Volume-4
Issue-2
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Study of Pancreatic Enzymes in Chronic Kidney Disease Patients
Background – Elevation in serum levels of amylase and lipase in the absence of pancreatitis, in CKD patients. Aim – Evaluation of pancreatic enzymes level in CKD patients. Materials and methods – 135 patients were included and they were classified in stage I - V of CKD according to KDIGO(Kidney Disease Improving Global Outcome) guidelines and their serum amylase and lipase levels were evaluated. Results – We included 135 patients, in the age group of 30-60 yrs. Among 135 patients, 110 patients were divided in stages from I to V of CKD (Chronic Kidney Disease) as per KDIGO (Kidney Disease Improving Global Outcome), and 25 patients were divided in Pre HD and Post HD group. The serum amylase and lipase were significantly higher in CKD patients as the stage progresses form I to V (p= 0.000). In Pre HD and Post HD group of patients mean value of serum amylase and serum lipase were significantly higher in Post HD group in comparison to Pre HD (p=0.000) Conclusion – Our study done among 135 patients indicate that there was certain amount of retention of pancreatic enzyme in CKD patients due to decreased excretion by kidneys. And patients on HD had elevated level of these enzymes in Post HD state which was probably due to increase in lipoprotein lipase from endothelial cells of capillaries and we were measuring Total lipase in serum. Secondly due to hemoconcentration which occurs during HD by removal of fluid from body. Hence levels of total amylase and lipase increases in serum after hemodialysis.
Study of Pancreatic Enzymes in Chronic Kidney Disease Patients
Dr. Mohammed Mohsin Khan, Dr. Shuchi Goyal, Dr. Mukesh Barjatiya
DOI : 10.5281/zenodo.7690330
Background – Elevation in serum levels of amylase and lipase in the absence of pancreatitis, in CKD patients. Aim – Evaluation of pancreatic enzymes level in CKD patients. Materials and methods – 135 patients were included and they were classified in stage I - V of CKD according to KDIGO(Kidney Disease Improving Global Outcome) guidelines and their serum amylase and lipase levels were evaluated. Results – We included 135 patients, in the age group of 30-60 yrs. Among 135 patients, 110 patients were divided in stages from I to V of CKD (Chronic Kidney Disease) as per KDIGO (Kidney Disease Improving Global Outcome), and 25 patients were divided in Pre HD and Post HD group. The serum amylase and lipase were significantly higher in CKD patients as the stage progresses form I to V (p= 0.000). In Pre HD and Post HD group of patients mean value of serum amylase and serum lipase were significantly higher in Post HD group in comparison to Pre HD (p=0.000) Conclusion – Our study done among 135 patients indicate that there was certain amount of retention of pancreatic enzyme in CKD patients due to decreased excretion by kidneys. And patients on HD had elevated level of these enzymes in Post HD state which was probably due to increase in lipoprotein lipase from endothelial cells of capillaries and we were measuring Total lipase in serum. Secondly due to hemoconcentration which occurs during HD by removal of fluid from body. Hence levels of total amylase and lipase increases in serum after hemodialysis.
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Pure Mucinous Breast Carcinoma In Young Female: A Rare Entity With Good Prognosis Among Infiltrating Breast Carcinoma S
Mucinous Breast carcinoma is rare malignant breast neoplasm and it constitute only 1-2 % of all invasive breast cancers. Tumor called as Pure mucinous breast cancer when mucinous component is 90% of the tumor. We present a case report of 36-year-old female patient with approximately 3x2 cm size mass on left breast. Lumpectomy specimen of breast with wide local excision received. This tumor was classified as grade 1 (well differentiated) according to modified scarf bloom Richardson grading system. Mucinous breast carcinoma commonly observed in old aged female. This type tumor of tumor usually shows immune histochemistry positivity for ER, PR and HER2 negative which indicate towards good prognosis. Pure mucinous breast carcinoma is very rare entity among all infiltrating breast carcinoma. It is very rarely observed in young age female patient & prognosis is excellent if diagnosed correctly. Therefore, we present this rare case report in this journal.
Pure Mucinous Breast Carcinoma In Young Female: A Rare Entity With Good Prognosis Among Infiltrating Breast Carcinoma S
Dr Parth R. Goswami & Dr Alpeshpuri Goswami
DOI : 10.5281/zenodo.7690376
Mucinous Breast carcinoma is rare malignant breast neoplasm and it constitute only 1-2 % of all invasive breast cancers. Tumor called as Pure mucinous breast cancer when mucinous component is 90% of the tumor. We present a case report of 36-year-old female patient with approximately 3x2 cm size mass on left breast. Lumpectomy specimen of breast with wide local excision received. This tumor was classified as grade 1 (well differentiated) according to modified scarf bloom Richardson grading system. Mucinous breast carcinoma commonly observed in old aged female. This type tumor of tumor usually shows immune histochemistry positivity for ER, PR and HER2 negative which indicate towards good prognosis. Pure mucinous breast carcinoma is very rare entity among all infiltrating breast carcinoma. It is very rarely observed in young age female patient & prognosis is excellent if diagnosed correctly. Therefore, we present this rare case report in this journal.
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Psychological and Behavioural Impact Of Flicks And Series On Adolescentsinan Urban Area Of India
Introduction: In India, there are about 253 million adolescents in the age group 10-19 years. Adolescence is the transient phase of life from childhood to adulthood. Being a unique stage of rapid physical, cognitive and psychosocial growth it is the right stage to implement good lifestyle for good health. But the prevalence of high blood pressure, obesity, high blood glucose and risk of future cardiovascular disease has increased among adolescents. Flicks/series set trends which they follow, some being negative may have an impact on their health. In this study we studied the influence of flicks and series on adolescents. Methodology: A Cross-sectional study was carried out among 150 students of 10thto 12thclass selected by simple random sampling by using pre designed semi structured questionnaire in 2 randomly selected public schools of Indore city. Data was entered into Microsoft excel spread sheet and analysed by SPSS software version 21. Results: All the study participants had the habit of watching flicks and series. 51.6% [n=77] of them prefer to watch romantic & action flicks/series. Nearly half of them [48.7%] follow language & dialogue shown in flicks/series while 31.3% follow dressing trend. The impact of flicks/series on driving speed and social behaviour was huge as 91 students [60.7%] drive at an higher speed after watching racing scenes in flicks/series, 95 students [63.3%] had tried alcohol or wanted to after watching alcohol related scenes in flicks/series 64.7% [n=91] think that alcohol is the coolest way of doing party. Conclusion: In our study we found the direct impact of alcohol/smoking on adolescents after watching flicks/series. They consider flicks/series as reflection of the happenings in the society. Though there are positives, the impact of negatives are higher in magnitude. Thus relishing such entertainment should be limited to possible minimum.
Psychological and Behavioural Impact Of Flicks And Series On Adolescentsinan Urban Area Of India
Dr.Chhaya Bohare; Dr.Salil Sakalle; Dr.Veena Yesikar; Dr.Abhay Singh; Dr.Preeti Shah Bhandari; Mr.Shivam Dixit; Dr.Vijayalakshmi Sridharan; Dr.VinothGnana Chellaiyan
DOI : 10.5281/zenodo.7700843
Introduction: In India, there are about 253 million adolescents in the age group 10-19 years. Adolescence is the transient phase of life from childhood to adulthood. Being a unique stage of rapid physical, cognitive and psychosocial growth it is the right stage to implement good lifestyle for good health. But the prevalence of high blood pressure, obesity, high blood glucose and risk of future cardiovascular disease has increased among adolescents. Flicks/series set trends which they follow, some being negative may have an impact on their health. In this study we studied the influence of flicks and series on adolescents. Methodology: A Cross-sectional study was carried out among 150 students of 10thto 12thclass selected by simple random sampling by using pre designed semi structured questionnaire in 2 randomly selected public schools of Indore city. Data was entered into Microsoft excel spread sheet and analysed by SPSS software version 21. Results: All the study participants had the habit of watching flicks and series. 51.6% [n=77] of them prefer to watch romantic & action flicks/series. Nearly half of them [48.7%] follow language & dialogue shown in flicks/series while 31.3% follow dressing trend. The impact of flicks/series on driving speed and social behaviour was huge as 91 students [60.7%] drive at an higher speed after watching racing scenes in flicks/series, 95 students [63.3%] had tried alcohol or wanted to after watching alcohol related scenes in flicks/series 64.7% [n=91] think that alcohol is the coolest way of doing party. Conclusion: In our study we found the direct impact of alcohol/smoking on adolescents after watching flicks/series. They consider flicks/series as reflection of the happenings in the society. Though there are positives, the impact of negatives are higher in magnitude. Thus relishing such entertainment should be limited to possible minimum.
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Risk Factor And Outcome Of Inguinal Hernia Repair Under Local Anesthesia Among Elderly Patients
Background: Hernia is the “protrusion of the viscous or part of the viscous through an abnormal opening in the walls of its containing cavity”. Inguinal hernias are the commonest of all hernias and adult inguinal herniorrhaphy accounts for 15% of operation in general surgery. Inguinal hernia is a common pathology seen during surgical practice. Objective: To find out risk factore and outcome of inguinal hernia repair under local anesthesia among elderly patients. Methods: In this prospective study was conducted in the Anesthesia Department, Sher-E-Bangla Medical College Hospital, Barishal, Bangladesh from January to December 2021. We enrolled 70 consecutive high risk elderly (age > 65 years) male patients who were admitted for repair of inguinal hernia outpatients’ department. Associated co-morbid conditions were labeled. All the patients received treatment with prosthetic mesh repair under local anesthesia. The patients were evaluated for tolerability and outcome of local anesthesia. Results: In the present study age of the patient varied from 20 to 70 years with the highest prevalence noted in the age group of 31-40 years. The mean age was 78.2±9.64 years (range 65–93 years). Present study shows more than 97.2% are male with only 2.8% of female presenting with inguinal hernia. Direct hernia was present in all (100%) patients, while 16(16%) patients also had indirect hernia. Right sided hernias were present in 67(67%) patients, while left sided hernias were present in 37(37%) patients. There were 71(71%) patients who had incomplete inguinal hernia, while 29(29%) patients had complete inguinal hernia. The frequency and percentage of the associated co-morbid condition. The procedure was successfully completed in all patients. The mean operative time was 46.35+7.82 minutes. No intra operative or postoperative mortality was observed. The mean hospital stay of the patients was 1.02+0.57 days. Pain during procedure was seen in 3(4.2%) patients, while nausea/vomiting and headache in 1(1.4%) patient each. Postoperatively, pain was seen among 3(4.2%) patients, urinary retention in 1(1.4%), inguinodynia in 1(1.4%) patient, and scrotal hematoma in 2(2.8%) patients. Conclusion: Our experience shows that prosthetic repair for inguinal hernia among elderly patients who are high risk for general or spinal anesthesia is well tolerated and has favorable outcome. In future it may erase the wait and watch strategy in such patients.
Risk Factor And Outcome Of Inguinal Hernia Repair Under Local Anesthesia Among Elderly Patients
Md. Mahbub Ur Rahman; A.K.M Fakhrul Alam; Md. Nazmul Ahsan; Kaneez Fatema; Md. Shafiqul Islam
DOI : 10.5281/zenodo.7704351
Background: Hernia is the “protrusion of the viscous or part of the viscous through an abnormal opening in the walls of its containing cavity”. Inguinal hernias are the commonest of all hernias and adult inguinal herniorrhaphy accounts for 15% of operation in general surgery. Inguinal hernia is a common pathology seen during surgical practice. Objective: To find out risk factore and outcome of inguinal hernia repair under local anesthesia among elderly patients. Methods: In this prospective study was conducted in the Anesthesia Department, Sher-E-Bangla Medical College Hospital, Barishal, Bangladesh from January to December 2021. We enrolled 70 consecutive high risk elderly (age > 65 years) male patients who were admitted for repair of inguinal hernia outpatients’ department. Associated co-morbid conditions were labeled. All the patients received treatment with prosthetic mesh repair under local anesthesia. The patients were evaluated for tolerability and outcome of local anesthesia. Results: In the present study age of the patient varied from 20 to 70 years with the highest prevalence noted in the age group of 31-40 years. The mean age was 78.2±9.64 years (range 65–93 years). Present study shows more than 97.2% are male with only 2.8% of female presenting with inguinal hernia. Direct hernia was present in all (100%) patients, while 16(16%) patients also had indirect hernia. Right sided hernias were present in 67(67%) patients, while left sided hernias were present in 37(37%) patients. There were 71(71%) patients who had incomplete inguinal hernia, while 29(29%) patients had complete inguinal hernia. The frequency and percentage of the associated co-morbid condition. The procedure was successfully completed in all patients. The mean operative time was 46.35+7.82 minutes. No intra operative or postoperative mortality was observed. The mean hospital stay of the patients was 1.02+0.57 days. Pain during procedure was seen in 3(4.2%) patients, while nausea/vomiting and headache in 1(1.4%) patient each. Postoperatively, pain was seen among 3(4.2%) patients, urinary retention in 1(1.4%), inguinodynia in 1(1.4%) patient, and scrotal hematoma in 2(2.8%) patients. Conclusion: Our experience shows that prosthetic repair for inguinal hernia among elderly patients who are high risk for general or spinal anesthesia is well tolerated and has favorable outcome. In future it may erase the wait and watch strategy in such patients.
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Correlation of C- reactive protein and Blood culture in Neonatal Sepsis in a Tertiary Health Care Centre of South India
Introduction: Neonatal sepsis is a common cause of neonatal morbidity and mortality. Gold standard method for diagnosing neonatal sepsis is blood culture but it is time consuming, requires well equipped laboratory and trained laboratory personnel. Serum C-Reactive Protein (CRP) is an acute phase reactant, which is released in response to the inflammatory reaction. CRP levels reflect the individual's association between microbial infection. This study is conducted for evaluation of CRP role in the blood as early marker in neonatal sepsis and to find its correlation with blood culture. Methodology: This study was conducted in microbiology laboratory from Nov 2022 to Feb 2023 to evaluate the correlation of C-Reactive Protein and Blood Culture in Neonatal Sepsis. Suspected neonatal sepsis cases in the department of Pediatrics were included in the study. After taking aseptic precautions, 1-2 ml of blood was collected and inoculated into blood culture bottle containing 5 ml of Brain Heart Infusion Broth. CRP level was detected by Latex Agglutination Card test. Results: Out of total 350 samples, 246 were from female and 104 were from male. Among350 samples tested,43 were blood culture positive and 156 were CRP positive. All blood culture positive samples were CRP positive also. Among the blood culture negative samples, 113 were CRP positive. Conclusion: Early diagnosis of neonatal sepsis with the help of biomarkers like C-Reactive Protein plays a major role in reducing mortality & morbidity among the neonates.
Correlation of C- reactive protein and Blood culture in Neonatal Sepsis in a Tertiary Health Care Centre of South India
Dr. Shakthi.R, MBBS, MD; Venkatesha D
DOI : 10.5281/zenodo.7710609
Introduction: Neonatal sepsis is a common cause of neonatal morbidity and mortality. Gold standard method for diagnosing neonatal sepsis is blood culture but it is time consuming, requires well equipped laboratory and trained laboratory personnel. Serum C-Reactive Protein (CRP) is an acute phase reactant, which is released in response to the inflammatory reaction. CRP levels reflect the individual's association between microbial infection. This study is conducted for evaluation of CRP role in the blood as early marker in neonatal sepsis and to find its correlation with blood culture. Methodology: This study was conducted in microbiology laboratory from Nov 2022 to Feb 2023 to evaluate the correlation of C-Reactive Protein and Blood Culture in Neonatal Sepsis. Suspected neonatal sepsis cases in the department of Pediatrics were included in the study. After taking aseptic precautions, 1-2 ml of blood was collected and inoculated into blood culture bottle containing 5 ml of Brain Heart Infusion Broth. CRP level was detected by Latex Agglutination Card test. Results: Out of total 350 samples, 246 were from female and 104 were from male. Among350 samples tested,43 were blood culture positive and 156 were CRP positive. All blood culture positive samples were CRP positive also. Among the blood culture negative samples, 113 were CRP positive. Conclusion: Early diagnosis of neonatal sepsis with the help of biomarkers like C-Reactive Protein plays a major role in reducing mortality & morbidity among the neonates.
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Perception And Practice Of Hospital Waste Management Among Medical And Nursing Personnel
Introduction: Present study attempts to assess the knowledge, attitude, and practices regarding hospital waste management among PG residents, nurses, and students in selected hospitals of Indore district (M.P.).Biomedical waste management has recently emerged as an issue of major concern not only to hospitals, and nursing home authorities but also to the environment. The proper management of biomedical waste has become a worldwide humanitarian topic today. It is a well-established fact that there are many adverse and harmful environmental effects including human beings caused by the ‘Hospital waste’ generated during patient care. Methodology: This study was a hospital-based cross-sectional study conducted among 150 Health care workers by simple random sampling. Pre-designed, semi-structured Observation checklist for Health care providers has been used to assess the knowledge, attitude, and practices regarding hospital waste management among PG residents, nurses, and students in selected hospitals of the Indore district. The collected data was analyzed using SPSS 21. Results- Most of the UG students and PG residents know about the color coding of BMW more than nurses. Most PG residents know that wastes in yellow bags are treated by incineration, unlike UG students and nurses. Most of the medical staff agreed that BMW reduces the incidence of hospital-acquired infection. Most of the PG residents and UG students agreed that the segregation of waste is necessary before waste disposal. Conclusion- Based on our study, PG residents had more knowledge and a better attitude toward biomedical waste management guidelines as compared to nurses and UG students.
Perception And Practice Of Hospital Waste Management Among Medical And Nursing Personnel
Dr.DhirendraSoni; Dr.Arunendra Deepanker; Dr. Sathish Saroshe; Dr.Praveen Yuwane; Dr.Abhay Singh; Mr. Shivam Dixit; Dr.KokilaaGL; Dr.Vinoth Gnana Chellaiyan D
DOI : 10.5281/zenodo.7710643
Introduction: Present study attempts to assess the knowledge, attitude, and practices regarding hospital waste management among PG residents, nurses, and students in selected hospitals of Indore district (M.P.).Biomedical waste management has recently emerged as an issue of major concern not only to hospitals, and nursing home authorities but also to the environment. The proper management of biomedical waste has become a worldwide humanitarian topic today. It is a well-established fact that there are many adverse and harmful environmental effects including human beings caused by the ‘Hospital waste’ generated during patient care. Methodology: This study was a hospital-based cross-sectional study conducted among 150 Health care workers by simple random sampling. Pre-designed, semi-structured Observation checklist for Health care providers has been used to assess the knowledge, attitude, and practices regarding hospital waste management among PG residents, nurses, and students in selected hospitals of the Indore district. The collected data was analyzed using SPSS 21. Results- Most of the UG students and PG residents know about the color coding of BMW more than nurses. Most PG residents know that wastes in yellow bags are treated by incineration, unlike UG students and nurses. Most of the medical staff agreed that BMW reduces the incidence of hospital-acquired infection. Most of the PG residents and UG students agreed that the segregation of waste is necessary before waste disposal. Conclusion- Based on our study, PG residents had more knowledge and a better attitude toward biomedical waste management guidelines as compared to nurses and UG students.
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Histopathological profile of Endometrial Thickness and serum LDH in Women with Post-Menopausal Bleeding
Introduction- Post menopause describes the period following the final menses. Despite a great increase in the life expectancy of women, the age at menopause remains remarkably constant. The life expectancy of women shows a steady rise in this era, hence women experience a longer postmenopausal phase [2]. A woman in the United States today will live approximately 30 years, or greater than a third of her life, beyond the menopause. The tumor environment is highly hypoxic so that cancer cells have an intensified anaerobic metabolism. Objective: To assess the histopathological profile of endometrial thickness and serum LDH in women with post-menopausal bleeding. Methods: This is a prospective cross-sectional study was carried out at Obstetrics and Gynecology, Sylhet MAG Osmani Medical Hospital, Sylhet, Bangladesh from January to December 2021. Total 101 women were selected for the present study after applying inclusion and exclusion criteria. The diagnostic reliability of combined serum LDH and endometrial thickness in diagnosis of endometrial carcinoma in cases of perimenopausal bleeding. All cases were subjected to full history, full clinical examination, transvaginal sonography, serum LDH and Diagnostic endometrial biopsy was taken for histopathological examination. Results: Total 101 women were selected for the present study after applying inclusion and exclusion criteria. The age of menopause was between 40 and 45 years in 15.8% of the women, 39.5% of women were between 45 and 50 years and 44.5% were above 50 years of age. It was noted that the age group of patients with postmenopausal bleeding was between 45 and 50 years in 13.9% of women, 50 to 60 years in 56.4% of the women and above the age of 60 years in 29.7% of women. It was found that TVS evaluation of endometrial thickness is not sensitive enough to detect cancer of the endometrium and therefore, could not replace histological evaluation of the endometrial tissue in women with postmenopausal bleeding. LDH level cutoff value of 430 U/L could differentiate malignant from benign lesions with a sensitivity of 80.5%, specificity 58.3%, PPV 56.7% and NPV 82.9% with a diagnostic accuracy of 66.3%. Thus, total serum LDH can be used as a good negative test using the cut-off level (430 U/L).In this study, endometrial thickness at 11.5mm cut off value showed 80.5% sensitivity, 53.3% specificity, PPV 53.3%, NPV 80.5%and diagnostic accuracy 64.4%. Combination of evaluation of endometrial thickness by TVS (with specificity of 53.3% and accuracy of 64.4%) and serum LDH (with specificity of 58.3% and accuracy of 66.3%) increase the specificity to 73.3%. also increase the accuracy to 67.3%. Conclusion: In conclusion, the measurement of serum LDH is considered another simple method to be combined with TVS if endometrial cancer is suspected. However, further studies are needed using LDH isoenzymes profile and TVS endometrial morphology.
Histopathological profile of Endometrial Thickness and serum LDH in Women with Post-Menopausal Bleeding
Mahnaz Syed; Mohammed Ziaur Rahman; Syed Tasnuv Sami
DOI : 10.5281/zenodo.7711013
Introduction- Post menopause describes the period following the final menses. Despite a great increase in the life expectancy of women, the age at menopause remains remarkably constant. The life expectancy of women shows a steady rise in this era, hence women experience a longer postmenopausal phase [2]. A woman in the United States today will live approximately 30 years, or greater than a third of her life, beyond the menopause. The tumor environment is highly hypoxic so that cancer cells have an intensified anaerobic metabolism. Objective: To assess the histopathological profile of endometrial thickness and serum LDH in women with post-menopausal bleeding. Methods: This is a prospective cross-sectional study was carried out at Obstetrics and Gynecology, Sylhet MAG Osmani Medical Hospital, Sylhet, Bangladesh from January to December 2021. Total 101 women were selected for the present study after applying inclusion and exclusion criteria. The diagnostic reliability of combined serum LDH and endometrial thickness in diagnosis of endometrial carcinoma in cases of perimenopausal bleeding. All cases were subjected to full history, full clinical examination, transvaginal sonography, serum LDH and Diagnostic endometrial biopsy was taken for histopathological examination. Results: Total 101 women were selected for the present study after applying inclusion and exclusion criteria. The age of menopause was between 40 and 45 years in 15.8% of the women, 39.5% of women were between 45 and 50 years and 44.5% were above 50 years of age. It was noted that the age group of patients with postmenopausal bleeding was between 45 and 50 years in 13.9% of women, 50 to 60 years in 56.4% of the women and above the age of 60 years in 29.7% of women. It was found that TVS evaluation of endometrial thickness is not sensitive enough to detect cancer of the endometrium and therefore, could not replace histological evaluation of the endometrial tissue in women with postmenopausal bleeding. LDH level cutoff value of 430 U/L could differentiate malignant from benign lesions with a sensitivity of 80.5%, specificity 58.3%, PPV 56.7% and NPV 82.9% with a diagnostic accuracy of 66.3%. Thus, total serum LDH can be used as a good negative test using the cut-off level (430 U/L).In this study, endometrial thickness at 11.5mm cut off value showed 80.5% sensitivity, 53.3% specificity, PPV 53.3%, NPV 80.5%and diagnostic accuracy 64.4%. Combination of evaluation of endometrial thickness by TVS (with specificity of 53.3% and accuracy of 64.4%) and serum LDH (with specificity of 58.3% and accuracy of 66.3%) increase the specificity to 73.3%. also increase the accuracy to 67.3%. Conclusion: In conclusion, the measurement of serum LDH is considered another simple method to be combined with TVS if endometrial cancer is suspected. However, further studies are needed using LDH isoenzymes profile and TVS endometrial morphology.
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Knowledge About Effects Of Substance Abuse Among Adolescents
Introduction: Abuse of substances creates a great threat to the health, social and economic condition of individual, family, community and to the nation. In the past two decades’ abuse of substances is an important public health concern among people, especially among adolescents. Objective: The major aims of the study were to assess the level of knowledge about effects of substance abuse among adolescents. Methods: This was a cross-sectional descriptive study carried out among 70 adolescents. Data analysis was done using SPSS version 25. Results: The socio-demographic characteristics of the adolescents were as fallows. 57.14% of respondents’ age was 16-17 years, approximately 82% of respondents belonged to Muslim religion. The majority believed that substance use would lead to unsatisfactory health such as respiratory problems 61.4%, 82.8% think that depression is the main mental effects and 61.42% said that, lack of parent understanding is the main social effect.62% Percentage distribution of knowledge of adolescents, 37.14% participants had poor knowledge, 55.71% respondents had average knowledge and only 37.14% had good knowledge regarding effects of substance abuse. Conclusion: After thorough analysis of the data, concluded that adolescents’ knowledge regarding effects of substance abuse should be increased in order to promote their health and there by avoid the consequences occurring due to substance abuse.
Knowledge About Effects Of Substance Abuse Among Adolescents
Sharmin Akter; Md. Obaidul Islam; A. K.M. Khairul Islam
DOI : 10.5281/zenodo.7711043
Introduction: Abuse of substances creates a great threat to the health, social and economic condition of individual, family, community and to the nation. In the past two decades’ abuse of substances is an important public health concern among people, especially among adolescents. Objective: The major aims of the study were to assess the level of knowledge about effects of substance abuse among adolescents. Methods: This was a cross-sectional descriptive study carried out among 70 adolescents. Data analysis was done using SPSS version 25. Results: The socio-demographic characteristics of the adolescents were as fallows. 57.14% of respondents’ age was 16-17 years, approximately 82% of respondents belonged to Muslim religion. The majority believed that substance use would lead to unsatisfactory health such as respiratory problems 61.4%, 82.8% think that depression is the main mental effects and 61.42% said that, lack of parent understanding is the main social effect.62% Percentage distribution of knowledge of adolescents, 37.14% participants had poor knowledge, 55.71% respondents had average knowledge and only 37.14% had good knowledge regarding effects of substance abuse. Conclusion: After thorough analysis of the data, concluded that adolescents’ knowledge regarding effects of substance abuse should be increased in order to promote their health and there by avoid the consequences occurring due to substance abuse.
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Study on ureteral duplication with its clinical significance in North Indian Population
Objectives: The aim of present study is to highlight incidence and clinical significance of bilateral variations of ureter in North Indian Population. The ureters are both sided thin tubular structures that connect the kidneys to the urinary bladder, convey urine from the renal pelvis of kidneys to the bladder. The human ureter is roughly 25-30 cm long in adults. The human ureters begin at the ureteropelvic junction of the kidneys, which lie posterior to the renal vein and artery in the hilum. Material and Methods: The present study comprises 44 kidneys (22 adult cadavers) of both sexes (12 males and 10 females) from North Indian origin. During routine abdominal dissection conducted for medical undergraduates at the department of Anatomy, The ureters were carefully dissected; observed and explored the variations of ureters were photographs and recorded. Results: We found unilateral double ureter in right side were (4.5%) and in left side (2.2%) in the cadavers of North Indian population. In this present study we did not found bilateral double ureter in the dissection of all cadavers. Conclusion: Ureteral duplication may potentially have urinary stones, ureterocele, vesicoureteral reflux and obstructive uropathy. The urologist and radiologist should be aware about variations in ureter is necessary for surgical management during renal transplantation, urological procedures, diagnosing urological images and preventing accidental injury during surgery
Study on ureteral duplication with its clinical significance in North Indian Population
Dr Muktyaz Hussein; Dr. Ved Prakash; Dr. Mukesh Bansal; Dr. Nigar Fatima
DOI : 10.5281/zenodo.7720871
Objectives: The aim of present study is to highlight incidence and clinical significance of bilateral variations of ureter in North Indian Population. The ureters are both sided thin tubular structures that connect the kidneys to the urinary bladder, convey urine from the renal pelvis of kidneys to the bladder. The human ureter is roughly 25-30 cm long in adults. The human ureters begin at the ureteropelvic junction of the kidneys, which lie posterior to the renal vein and artery in the hilum. Material and Methods: The present study comprises 44 kidneys (22 adult cadavers) of both sexes (12 males and 10 females) from North Indian origin. During routine abdominal dissection conducted for medical undergraduates at the department of Anatomy, The ureters were carefully dissected; observed and explored the variations of ureters were photographs and recorded. Results: We found unilateral double ureter in right side were (4.5%) and in left side (2.2%) in the cadavers of North Indian population. In this present study we did not found bilateral double ureter in the dissection of all cadavers. Conclusion: Ureteral duplication may potentially have urinary stones, ureterocele, vesicoureteral reflux and obstructive uropathy. The urologist and radiologist should be aware about variations in ureter is necessary for surgical management during renal transplantation, urological procedures, diagnosing urological images and preventing accidental injury during surgery
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Neem (Azadirachta Indica) In Oral Hygiene- An Update
Herbal Medicines are a fast emerging trend in recent times, as they provide safer, effective and economical treatment to patients. Azadirachta indica (neem) has been an integral part of health and oral care since times immemoral. It has shown to be an effective antimicrobial ant inflammatory and anticancer agent. In india it has been an indespensible part of oral care and is still a popular dental care agent in rural india. Incorporation of neem extract in oral health care products provides a natural solution to oro-dental problems and in maintaining oral health.
Neem (Azadirachta Indica) In Oral Hygiene- An Update
Sana Aftab; Dr. Mamta Sachdeva Dhingra; Manisha Kumari
DOI : 10.5281/zenodo.7737639
Herbal Medicines are a fast emerging trend in recent times, as they provide safer, effective and economical treatment to patients. Azadirachta indica (neem) has been an integral part of health and oral care since times immemoral. It has shown to be an effective antimicrobial ant inflammatory and anticancer agent. In india it has been an indespensible part of oral care and is still a popular dental care agent in rural india. Incorporation of neem extract in oral health care products provides a natural solution to oro-dental problems and in maintaining oral health.
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Cyperus Rotundus LINN: A Medicinal Plant: A Review
Ayurveda, or the science of life, takes a holistic approach to healthy living. It discusses the physiology and pathology of diseases, as well as their treatments. Several diseases have been treated with plant extracts based on traditional medicine since ancient times. Cyperus rotundus L. (Cyperaceae family) is a colonial, perennial herb. As science and cutting-edge technologies advanced, different herbal extracts and chemical constituents of herbs were identified as therapeutic targets. Cyperus rotundus, also known as mustaka, is an ancient herb found in tropical and subtropical regions around the world. The tuberous and aerial parts of the herb have been found to have a variety of pharmacological properties. The synergistic actions of the Cyperus compounds provide an advantage over a single compound.
Cyperus Rotundus LINN: A Medicinal Plant: A Review
Ruchi Mishra; Pankaj Yadav; Vikash Chandra; Navneet Kumar Verma; Vikas Yadav
DOI : 10.5281/zenodo.7737684
Ayurveda, or the science of life, takes a holistic approach to healthy living. It discusses the physiology and pathology of diseases, as well as their treatments. Several diseases have been treated with plant extracts based on traditional medicine since ancient times. Cyperus rotundus L. (Cyperaceae family) is a colonial, perennial herb. As science and cutting-edge technologies advanced, different herbal extracts and chemical constituents of herbs were identified as therapeutic targets. Cyperus rotundus, also known as mustaka, is an ancient herb found in tropical and subtropical regions around the world. The tuberous and aerial parts of the herb have been found to have a variety of pharmacological properties. The synergistic actions of the Cyperus compounds provide an advantage over a single compound.
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Study of Correlation Between Rbc and It’s Indices In Students of Osmania Medical College With Different Body Mass Indices
Currently nutritional changes are a public health problem in all over the world, affecting all age groups including young adults. While the under nutrition is affecting one side, over nutrition is also affecting the people on the other side. This leads to obesity. Levels of overweight and obesity together with other cardiovascular risk factors increase with age even within this age span[1]. The Study aims the Correlation between RBC and it’s indices in Students of Osmania Medical College with different body mass indices and look for correlation between BMI and RBC and it’s indices. A cross-sectional study was conducted in 100 healthy individuals with different body mass indices in the age group of 18-35yrs. Subjects were divided into 4 categories on BMI. 2ml venous blood collected in EDTA containers. It is analysed in automatic Haemocytometer. Pearson correlation was done to find the correlation between BMI & RBC and it’s indices. Pearson correlation was done to find the correlation between BMI & RBC and it’s indices. In the study there was significant positive correlation between BMI and RBC, negative correlation between BMI and MCV, MCH, MCHC. Individuals with high BMI have increased RBC count & low RBC indices.
Study of Correlation Between Rbc and It’s Indices In Students of Osmania Medical College With Different Body Mass Indices
Padmavathi kasa; Anitha R; Geetha Shavali
DOI : 10.5281/zenodo.7737792
Currently nutritional changes are a public health problem in all over the world, affecting all age groups including young adults. While the under nutrition is affecting one side, over nutrition is also affecting the people on the other side. This leads to obesity. Levels of overweight and obesity together with other cardiovascular risk factors increase with age even within this age span[1]. The Study aims the Correlation between RBC and it’s indices in Students of Osmania Medical College with different body mass indices and look for correlation between BMI and RBC and it’s indices. A cross-sectional study was conducted in 100 healthy individuals with different body mass indices in the age group of 18-35yrs. Subjects were divided into 4 categories on BMI. 2ml venous blood collected in EDTA containers. It is analysed in automatic Haemocytometer. Pearson correlation was done to find the correlation between BMI & RBC and it’s indices. Pearson correlation was done to find the correlation between BMI & RBC and it’s indices. In the study there was significant positive correlation between BMI and RBC, negative correlation between BMI and MCV, MCH, MCHC. Individuals with high BMI have increased RBC count & low RBC indices.
