Apollo Medicine

22/04/2025

https://doi.org/10.1177/09760016251330369
The purpose of this study was to compare the clinical efficacy and safety of 3 mL (15 mg) of 0.5% hyperbaric bupivacaine and 3 mL (22.5 mg) of 0.75% hyperbaric ropivacaine for infraumbilical surgeries under spinal anaesthesia in terms of sensory and motor blockade onset and duration, as well as haemodynamic stability.
Methods:
This is a prospective randomised comparison study of 60 patients undergoing elective infraumbilical operations under SA at Apollo Main Hospital in Chennai. Based on inclusion and exclusion criteria, they were randomised into Group R, who received 3 mL of 0.75% hyperbaric ropivacaine (21 mg), and Group B, who received 3 mL of hyperbaric bupivacaine (15 mg).
Results:
Our study result shows that patients receiving 0.75% hyperbaric ropivacaine had sensory and motor block for a shorter amount of time than those receiving 0.5% hyperbaric bupivacaine. Patients who received 0.75% ropivacaine as opposed to 0.5% bupivacaine also experienced a delayed onset of motor as well as sensory block. The group receiving ropivacaine had a lower incidence of complications such as hypotension and fewer haemodynamic alterations than bupivacaine.
Conclusion:
This study concludes that ropivacaine is a suitable drug for spinal anaesthesia for procedures of intermediate duration since it has a quicker recovery profile than the widely used hyperbaric 0.5% bupivacaine. It is also equivalent in terms of block quality.
Sage India

Background and Aims: The purpose of this study was to compare the clinical efficacy and safety of 3 mL (15 mg) of 0.5% hyperbaric bupivacaine and 3 mL (22.5 mg)...

04/04/2025

https://journals.sagepub.com/.../10.1177/09760016251321281
Acute colonic pseudo-obstruction is a massive colonic dilation with signs and symptoms of colonic obstruction, but without a mechanical cause.
Methodology:
A 73-year-old hypertensive male on clonidine therapy developed spontaneous left basal ganglia haemorrhage with interventricular haemorrhage. While undergoing neurological treatment patient developed abdominal distension and constipation during hospital stay. All investigations done lead to the diagnosis of Acute colonic pseudo-obstruction (ACPO) (Ogilvie Syndrome).
Results:
Clonidine was suspected cause of Acute colonic pseudo-obstruction (ACPO). Hence clonidine was stopped and patient gradually improved.

18/03/2025

03/02/2025

Top 10 Cited Articles from Scopus in 10 years for Apollo Medicine:
1. Biosensors applications in fighting COVID-19 pandemic.
2. Multi-agent system applications to fight COVID-19 pandemic.
3. Customer relationship management (CRM) towards service orientation in hospitals: A review.
4. Automated COVID-19 emergency response using modern technologies.
5. Biologics, biosimilars, intended copies and the era of competitive medicine.
6. Association of vitamin D and knee osteoarthritis—a review.
7. The impact of loneliness on physical and mental health among older adults in the era of coronavirus disease 2019 pandemic.
8. Circulating irisin is increased in type 2 diabetes mellitus and correlates with fasting glucose levels.
9. A review on pharmacological use of recombinant human erythropoietin in renal and nonrenal anemia and other potential applications in clinical practice.
10. The havoc caused by the 2nd wave of COVID-19 in India.

14/01/2025

https://journals.sagepub.com/doi/10.1177/09760016241307373

Maternal, placental and foetal factors together or in isolation influence the well-being of the foetus. The two most important causes of intrauterine growth retardation (IUGR) and intrauterine death (IUD) are placental factors and hypoxemia.

Material & Methods:

The present study was a prospective study conducted in the Department of Pathology. Placentas of IUD and IUGR cases were collected and routinely processed.

Results:

There were a total of 52 placentas, 40 from IUD cases and 12 from IUGR cases. Gross infarction was identified in 13.46% cases and microscopic infarction in 23.1% cases which were the most common findings.

Conclusion:

Chorioamnionitis was the most common histological finding in both IUGR and IUD cases. Careful examination of the placenta is necessary in IUD and IUGR cases.

Introduction: Maternal, placental and foetal factors together or in isolation influence the well-being of the foetus. The two most important causes of intrauter...

