IMA Kerala Medical Journal <p>Kerala Medical Journal is the academic journal published by Indian Medical Association – Kerala State Branch.</p> en-US (Dr. Benny PV) (Dr. Anoop Lal) Mon, 21 Dec 2020 00:00:00 -0800 OJS 60 Cancer Incidence and Mortality: Global Trends <p>Cancer remains one of the leading causes of morbidity and mortality worldwide. Despite decreases in the cancer death rates in high-resource countries, such as the USA, the number of cancer cases and deaths is projected to more than double worldwide over the next 20–40 years.1 Globally by 2030, it is projected that there will be ∼26 million new cancer cases and 17 million cancer deaths per year. The projected increase will be driven largely by growth and aging of populations and will be largest in low- and medium-resource countries. Under current trends, increased longevity in developing countries will nearly triple the number of people who survive to age 65 by 2050.</p> PV Benny ##submission.copyrightStatement## Mon, 21 Dec 2020 00:00:00 -0800 Awareness and Symptoms of Computer Vision Syndrome among Computer Users <p>Background: Computer Vision Syndrome (CVS) is a series of visual symptoms caused by excessive viewing of Visual Display Terminal (VDT) screens without proper attention to practical visual hygiene. This study was to assess the awareness and extent of symptoms of Computer Vision Syndrome among computer users. <br>Materials &amp; Method: Cross-sectional study conducted between January and May 2014. Structured questionnaire was given to 220 computer users 20-40 years of age. <br>Results: Data was collected from 220 computer users (106 males and 114 females). Median age was 29.83. About 79% indicated ‘yes’ to at least one symptom. 25.9% were aware of Computer Vision Syndrome. Most common symptom was headache (37.35%).The other symptoms were eye strain (29.88%), dryness (15.51%), watering of eyes (12.06%), and others symptoms like blurred vision, redness (5.2%). All of them used computers with screen at the level of eyes. <br>Conclusion: CVS is a significant occupational hazard in people using VDT for prolonged duration. Computer Vision Syndrome symptoms was experienced by 79% of computer users in the study group with common symptom being headache. Proper awareness and preventive measures such as work place ergonomics may help in reducing the incidence.</p> Bindu Thampi, J Antony, Ajith Mohan M, Varsha Vijayan ##submission.copyrightStatement## Mon, 21 Dec 2020 00:00:00 -0800 Clinical Profile and Triggers of Childhood Asthma among Patients Diagnosed at Paediatric Asthma Clinic <p>Asthma is a major cause of chronic morbidity and mortality throughout the world and there is evidence that its prevalence has increased considerably over the past 20 years, especially in children.1 It is now estimated that as many as 300 million people of all ages, and all ethnic backgrounds, suffer from asthma and the burden of this disease to governments, health care systems, families, and patients is increasing worldwide.2 Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation in which many cells and cellular elements play a significant role. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation. In asthma the environmental and genetic factors are implicated in causation. The rapid rise in asthma during the 1980s and 1990s was too abrupt to be explained solely by change in prevalence of genetic variations.3 Even though genetic predisposition is one of the factors in children for the increased prevalence –urbanisation, air pollution and environmental tobacco smoke contribute more significantly</p> MD Balaji, SM Shaji, Anuradha Krishnadas Nair ##submission.copyrightStatement## Mon, 21 Dec 2020 00:00:00 -0800 Randomised Controlled Trial of Mitomycin-C Versus Standard Care in Middle Meatal Antrostomy <p>Background: Perioperative use of topical Mitomycin-C has been found to be effective in reducing stenosis and synechiae formation after Endoscopic Sinus Surgery (ESS). Meticulous postoperative care with frequent nasal douching can prevent crusting and adhesion to a great extent. This study is to examine the clinical effects of Mitomycin-C applied to the sinonasal mucosa and to determine whether such an application significantly alters the incidence of postoperative maxillary sinus ostium stenosis and adhesion formation thereby improving the surgical outcome. <br>Materials &amp; Methods: Randomised controlled trial of Mitomycin-C versus standard care in Middle meatal antrostomy in prevention of post operative synechiae and ostial stenosis. This study was conducted in a tertiary care teaching hospital in Kerala state of India, from December 2012 to May 2014. A total of 60 patients were included in this, consists of 30 experimental group and 30 control group. Intra operatively Mitomycin–C (MMC) was topically applied over the Middle meatal antrostomy site in the experimental group. <br>Results: There was a statistically significant