is a rare congenital abnormality. Bilateral temporal lobe agenesis along with middle cranial fossa arachnoid cysts is extremely rare, and only very few cases have been reported in the literature. Case report: We present the case of 21-year-old child with bilateral arachnoid cysts and temporal lobe agenesis whose mental examination and neurologic assessment is normal. The Magnetic resonance imaging (MRI) findings revealed bilateral temporal lobe agenesis with bilateral arachnoid cysts. Brain MRI sequence showing bilateral middle cranial fossa arachnoidal cysts, following CSF signal intensity on MRI. Bilateral middle cranial fossa arachnoid cysts with temporal lobe agenesis. The patient was managed conservatively. Conclusion: Bilateral middle cranial fossa arachnoid cysts with temporal lobe agenesis in adult is very rare. The diagnosis is made by brain MRI. Prophylactic surgery in asymptomatic cases is not advisable. These patients must be followed by the practician. The patient and his family must be sensualized and informed of some precautions, especially brain head trauma.
Adult, headache, brain MRI, Bilateral temporal lobe agenesis, bilateral middle cranial fossa arachnoid cysts.
Ahmed El Mostarchid, Mamoune El Mostarchid, Ahmed Jidane.
Copyright (c) 2024 Ahmed El Mostarchid, Mamoune El Mostarchid, Ahmed Jidane. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Assessment of Dental Anxiety during Pulp Therapy, Restorations & Extraction in 6- to 9-year-old Children Using Drawings and Questionnaire – A cross sectional study.
Childhood dental fear and anxiety are prevalent from an early age through adolescence, posing a significant challenge in pediatric dental care. Understanding children's emotions during dental procedures is crucial for pediatric dentists to anticipate and address behavioral responses in future visits. Utilizing drawings and questionnaires can effectively gauge an individual's self-concept, anxiety, attitude, or conflicts. Aim: This study aimed to assess children's drawings and questionnaires as means to measure dental anxiety related to dental treatment. Methodology: Forty children aged 6-9 years participated in this study. During the initial therapeutic session, all participants underwent pulp therapy and restorative treatment with local anesthesia administration. Objective assessment of distress during treatment was conducted using the Sound, Eye, Motor (SEM), and Frankl Scales. Subsequently, children were provided with a predetermined set of questions before the treatment, and their responses were recorded. Following the interview, children were asked to draw a picture of their surroundings. Pediatric dentists and psychologists scored the children's drawings using the Child Drawing: Hospital (CD: H) scale. The findings were compared with Frankl and SEM Scores. Results: A statistically significant association was observed between Frankl score and SEM Score (p<0.001*). A strong positive correlation was found between CD:H Scores Examiner 1 and CD:H Scores Examiner 2 (p<0.001*; r=0.760). Conclusion: Assessing dental anxiety through children's drawings, which reflect their inner feelings, offers an alternative to self-report techniques for pediatric dentists. Drawing, being both easier and enjoyable, emerges as a valuable tool for measuring children’s levels of dental anxiety.
Children, Dental Anxiety, Drawings, Pain Perception, Behaviour Management
Rajvi Rashmikant Shah, Mayur Shrigopal Bhattad, Ankita Chandak, Jyoti Kamble.
Copyright (c) 2024 Rajvi Rashmikant Shah, Mayur Shrigopal Bhattad, Ankita Chandak, Jyoti Kamble. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
The classical Biomarkers to Predict Diabetes Mellitus
Diabetes mellitus is metabolic disorders; depicted by elevated blood glucose levels ascribed to a futile, scanty or sojourns production of insulin. Enduring complications of the disease have been related to peripheral vascular problems, steering to cardiovascular diseases, stroke, diabetic retinopathy, nephropathy and foot. Precise monitoring of these complications and early therapy stages will allow improvement in prevention and treatment approaches. The availability of measurable, accurate and reproducible biomarkers allow the patient to receive timely enactment of personalized therapies and circumventing harmful blood sugar fluctuations that ultimately progress to life-threatening impediments. Profound knowledge of these biomarkers released by extracellular vesicles in metabolic diseases and other disease condition may guide the development of novel therapeutic approaches to restore the affected pathogenesis, rather than merely treating the symptoms. With advent of method that can isolate (ultracentrifugation, affinity-based capture, size exclusion chromatography/filtration, polymer precipitation) and characterize (protein quantification, transmission electron microscopy, atomic force microscopy, ELISA, nanoparticles tracking analysis, flow cytometry, western blot) from body fluids have become a major diagnostic and prognostic biomarkers not only in diabetes, in other conditions like cancer, neurodegradative disease.
Biomarkers, diabetes mellitus, blood glucose, metabolic diseases
Junapudi Sunil, Yasodha Krishna Janapati, Syam Sundar Junapudi.