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Morphometric and morphological study of most common sternal entity: sternal foramen
Introduction: The sternal foramina are the most common congenital variation which is usually asymptomatic. Since the sternum is used for red bone marrow aspiration and in open heart surgeries, presence of sternal foramen may cause life threatening complications like cardiac tamponade. If death occur due to such life-threatening complication due to sternal foramen may raise medico-legal issue. Aims and Objectives: The present study was aimed to determine the prevalence of sternal foramen and to provide statistical data of the morphometry and morphology of the sternal foramen in the Gujarat population. Material and Method: The study was conducted on 112 human dry sternum bones of unknown age and sex from bone stores of various medical colleges of central Gujarat during June 2022 to December 2022. All the sternum bones were macroscopically inspected for the presence of sternal foramen and its location, size, number and shape. The transverse, vertical and maximum diameters of the sternal foramen were measured. The vertical distance of the sternal foramen from the imaginary line connecting the superior border of adjacent costal cartilage and distance of the foramen from the left and right sternal borders were also measured. All the measurements were obtained using sliding vernier calliper and recorded in millimeter (mm). Statistical analysis was finally conducted in Microsoft excel. Results: In the present study out of 112 dry sternum bones observed the sternal foramina were found in 11 sternums. Out of 11 sternums only 1 sternum had 2 foramina while other sternums had only one foramen. In the present study most of the sternal foramina were located on the body of sternum (72.73%) median in position (91.66%) and round in shape (58.33 %). Average vertical diameter was 7.16 mm and transverse diameter was 5.75 mm while highest diameter measured was 13mm. Conclusion: The sternal foramina are common congenital defect commonly found in body of sternum. it is very important to be aware of its prevalence in various populations and its morphological and morphometric data for clinician, surgeons and forensic experts to diagnose sternal foramen and to prevent unwanted serious complications during invasive procedures.
Morphometric and morphological study of most common sternal entity: sternal foramen
Dr Rupal S Gautam; Dr Hina Rajput; Dr Bhavik Doshi; Dr Jigna Parmar
DOI : 10.5281/zenodo.7737838
Introduction: The sternal foramina are the most common congenital variation which is usually asymptomatic. Since the sternum is used for red bone marrow aspiration and in open heart surgeries, presence of sternal foramen may cause life threatening complications like cardiac tamponade. If death occur due to such life-threatening complication due to sternal foramen may raise medico-legal issue. Aims and Objectives: The present study was aimed to determine the prevalence of sternal foramen and to provide statistical data of the morphometry and morphology of the sternal foramen in the Gujarat population. Material and Method: The study was conducted on 112 human dry sternum bones of unknown age and sex from bone stores of various medical colleges of central Gujarat during June 2022 to December 2022. All the sternum bones were macroscopically inspected for the presence of sternal foramen and its location, size, number and shape. The transverse, vertical and maximum diameters of the sternal foramen were measured. The vertical distance of the sternal foramen from the imaginary line connecting the superior border of adjacent costal cartilage and distance of the foramen from the left and right sternal borders were also measured. All the measurements were obtained using sliding vernier calliper and recorded in millimeter (mm). Statistical analysis was finally conducted in Microsoft excel. Results: In the present study out of 112 dry sternum bones observed the sternal foramina were found in 11 sternums. Out of 11 sternums only 1 sternum had 2 foramina while other sternums had only one foramen. In the present study most of the sternal foramina were located on the body of sternum (72.73%) median in position (91.66%) and round in shape (58.33 %). Average vertical diameter was 7.16 mm and transverse diameter was 5.75 mm while highest diameter measured was 13mm. Conclusion: The sternal foramina are common congenital defect commonly found in body of sternum. it is very important to be aware of its prevalence in various populations and its morphological and morphometric data for clinician, surgeons and forensic experts to diagnose sternal foramen and to prevent unwanted serious complications during invasive procedures.
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A Triple-Blinded Randomized Controlled Trialto Evaluate the effectiveness of Hydrotherapy versus Land-based exercises outcome on Quality of Life among patients with Rheumatoid Arthritis
Background: One of the most common non-pharmacological interventions for rheumatoid arthritis is hydrotherapy and land-based exercises. The goal of the study was to determine the effectiveness of hydrotherapy versus land-based exercise outcomes to improve the quality of life among chronic rheumatoid arthritis. Methods: A Triple-Blinded, Randomized Controlled, Parallel-Group, Multiple Arm Trial was conducted between 29/09/2019 to 30/09/2021. Single centre, the study was done at the Department of Physical Medicine & Rehabilitation, KGMU (India). Eligible 90 patients (45 males and 45 females aged 17 to 75 years old suffering from chronic rheumatoid arthritis) and randomisation through the Sequentially Numbering Sealed Opaque Envelope method (SNSOE). The intervention (RJHLERA) administered was hydrotherapy exercise (Week30-minutes session for 6 weeks and exercises in a hydrotherapy bathtub submerging body, water temperature (30-35 degrees Celsius) and land-based exercises (Weekly 30-minute session for 6 weeks and exercises in land and 11 minutes planned set of an active exercise (as a placebo) on land exercises for the clear control group. Assess the Quality of life using by RJQOL-22 Scale. Findings: For the quality of life, the pre-test results showed all the subjects had either poor or neither poor nor good levels of RJQOL-22 selected in each group. At post-test, the hydrotherapy exercise group showed the maximum response with 67.9% very good and, 21.4% good. The group land-based exercises group showed the next to maximum response with 19.2% good while the group the clear control group showed the least/poor response with nil cases in the good/very good category. Interpretation: The study recommends hydrotherapy and land-based exercise as safe, inexpensive interventions. Amongst hydrotherapy exercise and land-based exercises, Hydrotherapy showed the maximum (much better) to improve the quality of life in chronic rheumatoid arthritis patients
A Triple-Blinded Randomized Controlled Trialto Evaluate the effectiveness of Hydrotherapy versus Land-based exercises outcome on Quality of Life among patients with Rheumatoid Arthritis
Dr.Rajendra Kumar Jinjwaria; Associate. Prof (Dr) Rashmi P. John; Associate. Prof Arvind Kumar; Prof. (Dr) Sanjay Kumar; Ramesh Singh Chauhan; Kirti; Devesh Kumar
DOI : 10.5281/zenodo.7747693
Background: One of the most common non-pharmacological interventions for rheumatoid arthritis is hydrotherapy and land-based exercises. The goal of the study was to determine the effectiveness of hydrotherapy versus land-based exercise outcomes to improve the quality of life among chronic rheumatoid arthritis. Methods: A Triple-Blinded, Randomized Controlled, Parallel-Group, Multiple Arm Trial was conducted between 29/09/2019 to 30/09/2021. Single centre, the study was done at the Department of Physical Medicine & Rehabilitation, KGMU (India). Eligible 90 patients (45 males and 45 females aged 17 to 75 years old suffering from chronic rheumatoid arthritis) and randomisation through the Sequentially Numbering Sealed Opaque Envelope method (SNSOE). The intervention (RJHLERA) administered was hydrotherapy exercise (Week30-minutes session for 6 weeks and exercises in a hydrotherapy bathtub submerging body, water temperature (30-35 degrees Celsius) and land-based exercises (Weekly 30-minute session for 6 weeks and exercises in land and 11 minutes planned set of an active exercise (as a placebo) on land exercises for the clear control group. Assess the Quality of life using by RJQOL-22 Scale. Findings: For the quality of life, the pre-test results showed all the subjects had either poor or neither poor nor good levels of RJQOL-22 selected in each group. At post-test, the hydrotherapy exercise group showed the maximum response with 67.9% very good and, 21.4% good. The group land-based exercises group showed the next to maximum response with 19.2% good while the group the clear control group showed the least/poor response with nil cases in the good/very good category. Interpretation: The study recommends hydrotherapy and land-based exercise as safe, inexpensive interventions. Amongst hydrotherapy exercise and land-based exercises, Hydrotherapy showed the maximum (much better) to improve the quality of life in chronic rheumatoid arthritis patients
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Prevalence of Pulmonary Artery Hypertension and its Correlation with Severity of Bronchiectasis in a Tertiary care Hospital
Background: Pulmonary arterial hypertension (PAH) is a complication of chronic obstructive pulmonary disease (COPD) in advanced stages, and its presence indicates a poor prognosis. Aim of the study: The study aimed to find out the Prevalence of Pulmonary Artery Hypertension and its Correlation with the Severity of Bronchiectasis in a Tertiary Care Hospital. Methods: In this observational cross-sectional study we enrolled and analyzed 34 patients. The study was considered at the department of Cardiology, at Khulna Medical College and Hospital, Khulna, Bangladesh. The analysis was performed on patients who were admitted with chronic lung disease and the study duration was one year from June 2021 to July 2022. Result: The prevalence and severity of pulmonary hypertension; more than 60% of patients had pulmonary hypertension, and 40% had no complications (Table 2). According to comorbidities, 34 patients have diabetes, and 24 suffer from hypertension (Table 3). The echo findings of the study population are based on Pulmonary artery pressure (N=13), TAPSE (N=8) and FAC (N=13). Conclusion: It is essential to evaluate the cardiac status of bronchiectasis patients at the time of diagnosis as cardiac manifestations are one of the dreadful complications.
Prevalence of Pulmonary Artery Hypertension and its Correlation with Severity of Bronchiectasis in a Tertiary care Hospital
Dr. Md. Mostafa Kamal; Dr. Anirudha Sardar; Dr. Mst. Nazneen Nahar
DOI : 10.5281/zenodo.7747828
Background: Pulmonary arterial hypertension (PAH) is a complication of chronic obstructive pulmonary disease (COPD) in advanced stages, and its presence indicates a poor prognosis. Aim of the study: The study aimed to find out the Prevalence of Pulmonary Artery Hypertension and its Correlation with the Severity of Bronchiectasis in a Tertiary Care Hospital. Methods: In this observational cross-sectional study we enrolled and analyzed 34 patients. The study was considered at the department of Cardiology, at Khulna Medical College and Hospital, Khulna, Bangladesh. The analysis was performed on patients who were admitted with chronic lung disease and the study duration was one year from June 2021 to July 2022. Result: The prevalence and severity of pulmonary hypertension; more than 60% of patients had pulmonary hypertension, and 40% had no complications (Table 2). According to comorbidities, 34 patients have diabetes, and 24 suffer from hypertension (Table 3). The echo findings of the study population are based on Pulmonary artery pressure (N=13), TAPSE (N=8) and FAC (N=13). Conclusion: It is essential to evaluate the cardiac status of bronchiectasis patients at the time of diagnosis as cardiac manifestations are one of the dreadful complications.
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A Clinical Study of Incidence and Determinants of Ectopic Pregnancy in a Tertiary Centre
Ectopic pregnancy is leading cause of maternal morbidity and mortality in first trimester. It accounts for 2% of all pregnancies. Aims and objectives: To find out the incidence of ectopic pregnancy in our hospital and to determine the risk factors, clinical presentation, management and outcome of ectopic pregnancy. Methods: A Hospital based Retrospective clinical study carried out in Department of Obstetrics and Gynaecology of Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru for four years from August 2019 to August 2022. Results: The incidence of ectopic pregnancy was 2.8%, of which 93.93% were ruptured, 6.06% unruptured and 4.54% heterotopic pregnancies. Maximum patients (65%) were among age group of 21 to 30 years and were multigravida, 45.4% presented between 7-8+6 weeks of gestation. The common risk factor was previous abortion with Dilatation and curettage. Surgical management with salpingectomy was done in majority of cases(86.3%). 91% of ectopic pregnancy was in fallopian tube, 2 in ovaries and 1 in rudimentary horn of bicornuate uterus. The commonest site was ampulla (45.4%). Outcome was studied by need of blood transfusion in 39.3%, ICU admission in 15.15%. No maternal mortality encountered in this study. Conclusion: Since the incidence of ectopic pregnancy is on raising trend, high index of suspicion, early diagnosis and management are required to reduce maternal morbidity and mortality and for conservation of future reproductive capacity.
A Clinical Study of Incidence and Determinants of Ectopic Pregnancy in a Tertiary Centre
Dr Deepthi K; Dr. Krupa BM; Dr. Bhavana R
DOI : 10.5281/zenodo.7747910
Ectopic pregnancy is leading cause of maternal morbidity and mortality in first trimester. It accounts for 2% of all pregnancies. Aims and objectives: To find out the incidence of ectopic pregnancy in our hospital and to determine the risk factors, clinical presentation, management and outcome of ectopic pregnancy. Methods: A Hospital based Retrospective clinical study carried out in Department of Obstetrics and Gynaecology of Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru for four years from August 2019 to August 2022. Results: The incidence of ectopic pregnancy was 2.8%, of which 93.93% were ruptured, 6.06% unruptured and 4.54% heterotopic pregnancies. Maximum patients (65%) were among age group of 21 to 30 years and were multigravida, 45.4% presented between 7-8+6 weeks of gestation. The common risk factor was previous abortion with Dilatation and curettage. Surgical management with salpingectomy was done in majority of cases(86.3%). 91% of ectopic pregnancy was in fallopian tube, 2 in ovaries and 1 in rudimentary horn of bicornuate uterus. The commonest site was ampulla (45.4%). Outcome was studied by need of blood transfusion in 39.3%, ICU admission in 15.15%. No maternal mortality encountered in this study. Conclusion: Since the incidence of ectopic pregnancy is on raising trend, high index of suspicion, early diagnosis and management are required to reduce maternal morbidity and mortality and for conservation of future reproductive capacity.
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Are residents in India trained in ultrasound guided central venous cannulation? A prospective survey on the training and practices of anaesthesiology residents in central venous cannulation
Background and Aims: The present survey aims to assess the training and practices of Indian anaesthesia residents in central venous cannulation, and the barriers for not using US (ultrasound) and practicing internationally accepted guidelines for improved patient safety. Methods: The cross-sectional survey was conducted among Doctor of Medicine (MD) and Diplomate of National board of examinations (DNB)anaesthesia residents from different medical institutes across the country.The questionnaire included 20 questions and was validated for content by 6 experts. It was formatted on Google Forms and the link was sent on different zonal PG groups using WhatsApp. Results: Supervised training method was reported by 84.9% and 74.9% of the residents for landmark and US-guided CVC insertion respectively. Only around 8-9% had attended simulation sessions. Almost one-third of the residents did not have a printed checklist for the same, and one-fifth did not obtain informed consent at alltimes. About 12.2% residents either never followed all aseptic guidelines, or followed them occasionally. The most common barriers for not using US by residents for CVC cannulation were its non-availability in the institute (16.9%), limited availability for residents (63.8%), longer procedure time and learning curve (16.4 % and 12.7% respectively), and faculty preference for teaching by landmark technique (13.4%). Conclusion: Although anaesthesiology residents are being trained in US-guided CVC insertion, there are various barriers to its use in clinical practice like limited availability of USG for residents after routine hours, longer procedure time and learning curve, and faculty preference for teaching by landmark technique. The survey advocates and encourages simulation based training for the residents, and workshops for training and teaching of US and simulation for the faculty.
Are residents in India trained in ultrasound guided central venous cannulation? A prospective survey on the training and practices of anaesthesiology residents in central venous cannulation
Anjali Kochhar; Pratibha Panjiar; Sargam Goel; Swathi Pandurangi; Megha Maheshwari; Kharat Mohammed Bhat
DOI : 10.5281/zenodo.7748123
Background and Aims: The present survey aims to assess the training and practices of Indian anaesthesia residents in central venous cannulation, and the barriers for not using US (ultrasound) and practicing internationally accepted guidelines for improved patient safety. Methods: The cross-sectional survey was conducted among Doctor of Medicine (MD) and Diplomate of National board of examinations (DNB)anaesthesia residents from different medical institutes across the country.The questionnaire included 20 questions and was validated for content by 6 experts. It was formatted on Google Forms and the link was sent on different zonal PG groups using WhatsApp. Results: Supervised training method was reported by 84.9% and 74.9% of the residents for landmark and US-guided CVC insertion respectively. Only around 8-9% had attended simulation sessions. Almost one-third of the residents did not have a printed checklist for the same, and one-fifth did not obtain informed consent at alltimes. About 12.2% residents either never followed all aseptic guidelines, or followed them occasionally. The most common barriers for not using US by residents for CVC cannulation were its non-availability in the institute (16.9%), limited availability for residents (63.8%), longer procedure time and learning curve (16.4 % and 12.7% respectively), and faculty preference for teaching by landmark technique (13.4%). Conclusion: Although anaesthesiology residents are being trained in US-guided CVC insertion, there are various barriers to its use in clinical practice like limited availability of USG for residents after routine hours, longer procedure time and learning curve, and faculty preference for teaching by landmark technique. The survey advocates and encourages simulation based training for the residents, and workshops for training and teaching of US and simulation for the faculty.
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Implications of Facial Nerve Landmarks In Parotid Surgery
The facial nerve weakness post parotid surgery can result from a combination of trauma while dissecting right on the nerve, traction injury to the nerve, heat injury secondary to use of electrocautery and prolonged operating time. We tried to study the one factor i.e. the operating time. Total of 30 patients admitted in the ENT department between year 2014 and 2018, undergoing parotid surgery for benign pathology by the same primary surgeon were selected. Facial nerve was identified in each by antegrade method. In first ten (10) patients, tragal pointer was used to identify facial nerve and for further twenty (20) cases, posterior belly digastric was used for the identification. Average time taken using tragal pointer as the landmark was 39.7 minutes and average time taken using posterior belly of digastric was 20.65 minutes. P value was found to be significant ( < 0.01) by using both independent sample t test and one way ANOVA test. We found that time taken using posterior belly of digastric as landmark was significantly shorter than tragal pointer. Hence we can control the operating time by using posterior belly of digastric as the primary landmark for facial nerve identification.
Implications of Facial Nerve Landmarks In Parotid Surgery
Dr Pooja Kataria Jain; Dr Chandan Kumari Thakur; Dr Himanshu Bhasin
DOI : 10.5281/zenodo.7748190
The facial nerve weakness post parotid surgery can result from a combination of trauma while dissecting right on the nerve, traction injury to the nerve, heat injury secondary to use of electrocautery and prolonged operating time. We tried to study the one factor i.e. the operating time. Total of 30 patients admitted in the ENT department between year 2014 and 2018, undergoing parotid surgery for benign pathology by the same primary surgeon were selected. Facial nerve was identified in each by antegrade method. In first ten (10) patients, tragal pointer was used to identify facial nerve and for further twenty (20) cases, posterior belly digastric was used for the identification. Average time taken using tragal pointer as the landmark was 39.7 minutes and average time taken using posterior belly of digastric was 20.65 minutes. P value was found to be significant ( < 0.01) by using both independent sample t test and one way ANOVA test. We found that time taken using posterior belly of digastric as landmark was significantly shorter than tragal pointer. Hence we can control the operating time by using posterior belly of digastric as the primary landmark for facial nerve identification.
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Forget me not: Epidermal inclusion cyst of the Ear Pinna- A common lesion at unusual location: A case report
Epidermoid cysts are developmental benign cysts which are frequently encountered on location like extremities, scalp, face, rarely on locations like external ear. Very few cases of EIC are described in this location and have been reported in literature. The lesion is usually benign but may undergo malignant transformation if left untreated. Therefore timely diagnosis by FNAC is useful and considered necessary for evaluation of such cases. We hereby describe a case of 4 years old child who was referred to cytopathology department for FNAC for the swelling involving upper part of left side of pinna extending to posterior aspect measuring 3.0 x 2.1 cm in size and was non tender. It was diagnosed as EIC on FNAC and subsequently confirmed on HPE. FNAC is found useful tool to diagnose such uncommon lesions found at unusual locations.
Forget me not: Epidermal inclusion cyst of the Ear Pinna- A common lesion at unusual location: A case report
Dr. Anmol Taneja; Dr. Parneet Kaur; Dr. Prem Singh; Dr. Irbinder Kour Bali
DOI : 10.5281/zenodo.7750303
Epidermoid cysts are developmental benign cysts which are frequently encountered on location like extremities, scalp, face, rarely on locations like external ear. Very few cases of EIC are described in this location and have been reported in literature. The lesion is usually benign but may undergo malignant transformation if left untreated. Therefore timely diagnosis by FNAC is useful and considered necessary for evaluation of such cases. We hereby describe a case of 4 years old child who was referred to cytopathology department for FNAC for the swelling involving upper part of left side of pinna extending to posterior aspect measuring 3.0 x 2.1 cm in size and was non tender. It was diagnosed as EIC on FNAC and subsequently confirmed on HPE. FNAC is found useful tool to diagnose such uncommon lesions found at unusual locations.
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Study of Prevalence of Iodine Deficiency Disorders and Salt Consumption Patterns in an Urban area of South- West Maharashtra. A Cross Sectional Study
Introduction: Globally more than 1•9 billion individuals have inadequate iodine nutrition of whom 285 million are school-aged children. [1] Nutritional Iodine deficiency could result in abortion, stillbirth, mental retardation, deaf mutism, squint, dwarfism, goitre, neuromotor defects etc. [2] Prevalence surveys of iodine status, including measurement of urinary iodine levels and an analysis of the salt situation is needed for sustained elimination. [3] It was found in India, 337 districts were endemic for Iodine deficiency disorder i.e., prevalence is >10% [4]. Community based research may be more practical and less costly and possible on a more regular basis. [4,5] Considering this the present study was undertaken to find the recent status of Iodine deficiency disorders in the subpopulation of Maharashtra. Objectives: To study the prevalence of goitre, median urine iodine levels in 6 to 12 years children. And to study pattern and practices of salt consumption and salt iodine estimation at household level. Methodology: A cross sectional observational study of 551 children from six randomly selected schools from different localities was done during the period, 1/4/2019 to 1/3/2020.History taking, clinical examination was done and on spot urine sample and household salt sample were collected for iodine estimation. Results: Prevalence of goitre was 1.45%. Median urinary iodine level was 90mcg/L. 55% of households were having Salts with Iodine content of >15 pp Study shows the Iodine deficiency of mild endemicity in the area. Goitre was not found to be a public health problem.
Study of Prevalence of Iodine Deficiency Disorders and Salt Consumption Patterns in an Urban area of South- West Maharashtra. A Cross Sectional Study
Dr. Kotnis Shubhalaxmi Devdatt; Dr. Rokade Hemalata G.; Dr. Rohan Bembre; Dr Talekar Swati; Dr. Dhanashri Kakade; Mrs Rajshri Salamwade; Dr.Kamalakar Mane; Dr, Anurag Gupta
DOI : 10.5281/zenodo.7748373
Introduction: Globally more than 1•9 billion individuals have inadequate iodine nutrition of whom 285 million are school-aged children. [1] Nutritional Iodine deficiency could result in abortion, stillbirth, mental retardation, deaf mutism, squint, dwarfism, goitre, neuromotor defects etc. [2] Prevalence surveys of iodine status, including measurement of urinary iodine levels and an analysis of the salt situation is needed for sustained elimination. [3] It was found in India, 337 districts were endemic for Iodine deficiency disorder i.e., prevalence is >10% [4]. Community based research may be more practical and less costly and possible on a more regular basis. [4,5] Considering this the present study was undertaken to find the recent status of Iodine deficiency disorders in the subpopulation of Maharashtra. Objectives: To study the prevalence of goitre, median urine iodine levels in 6 to 12 years children. And to study pattern and practices of salt consumption and salt iodine estimation at household level. Methodology: A cross sectional observational study of 551 children from six randomly selected schools from different localities was done during the period, 1/4/2019 to 1/3/2020.History taking, clinical examination was done and on spot urine sample and household salt sample were collected for iodine estimation. Results: Prevalence of goitre was 1.45%. Median urinary iodine level was 90mcg/L. 55% of households were having Salts with Iodine content of >15 pp Study shows the Iodine deficiency of mild endemicity in the area. Goitre was not found to be a public health problem.
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A Study on Correlation Between Serum Free Testosterone Levels And Adult Acne In Women at A Tertiary Care Hospital
Background: Acne is generally regarded as a skin disorder of adolescents, but off late the prevalence has been increasing in adults too; especially in women. Hyperandrogenism is considered as an important contributing factor for the development of acne in adult women. If elevated androgens are found patients may benefit from various methods of hormonal therapy and reduce psychological morbidity. As there is paucity of data on role of circulating androgens in female acne, this study was undertaken to evaluate the same. Aims and objectives: To evaluate the correlation between serum free testosterone levels and adult acne in females. Materials and methods: A case control study from January 2020 to June 2021 was conducted at Department of DVL, Guntur Medical College. 50 adult acne female patients and 50 age and sex-matched healthy controls were enrolled in the study. Blood levels of free testosterone, total testosterone, sex hormone binding globulin were measured on day 1-3 of menstrual cycle and free androgen index was calculated. Results: Adult acne cases were commonly reported in 25-30years age group with moderate severity. Although free testosterone levels were within normal limits in cases statistically significant difference was seen compared to the controls. Total testosterone and free androgen index vales were significantly elevated in cases and correlated positively with severity of acne. Conclusion: Free androgen index can be used as a surrogate marker for hyperandrogenemia in cases where free and total testosterone cases fall within normal limits. We reiterate the role of androgens and as a corollary the need for hormonal evaluation and timely anti- androgen therapy for adult acne in females.
A Study on Correlation Between Serum Free Testosterone Levels And Adult Acne In Women at A Tertiary Care Hospital
Dr. Sravani G; Dr. Mohana Rao T S; Dr. Duggirala S.S Srinivas Prasad
DOI : 10.5281/zenodo.7748429
Background: Acne is generally regarded as a skin disorder of adolescents, but off late the prevalence has been increasing in adults too; especially in women. Hyperandrogenism is considered as an important contributing factor for the development of acne in adult women. If elevated androgens are found patients may benefit from various methods of hormonal therapy and reduce psychological morbidity. As there is paucity of data on role of circulating androgens in female acne, this study was undertaken to evaluate the same. Aims and objectives: To evaluate the correlation between serum free testosterone levels and adult acne in females. Materials and methods: A case control study from January 2020 to June 2021 was conducted at Department of DVL, Guntur Medical College. 50 adult acne female patients and 50 age and sex-matched healthy controls were enrolled in the study. Blood levels of free testosterone, total testosterone, sex hormone binding globulin were measured on day 1-3 of menstrual cycle and free androgen index was calculated. Results: Adult acne cases were commonly reported in 25-30years age group with moderate severity. Although free testosterone levels were within normal limits in cases statistically significant difference was seen compared to the controls. Total testosterone and free androgen index vales were significantly elevated in cases and correlated positively with severity of acne. Conclusion: Free androgen index can be used as a surrogate marker for hyperandrogenemia in cases where free and total testosterone cases fall within normal limits. We reiterate the role of androgens and as a corollary the need for hormonal evaluation and timely anti- androgen therapy for adult acne in females.
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Retrospective Study on Seroprevalence of HIV, Hepatitis B, Hepatitis C and Syphilis Among Blood Donors in a Rural Tertiary Care Hospital
Background: Blood safety begins with a healthy donor. Collecting blood which is safe for transfusion is one of the principal challenges in the health care system. Transfusion of a contaminated blood increases the morbidity and mortality of the recipient. Aims and objectives: The aim of the present study was to estimate the seroprevalence of Transfusion Transmissible Infections(TTI’s) among blood donors and to estimate the prevalence of co-infection rate. Materials and methods: A retrospective study was conducted at Adichunchanagiri hospital and research centre, B.G. Nagara for a period of two years and involved testing of 3831 blood donors, who were serologically screened for HIV, HCV, HBV and Syphilis at the blood bank. Results: For a period of 2 years, a total of 3831 donors were tested. Among them 2339(61.05%) were voluntary donors and 1492(38.94%) were replacement donors. Male donors constituted for about 2681(69.98%) and females 1150(30.01%). Overall seropositivity for all TTI’s was 1.33%. Seropositivity was more among voluntary donors(0.83%) compared to replacement donors(0.5%). Seroprevalence of HIV is 0.10%, HBV is 0.96%, HCV is 0.26%, Syphilis is 0%. There were no occurrence of concomitant infections in the present study. Conclusion: Seroprevalence of HBV was more among voluntary donors, HIV and HCV seroprevalence was higher among replacement donors. Hence thorough screening of blood donors is must to prevent TTI’s to recipients. Category: Infectious diseases, Serology
Retrospective Study on Seroprevalence of HIV, Hepatitis B, Hepatitis C and Syphilis Among Blood Donors in a Rural Tertiary Care Hospital
Dr. Megha S; Dr. Sheethal MP; Dr. Shashikantha SK; Dr. Venkatesha D
DOI : 10.5281/zenodo.7748460
Background: Blood safety begins with a healthy donor. Collecting blood which is safe for transfusion is one of the principal challenges in the health care system. Transfusion of a contaminated blood increases the morbidity and mortality of the recipient. Aims and objectives: The aim of the present study was to estimate the seroprevalence of Transfusion Transmissible Infections(TTI’s) among blood donors and to estimate the prevalence of co-infection rate. Materials and methods: A retrospective study was conducted at Adichunchanagiri hospital and research centre, B.G. Nagara for a period of two years and involved testing of 3831 blood donors, who were serologically screened for HIV, HCV, HBV and Syphilis at the blood bank. Results: For a period of 2 years, a total of 3831 donors were tested. Among them 2339(61.05%) were voluntary donors and 1492(38.94%) were replacement donors. Male donors constituted for about 2681(69.98%) and females 1150(30.01%). Overall seropositivity for all TTI’s was 1.33%. Seropositivity was more among voluntary donors(0.83%) compared to replacement donors(0.5%). Seroprevalence of HIV is 0.10%, HBV is 0.96%, HCV is 0.26%, Syphilis is 0%. There were no occurrence of concomitant infections in the present study. Conclusion: Seroprevalence of HBV was more among voluntary donors, HIV and HCV seroprevalence was higher among replacement donors. Hence thorough screening of blood donors is must to prevent TTI’s to recipients. Category: Infectious diseases, Serology
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Pattern and clinical outcome of patients admitted in pediatric intensive care unit of a tertiary care Hospital, Dhaka, Bangladesh
Background: In the developing world, morbidity and mortality in under-five year old children is an important public health problem. Paediatric intensive care unit (PICU) is set aside for managing children with life-threatening illnesses. There is increased survival of critically ill children, with advances in intensive care facilities. Outcome depends on the underlying nature of the disease, associated co-morbidities, clinical condition of the patient at presentation, infrastructure and the quality of care provided in the unit. Objective: To examine pattern and clinical outcome of patients admitted in the pediatric intensive care unit. Methods: This is a prospective observational study conducted in Pediatric Intensive Care Unit (PICU) of-Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh from January to December 2021. All patients from age of 1 month to 18 years admitted to PICU meeting the inclusion criteria are included in the study. PICU records of all admissions, transfer out, discharges and deaths were used for this study. Data used from the records included age, sex, diagnosis, and outcome of all the patients admitted to PICU. The outcome is classified as transfers to pediatric wards, discharges, patients who left against medical advice (LAMA), and deaths. Results: Total of 431 patients were admitted into PICU. (201) 46.6% were infants, and (230) 53.4% patients aged 1-18 years. Their ages ranged from one month to 18 years, with the mean age being 40.01 ± 45.79 months. There were 264 (61.3%) male and 167 (38.7%) female patients giving an M: F ratio of 1.58:1. The most common cause of admission was respiratory 195 (45.2%), infectious 107 (24.8%), surgical 31 (7.2%), cardiovascular 21 (4.9%), neurological 45 (10.4%), haematological 12(2.8%), renal 04 (0.9%) and others 16 (2.7%). Disorders needing surgical intervention were the commonest condition in children of all age groups. The overall mortality rate was 22.5%. Ninety Seven (22.5%) patients died during the period, consisting of 53 (54.6%) males and 44 (45.4%) females, with their mean age being 53.71 months (range, one month to 18 years). 40 (41.2%) of Respiratory dysfunction, 23 (23.7%) of cardiovascular disorders, 12 (12.4%) of neurological problems, 5 (5.2%) of Haematological disfunction, and 17 (17.5%) patients died in the postoperative period. Conclusions: Diseases including infections were the predominant conditions leading to PICU admissions in our setting. In our PICU, mortality is low. Most of the deaths were serious illnesses with poor prognosis that require adequate medical knowledge, facilities, equipment and infrastructure. This forms a major challenge in Low and Middle Income Countries (LMIC). We advocate a focus on continuous development within the sphere of influence. This highlights the importance of addressing critically ill children and expanding intensive care facilities in the region
Pattern and clinical outcome of patients admitted in pediatric intensive care unit of a tertiary care Hospital, Dhaka, Bangladesh
Mohammad Mashiur Rahman; Md. Mahbubul Hoque; Asma Hoque; Mohhammed Akter Hossan Masud
DOI : 10.5281/zenodo.7772197
Background: In the developing world, morbidity and mortality in under-five year old children is an important public health problem. Paediatric intensive care unit (PICU) is set aside for managing children with life-threatening illnesses. There is increased survival of critically ill children, with advances in intensive care facilities. Outcome depends on the underlying nature of the disease, associated co-morbidities, clinical condition of the patient at presentation, infrastructure and the quality of care provided in the unit. Objective: To examine pattern and clinical outcome of patients admitted in the pediatric intensive care unit. Methods: This is a prospective observational study conducted in Pediatric Intensive Care Unit (PICU) of-Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh from January to December 2021. All patients from age of 1 month to 18 years admitted to PICU meeting the inclusion criteria are included in the study. PICU records of all admissions, transfer out, discharges and deaths were used for this study. Data used from the records included age, sex, diagnosis, and outcome of all the patients admitted to PICU. The outcome is classified as transfers to pediatric wards, discharges, patients who left against medical advice (LAMA), and deaths. Results: Total of 431 patients were admitted into PICU. (201) 46.6% were infants, and (230) 53.4% patients aged 1-18 years. Their ages ranged from one month to 18 years, with the mean age being 40.01 ± 45.79 months. There were 264 (61.3%) male and 167 (38.7%) female patients giving an M: F ratio of 1.58:1. The most common cause of admission was respiratory 195 (45.2%), infectious 107 (24.8%), surgical 31 (7.2%), cardiovascular 21 (4.9%), neurological 45 (10.4%), haematological 12(2.8%), renal 04 (0.9%) and others 16 (2.7%). Disorders needing surgical intervention were the commonest condition in children of all age groups. The overall mortality rate was 22.5%. Ninety Seven (22.5%) patients died during the period, consisting of 53 (54.6%) males and 44 (45.4%) females, with their mean age being 53.71 months (range, one month to 18 years). 40 (41.2%) of Respiratory dysfunction, 23 (23.7%) of cardiovascular disorders, 12 (12.4%) of neurological problems, 5 (5.2%) of Haematological disfunction, and 17 (17.5%) patients died in the postoperative period. Conclusions: Diseases including infections were the predominant conditions leading to PICU admissions in our setting. In our PICU, mortality is low. Most of the deaths were serious illnesses with poor prognosis that require adequate medical knowledge, facilities, equipment and infrastructure. This forms a major challenge in Low and Middle Income Countries (LMIC). We advocate a focus on continuous development within the sphere of influence. This highlights the importance of addressing critically ill children and expanding intensive care facilities in the region
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Different Doses of Intravenous Ondansetron With Placebo on Attenuation of Spinal-induced Hypotension
Introduction: Spinal anesthesia is a simple, reliable, and most common anesthetic technique practiced worldwide. However, spinal anesthesia is associated with side effects such as hypotension, bradycardia, and shivering. Hypotension is most common intraoperative complication during spinal anaesthesia for caesarean section which has detrimental effects on both mother and fetus. Objective: To compare the effect of intravenous ondansetron with placebo for attenuation of spinal induced hypotension, change in heart rate, requirement for vasopressor and incidence of shivering and postoperative nausea- vomiting. Methods: A prospective randomised double blind study was conducted at Department of Anesthesia, Monno Medical College & Hospital, Manikganj, Bangladesh from July to December 2022. Total 100 patients belonging to ASA Class-I and II, aged 25-35 years, weight 40-60 kilograms, undergoing cesarean delivery under spinal anesthesia were included in this study. Group O (n=50) received 6mg ondansetron in normal saline intravenously; total volume made 10ml. Group S (n=50) received 10ml normal saline intravenously. Patient with history of PIH, convulsion, compromised airway or morbid obesity and required general anaesthesia for supplementation were excluded from study. Blood pressure and heart rate were checked every 5minutes till the end of the surgery. Data was analyzed by chi square test. Results: Total 100 patients were investigated for the effect of prophylactic ondansetron 6mg intravenously on fall in SBP, DBP and MBP, number of vasopressor boluses and total dose of vasopressor required. Distribution of cases according to age was comparable (p-0.339) in both groups (ondansetron group-25.27±3.62 and normal saline group- 24.63±3.60). In both groups maximum patients were below 25yrs old. We also studied the effect of ondansetron on the level of sensory height, duration of subarachnoid block to start of surgery, duration of surgery, heart rate, incidence of nausea, shivering and bradycardia. Systolic, diastolic and mean blood pressure were found to be higher in group O as compare to group S at different time intervals (p value < 0.05). In group O 66% patients required vasopressors whereas in group S 90% patients required vasopressors. Incidence of nausea and vomiting is less in group O (p-value=0.001). Conclusion: we conclude that prophylactic use of intravenous ondansetron prevent incidence of hypotension and less vasopressor is required to treat hypotension. Prophylactic ondansetron use is associated with less incidence of nausea and vomiting in spinal anesthesia in healthy parturient.
