Telangana Journal of IMA <p>Telangana Journal of IMA (TJIMA) is is a semi- annual, peer reviewed publication with circulation in India and abroad. It is the official journal of Indian Medical Association, Telangana State Branch. TJIMA publishes original research work of high standard for dissemination in both print and online media. </p> <p>We publish Review articles, Original articles, Case reports, Editorials, and other forms of scientific information, in all disciplines of medical science. The journal aims to provide its readers with the latest clinical and basic research from across specialties with an objective to arm the practitioners of modern medicine with contemporary knowledge and providing an opportunity to practice evidence-based medicine. TJIMA also publishes informed opinions and perspectives by experts. Content related to a general medical and topics with multi-disciplinary appeal are encouraged. Separate theme sections are published from time to time on relevant topics such as infectious disease, lifestyle diseases, and medical education giving different viewpoints to our varied readers.</p> <p>The Editorial Board comprises eminent specialists and consultants from India and abroad. Although preference is given to original work carried out in the Indian subcontinent, contributions are welcome from anywhere in the world.</p> en-US Telangana Journal of IMA Implementing Attitude, Ethics and Communication (AETCOM) Module Teaching with Special Emphasis on Ethics to Undergraduate Medical Students Momin Kashif ND Sanjay Kumar Copyright (c) 2023 2023-12-21 2023-12-21 3 2 4 6 10.52314/tjima.2023.v3i2.123 Trikala Sandya - Sandyavandanam P Kishan Uttam Kishan Copyright (c) 2023 2023-12-21 2023-12-21 3 2 7 7 10.52314/tjima.2023.v3i2.124 Charting a Legacy of Excellence and Community Empowerment: The Odyssey of IMA Hyderabad City Branch Minhaj Zafar Nasirabadi Srirang Abkari Khan Mohammed Zeeshan Ali Copyright (c) 2023 2023-12-21 2023-12-21 3 2 1 3 10.52314/tjima.2023.v3i2.121 A Cross-sectional study on Workplace Violence Among Resident Doctors of Government Tertiary Care Hospital in Telangana <p><strong>Background:</strong> Workplace violence (WPV) has increased worldwide and is impacting the lives of healthcare workers. This affects the physical, and psychological well-being of doctors and affects patients’ care adversely.</p> <p><strong>Aims and Objectives:</strong> To estimate the prevalence of WPV among doctors and their associated risk factors.</p> <p>Materials and Methods: The study was conducted using google forms using a pre-validated questionnaire on a sample of 100 doctors working in a government tertiary care hospital.</p> <p><strong>Results: </strong>A prevalence of 92% was found in the sample population. A majority had experienced verbal violence (68%). The maximum violence occurred in the emergency department (55%) and was against postgraduates (77%), mostly during the night times (51%). In most of the incidents, the perpetrators were the patient’s attendants. The main risk factors were the non-availability of medications, less staff, more workload, and dissatisfaction with doctors.</p> <p><strong>Conclusion:</strong> This study highlights the high prevalence of WPV and draws attention to the need of the hour which is to address WPV aggressively and comprehensively.</p> Siva Prasad Sireesha Srinivasa Rao Uma Maheswari Copyright (c) 2023 2023-12-21 2023-12-21 3 2 8 12 10.52314/tjima.2023.v3i2.125 Evaluation of Serum Ferritin as Prognostic Marker in Acute Hemorrhagic Stroke <p class="Abstract" style="margin-bottom: 1.4pt;">Acute neurological dysfunction caused by a stroke or cerebrovascular accident can have either an ischemic or hemorrhagic cause. A blood artery rupture that results in bleeding into the brain causes hemorrhagic stroke. There are two types of hemorrhagic stroke: subarachnoid haemorrhage (SAH), and intracerebral haemorrhage (ICH) which is more prevalent. High mortality and significant morbidity are linked to hemorrhagic stroke.1 Serum ferritin levels were one of 61 independent predictive molecular biomarkers evaluated in the immediate phase following a hemorrhagic stroke that could predict motor functional recovery.2 The goal of this study was to identify the serum ferritin level at admission time as a predictive prognostic biomarker in acute hemorrhagic stroke. This cross-sectional observational study was conducted on 72 patients hospitalized to the medical intensive care unit between October and December in a single institution. 