Copyright (c) 2024 Junapudi Sunil, Yasodha Krishna Janapati, Syam Sundar Junapudi. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Perceived Social Support With Early Maladaptive Schemas Among Male And Female Epileptics.
Individuals with epilepsy face number of psychological and physical challenges in their daily life. One of the issues is the faulty thought processes, such as disturbed thinking, holding negative beliefs about their selves, lack of social support from their family. Objectives: To examine (a) Younger epileptics will exhibit more early maladaptive schemas, and perceived low social support as compare to older epileptics.(b) Female epileptics will have more early maladaptive schemas, and perceived more social support as compared to male epileptics. (c) Married epileptics will experience less early maladaptive schemas, and perceived more social support as compared to unmarried epileptics. Methodology: This Correlational study was conducted on epileptic patients from March 2021 to December 2021. Sample of the current study was comprised of 200 epileptic patients. The sample was purposefully selected from hospitals and clinics of Lahore Pakistan. The questionnaire, Urdu version of young schema questionnaire short form (YSQ-SF), Urdu version of the multidimensional scale of perceived social support (MSPSS), were used to analyze the effect of early maladaptive schemas on perceived social support and quality of life among epileptics. Result: Results of the current study concluded that old-aged epileptics have less early maladaptive schemas, and perceived more social support as compared to young-aged epileptic. It is also concluded that female epileptics exhibited more maladaptive schemas, and perceived social support, as compared to male epileptics. Unmarried epileptics suffering from generalized seizure scored higher on early maladaptive schema and perceived low social support. While married epileptics suffering from generalized epileptic seizure and have perceived low social support. Conclusion: The results of study confirm the hypothesis by establishing examine the effect of early maladaptive schemas with perceived social support. Early maladaptive schemas have negative affect with perceived social support. Generalize seizure have high scores on early maladaptive schema and low score on perceived social support as compared to focal seizure epileptics. Key Word: Early Maladaptive Schemas, Perceived Social Support, and Quality of Life.
Early Maladaptive Schemas, Perceived Social Support, and Quality of Life.
Jauhar Ali, Muhammad Ali Lak, Noshaba Razaq, Hifza Sehar, Fatir Abbas, Zunaira Anjum.
Copyright (c) 2024 Jauhar Ali, Muhammad Ali Lak, Noshaba Razaq, Hifza Sehar, Fatir Abbas, Zunaira Anjum. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
A Rare Antepartum Intervention For Gross Hydrocephalus- Cephalocentesis
Fetal hydrocephalus detected antenatally presents challenges in management and prognostication, necessitating careful consideration of therapeutic intervention. We report a case of 22 year old primigravida at 35 weeks gestational age with a diagnosis of isolated gross hydrocephalus in a single live intrauterine fetus. Following thorough counselling and consent, the patient underwent fetal cephalocentesis due to maternal contraindications for cesarean section. Under ultrasound guidance and local anesthesia, cerebrospinal fluid was drained. The procedure was well tolerated by both mother and fetus without immediate complications .Post procedure monitoring revealed a reduction in fetal biparietal diameter and alleviation of ventricular distension. This case, underscores the feasibility and potential benefits of fetal cephalocentesis in selected cases of antenatal hydrocephalus, despite the associated neurodevelopment risks and postnatal complications that warrant ongoing monitoring and multidisciplinary care. It also highlights the successful management of isolated gross fetal hydrocephalus through prenatal intervention, emphasizing the multidisciplinary care for maternal and child health care.
Fetal hydrocephalus , Cephalocentesis, Ventriculoamniotic shunting
Copyright (c) 2025 Apoorva Bathula. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
An effectively handled case of abnormal uterine bleeding due to retained intrauterine bony fragments: A rare case report
The presence of retained intrauterine fetal bones is a rare but well-known entity. Patients may present with abnormal uterine bleeding, subfertility, secondary infertility, chronic pelvic pain, vaginal discharge, and, pelvic inflammatory disease. Calcification appears as a hyperechoic area on ultrasound. Hysteroscopy-guided removal of bony fragments is the most widely practiced management and leads to complete resolution of symptoms.
Abnormal uterine bleeding, Bony fragment, Infertility
Copyright (c) 2025 Shweta Sharma, Mohit Gaur, Deepa Singh. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Title: Yoga therapy - A proactive approach to promote successful aging
Yoga, an ancient health technique, is gaining renewed interest due to its potential to promote healthy aging. Previously, the scientific validation of its effectiveness was predominantly based on limited and inadequately constructed studies, but this situation is now undergoing a transformation. Various meticulously conducted research offer empirical evidence indicating that engaging in yoga has beneficial impacts on cellular aging, physical mobility, balance, mental well-being, and the prevention of cognitive decline. These are all areas of particular interest and importance for older individuals. Due to the low cost of adopting yoga-based treatments in communities and homes, policymakers are considering yoga practice as a cost-effective method to decrease medical expenses and enhance outcomes for the increasing elderly population. This commentary explores the benefits of yoga therapy for older adults and highlight its potential to improve their overall well-being. The yoga offerings encompass a diverse array of programs and levels of difficulty, ensuring that virtually everyone can partake and reap the health advantages through regular practice.