Different Doses of Intravenous Ondansetron With Placebo on Attenuation of Spinal-induced Hypotension
Md. Mehedi Hasan; Mushfique Manjur; Syed Sabbir Ahammed; Jinia Afroz
DOI : 10.5281/zenodo.7772209
Introduction: Spinal anesthesia is a simple, reliable, and most common anesthetic technique practiced worldwide. However, spinal anesthesia is associated with side effects such as hypotension, bradycardia, and shivering. Hypotension is most common intraoperative complication during spinal anaesthesia for caesarean section which has detrimental effects on both mother and fetus. Objective: To compare the effect of intravenous ondansetron with placebo for attenuation of spinal induced hypotension, change in heart rate, requirement for vasopressor and incidence of shivering and postoperative nausea- vomiting. Methods: A prospective randomised double blind study was conducted at Department of Anesthesia, Monno Medical College & Hospital, Manikganj, Bangladesh from July to December 2022. Total 100 patients belonging to ASA Class-I and II, aged 25-35 years, weight 40-60 kilograms, undergoing cesarean delivery under spinal anesthesia were included in this study. Group O (n=50) received 6mg ondansetron in normal saline intravenously; total volume made 10ml. Group S (n=50) received 10ml normal saline intravenously. Patient with history of PIH, convulsion, compromised airway or morbid obesity and required general anaesthesia for supplementation were excluded from study. Blood pressure and heart rate were checked every 5minutes till the end of the surgery. Data was analyzed by chi square test. Results: Total 100 patients were investigated for the effect of prophylactic ondansetron 6mg intravenously on fall in SBP, DBP and MBP, number of vasopressor boluses and total dose of vasopressor required. Distribution of cases according to age was comparable (p-0.339) in both groups (ondansetron group-25.27±3.62 and normal saline group- 24.63±3.60). In both groups maximum patients were below 25yrs old. We also studied the effect of ondansetron on the level of sensory height, duration of subarachnoid block to start of surgery, duration of surgery, heart rate, incidence of nausea, shivering and bradycardia. Systolic, diastolic and mean blood pressure were found to be higher in group O as compare to group S at different time intervals (p value < 0.05). In group O 66% patients required vasopressors whereas in group S 90% patients required vasopressors. Incidence of nausea and vomiting is less in group O (p-value=0.001). Conclusion: we conclude that prophylactic use of intravenous ondansetron prevent incidence of hypotension and less vasopressor is required to treat hypotension. Prophylactic ondansetron use is associated with less incidence of nausea and vomiting in spinal anesthesia in healthy parturient.
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Risk Factors of Severe Dengue Infection in Paediatric Patients-A Single Centre Prospective Study
Introduction: Dengue epidemics are known to have occurred over the last three centuries in tropical, subtropical and temperate areas of the world. Dengue creates a huge burden on public health world-wide. Severe dengue can lead to more lethal condition. Hence early recognition of severe cases is important for management of paediatric dengue patients. Objective: To assess the risk factors of severe dengue infection in paediatric patients. Methods: A hospital-based prospective study was conducted at from June 2022 to November 2022 Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh. Seventy two (72) patients included in the study. In children with high degree clinical suspicion of dengue infection NS 1 antigen (who came within first 72 hours of fever) and/or dengue antibody IgM, IgG (who came after five days of fever) were performed. Positive dengue cases were taken written informed consent & interviewed on the risk factors of dengue infection. Data related to patient’s demography, risk factors, clinical presentation, pattern of dengue infection and outcome were documented on the pre-structured questionnaire. Results: Total of 72 patients with dengue infection met the inclusion criteria, in which 29 and 43 were diagnosed as severe dengue and non-severe dengue infection, respectively. All patients were confirmed by serologic marker (NS-1 or IgM/ IgG Dengue). All subjects were carried out anamnesis, physical examination, and laboratory. Clinical and laboratory examination (complete blood count, AST, ALT, albumin, APTT, S. ferritin and d-dimer) were analysis comparing non-severe dengue and severe dengue patients. Characteristics of 72 research subjects can be seen. On bivariate analysis, there were significant differences of nutritional status, abdominal pain, vomiting, petechiae, hepatomegaly, pleural effusion, leukopenia, thrombocytopenia, hypoalbuminemia, increasing AST > 3x, elevated D- dimer, hyperferritinemia and prolonged APTT between severe and non-severe dengue group. After multivariate analysis, the prognostic factors of severe dengue were overweight/obesity (p=0.003, RR 94), vomiting (p=0.02, RR 13.3), hepatomegaly (p=0.01, RR=69.4), hyperferritinemia (p=0.01, RR=15.4) and prolonged APTT (p=0.005, RR=43.25). In overweight/obesity, vomiting, hepatomegaly, and hyperferritinemia prolonged APTT were prognostic factors in severe dengue infection in children. Conclusion: In conclusion, overweight/obesity, vomiting, hepatomegaly, and hyperferritinemia prolonged APTT were prognostic factors in severe dengue infection in children. Considering these factors for awareness of severe dengue in patients with dengue virus infection. Clinicians should emphasize the monitoring of these factors for early detection of serious dengue state.
Risk Factors of Severe Dengue Infection in Paediatric Patients-A Single Centre Prospective Study
Farhana Ahmed; Mirza Mohammed Ziaul Islam
DOI : 10.5281/zenodo.7786477
Introduction: Dengue epidemics are known to have occurred over the last three centuries in tropical, subtropical and temperate areas of the world. Dengue creates a huge burden on public health world-wide. Severe dengue can lead to more lethal condition. Hence early recognition of severe cases is important for management of paediatric dengue patients. Objective: To assess the risk factors of severe dengue infection in paediatric patients. Methods: A hospital-based prospective study was conducted at from June 2022 to November 2022 Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh. Seventy two (72) patients included in the study. In children with high degree clinical suspicion of dengue infection NS 1 antigen (who came within first 72 hours of fever) and/or dengue antibody IgM, IgG (who came after five days of fever) were performed. Positive dengue cases were taken written informed consent & interviewed on the risk factors of dengue infection. Data related to patient’s demography, risk factors, clinical presentation, pattern of dengue infection and outcome were documented on the pre-structured questionnaire. Results: Total of 72 patients with dengue infection met the inclusion criteria, in which 29 and 43 were diagnosed as severe dengue and non-severe dengue infection, respectively. All patients were confirmed by serologic marker (NS-1 or IgM/ IgG Dengue). All subjects were carried out anamnesis, physical examination, and laboratory. Clinical and laboratory examination (complete blood count, AST, ALT, albumin, APTT, S. ferritin and d-dimer) were analysis comparing non-severe dengue and severe dengue patients. Characteristics of 72 research subjects can be seen. On bivariate analysis, there were significant differences of nutritional status, abdominal pain, vomiting, petechiae, hepatomegaly, pleural effusion, leukopenia, thrombocytopenia, hypoalbuminemia, increasing AST > 3x, elevated D- dimer, hyperferritinemia and prolonged APTT between severe and non-severe dengue group. After multivariate analysis, the prognostic factors of severe dengue were overweight/obesity (p=0.003, RR 94), vomiting (p=0.02, RR 13.3), hepatomegaly (p=0.01, RR=69.4), hyperferritinemia (p=0.01, RR=15.4) and prolonged APTT (p=0.005, RR=43.25). In overweight/obesity, vomiting, hepatomegaly, and hyperferritinemia prolonged APTT were prognostic factors in severe dengue infection in children. Conclusion: In conclusion, overweight/obesity, vomiting, hepatomegaly, and hyperferritinemia prolonged APTT were prognostic factors in severe dengue infection in children. Considering these factors for awareness of severe dengue in patients with dengue virus infection. Clinicians should emphasize the monitoring of these factors for early detection of serious dengue state.
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Vasospasm Management Strategies
Aim- In this study, we present a broad presentation of the current state of cerebral vasospasm, including its pathogenesis, commonly used treatments, and future outlook. Methods- A literature review was conducted for cerebral vasospasms using the PubMed journal database (https://pubmed.ncbi.nlm.nih.gov). Relevant journal articles were narrowed down and selected using the Medical Subject Headings (MeSH) option in PubMed. Results- Cerebral vasospasm is the persistent narrowing of cerebral arteries days after experiencing a subarachnoid hemorrhage (SAH). Eventually, if not corrected, this can lead to cerebral ischemia with significant neurological deficits and/or death. Therefore, it is clinically beneficial to diminish or prevent the occurrence or reoccurrence of vasospasm in patients following a SAH to prevent unwanted comorbidities or fatalities. We discuss the pathogenesis and mechanism of development that have been implicated in the progression of vasospasms as well as the manner in which clinical outcomes are quantitively measured. Further, we mention and highlight commonly used treatments to inhibit and reverse the course of vasoconstriction within the cerebral arteries. Additionally, we mention innovations and techniques that are being used to treat vasospasms and the outlook of their therapeutic value. Conclusion- Overall, we give a comprehensive summary of the disease that encapsulates cerebral vasospasm and the current and future standards of care that are used to treat it.
Vasospasm Management Strategies
Arman Tabarestani; Aashay Patel; Akshay Reddy; Ramy Sharaf; Brandon Lucke-Wold
DOI : 10.5281/zenodo.7791517
Aim- In this study, we present a broad presentation of the current state of cerebral vasospasm, including its pathogenesis, commonly used treatments, and future outlook. Methods- A literature review was conducted for cerebral vasospasms using the PubMed journal database (https://pubmed.ncbi.nlm.nih.gov). Relevant journal articles were narrowed down and selected using the Medical Subject Headings (MeSH) option in PubMed. Results- Cerebral vasospasm is the persistent narrowing of cerebral arteries days after experiencing a subarachnoid hemorrhage (SAH). Eventually, if not corrected, this can lead to cerebral ischemia with significant neurological deficits and/or death. Therefore, it is clinically beneficial to diminish or prevent the occurrence or reoccurrence of vasospasm in patients following a SAH to prevent unwanted comorbidities or fatalities. We discuss the pathogenesis and mechanism of development that have been implicated in the progression of vasospasms as well as the manner in which clinical outcomes are quantitively measured. Further, we mention and highlight commonly used treatments to inhibit and reverse the course of vasoconstriction within the cerebral arteries. Additionally, we mention innovations and techniques that are being used to treat vasospasms and the outlook of their therapeutic value. Conclusion- Overall, we give a comprehensive summary of the disease that encapsulates cerebral vasospasm and the current and future standards of care that are used to treat it.
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Tolerability of Rituximab CHOP(Cyclophosphamide, Hydroxydaunorubicin, Oncovin and Prednisolone) regimen for follicular lymphoma
Background And Objective: Many clinical trials conducted in the western population have shown that the addition of Rituximab to CHOP regimen provided a higher response rate and excellent early survival in follicular lymphoma. This study aimed to assess the tolerability to Rituximab-CHOP regimen for Follicular lymphoma in Indian population. Methods: From January 2015 to January 2016, 32 patients with histopathologically proven denovo follicular lymphoma who were prescribed. Rituximab-CHOP regimen once every 21 days for 6-8 cycles were included in the study. Adverse events causing non compliance to chemotherapy schedule were studied. Causality assessment and grading of severity were done for the above adverse events. Results And Discussion: Age range of the study population was from 37-83 years.78.125% patients were males. Most of the patients belonged to Ann Arbor Stage III/IV. Adverse events causing noncompliance included Infusion related reaction in two patients which was certainly related to Rituximab with a toxicity grade 3 and febrile neutropenia (possibly caused by Doxorubicin with toxicity grade 3 ), leukopenia ( possibly caused by Doxorubicin or Vincristine with a toxicity grade 2 ) and pancytopenia ( possibly caused by Cyclophosphamide or Doxorubicin or Vincristine with a toxicity grade of 3 ) in one patient each. Conclusion: Adverse drug reactions caused by Rituximab and possibly by Doxorubicin, Vincristine or Cyclophosphamide were a reason for non compliance.
Tolerability of Rituximab CHOP(Cyclophosphamide, Hydroxydaunorubicin, Oncovin and Prednisolone) regimen for follicular lymphoma
Dr. Ann George; Dr.Dawnji S.R; Dr. K.L.Jayakumar
DOI : 10.5281/zenodo.7791610
Background And Objective: Many clinical trials conducted in the western population have shown that the addition of Rituximab to CHOP regimen provided a higher response rate and excellent early survival in follicular lymphoma. This study aimed to assess the tolerability to Rituximab-CHOP regimen for Follicular lymphoma in Indian population. Methods: From January 2015 to January 2016, 32 patients with histopathologically proven denovo follicular lymphoma who were prescribed. Rituximab-CHOP regimen once every 21 days for 6-8 cycles were included in the study. Adverse events causing non compliance to chemotherapy schedule were studied. Causality assessment and grading of severity were done for the above adverse events. Results And Discussion: Age range of the study population was from 37-83 years.78.125% patients were males. Most of the patients belonged to Ann Arbor Stage III/IV. Adverse events causing noncompliance included Infusion related reaction in two patients which was certainly related to Rituximab with a toxicity grade 3 and febrile neutropenia (possibly caused by Doxorubicin with toxicity grade 3 ), leukopenia ( possibly caused by Doxorubicin or Vincristine with a toxicity grade 2 ) and pancytopenia ( possibly caused by Cyclophosphamide or Doxorubicin or Vincristine with a toxicity grade of 3 ) in one patient each. Conclusion: Adverse drug reactions caused by Rituximab and possibly by Doxorubicin, Vincristine or Cyclophosphamide were a reason for non compliance.
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Expression of P16ink4a In Cervical Intraepithelial Neoplasia And Invasive Squamous Cell Carcinoma Of Uterine Cervix
Carcinoma’s of cervix remains a major killer in women in the developing world including India. According to recent data provided by the atlas of cancer in India project by the ICMR, cervical cancer is the second most common cancer in women after breast cancer .In our country , cervical cancer shows an incidence of 25 per 1,00,000 women. The association of cervical cancer with high risk HPV infection has long been established. The protein p16 serves as a surrogate marker for the oncogenic activities of HPV in replication – competent cells of cervical epithelia and its over expression is well established in CIN and invasive squamous cell carcinoma by many studies. SUMMARY: P16 can be used as a marker for determining HPV infection in Cervical intraepithelial neoplasms (CIN) and Squamous cell carcinoma (SCC) of cervix where there is non-availabitlity of HPV-PCR method in a tertiary care Hospital
Expression of P16ink4a In Cervical Intraepithelial Neoplasia And Invasive Squamous Cell Carcinoma Of Uterine Cervix
Dr. PavuluriNeelima; Dr. Sucharita Kakaturu; Dr. Swetha Annaram; Dr.Kanigiri Lavanya
DOI : 10.5281/zenodo.7791645
Carcinoma’s of cervix remains a major killer in women in the developing world including India. According to recent data provided by the atlas of cancer in India project by the ICMR, cervical cancer is the second most common cancer in women after breast cancer .In our country , cervical cancer shows an incidence of 25 per 1,00,000 women. The association of cervical cancer with high risk HPV infection has long been established. The protein p16 serves as a surrogate marker for the oncogenic activities of HPV in replication – competent cells of cervical epithelia and its over expression is well established in CIN and invasive squamous cell carcinoma by many studies. SUMMARY: P16 can be used as a marker for determining HPV infection in Cervical intraepithelial neoplasms (CIN) and Squamous cell carcinoma (SCC) of cervix where there is non-availabitlity of HPV-PCR method in a tertiary care Hospital
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Warthintumor in a young non-smoker female diagnosed on Fine Needle Aspiration Cytology – A rare Case Report
Warthintumor is the second most common benign tumor occurring in the Salivary Glands following Pleomorphic Adenoma. It gets its name from the American Pathologist – ‘Aldred Scott Warthin,’ who described it in 1929. The tumor commonly affects males with incidence peaking around 6th-7th decade. Smoking is a well-established etiological agent of Warthin tumor. We hereby describe a case of a young non-smoker female who presented with a painless swelling in the infra-auricular region. Fine needle aspiration cytology of the swelling revealed oncocytes arranged in sheets, clusters and scattered singly. Cells had abundant amount of granular cytoplasm with eccentric nuclei. Background was composed of lymphocytes and granular debris. Diagnosis was rendered as - ‘Milan Category IV-A’ – NEOPLASM: BENIGN suggestive of Warthin tumor according to The Milan System for Reporting Salivary Gland Cytopathology. The patient underwent superficial parotidectomy and the specimen of the same was received in the histopathology department. Gross examination revealed that the tumor was ovoid and well circumscribed with cut section showing solid-cystic areas. Microscopy revealed that the tumor comprised of both epithelial and lymphocytic component with epithelium thrown into papillary folds. The epithelium was oncocytic with foci showing squamous metaplasia. The final diagnosis was confirmed as ‘Warthin tumor.’ A young non-smoker female presenting as Warthin tumor is a rare entity. The recent changing trends in mean age and decrease in gender predilection for men not only needs careful and comprehensive evaluation of the patients by the clinicians but also more research work regarding the pathogenesis needs to be carried out
Warthintumor in a young non-smoker female diagnosed on Fine Needle Aspiration Cytology – A rare Case Report
Dr Agam Hans; Dr Prem Singh; Dr Rupinder Kaur; Dr Irbinder Kour Bali
DOI : 10.5281/zenodo.7791675
Warthintumor is the second most common benign tumor occurring in the Salivary Glands following Pleomorphic Adenoma. It gets its name from the American Pathologist – ‘Aldred Scott Warthin,’ who described it in 1929. The tumor commonly affects males with incidence peaking around 6th-7th decade. Smoking is a well-established etiological agent of Warthin tumor. We hereby describe a case of a young non-smoker female who presented with a painless swelling in the infra-auricular region. Fine needle aspiration cytology of the swelling revealed oncocytes arranged in sheets, clusters and scattered singly. Cells had abundant amount of granular cytoplasm with eccentric nuclei. Background was composed of lymphocytes and granular debris. Diagnosis was rendered as - ‘Milan Category IV-A’ – NEOPLASM: BENIGN suggestive of Warthin tumor according to The Milan System for Reporting Salivary Gland Cytopathology. The patient underwent superficial parotidectomy and the specimen of the same was received in the histopathology department. Gross examination revealed that the tumor was ovoid and well circumscribed with cut section showing solid-cystic areas. Microscopy revealed that the tumor comprised of both epithelial and lymphocytic component with epithelium thrown into papillary folds. The epithelium was oncocytic with foci showing squamous metaplasia. The final diagnosis was confirmed as ‘Warthin tumor.’ A young non-smoker female presenting as Warthin tumor is a rare entity. The recent changing trends in mean age and decrease in gender predilection for men not only needs careful and comprehensive evaluation of the patients by the clinicians but also more research work regarding the pathogenesis needs to be carried out
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Evaluation of Awareness of Radiation Protection Among Medical Professionals in Faridpur, Bangladesh
Background: Several challenges with radiation protection and safety culture in radiology departments needs to be addressed as few studies done in this aspect in our country. Especially with regard to the awareness about radiation protection, hazards, dosimetry usage and measurement. Aim of the study: The aim of this study was to evaluate the awareness of radiation protection issues and the knowledge of dose levels of imaging procedures among medical staff in Department of Radiology and imaging, Bangabandhu Sheikh Mujib Medical College (BSMMC), Faridpur, Bangladesh. Methods: It was a cross-sectional survey among the medical professionals who work in Department of Radiology and imaging, Bangabandhu Sheikh Mujib Medical College (BSMMC), Faridpur, Bangladesh was conducted from June 2021 to July 2022. Result: A total of 113 medical staff (including 27 physician, 28 nurse, 31 medical technician and 27 resident physician) were provided a questionnaire consisting of 22 multiple-choice questions divided into three parts (i.e., demographic data, awareness about radiation protection issues, and knowledge about radiation dose levels of common radiological examinations). Results showed that, physicians and medical technicians revealed the highest level of knowledge regarding radiation protection principles and dose levels. Medical staff working in radiology departments claimed to have the best knowledge of radiation protection issues more frequently compared to participants in other departments. Conclusion: The level of knowledge among the individuals who participate in the operation of ionizing radiation equipment throughout the country is low. The benefit of training in the use of the C-arm image intensifier is highlighted by the revelation that the individuals who had formal training in the use of these machines performed better than those individuals without training. Annual recertification courses should be implemented such that individuals are kept abreast with current changes and reminded of commonly neglected safety practices
Evaluation of Awareness of Radiation Protection Among Medical Professionals in Faridpur, Bangladesh
Dr. Mst. Maksuda Khatun; Dr. Mohammad Shahin Akter; Dr.Salma Shahnawaz Parvin; Dr. Md. Towrit Reza
DOI : 10.5281/zenodo.7791690
Background: Several challenges with radiation protection and safety culture in radiology departments needs to be addressed as few studies done in this aspect in our country. Especially with regard to the awareness about radiation protection, hazards, dosimetry usage and measurement. Aim of the study: The aim of this study was to evaluate the awareness of radiation protection issues and the knowledge of dose levels of imaging procedures among medical staff in Department of Radiology and imaging, Bangabandhu Sheikh Mujib Medical College (BSMMC), Faridpur, Bangladesh. Methods: It was a cross-sectional survey among the medical professionals who work in Department of Radiology and imaging, Bangabandhu Sheikh Mujib Medical College (BSMMC), Faridpur, Bangladesh was conducted from June 2021 to July 2022. Result: A total of 113 medical staff (including 27 physician, 28 nurse, 31 medical technician and 27 resident physician) were provided a questionnaire consisting of 22 multiple-choice questions divided into three parts (i.e., demographic data, awareness about radiation protection issues, and knowledge about radiation dose levels of common radiological examinations). Results showed that, physicians and medical technicians revealed the highest level of knowledge regarding radiation protection principles and dose levels. Medical staff working in radiology departments claimed to have the best knowledge of radiation protection issues more frequently compared to participants in other departments. Conclusion: The level of knowledge among the individuals who participate in the operation of ionizing radiation equipment throughout the country is low. The benefit of training in the use of the C-arm image intensifier is highlighted by the revelation that the individuals who had formal training in the use of these machines performed better than those individuals without training. Annual recertification courses should be implemented such that individuals are kept abreast with current changes and reminded of commonly neglected safety practices
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A Study On HbA1c And Serum Uric Acid Level In Diagnosed Patients Of Diabetes Mellitus Type 2
The association between serum uric acid levels and glycemic control in diabetic patients was not fully clarified. This study aimed to investigate the correlation between uric acid levels and glycemic control in patients with type II diabetes mellitus. A total of 140 patients were recruited and their uric acid levels and glycated hemoglobin (HbA1c) levels were measured. The results showed a significant positive correlation between uric acid levels and HbA1c levels, indicating that higher levels of uric acid were associated with poorer glycemic control in patients with type II diabetes. Moreover, patients with higher uric acid levels were found to have a higher risk of developing diabetic complications. These findings suggest that monitoring uric acid levels may be a useful marker for assessing glycemic control and predicting diabetic complications in type II diabetic patients.
A Study On HbA1c And Serum Uric Acid Level In Diagnosed Patients Of Diabetes Mellitus Type 2
Dr. (Mrs.) Gulab Kanwar; Dr. Ashima; Dr Mohammad Anis Pathan; Dr. Mukesh Vijayvergia
DOI : 10.5281/zenodo.7799136
The association between serum uric acid levels and glycemic control in diabetic patients was not fully clarified. This study aimed to investigate the correlation between uric acid levels and glycemic control in patients with type II diabetes mellitus. A total of 140 patients were recruited and their uric acid levels and glycated hemoglobin (HbA1c) levels were measured. The results showed a significant positive correlation between uric acid levels and HbA1c levels, indicating that higher levels of uric acid were associated with poorer glycemic control in patients with type II diabetes. Moreover, patients with higher uric acid levels were found to have a higher risk of developing diabetic complications. These findings suggest that monitoring uric acid levels may be a useful marker for assessing glycemic control and predicting diabetic complications in type II diabetic patients.
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Association between high sensitivity C-Reactive protein and glycatedhemoglobin in patients with Type 2 Diabetes Mellitus
Background: Hyperglycemia is considered an inflammatory condition. Among several markers of inflammation, hs-CRP (high sensitive C-reactive protein) takes a front seat in people with diabetes. So we conducted this study to find the association between hs-CRP and HbA1c(glycatedhemoglobin) levels in type 2 diabetics. Methods: This is a retrospective study of 70 (Males=42, Females=28) type 2 diabetic patients in NIMS (Nizam’s Institute of medical sciences) hospital, Hyderabad, India. We divided the patients into two groups based on their HbA1c levels (HbA1c <53 mmol/mol [7%]- well controlled [group1] and >53 mmol/mol [7%] – poorly controlled [group2] and compared hs-CRP levels between the two groups. Mann Whitney U testand Spearman correlation were performed. p-value<0.05 was considered significant. Results: Median(Range) for hs-CRP in group1 is 1.5mg/L( 0.1-7.6) and for group 2 poorly controlled group is 6.2mg/L(1.3-118).We found a statistically significant difference in hs-CRP between the two groups (p=0.0008). We also found a positive correlation between hs-CRP and HbA1c. Conclusion: In this study, hs-CRP levels positively correlated with HbA1C levels in type 2 diabetic patients.
Association between high sensitivity C-Reactive protein and glycatedhemoglobin in patients with Type 2 Diabetes Mellitus
Lakshmi Deepika Yarlagadda; Rohit Kumar Bonthapally
DOI : 10.5281/zenodo.7792305
Background: Hyperglycemia is considered an inflammatory condition. Among several markers of inflammation, hs-CRP (high sensitive C-reactive protein) takes a front seat in people with diabetes. So we conducted this study to find the association between hs-CRP and HbA1c(glycatedhemoglobin) levels in type 2 diabetics. Methods: This is a retrospective study of 70 (Males=42, Females=28) type 2 diabetic patients in NIMS (Nizam’s Institute of medical sciences) hospital, Hyderabad, India. We divided the patients into two groups based on their HbA1c levels (HbA1c <53 mmol/mol [7%]- well controlled [group1] and >53 mmol/mol [7%] – poorly controlled [group2] and compared hs-CRP levels between the two groups. Mann Whitney U testand Spearman correlation were performed. p-value<0.05 was considered significant. Results: Median(Range) for hs-CRP in group1 is 1.5mg/L( 0.1-7.6) and for group 2 poorly controlled group is 6.2mg/L(1.3-118).We found a statistically significant difference in hs-CRP between the two groups (p=0.0008). We also found a positive correlation between hs-CRP and HbA1c. Conclusion: In this study, hs-CRP levels positively correlated with HbA1C levels in type 2 diabetic patients.
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An Epidemiological Study of Iron Deficiency Anaemia in Adolescents- Tertiary Care Centre Study
Background: Adolescents constitute over 21.4% of the population in India. This age group needs special attention because of the turmoil of adolescence, which they face the different stages of development, different circumstances, their different needs. Anaemia leads to poor cognitive function and motor development outcomes in adolescents. Iron deficiency anaemia is most common anaemia out of all nutritional anaemia1 Method and Material: It was a single centre cross-sectional, clinical observational study done in Department of pediatrics and Medicine, Assam Medical college and Hospital, Dibrugarh, Assam, during the period 1st june 2021 to 31thMay2022 (12 months). A sample of 200 patients were included in the study. A detailed clinical history and physical examinations were carried out. All cases are selected according to inclusion and exclusion criteria from outdoor and indoor after evaluation and informed consent was taken enrolled for study. Ethical committee permission was taken before conducting the study. Complete blood count, serum ferritin, and anthropometric measurement, food habits, socioeconomic status was taken. All data are put in predesigned proforma and analysed in Microsoft excel and Statistical Package for Social Sciences (SPSS for Windows, version 20.0, Chicago, SPSS Inc.). Results: Out of 200 adolescents prevalence of anaemia in adolescents is 51%.Prevalence of IDA in all anaemic adolescents is 34.3% and non IDA (other anaemia).IDA in male adolescents is-16.5% and that of female adolescents is 18.8%.Female adolescents of 14-18 years having higher rate of IDA. Consumption of junk food associated with high prevalence of IDA. Adolescents has low BMI developed -60% IDA, Overweight-14.2% IDA and Normal BMI-7% IDA. Upper lower and lower socioeconomic class having high prevalence of IDA.
An Epidemiological Study of Iron Deficiency Anaemia in Adolescents- Tertiary Care Centre Study
Dr. Abdus Salam Khan; Dr. Abhijit Dutta; Dr. Arpita Gogoi; Dr. Srimanta Madhab Baruah
DOI : 10.5281/zenodo.7792415
Background: Adolescents constitute over 21.4% of the population in India. This age group needs special attention because of the turmoil of adolescence, which they face the different stages of development, different circumstances, their different needs. Anaemia leads to poor cognitive function and motor development outcomes in adolescents. Iron deficiency anaemia is most common anaemia out of all nutritional anaemia1 Method and Material: It was a single centre cross-sectional, clinical observational study done in Department of pediatrics and Medicine, Assam Medical college and Hospital, Dibrugarh, Assam, during the period 1st june 2021 to 31thMay2022 (12 months). A sample of 200 patients were included in the study. A detailed clinical history and physical examinations were carried out. All cases are selected according to inclusion and exclusion criteria from outdoor and indoor after evaluation and informed consent was taken enrolled for study. Ethical committee permission was taken before conducting the study. Complete blood count, serum ferritin, and anthropometric measurement, food habits, socioeconomic status was taken. All data are put in predesigned proforma and analysed in Microsoft excel and Statistical Package for Social Sciences (SPSS for Windows, version 20.0, Chicago, SPSS Inc.). Results: Out of 200 adolescents prevalence of anaemia in adolescents is 51%.Prevalence of IDA in all anaemic adolescents is 34.3% and non IDA (other anaemia).IDA in male adolescents is-16.5% and that of female adolescents is 18.8%.Female adolescents of 14-18 years having higher rate of IDA. Consumption of junk food associated with high prevalence of IDA. Adolescents has low BMI developed -60% IDA, Overweight-14.2% IDA and Normal BMI-7% IDA. Upper lower and lower socioeconomic class having high prevalence of IDA.
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Role of Platelet Indices in Patients With Thrombocytopenia in Serologically Positive Dengue Patients
Background: Dengue fever (DENV) is one of the most rapidly spreading mosquito-borne viral diseases in the world. An estimated 50 million infections per year occur across approximately 100 countries. 30 fold increased incidence and geographic expansion with potential for further spread has been noted. Platelet count is a predictive prognostic factor of severe dengue. Besides platelet count, automation in haematology has provided newer parameters i.e., platelet indices like Plateletcrit (PCT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Large Cell Count (P-LCC) and Platelet Large Cell Ratio (P-LCR). This study aims to analyse the relationship of platelet indices in thrombocytopenic dengue patients thus helping clinicians by providing quick and reliable diagnostic and prognostic findings. Objective: To analyse the relationship of platelet indices in thrombocytopenic dengue patients. Materials and Methods: A cross sectional, observational study at a tertiary health care centre over a period of 2 years including 113 dengue cases presenting with thrombocytopenia. Thrombocytopenia was graded according to platelet count per ml as Grade 1 (75,000-1,50,000), Grade 2 (50,000-75,000), Grade 3 (25,000-50,000) and Grade 4 (<25,000). Results: In this study of 113 cases, maximum cases (46.9%) were seen in 21-30 year age group followed by 11-20 year age group (15.04%). Least number of cases belonged to 61-70 year age group (2.65%). 81 were males and 32 were females. Most common presenting symptom was headache (58.40%). The other symptoms were body ache (46.90%), arthralgia (27.43%) and maculopapular rash(32.74%). A total 50 cases (44.25%) shows grade 2 thrombocytopenia, 31 cases (27.43%) show grade 3 thrombocytopenia and 13 cases (11.50%) show grade 4 . The Mean values of the Platelet indices were as follows: Mean Platelet Volume (MPV)= 6.43 fL which was less than normal limit (8-11 fL); Platelet Distribution Width (PDW) = 19.67% which was greater than normal range of 11-18%; Plateletcrit (PCT) = 0.05which was near the lower limit of laboratory reference range; Platelet Large Cell Count (PLCC) = 35.68 x 103/ul which was lower than normal range 44-140 x 103/ul; Platelet Large Cell Ratio (PLCR) = 32.35 % which was within laboratory reference range of 18-50%. Conclusion: In conclusion, significant differences i.e., Low platelet count, MPV, PCT, PLCC and high PDW, observed in dengue fever with thrombocytopenia can be used as a diagnostic aid with considerable sensitivity for dengue fever in endemic areas.
