Medico Research Chronicles <p>Medico Research Chronicles (Medrech) ISSN No. <a href="">2394-3971</a>, is an official journal of Medico Edge Publications. It is a peer-reviewed, open-access journal of medical and health sciences, published on bi-monthly intervals. It publishes various manuscripts on the diverse specialization of medical, health science, and clinical research.</p> <p>Indexed by the <a href=""><strong>United States'&nbsp;NLM Catalogue, NCBI </strong></a></p> <p>Successfully reviewed for 2018 by <strong>Index Copernicus and assigned ICV Value 87.17 </strong></p> <p>COVID-19 is an emerging, rapidly evolving situation.</p> <p>Get the latest public health information from CDC:&nbsp;<a href=""></a></p> <p>Get the latest research from NIH:&nbsp;<a href=""></a></p> Medico Edge Publications en-US Medico Research Chronicles 2394-3971 Asthma COPD overlap syndrome [ACOS] Santosh Kumar Copyright (c) 2020 Medico Research Chronicles 2020-09-06 2020-09-06 7 4 i iii Assessment of psychiatric co-morbidities in patient of interstitial lung disease attending a tertiary medical centre <p><strong>Aims and Objectives:</strong> Interstitial lung disease (ILD) is a diverse group of conditions that are characterized by inflammation and fibrosis of the pulmonary parenchyma. In general, ILD is chronic and progressive diseases that result in substantial morbidity and mortality. The cardinal symptom of ILD is dyspnea; however, other pulmonary and extra-pulmonary symptoms are often present [1]. ILD is a common respiratory illness, in which some of the disease-related factors may increase the vulnerability to psychiatric disorders. This study was done to determine the prevalence of psychiatric co-morbidity in patients of ILD.</p> <p><strong>Methodology:</strong> It is an observational study conducted in 110 follow-up patients of Interstitial lung disease attending respiratory medicine OPD at a tertiary care center in central India. Psychiatric comorbidities are assessed by a pre-designed short structured questionnaire using Mini international neuropsychiatric interview.</p> <p><strong>Result:</strong> Among 110 patients of ILD 28% had psychiatric co-morbidity mainly depressive episodes (59%). A significant association is found between upper socioeconomic status (P =0.01), duration of active illness (more than 1 year) (P =0.001), and age of patient between 40 to 60 years (P =0.001) with psychiatric co-morbidity of ILD patient.</p> <p><strong>Conclusion</strong>: Our study shows there is an increased prevalence of psychiatric co-morbidities in patients of ILD, higher than the national average. The predominant psychiatric disorder seen is depressive disorder, so treatment of ILD should be a multidisciplinary approach including medical treatment of ILD and psychiatric evaluation to prevent psychiatric comorbidity or its early management. This will greatly reduce the morbidity, visits to hospitals, expenditure on treatment and thereby having better outcomes in our patients of ILD.</p> Komal Lohchab Sanjeev Anand Ankit Mehrotra Gajendra Vikram Singh Ashutosh Kumar Gupta R Aravind Santosh Kumar Amirul Haque Copyright (c) 2020-09-06 2020-09-06 7 4 163 169 Comparative analysis of microbial quality and safety of raw cow milk in Andassa Livestock Research Center and Dairy cooperatives in Bahir Dar city, Bahirdar, Ethiopia, 2018 <p>Milk is an important source of nutrients to humans and animals. Because of its high water activity and nutritional value, it serves as an excellent medium for growth of many kinds of microorganisms under suitable conditions. This study deals with comparative analysis of the microbiological quality and safety of raw cow milk samples from Andassa Livestock Research Center (ALRC) and Bahirdar Dairy Cooperatives (BDDC). A total of 60 samples (30 from each site) of raw cows’ milk were collected. 200ml of raw milk sample were taken aseptically from mixing container for quantification of Aerobic Mesophilic Bacteria (AMB), <em>Staphylococcus aureus</em>, Total Coliform (TC), Fecal Coliform (FC) and Yeasts and Moulds. Isolation of <em>Brucella</em> and <em>Salmonella</em> was conducted in all samples. The mean values of the five quality parameters in the milk samples of both sites were: AMBC (ALRC,7.47±0.06; BDDC,6.97±0.4logcfu/ml), <em>S</em>.<em>aureus </em>(ALRC, 5.30±0.13log10cfu/ml; BDDC, 4.75±0.46log10cfu/m), TC (ALRC, 2.94±0.23logMPN/ml; BDDC,2.43±0.53logMPN/ml) ,FC (ALRC,1.80±0.69logMPN/ml; &nbsp;BDDC,1.18±0.40logMPN/ml) and Yeast and Mould (ALRC, 6.41±0.084 log10cfu/ml; BDDC, 5.13±0.19log10cfu/ml). From the 60 samples, <em>Brucella </em>was detected in 19(31.6%) samples (ALRC, 8(26.6%); BDDC, 11 (36.6%)) and <em>Salmonella</em> was detected in 10(16.6%) samples (ALRC 6 (20%); BDDC, 4 (13.3%)). The microbial quality of raw milk obtained from ALRC was significantly higher than (P = 0.00) the sample obtained from BDDC. All the parameters did not satisfy the WHO standards. A source of water for washing milk utensils (0.002), practice of washing hands (0.021), the frequency of barn cleaning (0.012) and frequency of washing milk utensils and collecting tanks (0.033)&nbsp;</p> Dessalegn Alehegn Baye Sitotaw Pulluri Surender Reddy Copyright (c) 2020-09-07 2020-09-07 7 4 177 197 A corrected H-index for academic leadership determination: A bibliographic research <p><strong>Background:</strong> Academic medical leadership is closely related to scientific research productivity and publication. A researcher’s h-index is based on his/her most cited papers and the number of citations that they have received in other’s publications. It is generally determined by knowing the number of articles written by the author indexed in citation databases. An H-index will be 10 if 10 articles have received at least 10 citations. Ignoring the order and authorship role of an individual researcher may lead to rather a misleading H-index that is totally not relevant to academic leadership determination.