Copyright (c) 2025 Divya Sharma, B R Sharma. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
REVERSIBLE AKINETIC CATATONIA DUE TO A LEFT TEMPORAL LOBE ARACHNOID CYST AFTER STEREOTACTIC EVACUATION IN CHILDREN: CASE REPORT
Catatonia is caused by a variety of psychiatric and organic conditions. Association between temporal lobe arachnoid cyst (ACs) and catatonia was reported and largely debated, in literature. Aim: To report a case of reversible akinetic catatonia after stereotactic removal of left mesiotemporal ACs is reported. Case report: A 16-year-old female admitted for akinetic catatonic is reported. The patient was treated for schizophrenia for one year without any results. One months later, she presented with typic akinetic catatonia. Brain magnetic resonance imaging (MRI) showed an ACs in the mesiotemporal left temporal lobe. She was evacuated by stereotactic evacuation, with good results and amelioration. Conclusion: ACs on the left temporal lobe were reported to be related to psychological and psychiatric disorders. Catatonia can be presented as an acute onset of psychosis in a patient with a left temporal lobe arachnoid cyst in child.
akinetic catatonia; brain MRI; temporal arachnoid cyst; stereotactic evacuation; disappear of catatonia.
El Mostarchidmamoune, Salami Mohcine, Laaguilijaoud, Inaskassemi, Asri A., Chrif, Gazzazmiloudi. Neurosurgery Department Of Military Mohamed V Teaching Hospital. Mohamed V Souissi University. Rabat. Morocco..
Copyright (c) 2025 El Mostarchidmamoune, Salami Mohcine, Laaguilijaoud, Inaskassemi, Asri A., Chrif, Gazzazmiloudi. Neurosurgery Department Of Military Mohamed V Teaching Hospital. Mohamed V Souissi University. Rabat. Morocco.. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
A RARE CASE OF PEUTZ-JEGHERS SYNDROME PRESENTING WITH MELENA
Peutz-Jeghers Syndrome (PJS) is a rare autosomal dominant disorder characterized by hamartomatous polyps throughout the gastrointestinal tract and distinctive mucocutaneous pigmentation. We present a case of PJS in a 17-year-old male who presented with melena, which led to the discovery of multiple hamartomatous polyps in the small intestine, colon, and stomach. Despite the rarity of this syndrome, prompt recognition of its clinical manifestations, including gastrointestinal bleeding, is crucial for early diagnosis and management. This case underscores the importance of considering PJS in the differential diagnosis of patients presenting with melena, as timely intervention can prevent serious complications such as bowel ischemia and malignant transformation. Additionally, it highlights the significance of comprehensive surveillance and screening protocols for individuals with PJS to detect and manage associated malignancies and gastrointestinal complications effectively.
Peutz-Jeghers Syndrome, melena, Hamartomatous polyps, Mucocutaneous pigmentations
Copyright (c) 2025 Neha Anjum, Harish Chilakala. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
A study to evaluate the role of antioxidants and iron as diagnostic markers in oral cancer
Oral cavity (OC) and oropharyngeal (OP) cancers afflict about 500,000 people globally. Dental health care practitioners need to understand the causes, diagnosis, and treatment of oral cavities and oropharyngeal cancer. The constant and direct exposure of oral mucosal cells to tobacco product chemical carcinogens such as polynuclear aromatic hydrocarbons and nitrosamines causes the generation of free radicals/reactive oxygen species. Changes in salivary antioxidant and micronutrient levels may prove to be an important factor in the pathogenesis of oral premalignant and malignant disorders. The present study aimed to evaluate the levels of Vitamin C, MDA and iron levels in oral cancer, pre-malignant group and the oral cancer group. 15 oral cancer patients, 30 premalignant condition patients, and 15 normal controls were analyzed in the study. Among the 30 patients of the premalignant conditions- group (Group S1) 12 were diagnosed with oral submucous fibrosis, and 18 of them were diagnosed with oral leukoplakia. The oral cancer patients (Group S2) were segregated based on the TNM system from stages I to IV. The oral submucous fibrosis patients were subdivided into four grades. The oral leukoplakia patients were categorized into homogenous and speckled types. A detailed history was obtained from the patients. After obtaining informed consent, saliva samples will be collected from patients who have not consumed any food or any form of tobacco 2 hours before collection. Following a thorough mouth rinse using distilled water, saliva is allowed to accumulate in his or her mouth for 5 minutes. Accumulated saliva is collected by the spit method. 5ml of blood sample will also be collected from these patients, Serum was separated by Centrifugation. Collected serum and saliva were stored at -80℃ until further analysis. The serum and salivary samples were then analyzed for Vitamin C, iron, and malonaldehyde (lipid peroxidation) according to the standardized protocol. In the present study, a total of 60 samples were screened for Vitamin C, Iron, and MDA in both serum and saliva of normal control, premalignant, and oral cancer patients. We found that there was a decreased level of Vitamin C and iron in both serum and saliva of premalignant and oral cancer patients. MDA level was higher in premalignant, and oral cancer patients and there was a significant increase in the level of MDA in oral cancer patients. Understanding antioxidants can help reduce the incidence of oral cancer in its early stages. More study is needed before this supplement may be recommended as an adjuvant treatment.