72 patients who were admitted to the medical ICU between October 2020 and March 2022 for their first episode of stroke and who were clinically and radiologically determined to have primary intra cerebral haemorrhage were included in this single-center, hospital-based, cross-sectional observational study. The study participants were divided into three groups according to their mRS scores: those with a good prognosis (mRS = 0-2), those with a poor prognosis (mRS = 3-5), and those with the worst prognostic outcome of death (mRS = 6). Also, patients were divided into three groups according to the GCS Score change: better, deteriorated, and died. In addition to being compared between research groups, ferritin levels were also linked to ICH severity indices. Low GCS and high mRS scores were related with high serum ferritin concentrations, indicating the severity of the stroke.</p> Bammidi Rohit kumar Makarand Mane Priyanka M Mane Copyright (c) 2023 2023-12-21 2023-12-21 3 2 13 22 10.52314/tjima.2023.v3i2.126 “Assessing the Physician’s Psychological Range of Response to Loss following recent Death of a Patient in a Tertiary Care Teaching Hospital” <p><strong>Background: </strong>Grief is a complex emotion and is extensively implicated as a cause of psychiatric morbidity. The way each individual perceives grief and addresses it is variable. With the recent Covid 19 pandemic, physician burnout was a major concern owing to the long work hours and multitudes of deaths witnessed. A population in whom there is a lack of literature about the effects of grief is healthcare workers, so this study was conducted to study the psychological range of responses to witnessed patient deaths.</p> <p>Methods and Methodology: This was a cross sectional questionnaire-based study conducted between October 2021 and January 2022. The 102 participants were administered the “Adult attitude to grief” scales in addition to a brief structured interview by the investigators.&nbsp;</p> <p><strong>Results:</strong> Our study included a total of 102 physicians who met the inclusion criteria. 53 (51.96%) Intern Medical Officers (IMOs) had an average grief score of 19.15 and 34 (33.33%) post graduate students had a score of 17 indicating low level of vulnerability. 15 (14.7%) faculty who answered the questionnaire had an average grief score of 16.4 again indicating low level of vulnerability and best among the three subgroups of participants.</p> <p>57% of the respondents sought help to cope with the loss and 77% of the respondents agreed that having a provision in the hospital policies that encourages them to seek help when they are grieving.</p> <p><strong>Conclusion:</strong> There is a need for systematic psychological evaluation of various subgroups of physicians and formulate new policies to prevent physician burnout and significant psychological distress.</p> Nidhishri Sridhar Kiran Kumar K N Moksha Prasad Ojas Balaji Nachiketh Rao Copyright (c) 2023 2023-12-21 2023-12-21 3 2 23 27 10.52314/tjima.2023.v3i2.127 A Study of Association of Consanguineous Marriages with Congenital Anomalies among the People Around RHTC of a Medical College in Karimnagar <p>Congenital anomalies are a major health problem all over the world; especially since it is an important cause of birth defects, chronic illness and disability and death in infants. The major cause of this is consanguineous marriages. Generations of cousin marriages have a significant association with congenital anomalies.</p> <p>Objective: To find out the association of consanguineous marriages with congenital anomalies present at the time of birth Methods: A cross-sectional study was conducted in 2022: The adult individuals aged between 19 to 55 years, with and without cousin marriage of both genders were consecutively enrolled. Participants were assessed through a pre-tested questionnaire, with prior written informed consent. Unwilling married individuals and individuals from other hospitals were not selected</p> <p>Results: According to results there was a significant association between the generation of cousin marriages with congenital anomalies present at the time of birth, as the p value was 0.002</p> <p>Conclusions: The study concluded that the generation of cousin marriages has a significant association with congenital anomalies present at the time of birth and due to cousin marriage 59% of the couples had congenital abnormalities in their children and 85% had genetic disorders.&nbsp;</p> Atul G Agarwal Copyright (c) 2023 2023-12-21 2023-12-21 3 2 28 31 10.52314/tjima.2023.v3i2.128 Mary Ainsworth <p class="Abstract" style="margin-bottom: 1.4pt;"><span lang="EN-GB">Mary Ainsworth (1913–1999), a pioneering developmental psychologist, co-developed attachment theory. Renowned for the “Strange Situation” procedure, she identified secure, insecure-avoidant, and insecure-ambivalent attachment patterns in children. Ainsworth’s impactful research revolutionized our understanding of early relationships, influencing theories of parenting and child development.