Role of Platelet Indices in Patients With Thrombocytopenia in Serologically Positive Dengue Patients
Dr Snehal Eknath Karanjekar; Dr Shivani Battin; Dr Gauri Kelkar; Dr Shreya Pawaskar; Dr Surekha Kadadi; Dr Rashmi Vanjari
DOI : 10.5281/zenodo.7811880
Background: Dengue fever (DENV) is one of the most rapidly spreading mosquito-borne viral diseases in the world. An estimated 50 million infections per year occur across approximately 100 countries. 30 fold increased incidence and geographic expansion with potential for further spread has been noted. Platelet count is a predictive prognostic factor of severe dengue. Besides platelet count, automation in haematology has provided newer parameters i.e., platelet indices like Plateletcrit (PCT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Large Cell Count (P-LCC) and Platelet Large Cell Ratio (P-LCR). This study aims to analyse the relationship of platelet indices in thrombocytopenic dengue patients thus helping clinicians by providing quick and reliable diagnostic and prognostic findings. Objective: To analyse the relationship of platelet indices in thrombocytopenic dengue patients. Materials and Methods: A cross sectional, observational study at a tertiary health care centre over a period of 2 years including 113 dengue cases presenting with thrombocytopenia. Thrombocytopenia was graded according to platelet count per ml as Grade 1 (75,000-1,50,000), Grade 2 (50,000-75,000), Grade 3 (25,000-50,000) and Grade 4 (<25,000). Results: In this study of 113 cases, maximum cases (46.9%) were seen in 21-30 year age group followed by 11-20 year age group (15.04%). Least number of cases belonged to 61-70 year age group (2.65%). 81 were males and 32 were females. Most common presenting symptom was headache (58.40%). The other symptoms were body ache (46.90%), arthralgia (27.43%) and maculopapular rash(32.74%). A total 50 cases (44.25%) shows grade 2 thrombocytopenia, 31 cases (27.43%) show grade 3 thrombocytopenia and 13 cases (11.50%) show grade 4 . The Mean values of the Platelet indices were as follows: Mean Platelet Volume (MPV)= 6.43 fL which was less than normal limit (8-11 fL); Platelet Distribution Width (PDW) = 19.67% which was greater than normal range of 11-18%; Plateletcrit (PCT) = 0.05which was near the lower limit of laboratory reference range; Platelet Large Cell Count (PLCC) = 35.68 x 103/ul which was lower than normal range 44-140 x 103/ul; Platelet Large Cell Ratio (PLCR) = 32.35 % which was within laboratory reference range of 18-50%. Conclusion: In conclusion, significant differences i.e., Low platelet count, MPV, PCT, PLCC and high PDW, observed in dengue fever with thrombocytopenia can be used as a diagnostic aid with considerable sensitivity for dengue fever in endemic areas.
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A study of the histopathological spectrum of breast malignancy in a rural area
Background- Breast cancer is the most common cancer of women worldwide representing approximately16% of all female cancer[1]. It represents the second leading cause of cancer death among women after lung cancer[2], In some of the studies, it occurs secondary to cervical cancer[3,4], presently 75,000 new cases occur in Indian women every year[5]. Aetiology of breast cancer is multifactorial. The present study was done to know the histopathological spectrum of breast malignancies in Ashwini Rural Medical college and research centre, Kumbhari, Solapur. Aim and objectives- This study is aimed to analyse the histopathological spectrum of various breast malignancies and to study the distribution of breast malignancies in different age groups in rural area. Material and methods- After receiving approval of Institutional ethics committee the study was conducted in the histopathology section of our department using the specimens of Modified Radical Mastectomy sent for histopathological evaluations during the mentioned study period. Total 70 specimens were evaluated and the slides were stained with routine stains like H and E. Histo-morphological features as seen in the slides mentioned above were studied and following observations were made. Observations and results-Invasive duct cell carcinoma, 47 cases (66.9%) was the most common malignant breast lesion. Followed by Malignant phyllodestumour which were 10 cases (14.2%). There were 5 cases of Invasive lobular carcinoma and 4 cases of carcinoma in situ. Most number of cases in Invasive ductal carcinoma were of grade 2, followed by grade 1 invasive ductal carcinoma.20 cases of breast carcinoma were of Stage IIA. 14 cases were of stage IIB and stage IIIA. Conclusion-We observed that the females presented at a later stages in the rural areas. It is advisable that awareness should be created about breast health in rural areas and all cases of breast lesions should be carefully evaluated as early as possible to exclude the possibility of malignant breast lesions.
A study of the histopathological spectrum of breast malignancy in a rural area
Dr. Shreya Pawaskar; Dr. Sagar Mhetre; Dr. Aditya Dorkar; Dr. Snehal Karanjekar; Dr. Surekh Kadadi; Dr Monika Kashid
DOI : 10.5281/zenodo.7797133
Background- Breast cancer is the most common cancer of women worldwide representing approximately16% of all female cancer[1]. It represents the second leading cause of cancer death among women after lung cancer[2], In some of the studies, it occurs secondary to cervical cancer[3,4], presently 75,000 new cases occur in Indian women every year[5]. Aetiology of breast cancer is multifactorial. The present study was done to know the histopathological spectrum of breast malignancies in Ashwini Rural Medical college and research centre, Kumbhari, Solapur. Aim and objectives- This study is aimed to analyse the histopathological spectrum of various breast malignancies and to study the distribution of breast malignancies in different age groups in rural area. Material and methods- After receiving approval of Institutional ethics committee the study was conducted in the histopathology section of our department using the specimens of Modified Radical Mastectomy sent for histopathological evaluations during the mentioned study period. Total 70 specimens were evaluated and the slides were stained with routine stains like H and E. Histo-morphological features as seen in the slides mentioned above were studied and following observations were made. Observations and results-Invasive duct cell carcinoma, 47 cases (66.9%) was the most common malignant breast lesion. Followed by Malignant phyllodestumour which were 10 cases (14.2%). There were 5 cases of Invasive lobular carcinoma and 4 cases of carcinoma in situ. Most number of cases in Invasive ductal carcinoma were of grade 2, followed by grade 1 invasive ductal carcinoma.20 cases of breast carcinoma were of Stage IIA. 14 cases were of stage IIB and stage IIIA. Conclusion-We observed that the females presented at a later stages in the rural areas. It is advisable that awareness should be created about breast health in rural areas and all cases of breast lesions should be carefully evaluated as early as possible to exclude the possibility of malignant breast lesions.
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Prognostic Significance of Worst Pattern of Invasion in oral cavity Squamous Cell Carcinoma in relation to lymph node metastasis —A Retrospective Study from tertiary care centre
Introduction: Squamous cell carcinoma is the most common head and neck carcinoma, comprising 90% of cancers of the head and neck region1.Globally, oral cancer ranks sixth among all types of cancer. India has the largest number of oral cancer cases and one-third of the total burden of oral cancer globally. It is an important cause of morbidity and mortality worldwide. Oral cavity Squamous Cell Carcinoma(OSCC) commonly results from potentially malignant lesions or normal epithelium linings. Oral SCC spread typically occurs via lymphatic system. Conventional OSCC is aggressive, with a propensity for local invasion & early lymph node metastasis. Lymph node involvement is important prognostic factor in OSCC. So it’s important to access most influencing histological parameter in association with lymph node metastasis. This study was conducted to evaluate the role of histological parameters including Worst pattern of invasion (WPOI) and Depth of invasion (DOI) to determine the risk of LN metastasis in cases of OSCC. Objective: To evaluate the role of worst pattern of invasion to determine risk of lymph node metastasis in oral squamous cell carcinomas. Methodology: After receiving an approval of institutional ethical committee the study was conducted in histopathology section of pathology department. This was a retrospective study. All the cases of buccalmucosa and tongue SCC who underwent resection with cervical lymph node dissection in our institute from October 2021 to January 2023 were included. Cases where patient received preoperative radiotherapy or chemotherapy or where LN dissection was not performed or where slides were not available for review were excluded. Total 108 cases were evaluated and slides were stained by H & E and examined microscopically. Collected data is entered in Microsoft excel. Observation And Results: A total of 108 cases were studied, which included 94 males and 14 females (M:F = 6.7:1). 76 (70.37%) cases were of above 50 years of age and 32 (29.6%) cases were of below 50 years of age (average: 47.2 years). The most common site in our study was buccal mucosa (42 cases i.e. 38.8%). P value is 0.00(at 5% level of significance), so there is strong association between DOI of tumor with WPOI. p value is 0.0092(at 10% level of significance ), so there is strong association between lymph node metastasis and WPOI. In this study number of cases of moderately and poorly differentiated tumors is 48 out of which 24 (50%) cases were positive for LN metastasis and out of 60 well differentiated tumors 12 (20%) were positive for Lymph node metastasis with p value 0.02 at 5% level of significance. Other parameters such as tumor grade, tumor stage, lymphovascular emboli(LVE), perneural infiltration(PNI), Tumor thickness do not show any significant association with WPOI. Conclusion: The present study concluded that aggressive POI are significantly associated with number of lymph nodes metastasis and Depth of invasion and hence can be an independent histopathologic prognostic parameter in OSCC
Prognostic Significance of Worst Pattern of Invasion in oral cavity Squamous Cell Carcinoma in relation to lymph node metastasis —A Retrospective Study from tertiary care centre
Dr. Monika Kashid; Dr. Tahniyat Ara; Dr. Surekha Kadadi; Dr. Shreya Pawaskar; Dr. Saumitra Praveen Kulkarni
DOI : 10.5281/zenodo.7797216
Introduction: Squamous cell carcinoma is the most common head and neck carcinoma, comprising 90% of cancers of the head and neck region1.Globally, oral cancer ranks sixth among all types of cancer. India has the largest number of oral cancer cases and one-third of the total burden of oral cancer globally. It is an important cause of morbidity and mortality worldwide. Oral cavity Squamous Cell Carcinoma(OSCC) commonly results from potentially malignant lesions or normal epithelium linings. Oral SCC spread typically occurs via lymphatic system. Conventional OSCC is aggressive, with a propensity for local invasion & early lymph node metastasis. Lymph node involvement is important prognostic factor in OSCC. So it’s important to access most influencing histological parameter in association with lymph node metastasis. This study was conducted to evaluate the role of histological parameters including Worst pattern of invasion (WPOI) and Depth of invasion (DOI) to determine the risk of LN metastasis in cases of OSCC. Objective: To evaluate the role of worst pattern of invasion to determine risk of lymph node metastasis in oral squamous cell carcinomas. Methodology: After receiving an approval of institutional ethical committee the study was conducted in histopathology section of pathology department. This was a retrospective study. All the cases of buccalmucosa and tongue SCC who underwent resection with cervical lymph node dissection in our institute from October 2021 to January 2023 were included. Cases where patient received preoperative radiotherapy or chemotherapy or where LN dissection was not performed or where slides were not available for review were excluded. Total 108 cases were evaluated and slides were stained by H & E and examined microscopically. Collected data is entered in Microsoft excel. Observation And Results: A total of 108 cases were studied, which included 94 males and 14 females (M:F = 6.7:1). 76 (70.37%) cases were of above 50 years of age and 32 (29.6%) cases were of below 50 years of age (average: 47.2 years). The most common site in our study was buccal mucosa (42 cases i.e. 38.8%). P value is 0.00(at 5% level of significance), so there is strong association between DOI of tumor with WPOI. p value is 0.0092(at 10% level of significance ), so there is strong association between lymph node metastasis and WPOI. In this study number of cases of moderately and poorly differentiated tumors is 48 out of which 24 (50%) cases were positive for LN metastasis and out of 60 well differentiated tumors 12 (20%) were positive for Lymph node metastasis with p value 0.02 at 5% level of significance. Other parameters such as tumor grade, tumor stage, lymphovascular emboli(LVE), perneural infiltration(PNI), Tumor thickness do not show any significant association with WPOI. Conclusion: The present study concluded that aggressive POI are significantly associated with number of lymph nodes metastasis and Depth of invasion and hence can be an independent histopathologic prognostic parameter in OSCC
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Association Between Risk Factors and Still Birth in Pregnancy in Tertiary Care Center
Introduction: Stillbirth is a sensitive indicator of maternal care during the antepartum and intrapartum period. Globally around 2.6 million stillbirths occurred in 2019 out of which India accounting for 22%. Aims and Objectives: 1.To correlate the association between stillbirth in pregnancy and risk factor in tertiary care center.2.To assess the modifiable risk factors and propose preventable strategies. Methods: A Hospital based Retrospective clinical study carried out in Department of Obstetrics and Gynaecology of Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru for three years from October 2018-October 2021. Results: Young primigravida’s were more at risk of having a stillbirth. Obesity and smoking did not play a major in this study. Majority of the cases were pre-term 78.18%. Hypertensive disorder in pregnancy 36.36% was the leading cause of fetal death. Antepartum hemorrhageand anemia accounted for 14.54%, Rh negative pregnancy and endocrine dysfunction accounted for 9% of still birth. None of the cases had any screening strategies done, example: pre-eclampsia, diabetes, or thyroid studies. Conclusion: Highest prevalent risk factors associated with stillbirths are hypertension and prematurity. There is a need to provide and assure access to specialized quality antenatal care to pregnant women to control and modify where feasible the risk factors associated with stillbirths. Implementation of available screening strategies especially for hypertensive disorder in pregnancy and gestational diabetes mellitus will help in modifying fetal and neonatal outcomes.
Association Between Risk Factors and Still Birth in Pregnancy in Tertiary Care Center
Dr Bhavana R; Dr. Ashwini Chandankhede; Dr. Deepthi K
DOI : 10.5281/zenodo.7797301
Introduction: Stillbirth is a sensitive indicator of maternal care during the antepartum and intrapartum period. Globally around 2.6 million stillbirths occurred in 2019 out of which India accounting for 22%. Aims and Objectives: 1.To correlate the association between stillbirth in pregnancy and risk factor in tertiary care center.2.To assess the modifiable risk factors and propose preventable strategies. Methods: A Hospital based Retrospective clinical study carried out in Department of Obstetrics and Gynaecology of Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru for three years from October 2018-October 2021. Results: Young primigravida’s were more at risk of having a stillbirth. Obesity and smoking did not play a major in this study. Majority of the cases were pre-term 78.18%. Hypertensive disorder in pregnancy 36.36% was the leading cause of fetal death. Antepartum hemorrhageand anemia accounted for 14.54%, Rh negative pregnancy and endocrine dysfunction accounted for 9% of still birth. None of the cases had any screening strategies done, example: pre-eclampsia, diabetes, or thyroid studies. Conclusion: Highest prevalent risk factors associated with stillbirths are hypertension and prematurity. There is a need to provide and assure access to specialized quality antenatal care to pregnant women to control and modify where feasible the risk factors associated with stillbirths. Implementation of available screening strategies especially for hypertensive disorder in pregnancy and gestational diabetes mellitus will help in modifying fetal and neonatal outcomes.
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A Study of Bacterial Vagenosis As A Causative Factor In Preterm Labour
Introduction: Preterm birth is the leading cause of perinatal morbidity and mortality. Bacterial vaginosis is a condition characterized by an alteration of the vaginal ecology in which the normal flora, dominated by lactobacilli, is replaced by a mixed bacterial flora which includes Gardnerella vaginalis, Mobiluncus species, Mycoplasma hominis. The prevalence of bacterial vaginosis among pregnant women varies from 6-32% in various studies. The classic symptoms of bacterial vaginosis include vaginal discharge and fishy odour. Its Complications of Bacterial vaginosis include spontaneous abortion, preterm labour and delivery, premature rupture of membranes. Aim of study: To assess the role of bacterial vaginosis in Preterm labour. Materials and methods: Prospective case control study done in all Antenatal cases with gestational age 28 weeks to 37 weeks attending the OPD or admitted in the department of OBG at Sri Siddartha Medical College, Tumakuru for duration of 24 months. Results: The incidence of Bacterial vaginosis in preterm labour cases was 31.2%. The mean gestational age who has gone into preterm labour was 32-36 weeks. Amsel’s criteria and Nugent score on examination, was statistically significant on comparison of cases and controls (p=0.0006). Conclusion: Bacterial vaginosis in pregnancy is associated with adverse pregnancy outcomes including preterm labour, low birth weight and puerperal sepsis. Thus screening for bacterial vaginosis in all pregnant women complaining of vaginal discharge is essential
A Study of Bacterial Vagenosis As A Causative Factor In Preterm Labour
Dr Hema K.R; Dr Abhinaya.S; Dr Lalitha H.S
DOI : 10.5281/zenodo.7799048
Introduction: Preterm birth is the leading cause of perinatal morbidity and mortality. Bacterial vaginosis is a condition characterized by an alteration of the vaginal ecology in which the normal flora, dominated by lactobacilli, is replaced by a mixed bacterial flora which includes Gardnerella vaginalis, Mobiluncus species, Mycoplasma hominis. The prevalence of bacterial vaginosis among pregnant women varies from 6-32% in various studies. The classic symptoms of bacterial vaginosis include vaginal discharge and fishy odour. Its Complications of Bacterial vaginosis include spontaneous abortion, preterm labour and delivery, premature rupture of membranes. Aim of study: To assess the role of bacterial vaginosis in Preterm labour. Materials and methods: Prospective case control study done in all Antenatal cases with gestational age 28 weeks to 37 weeks attending the OPD or admitted in the department of OBG at Sri Siddartha Medical College, Tumakuru for duration of 24 months. Results: The incidence of Bacterial vaginosis in preterm labour cases was 31.2%. The mean gestational age who has gone into preterm labour was 32-36 weeks. Amsel’s criteria and Nugent score on examination, was statistically significant on comparison of cases and controls (p=0.0006). Conclusion: Bacterial vaginosis in pregnancy is associated with adverse pregnancy outcomes including preterm labour, low birth weight and puerperal sepsis. Thus screening for bacterial vaginosis in all pregnant women complaining of vaginal discharge is essential
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Comparative Study of Methylprednisolone, Platelet-Rich Plasma and Prolotherapy Injections In Management of Shoulder Rotator Cuff Tendinopathies
Introduction: RC tendinopathies account for 85% of cases of shoulder pain. Conservative management includes, NSAIDs, Physiotherapy and Local corticosteroid injections. Emerging treatments include local PRP and Prolotherapy injections with the latter one showing promising results. Prolotherapy injections most commonly used are Hyperosmolar dextrose injections (25%) which help in healing of tendinosis and partial tears by stimulating a local inflammatory cascade and release of growth factors and cytokines causing regeneration of connective tissues and tendons. Methodology: It was a Prospective Observational Randomized Comparative Double blinded Study with 3 groups having 20 patients each (COR, PRP, PRO). Each patient was assessed clinically and if needed radiologically investigated. All injections were given through a landmark based posterior approach under aseptic precautions and the patient followed up at 3,12 and 24 weeks and pain and functional outcome measured on the basis of VAS and ASES score. Results: Median(25th-75th percentile) of visual analogue scale (VAS) on 24th week in COR was 4(3.75-5) which was significantly higher as compared to PRP (3(3-3.25)) (p value=0.007) and PRO(1.5(1-2)) (p value<.0001). Median(25th-75th percentile) of visual analogue scale (VAS) on 24th week in PRP was significantly higher as compared to PRO. (p value=0.0004) Mean ± SD of American shoulder and elbow surgeons shoulder score(ASES) on 24th week in COR was 63.9 ± 12.01 which was significantly lower as compared to PRO (85.75 ± 4.33) (p value<.0001) and PRP (84.55 ± 4.75) (p value<.0001). No significant difference was seen in American shoulder and elbow surgeons shoulder score(ASES) on 24th week between PRP and PRO. (p value=0.631). Conclusion: Intra articular shoulder injection is a safe and effective management of shoulder pain. Corticosteroids provide great short term pain relief and improved ROM, but the effect is not well sustained. PRP when injected takes about 6 weeks to show any improvement but with long term follow up of up to 24 weeks there is good amount of pain relief and improved function, the only shortcoming being cumbersome procedure of PRP preparation with many variations in each preparation and reluctance of many patients for venepuncture. Dextrose prolotherapy being a readily available compound in Hospital setting, is a good candidate to provide long term relief in pain with gradual ROM improvement, with no adverse effects even in well controlled diabetics.
Comparative Study of Methylprednisolone, Platelet-Rich Plasma and Prolotherapy Injections In Management of Shoulder Rotator Cuff Tendinopathies
Dr. Ansh Pal Singh; Dr. O. P. Lakhwani; Dr Dhruv Suri
DOI : 10.5281/zenodo.7805071
Introduction: RC tendinopathies account for 85% of cases of shoulder pain. Conservative management includes, NSAIDs, Physiotherapy and Local corticosteroid injections. Emerging treatments include local PRP and Prolotherapy injections with the latter one showing promising results. Prolotherapy injections most commonly used are Hyperosmolar dextrose injections (25%) which help in healing of tendinosis and partial tears by stimulating a local inflammatory cascade and release of growth factors and cytokines causing regeneration of connective tissues and tendons. Methodology: It was a Prospective Observational Randomized Comparative Double blinded Study with 3 groups having 20 patients each (COR, PRP, PRO). Each patient was assessed clinically and if needed radiologically investigated. All injections were given through a landmark based posterior approach under aseptic precautions and the patient followed up at 3,12 and 24 weeks and pain and functional outcome measured on the basis of VAS and ASES score. Results: Median(25th-75th percentile) of visual analogue scale (VAS) on 24th week in COR was 4(3.75-5) which was significantly higher as compared to PRP (3(3-3.25)) (p value=0.007) and PRO(1.5(1-2)) (p value<.0001). Median(25th-75th percentile) of visual analogue scale (VAS) on 24th week in PRP was significantly higher as compared to PRO. (p value=0.0004) Mean ± SD of American shoulder and elbow surgeons shoulder score(ASES) on 24th week in COR was 63.9 ± 12.01 which was significantly lower as compared to PRO (85.75 ± 4.33) (p value<.0001) and PRP (84.55 ± 4.75) (p value<.0001). No significant difference was seen in American shoulder and elbow surgeons shoulder score(ASES) on 24th week between PRP and PRO. (p value=0.631). Conclusion: Intra articular shoulder injection is a safe and effective management of shoulder pain. Corticosteroids provide great short term pain relief and improved ROM, but the effect is not well sustained. PRP when injected takes about 6 weeks to show any improvement but with long term follow up of up to 24 weeks there is good amount of pain relief and improved function, the only shortcoming being cumbersome procedure of PRP preparation with many variations in each preparation and reluctance of many patients for venepuncture. Dextrose prolotherapy being a readily available compound in Hospital setting, is a good candidate to provide long term relief in pain with gradual ROM improvement, with no adverse effects even in well controlled diabetics.
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A Randomised Comparative Study of the Modulation of Genetic Expression of TIMP 1 and ERK in Patients with Post-Herpetic Neuralgia
Objectives: To evaluate the efficacy of fixed-dose combination pharmacotherapy of Pregabalin plus Nortryptyline and compare it with Pregabalin monotherapy in patient of post-herpetic neuralgia (PHN) in modulating mRNA expression of TIMP 1 and ERK genes. Methods: A randomized, controlled study was conducted From November 2016 to April 2018. Forty patients were assessed for pain scores and the patients with NRS ≥5/10 were randomized into two groups (Group A and Group B; each group n=20). GROUP A received fixed-dose combination pharmacotherapy of Pregabalin plus Nortriptyline and Group B received Pregabalin monotherapy for 12 weeks. RT PCR was used for assessing the gene expressions of ERK and TIMP1. The primary outcome measures were changes in ERK and TIMP1expression and secondary outcome measures were change in NRS pain. Results: The baseline NRS pain score in group A was 7.45 while in group B was 6.8 (p=0.055). During the followup of 12 weeks, group A showed a significantly higher reduction in the pain score (0.8 vs 2.9, p<0.001) Compared to group B, the mRNA expression level of ERK in Group A gene was more down-regulated at 12th week (p<0.001) and for TIMP1, it was more up-regulated (0.5 fold vs 0.4 fold, p=0.046). Conclusion: The drug combination of Pregabalin plus Nortriptyline holds significant superiority over Pregabalin alone in modulating the genetic expression of TIMP1 in patients with PHN while for ERK, pregabalin alone holds importance.
A Randomised Comparative Study of the Modulation of Genetic Expression of TIMP 1 and ERK in Patients with Post-Herpetic Neuralgia
Swati Das; Ashok Kumar Saxena; Geetanjali T Chilkoti; Sargam Goel; Basu Dev Banerjee
DOI : 10.5281/zenodo.7809980
Objectives: To evaluate the efficacy of fixed-dose combination pharmacotherapy of Pregabalin plus Nortryptyline and compare it with Pregabalin monotherapy in patient of post-herpetic neuralgia (PHN) in modulating mRNA expression of TIMP 1 and ERK genes. Methods: A randomized, controlled study was conducted From November 2016 to April 2018. Forty patients were assessed for pain scores and the patients with NRS ≥5/10 were randomized into two groups (Group A and Group B; each group n=20). GROUP A received fixed-dose combination pharmacotherapy of Pregabalin plus Nortriptyline and Group B received Pregabalin monotherapy for 12 weeks. RT PCR was used for assessing the gene expressions of ERK and TIMP1. The primary outcome measures were changes in ERK and TIMP1expression and secondary outcome measures were change in NRS pain. Results: The baseline NRS pain score in group A was 7.45 while in group B was 6.8 (p=0.055). During the followup of 12 weeks, group A showed a significantly higher reduction in the pain score (0.8 vs 2.9, p<0.001) Compared to group B, the mRNA expression level of ERK in Group A gene was more down-regulated at 12th week (p<0.001) and for TIMP1, it was more up-regulated (0.5 fold vs 0.4 fold, p=0.046). Conclusion: The drug combination of Pregabalin plus Nortriptyline holds significant superiority over Pregabalin alone in modulating the genetic expression of TIMP1 in patients with PHN while for ERK, pregabalin alone holds importance.
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A Case Control Study of Insulin Resistance in Young Patients of Age Group 14-25 Years with Acne Vulgaris Attending Tertiary Care Center
Background: The pathogenesis of acne vulgaris(AV) is multifactorial. Insulin resistance has been implicated in the pathogenesis of AV in few recent studies. Strong evidence of the association of insulin resistance with AV patients is lacking in the Indian population. This study was done to evaluate insulin resistance in young patients with AV. Objectives: To assess the prevalence of insulin resistance in patients aged 14-25 years with AV and to compare it between AV patients and controls. Methodology: The study group was recruited from patients attending the Dermatology department at a General Hospital for a period of 18 months to study the insulin resistance using the HOMA-IR index in the age group 14-25 years with and without AV. In this prospective case-control study, 50 cases of acne vulgaris with 50 healthy age and sex-matched controls were included. Patients were counselled and informed consent was taken. In each case, detailed history, local and systemic examination was done. Acne grading for each patient was done based on the Global Acne Grading System (GAGS). Samples for fasting blood sugar and fasting serum insulin levels were taken. HOMA-IR index > 2 was arbitrarily taken as insulin resistance. Results: Mean HOMA-IR Index in cases was 2.21 ±0.88 whereas in controls it was 1.50 ±0.58 (p<0.05). The prevalence of insulin resistance was significantly higher in cases (56%) compared with controls (12%) (P = <0.001). The prevalence of insulin resistance did not differ significantly among the acne severity groups. Conclusions: Insulin resistance has to be considered as a major determinant in the pathogenesis of AV. The insulin resistance may be a phase of prediabetes and may develop diabetes mellitus in the future. The patients of AV should be followed up to find out about the development of the metabolic syndrome. Further large scale studies are required in this aspect to evaluate insulin resistance in AV patients. Interventional studies are required regarding target therapies directed towards insulin resistance in the treatment of AV.
A Case Control Study of Insulin Resistance in Young Patients of Age Group 14-25 Years with Acne Vulgaris Attending Tertiary Care Center
Girishkumar M Chalawadi; Logeshwari J; Shankar Kunti; A. Venkatakrishna
DOI : 10.5281/zenodo.7812615
Background: The pathogenesis of acne vulgaris(AV) is multifactorial. Insulin resistance has been implicated in the pathogenesis of AV in few recent studies. Strong evidence of the association of insulin resistance with AV patients is lacking in the Indian population. This study was done to evaluate insulin resistance in young patients with AV. Objectives: To assess the prevalence of insulin resistance in patients aged 14-25 years with AV and to compare it between AV patients and controls. Methodology: The study group was recruited from patients attending the Dermatology department at a General Hospital for a period of 18 months to study the insulin resistance using the HOMA-IR index in the age group 14-25 years with and without AV. In this prospective case-control study, 50 cases of acne vulgaris with 50 healthy age and sex-matched controls were included. Patients were counselled and informed consent was taken. In each case, detailed history, local and systemic examination was done. Acne grading for each patient was done based on the Global Acne Grading System (GAGS). Samples for fasting blood sugar and fasting serum insulin levels were taken. HOMA-IR index > 2 was arbitrarily taken as insulin resistance. Results: Mean HOMA-IR Index in cases was 2.21 ±0.88 whereas in controls it was 1.50 ±0.58 (p<0.05). The prevalence of insulin resistance was significantly higher in cases (56%) compared with controls (12%) (P = <0.001). The prevalence of insulin resistance did not differ significantly among the acne severity groups. Conclusions: Insulin resistance has to be considered as a major determinant in the pathogenesis of AV. The insulin resistance may be a phase of prediabetes and may develop diabetes mellitus in the future. The patients of AV should be followed up to find out about the development of the metabolic syndrome. Further large scale studies are required in this aspect to evaluate insulin resistance in AV patients. Interventional studies are required regarding target therapies directed towards insulin resistance in the treatment of AV.
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Assessment of the Effectiveness of e-Learning Versus Conventional Teaching as a teaching Method During the COVID-19 Pandemic Among Medical Students and Faculty in Teaching Institutions
Introduction: E-learning is internet-aided learning which stands for electronic learning. E-learning uses a strategy that is pedagogical in concept. E-learning followed during the COVID-19 pandemic is considered a learning modality for emergency management. The usage of e-learning has increased considerably during COVID-19 but its actual effectiveness and satisfaction remain the big question from both the students as well as the faculty aspects. Hence there is a requirement for research involving faculty and students in e-learning experiences. Aims and Objectives: The aim of the study was to evaluate the effectiveness and satisfaction of e-learning among medical students and faculty. Materials and Methods: The online cross-sectional survey was conducted on medical students and faculty. A total of 302 students and 51 faculty responded to the questionnaire. The study was conducted after 2 months of online classes. Both sets of questionnaires based on a 5-point Likert scale were given to both the students and faculty respectively. All the students and faculty participated in the survey voluntarily. Results: The online survey for students agreed that e-learning was effective in 6 parameters and it was the same and less effective as classroom traditional teaching in the remaining parameters. But the faculty online survey revealed they agreed that e-learning was effective in almost 12 parameters and felt as same and less effective as traditional teaching in other parameters. Conclusion: We could come to an interpretation that though e-learning is equally effective in some parameters still it is less effective in other parameters too. Hence it is not at all taken as superior to traditional face-to-face teaching. Our research led us to draw the conclusion that while e-learning can support the current educational process, it cannot take the place of the current educational system as a whole.
Assessment of the Effectiveness of e-Learning Versus Conventional Teaching as a teaching Method During the COVID-19 Pandemic Among Medical Students and Faculty in Teaching Institutions
Dr. Santhanalakshmi P; Dr.Manimekalai K; Dr. Kartik J Salwe
DOI : 10.5281/zenodo.7812672
Introduction: E-learning is internet-aided learning which stands for electronic learning. E-learning uses a strategy that is pedagogical in concept. E-learning followed during the COVID-19 pandemic is considered a learning modality for emergency management. The usage of e-learning has increased considerably during COVID-19 but its actual effectiveness and satisfaction remain the big question from both the students as well as the faculty aspects. Hence there is a requirement for research involving faculty and students in e-learning experiences. Aims and Objectives: The aim of the study was to evaluate the effectiveness and satisfaction of e-learning among medical students and faculty. Materials and Methods: The online cross-sectional survey was conducted on medical students and faculty. A total of 302 students and 51 faculty responded to the questionnaire. The study was conducted after 2 months of online classes. Both sets of questionnaires based on a 5-point Likert scale were given to both the students and faculty respectively. All the students and faculty participated in the survey voluntarily. Results: The online survey for students agreed that e-learning was effective in 6 parameters and it was the same and less effective as classroom traditional teaching in the remaining parameters. But the faculty online survey revealed they agreed that e-learning was effective in almost 12 parameters and felt as same and less effective as traditional teaching in other parameters. Conclusion: We could come to an interpretation that though e-learning is equally effective in some parameters still it is less effective in other parameters too. Hence it is not at all taken as superior to traditional face-to-face teaching. Our research led us to draw the conclusion that while e-learning can support the current educational process, it cannot take the place of the current educational system as a whole.
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Characterization and Antibiotic Susceptibility Testing Of Acinetobacter Species in a Tertiary Care Hospital with Special Reference to NDM and OXA Genes
Background-Acinetobacter has emerged as a nosocomial pathogen. It was sensitive to most antibiotics, but today it exhibits resistance to most first line antibiotics. Carbapenems are the drug of choice for treating this infection but now resistance to carbapenems is being reported worldwide. Antibiotic susceptibility pattern of Acinetobacter may vary geographically and between various units of the same hospital at various point of time. The variation in antibiogram necessitates a periodic surveillance. Hence this study was conducted to understand the difference in phenotypic and genotypic methods by detection of OXA and NDM genes for accurate identification of antibiotic resistance, thus enabling successful implementation of antibiotic policy. METHODS- 70 isolates of Acinetobacter were collected and speciated. Antibiotic susceptibility pattern of all the isolates was determined and the carbapenem resistant isolates were subjected to real-time PCR for identification of NDM and OXA genes. RESULTS- A baumannii was the most common (74.3%) species, followed by A. lwoffii (25.7%). A. lwoffii was 100% sensitive to carbapenems. 50 strains of A. baumannii were carbapenems resistant and remaining were susceptible. In Carbapenem resistant A baumannii OXA 23 and OXA 51 are the most common gene detected by realtime PCR, followed by OXA 48 and OXA 58, while NDM was detected in 100% strains. DISCUSSION AND CONCLUSION- Knowledge of NDM and OXA producing Acinetobacter is imperative in formulating Institutional antibiotic stewardship program and infection control practices to control the spread of carbapenem resistant strains of Acinetobacterbaumanii. This information is extremely valuable for pharmaceutical companies towards development of newer antibiotics.