Oral Cancer, Leukoplakia, Antioxidants, MDA
Naresh Yajamanam, Nireeksha Shetty, Bheemesh Vangalapati, Preethi Hegde, Suresh Babu, Mehaboob Ali, Kundubai N, Mamatha Kshatriya.
Copyright (c) 2025 Naresh Yajamanam, Nireeksha Shetty, Bheemesh Vangalapati, Preethi Hegde, Suresh Babu, Mehaboob Ali, Kundubai N, Mamatha Kshatriya. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
ANALYZING STAT-3 GENE EXPRESSION IN ORAL SQUAMOUS CELL CARCINOMA CELLS PRE- AND POST-CARBOPLATIN TREATMENT IN VITRO
Oral squamous cell carcinoma (OSCC) represents a small percentage of global cancer cases, with oral tumors being the most common. OSCC can be caused by various factors including tobacco, alcohol, and viral infections. Carboplatin, a platinum-based chemotherapy drug, shows promise in treating OSCC with fewer side effects. However, activation of Signal Transducer and Activator of Transcription 3 (STAT3) in OSCC cells can hinder carboplatin's effectiveness. This study aims to assess carboplatin's efficacy in OSCC treatment and explore the potential benefits of combining it with STAT3 inhibitors. Materials and methods: KB cells were subjected to treatment with varying concentrations of carboplatin. Cell proliferation was evaluated through the MTT assay, while RNA isolation was performed using the TRIzol method followed by cDNA conversion. Gene expression analysis was carried out using qRT-PCR. Statistical analysis of the results was conducted using SPSS. Results: The significant reduction in STAT3 expression post-treatment compared to untreated cancer cells indicates a promising avenue for further exploration of carboplatin’s therapeutic efficacy in targeting oncogenic signaling pathways. Conclusion: The results show a significant decrease in STAT3 expression post-treatment compared to untreated OSCC cells, suggesting carboplatin's strong anti-cancer effect and its potential as a therapeutic option for OSCC treatment.
Oral squamous cell carcinoma, Carboplatin, STAT3, expression, treatment
Aashruthaa S, Dhanraj Ganapathy, Ameya K P, Ashikha Shirin Usman P P, Durairaj Sekar.
Copyright (c) 2025 Aashruthaa S, Dhanraj Ganapathy, Ameya K P, Ashikha Shirin Usman P P, Durairaj Sekar. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Van Der Knaap disease in a 5 year old male child : A Case Report
We present a case of 5 years old male child presenting with complains of recurrent fall while walking followed by seizure activity with developmental delay
Van der Knaap disease, Megaencephalic leukoencephalopathy, Vanishing white matter disease
Copyright (c) 2023 Kunal Raj Kumar Agrawal (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Hydatid cysts of liver with secondary peritoneal hydatidosis- a case report
secondary peritoneal hydatidosis constitutes about 10-16% cases of hydatid disease and occurs secondary to rupture of hepatic hydatid cysts which can be spontaneous or due to traumatic rupture.Imaging plays an important role in diagnosing secondary peritoneal hydatidosis as most of the cases are asymptomatic and present later due to mass effect characteristic imaging findings like presence of daughter cysts ,membranes ,hydatid sand and presence of multiloculated cysts helps in diagnosing hydatid cysts.Although liver and lung are most common organs affected by hydatid disease ,disseminated hydatidosis is also seen of which primary peritoneal hydatidosis is rare constituting only 2% of cases
Hydatid, hepatic hydatid cyst, secondary peritoneal hydatidosis,imaging
Swetha Reddy Masani, Laxmi Priyadarshini Kontham, Ramya Krishna Kudaravalli.
Copyright (c) 2023 Swetha Reddy Masani, Laxmi Priyadarshini Kontham, Ramya Krishna Kudaravalli. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Macular oedema in Rural Central Indian population- Etiology, Visual impact and associations and outcome of treatment.
