Kerala Medical Journal

Cancer Vaccines - A Promising Frontier in Oncology

Cyriac Thomas — Mon, 30 Dec 2024 00:00:00 -0800

Cancer remains one of the leading causes of death worldwide, prompting extensive research into innovative therapeutic strategies. Among these, cancer vaccines have emerged as a promising approach to prevent and treat various types of cancer. This review article explores the development, mechanisms, types, and current status of cancer vaccines, along with their challenges and further prospects.

Awareness of Classical and Advanced Hematology Concepts among Medical Postgraduates in Kerala: A Cross-Sectional Study

Bobby Abraham, Anupa Jacob, Bonnie Anna George, Chepsy Philip — Mon, 30 Dec 2024 00:00:00 -0800

Background: Clinical hematology is advancing rapidly, addressing both benign and malignant blood disorders. However, in Kerala, specialized hematology services remain limited. We undertook a survey to evaluate the awareness of classical and emerging hematology concepts among medical postgraduates in Kerala.
Methods: A cross-sectional, web-based survey was conducted using a 30-item multiple-choice questionnaire. It assessed knowledge of classical hematology topics and advanced therapies (e.g., bone marrow transplantation, CAR-T therapy, Next-Generation Sequencing [NGS]). Respondents’ knowledge was categorized as Excellent (≥85%), Good (70–84%), Satisfactory (50–69%), or Needs Improvement (<50%). Awareness levels were further stratified into high (>90%), moderate (75–90%), partial (50–75%), and low (<50%).
Results: Among respondents, 30% demonstrated excellent knowledge, 36.7% good, 30% satisfactory, and 3.3% needed improvement. High awareness (>90%) was observed in the clinical features of aplastic anemia (93.2%), multiple myeloma (97.7%), and the role of NGS (100%). Moderate awareness (75–90%) included immunosuppressive therapy for aplastic anemia (81.8%) and CAR-T therapy (81.8%). Partial awareness (50–75%) was noted for viral associations with aplastic anemia (52.3%) and autologous transplantation for multiple myeloma (68.2%). Low awareness (<50%) was seen in peripheral smear findings for aplastic anemia (43.2%) and diagnostic tools for multiple myeloma (SPEP 34.1%, bone marrow biopsy 36.4%).
Conclusion: While awareness of traditional concepts is strong, areas such as CAR-T therapy side effects, diagnostic tools, and transplant options could benefit from educational interventions. Establishing dedicated hematology departments and incorporating these topics into postgraduate curricula could bridge these gaps.

Community Training on Emergency Medicine and Trauma Care in Improvement of Public Health

Zulfiker Ali — Mon, 30 Dec 2024 00:00:00 -0800

Emergency medicine and trauma care are critical components of public health, especially in underserved and disaster-prone regions. Community-based training programs have proven effective in equipping individuals with the skills and knowledge needed to respond promptly to medical emergencies, thereby reducing morbidity and mortality. This paper explores the role of community training programs in emergency medicine and trauma care, focusing on their implementation, benefits, challenges, and impact on public health.

Otitis Media in an Infant - A Case Report of Langerhans Cell Histiocytosis

Sreya Mathew, Kavitha Ravi — Mon, 30 Dec 2024 00:00:00 -0800

Langerhans cell histiocytosis is a clonal proliferation of myeloid dendritic cells expressing a Langerhans cell phenotype. It can be unifocal or multifocal within a single system (usually bone) or it can be multisystem. Annual incidence in children is about 5 cases per 1 million. The disease is more common among individuals of European origin and Hispanics.² Here we describe a case of a 9-month-old male baby who presented with right sided ear discharge for 2 weeks and a mass protruding through the right ear. Radiological evaluation revealed a lytic lesion in the temporal bone which was histologically confirmed as a case of Langerhans Cell Histiocytosis.

Skin is a Mirror of Internal Disease: A Case of Acrodermatitis Enteropathica with Delayed Presentation

M Radhamony, TS Nasiha — Mon, 30 Dec 2024 00:00:00 -0800

A 5 year old, female child, born normally at full term to second degree consanguineous parents, presented with complaints of skin lesions and loss of hair since the age of 18 months. They visited many hospitals, treated with multiple topical steroids & antifungals. Lesions showed no response to any medications and new lesions continued to appears. Cutaneous examination revealed Bilaterally symmetrical erythematous scaly crusted plaques presented over perianal & perineal areas, dorsal aspects knees and ankle. Toe nails showed dystrophy. Scalp hair was dry and brittle with areas of alopecia. Weight and height of child was only 12.5 kg,98.5 cm respectively. Clinical diagnosis made as Acrodermatitis Enteropathica.

An Unusual Presentation of Dysphagia in a Young Male with Myositis

Mon, 30 Dec 2024 00:00:00 -0800

Dysphagia is a rare presentation in patients with viral myositis and only 10%-20% of patients with myositis developed weakness of oropharyngeal, laryngeal, and oesophageal musculature that leads to impairment in the oropharyngeal phase of swallowing. The proper mechanism of dysphagia in patients with myositis remains unclear and it is thought to be due to impaired muscle contractions and decreased hyo-laryngeal excursion that leads to impaired relaxation of the upper oesophageal sphincter. Delayed treatment, bulbar involvement, respiratory involvement, old age, and occurrence of malignancy are associated with poor prognosis. Here we are describing a case of a 25-year-old gentleman who presented with fever, myalgia, and dark-colored urine, who was diagnosed as viral myositis with dysphagia, and a holistic approach in the management of the disease.

Acute Myocardial Infarction in a Young Female: Ball Valve Thrombus and Coronary Embolism in Rheumatic Heart Disease

Sajan Z Ahmad — Mon, 30 Dec 2024 00:00:00 -0800

Acute coronary syndrome in a young patient should prompt a search for non-atherosclerotic causes too. This case demonstrates the classical finding of ball valve thrombus in a young female with rheumatic mitral valve stenosis and atrial fibrillation who presented with an acute inferior wall myocardial infarction due to coronary embolism.

Haemorrhagic Thymic Cyst Masquerading a Thick Walled Neoplasm: A Case Report and Review of Literature

Ruma Madhu Sreedharan, PB Dhanush, JS Ajitha, LR Jayasree — Mon, 30 Dec 2024 00:00:00 -0800

Thymic cysts are rare anterior mediastinal cysts that are incidentally detected during routine imaging in patients or during the workup for chest pain with dyspnea. Here, we describe a rare case of a hemorrhagic thymic cyst in a 30-year-old man who presented with recurrent chest pain. Upon further evaluation using echocardiography, CT, and MRI, a well-defined, thick-walled, multiloculated cystic lesion in the anterior mediastinum was identified. The patient underwent surgery and was diagnosed with a hemorrhagic thymic cyst. Postoperatively, he was stable and discharged on the fifth day without complications. This report highlights the role of multimodality imaging in the diagnosis of thymic cysts.

From Tree to Tablet…The Story of Aspirin

J Sajikumar — Mon, 30 Dec 2024 00:00:00 -0800

Aspirin, the trade name for acetylsalicylic acid, was introduced to the market by Friedrich Bayer & Company in 1899. In addition to its well-known use as an analgesic, antipyretic, and anti-inflammatory agent, research has shown that aspirin can serve as a life-saving preventive treatment for a variety of conditions. These include heart attacks, strokes, colon cancer, pregnancy complications, diabetes, and even dementia. The Columbia round stamp issued in 1999 celebrates 100 years of Aspirin.