difference in the occurrence of maxillary sinus ostium stenosis and synechiae formation in the experimental group with Mitomycin-C application as compared to the control group in the 1st, 3rd and 6th month follow up. ). At 3 months 40% in control group got synechiae, and only 3.3% in experimental group (p-value = 0.001), and in 6 months 56.7% of the control group got synechiae compared with 6.7% in experimental group (p-value = &lt;0.0001) A highly significant reduction in stenosis, compared to control group after six months of surgery in experimental group (93.3 % experimental group were free from stenosis compared to 66.7% of the control group, p-value of 0.009. <br>Conclusion: The topical application of MMC is helpful in prevention of post operative complications like synechiae formation and ostial stenosis.</p> Shaheer Ibrahim A, K Krishnan, KB Rajamma ##submission.copyrightStatement## Mon, 21 Dec 2020 00:00:00 -0800 Venous Thromboembolism following Major Abdominal Surgery in Indian Population: A Single Center Experience <p>Background: Postoperative venous thromboembolism is a proven major health problem in western countries. Hence there are specific guidelines advocating thromboprophylaxis in most cases. The few studies available regarding incidence in Indian patients provide conflicting data regarding the incidence of thromboembolism and need for thromboprophylaxis in our patients. In our study, we analysed the incidence of deep venous thrombosis in patients who underwent major abdominal surgeries over 5 years.<br>Materials &amp; Methods: This was a retrospective descriptive study among 757 patients admitted in the surgical wards of Government Medical College, Trivandrum from January 2005 to December 2009 and underwent major abdominal surgeries. From the data, the incidence of postoperative deep venous thrombosis was detected. <br>Results: Of the 757 patients studied, 0.92% developed deep venous thrombosis in the post-operative setting. No form of prophylaxis was found to be used in any of these patients.<br>Conclusion: It has been found in this study that the rate of postoperative DVT is negligible after major abdominal surgeries. This prompts us to say that routine chemical prophylaxis is an unnecessary intervention in Indian patients who undergo major abdominal operations and may be administered only in very high risk patients.</p> KG Krishnakumar, AV Anilkumar, M Chisthi Meer ##submission.copyrightStatement## Mon, 21 Dec 2020 00:00:00 -0800 Epidemiological Methods for Pharmaco-Vigilance: The Case of Vaccine Safety <p>Pharmacovigilance is “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problem”. There is criticism that drug safety reporting in medical research is inadequate. There is possibility of many types of bias in vaccine safety studies especially in the diagnostic process, at investigator level and in the process of recall. Vaccines generally have two primary concerns. Clinical research is the method for establishing both. Epidemiology is the methodology for research and is the foundation for evidence based vaccine delivery in the community in the clinical practice mode as well as immunization program mode.</p> Rajamohanan K Pillai ##submission.copyrightStatement## Mon, 21 Dec 2020 00:00:00 -0800 Idiopathic Pneumoperitoneum <p>Pneumoperitoneum is generally due to gastrointestinal perforation and need emergency laparotomy. We report three cases of pneumoperitoneum without definite cause. A six month old infant, who had ventriculoperitoneal shunt in place and on mechanical ventilation, was conservatively treated for pneumoperitoneum, and recovered. Two newborns underwent emergency laparotomy with diagnosis of perforation peritonitis; but no gastrointestinal pathology was found at operation. In one of them features of ruptured meconium-cyst could be found. All patients survived. The causes of idiopathic pneumoperitoneum are analysed.</p> R Rajendran, Ghazi Mukttash, Amanulla Mugheri, Samir Hegab ##submission.copyrightStatement## Mon, 21 Dec 2020 00:00:00 -0800 Parathyroid Carcinoma, Parathyroid Crisis and Hungry Bone Syndrome <p>Parathyroid carcinoma is a rare endocrine malignancy accounting for &lt;1% of cases of sporadic primary hyperparathyroidism (PHPT) and is associated with more severe clinical disease than its much more common benign counterpart, parathyroid adenoma. Clinical suspicion of a parathyroid cancer, therefore, should lead the surgeon to an aggressive initial operative approach as a complete resection of all malignant tissue at the time of initial surgery allows for the greatest likelihood of a cure. We report a case of parathyroid carcinoma induced parathyroid crisis with development of hungry bone syndrome in the postoperative period.</p> Dayananda R Babu, Srijith T Prasad ##submission.copyrightStatement## Mon, 21 Dec 2020 00:00:00 -0800 Recent Advances in Medical Oncology Bijay Nair ##submission.copyrightStatement## Mon, 21 Dec 2020 00:00:00 -0800