BACKGROUND- Macular edema is a result of diverse etiologies, Diabetes and Hypertension being the most prominent, manifesting as Diabetic Macular edema and macular edema secondary to retinal vein occlusion. Present study aims to evaluate the causes, visual impact and associations of macular edema and outcome of treatment, in rural Indian Population. METHODS- This prospective evaluation is based on evaluation of 100 consecutive patients of Macular edema, aged 18 years or more, presenting to a tertiary care ophthalmic facility. They were ophthalmologically evaluated and treated as per established protocols. RESULTS- Mean age in the study population with macular edema was 55.20 ± 7.84 years; with Male to female ratio of 2.44:1. Diabetic retinopathy (seen in 58%) eyes was commonest cause of macular edema, followed by RVO (seen in 20%) of eyes. 92% of the patients received intra -vitreal injections for the treatment of macular oedema. Additional laser photocoagulation for co- existent diabetic retinopathy as an additional treatment was done in 48% of the cases and 5% received surgical treatment in form of vitrectomy. Pre treatment visual acuity was 6/18 to 6/36 in 40%, 6/60 in 19% and <6/60 in 41% of the patients. Post treatment, the acuity proportions improved to 31% between 6/6 to 6/12, 45 in 6/18 to 6/36 and 13% had 6/60 and 11% had less than 6/60. CONCLUSIONS- Systemic disorders have important causeation on macular edema which causes significant effect on the visual status and the treatment with established protocolos helps in betterment of visual status of these cases.
Macular edema. Diabetic retinopathy, Retinal vein Occlusion, Anti VEGF therapy
Bodhraj Dhawan, Vaishali Dhawan, Anand Saraswat
Copyright (c) 2023 Bodhraj Dhawan, Vaishali Dhawan, Anand Saraswat (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Knowledge and Practice Regarding The Administration Of the Pentavalent Vaccine Among Health Care Workers In Vientiane Capital, Lao PDR: A Mixed Method Approach
Background: The pentavalent vaccine is an essential, cost-effective public health measure to reduce preventable premature child mortality and childhood mobility and contributes to lowering the spread of vaccine-preventable diseases. The aim of this study is to assess the knowledge and practice of providing pentavalent vaccines and its related factors among health care workers (HCWs). Method: This was a cross-sectional analytical study, using the qualitative and quantitative methods. The study was conducted in nine district hospitals and 33 health centers in Vientiane Capital. In total, 184 health care workers were involved in the study and in-depth interviews were conducted with 12 HCWs. Descriptive and inferential statistics were applied to determine the factors associated with the knowledge and the practice of pentavalent vaccines. A thematic analysis was applied to the qualitative data. Results: The results showed that more than half (63.3%) had poor knowledge of the pentavalent vaccine, while about two thirds (65.7%) reported good practices for delivering the pentavalent vaccine. In the multiple logistic regression, significant factors associated with the knowledge of the pentavalent vaccine were the qualification of HCWs (AOR=2.6, 95% CI=1.1 – 6.3, p=0.030), receiving training on vaccines (AOR=3.4, 95% CI=1.7 – 6.8, p<0.001), and incentives of working for vaccination programmes (AOR=2.7, 95% CI=1.2 – 6.1, p=0.020). The qualitative study revealed the need to improve supply-side determinants including increased training to improve the health staff’s competency, knowledge and practice of immunization. Conclusion: The data from this research indicated that more than half of the HCWs had poor knowledge about the pentavalent vaccine, despite vaccination practice being relatively good. There was a correlation between improved knowledge, with those HCWs who had higher education, and received training and incentives. These findings demonstrate there is a need for more efficient training and the continuous education of HCWs in the field of immunization. Keywords: Pentavalent vaccine, health care workers, knowledge and practice, Lao PDR.
Pentavalent vaccine, health care workers, knowledge and practice, Lao PDR.
Bounthome Samontry, Manyvanh Vongsy, Do Thi Hanh Trang, Kongmany Chaleunvong, Vanphanom Sychareun, Jo Durham.
Copyright (c) 2023 Bounthome Samontry, Manyvanh Vongsy, Do Thi Hanh Trang, Kongmany Chaleunvong, Vanphanom Sychareun, Jo Durham. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
TRIO CASE STUDY SHOWING NOVEL MUTATION IN LAMB3 GENE CA JUNCTIONAL EPIDERMOLYSIS BULLOSA [INTERMEDIATE/SEVERE]
Background: Junctional epidermolysis bullosa (JEB) is a type of Epidermolysis Bullosa, a group of genetic conditions that cause the skin to be very fragile and to blister easily. It is categorized into Herlitz type and Non-Herlitz types. JEB is inherited in an autosomal recessive pattern and the most common genetic mutations associated are LAMB3, COL17A1, or LAMC2, and LAMA3 genes. Case presentation: This study reports a consanguineous couple, who are carriers for pathogenic variant for LAMB3 gene, with an affected child with a homozygous mutation in the LAMB3 gene causing Herlitz type of Junctional epidermolysis Bullosa/ Non-Herlitz type of junctional epidermolysis bullosa. Furthermore, prenatal diagnosis for the Gravida also showed the same pathogenic variant. Conclusion: For autosomal recessive genetic conditions, it is advisable to perform a Trio whole-exome sequencing or next-generation sequencing to detect the genes associated with the disease. Depending on the type of variants involved prenatal diagnosis for the next pregnancy and treatment or management (if available) options can be offered/discussed.