&nbsp;</p> <p><strong>Materials and methods: </strong>An author was found to have an extremely misleading H-index of 28 at Google Scholar citation that is not relevant to academic leadership deterioration. The papers’ citations in his profile were assessed and a corrected rational non-misleading H-index was determined.</p> <p><strong>Results:</strong> The author's name was not among the first five authors for the first 20 papers listed by Google Scholar Citation, and in most of these papers, his name was not present among the first ten authors. The author's name appears among the first three authors in 9 papers (Number 27, 28,29, 36, 41, 43, 45, 47, 50) as listed by Google Scholar Citation. These papers has 34, 30, 21, 10, 5, 5,4,4,3 citations respectively. The author real H-index is 5; because he has at least 5 papers having five citations (Number 27, 28, 29, 36, 41, 43).</p> <p><strong>Conclusion:</strong> The corrected H-index should be calculated while considering the papers really authored by an individual author who should be among the first three authors. Many authors who join a large collaborative research group will generally have a minor contribution to research development and publication, but they may achieve a rather misleading high H-index. It is recommended that Google Scholar Citation adopt the corrected H-index to guarantee the reliability and usefulness of the H-index.</p> Aamir Jalal Al-Mosawi Copyright (c) 2020-09-07 2020-09-07 7 4 207 216 Cerebral palsy: A unique illustrated experience <p><strong>Background:</strong> Cerebral palsy is a heterogeneous condition associated with a non-progressive lesion causing permanent disorder of movement with limited mobility, and is generally associated with gross motor developmental delay. In moderate to severe cases of cerebral palsy, motor developmental milestones such as walking may never be achieved. Impaired cognition and delayed speech are also common.&nbsp;</p> <p><strong>Patients and methods: </strong>Seventeen patients with cerebral palsy are described in this paper including two female patients whose early treatment courses were included in previous publications, and 15 new cases (11 males and 4 females) observed during seven months period (May-November,2019). Their ages ranged from 10 months to 9 years. Ten patients had significant spasticity limiting their movements. All patients had developmental delays including delayed speech. Nine patients were unable to sit without support, including a patient with significant dystonia, and a patient who could stand and walk with support but was unable to sit without support. Only two patients were able to walk alone, but slowly and with difficulty. Two patients had history of birth asphyxia, and one patient had a genetic condition with 2 of his brothers being affected. The patients were treated based on our published experiences with individualized treatment plans providing a combination of various interventions including nutritional support, muscle relaxants, oral pyritinol, intramuscular piracetam, citicoline (oral and injectable), intramuscular cerebrolysin, and intramuscular nandrolone decanoate. The aims of these therapies include overcoming spasticity, repairing the brain and improving its function, and ultimately improving mobility and advancing development.&nbsp;</p> <p><strong>Results:</strong> All patients experienced improvement in motor development without the occurrence of any side effect. However, it was not possible to document the details of treatments and follow-up for all patients, but it was possible to provide an illustrated demonstration of improvement in seven patients.&nbsp;</p> <p><strong>Conclusion</strong>: Cerebral palsy is a heterogeneous condition, and the emergence of a single therapeutic agent that offers a comprehensive effect to improve its manifestations is very unlikely is the near future. Therefore, the use of evidence-based multi-factorial therapies is advisable. Adequate muscle relaxation is vital to prevent the complications of contractures which appear to cause a progressive disability.</p> Aamir Jalal Al-Mosawi Copyright (c) 2020-09-07 2020-09-07 7 4 217 239 The comparison of effectiveness of different doses of fentanyl added to hyperbaric bupivacaine for spinal anaesthesia in emergency appendectomy <p><strong>Introduction:</strong> General anesthesia is associated with greater risk from airway mishaps, gastric aspiration, and higher postoperative morbidity and mortality. Spinal anesthesia is similar to a nerve or plexus block method of eliminating pain sensation in a region of the body.