</span></p> Sudhaker Bale K Kalyan Copyright (c) 2023 2023-12-21 2023-12-21 3 2 65 69 10.52314/tjima.2023.v3i2.138 Erik Homburger Erikson Matam Apoorva Copyright (c) 2023 2023-12-21 2023-12-21 3 2 70 72 10.52314/tjima.2023.v3i2.139 Rett Syndrome in Boys: A Rarity <p class="Abstract" style="margin-bottom: 1.4pt;">Rett syndrome (RTT) is a disorder of neurodevelopment in which there is a regression of previously acquired skills after a period of normal development. Originally, RTT was thought to be present exclusively in females. However, advances in phenotypic identification and genetic testing revealed cases of males. A case series of RTT which comprises two cases in boys and one case in a girl is reported here. There is a need to recognize this uncommon disorder and differentiate it from other neurodegenerative disorders.</p> Madhu Vamsi G D Geethanjali K Siva Prasad Copyright (c) 2023 2023-12-21 2023-12-21 3 2 37 41 10.52314/tjima.2023.v3i2.130 Cerebellopsychosis <p class="Abstract" style="margin-bottom: 1.4pt;">This case report explores the intricate relationship between the cerebellum and psychosis, aiming to elucidate the role of this brain region in the manifestation of psychotic disorders. While traditionally associated with motor control and coordination, emerging research suggests the cerebellum's involvement in cognitive and emotional processes. We delve into neuroanatomical and functional findings, highlighting the cerebellum's connectivity with cerebral regions implicated in psychosis. Understanding the cerebellum's contribution to psychosis may offer novel insights into the etiology and treatment of psychotic disorders, paving the way for targeted therapeutic interventions.</p> Varsha Galipelli J Sharanya Rishi Raj Mohammed Copyright (c) 2023 2023-12-21 2023-12-21 3 2 42 44 10.52314/tjima.2023.v3i2.131 Xanthogranulomatous Oophoritis - A Rare Case Report <p>Xanthogranulomatous inflammation is a rare form of chronic inflammation that is destructive of normal tissue in affected organs. It is characterised by the presence of foamy histiocytes associated with other inflammatory cells like lymphocytes, plasma cells and neutrophils. Only 15 cases have been reported in literature involving the ovary. Here, we report a case of xanthogranulomatous oophoritis in a patient with endometriosis, suffering from chronic pelvic pain and infertility. The association between endometriosis and xanthogranulomatous inflammation is extremely rare and can possibly represent a severe histologic expression of this common disorder.</p> Vijayalakshmi Mantri Shruthi Rachuri Naveen Kumar Shanker Mantri Sumalatha Kasturi Copyright (c) 2023 2023-12-21 2023-12-21 3 2 45 47 10.52314/tjima.2023.v3i2.132 Traumatic Pneumatocele in a 12 year Old Boy - A Rare Case Report <p class="Abstract" style="margin-bottom: 1.4pt;">Traumatic pneumatocele is a rare complication of blunt chest trauma with uncertain pathogenesis. It occurs primarily in pediatric age group and is characterized by single or multiple pulmonary cystic lesions concomitant with other type of injuries of the lung parenchyma. We present a case of traumatic pneumatocele in a 12-year-old boy, together with a brief review of the literature. This rare entity should be considered in the differential diagnosis of cystic lesions complicating blunt chest trauma, especially in young adults. The disease generally has a benign and self-limiting course. Significantly large traumatic pneumatoceles with failure of initial conservative management warrant surgical exploration and management to optimise recovery and prevent complications.</p> Sana Arshy Sudigali Sunanda Yenganti Prashanth Kairi Anil Copyright (c) 2023 2023-12-21 2023-12-21 3 2 48 50 10.52314/tjima.2023.v3i2.133 Sclerosing Pneumocytoma - A Rare Benign Lung Tumor Case Report <p class="Abstract" style="margin-bottom: 1.4pt;"><span lang="EN-GB">Sclerosing pneumocytoma is an uncommon benign tumour which may turn malignant. It is usually asymptomatic, discovered incidentally on radiography. We present a case of sclerosing pneumocytoma in a 50-year-old female who presented with non-specific symptoms., she was investigated with radial EBUS-guided cryobiopsy, histopathological examination, immunohistochemistry studies and treated with lobectomy.