Keywords: Epidermolysis Bullosa, Skin blistering, Trio-exome sequencing, LAMB3, Autosomal recessive, Prenatal diagnosis
Shaile Bandla, Srinadh Buraggada, Soumya Peruchala.
Copyright (c) 2023 Shaile Bandla, Dr. Srinadh Buraggada, Dr.soumya Peruchala. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Changes Caused by Apoptosis In the Follicular of Ovarian Torsions
Ovarian torsion can be given as an example of ischemia/reperfusion (I/R) injuries. It is likely to be encountered in young women who apply to the emergency department. Reactive oxygen radicals (ROS) formed as a result of I/R are an important damaging mechanism in this mechanism. Here, apoptotic mechanisms are also triggered and lead to cell death. Material and method Sixteen rats were equally divided into two groups (n=8). In Group 1, only laparotomy was applied to the control group (n=8), and ovarian torsion was applied to the experimental group (n=8) in Group 2. Results In the rats in the control group, the difference in bcl-2 and P53 staining scores in the primordial follicle, secondary follicle, antral follicle was found to be statistically significant (I p<0.001, p=0.007, p=0.007, respectively). For bcl-2 and p53 in the Corpus Luteum tissue, the difference between the groups was found to be statistically significant (P=0.007, p=0.007, respectively) Conclusion: It is thought that total loss may not occur in ovarian ischemia and preventive surgery can be performed. These results should be supported by hormonal levels and rat studies at different ages.
Ovary, Ischemia/reperfusion, Apoptosis, Age
Havva Erdem, Adem Küçük, Yeliz Kaşko Arıcı, Dursun Kurt, Kübra Kalkışım, Handan Ankaralı, Onur Yalçın, İlker Coşkun.
Copyright (c) 2025 Havva Erdem, Adem Küçük, Yeliz Kaşko Arıcı, Dursun Kurt, Kübra Kalkışım, Handan Ankaralı, Onur Yalçın, İlker Coşkun. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Comprehensive NMR Spectral Analysis and Prediction of Selected Coumarin Derivatives Using 1H, 13C, 2D-COSY, HSQC, and HMBC Techniques
Nuclear Magnetic Resonance (NMR) spectroscopy is a powerful analytical technique extensively used in structural elucidation of complex organic compounds. Recent advancements in computational tools have enabled accurate spectral prediction and structure generation from multidimensional NMR datasets. This study aimed to evaluate the effectiveness of the Spec2D expert system in predicting and interpreting 1H, 13C, and 2D NMR spectra (COSY, HSQC) for the structural elucidation of selected coumarin derivatives. A total of nine coumarin derivatives were subjected to in silico NMR spectral prediction using ChemOffice Ultra and the online platform nmrdb.org. Detailed structure elucidation was performed using the Spec2D system, which applies graph-based modelling and a COSY-based knowledge base for substructure extraction and candidate structure generation. Input spectra included 1D (1H, 13C) and 2D (COSY, HSQC) data, with cross-peak information derived from H–H COSY spectra. The analysis module successfully extracted relevant substructures and proposed candidate structures based on spectral constraints. For all compounds, the correct structures were consistently ranked highest by the system, with isomeric structures appearing in lower ranks. Spec2D demonstrated flexibility in handling compounds with different molecular formulas and exchangeable protons. Processing time per compound ranged from 30 seconds to 2 minutes. Spec2D proved to be a reliable and efficient tool for NMR-based structural elucidation of coumarin derivatives. Its ability to generate accurate predictions without molecular formula input, accommodate spectral variability, and utilize a COSY-driven knowledge base underscores its utility in modern cheminformatics and metabolomics research.
Coumarin derivatives, NMR spectroscopy, 1H NMR, 13C NMR, 2D COSY, HSQC, Structure elucidation, Spectral prediction
Junapudi Sunil, Yasodha Krishna Janapati, Mallika Chikkala, Atchutuni V S Rav I Sai Nadh, Sheetal Maru.