Characterization and Antibiotic Susceptibility Testing Of Acinetobacter Species in a Tertiary Care Hospital with Special Reference to NDM and OXA Genes
Dr Nishat Khan; Dr Duhita Jadhav; Dr Jayanthi Shastri
DOI : 10.5281/zenodo.7823590
Background-Acinetobacter has emerged as a nosocomial pathogen. It was sensitive to most antibiotics, but today it exhibits resistance to most first line antibiotics. Carbapenems are the drug of choice for treating this infection but now resistance to carbapenems is being reported worldwide. Antibiotic susceptibility pattern of Acinetobacter may vary geographically and between various units of the same hospital at various point of time. The variation in antibiogram necessitates a periodic surveillance. Hence this study was conducted to understand the difference in phenotypic and genotypic methods by detection of OXA and NDM genes for accurate identification of antibiotic resistance, thus enabling successful implementation of antibiotic policy. METHODS- 70 isolates of Acinetobacter were collected and speciated. Antibiotic susceptibility pattern of all the isolates was determined and the carbapenem resistant isolates were subjected to real-time PCR for identification of NDM and OXA genes. RESULTS- A baumannii was the most common (74.3%) species, followed by A. lwoffii (25.7%). A. lwoffii was 100% sensitive to carbapenems. 50 strains of A. baumannii were carbapenems resistant and remaining were susceptible. In Carbapenem resistant A baumannii OXA 23 and OXA 51 are the most common gene detected by realtime PCR, followed by OXA 48 and OXA 58, while NDM was detected in 100% strains. DISCUSSION AND CONCLUSION- Knowledge of NDM and OXA producing Acinetobacter is imperative in formulating Institutional antibiotic stewardship program and infection control practices to control the spread of carbapenem resistant strains of Acinetobacterbaumanii. This information is extremely valuable for pharmaceutical companies towards development of newer antibiotics.
Post Traumatic Pseudo-Aneurysms From A Branch of Thyro-cervical Trunk and External Carotid Artery With Concomitant Arteriovenous Fistula-A Rare Entity and Diagnostic Challenge in Interventional Radiology
Rabia Ahmed Siddiqui; Ramsha Fatima; Rida Zainab; Muhammad Misbah Tahir; Muhammad Ali; Azzan Mujahid
DOI : 10.5281/zenodo.7826488
Pseudo-aneurysms from branches of thyro-cervical trunk and external carotid artery lie in deep tissues of the neck. Iatrogenic and post traumatic cases are the most common cause[1]. Pseudoaneurysm with concomitant arteriovenous fistula present a great challenge for Interventional Radiologists. The chances of other small co-existing pseudo-aneurysm is also possible in such cases and they maybe masked by the larger out pouching making the management even more complex and therefore the Interventional radiology team needs to be vigilant while dealing with such cases. We report a case of a 30 year old male with two pseudo-aneurysms arising from a branch of thyro-cervical trunk and external carotid artery with concomitant arteriovenous fistula following stab wound injury to the left side of neck.
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Pattern and Factors of Renal Disease Among Children Admitted in a Tertiary Level Hospital, Dhaka, Bangladesh
Introduction: Renal diseases in children can be congenital or acquired. In Bangladesh, pediatric nephrology care is available for last 2 decades, but there was no epidemiological study to see the pattern and factors of renal diseases in children of the country. So, this study was carried out to observe the pattern and factors of renal diseases in children of pediatric nephrology centers of Dhaka city. Objective: This study was conducted to find out the pattern and factors of renal diseases among children admitted in a tertiary level hospital (Dhaka Shishu Hospital), Dhaka, Bangladesh. Methods: A retrospective cross sectional study was conducted for a period of four months using data was collected from the Secondary data. Results: In an inpatient department among 41 patients, 22(52.50 %) were male and 19 (47.50%) were female. Most common renal disease, Nephrotic syndrome were 23 (55%), Chronic Kidney Disease 6 (15%), Glomerulonephritis 3 (7.5%) and Acute Kidney Injury 5 (12.5%). Other less common renal disorders include Obstructive Uropathy and Urinary Tract Infection were 2 (5%) respectively. Common symptom were edema (37.5%), oliguria or anuria (27.5%) and proteinuria (25%). Most common pattern of patients were Minimal Change Disease (MCD) 13 (32.5%), Focal Segmental Glomerulosclerosis (FSGS) 11 (27.5%) and Membranous Nephropathy 6 (15%) respectively and most common factors birth defect and hereditary disease 90%. Conclusion: The current pattern of renal diseases shows that the most common renal diseases are NS followed by CKD and UTI and most common pattern of IPD patients were MCD then FSGS and most common factors birth defect and hereditary disease. In the study, male patients are more common than female.
Pattern and Factors of Renal Disease Among Children Admitted in a Tertiary Level Hospital, Dhaka, Bangladesh
AKM Khairul Islam; Quamrun Nahar; Md. Jahangir Alam; Md. Abu Tayab; Mahbubur Rahman
DOI : 10.5281/zenodo.7827284
Introduction: Renal diseases in children can be congenital or acquired. In Bangladesh, pediatric nephrology care is available for last 2 decades, but there was no epidemiological study to see the pattern and factors of renal diseases in children of the country. So, this study was carried out to observe the pattern and factors of renal diseases in children of pediatric nephrology centers of Dhaka city. Objective: This study was conducted to find out the pattern and factors of renal diseases among children admitted in a tertiary level hospital (Dhaka Shishu Hospital), Dhaka, Bangladesh. Methods: A retrospective cross sectional study was conducted for a period of four months using data was collected from the Secondary data. Results: In an inpatient department among 41 patients, 22(52.50 %) were male and 19 (47.50%) were female. Most common renal disease, Nephrotic syndrome were 23 (55%), Chronic Kidney Disease 6 (15%), Glomerulonephritis 3 (7.5%) and Acute Kidney Injury 5 (12.5%). Other less common renal disorders include Obstructive Uropathy and Urinary Tract Infection were 2 (5%) respectively. Common symptom were edema (37.5%), oliguria or anuria (27.5%) and proteinuria (25%). Most common pattern of patients were Minimal Change Disease (MCD) 13 (32.5%), Focal Segmental Glomerulosclerosis (FSGS) 11 (27.5%) and Membranous Nephropathy 6 (15%) respectively and most common factors birth defect and hereditary disease 90%. Conclusion: The current pattern of renal diseases shows that the most common renal diseases are NS followed by CKD and UTI and most common pattern of IPD patients were MCD then FSGS and most common factors birth defect and hereditary disease. In the study, male patients are more common than female.
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“Hoodie Unearthed”: Anatomy of Extensor Expansion of Thumb, its Variations and Surgical Advantages
Introduction: Review of literature or current anatomy textbooks provides scanty description of the extensor apparatus of thumb. Existing studies on extensor tendons of hand revolve around their application in surgical repairs of ruptured tendons or in reconstructive surgeries involving re-routing of flexor tendons to extensor tendons in radial n palsy. The knowledge about the prevalence of variations in the structure and formation of the extensor expansion of thumb would help surgeons in planning new reconstructive techniques for better functional output. Aim: To study the variations in the formation and structure of dorsal digital expansion of thumb in cadavers and statistically analyze the prevalence of its variations in males and females. Method: By cadaveric dissection of 11 right and 11 left thumbs, the formative tendons of extensor expansion of thumb (EET) were observed; namely extensor pollicis longus(EPL) and extensor pollicis brevis(EPB), and presence of contributing tendons of extensor expansion of thumb (EET) namely Abductor pollicis brevis(ABP), adductor pollicis(ADP)and palmar interossei (PI) were noted. Results: In all the 22 thumbs a triangular shaped extensor expansion existed over the dorsal aspect of base of proximal phalanx.9 out of 22 thumbs had tendinous extension of EPB extending with EPL upto the distal phalanx. ABP, ADP and PI were contributing to EET in 2, 1, and 9 thumbs respectively. Conclusion: Extensor expansion of thumb, hitherto not mentioned in standard textbooks of Anatomy was dissected and its formation, design and variations displayed.
“Hoodie Unearthed”: Anatomy of Extensor Expansion of Thumb, its Variations and Surgical Advantages
Geetha SG; Mrudula Chandrupatla; Omkar Patnaik; Aadil Sinha; Jhanvi Chauhan SS
DOI : 10.5281/zenodo.7838556
Introduction: Review of literature or current anatomy textbooks provides scanty description of the extensor apparatus of thumb. Existing studies on extensor tendons of hand revolve around their application in surgical repairs of ruptured tendons or in reconstructive surgeries involving re-routing of flexor tendons to extensor tendons in radial n palsy. The knowledge about the prevalence of variations in the structure and formation of the extensor expansion of thumb would help surgeons in planning new reconstructive techniques for better functional output. Aim: To study the variations in the formation and structure of dorsal digital expansion of thumb in cadavers and statistically analyze the prevalence of its variations in males and females. Method: By cadaveric dissection of 11 right and 11 left thumbs, the formative tendons of extensor expansion of thumb (EET) were observed; namely extensor pollicis longus(EPL) and extensor pollicis brevis(EPB), and presence of contributing tendons of extensor expansion of thumb (EET) namely Abductor pollicis brevis(ABP), adductor pollicis(ADP)and palmar interossei (PI) were noted. Results: In all the 22 thumbs a triangular shaped extensor expansion existed over the dorsal aspect of base of proximal phalanx.9 out of 22 thumbs had tendinous extension of EPB extending with EPL upto the distal phalanx. ABP, ADP and PI were contributing to EET in 2, 1, and 9 thumbs respectively. Conclusion: Extensor expansion of thumb, hitherto not mentioned in standard textbooks of Anatomy was dissected and its formation, design and variations displayed.
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A Record Based Analysis of Outcome of Organophosphorus Compound Poisonings in Tertiary Care Hospital Mandya
Background: This study aimed to investigate factors that may impact survival in patients exposed to organophosphorus compound, including route of exposure, presence of certain symptoms , duration of ICU stay and mechanical ventilation. Understanding these factors can help inform treatment decisions and improve patient outcomes. Methods: A retrospective study was conducted on patients who presented to our hospital between 2021 and 2022 with exposure to organophosphorus compound. Data on demographics, route of exposure, and symptoms were collected and analyzed. Survival rates were calculated and compared across different subgroups. Results: Of the 120 patients included in the study, the overall mortality rate was 9%. Males had a higher survival rate than females (92% vs. 85%). Patients who inhaled the compound had a higher survival rate (100%) than those who ingested it (96%). Patients with diarrhea had a 100% survival rate, while those with bronchial secretion had an 18% survival rate. Fasciculations were not found to be a significant predictor of mortality. Conclusion: Our study provides insight into the factors that may impact survival in patients exposed to organophosphorus compound. More research is needed to fully understand the complex interplay of factors that contribute to mortality in these cases.
A Record Based Analysis of Outcome of Organophosphorus Compound Poisonings in Tertiary Care Hospital Mandya
Dr. Ramakrishna S; Dr. Arundhati R Chitnis; Dr. Chethan Kumar K L; Dr. Vaishak. K .M
DOI : 10.5281/zenodo.7838651
Background: This study aimed to investigate factors that may impact survival in patients exposed to organophosphorus compound, including route of exposure, presence of certain symptoms , duration of ICU stay and mechanical ventilation. Understanding these factors can help inform treatment decisions and improve patient outcomes. Methods: A retrospective study was conducted on patients who presented to our hospital between 2021 and 2022 with exposure to organophosphorus compound. Data on demographics, route of exposure, and symptoms were collected and analyzed. Survival rates were calculated and compared across different subgroups. Results: Of the 120 patients included in the study, the overall mortality rate was 9%. Males had a higher survival rate than females (92% vs. 85%). Patients who inhaled the compound had a higher survival rate (100%) than those who ingested it (96%). Patients with diarrhea had a 100% survival rate, while those with bronchial secretion had an 18% survival rate. Fasciculations were not found to be a significant predictor of mortality. Conclusion: Our study provides insight into the factors that may impact survival in patients exposed to organophosphorus compound. More research is needed to fully understand the complex interplay of factors that contribute to mortality in these cases.
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Predisposing Factors for Progression of Hyperbilirubinemia from Low Risk to High Risk in Healthy Full Term Neonates
Introduction: The great burden of neonatal hyperbilirubinemia is exemplified by the fact that globally about 60% of the term and the 80% of preterm babies develop jaundice. Concerns regarding an apparent increase in kernicterus had put forward non invasive new approaches in its prevention and diagnosis in worldwide mainly focusing on body weight loss and feeding pattern in newborns. Objectives: To correlate post natal weight loss with serum bilirubin level during first 72 hours in term newborns and to determine the association of other factors. Method: This prospective observational study included 350 full term neonates who were assessed for clinical jaundice, body weight loss and feeding pattern for the first 72 hours of life. Daily TcB and TSB was done on Day 3. Results: Among the 350 term neonates they were categorized into risk zone based on TSB level in which 217 (62%) were in low, 127 (36%) were in intermediate and 7 (2%) were in high risk zone. The study revealed a significant (p <0.001) difference in mean body weight loss (%) values between these risk groups and can be used as a predictor for significant jaundice (area under roc curve 0.83).The feeding pattern, Kramer’s scale, TcB, urine and stool frequency were also significant (p <0.05) in these groups. Conclusion: Body weight loss percentage can predict neonatal hyperbilirubinemia in the initial 72 hours of life. Other factors were feeding pattern, urine and stool frequency.
Predisposing Factors for Progression of Hyperbilirubinemia from Low Risk to High Risk in Healthy Full Term Neonates
Dr. Athullya Muraleedas K; Dr. Sunita Koreti; Dr. Ajay Gaur
DOI : 10.5281/zenodo.7838665
Introduction: The great burden of neonatal hyperbilirubinemia is exemplified by the fact that globally about 60% of the term and the 80% of preterm babies develop jaundice. Concerns regarding an apparent increase in kernicterus had put forward non invasive new approaches in its prevention and diagnosis in worldwide mainly focusing on body weight loss and feeding pattern in newborns. Objectives: To correlate post natal weight loss with serum bilirubin level during first 72 hours in term newborns and to determine the association of other factors. Method: This prospective observational study included 350 full term neonates who were assessed for clinical jaundice, body weight loss and feeding pattern for the first 72 hours of life. Daily TcB and TSB was done on Day 3. Results: Among the 350 term neonates they were categorized into risk zone based on TSB level in which 217 (62%) were in low, 127 (36%) were in intermediate and 7 (2%) were in high risk zone. The study revealed a significant (p <0.001) difference in mean body weight loss (%) values between these risk groups and can be used as a predictor for significant jaundice (area under roc curve 0.83).The feeding pattern, Kramer’s scale, TcB, urine and stool frequency were also significant (p <0.05) in these groups. Conclusion: Body weight loss percentage can predict neonatal hyperbilirubinemia in the initial 72 hours of life. Other factors were feeding pattern, urine and stool frequency.
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A Study of Serum Aminotransferase Levels in Dengue Fever and Its Correlation with Clinical Profile
BACKGROUND: Dengue fever is one of the world’s most common viral hemorrhagic fever diseases, the most geographically widespread of the arthropod-borne virus illnesses. Caused by arbovirus of Flavivirus genus with 4 serotypes. It is transmitted by Aedesaegypti, Aedesalbopictus. 4 spectra of illness are seen; an asymptomatic phase, acute febrile illness, classic Dengue fever (DF), Dengue Hemorrhagic Fever (DHF) which includes Dengue Shock Syndrome (DSS). Dengue viral infection has been recognized as one of the world’s biggest emerging epidemics. Throughout the tropics this infection has an annual incidence of 100 million cases of DF with another 2, 50,000 cases of DHF and mortality rate of 24000-25000 per year. The involvement of liver in dengue fever has not been uncommon as reported in literature since 1970. Liver and nervous system involvement simultaneously predicts poor outcome in dengue fever. Atypical manifestations include liver involvement with elevation of enzymes, central nervous involvement (encephalopathy) and cardiac alterations (myocarditis). Liver involvement in dengue fever is manifested by the elevation of transaminases representing reactive hepatitis, due to direct attack of virus itself or the use of hepatotoxic drugs. MATERIALS AND METHODS: The study was performed on patients admitted for dengue fever in Medical College, Baroda. The total duration of the study was 10 months. INCLUSION CRITERIA: Dengue IgM positive EXCLUSION CRITERIA: Age <18 years, Chronic liver disease, Viral hepatitis (Hepatitis. A, Hepatitis. B, Hepatitis. C), Malaria, Leptospirosis, Typhoid, History of alcohol abuse. RESULTS: 85 patients reactive for dengue virus specific IgM/NS1 were studied. As per WHO classification, 39(45.88%) patients were classified as dengue without warning signs,32(37.65) patients as dengue with warning signs and 14(16.47) as severe dengue. Mean age of dengue infection was 23yrs with standard deviation of 8years with female predominance. Hepatic dysfunction is very common in all forms of dengue infection with AST rising significantly more than ALT. xi Serum aminotransferase levels appear to have a direct proportional correlation with grading of dengue infection. CONCLUSION: Serum aminotransferase levels are significantly raised in all forms of dengue infection, and it directly correlates with severity of infection. Serum aspartate aminotransferase was significantly raised compared to alanine aminotransferase levels in all forms of dengue infection. The degree of affection of serum albumin and prothrombin time which are absolute indicators of liver cell function correlated with severity of dengue infection.
A Study of Serum Aminotransferase Levels in Dengue Fever and Its Correlation with Clinical Profile
Dr Jeet Shah; Dr Bishal Sharma; Dr Mahendra C Parmar; Dr Priya Kuwar
DOI : 10.5281/zenodo.7838740
BACKGROUND: Dengue fever is one of the world’s most common viral hemorrhagic fever diseases, the most geographically widespread of the arthropod-borne virus illnesses. Caused by arbovirus of Flavivirus genus with 4 serotypes. It is transmitted by Aedesaegypti, Aedesalbopictus. 4 spectra of illness are seen; an asymptomatic phase, acute febrile illness, classic Dengue fever (DF), Dengue Hemorrhagic Fever (DHF) which includes Dengue Shock Syndrome (DSS). Dengue viral infection has been recognized as one of the world’s biggest emerging epidemics. Throughout the tropics this infection has an annual incidence of 100 million cases of DF with another 2, 50,000 cases of DHF and mortality rate of 24000-25000 per year. The involvement of liver in dengue fever has not been uncommon as reported in literature since 1970. Liver and nervous system involvement simultaneously predicts poor outcome in dengue fever. Atypical manifestations include liver involvement with elevation of enzymes, central nervous involvement (encephalopathy) and cardiac alterations (myocarditis). Liver involvement in dengue fever is manifested by the elevation of transaminases representing reactive hepatitis, due to direct attack of virus itself or the use of hepatotoxic drugs. MATERIALS AND METHODS: The study was performed on patients admitted for dengue fever in Medical College, Baroda. The total duration of the study was 10 months. INCLUSION CRITERIA: Dengue IgM positive EXCLUSION CRITERIA: Age <18 years, Chronic liver disease, Viral hepatitis (Hepatitis. A, Hepatitis. B, Hepatitis. C), Malaria, Leptospirosis, Typhoid, History of alcohol abuse. RESULTS: 85 patients reactive for dengue virus specific IgM/NS1 were studied. As per WHO classification, 39(45.88%) patients were classified as dengue without warning signs,32(37.65) patients as dengue with warning signs and 14(16.47) as severe dengue. Mean age of dengue infection was 23yrs with standard deviation of 8years with female predominance. Hepatic dysfunction is very common in all forms of dengue infection with AST rising significantly more than ALT. xi Serum aminotransferase levels appear to have a direct proportional correlation with grading of dengue infection. CONCLUSION: Serum aminotransferase levels are significantly raised in all forms of dengue infection, and it directly correlates with severity of infection. Serum aspartate aminotransferase was significantly raised compared to alanine aminotransferase levels in all forms of dengue infection. The degree of affection of serum albumin and prothrombin time which are absolute indicators of liver cell function correlated with severity of dengue infection.
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Antibiotic Susceptibility Pattern of Nitrofurantoin VS Fosfomycin in Urinary Tract Infections Caused by Escherichia Coli in a Tertiary Care Hospital, Visakhapatnam, Andhra Pradesh
Aims and Objectives: Aim of the study is to estimate prevalence of Escherichia coli among clinically suspected Urinary Tract Infection cases and comparison of antibiogram between Nitrofurantoin VS Fosfomycin as the first line agent for treatment of Urinary Tract Infection caused by Escherichia coli. Materials and Methods: The study was conducted on urine samples over a period of six months (August 2022 to January 2023) during which 3215 urine samples were taken from patients at King George Hospital, Visakhapatnam and were processed for bacterial culture and sensitivity. Out of 3215 urine samples,816 were culture positives among them, 373 were Escherichia coli isolates and these isolates were subjected to Antibiotic susceptibility by Kirby-Bauer disc diffusion Method according to the Clinical Laboratory Standard Institute Guidelines 2022 in Microbiology department, Andhra Medical College. Results: Among 816 culture positives, 373 isolates were Escherichia coli (45.71%), followed by Klebsiella sps (26.5%), others were Acinetobacter sps, Candida sps, Pseudomonas sps, Proteus sps, Enterococcus sps, Citrobacter sps and MRSA. The Antibiotic susceptibility of Escherichia coli isolates to Nitrofurantoin and Fosfomycin was 89.54% and 73.99% respectively. Conclusion: This study helps us to understand that Escherichia coli is the common Urinary pathogen causing Urinary Tract Infection. The use of Nitrofurantoin and Fosfomycin against Escherichia coli indicates that these two drugs are therapeutic alternatives for Urinary Tract Infection. Among these two drugs, Nitrofurantoin is most effective in the empirical treatment of Urinary Tract Infections.
Antibiotic Susceptibility Pattern of Nitrofurantoin VS Fosfomycin in Urinary Tract Infections Caused by Escherichia Coli in a Tertiary Care Hospital, Visakhapatnam, Andhra Pradesh
Swathi Ronanki; T. Kanaka Durgamba; Dr. K. Lavanya; P. Ratna Kumari; Kamala.P
DOI : 10.5281/zenodo.7843642
Aims and Objectives: Aim of the study is to estimate prevalence of Escherichia coli among clinically suspected Urinary Tract Infection cases and comparison of antibiogram between Nitrofurantoin VS Fosfomycin as the first line agent for treatment of Urinary Tract Infection caused by Escherichia coli. Materials and Methods: The study was conducted on urine samples over a period of six months (August 2022 to January 2023) during which 3215 urine samples were taken from patients at King George Hospital, Visakhapatnam and were processed for bacterial culture and sensitivity. Out of 3215 urine samples,816 were culture positives among them, 373 were Escherichia coli isolates and these isolates were subjected to Antibiotic susceptibility by Kirby-Bauer disc diffusion Method according to the Clinical Laboratory Standard Institute Guidelines 2022 in Microbiology department, Andhra Medical College. Results: Among 816 culture positives, 373 isolates were Escherichia coli (45.71%), followed by Klebsiella sps (26.5%), others were Acinetobacter sps, Candida sps, Pseudomonas sps, Proteus sps, Enterococcus sps, Citrobacter sps and MRSA. The Antibiotic susceptibility of Escherichia coli isolates to Nitrofurantoin and Fosfomycin was 89.54% and 73.99% respectively. Conclusion: This study helps us to understand that Escherichia coli is the common Urinary pathogen causing Urinary Tract Infection. The use of Nitrofurantoin and Fosfomycin against Escherichia coli indicates that these two drugs are therapeutic alternatives for Urinary Tract Infection. Among these two drugs, Nitrofurantoin is most effective in the empirical treatment of Urinary Tract Infections.
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Cross Sectional Study to Assess Proportion of Fraility and its Association with Sociodemographic Factors, Depression, Activities of Daily Life and Instrumental Activities of Daily Life among Community Dwelling Elderly Inan Urban Slum-A Study Done in Dharavi, Mumbai
Introduction: Report of the Technical Group on Population Projections for India and States 2011-2036, says an increase of nearly 34 million elderly persons was seen in 2021 over the Population Census 2011 and is expected to increase by around 56 million elderly persons in 2031.Fraility is a multidimensional geriatric syndrome that increases the risk for adverse health outcomes, such as falls, hospitalization, increased morbidity and mortality. The aim of present study was to find out the proportion offraility and its association with socio-demographic factors, depression, activities of daily life and instrumental activities of daily life among community dwelling elderly in the field practice area of urban health training centre in urban slum. Methods: Community based cross sectional study among 147 elderly persons selected by multistage sampling from 8 health posts under the urban health training centre was done. A pretested semi structured guided questionnaire with respective scales were used to collect data. Results: Proportion of fraility was 28.6%.Age, illiteracy, people without job, loss of spouse, economic dependency were significantly associated with fraility. Fraility was also associated with unsatisfactory Activities of Daily Life score (p – 0.009), unsatisfactory Instrumental Activites of Daily Life score (p <0.001) and high Geriatric Depression Score(p<0.001). Conclusion: Fraility should be recognised as a public health priority and by taking appropriate measures to identify frail elderly, we can help our population to have a healthy ageing.
Cross Sectional Study to Assess Proportion of Fraility and its Association with Sociodemographic Factors, Depression, Activities of Daily Life and Instrumental Activities of Daily Life among Community Dwelling Elderly Inan Urban Slum-A Study Done in Dharavi, Mumbai
Dr. Steffin Sara Joseph; Dr. Vijaykumar Singh; Dr. Pallavi Shelke; Dr. Seema. S Bansode Gokhe
DOI : 10.5281/zenodo.7844385
Introduction: Report of the Technical Group on Population Projections for India and States 2011-2036, says an increase of nearly 34 million elderly persons was seen in 2021 over the Population Census 2011 and is expected to increase by around 56 million elderly persons in 2031.Fraility is a multidimensional geriatric syndrome that increases the risk for adverse health outcomes, such as falls, hospitalization, increased morbidity and mortality. The aim of present study was to find out the proportion offraility and its association with socio-demographic factors, depression, activities of daily life and instrumental activities of daily life among community dwelling elderly in the field practice area of urban health training centre in urban slum. Methods: Community based cross sectional study among 147 elderly persons selected by multistage sampling from 8 health posts under the urban health training centre was done. A pretested semi structured guided questionnaire with respective scales were used to collect data. Results: Proportion of fraility was 28.6%.Age, illiteracy, people without job, loss of spouse, economic dependency were significantly associated with fraility. Fraility was also associated with unsatisfactory Activities of Daily Life score (p – 0.009), unsatisfactory Instrumental Activites of Daily Life score (p <0.001) and high Geriatric Depression Score(p<0.001). Conclusion: Fraility should be recognised as a public health priority and by taking appropriate measures to identify frail elderly, we can help our population to have a healthy ageing.
The Pictorial Glossary of Fancy terminologies in Cytopathology
Dr Agam Hans & Dr Parneet Kaur
DOI : 10.5281/zenodo.7844429
Pictorial glossary is the best way for the residents to understand the subject of Cytopathology. Certain terminologies and their etymology is sometimes necessary for better retention and their reproducibility
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Evaluation of Predictors of High Vasoactive Ionotropic Score Following Mitral Valve Replacement Surgery
This study was performed in patients undergoing mitral valve replacement surgery to know the effectiveness of predictors of high VIS (Vasoactive Inotropic Score), leading to increased requirements of inotropic supports post operatively, prolonged mechanical ventilation and ICU stay with increased morbidity and mortality. This prospective observational study was carried in cardiac operation theatre in a tertiary care hospital. 60 patients undergoing MVR were included under the study. Patient and surgical factors pre operatively and requirement of VIS post operatively, with any morbidity or mortality were studied. We found that mean age >60 years, female gender were associated with high VIS. Preoperative factors such as comorbidities (COPD, Hypertension, DM), EF between30-50%, severe pulmonary hypertension, severity of MS, hepatic and renal dysfunction have predictive value. Also, the intraoperative factors such as mean CPB time, mean aortic clamp time and duration of ventilation can predict the requirement of high VIS. Patients who require high VIS during mitral valve replacement surgery were at risk for prolonged mechanical ventilation and an extended ICU stay. Hence, through our study, we concluded that patients with the above mentioned predictors should be treated with caution.
Evaluation of Predictors of High Vasoactive Ionotropic Score Following Mitral Valve Replacement Surgery
Dr. Bhagyashree Bhalerao; Dr. Vedika Agrawal; Dr. Shrikant Ghuge
DOI : 10.5281/zenodo.7844451
This study was performed in patients undergoing mitral valve replacement surgery to know the effectiveness of predictors of high VIS (Vasoactive Inotropic Score), leading to increased requirements of inotropic supports post operatively, prolonged mechanical ventilation and ICU stay with increased morbidity and mortality. This prospective observational study was carried in cardiac operation theatre in a tertiary care hospital. 60 patients undergoing MVR were included under the study. Patient and surgical factors pre operatively and requirement of VIS post operatively, with any morbidity or mortality were studied. We found that mean age >60 years, female gender were associated with high VIS. Preoperative factors such as comorbidities (COPD, Hypertension, DM), EF between30-50%, severe pulmonary hypertension, severity of MS, hepatic and renal dysfunction have predictive value. Also, the intraoperative factors such as mean CPB time, mean aortic clamp time and duration of ventilation can predict the requirement of high VIS. Patients who require high VIS during mitral valve replacement surgery were at risk for prolonged mechanical ventilation and an extended ICU stay. Hence, through our study, we concluded that patients with the above mentioned predictors should be treated with caution.
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Comparison of Positivity Rates of COVID-19 Rapid Antigen Tests (RAT) and GeneXpert During COVID-19 Pandemic in a Tertiary Care Hospital, Mumbai, Maharashtra
The advent of the coronavirus disease 2019 (COVID-19) in India caused a new range of challenges in diagnosing the virus & containing its community spread. Various point-of-care tests have been introduced for rapid diagnosis. Although rapid antigen tests (RAT) are the most commonly used, the false-negative rates are high. The purpose of this study was to compare the positivity rate of a molecular diagnostic test such as GeneXpert in RAT negative cases of COVID-19 during COVID pandemic. A retrospective observational analysis conducted on a total of 13633 symptomatic patients’ samples were tested for RAT & GeneXpert of which 1508 were positive (11.06%). Out of 20526 symptomatic patients tested for GeneXpert, 3811 were positive (18.56%) and out of 12125 RAT negatives, 214 patients tested GeneXpert positive (1.8%). The main conclusions of this study were that negative rapid antigen tests should always be confirmed with a molecular diagnostic test such as GeneXpert or RT-PCR for the diagnosis of COVID-19 in symptomatic patients. Proper methods of sample collection must be ensured as improper methods might lead to increase in the number of false-negative results on point-of-care &; screening tests.
Comparison of Positivity Rates of COVID-19 Rapid Antigen Tests (RAT) and GeneXpert During COVID-19 Pandemic in a Tertiary Care Hospital, Mumbai, Maharashtra
Dr. Adhunika Singh; Dr. Anjali Swami; Dr. Mrudul Randive; Dr. Desma D’Souza; Dr. Prachi Srivastava; Dr. Sujata Baveja; Dr. Dilip Turbadkar
DOI : 10.5281/zenodo.7844467
The advent of the coronavirus disease 2019 (COVID-19) in India caused a new range of challenges in diagnosing the virus & containing its community spread. Various point-of-care tests have been introduced for rapid diagnosis. Although rapid antigen tests (RAT) are the most commonly used, the false-negative rates are high. The purpose of this study was to compare the positivity rate of a molecular diagnostic test such as GeneXpert in RAT negative cases of COVID-19 during COVID pandemic. A retrospective observational analysis conducted on a total of 13633 symptomatic patients’ samples were tested for RAT & GeneXpert of which 1508 were positive (11.06%). Out of 20526 symptomatic patients tested for GeneXpert, 3811 were positive (18.56%) and out of 12125 RAT negatives, 214 patients tested GeneXpert positive (1.8%). The main conclusions of this study were that negative rapid antigen tests should always be confirmed with a molecular diagnostic test such as GeneXpert or RT-PCR for the diagnosis of COVID-19 in symptomatic patients. Proper methods of sample collection must be ensured as improper methods might lead to increase in the number of false-negative results on point-of-care &; screening tests.
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‘The Social impact and coping mechanism of Covid- 19 on Staff Nurses’-A retrospective study
The ongoing COVID-19 pandemic has affected people in more than one way. It is accompanied by various morbidity and mortality trajectories with long lasting effects impacting public health, with social consequences across the globe. This upsurge in COVID-19 cases has heavily burdened and in many cases overwhelmed and impaired the healthcare systems. Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Healthcare professional face lot of difficulties in maintaining the quality of healthcare in these days. Investigator herself worked a lot during that period and could able to see the impact of the staff nurses of covid -19. Objectives: • To asses social impact in terms for social isolation of staff nurses in COVID19 situation • To assess coping mechanism of the staff nurse in COVID19 situation • To find out the relationship of Social impact with demographic variables of the staff nurses. • To find out the relationship of coping mechanism with demographic variables of the staff nurses. Research Methodology: Research Design-Descriptive survey research design. Population of the study- Staff nurses of Govt and Private Hospitals. Total sample size-300. Sampling technique- Non probability convenience sampling technique. Research TOOL- A. Standardized tool UCLA Loneliness standardized scale was used to assess the Social isolation of the staff nurses B. Brief cope scale was used for measuring coping of the staff nurses. Results: Majority of the staff nurses 51.6% (155) are from the age group of more than 30 years. Majority of the staff nurses 50.6% (152) are from the Govt Hospital. Study revealed that 158(52.66%) staff had experienced moderate level of loneliness. 162 (54%) staff had moderate coping. Conclusion: Social isolation was an issue that was mentioned by all nurses. The staff faced one of the biggest challenges was no longer being able to see their families, friends, and acquaintances. This concern was mentioned by nurses of both genders, of all ages, in all locations (city/country), and regardless of how many people (alone to more than eight people) lived in a common household.