04/01/2025

https://journals.sagepub.com/doi/full/10.1177/09760016241301471
Over the past 20 years, Enhanced Recovery After Surgery (ERAS) has gained popularity in colorectal cancer surgery. In addition, single-port laparoscopic surgery has been shown to have advantages. In colon cancer surgery, single-port laparoscopic surgery and ERAS can improve short-term results. However, whereas the former depends on surgical ability, the latter requires multidisciplinary teamwork.
Aim:
The goal of this project is to investigate the application and outcomes of ERAS protocols throughout the whole continuum of care for colorectal cancer surgery. Examine the details of how ERAS protocols enhance surgical results, with an emphasis on comprehending the subtleties of its use in the treatment of colorectal cancer and the possible obstacles to its broad adoption.
Materials and Methods:
A literature review was conducted, spanning Medline, Embase, and Cochrane Library databases for research conducted between January 2007 and June 2022 and involved specific keywords. The analysis included studies that had to meet two essential criteria: least investigation period of 30 days and compliance with a minimum of four out of the five core components of ERAS.
Results:
Following a comprehensive assessment, five studies satisfied the inclusion criteria. Among these studies, there were two ‘Randomized Controlled Trials’ (RCTs) and three Observational studies. These studies collectively encompassed 1454 patients: 820 patients treated following ERAS protocols, and 634 patients treated with non-ERAS protocols.
Conclusion:
The evidence supporting ERAS’s potential to enhance patient outcomes and its implementation challenges is compiled in this article. That allows to guide future research, enhance treatment following colorectal cancer surgery, and influence clinical practice

09/12/2024

Diabetic ketoacidosis (DKA) poses a risk for acute kidney injury (AKI) in children, with incidence varying across different regions and populations. The aim of the study is to assess the proportion and predictors of AKI in children with DKA and to assess the impact of AKI on the duration of hospital stay and recovery from metabolic acidosis.
Methods:
Medical records of children under 14 years admitted with DKA between 2021 and 2023 were analysed retrospectively. Data on clinical characteristics and outcomes were collected and analysed using descriptive and inferential statistics.
Results:
Out of 31 patients, 7 (22.6%) developed AKI. Statistically significant differences were found between the AKI and non-AKI groups in terms of age, body mass index, corrected sodium and blood urea levels. Children with AKI had a longer median duration of hospital stay (10 vs. 6 days, P = .002) and a longer time to recover from metabolic acidosis (96 vs. 39 hours, P = .001) compared with those without AKI.
Conclusion:
A significant proportion of children with DKA are affected with AKI, leading to prolonged hospitalisation and delayed recovery from metabolic acidosis. Identifying predictors of AKI can help in the early recognition and management of this complication, improving patient outcomes.

27/11/2024

Clinical trials are gold standard for research and evaluating the efficacy and safety of healthcare interventions. Teaching about clinical trials is part of the pharmacology curriculum for undergraduate medical students. The aim of this study is to evaluate the knowledge, attitude and perception (KAP) of undergraduate medical students towards clinical trial.
Methodology:
An observational cross-sectional study was conducted at a medical college of Ahmedabad, using standardised self-administered questionnaires having total 25 questions regarding KAP, prepared by the authors. The pre- and post-KAP questionnaires (after educational intervention) were offered to the participants after taking an informed consent. Analysis was done using SPSS software, version 26. P value

Background and Aims: Clinical trials are gold standard for research and evaluating the efficacy and safety of healthcare interventions. Teaching about clinical ...