Copyright (c) 2025 Junapudi Sunil, Yasodha Krishna Janapati, Mallika Chikkala, Atchutuni V S Rav I Sai Nadh, Sheetal Maru. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Study On the Levels of Inflammatory Markers in Venous Blood From Varicose Vein in-situ and from Peripheral Vein in Patients with Varicose Veins
Background/objectives: To evaluate the role, variations and correlate the inflammatory markers such as C-reactive Protein (CRP), Neutrophil to Lymphocyte ratio (NLR) and Erythrocyte Sedimentation Rate (ESR) as well as to analyze the changes in hematological parameters at the site of varicose veins (in-situ). Materials and methods: The study enrolled Thirty adult patients (both male and female, aged 18-64 years) with varicose veins. The study groups were divided into patients with varicose veins and a control group. Blood samples were collected from the antecubital vein of the control group and the patient group, and from the varicose vein in-situ of the patient group. Parameters assessed included Erythrocyte count, Leukocyte count, Hemoglobin concentration, Neutrophil and Lymphocyte count, ESR and serum high sensitivity CRP levels. Results: Significant increase was found in Erythrocyte count, Leukocyte count, Neutrophil count, Lymphocyte count, NLR, ESR, and CRP levels in patients compared to healthy controls. There was also a significant increase in these parameters including Haemoglobin concentration in blood samples taken from varicose veins compared to systemic blood in patients. The study also found a strong correlation between the Erythrocyte count, Haemoglobin concentration, ESR, and CRP levels in systemic blood and varicose vein samples in patients. Conclusion: Levels of inflammatory markers is significantly higher in blood samples collected from patients with varicose veins when compared to those from healthy controls, particularly at the site of varicose vein. This study confirms the hypothesis that inflammation is involved in the pathogenesis and progression of the disease. Therefore, our findings may have implications for the management of patients with varicose veins. Identifying and monitoring inflammatory markers in patients with varicose veins could help in early detection of potential complications and timely intervention along with finding targeted anti-inflammatory therapy for the management of the same.
Anti-inflammatory therapy, Anti-leukocyte therapy, Endothelial damage, Inflammation, Inflammatory markers, Varicose veins
Vijaya Jovita Jayachandran, Nagaraja Puranik.
Copyright (c) 2025 Vijaya Jovita Jayachandran, Nagaraja Puranik. (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Identification and Functional Analysis of miR-204-3p in Oral Squamous Cell Carcinoma: Insights into Target Gene and Expression Patterns in Indian Population- A Pilot Study
Introduction Oral Squamous Cell Carcinoma (OSCC) is a significant global health issue, originating from squamous cells in the oral cavity. Tumor necrosis factor-alpha (TNF-α), a pro-inflammatory cytokine, plays a crucial role in promoting cell proliferation, metastasis, and invasion in OSCC. This study investigates the role of miR-204-3p in regulating TNF-α, exploring its potential as a therapeutic target and its impact on cancer progression. Aim The primary aim of this study is to explore the regulatory relationship between miR-204-3p and TNF-α in OSCC, focusing on miR-204-3p's potential role as a tumor suppressor and its implications for targeted therapies in OSCC. Methods Human genome sequences were obtained from NCBI, and OSCC-specific sequences were filtered to create a nucleotide database. miRNA reference sequences were sourced from miRBase, and miRNA targets were predicted using TargetScan based on conserved binding sites. The structural stability of precursor-miRNAs was validated using RNAfold. OSCC tissue samples were ethically collected, and total RNA was isolated using TRIzol. Gene expression levels of TNF-α and miR-204-3p were analyzed using qRT-PCR, with statistical analysis performed using SPSS. Results The study identified hsa-miR-204-3p as a regulator of TNF-α, characterized by a stable stem-loop structure. qRT-PCR analysis revealed significant downregulation of miR-204-3p and upregulation of TNF-α in OSCC tissues compared to normal tissues. Conclusion hsa-miR-204-3p may act as a tumor suppressor in OSCC by targeting TNF-α, suggesting its potential as a therapeutic target for OSCC treatment.
Micro-RNA, Oral Squamous Cell Carcinoma, Therapeutic target, TNF-α
Ishwarya S 1, Ashikha Shirin Usman P P2, Ameya K P2, Dhanraj M Ganapathy1, Durairaj Sekar2*
Copyright (c) 2025 Ishwarya S 1, Ashikha Shirin Usman P P2, Ameya K P2, Dhanraj M Ganapathy1, Durairaj Sekar2* (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Effective Communication in Nursing Clinical Practice
This comprehensive article delves into the intricacies of nursing communication in the diverse realm of healthcare. With a focus on the significance of effective communication in nursing, acknowledge that this facet is not just a mere exchange of information but a critical factor in ensuring the provision of high-quality patient care. Further, explore the sanctity of nurse-patient consultations, a crucial element in creating a safe space for patient’s health concerns and opinions. Meanwhile, also surveys the inherent risks in communicating treatment plans, highlighting the delicate balance between honesty and empowerment. Lastly, navigate the delicate matter of delivering unfavorable news, an inevitable part of healthcare that demands tact, empathy, and compassion. Explore these necessary dialogues of care within the healthcare profession and examine the power held in words spoken and unspoken in the nursing community.