‘The Social impact and coping mechanism of Covid- 19 on Staff Nurses’-A retrospective study
Usha Mallick & Dr Ratna Chhaya Singh
DOI : 10.5281/zenodo.7844477
The ongoing COVID-19 pandemic has affected people in more than one way. It is accompanied by various morbidity and mortality trajectories with long lasting effects impacting public health, with social consequences across the globe. This upsurge in COVID-19 cases has heavily burdened and in many cases overwhelmed and impaired the healthcare systems. Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Healthcare professional face lot of difficulties in maintaining the quality of healthcare in these days. Investigator herself worked a lot during that period and could able to see the impact of the staff nurses of covid -19. Objectives: • To asses social impact in terms for social isolation of staff nurses in COVID19 situation • To assess coping mechanism of the staff nurse in COVID19 situation • To find out the relationship of Social impact with demographic variables of the staff nurses. • To find out the relationship of coping mechanism with demographic variables of the staff nurses. Research Methodology: Research Design-Descriptive survey research design. Population of the study- Staff nurses of Govt and Private Hospitals. Total sample size-300. Sampling technique- Non probability convenience sampling technique. Research TOOL- A. Standardized tool UCLA Loneliness standardized scale was used to assess the Social isolation of the staff nurses B. Brief cope scale was used for measuring coping of the staff nurses. Results: Majority of the staff nurses 51.6% (155) are from the age group of more than 30 years. Majority of the staff nurses 50.6% (152) are from the Govt Hospital. Study revealed that 158(52.66%) staff had experienced moderate level of loneliness. 162 (54%) staff had moderate coping. Conclusion: Social isolation was an issue that was mentioned by all nurses. The staff faced one of the biggest challenges was no longer being able to see their families, friends, and acquaintances. This concern was mentioned by nurses of both genders, of all ages, in all locations (city/country), and regardless of how many people (alone to more than eight people) lived in a common household.
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Impact of Some Personal Variables on Selective Components of e-learning & Face to Face Learning Strategies for Nursing Students
In the current scenario when globally there is digital advancement, Nurse Educators are required to upgrade themselves with the use of technology, preparing e- modules, e-lessons and their evaluations, and the students’ needs to have computer literacy and required supporting infrastructure to access the e-learning and administrators needs to make sure that adequate online resources are mobilized to meet the educational needs of their students. Hence it is a crucial area of research area. This study aims to investigate the Impact of some personal variables such as parental educational, occupation and income variation on selective Components of E-learning & Face to Face learning strategies for Nursing students. Convenient sampling method was used to select 300 nursing students studying in different nursing colleges of Kolkata. A 5 point likert scale questionnaire was used. Result shows that there exist significant difference between the use of selective component of E-learning strategies i.e. P.P.T., You-Tube, Live class (Google meet, Zoom), Sharing of Text sheet of nursing students in relation to parental education, occupation and income variation as obtained “t” values are > tabular value at 0.05 levels 1.98 and at 0.01 level2.63 There exist significant difference between the use of selective component of Face to Face learning strategies i.e. Lecture method, Interaction session, Note dictation & Demonstration of nursing students in relation to parental education, occupation and income variation as obtained “t” values are > tabular value at 0.05 levels 1.98 and at 0.01 level2.63 It is concluded that parental education, occupation and income have significance relation with E-learning and Face to Face learning strategies for Nursing students.
Impact of Some Personal Variables on Selective Components of e-learning & Face to Face Learning Strategies for Nursing Students
Rumi Sen & Dr. Ratna Chhaya Singh
DOI : 10.5281/zenodo.7844525
In the current scenario when globally there is digital advancement, Nurse Educators are required to upgrade themselves with the use of technology, preparing e- modules, e-lessons and their evaluations, and the students’ needs to have computer literacy and required supporting infrastructure to access the e-learning and administrators needs to make sure that adequate online resources are mobilized to meet the educational needs of their students. Hence it is a crucial area of research area. This study aims to investigate the Impact of some personal variables such as parental educational, occupation and income variation on selective Components of E-learning & Face to Face learning strategies for Nursing students. Convenient sampling method was used to select 300 nursing students studying in different nursing colleges of Kolkata. A 5 point likert scale questionnaire was used. Result shows that there exist significant difference between the use of selective component of E-learning strategies i.e. P.P.T., You-Tube, Live class (Google meet, Zoom), Sharing of Text sheet of nursing students in relation to parental education, occupation and income variation as obtained “t” values are > tabular value at 0.05 levels 1.98 and at 0.01 level2.63 There exist significant difference between the use of selective component of Face to Face learning strategies i.e. Lecture method, Interaction session, Note dictation & Demonstration of nursing students in relation to parental education, occupation and income variation as obtained “t” values are > tabular value at 0.05 levels 1.98 and at 0.01 level2.63 It is concluded that parental education, occupation and income have significance relation with E-learning and Face to Face learning strategies for Nursing students.
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Prospective and Retrospective Study of Prevalence, Pattern and Outcome of Trauma Patients in a Tertiary Care Government Hospital Study
Background: Roadside trauma in India is an increasingly significant problem, particularly because of bad roads, irregular road signs, overcrowding, over speeding, and bad traffic etiquettes. Adequate information on the characteristics of victims, causes of accidents, frequency, vehicles involved, alcohol intake, and outcome of management is essential for understanding and planning for better management. Aim: This study aimed to determine the pattern, characteristics of polytrauma victims admitted to emergency trauma centers in India. The purpose of this study is to examine the epidemiology of trauma in western UP in India through data gained from the patients presenting in emergency centers and to analyze trauma patients to find the predictors that led to the deaths of trauma patients. Materials and methods: The present observational study involved trauma victims over 5-year period in three centers. Demographical details recorded were age, sex, alcohol intake, referral status, first aid taken, vitals on arrival, Glasgow Outcome Score (GOS) for head injury, risk factors, hospital stay, and outcome. Results: A total of 3000 patients were included in study. The mean age was 42.45 ± 15.7 years, the mean ISS was 13.82 ± 6.2, and the mean GCS was 12.20 ± 4.1. The mean time to admission at different trauma centres was 48.41 ± 172.8 h. The head injury was the most common (29.52%). Conclusion: According to this study, there is need for improvement in the referral services, the quality of first aid given, and for the development of good ambulance service with trained medical personnel accompany the patient is also required to improve rapid transport. We also noted high prevalence of head trauma in our study which enhance the need of neurosurgery Department.
Prospective and Retrospective Study of Prevalence, Pattern and Outcome of Trauma Patients in a Tertiary Care Government Hospital Study
Ritika; Sanjay Sharma; Harinder Sandhu; Gyaneshwar Tonk; Virendra Kumar; Anuj Sharma; Dr Sudheer Rathi
DOI : 10.5281/zenodo.7844564
Background: Roadside trauma in India is an increasingly significant problem, particularly because of bad roads, irregular road signs, overcrowding, over speeding, and bad traffic etiquettes. Adequate information on the characteristics of victims, causes of accidents, frequency, vehicles involved, alcohol intake, and outcome of management is essential for understanding and planning for better management. Aim: This study aimed to determine the pattern, characteristics of polytrauma victims admitted to emergency trauma centers in India. The purpose of this study is to examine the epidemiology of trauma in western UP in India through data gained from the patients presenting in emergency centers and to analyze trauma patients to find the predictors that led to the deaths of trauma patients. Materials and methods: The present observational study involved trauma victims over 5-year period in three centers. Demographical details recorded were age, sex, alcohol intake, referral status, first aid taken, vitals on arrival, Glasgow Outcome Score (GOS) for head injury, risk factors, hospital stay, and outcome. Results: A total of 3000 patients were included in study. The mean age was 42.45 ± 15.7 years, the mean ISS was 13.82 ± 6.2, and the mean GCS was 12.20 ± 4.1. The mean time to admission at different trauma centres was 48.41 ± 172.8 h. The head injury was the most common (29.52%). Conclusion: According to this study, there is need for improvement in the referral services, the quality of first aid given, and for the development of good ambulance service with trained medical personnel accompany the patient is also required to improve rapid transport. We also noted high prevalence of head trauma in our study which enhance the need of neurosurgery Department.
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The Association between Elevated Serum Uric Acid and Acute Ischemic Stroke in Adult
Background: Elevated serum uric acid levels have been associated with an increased risk of stroke. However, the prevalence of hyperuricemia in patients with acute ischemic stroke and its association with gender and age remain unclear. Materials and Methods: This retrospective study included 110 patients with acute ischemic stroke who were admitted to a single center. Serum uric acid levels were measured within 24 hours of admission. Data on age, gender, and other clinical and laboratory variables were collected from medical records. Results: The study found that 27.3% of the patients had elevated serum uric acid levels, with a mean serum uric acid level of 6.2 mg/dL. The majority of the patients had serum uric acid levels within the normal range, and only 8.2% of the patients had low serum uric acid levels. The study also found that the mean serum uric acid level was higher in males compared to females and that there was a significant association between age and serum uric acid levels, with the highest levels observed in the age group of 80 years and above. Conclusion: The present study highlights the high prevalence of hyperuricemia in patients with acute ischemic stroke, with males and older patients being at a higher risk. These findings underscore the importance of monitoring serum uric acid levels in patients with acute ischemic stroke, especially in high-risk populations. Further studies are needed to investigate the possible mechanisms underlying the association between hyperuricemia and stroke, which may provide new insights into the pathophysiology of stroke and potential therapeutic targets.
The Association between Elevated Serum Uric Acid and Acute Ischemic Stroke in Adult
Dr Lokesh NK & Dr Pavan Kumar MH
DOI : 10.5281/zenodo.7844590
Background: Elevated serum uric acid levels have been associated with an increased risk of stroke. However, the prevalence of hyperuricemia in patients with acute ischemic stroke and its association with gender and age remain unclear. Materials and Methods: This retrospective study included 110 patients with acute ischemic stroke who were admitted to a single center. Serum uric acid levels were measured within 24 hours of admission. Data on age, gender, and other clinical and laboratory variables were collected from medical records. Results: The study found that 27.3% of the patients had elevated serum uric acid levels, with a mean serum uric acid level of 6.2 mg/dL. The majority of the patients had serum uric acid levels within the normal range, and only 8.2% of the patients had low serum uric acid levels. The study also found that the mean serum uric acid level was higher in males compared to females and that there was a significant association between age and serum uric acid levels, with the highest levels observed in the age group of 80 years and above. Conclusion: The present study highlights the high prevalence of hyperuricemia in patients with acute ischemic stroke, with males and older patients being at a higher risk. These findings underscore the importance of monitoring serum uric acid levels in patients with acute ischemic stroke, especially in high-risk populations. Further studies are needed to investigate the possible mechanisms underlying the association between hyperuricemia and stroke, which may provide new insights into the pathophysiology of stroke and potential therapeutic targets.
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Perception of covid-19 vaccine in pregnant women
Background: Vaccine safety scares, whether factual or fabricated, can erode confidence and reduce coverage. Acceptance of vaccination during pregnancy is likely to raise specific questions and concerns among pregnant women. The effects of vaccination on the placenta and foetus and physiological changes in pregnancy make pregnant women a specific population that may respond differently to vaccination. These uncertainties must be considered in order to assess the benefit-risk balance and to make the most appropriate choice for pregnant patients at increased risk of severe COVID-19 [1]. Hence this study was conducted to study the prevalence of acceptance of COVID-19 vaccine in pregnant women and to find out hesitancy of COVID-19 vaccine in pregnant women. Methods: This Cross-sectional study was conducted among 83 Pregnant women by using Convenience Sampling method at Terna Medical Hospital. The questionnaire was prepared and validated. Participants were asked whether or not they would agree to be vaccinated against Covid 19 and why. Analysis was done by SPSS version (20.0) by applying chi square test. Results: 94% were aware about the existence of COVID 19 Vaccination and 93.9% accepted getting vaccinated against COVID 19. 6.1% didn’t agree for vaccination. The top three reasons for pregnant women to decline COVID-19 vaccination during pregnancy even if the vaccine were safe and free were that: 1.Do not want to expose their developing baby to any possible harmful side effect 2.afraid of side effects to themselves 3. Had insufficient knowledge about vaccine. Conclusion: To increase vaccine acceptance, locally-specific vaccine programs are needed in population. Vaccine education campaigns should emphasize the pandemic as a whole and its impact on communities, rather than limiting to vaccine safety and effectiveness.
Perception of covid-19 vaccine in pregnant women
Dr. Shalini Ojha & Dr. Usha Rathod
DOI : 10.5281/zenodo.7844634
Background: Vaccine safety scares, whether factual or fabricated, can erode confidence and reduce coverage. Acceptance of vaccination during pregnancy is likely to raise specific questions and concerns among pregnant women. The effects of vaccination on the placenta and foetus and physiological changes in pregnancy make pregnant women a specific population that may respond differently to vaccination. These uncertainties must be considered in order to assess the benefit-risk balance and to make the most appropriate choice for pregnant patients at increased risk of severe COVID-19 [1]. Hence this study was conducted to study the prevalence of acceptance of COVID-19 vaccine in pregnant women and to find out hesitancy of COVID-19 vaccine in pregnant women. Methods: This Cross-sectional study was conducted among 83 Pregnant women by using Convenience Sampling method at Terna Medical Hospital. The questionnaire was prepared and validated. Participants were asked whether or not they would agree to be vaccinated against Covid 19 and why. Analysis was done by SPSS version (20.0) by applying chi square test. Results: 94% were aware about the existence of COVID 19 Vaccination and 93.9% accepted getting vaccinated against COVID 19. 6.1% didn’t agree for vaccination. The top three reasons for pregnant women to decline COVID-19 vaccination during pregnancy even if the vaccine were safe and free were that: 1.Do not want to expose their developing baby to any possible harmful side effect 2.afraid of side effects to themselves 3. Had insufficient knowledge about vaccine. Conclusion: To increase vaccine acceptance, locally-specific vaccine programs are needed in population. Vaccine education campaigns should emphasize the pandemic as a whole and its impact on communities, rather than limiting to vaccine safety and effectiveness.
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Association of Clinical Profile and Demographic Factors Associated with the Adverse Outcomes in Elderly with Covid-19 Infection in a Tertiary Care Hospital
INTRODUCTION: Elderly people are at a higher risk of COVID-19 infection due to their decreased immunity and body reserves, as well as multiple associated comorbidities. Also, course of disease tends to be more severe in case of elderly resulting in higher mortality. MATERIALS AND METHODS: This retrospective study included 757 admitted covid-19 patients in a dedicated tertiary care hospital. The data was collected between December 2021 to March 2022 were analysed for the clinical profile, demographic factors with adverse outcomes in elderly patients. RESULTS: 308 were elderly patients, Mean age was 70.2,males-190(61.7%) females118(38.3%), 267(86.7%) were discharged,40 (13%) died,1(0.3%) went dama.6(1.9%) were asymptomatic,131(42.5%) had mild disease,128(41.6) had moderate disease , 43(14%) had severe disease. 52(16.9%) were vaccinated with covaxin,166(53.9%) were vaccinated with covishield, 90(29.2%) were not vaccinated. Diabetes(62%) and hypertension(53.9) were the major risk factors. Other risk factors included ischemic heart disease, chronic kidney disease, chronic obstructive pulmonary disease, seizures, pulmonary tuberculosis. CONCLUSION: The disease is more severe in patients with comorbidities and unvaccinated when compared to general population. Early diagnosis and individualized therapeutic management should be developed for elderly subjects based on personal medical history and comorbidities .
Association of Clinical Profile and Demographic Factors Associated with the Adverse Outcomes in Elderly with Covid-19 Infection in a Tertiary Care Hospital
Dr. Vidyasagar B; Dr. Nagaraja B S; Dr. Sheshan V S; Dr. Madhumathi. R; Dr. Aishwarya D Malagi; Dr. Ramesh NarasappaTeli
DOI : 10.5281/zenodo.7844676
INTRODUCTION: Elderly people are at a higher risk of COVID-19 infection due to their decreased immunity and body reserves, as well as multiple associated comorbidities. Also, course of disease tends to be more severe in case of elderly resulting in higher mortality. MATERIALS AND METHODS: This retrospective study included 757 admitted covid-19 patients in a dedicated tertiary care hospital. The data was collected between December 2021 to March 2022 were analysed for the clinical profile, demographic factors with adverse outcomes in elderly patients. RESULTS: 308 were elderly patients, Mean age was 70.2,males-190(61.7%) females118(38.3%), 267(86.7%) were discharged,40 (13%) died,1(0.3%) went dama.6(1.9%) were asymptomatic,131(42.5%) had mild disease,128(41.6) had moderate disease , 43(14%) had severe disease. 52(16.9%) were vaccinated with covaxin,166(53.9%) were vaccinated with covishield, 90(29.2%) were not vaccinated. Diabetes(62%) and hypertension(53.9) were the major risk factors. Other risk factors included ischemic heart disease, chronic kidney disease, chronic obstructive pulmonary disease, seizures, pulmonary tuberculosis. CONCLUSION: The disease is more severe in patients with comorbidities and unvaccinated when compared to general population. Early diagnosis and individualized therapeutic management should be developed for elderly subjects based on personal medical history and comorbidities .
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‘Family Centered Structured Play Therapy’: A Way To Combat Physical & Developmental Delay In Severe Acute Malnutrition
Introduction-The WHO recommends incorporating psycho-motor and psycho-social stimulation into the management of SAM as it helps recover the psycho-motor and psycho-social deficit and stimulate the malnourished children to regain their appetite more quickly and gain weight faster. Objectives-To determine the effect of Play based Psycho-Motor and Psycho-Social stimulation on development and linear growth in children with SAM and to estimate the prevalence of delayed developmental milestones in SAM. Methods- This prospective study included 130 SAM children of 6 months to 5 years age, play-based psychomotor and psycho-social stimulation was provided. Linear growth and developmental growth were assessed during hospital stay and at 3 months, 6 months follow up and outcome was assessed. Results- Among 130 SAM children, 601.5% were of age group 13-36 months, 60% were male and 40% female, majority belongs to upper lower socioeconomic class (80%). In 8.1% pedal edema present. 91.54% have delayed milestones in at least 1 domain, delayed social personal domain noted in maximum children (66.92%), mean weight was 6.19+/-1.44 kg and mean height 73.3+/-8.4cm at admission. During 6 months follow up maximum improvement noted in fine motor in 76.19% children followed by gross motor in 61.62% children. Mean weight gain after 6months was 2.05+/-0.17 kg and mean height gain was 2.52cm+/-0.14cm. Conclusion- developmental delay is associated with SAM (91.5%) in atleast one domain. Structured play therapy has positive effect on developmental growth and linear growth of SAM children.
‘Family Centered Structured Play Therapy’: A Way To Combat Physical & Developmental Delay In Severe Acute Malnutrition
Dr.Sheetal Jadhaw; Dr. Sunita Koreti; Dr. Ajay Gaur
DOI : 10.5281/zenodo.7847835
Introduction-The WHO recommends incorporating psycho-motor and psycho-social stimulation into the management of SAM as it helps recover the psycho-motor and psycho-social deficit and stimulate the malnourished children to regain their appetite more quickly and gain weight faster. Objectives-To determine the effect of Play based Psycho-Motor and Psycho-Social stimulation on development and linear growth in children with SAM and to estimate the prevalence of delayed developmental milestones in SAM. Methods- This prospective study included 130 SAM children of 6 months to 5 years age, play-based psychomotor and psycho-social stimulation was provided. Linear growth and developmental growth were assessed during hospital stay and at 3 months, 6 months follow up and outcome was assessed. Results- Among 130 SAM children, 601.5% were of age group 13-36 months, 60% were male and 40% female, majority belongs to upper lower socioeconomic class (80%). In 8.1% pedal edema present. 91.54% have delayed milestones in at least 1 domain, delayed social personal domain noted in maximum children (66.92%), mean weight was 6.19+/-1.44 kg and mean height 73.3+/-8.4cm at admission. During 6 months follow up maximum improvement noted in fine motor in 76.19% children followed by gross motor in 61.62% children. Mean weight gain after 6months was 2.05+/-0.17 kg and mean height gain was 2.52cm+/-0.14cm. Conclusion- developmental delay is associated with SAM (91.5%) in atleast one domain. Structured play therapy has positive effect on developmental growth and linear growth of SAM children.
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Analgesic Efficacy of Dexmedetomidine as an Adjunct in Ultrasound-Guided Supraclavicular Block for Pediatric Upper Limb Surgeries: A Randomised Double Blind Controlled Study
Background and Aims: Dexmedetomidine has been studied extensively in peripheral nerve blocks in adults. However, a literature search revealed no study regarding its use in the ultrasound-guided supraclavicular block in pediatrics. Hence, the present study evaluated the analgesic efficacy of dexmedetomidine in combination with bupivacaine in the ultrasound-guided supraclavicular block in pediatric patients undergoing upper limb surgeries. Material and Methods: This prospective randomized, double-blind study was conducted in fifty patients of American Society of Anesthesiologists (ASA) physical status grade I and II, aged 3-12 years, undergoing elective upper limb surgeries. Patients were divided into two groups of 25 each. Group A received general anesthesia (GA) and ultrasound(USG)- guided supraclavicular brachial plexus block with 0.25% bupivacaine 0.3ml/kg, and 0.5ml normal saline. Group B patients received GA and USG guided supraclavicular block with 0.25% bupivacaine 0.3ml/kg and dexmedetomidine 1 µg/kg in a volume of 0.5 ml. The time to first rescue analgesic request, pain scores, consumption of postoperative rescue analgesics, hemodynamics, patient satisfaction and adverse effects were noted. For normally distributed variables, Unpaired Student’s t test and Chi-square test were used. Mann Whitney Test was used for variables that were not normally distributed. Results: Patients receiving dexmedetomidine had a longer time to the first analgesic request in the postoperative period (p-value:0.004),reduced consumption of rescue analgesics (p-value: 0.002), and better satisfaction scores (p-value: 0.003). Conclusion: USG-guided supraclavicular block with bupivacaine and dexmedetomidinein pediatric patients provides superior analgesia in terms of the longer time to the first rescue analgesic request, reduced requirement of rescue analgesics, and stable hemodynamics. In addition, the use of dexmedetomidine results in better patient satisfaction as compared to bupivacaine alone, without any significant adverse effects.
Analgesic Efficacy of Dexmedetomidine as an Adjunct in Ultrasound-Guided Supraclavicular Block for Pediatric Upper Limb Surgeries: A Randomised Double Blind Controlled Study
Sargam Goel; Bhumika Kalra; Aikta Gupta; Geeta Kamal; Shilpa Agarwal
DOI : 10.5281/zenodo.7847849
Background and Aims: Dexmedetomidine has been studied extensively in peripheral nerve blocks in adults. However, a literature search revealed no study regarding its use in the ultrasound-guided supraclavicular block in pediatrics. Hence, the present study evaluated the analgesic efficacy of dexmedetomidine in combination with bupivacaine in the ultrasound-guided supraclavicular block in pediatric patients undergoing upper limb surgeries. Material and Methods: This prospective randomized, double-blind study was conducted in fifty patients of American Society of Anesthesiologists (ASA) physical status grade I and II, aged 3-12 years, undergoing elective upper limb surgeries. Patients were divided into two groups of 25 each. Group A received general anesthesia (GA) and ultrasound(USG)- guided supraclavicular brachial plexus block with 0.25% bupivacaine 0.3ml/kg, and 0.5ml normal saline. Group B patients received GA and USG guided supraclavicular block with 0.25% bupivacaine 0.3ml/kg and dexmedetomidine 1 µg/kg in a volume of 0.5 ml. The time to first rescue analgesic request, pain scores, consumption of postoperative rescue analgesics, hemodynamics, patient satisfaction and adverse effects were noted. For normally distributed variables, Unpaired Student’s t test and Chi-square test were used. Mann Whitney Test was used for variables that were not normally distributed. Results: Patients receiving dexmedetomidine had a longer time to the first analgesic request in the postoperative period (p-value:0.004),reduced consumption of rescue analgesics (p-value: 0.002), and better satisfaction scores (p-value: 0.003). Conclusion: USG-guided supraclavicular block with bupivacaine and dexmedetomidinein pediatric patients provides superior analgesia in terms of the longer time to the first rescue analgesic request, reduced requirement of rescue analgesics, and stable hemodynamics. In addition, the use of dexmedetomidine results in better patient satisfaction as compared to bupivacaine alone, without any significant adverse effects.
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Efficacy of Ultrasound Guided Continuous Transverse Abdominis Plane Block for Lower Abdominal Surgeries
Introduction: The effect of a single transverse abdominis plane(TAP) block is not durable, and its analgesic efficacy lasts less than 24 hr. Thus, continuous transverse abdominis plane block by placing the catheter into the transverse abdominal plane and infusing local anaesthetic drugs continuously or intermittently through the catheter were used. This study evaluates the efficacy of ultrasound guided continuous TAP block in comparison with conventional TAP block for lower abdominal surgeries. Material and methods: There were 60 patients in the study, allocated to continuous TAP and control groups. parameters measured were pain scores on a visual analog scale (VAS) at various time interval. patients satisfaction were recorded in continuous TAP block group along with its complications related to the block. Results: Preoperative pain score was 1 for 2 patients of continuous TAP group and 6 patients of conventional block group. Preoperative pain score was 2 for 13 patients of continuous TAP group and11 patients of conventional block group. Preoperative pain score was 3 for 15 patients of continuous TAP group and 13 patients of conventional block group. Conclusion: The anatomical approach of Continuous TAP block is also very safe and reasonably effective. Ultrasound-guided Continuous TAP block reduced postoperative rest and movement pain and analgesic requirements after lower abdominal surgeries and was more effective than conventional block.
Efficacy of Ultrasound Guided Continuous Transverse Abdominis Plane Block for Lower Abdominal Surgeries
Dr Mayuri Mali; Dr A.S.Tarkase; Dr kirti Chavan
DOI : 10.5281/zenodo.7847867
Introduction: The effect of a single transverse abdominis plane(TAP) block is not durable, and its analgesic efficacy lasts less than 24 hr. Thus, continuous transverse abdominis plane block by placing the catheter into the transverse abdominal plane and infusing local anaesthetic drugs continuously or intermittently through the catheter were used. This study evaluates the efficacy of ultrasound guided continuous TAP block in comparison with conventional TAP block for lower abdominal surgeries. Material and methods: There were 60 patients in the study, allocated to continuous TAP and control groups. parameters measured were pain scores on a visual analog scale (VAS) at various time interval. patients satisfaction were recorded in continuous TAP block group along with its complications related to the block. Results: Preoperative pain score was 1 for 2 patients of continuous TAP group and 6 patients of conventional block group. Preoperative pain score was 2 for 13 patients of continuous TAP group and11 patients of conventional block group. Preoperative pain score was 3 for 15 patients of continuous TAP group and 13 patients of conventional block group. Conclusion: The anatomical approach of Continuous TAP block is also very safe and reasonably effective. Ultrasound-guided Continuous TAP block reduced postoperative rest and movement pain and analgesic requirements after lower abdominal surgeries and was more effective than conventional block.
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Evaluation of Nebulised Dexmedetomidine in Blunting Haemodynamic Response to Laryngoscopy and Intubation: Tertiary Care Centre
Introduction: The process of laryngoscopy and endotracheal tube intubation causes immense sympathetic system activation which further causes intra-operative complications. In high risk patients, this pressor response can increase morbidity and mortality. Dexmedetomidine has good bioavailability and rapid absorption through nasal mucosa so this study evaluates effects of nebulised dexmedetomidine in blunting haemodynamic response to laryngoscopy and intubation. Material and methods: Analytical study was conducted in 100 ASA 1&2 patients. Study population was divided randomly into 2 groups. Control group B(n=50)received nebulisation with 5ml of normal saline and Study group A(n=50)received 1mics/kg dexmedetomidine in 5ml saline 10min before induction in sitting position. Results: Demographics are compared. Following laryngoscopy and intubation SBP, DBP, MAP, HR showed significant increase in control group B as compared to study group A. There was a dose sparing effect of propofol in group A. Conclusion: Nebulised dexmedetomidine effectively blunts the stress response to laryngoscopy and intubation with no adverse effects.
Evaluation of Nebulised Dexmedetomidine in Blunting Haemodynamic Response to Laryngoscopy and Intubation: Tertiary Care Centre
Dr Kirti Chavan; Dr A.S.Tarkase; Dr Mayuri Mali
DOI : 10.5281/zenodo.7847874
Introduction: The process of laryngoscopy and endotracheal tube intubation causes immense sympathetic system activation which further causes intra-operative complications. In high risk patients, this pressor response can increase morbidity and mortality. Dexmedetomidine has good bioavailability and rapid absorption through nasal mucosa so this study evaluates effects of nebulised dexmedetomidine in blunting haemodynamic response to laryngoscopy and intubation. Material and methods: Analytical study was conducted in 100 ASA 1&2 patients. Study population was divided randomly into 2 groups. Control group B(n=50)received nebulisation with 5ml of normal saline and Study group A(n=50)received 1mics/kg dexmedetomidine in 5ml saline 10min before induction in sitting position. Results: Demographics are compared. Following laryngoscopy and intubation SBP, DBP, MAP, HR showed significant increase in control group B as compared to study group A. There was a dose sparing effect of propofol in group A. Conclusion: Nebulised dexmedetomidine effectively blunts the stress response to laryngoscopy and intubation with no adverse effects.
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Prospective Study on the Clinico-Hematological Profile of Dengue Fever Patients in Hims, Hassan
Introduction: Dengue virus causes a spectrum of illness ranging from in apparent, self-limiting classical dengue fever (DF) to life threatening dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Present study is done to identify the clinical profile, hematological profile and disease outcome in dengue fever cases. Methods: A total of120 cases aging 18 to 80 years diagnosed as dengue fever based on rapid immunological card test (Ns1 antigen, IgG and IgM antibodies) were analysed for clinical and hematological parameters. A prospective observational study was conducted at HIMS, Hassan. Result: During the study period, a total of 120 dengue cases were included in the study. Of these61%male, 39%female.NS1 antigen positive 35(29%), IGM 50%positive was being highest and IGG 21%.The most common presentation was fever (100%) followed by myalgia (75%),retro orbital pain and vomiting (33%).The common hematological finding was thrombocytopenia 81(67.5%),followed by anemia66(55%), leucopenia39(39%) and the elevated levels of AST and ALT was noted. Conclusion: Thrombocytopenia, leucopenia, elevated AST and ALT gives clues to test dengue fever so that the dengue cases can be identified in early stages and prompt management can be started to prevent complications.
Prospective Study on the Clinico-Hematological Profile of Dengue Fever Patients in Hims, Hassan
Dr Kanchana; Dr Bindu C B; Dr Inchara K M; Dr Muthuraj N
DOI : 10.5281/zenodo.7847891
Introduction: Dengue virus causes a spectrum of illness ranging from in apparent, self-limiting classical dengue fever (DF) to life threatening dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS). Present study is done to identify the clinical profile, hematological profile and disease outcome in dengue fever cases. Methods: A total of120 cases aging 18 to 80 years diagnosed as dengue fever based on rapid immunological card test (Ns1 antigen, IgG and IgM antibodies) were analysed for clinical and hematological parameters. A prospective observational study was conducted at HIMS, Hassan. Result: During the study period, a total of 120 dengue cases were included in the study. Of these61%male, 39%female.NS1 antigen positive 35(29%), IGM 50%positive was being highest and IGG 21%.The most common presentation was fever (100%) followed by myalgia (75%),retro orbital pain and vomiting (33%).The common hematological finding was thrombocytopenia 81(67.5%),followed by anemia66(55%), leucopenia39(39%) and the elevated levels of AST and ALT was noted. Conclusion: Thrombocytopenia, leucopenia, elevated AST and ALT gives clues to test dengue fever so that the dengue cases can be identified in early stages and prompt management can be started to prevent complications.
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Study of Clinical Profile of Dilated Cardiomyopathy
BACKGROUND: Cardiomyopathy is a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body. Cardiomyopathy can lead to heart failure. The main types of cardiomyopathies include dilated, hypertrophic and restrictive cardiomyopathy. Treatment — which might include medications, surgically implanted devices, heart surgery or, in severe cases, a heart transplant — depends on the type of cardiomyopathy and how serious it is[1]. Dilated Cardiomyopathy (DCM) is a disease of the heart muscle characterized by enlargement and dilation of one or both of the ventricles along with impaired contractility defined as left ventricular ejection fraction (LVEF) less than 40%. Patients have systolic dysfunction and may or may not have overt symptoms of heart failure. A previous prominent classification of cardiomyopathies (1995) was represented in a very brief document under the auspices of the World Health Organization (WHO)[2], The natural history of DCM remains incompletely understood. This is because this diagnosis clearly contains a variety of causes and patients have highly variable presentations. The prognosis of DCM may be much more variable than previously appreciated. Several features of the clinical presentation may be valuable in predicting patient outcome. In view of high prevalence of heart failure and also lack of data on dilated cardiomyopathy this study was undertaken. The ECG and echocardiography were also evaluated in the present study. METHODS - A cross sectional study on 60 patients with dilated cardiomyopathy was conducted in a teaching hospital in Vadodara, Gujarat. RESULTS - In our study the most common type of dilated cardiomyopathy was idiopathic dilated cardiomyopathy being present in 60% of our patients, followed by alcoholic cardiomyopathy seen in 15 %. Diabetic cardiomyopathy was found to be the third most common type seen in 13.3% of patients while Peripartum cardiomyopathy were seen in 11.6%. n our study 32 % of patients had anemia, most of the patients had mild anemia (i.e., Hb between 8.5 – 11 gm %). In a study done by A. Justin et al anemia was found in 27% of patients with congestive heart failure. The prevalence of anemia in our study is similar. Anemia is known to be associated with adverse outcome in patients with heart failure. Among alcoholic's alcohol plays a significant etiological role (p value <0.0001). Biventricular failure was present in 70% of patients and isolated LV failure was seen in 27%, 3% patient in our study had RV failure. The cardio thoracic ratio was more than 0.7 in 22%, it was between 0.6 to 0.7(moderate) in 43% and 35% of patients had mild cardiomegaly i.e., between 0.5 to 0.6 CONCLUSION- The major cause of dilated cardiomyopathy in our study was found to be idiopathic followed by alcoholic, diabetic and peripartum cardiomyopathy. The most common clinical presentation is biventricular failure. Almost all patients showed cardiomegaly in chest x-ray.