13/11/2024

Advances in digital technology have led to widespread availability of digital devices and consequent increased usage amongst across the population including practising healthcare professionals. Increased ‘Digital Screen time’ and its effect on physical, psychological health, and sleep patterns has been predominantly evaluated in children, adolescents and adults from various walks of life.
Purpose of the Study:
The purpose of this survey was to evaluate the impact of Digital Screen usage (time and patterns) spent on portable and desktop digital devices amongst physicians, surgeons and radiologists.
Material & Methods:
An online cross-sectional survey of an 11-part questionnaire (multiple choice questions and free text box) was circulated amongst orthopaedic surgeons, radiologists and physicians in India and the UK, to evaluate demographics, speciality and place of practice; Digital platform usage reasons and time; effect on mental health, physical health, sleep time amongst practising healthcare professionals.
Results:
There was an even spread amongst the various age groups. Smartphones were the commonest device utilised for digital screening in 90 (67.7%) doctors with 29 (38.5%) of doctors reporting more than five hours of daily screen time. Sixty-three (47%) of doctors used this for academic purposes, whereas 43 (32%) used it for entertainment more than for academic purposes. Thirty-nine doctors (29%) were unaware of whether screen usage affected mental health. Seventy-two (53%) were of the opinion that screen usage was having a negative effect on their physical health whilst 81 (60%) thought that it was having an adverse effect on their sleeping time respectively.
Conclusion:
A significant proportion of doctors appear to be using digital devices beyond the recommended ‘Digital Screen time’ by various national or international healthcare organisations. There is an emerging need to highlight the deleterious effect of excessive ‘Digital Screen time’ on various health parameters and be part of a global health narrative to mitigate ill-effects and a sustainable lifestyle.

19/09/2024

We are thrilled to share that at least 11 of our Editorial Board Members of Apollo Medicine have been recognized as the top 2% global scientists for 2023 in the prestigious database created by John P.A. Ioannidis (Stanford University, USA) and Elsevier Data Repository (https://elsevier.digitalcommonsdata.com/datasets/btchxktzyw/7). It's an honour to be included among such a distinguished group of researchers. Congratulations to all of them.
Dr Arvind Bagga
Dr Anil D Cruz
Dr Raju Vaishya
Dr Ravi Prakash Mahajan
Prof. Abid Haleem
Dr Kartikeyan P Iyengar
Dr Deepali Jain
Dr Vijay K Jain
Dr Vikas Khanduja
Dr Manish Chand
Dr Prokar Dasgupta

09/09/2024

In patients with chronic liver disease and ascites, spontaneous bacterial peritonitis (SBP) is a common complication. This can progress gradually and subtly or go undiagnosed until signs start to show. Early diagnosis is essential for effective treatment and the prevention of subsequent episodes because the mortality rate following a single episode varies from 20% to 40%. The goal was to study the incidence, clinical profile, and microbiological characteristics of SBP and its variants in people with liver cirrhosis and ascites.
Materials and Methods:
This observational study was done on 104 cirrhotic patients with ascites admitted at a tertiary care hospital. Basic demographics, symptoms, and clinical signs of patients were recorded. Diagnostic paracentesis was done aseptically and immediately sent for ascitic fluid cytology, biochemistry, and culture. Bacterial examination and antibiotic sensitivity tests were carried out by standard microbiological techniques.
Results:
Out of a total of 104 cirrhotic patients, 28 (26.9%) were diagnosed with SBP. Alcohol was the most common etiological factor, followed by hepatitis C infection. Among the SBP patients, the most common presentation was culture-negative neutrocytic ascites (71.4%), followed by classical SBP (17.8%), then mono bacterial non neutrocytic bacterascites MNB (10.7%). Among the symptoms, the most common was abdominal distension, followed by icterus, pedal edema, and abdominal pain. Majority of the patients belonged to Child–Pugh’s Grade C. Of 28 cases of SBP, 8 were culture positive. Gram-negative isolates were predominant (75%) and Escherichia coli were the most common isolate.
Interpretation and Conclusion:
The prevalence of SBP in cirrhotic patients was 26.9%, and Gram-negative isolates were predominant. Ascitic fluid culture and susceptibility testing can lead to accurate diagnosis of SBP and can guide for treatment as resistance to antibiotics is common.

Background and Objectives: In patients with chronic liver disease and ascites, spontaneous bacterial peritonitis (SBP) is a common complication. This can progre...

06/09/2024

Medical Education Technology has witnessed significant transformation over the years, largely influenced by advancements in technology. From traditional lecture-based teaching to the integration of multimedia tools and virtual simulations, the landscape of medical education has evolved to meet the needs of learners in an ever-changing healthcare environment.

Background and Aims: Medical Education Technology has witnessed significant transformation over the years, largely influenced by advancements in technology. Fro...