</p> <p><strong>Objectives:</strong> To evaluate the effects of intrathecally administered fentanyl on the onset and duration of hyperbaric bupivacaine-induced sensory and motor spinal block and to determine the most suitable dose combination of fentanyl to local anesthesia.</p> <p><strong>Methodology</strong>: 120 patients who met the inclusion criteria were enrolled for the study and randomly divided into 4 groups after obtaining informed written consent. Group A (3ml of 0.5% hyperbaric bupivacaine + 0.6ml of normal saline), Group B (3ml of 0.5% hyperbaric bupivacaine + 10µg of fentanyl (0.2ml) + 0.4ml of normal saline), Group C (3ml of 0.5% hyperbaric bupivacaine + 20µg of fentanyl (0.4ml) + 0.2ml of normal saline) and Group D (3ml of 0.5% hyperbaric bupivacaine + 30µg of fentanyl (0.6ml)). The patients were then assessed for onset and duration of sensory block, side effects (nausea, vomiting, shivering) along with post-operative pain.</p> <p><strong>Results:</strong> There was no significant difference in ASA and nausea/vomiting except in shivering, rescue analgesia, and pain-free period. The duration of the pain-free period was longer in Group D. Group A had the highest incidence of Nausea/vomiting. The Group C (2.22±2.11hrs) patients required a longer duration for sensory regression of two dermatomes whereas Group A (1.49±0.01hrs) had a shorter duration for sensory regression of two dermatomes.</p> <p><strong>Conclusion:</strong> Addition of fentanyl 10µg, 20µg, and 30µg to bupivacaine in the spinal block for appendectomy provided excellent surgical anesthesia, prolonged the duration of spinal anesthesia with lesser incidences of side effects.</p> Diwash Rajbhandari Mahendra Prasad Mahato Prerana Dahal Ravi Bastakoti Rabin Raj Singh Rupesh Rajbhandari Copyright (c) 2020-09-07 2020-09-07 7 4 240 249 Keratolytic and anti-inflammatory action of salicylic acid in patients with seborrheic dermatitis associated with psoriasis, cases report <p><strong>Objectives:</strong> The objective was to evaluate the keratolytic and anti-inflammatory action of salicylic acid in two reported cases of patients with seborrheic dermatitis associated with psoriasis.</p> <p><strong>Methods:</strong> Clinical photographs of the frontal region and retro headset were taken with a digital camera olimpus SP570UZ with master software 2.0. The images obtained both in the initial phase of the study and at the 24 hours of treatment were transferred and stored on a 4-core Sansung computer. Image J software was used to measure the area selected for the study in both cases. This measurement was made in pixels for the photographic region under study. Aspects such as the presence of erythematous scales, inflammatory zones, hyperkeratosis, or scabs were evaluated before and after treatment.</p> <p><strong>Results:</strong> Case 1 showed a 48.89% reduction in the affected area after 24 hours of treatment. Case 2 showed a 52.98% reduction at 24 hours of treatment. Conclusions: The keratolytic and anti-inflammatory action of salicylic acid was evident in this case report.</p> Wilfredo José Molina Wills Vanessa Rodriguez Copyright (c) 2020-09-06 2020-09-06 7 4 170 176 10.26838//MEDRECH.2020.7.4.437 Revised Starling’s Principle (RSP): A misnomer as Starling’s law is proved wrong. <p>Substantial evidence based on results of new physics experiments and physiological research affirm Starling’s law wrong. Here we demonstrate that the Revised Starling’s Principle (RSP) is also misleading. The article is a futile attempt to revive Starling’s law after it has long been dead and buried. A most recent article seriously criticized RSP. We hope the excuse for the authors is unawareness of new contributions rather than a desperate attempt to defend the indefensible. Nether Starling nor the authors who made the hypothesis a law were aware of the discovery of the precapillary sphincter that demonstrates capillary pressure induce suction not filtration as demonstrated in the G tube, and the wide intercellular slit pores of the capillary wall that allow the passage of plasma proteins, thus nullifying oncotic pressure in vivo. In addition to previously reported 21 reasons affirming Starling’s law is wrong we add two more that concern the main reports that transformed Starling’s hypothesis into a law. Physiologists and physicists are concerned about formulae and calculations while physicians are more concerned about the lives and safety of their patients. Hence physicians understand the importance of discarding Starling’s law; being wrong is responsible for the induction of the new volume kinetic shocks and the causation of the acute respiratory distress syndrome that kills hundreds of thousands of patients every year. Now, there is a replacement for it: The hydrodynamic phenomenon of the porous orifice (G) tube. It is time to say goodbye Starling’s law, hello G tube.</p> Ahmed N. Ghanem Khaled A. Ghanem Copyright (c) 2020 Medico Research Chronicles 2020-09-07 2020-09-07 7 4 198 206