Study of Clinical Profile of Dilated Cardiomyopathy
Dr Kaushal patel; Dr Anirudham baliya; Dr Jeet shah
DOI : 10.5281/zenodo.7847904
BACKGROUND: Cardiomyopathy is a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body. Cardiomyopathy can lead to heart failure. The main types of cardiomyopathies include dilated, hypertrophic and restrictive cardiomyopathy. Treatment — which might include medications, surgically implanted devices, heart surgery or, in severe cases, a heart transplant — depends on the type of cardiomyopathy and how serious it is[1]. Dilated Cardiomyopathy (DCM) is a disease of the heart muscle characterized by enlargement and dilation of one or both of the ventricles along with impaired contractility defined as left ventricular ejection fraction (LVEF) less than 40%. Patients have systolic dysfunction and may or may not have overt symptoms of heart failure. A previous prominent classification of cardiomyopathies (1995) was represented in a very brief document under the auspices of the World Health Organization (WHO)[2], The natural history of DCM remains incompletely understood. This is because this diagnosis clearly contains a variety of causes and patients have highly variable presentations. The prognosis of DCM may be much more variable than previously appreciated. Several features of the clinical presentation may be valuable in predicting patient outcome. In view of high prevalence of heart failure and also lack of data on dilated cardiomyopathy this study was undertaken. The ECG and echocardiography were also evaluated in the present study. METHODS - A cross sectional study on 60 patients with dilated cardiomyopathy was conducted in a teaching hospital in Vadodara, Gujarat. RESULTS - In our study the most common type of dilated cardiomyopathy was idiopathic dilated cardiomyopathy being present in 60% of our patients, followed by alcoholic cardiomyopathy seen in 15 %. Diabetic cardiomyopathy was found to be the third most common type seen in 13.3% of patients while Peripartum cardiomyopathy were seen in 11.6%. n our study 32 % of patients had anemia, most of the patients had mild anemia (i.e., Hb between 8.5 – 11 gm %). In a study done by A. Justin et al anemia was found in 27% of patients with congestive heart failure. The prevalence of anemia in our study is similar. Anemia is known to be associated with adverse outcome in patients with heart failure. Among alcoholic's alcohol plays a significant etiological role (p value <0.0001). Biventricular failure was present in 70% of patients and isolated LV failure was seen in 27%, 3% patient in our study had RV failure. The cardio thoracic ratio was more than 0.7 in 22%, it was between 0.6 to 0.7(moderate) in 43% and 35% of patients had mild cardiomegaly i.e., between 0.5 to 0.6 CONCLUSION- The major cause of dilated cardiomyopathy in our study was found to be idiopathic followed by alcoholic, diabetic and peripartum cardiomyopathy. The most common clinical presentation is biventricular failure. Almost all patients showed cardiomegaly in chest x-ray.
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A Prevalence of Malnutrition and its Risk Factors Among Under-5 Children of an Urban Slum Area Under the Field Practice Area of Urban Health & Training Center of A Tertiary Care Hospital
INTRODUCTION: Children under five years constitute the one of the most vulnerable group of a country. Their nutritional status and mortality rate is a sensitive indicator of community health services and nutritional status of that community. In developing countries, the nutritional status of children depends on socioeconomic status, immunization status, breastfeeding practices awareness of diseases such as diarrhea and acute respiratory tract infection, educational status of mother and availability of safe drinking water etc. OBJECTIVES: To study the prevalence of malnutrition among the under -5 children in an urban slum area under urban field practice area of tertiary care hospital &to study the various risk factors affecting malnutrition among them. MATERIAL & METHODS: A Community based descriptive Cross-Sectional Study was conducted on 175 Children under 5 years of age in a slum area under Urban field practice area of a tertiary care hospital during 1st November 2021 to 31st December 2021. Anthropometric measurements were taken using shakir’s tapes and calibrated weighing machine. RESULTS: Present study shows that the overall prevalence of malnutrition is 63.99% in under-5 children out of which 26.28% study subject was moderately malnourished and majority i.e. 37.71% study subjects was severely malnourished. Out of various risk factors studied, age and socioeconomic status was found significant with p value of 0.04 and 0.003 respectively. CONCLUSION: Nearly one third of children were underweight (32%), half of the children were stunted (51.42%) & one fifth of children were wasted (16.57%). Thus chronic malnutrition was more prevalent in the urban slum area.
A Prevalence of Malnutrition and its Risk Factors Among Under-5 Children of an Urban Slum Area Under the Field Practice Area of Urban Health & Training Center of A Tertiary Care Hospital
Dr. Santosh J. Haralkar; Dr. Gajanan M. Jatti; Dr. Vilas Sarjerao Mane; Dr Ladgir L. Gaikwad; Mr. Bennishirur W.A
DOI : 10.5281/zenodo.7847922
INTRODUCTION: Children under five years constitute the one of the most vulnerable group of a country. Their nutritional status and mortality rate is a sensitive indicator of community health services and nutritional status of that community. In developing countries, the nutritional status of children depends on socioeconomic status, immunization status, breastfeeding practices awareness of diseases such as diarrhea and acute respiratory tract infection, educational status of mother and availability of safe drinking water etc. OBJECTIVES: To study the prevalence of malnutrition among the under -5 children in an urban slum area under urban field practice area of tertiary care hospital &to study the various risk factors affecting malnutrition among them. MATERIAL & METHODS: A Community based descriptive Cross-Sectional Study was conducted on 175 Children under 5 years of age in a slum area under Urban field practice area of a tertiary care hospital during 1st November 2021 to 31st December 2021. Anthropometric measurements were taken using shakir’s tapes and calibrated weighing machine. RESULTS: Present study shows that the overall prevalence of malnutrition is 63.99% in under-5 children out of which 26.28% study subject was moderately malnourished and majority i.e. 37.71% study subjects was severely malnourished. Out of various risk factors studied, age and socioeconomic status was found significant with p value of 0.04 and 0.003 respectively. CONCLUSION: Nearly one third of children were underweight (32%), half of the children were stunted (51.42%) & one fifth of children were wasted (16.57%). Thus chronic malnutrition was more prevalent in the urban slum area.
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Morphological Study of Lungs and Variations in Rajasthan-A Cross-sectional Observational Study
Objective: Morphological study and variations in the right and left lung, through the study of lobes, fissures, hilar structures and their variations. Methods: We examined the changes in fissures, lobes, and hilar structures in 65 right and 73 left isolated lungs from the dissection hall of Jhalawar Medical College, Rajasthan. Results: Horizontal fissure was absent in 3.07% and incomplete in 35.38% of right lungs. 3.07% of right lungs had 3 arteries, 67.69% had 2 arteries, and 29.23% had only one artery in the hilum. 63.07% of right lungs had two veins, 32.30% had 3 veins, and 4.61% had more than 3 veins in the hilum. 98.46% of right lungs showed 2 bronchi and 1.53% of them showed 3 bronchi in the hilum. Two of the right lungs (3.07%) had an artery passing across the oblique fissure. 15.06% of left lungs showed incomplete oblique fissures and 2.73% showed 2 fissures and 3 lobes. 5.47% of left lungs showed 2 arteries and 94.52% had only one artery in the hilum. 80.82% of left lungs had two veins in the hilum and 19.17% had 3 veins in the hilum. 21.91% of left lungs had 2 bronchi and 78.08% had only one bronchus in the hilum. Conclusion: The results of the present study show that a variety of variations can occur at the hilar structures as well as the shape, fissures and lobes of the lungs in humans.
Morphological Study of Lungs and Variations in Rajasthan-A Cross-sectional Observational Study
Dr. Sabila khan
DOI : 10.5281/zenodo.7847938
Objective: Morphological study and variations in the right and left lung, through the study of lobes, fissures, hilar structures and their variations. Methods: We examined the changes in fissures, lobes, and hilar structures in 65 right and 73 left isolated lungs from the dissection hall of Jhalawar Medical College, Rajasthan. Results: Horizontal fissure was absent in 3.07% and incomplete in 35.38% of right lungs. 3.07% of right lungs had 3 arteries, 67.69% had 2 arteries, and 29.23% had only one artery in the hilum. 63.07% of right lungs had two veins, 32.30% had 3 veins, and 4.61% had more than 3 veins in the hilum. 98.46% of right lungs showed 2 bronchi and 1.53% of them showed 3 bronchi in the hilum. Two of the right lungs (3.07%) had an artery passing across the oblique fissure. 15.06% of left lungs showed incomplete oblique fissures and 2.73% showed 2 fissures and 3 lobes. 5.47% of left lungs showed 2 arteries and 94.52% had only one artery in the hilum. 80.82% of left lungs had two veins in the hilum and 19.17% had 3 veins in the hilum. 21.91% of left lungs had 2 bronchi and 78.08% had only one bronchus in the hilum. Conclusion: The results of the present study show that a variety of variations can occur at the hilar structures as well as the shape, fissures and lobes of the lungs in humans.
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Clinical and Radiological Features and Outcome of Hospitalized Patients with CNS Tuberculosis : A Prospective Observational Study in A Tertiary Care Centre, Mumbai
Background: Tuberculosis (TB) is a major public health problem in India. Ten percent of all patients with TB have CNS involvement. Delayed diagnosis of this disease is associated with increased mortality. This study assesses the clinico-radiological features as well as outcomes in patients with various forms of CNS TB. Methods: A prospective observational study conducted at tertiary care centre Mumbai between January 2020-July 2022.Each patient was assessed from admission to 3- month follow up. Detailed clinical examination including lab examination was done. All patients were divided into different categories based on Singhal staging and Modified MRC grading for TBM. APACHE 2 score was evaluated for severity of illness. Outcome was measured in terms of mortality and morbidity. Results: Our study had 70 patients with a mean age of 38.94 ± 20.75 years. Fever was the most common symptom in patients with TBM (98.57%).Of total 70 enrolled cases it was found that 57(81.43%) patients survived whereas 13(18.57%) were expired. Co infection with HIV, HBV as well as basal exudate, hydrocephalus, infarct and tuberculoma on CT were significant predictor for mortality in CNS TB. Conclusions: Mortality rate in CNS TB is high. With optimal medical management and timely surgical interventions like Ventriculoperitoneal shunt , External Ventricular Drain (EVD), Decompression Craniotomy many lives can be saved.
Clinical and Radiological Features and Outcome of Hospitalized Patients with CNS Tuberculosis : A Prospective Observational Study in A Tertiary Care Centre, Mumbai
Pravin G.Shilkande; Trupti H. Trivedi; Aishwarya Desai; Pandurang Harale; Sonal Honrao; Priyanshu Shah
DOI : 10.5281/zenodo.7847950
Background: Tuberculosis (TB) is a major public health problem in India. Ten percent of all patients with TB have CNS involvement. Delayed diagnosis of this disease is associated with increased mortality. This study assesses the clinico-radiological features as well as outcomes in patients with various forms of CNS TB. Methods: A prospective observational study conducted at tertiary care centre Mumbai between January 2020-July 2022.Each patient was assessed from admission to 3- month follow up. Detailed clinical examination including lab examination was done. All patients were divided into different categories based on Singhal staging and Modified MRC grading for TBM. APACHE 2 score was evaluated for severity of illness. Outcome was measured in terms of mortality and morbidity. Results: Our study had 70 patients with a mean age of 38.94 ± 20.75 years. Fever was the most common symptom in patients with TBM (98.57%).Of total 70 enrolled cases it was found that 57(81.43%) patients survived whereas 13(18.57%) were expired. Co infection with HIV, HBV as well as basal exudate, hydrocephalus, infarct and tuberculoma on CT were significant predictor for mortality in CNS TB. Conclusions: Mortality rate in CNS TB is high. With optimal medical management and timely surgical interventions like Ventriculoperitoneal shunt , External Ventricular Drain (EVD), Decompression Craniotomy many lives can be saved.
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Relationship between C-Reactive Protein and Stages of Chronic Obstructive Pulmonary Disease; A Cross-Sectional Study
Background: Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that obstructs airflow. Here, we evaluate the relationship between C-reactive protein (CRP) levels and the stages of COPD. Methods: A cross-sectional study involving 60 patients diagnosed with COPD aged between 35 to 70 years was performed, and the relationship between CRP and stages of COPD was noted. Data was tabulated and analyzed using Analysis of Variance (ANOVA), and a p-value of <0.05 was considered significant. Results: Fifty percent of the study participants were aged between 51 to 60 years, with a mean of 55.85 ± 7.64 years. According to the Global Initiative for Lung Disease (GOLD) criteria, 50 percent of the study participants were diagnosed with Stage II COPD and 35% with Stage III COPD. The mean forced expiratory volume in one second (FEV1) was 84 ±2.39 percent in stage I COPD and 28.20 ±1.48 percent in stage IV. The mean CRP levels recorded were 3.91 ±1.26 mg/dL in stage I COPD (p<0.05), 5.79 ±1.23 mg/dL in stage II (p<0.05), 9.01 ±0.96 mg/dL in stage III (p<0.05) and 11.98 ±0.73 stage IV (p<0.05). Statistically significant incremental mean CRP level was noted with progressive stages of COPD. Conclusions: COPD is a systemic inflammatory disease in which CRP levels significantly increase with the progression of the disease. This warrants serial measurement of CRP in patients with COPD to monitor the progression of the disease. In addition, the measurement of CRP should also be considered in stable COPD patients to document the baseline for follow-up.
Relationship between C-Reactive Protein and Stages of Chronic Obstructive Pulmonary Disease; A Cross-Sectional Study
Ashwini Prakash; Vikyath Satish; Vedavathi R
DOI : 10.5281/zenodo.7857874
Background: Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that obstructs airflow. Here, we evaluate the relationship between C-reactive protein (CRP) levels and the stages of COPD. Methods: A cross-sectional study involving 60 patients diagnosed with COPD aged between 35 to 70 years was performed, and the relationship between CRP and stages of COPD was noted. Data was tabulated and analyzed using Analysis of Variance (ANOVA), and a p-value of <0.05 was considered significant. Results: Fifty percent of the study participants were aged between 51 to 60 years, with a mean of 55.85 ± 7.64 years. According to the Global Initiative for Lung Disease (GOLD) criteria, 50 percent of the study participants were diagnosed with Stage II COPD and 35% with Stage III COPD. The mean forced expiratory volume in one second (FEV1) was 84 ±2.39 percent in stage I COPD and 28.20 ±1.48 percent in stage IV. The mean CRP levels recorded were 3.91 ±1.26 mg/dL in stage I COPD (p<0.05), 5.79 ±1.23 mg/dL in stage II (p<0.05), 9.01 ±0.96 mg/dL in stage III (p<0.05) and 11.98 ±0.73 stage IV (p<0.05). Statistically significant incremental mean CRP level was noted with progressive stages of COPD. Conclusions: COPD is a systemic inflammatory disease in which CRP levels significantly increase with the progression of the disease. This warrants serial measurement of CRP in patients with COPD to monitor the progression of the disease. In addition, the measurement of CRP should also be considered in stable COPD patients to document the baseline for follow-up.
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Estimation of Serum Fibrinogen Level in Type 2 Diabetics and Its Association with Major Adverse Cardiovascular Events (Mace)
Background: Diabetes mellitus is a group of metabolic disorders that share the phenotype of hyperglycemia. CVD remains the principal comorbid condition and primary contributor to mortality in patient with diabetes, usually in the form of coronary artery disease. Genetic studies have shown association of β fibrinogen gene polymorphism with increased levels of serum fibrinogen and increased risk of MI in patients with CAD. Fibrinogen levels are frequently elevated in diabetes, regardless of diabetes duration, but particularly in those with type 2 diabetes and preexisting vascular complications. Fibrinogen being an acute phase reactant is also a procoagulant. It plays a major role in coagulation of blood. It has a significant role in athero-thrombosis. Objectives: To estimate serum fibrinogen level in type 2 diabetic patients and to associate the Fibrinogen level with major adverse cardiovascular events in type 2 diabetics. Methods: A Hospital based Cross sectional study included 70 study participants conducted between February 2021 to August 2022 in hospitals attached to BMCRI. Patients diagnosed with type 2 diabetes mellitus according to ADA guideline. Results: Mean TCH in subjects with arrythmias was 205.00+42.117, it was 204.00+36.333 in CCF, 205.57+33.297 in MI and 210.27+34.661 in recurrent angina. Mean HDL was 40.50+7.944 in arrythmias, 39.25+6.754 in CCF, 39.81+6.623 in MI, 38.55.09+8.722 in recurrent angina. Mean LDL was 117.83+43.273 in arrythmias, 128.88+36.515 in CCF, 126.76+38.188 in MI and 136.00+41.027 in recurrent angina. Mean TG was 236.67+77.871 in arrythmias, 179.28+63.849 in CCF, 194.57+71.152 in MI and 178.55+55.012 in recurrent angina. The duration of diabetes was found to be positively correlating with the serum fibrinogen levels. Conclusion: The study concludes that hyperfibrinogenemia among type 2 diabetic patients can be used as a predictor of major adverse cardiac events. Further case control studies with larger sample size is required to warrant the same
Estimation of Serum Fibrinogen Level in Type 2 Diabetics and Its Association with Major Adverse Cardiovascular Events (Mace)
Dr Suresh K; Dr Raghavendra BM; Dr.Tejas H.S; Dr. Swasthik S K
DOI : 10.5281/zenodo.7857910
Background: Diabetes mellitus is a group of metabolic disorders that share the phenotype of hyperglycemia. CVD remains the principal comorbid condition and primary contributor to mortality in patient with diabetes, usually in the form of coronary artery disease. Genetic studies have shown association of β fibrinogen gene polymorphism with increased levels of serum fibrinogen and increased risk of MI in patients with CAD. Fibrinogen levels are frequently elevated in diabetes, regardless of diabetes duration, but particularly in those with type 2 diabetes and preexisting vascular complications. Fibrinogen being an acute phase reactant is also a procoagulant. It plays a major role in coagulation of blood. It has a significant role in athero-thrombosis. Objectives: To estimate serum fibrinogen level in type 2 diabetic patients and to associate the Fibrinogen level with major adverse cardiovascular events in type 2 diabetics. Methods: A Hospital based Cross sectional study included 70 study participants conducted between February 2021 to August 2022 in hospitals attached to BMCRI. Patients diagnosed with type 2 diabetes mellitus according to ADA guideline. Results: Mean TCH in subjects with arrythmias was 205.00+42.117, it was 204.00+36.333 in CCF, 205.57+33.297 in MI and 210.27+34.661 in recurrent angina. Mean HDL was 40.50+7.944 in arrythmias, 39.25+6.754 in CCF, 39.81+6.623 in MI, 38.55.09+8.722 in recurrent angina. Mean LDL was 117.83+43.273 in arrythmias, 128.88+36.515 in CCF, 126.76+38.188 in MI and 136.00+41.027 in recurrent angina. Mean TG was 236.67+77.871 in arrythmias, 179.28+63.849 in CCF, 194.57+71.152 in MI and 178.55+55.012 in recurrent angina. The duration of diabetes was found to be positively correlating with the serum fibrinogen levels. Conclusion: The study concludes that hyperfibrinogenemia among type 2 diabetic patients can be used as a predictor of major adverse cardiac events. Further case control studies with larger sample size is required to warrant the same
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Deep Neck Abscess: A Retrospective Study of 52 Cases
Deep neck space infection leading to Abscess (DNA) are serious diseases that involve several spaces in the neck due to bacterial infections originating from the upper aero digestive tract [1, 4]. Although the incidence of Deep Neck Abscess (DNA) has decreased mainly for the availability of antibiotics, this infection still occurs with considerable frequency in developing countries [2, 3], low socioeconomics [3] group and with comorbidities [3, 4]. A retrospective study of 52 patient with deep neck abscesses caused by multiple etiologiesadmitted at Dept. of ENT Head & Neck Surgery, AGMC and GBP hospital Agartala, Tripura, India was conducted and bacterial tonsillitis is most common etiology commonly involving the peritonsillar space and Streptococcus pyogenes was found to be most common microorganism associated with DNA. Surgical intervention along with appropriate antimicrobials are mainstay of Treatment of DNA. The main complications of DNA were septic shock.
Deep Neck Abscess: A Retrospective Study of 52 Cases
Dr. Sukumar Debbarma; Dr. Bhupendra Debbarma; Dr. Sankar Sarkar
DOI : 10.5281/zenodo.7857936
Deep neck space infection leading to Abscess (DNA) are serious diseases that involve several spaces in the neck due to bacterial infections originating from the upper aero digestive tract [1, 4]. Although the incidence of Deep Neck Abscess (DNA) has decreased mainly for the availability of antibiotics, this infection still occurs with considerable frequency in developing countries [2, 3], low socioeconomics [3] group and with comorbidities [3, 4]. A retrospective study of 52 patient with deep neck abscesses caused by multiple etiologiesadmitted at Dept. of ENT Head & Neck Surgery, AGMC and GBP hospital Agartala, Tripura, India was conducted and bacterial tonsillitis is most common etiology commonly involving the peritonsillar space and Streptococcus pyogenes was found to be most common microorganism associated with DNA. Surgical intervention along with appropriate antimicrobials are mainstay of Treatment of DNA. The main complications of DNA were septic shock.
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Comparative Evaluation of Two Different Bolus Doses of Nor-Epinephrine to Prevent Post Spinal Hypotension in Patients Undergoing PCNL: A Prospective Randomized Study
Spinal anaesthesia is a recently accepted technique for PCNL. Vasopressors for prophylaxis and treatment of spinal hypotension have grown in popularity in recent years. The aim of our study was to evaluate the effectiveness of two different bolus doses of nor-epinephrine given pre-emptively for prevention of hypotension during spinal anaesthesia in patients undergoing PCNL and also to evaluate any associated adverse effects. A total 60 patients undergoing PCNL under spinal anaesthesia were enrolled in the study to receive either prophylactic nor-epinephrine bolus 10 µg (group A) or 15 µg (group B) immediately after spinal anaesthesia. Only one patient in group A developed hypotension requiring a rescue dose of vasopressor. 4 patients in group B developed systolic hypertension which settled without requiring intervention. Fall in blood pressure (systolic, diastolic and mean) were comparable between two groups. Maximum hypotension was encountered after the patient was put in prone position from supine position. From the above study we concluded that both 10 and 15 µg of Norepinephrine were effective in preventing hypotension. The dose of 15µg did not have any added benefit; rather it led to a statistically significant incidence of hypertension; which could prove hazardous in patients with pre-existing hypertension. Thus a bolus dose of 10 µg of Norepinephrine proved to be a good preventive measure against hypotension with reduced incidence of adverse effects.
Comparative Evaluation of Two Different Bolus Doses of Nor-Epinephrine to Prevent Post Spinal Hypotension in Patients Undergoing PCNL: A Prospective Randomized Study
Dr. Rahul Gupta; Dr. Diskit dolma; Dr. Vikas Gupta
DOI : 10.5281/zenodo.7858022
Spinal anaesthesia is a recently accepted technique for PCNL. Vasopressors for prophylaxis and treatment of spinal hypotension have grown in popularity in recent years. The aim of our study was to evaluate the effectiveness of two different bolus doses of nor-epinephrine given pre-emptively for prevention of hypotension during spinal anaesthesia in patients undergoing PCNL and also to evaluate any associated adverse effects. A total 60 patients undergoing PCNL under spinal anaesthesia were enrolled in the study to receive either prophylactic nor-epinephrine bolus 10 µg (group A) or 15 µg (group B) immediately after spinal anaesthesia. Only one patient in group A developed hypotension requiring a rescue dose of vasopressor. 4 patients in group B developed systolic hypertension which settled without requiring intervention. Fall in blood pressure (systolic, diastolic and mean) were comparable between two groups. Maximum hypotension was encountered after the patient was put in prone position from supine position. From the above study we concluded that both 10 and 15 µg of Norepinephrine were effective in preventing hypotension. The dose of 15µg did not have any added benefit; rather it led to a statistically significant incidence of hypertension; which could prove hazardous in patients with pre-existing hypertension. Thus a bolus dose of 10 µg of Norepinephrine proved to be a good preventive measure against hypotension with reduced incidence of adverse effects.
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Thyroid Screening of Preterm and Term Newborn Discharged from SNCU
Background: The TSH and T4 level rises in 24 hours and decline gradually to 4 weeks of age and stabilizes at slightly at higher level than the adult in term newborns. In the preterm T4 level decline profoundly after birth resulting in hypothyroxemia of prematurity most marked in infants born prior to 30 weeks gestation. There is also in delay rise of TSH. Aims and Objections: To do thyroid screening preterm and term newborns babies admitted and later discharged from Special Newborn Care Unit. Material and Methods: This study was conducted from 2022 in Department of Pediatrics, Kamla Raja Hospital, G.R.M.C., Gwalior. Setting: Department of Pediatrics, SNCU, KRH in GRMC, Gwalior. Study design: Prospective cohort study. Sample size:120 newborns (60term and 60 preterm). Duration of study: 2 years. Statistical analysis: SPSS version 25. Results and Conclusion: 120 newborns (60 term and 60 preterm) were taken. Out of 60 preterms, 40 (66.66%) males and 20 (33.3%) females while 32 (53.3%) males and 28 (46.7%) were female term newborns. In the study, 2 preterm (1.67%) were having true congenital hypothyroidism and delay TSH rise was reported 3 preterm (5.1%) and 2 (3.3%) term newborn. In the study 3(5%) preterm and 2(3.33%) term newborn were having congenital hypothyroidism on admission but on second and third screening their thyroid becomes normal. So they were level as transient hypothyroidism. No case of congenital hypothyroidism in term newborn.
Thyroid Screening of Preterm and Term Newborn Discharged from SNCU
Dr. R.D. Dutt; Dr. Suraj Singh Yadav; Dr. Ajay Gaur; Dr. Chandrakala Dutt; Dr. Tarushi Dutt
DOI : 10.5281/zenodo.7858068
Background: The TSH and T4 level rises in 24 hours and decline gradually to 4 weeks of age and stabilizes at slightly at higher level than the adult in term newborns. In the preterm T4 level decline profoundly after birth resulting in hypothyroxemia of prematurity most marked in infants born prior to 30 weeks gestation. There is also in delay rise of TSH. Aims and Objections: To do thyroid screening preterm and term newborns babies admitted and later discharged from Special Newborn Care Unit. Material and Methods: This study was conducted from 2022 in Department of Pediatrics, Kamla Raja Hospital, G.R.M.C., Gwalior. Setting: Department of Pediatrics, SNCU, KRH in GRMC, Gwalior. Study design: Prospective cohort study. Sample size:120 newborns (60term and 60 preterm). Duration of study: 2 years. Statistical analysis: SPSS version 25. Results and Conclusion: 120 newborns (60 term and 60 preterm) were taken. Out of 60 preterms, 40 (66.66%) males and 20 (33.3%) females while 32 (53.3%) males and 28 (46.7%) were female term newborns. In the study, 2 preterm (1.67%) were having true congenital hypothyroidism and delay TSH rise was reported 3 preterm (5.1%) and 2 (3.3%) term newborn. In the study 3(5%) preterm and 2(3.33%) term newborn were having congenital hypothyroidism on admission but on second and third screening their thyroid becomes normal. So they were level as transient hypothyroidism. No case of congenital hypothyroidism in term newborn.
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Assess Knowledge Gap on Morbidities, its Preventive, Control Measures and Practice of Using Preventive Measures Related to Air Pollution among Traffic Police in W.B (Kolkata)
Background: Air pollution is a major problem of present scenario, which has serious toxicological impact on human health and environment Air pollution is considered as the major environmental risk factor in the incidence and progression of some diseases such as asthma, lung cancer. Traffic police by their profession doing well for our society. They are vulnerable people to developed morbidities related air pollution. Aims and objectives: To assess Knowledge gap of the traffic regarding morbidities, its preventive, control measures and practice of preventive and control measures related to air pollution among Traffic police in W.B (Kolkata) and to examine the association of knowledge gap with practice measures. Materials & Methods: A descriptive study was conducted “Assess knowledge gap on morbidities, its preventive, control measures and practice of using preventive measures related to air pollution among Traffic police in W.B (Kolkata).Conceptual frame work of the study was based on Pender’s health promotional model. Study was done with 200 Traffic Police under different Kolkata traffic guard, W.B. sample selection was done by probability sampling technique through lottery method. Data regarding knowledge were collected through structured questionnaire. Results: Descriptive and inferential statistics were used for data analysis. Study findings revealed that Maximum 47.5 % traffic police have good knowledge regarding morbidities, its preventive, control measures related to air pollution. Mean of the knowledge score is 6.5, median 7, mode 15.375, SD 3. There is significant association between Knowledge level of traffic police & practice of using preventive measures for prevention of morbidities regarding Air pollution among traffic police as at one degree of freedom calculated chi-square value (8.8551),yates correction (7.7944)is greater than p value at level 0.05. Conclusion: It has implication on control and prevention of occupational health hazards. Based on the study findings information booklet to be developed for increase their knowledge and practice of preventive measures during their working period
Assess Knowledge Gap on Morbidities, its Preventive, Control Measures and Practice of Using Preventive Measures Related to Air Pollution among Traffic Police in W.B (Kolkata)
Snita Bhunia & Dr. Ratna Chhaya Sing
DOI : 10.5281/zenodo.7858109
Background: Air pollution is a major problem of present scenario, which has serious toxicological impact on human health and environment Air pollution is considered as the major environmental risk factor in the incidence and progression of some diseases such as asthma, lung cancer. Traffic police by their profession doing well for our society. They are vulnerable people to developed morbidities related air pollution. Aims and objectives: To assess Knowledge gap of the traffic regarding morbidities, its preventive, control measures and practice of preventive and control measures related to air pollution among Traffic police in W.B (Kolkata) and to examine the association of knowledge gap with practice measures. Materials & Methods: A descriptive study was conducted “Assess knowledge gap on morbidities, its preventive, control measures and practice of using preventive measures related to air pollution among Traffic police in W.B (Kolkata).Conceptual frame work of the study was based on Pender’s health promotional model. Study was done with 200 Traffic Police under different Kolkata traffic guard, W.B. sample selection was done by probability sampling technique through lottery method. Data regarding knowledge were collected through structured questionnaire. Results: Descriptive and inferential statistics were used for data analysis. Study findings revealed that Maximum 47.5 % traffic police have good knowledge regarding morbidities, its preventive, control measures related to air pollution. Mean of the knowledge score is 6.5, median 7, mode 15.375, SD 3. There is significant association between Knowledge level of traffic police & practice of using preventive measures for prevention of morbidities regarding Air pollution among traffic police as at one degree of freedom calculated chi-square value (8.8551),yates correction (7.7944)is greater than p value at level 0.05. Conclusion: It has implication on control and prevention of occupational health hazards. Based on the study findings information booklet to be developed for increase their knowledge and practice of preventive measures during their working period
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The Probable Medicinal Usage of Cinnamon in Type 2 Diabetes Mellitus: An Overview
Diabetes mellitus (DM) is a chronic disease which causes major public health problemand its estimated that in 2019, worldwide 463 million people were suffering from DM.The main goal for the therapeutics is to regulate the glycemic control and reduce the secondary complications. There are several plant-based products has been reported to have the antidiabetic effect in type 2 diabetes (T2DM). Herein we are discussing the role of cinnamon, an herb with more than 250 species known so far. Each species contains several volatile compounds, which seems to be highly bioactive and helpful in modulating various physiological functions, further improving various disorders. Cinnamon appearing to have mimetic effect of the insulin, reducing insulin resistance via reduction of lipolysis in the adipocytes, improving lipid profile, increases incretin hormones release and regulating the glycemic control. So, we can conclude that due to increased incretins, reduced insulin resistance and insulin mimetic effect, cinnamon helps healthy persons need to secrete less insulin and in T2DM same secreted amount of insulin will help to reduce hyperglycemia due to increased glucose uptake in adipocytes and skeletal muscles. Thus, cinnamon can be used as an adjuvant to the existing therapy for T2DM, which help them to improve their glycemic control and decrease the chances of secondary complications.
The Probable Medicinal Usage of Cinnamon in Type 2 Diabetes Mellitus: An Overview
Shailendra Kumar Tripathi; Prem Shankar Pandey; Ruchi Tripathi; Manisha Arora; Manish Mishra
DOI : 10.5281/zenodo.7858160
Diabetes mellitus (DM) is a chronic disease which causes major public health problemand its estimated that in 2019, worldwide 463 million people were suffering from DM.The main goal for the therapeutics is to regulate the glycemic control and reduce the secondary complications. There are several plant-based products has been reported to have the antidiabetic effect in type 2 diabetes (T2DM). Herein we are discussing the role of cinnamon, an herb with more than 250 species known so far. Each species contains several volatile compounds, which seems to be highly bioactive and helpful in modulating various physiological functions, further improving various disorders. Cinnamon appearing to have mimetic effect of the insulin, reducing insulin resistance via reduction of lipolysis in the adipocytes, improving lipid profile, increases incretin hormones release and regulating the glycemic control. So, we can conclude that due to increased incretins, reduced insulin resistance and insulin mimetic effect, cinnamon helps healthy persons need to secrete less insulin and in T2DM same secreted amount of insulin will help to reduce hyperglycemia due to increased glucose uptake in adipocytes and skeletal muscles. Thus, cinnamon can be used as an adjuvant to the existing therapy for T2DM, which help them to improve their glycemic control and decrease the chances of secondary complications.
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A Hidden Popliteal Cyst in a Male Cadaver: A Case Report of Clinical Significance
The popliteal cyst also known as baker’s cyst is a fluid-filled synovial cyst in the popliteal region. It is fluid-filled distension of gastrocnemius-semimembranosus bursa which is commonly seen in 35-70 years of age. During routine dissection of a male cadaver we found a popliteal cyst in the popliteal region in the left lower limb. Clinically it is important as it compresses the neuro-vascular bundle surrounding it. Ultrasound is the best imaging modality to identify the baker’s cyst. Magnetic Resonance Imaging identify the baker’s cyst as either a unilocular or multilocular cyst. It is important to know the swellings & masses in the popliteal region for surgeons, neurovascular surgeons and anatomists as these swellings lead to neurovascular compressions.
A Hidden Popliteal Cyst in a Male Cadaver: A Case Report of Clinical Significance
Punnapa Raviteja; Mrudula Chandrupatla; Mantasha Patnaik; Nair Amrith Hari
DOI : 10.5281/zenodo.7858191
The popliteal cyst also known as baker’s cyst is a fluid-filled synovial cyst in the popliteal region. It is fluid-filled distension of gastrocnemius-semimembranosus bursa which is commonly seen in 35-70 years of age. During routine dissection of a male cadaver we found a popliteal cyst in the popliteal region in the left lower limb. Clinically it is important as it compresses the neuro-vascular bundle surrounding it. Ultrasound is the best imaging modality to identify the baker’s cyst. Magnetic Resonance Imaging identify the baker’s cyst as either a unilocular or multilocular cyst. It is important to know the swellings & masses in the popliteal region for surgeons, neurovascular surgeons and anatomists as these swellings lead to neurovascular compressions.