</span></p> Rayannagari Rishitha Sudigali Sunanda Yenganti Prashanth Copyright (c) 2023 2023-12-21 2023-12-21 3 2 51 54 10.52314/tjima.2023.v3i2.134 A Case Report - Astasia Abasia treated with Faradic Stimulation <p class="Abstract" style="margin-bottom: 1.4pt;"><span lang="EN-GB">Conversion disorder presents with a wide variety of symptoms, one of the rarest presentations being Astasia-Abasia; where the individual loses their ability to stand or walk normally without any apparent anatomic or physiologic abnormality. psychosocial stressors have been observed to closely precede the onset of symptoms. Management of conversion disorders centres around psychoeducation and psychotherapy but the response is slow and varied. This case report describes one such case of a 13-year-old female with Astasia-Abasia who was successfully treated with Faradic stimulation.</span></p> Samia Mirza Khan Mohammed Zeeshan Ali Saad Mohiuddin Minhaj Zafar Nasirabadi Copyright (c) 2023 2023-12-21 2023-12-21 3 2 55 57 10.52314/tjima.2023.v3i2.135 Pregnancy with Gilbert Syndrome - A Case Report <p>A rare case of Gilbert syndrome during pregnancy was reported at LOTUS HOSPITALS, LAKDIKAPOOL Obstetrics department. <br />A 38-week primigravida who had been having yellowish discolouration of both the skin and sclera since childhood was referred to LOTUS HOSPITALS, Lakdikapool from Singareni Hospital in view of Gilbert’s syndrome for further management and safe confinement. <br />She had icterus, no signs of dehydration, a uterus that corresponds to the period of gestation and a good foetal heart rate. Examination revealed that all of the obtained investigation were normal, except for mild unconjugated hyperbilirubinemia. <br />She had a Normal vaginal delivery with RMLE after being admitted and induction of labour done at term, and she delivered a 2.55 kg male baby. The baby was icteric at birth kept on phototherapy, evaluated and followed up. <br />To conclude when any patient presents with unconjugated hyperbilirubinemia associated with stress, infection or dehydration Gilbert syndrome must be excluded. Once this diagnosis is made patient must be reassured of its benign nature, excellent prognosis and normal life expectancy. </p> T Karunasree Sujatha Charles Copyright (c) 2023 2023-12-21 2023-12-21 3 2 58 61 10.52314/tjima.2023.v3i2.136 Recurrent Polyhydramnios: A Rare cause of Neonatal Bartter’s Syndrome Type IVA(BSND Gene Mutation) <p>Polyhydramnios occurs in 1-2% of pregnancies. It’s an enigma for treating obstetricians when it occurs in subsequent pregnancies. Causes of hydramnios can be due to maternal diabetes, multiple gestation, placental tumours incompatibility, foetal anomalies, aneuploidies, non-immune hydrops, Idiopathic, unexplained causes which are rare such as West syndrome or Polyuric syndromes like Bartter’s syndrome or genetic syndromes. In this report we discuss a case of 29yrs old fifth gravida, married for 5yrs, 2nd degree consanguineous. Her first pregnancy was a medical termination at 2MA, second was a term spontaneous vaginal delivery, healthy female child born with no complications, third pregnancy was terminated at 29w for acute massive hydramnios in spite of repeated amniocentesis for hydramnios, female child born, succumbed on day 12 of life in view of acute renal failure, cause has not be evaluated for any genetic syndrome. Fourth pregnancy was also a medical termination at 6w for unwanted pregnancy. Present was a fifth pregnancy which was a spontaneous conception, presented to us at 28w with hydramnios ,genetic evaluation done in view of previous adverse neonatal outcome, recurrent hydramnios, she had emergency LSCS, delivered a female baby, Who died at 42 days of life due to renal failure and sepsis. On genetic evaluation done by amniocentesis, only whole exome sequencing showed rare disorder of Bartter’s syndrome, one of the causes of hydramnios, Where karyotype is 46xx and chromosomal microarray was normal.</p> Ruheena Nakhuda Sujatha Charles Gauri Vinayak Copyright (c) 2023 Telangana Journal of IMA 2023-12-21 2023-12-21 3 2 62 64 10.52314/tjima.2023.v3i2.137 World Patient Safety Day <p class="Abstract" style="margin-bottom: 1.4pt;"><span lang="EN-GB">This paper critically examines the current landscape of global patient safety, highlighting key challenges and achievements. We analyze existing frameworks, technologies, and policies aimed at reducing medical errors and improving healthcare outcomes. Emphasizing the significance of World Patient Safety Day, we propose collaborative strategies involving healthcare providers, policymakers, and technology innovators. The abstract concludes with a call to action for sustained efforts, research advancements, and international cooperation to foster a safer and more resilient healthcare environment worldwide.</span></p> Vijay Rao Jakkula Copyright (c) 2023 2023-12-21 2023-12-21 3 2 32 36 10.52314/tjima.2023.v3i2.129