Effective Communication; Nursing; Clinical; Practice
Copyright (c) 2025 Ahmed Lateef Abed Alkhaqani, An Najaf (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
ACUTE A RARE CASE OF ABDOMINAL HYDATIDOSIS
Hydatid disease (HD)—also called hydatidosis, echinococcal disease or echinococcosis is a zoonosis caused by tapeworms of the genus Echinococcus. The disease is usually acquired when contaminated water or food that contains the parasitic larvae of echinococci is ingested. CT and MRI are ways to define better cyst calcifications; they are crucial for determining lesion viability and in turn, selecting the appropriate treatment. CT and MR imaging have important roles in the evaluation of extra-hepatic HD, as they enable better assessment of the extent of larger lesions and aid in establishing the relationships of the cyst with surrounding strctures. A 35 years old female patient was admitted with a history of abdomen distension of 6 months and abdomen pain of 2 weeks at Shridevi Institute of Medical Sciences and Research Hospital, Tumkur. To evaluate for the symptoms, USG was done followed by CT and MR which showed multiple large well defined cystic lesion with multiple thin septae, calcifications, debris with pelvic extension.Hydatid disease primarily affects the liver and typically demonstrates well-known, characteristic imaging findings. Hepatic hydatidosis are common but is rare to see all type of hydatidosis and with all stages at same time.
Copyright (c) 2023 Satender Singh, Divya. J (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
CORRELATION BETWEEN LUMBO SACRAL ANGLE AND PRORIOCEPTION IN SUBJECTS WITH CHRONIC LOW BACK PAIN
Background: Chronic low back pain is a significant issue that is only becoming worse, partly as a result of the ageing and expanding global population. It affects people of all ages and is typically linked to sedentary jobs, tobacco use, obesity, and low socioeconomic status. According to Andersons et al., the point prevalence of LBA in adults is estimated to be 30%, with the yearly incidence at 15%. Objective: To determine the correlation between lumbosacral angle and proprioception in subjects with chronic low back pain. Methods: A total of 175 subjects have been recruited for the study out of which 120 subjects with CLBA who met the selection criteria were included in the study. The subjects who reported having chronic low back pain without any radio-graphically visible abnormalities were taken into consideration; the VAS score and chronicity were also gathered to gauge the severity of the pain. Lumbosacral angle and Proprioception were recorded. Results: For males and females, the correlation between LSA and VAS has an r-value of -0.131 and 0.144. It was discovered that there was no correlation between the two (p>0.05).In men, the association between VAS and sickness duration has an r-value of 0.122, while in women, it has an r-value of -0.134. Both are discovered to be not significant (p>0.05). Conclusion: There is a positive correlation between joint proprioception impairment and chronicity in CLBP patients. This correlation was found to be more pronounced in females than in males in (JPE) lumbar flexion movement and significant in both males and females in (JPE) lumbar extension movement.
Copyright (c) 2023 Asian Journal of Medical Research and Health Sciences
OBSEVATIONAL STUDY ON ROLE OF NEUROSONGRAM IN INTRACRANIAL PATHOLOGIES IN NEONATES INA TETIARY CARE CENTER
Background: Neonates face a lot of challenges especially based on their gestational age, maternal factors, birth weight at the time of delivery, immediate cry following birth. Hypoxic ischemic encephalopathy and Germinal matrix haemorrhage constitutes major portion of those challenges. To identify varied conditions, we can take help of imaging in form of neurosonogram. Methods : Neurosonogram was carried out on all n tool including follow neonates both as screening and diagnostic up scans. A total of 100 preterm babies with positive findings were included in the study. An analysis was performed over different pathologies including grading of specific condition in required areas. Results: Our study comprising of 100 neonates with brain pathologies showed following results. In our study of 100 neonates, most of the disease burden is by vascular causes (56%), then followed by infective (19%), congenital (14%), trauma (8%), metabolic (2%) and miscellaneous (2%). 52% of PVL showed associated risk factors. Conclusion: In our study 100 preterm babies with suspected brain injuries were studied with ultrasound through anterior fontanelle and mastoid sutures. Neurosonogram can detect various intracranial pathologies on par with CT scan. Transcranial doppler can reflect the cerebral blood volume and perfusion status through resistive index and abnormal values according to literature are >0.8 and <0.4 and can be noticed in severe hypoxic ischemic encephalopathy and conditions which increases intracranial pressure . Any measure that decreases the vasospasm which decreases RI can eventually prevent the neonate having progression of ischemia and further new infarct.
Anterior cerebral artery system , Cerebroventricular hemorrhage; Germinal matrix hemorrhage
Meghana Shiny Repalle, Pravin Raj Thillai, Shivani Gogi