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Domiciliary Practices and Health Seeking Behaviour Among Dog Bite Cases in Patients Attending a Rural Health Training Centre
Background: Rabies is a viral zoonosis. Rabies is virtually 100% fatal once symptoms appear. is preventable with appropriate post-exposure prophylaxis. Objectives: This study aimed to study the socio-demographic profile of the study participants, domiciliary practices and health seeking behaviour among dog bite cases. Materials & Methods: A cross sectional study involving 141 participants (complete enumeration sampling method) in a Rural health Training Centre attached to a teaching institute using pretested, semi-structured questionnaire. Results: Out of 141 cases, Majority were males (%). Approximately 35% were in the age group of 26-45years, 5.6% were <5 years. 51% were employed. Mostly by stray dogs (61.7%), Category II bite approximately 54%, lower limb site (62.2%) seen commonly. 44 % study participants used domiciliary practices followed after dog bite (Taken first aid at home like application of antiseptic, washing with soap and water, home remedy, herbal remedy). Only 29% study participants reported to health care facility within ½ an hour. Majority of them approached directly to RHTC after dog bite incident. Conclusion: It was observed that a majority study participants approached healthcare facility (RHTC) for vaccination following dog bite, but did not practice proper wound care. A sizable proportion of study participants resorted to wrong non-allopathic practices e.g., application of garlic pastes, lime, mud etc. A rabies is preventable disease, increasing awareness relating to its prevention may prove to be beneficial in increasing the morbidity and mortality
Domiciliary Practices and Health Seeking Behaviour Among Dog Bite Cases in Patients Attending a Rural Health Training Centre
Dr. Manjusha Shinde; Dr. Pallavi Shelke; Dr. Seema S Bansode
DOI : 10.5281/zenodo.7858220
Background: Rabies is a viral zoonosis. Rabies is virtually 100% fatal once symptoms appear. is preventable with appropriate post-exposure prophylaxis. Objectives: This study aimed to study the socio-demographic profile of the study participants, domiciliary practices and health seeking behaviour among dog bite cases. Materials & Methods: A cross sectional study involving 141 participants (complete enumeration sampling method) in a Rural health Training Centre attached to a teaching institute using pretested, semi-structured questionnaire. Results: Out of 141 cases, Majority were males (%). Approximately 35% were in the age group of 26-45years, 5.6% were <5 years. 51% were employed. Mostly by stray dogs (61.7%), Category II bite approximately 54%, lower limb site (62.2%) seen commonly. 44 % study participants used domiciliary practices followed after dog bite (Taken first aid at home like application of antiseptic, washing with soap and water, home remedy, herbal remedy). Only 29% study participants reported to health care facility within ½ an hour. Majority of them approached directly to RHTC after dog bite incident. Conclusion: It was observed that a majority study participants approached healthcare facility (RHTC) for vaccination following dog bite, but did not practice proper wound care. A sizable proportion of study participants resorted to wrong non-allopathic practices e.g., application of garlic pastes, lime, mud etc. A rabies is preventable disease, increasing awareness relating to its prevention may prove to be beneficial in increasing the morbidity and mortality
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HELLP Syndrome: It’s Maternal and Foetal Outcome
Objective: To study maternal and foetal outcome in HELLP syndrome. Study design: The present study was a hospital based prospective observational study to find out maternal and perinatal outcome in HELLP syndrome. Subjects & methodology: This study was conducted at the Department of Obstetrics and Gynaecology, Government medical college, Aurangabad during six months (from July 2022 to December 2022) with more than 28 weeks gestation,150 patients of HELLP syndrome were studied. Most common age group is 21-25 years(40.67%), followed by 26-30 years(30.67%). All available detailed history, clinical data, detailed laboratory investigation were studied and characterized by Tennessee and Mississippi classification for better analysis of complications and outcome in HELLP syndrome. Conclusion: HELLP syndrome is a severe variant and dreadful complication of Preeclampsia and Eclampsia, it needs early diagnosis and timely intervention in the form of termination of pregnancy to arrest further progress of pathophysiology leading to complication.
HELLP Syndrome: It’s Maternal and Foetal Outcome
Dr Shrinivas N Gadappa; Dr Suchita Manikrao Suryawanshi; Dr Prashant Bhingare; Dr Sonali Deshpande
DOI : 10.5281/zenodo.7866753
Objective: To study maternal and foetal outcome in HELLP syndrome. Study design: The present study was a hospital based prospective observational study to find out maternal and perinatal outcome in HELLP syndrome. Subjects & methodology: This study was conducted at the Department of Obstetrics and Gynaecology, Government medical college, Aurangabad during six months (from July 2022 to December 2022) with more than 28 weeks gestation,150 patients of HELLP syndrome were studied. Most common age group is 21-25 years(40.67%), followed by 26-30 years(30.67%). All available detailed history, clinical data, detailed laboratory investigation were studied and characterized by Tennessee and Mississippi classification for better analysis of complications and outcome in HELLP syndrome. Conclusion: HELLP syndrome is a severe variant and dreadful complication of Preeclampsia and Eclampsia, it needs early diagnosis and timely intervention in the form of termination of pregnancy to arrest further progress of pathophysiology leading to complication.
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Knowledge and Awareness Towards the LGBTQA+ Population among First and Final Year Medical Undergraduates-A Cross-Sectional Comparative Study
Background: The people of the LGBT (lesbian, gay, bisexual and transgender) community are generally recognized as underprivileged in healthcare settings. Adequate Knowledge among doctors is needed to provide better health care. Objective: To study awareness and knowledge about the LGBTQA+ population among medical undergraduates. Materials and Methods: This Cross-sectional Study was done in the tertiary care hospital that includes first and final Year Undergraduate of both genders. A form containing Sociodemographic data as well as Riddle’sscale: Attitudes towards LGBT people was administered. P-value has been considered significant at a 5% level of significance for all comparisons. Results: Out of 298 students, 260 responded to the pre-intervention questionnaire. Based on the output of the study, medical students had afavorable attitude towards the LGBT community and a few lacunae of knowledge of LGBT healthcare needs. Male students had more hesitation in communicating with these patients than their female counterparts. Conclusions: It is concluded that the incorporation of lectures about how to care for LGBT in the medical curriculum will further enhance the knowledge of medical students which in turn helps the LGBT community to meet their healthcare needs
Knowledge and Awareness Towards the LGBTQA+ Population among First and Final Year Medical Undergraduates-A Cross-Sectional Comparative Study
Dr. Mano Ranjitha; Dr.Mohan Reddy; Dr Ruth Sneha Chandrashekar; Dr.Veni Nirudya
DOI : 10.5281/zenodo.7866874
Background: The people of the LGBT (lesbian, gay, bisexual and transgender) community are generally recognized as underprivileged in healthcare settings. Adequate Knowledge among doctors is needed to provide better health care. Objective: To study awareness and knowledge about the LGBTQA+ population among medical undergraduates. Materials and Methods: This Cross-sectional Study was done in the tertiary care hospital that includes first and final Year Undergraduate of both genders. A form containing Sociodemographic data as well as Riddle’sscale: Attitudes towards LGBT people was administered. P-value has been considered significant at a 5% level of significance for all comparisons. Results: Out of 298 students, 260 responded to the pre-intervention questionnaire. Based on the output of the study, medical students had afavorable attitude towards the LGBT community and a few lacunae of knowledge of LGBT healthcare needs. Male students had more hesitation in communicating with these patients than their female counterparts. Conclusions: It is concluded that the incorporation of lectures about how to care for LGBT in the medical curriculum will further enhance the knowledge of medical students which in turn helps the LGBT community to meet their healthcare needs
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Correlation of Overweight and Lipid Profile among Medical College Students at Jhalawar: A Cross Sectional Study
Abstract: There has a long been proven relationship between obesity and dyslipidemia. Overweight and obesity are disorders of imbalance of energy affecting people of various age groups and socio–economic status. So, hereby we undertook this study to determine the frequency of obesity and its relationship with lipid profile among medical students. Methodology: In this cross sectional study, 300 MBBS students of JMC Jhalawar, Rajasthan in age group 17-30 years were enrolled from period of September 2021 to August 2022.Their height and weight and lipid profile were assessed by using standard methods and techniques. Moreover, on these subjects body mass index (BMI) was calculated and it's association with lipid profile was found. Results: Amongst 300 students, a total of 175(58.3%) were male and 125 (41.7%) were females. Among studied subjects, The prevalence of overweight and obesity was 85 (28.3%) and 10 (3.3%) respectively. Prevalence of Overweight in male and females was 50(16.7%) and 35(11.7%), in obese were 8(2.7%) in male and 2 (0.7%) in female, with more men affected than women. Finding of lipid profile includes mean triglycerides 114.83 ±26.09 mg/dl, total cholesterol 145.96 ±22.02 mg/dl, LDL 102.40 ±14.58 mg/dl, HDL Cholesterol 28.59 ± 9.90 mg/dl, VLDL 23.82 ± 7.95 mg/dl. Obesity was positively association with triglycerides and no. of hypertensive subjects (p<.05%) but showed negative association with total cholesterol, LDL, HDL, VLDL , SBP and DBP (p>.05%). Conclusion: Findings showed males are more prone to be obese and change in the lipid profile is also seen. Though not very significant for all parameters but more on increasing trend. So, Preventive strategies for obesity may offer an early and cost-effective approach towards lowering lipid level and related complications.
Correlation of Overweight and Lipid Profile among Medical College Students at Jhalawar: A Cross Sectional Study
Dr. Jitendra kumar Jain; Dr. Shashikant Agarwal; Dr. Shrikant Shete; Dr.Kusum Bala Jain
DOI : 10.5281/zenodo.7869671
Abstract: There has a long been proven relationship between obesity and dyslipidemia. Overweight and obesity are disorders of imbalance of energy affecting people of various age groups and socio–economic status. So, hereby we undertook this study to determine the frequency of obesity and its relationship with lipid profile among medical students. Methodology: In this cross sectional study, 300 MBBS students of JMC Jhalawar, Rajasthan in age group 17-30 years were enrolled from period of September 2021 to August 2022.Their height and weight and lipid profile were assessed by using standard methods and techniques. Moreover, on these subjects body mass index (BMI) was calculated and it's association with lipid profile was found. Results: Amongst 300 students, a total of 175(58.3%) were male and 125 (41.7%) were females. Among studied subjects, The prevalence of overweight and obesity was 85 (28.3%) and 10 (3.3%) respectively. Prevalence of Overweight in male and females was 50(16.7%) and 35(11.7%), in obese were 8(2.7%) in male and 2 (0.7%) in female, with more men affected than women. Finding of lipid profile includes mean triglycerides 114.83 ±26.09 mg/dl, total cholesterol 145.96 ±22.02 mg/dl, LDL 102.40 ±14.58 mg/dl, HDL Cholesterol 28.59 ± 9.90 mg/dl, VLDL 23.82 ± 7.95 mg/dl. Obesity was positively association with triglycerides and no. of hypertensive subjects (p<.05%) but showed negative association with total cholesterol, LDL, HDL, VLDL , SBP and DBP (p>.05%). Conclusion: Findings showed males are more prone to be obese and change in the lipid profile is also seen. Though not very significant for all parameters but more on increasing trend. So, Preventive strategies for obesity may offer an early and cost-effective approach towards lowering lipid level and related complications.
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Study of QT Prolongation in ECG in Type 2 Diabetes patients and its Correlation to HbA1c Levels
Diabetes is one of the common diseases of 21st century. Long standing Diabetes is one of the risk factor for development of all microvascular complications of diabetes. HbA1c variability is an independent risk factor for the same. Cardiovascular autonomic neuropathy is present in 16-40% of diabetic population. High QTc indicates a dysfunction of the autonomic system of heart in patients with DM. In our study 75 adults with duration of diabetes longer than 5 years were randomly selected, their HbA1c measured and correlated with QTc interval. Analysis showed that ECG changes (blocks or ischemia) were present in 22.6 % of subjects. And the mean QTc interval was 397ms. Correlation crosstabs between QTc and Hba1c showed strong positive correlation (pearson correlation =0.677, p value =0.001) between HbA1c and QTc. The study demonstrates that there is strong positive correlation between HbA1c and QTc interval suggesting high incidence of microvascular complications in patients with high HbA1c.
Study of QT Prolongation in ECG in Type 2 Diabetes patients and its Correlation to HbA1c Levels
Dr. Midhun S & Dr.Suneetha DK
DOI : 10.5281/zenodo.7869855
Diabetes is one of the common diseases of 21st century. Long standing Diabetes is one of the risk factor for development of all microvascular complications of diabetes. HbA1c variability is an independent risk factor for the same. Cardiovascular autonomic neuropathy is present in 16-40% of diabetic population. High QTc indicates a dysfunction of the autonomic system of heart in patients with DM. In our study 75 adults with duration of diabetes longer than 5 years were randomly selected, their HbA1c measured and correlated with QTc interval. Analysis showed that ECG changes (blocks or ischemia) were present in 22.6 % of subjects. And the mean QTc interval was 397ms. Correlation crosstabs between QTc and Hba1c showed strong positive correlation (pearson correlation =0.677, p value =0.001) between HbA1c and QTc. The study demonstrates that there is strong positive correlation between HbA1c and QTc interval suggesting high incidence of microvascular complications in patients with high HbA1c.
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Hematological Study of Pancytopenia in Patients Attending in Tertiary Care Hospital at, SKMCH, Muzaffarpur, Bihar
Objective: The aim of present study was designed to ascertain the percentage of occurrence and cause of pancytopenia. Materials and Methods: A total of 232 patients fulfilled the criteria for Pancytopenia. Out of them 186 were subjected to Bone marrow examination and regular follow up and we have restricted our studies with them. Results: Most of the patients were ranged between 12 to 75 years of age with male preponderance and were seen in third decade of life. Commonest cause of pancytopenia was megaloblastic anemia Seen in 148 cases (79.56%) followed by hypersplenism due to kala-azar in 18 cases (9.67%) and in non-hodgkin'slymphoma 03(1.61%) cases. Pallor was seen in most cases. Massive splenomegaly was seen in kala azar, malaria. Hepatosplenomegaly was seen in many cases of megaloblastic anemia. In peripheral blood smear examination anisopoikilocytosis was the predominant finding of megaloblastic anemia, hypersplenism due to kala- azar and malaria. Conclusion: Bone marrow examination was of diagnostic value to the patients with pancytopenia. So, any case of anemia detailed study on physical finding, peripheral blood picture and for conformation bone marrow aspiration was done.
Hematological Study of Pancytopenia in Patients Attending in Tertiary Care Hospital at, SKMCH, Muzaffarpur, Bihar
Dr. Dilip kumar; Dr. Mahesh prasad; Dr. Satyendu sagar; Dr. Manoj kumar
DOI : 10.5281/zenodo.7874403
Objective: The aim of present study was designed to ascertain the percentage of occurrence and cause of pancytopenia. Materials and Methods: A total of 232 patients fulfilled the criteria for Pancytopenia. Out of them 186 were subjected to Bone marrow examination and regular follow up and we have restricted our studies with them. Results: Most of the patients were ranged between 12 to 75 years of age with male preponderance and were seen in third decade of life. Commonest cause of pancytopenia was megaloblastic anemia Seen in 148 cases (79.56%) followed by hypersplenism due to kala-azar in 18 cases (9.67%) and in non-hodgkin'slymphoma 03(1.61%) cases. Pallor was seen in most cases. Massive splenomegaly was seen in kala azar, malaria. Hepatosplenomegaly was seen in many cases of megaloblastic anemia. In peripheral blood smear examination anisopoikilocytosis was the predominant finding of megaloblastic anemia, hypersplenism due to kala- azar and malaria. Conclusion: Bone marrow examination was of diagnostic value to the patients with pancytopenia. So, any case of anemia detailed study on physical finding, peripheral blood picture and for conformation bone marrow aspiration was done.
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Cytopathological Spectrum of Space Occupying Lesions in Liver of the Patients Attending in Tertiary Care Hospital at N.M.C.H, Patna, A Demographic Study
Background: Fine needle aspiration cytology is a rapid, economical and minimally invasive technique without substantial complications for the diagnosis of benign and malignant lesion. The aim of present study was to evaluate the nature of space occupying lesion in liver (hepatic mass) by FNAC under ultrasound guidance as well as to assess the demographic spectrum of the patients. Material and Methods: A total of 234 cases presenting with space occupying lesion of liver were included in the study. Ultrasound guidance FNAC was performed from the sol liver in the presence of trained radiologist using 20-22 gauze disposable spinal needle connected to 10 ml disposable plastic syringe with full aseptic precautions. Results: The minimum and maximum age of the patients was 6 years and 89 years respectively. However, the mean age of the patient was 54 years with mean ± SD as (54±16 yrs.). Among the females, 75.4% were above the 40 years of age and whereas, 78.6% males were above 40 years of age. A highly statistically significant difference (p<0.0001) was found for age greater than 40 years for all categories of disease when compared to age less than 40 years. Occurrences of primary (84.3%), secondary (83.5%) and other (85.7%) malignancies were significantly (p <0.001) higher in patients aged above 40 years. Secondary malignancies, metastatic adenocarcinoma (50.0%) was the most common malignancy causing space occupying lesion of liver, followed by primary malignancy of liver (38.46%). Other malignancies were seen in (11.54%) cases. 7 cases (2.99%) were diagnosed as suspicious for malignant due to hypo cellular smear consisting of few atypical cells and 11 cases (4.70%) were non representative (inconclusive), as it contained only few scattered hepatocytes in the background of RBCs. Conclusion: Ultrasound guided FNAC from space occupying lesion of liver is highly accurate technique for making the diagnosis of hepatic lesions without any major complications and can accurately distinguish non-neoplastic lesions from neoplastic lesions as well as categorize primary and secondary malignancies, helping in management of hepatic lesions.
Cytopathological Spectrum of Space Occupying Lesions in Liver of the Patients Attending in Tertiary Care Hospital at N.M.C.H, Patna, A Demographic Study
Kritank Aman; C P Jaiswal; Satyendu Sagar; Dr. Sunil Kumar
DOI : 10.5281/zenodo.7874417
Background: Fine needle aspiration cytology is a rapid, economical and minimally invasive technique without substantial complications for the diagnosis of benign and malignant lesion. The aim of present study was to evaluate the nature of space occupying lesion in liver (hepatic mass) by FNAC under ultrasound guidance as well as to assess the demographic spectrum of the patients. Material and Methods: A total of 234 cases presenting with space occupying lesion of liver were included in the study. Ultrasound guidance FNAC was performed from the sol liver in the presence of trained radiologist using 20-22 gauze disposable spinal needle connected to 10 ml disposable plastic syringe with full aseptic precautions. Results: The minimum and maximum age of the patients was 6 years and 89 years respectively. However, the mean age of the patient was 54 years with mean ± SD as (54±16 yrs.). Among the females, 75.4% were above the 40 years of age and whereas, 78.6% males were above 40 years of age. A highly statistically significant difference (p<0.0001) was found for age greater than 40 years for all categories of disease when compared to age less than 40 years. Occurrences of primary (84.3%), secondary (83.5%) and other (85.7%) malignancies were significantly (p <0.001) higher in patients aged above 40 years. Secondary malignancies, metastatic adenocarcinoma (50.0%) was the most common malignancy causing space occupying lesion of liver, followed by primary malignancy of liver (38.46%). Other malignancies were seen in (11.54%) cases. 7 cases (2.99%) were diagnosed as suspicious for malignant due to hypo cellular smear consisting of few atypical cells and 11 cases (4.70%) were non representative (inconclusive), as it contained only few scattered hepatocytes in the background of RBCs. Conclusion: Ultrasound guided FNAC from space occupying lesion of liver is highly accurate technique for making the diagnosis of hepatic lesions without any major complications and can accurately distinguish non-neoplastic lesions from neoplastic lesions as well as categorize primary and secondary malignancies, helping in management of hepatic lesions.
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Case Report of Mucopolysaccharidosis type -1 (MPS-1)
Mucopolysaccharidosis (MPS) represents a heterogenous group of inheritable lysosomal storage disease in which accumulation of undegraded glycosaminoglycans (Gags)- {dermatan sulfate & heparan sulfate}interfere with cell functions and leads to progressive damage of affected tissue. Radiological features; skeletal radiograph and MRI allows theassessmentof the severity of the disease (10). The case highlights that abnormal clinical symptoms, such as growth failure, coarse facial features, and joint problems, are key points for further investigation relating to mucopolysaccharidosis disease. Deficiency of α-L-iduronidase results in a wide range of clinical involvement from severe Hurler disease to mild Scheie disease (MPS I S) & intermediate form Hurler-Scheie disease (MPS I HS) (2).
Case Report of Mucopolysaccharidosis type -1 (MPS-1)
Dr. Arzoo Yadav; Dr. Ashna Garg; Dr. Subhash Choudhary; Dr. Hemant Kumar Mishra
DOI : 10.5281/zenodo.7874447
Mucopolysaccharidosis (MPS) represents a heterogenous group of inheritable lysosomal storage disease in which accumulation of undegraded glycosaminoglycans (Gags)- {dermatan sulfate & heparan sulfate}interfere with cell functions and leads to progressive damage of affected tissue. Radiological features; skeletal radiograph and MRI allows theassessmentof the severity of the disease (10). The case highlights that abnormal clinical symptoms, such as growth failure, coarse facial features, and joint problems, are key points for further investigation relating to mucopolysaccharidosis disease. Deficiency of α-L-iduronidase results in a wide range of clinical involvement from severe Hurler disease to mild Scheie disease (MPS I S) & intermediate form Hurler-Scheie disease (MPS I HS) (2).
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Study of Trial of Labour after Caesarean Section (TOLAC)
Introduction: Caesarean section is one of the most commonly performed major surgical procedures. Worldwide increase in caesarean section (CS) rate during the last three decades has been the cause for concern. As ours is a tertiary health care centre catering around 20,000 deliveries per year and patients with previous caesarean scar get referred from surrounding primary health centers in huge number. In order to reduce c-section rates, TOLAC are conducted as per departmental standard operative procedures and WHO standards. Objective: To study incidence of trial of labour after c-section, progress of labour in active phase, maternal and fetal outcome in cases of trial of labour after c-section at tertiary care center. Methods: Prospective Observational study in tertiary institute from october 2020- september 2022 in the department of obgy. Ethical approval was taken. 200 cases were studied after applying inclusion and exclusion criteria with CTG monitoring. Results: A total of 200 subjects with previous one cesarean section were studied. 71.50% underwent successful trial of vaginal birth (57.50 % vbac, 08.50 % vaccum and 05.50 % forceps) and 28.50% required cesarean section. Maximum number of women who had VBAC has LSCS (Lower Segment Caesarean Section) in the past for fetal distress(33%). LSCS (failed VBAC) was done maximally for fetal distress 37 (64.90%), then for failure to progress 15 (26.30%) and impending scar dehiscence 5 (08.80%). Maternal complications were lower in the VBAC group: fever (0.69%), blood transfusion (06.30 %). Conclusion: Success rate of TOLAC at our institute is 75 %.The study shows encouraging result for VBAC in a well facilitated set up to be followed to reduce Caesarean rate.
Study of Trial of Labour after Caesarean Section (TOLAC)
Dr. Shrinivas N Gadappa; Dr. Varsha Somnath Powade; Dr. Anurag A Sonawane; Dr. Rupali A Gaikwad
DOI : 10.5281/zenodo.7874455
Introduction: Caesarean section is one of the most commonly performed major surgical procedures. Worldwide increase in caesarean section (CS) rate during the last three decades has been the cause for concern. As ours is a tertiary health care centre catering around 20,000 deliveries per year and patients with previous caesarean scar get referred from surrounding primary health centers in huge number. In order to reduce c-section rates, TOLAC are conducted as per departmental standard operative procedures and WHO standards. Objective: To study incidence of trial of labour after c-section, progress of labour in active phase, maternal and fetal outcome in cases of trial of labour after c-section at tertiary care center. Methods: Prospective Observational study in tertiary institute from october 2020- september 2022 in the department of obgy. Ethical approval was taken. 200 cases were studied after applying inclusion and exclusion criteria with CTG monitoring. Results: A total of 200 subjects with previous one cesarean section were studied. 71.50% underwent successful trial of vaginal birth (57.50 % vbac, 08.50 % vaccum and 05.50 % forceps) and 28.50% required cesarean section. Maximum number of women who had VBAC has LSCS (Lower Segment Caesarean Section) in the past for fetal distress(33%). LSCS (failed VBAC) was done maximally for fetal distress 37 (64.90%), then for failure to progress 15 (26.30%) and impending scar dehiscence 5 (08.80%). Maternal complications were lower in the VBAC group: fever (0.69%), blood transfusion (06.30 %). Conclusion: Success rate of TOLAC at our institute is 75 %.The study shows encouraging result for VBAC in a well facilitated set up to be followed to reduce Caesarean rate.
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Comparative Study of Corneal Endothelial Changes Among Contact Lens Wearers and Spectacle Users Using Non-Contact Specular Microscopy
The purpose of this study was to assess the changes in the corneal endothelial cells of medical students and doctors who used soft hydrogel contact lenses for myopia correction during a three-month period. The study included 50 subjects, with 25 wearing contact lenses and the remaining participants wearing spectacles. The morphology of corneal endothelial cells in both groups was assessed using a specular microscope to determine endothelial cell density, coefficient of variation, hexagonality, and central corneal thickness. At baseline (p-value = 0.14) and 3 months (p-value = 0.07), there was no statistically significant difference in refraction between Group A (-2.460.96 diopters) and Group B (-2.831.55 diopters). Similarly, at baseline (p-value = 0.26) or 3 months (p-value = 0.96), there is no statistically significant difference in ECD between Group A (3108.19228.30 cells/mm2) and Group B (3012.53225.95 cells/mm2). Furthermore, p-values larger than 0.05 show no statistically significant difference in COV, HEX, or CCT between the two groups at either time point. The study concluded that the absence of change in corneal endothelial cell shape is most likely attributable to the contact lens material's good oxygen permeability, compliance, and short wearing period.
Comparative Study of Corneal Endothelial Changes Among Contact Lens Wearers and Spectacle Users Using Non-Contact Specular Microscopy
Dr Raksha Kini; Dr Pradeep A V; Dr Varsha S B; Dr Shruthi KP
DOI : 10.5281/zenodo.7874475
The purpose of this study was to assess the changes in the corneal endothelial cells of medical students and doctors who used soft hydrogel contact lenses for myopia correction during a three-month period. The study included 50 subjects, with 25 wearing contact lenses and the remaining participants wearing spectacles. The morphology of corneal endothelial cells in both groups was assessed using a specular microscope to determine endothelial cell density, coefficient of variation, hexagonality, and central corneal thickness. At baseline (p-value = 0.14) and 3 months (p-value = 0.07), there was no statistically significant difference in refraction between Group A (-2.460.96 diopters) and Group B (-2.831.55 diopters). Similarly, at baseline (p-value = 0.26) or 3 months (p-value = 0.96), there is no statistically significant difference in ECD between Group A (3108.19228.30 cells/mm2) and Group B (3012.53225.95 cells/mm2). Furthermore, p-values larger than 0.05 show no statistically significant difference in COV, HEX, or CCT between the two groups at either time point. The study concluded that the absence of change in corneal endothelial cell shape is most likely attributable to the contact lens material's good oxygen permeability, compliance, and short wearing period.
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A Cross-Sectional Study On Association of Vitamin D Levels with Severity of Knee Osteoarthritis
Introduction: Vitamin D deficiency is worryingly highly prevalent among patients with osteoarthritis and is associated with worsening joint pain and functional decline. Vitamin D reduces bone turnover and cartilage degradation, thus potentially preventing the development and progression of osteoarthritis. Osteoarthritis formerly characteristics, history of chronic illnesses, drugs including vitamin D and calcium supplementation, duration of daily sunshine exposure, prior or current involvement in sports, alcohol and smoking. Objectives of the study: The aim and objectives of our study were to estimate serum vitamin D levels in subjects with osteoarthritis and to correlate vitamin D levels with severity of symptoms of osteoarthritis. Materials and Methods: We included a total of 120 in the age group of 40-60 years diagnosed patients of osteoarthritis using American College of Rheumatology clinical criteria. A questionnaire captured patient demographics and clinical characteristics. Joint pain, stiffness and physical function severity were assessed and graded based on the Western Ontario and McMaster Universities Arthritis Index (WOMAC). We determined serum vitamin D levels by electrochemilumniscence immunoassay. Results: In the present study, we included 120 diagnosed cases of Osteoarthritis, out of which 102 were females and 18 were males respectively accounting for 85% and 9% respectively. In our study 94 subjects belong to age group >50 years and 26 were aged <50 years accounting for 78% and 21.66% respectively. We found that 52 patients had family history of OA and 68 patients had no history of OA accounting for 43.3% and 56.6% respectively. Chronic disease status was evaluated, we found that 70 were diabetic and 50 were hypertensive accounting for 58.33% and 41.66 % respectively. Similarly, BMI was evaluated, we found that 42 patients had BMI in the range of overweight and 56 were obese. Laboratory investigations were performed using random blood sample for the estimation of plasma vitamin D and ionised calcium. We found that 112 (93.3%) patients had normal serum calcium levels, out of 120 patients 44 (36.66%) had sufficient vitamin D levels, 54 (45%) had insufficient levels and 22 (18.33%) had deficiency of vitamin D. We evaluated clinical presentation in these patients, we found that 118 (98.33%) had pain in knee, 82 (68.33%) had morning stiffness, 46 (38.33%) had crepitus on active movement, 44 (36.66%) had tenderness over knee, 12 (10%) had bony enlargement and 8 (6.66%) had palpable warmth over knee. We correlated vitamin D levels with joint symptoms, we found no significance existed between vitamin D levels and pain in knee, morning stiffness, physical function and total WOMAC. Conclusion: In the present study, we did not find statistically significant correlation between vitamin D levels and severity of osteoarthritis. Further studies are required with more sample size to confirm our findings.
A Cross-Sectional Study On Association of Vitamin D Levels with Severity of Knee Osteoarthritis
Dr. Saurabh Singh; Dr.Anubhav Agrawal; Dr. Rishi Dwivedi; Abdul Shakir Ansari
DOI : 10.5281/zenodo.7878429
Introduction: Vitamin D deficiency is worryingly highly prevalent among patients with osteoarthritis and is associated with worsening joint pain and functional decline. Vitamin D reduces bone turnover and cartilage degradation, thus potentially preventing the development and progression of osteoarthritis. Osteoarthritis formerly characteristics, history of chronic illnesses, drugs including vitamin D and calcium supplementation, duration of daily sunshine exposure, prior or current involvement in sports, alcohol and smoking. Objectives of the study: The aim and objectives of our study were to estimate serum vitamin D levels in subjects with osteoarthritis and to correlate vitamin D levels with severity of symptoms of osteoarthritis. Materials and Methods: We included a total of 120 in the age group of 40-60 years diagnosed patients of osteoarthritis using American College of Rheumatology clinical criteria. A questionnaire captured patient demographics and clinical characteristics. Joint pain, stiffness and physical function severity were assessed and graded based on the Western Ontario and McMaster Universities Arthritis Index (WOMAC). We determined serum vitamin D levels by electrochemilumniscence immunoassay. Results: In the present study, we included 120 diagnosed cases of Osteoarthritis, out of which 102 were females and 18 were males respectively accounting for 85% and 9% respectively. In our study 94 subjects belong to age group >50 years and 26 were aged <50 years accounting for 78% and 21.66% respectively. We found that 52 patients had family history of OA and 68 patients had no history of OA accounting for 43.3% and 56.6% respectively. Chronic disease status was evaluated, we found that 70 were diabetic and 50 were hypertensive accounting for 58.33% and 41.66 % respectively. Similarly, BMI was evaluated, we found that 42 patients had BMI in the range of overweight and 56 were obese. Laboratory investigations were performed using random blood sample for the estimation of plasma vitamin D and ionised calcium. We found that 112 (93.3%) patients had normal serum calcium levels, out of 120 patients 44 (36.66%) had sufficient vitamin D levels, 54 (45%) had insufficient levels and 22 (18.33%) had deficiency of vitamin D. We evaluated clinical presentation in these patients, we found that 118 (98.33%) had pain in knee, 82 (68.33%) had morning stiffness, 46 (38.33%) had crepitus on active movement, 44 (36.66%) had tenderness over knee, 12 (10%) had bony enlargement and 8 (6.66%) had palpable warmth over knee. We correlated vitamin D levels with joint symptoms, we found no significance existed between vitamin D levels and pain in knee, morning stiffness, physical function and total WOMAC. Conclusion: In the present study, we did not find statistically significant correlation between vitamin D levels and severity of osteoarthritis. Further studies are required with more sample size to confirm our findings.
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A Case Series and Review of Severe Leptospirosis
Background: The purpose of this retrospective case review was to identify the different patterns of clinical presentation of severe leptospirosis, and to find out any correlation between organ specific complications and outcome of the patients. Method: Leptospirosis patients who were admitted to the ICU of General Medicine Department of HIMS, Hassan during July 2021 – September 2021 were included. Organ specific involvement in 6 organs namely heart, lung, kidney, liver, vascular, brain and spinal cord was recorded. One score was given to each organ involvement. Score was recorded on admission and discharge. Outcome of the patients were recorded as either discharged or died. Result: Renal, hepatic, hematological involvement was found in all patients. One out of 13 patients died and 12 patients were discharged without any sequele. All patients except one had 3 organ involvements and one had involvement of 4 organs. All patients who had 3 organs involved were discharged without any sequel after an average admission period of 5 days. Conclusion: Outcome of severe leptospirosis was not determined by the involvement of renal, hepatic and hematological systems. 4 or more organ involvement was associated with increased mortality. Combination of respiratory system involvement with neurological involvement was associated with a bad outcome. Seeking critical care management at 3 organ involvement stage would improve the outcome of the patients.
A Case Series and Review of Severe Leptospirosis
Dr Madhu G; Dr Anjali V; Dr Girish P; Dr Abhishek TM
DOI : 10.5281/zenodo.7874504
Background: The purpose of this retrospective case review was to identify the different patterns of clinical presentation of severe leptospirosis, and to find out any correlation between organ specific complications and outcome of the patients. Method: Leptospirosis patients who were admitted to the ICU of General Medicine Department of HIMS, Hassan during July 2021 – September 2021 were included. Organ specific involvement in 6 organs namely heart, lung, kidney, liver, vascular, brain and spinal cord was recorded. One score was given to each organ involvement. Score was recorded on admission and discharge. Outcome of the patients were recorded as either discharged or died. Result: Renal, hepatic, hematological involvement was found in all patients. One out of 13 patients died and 12 patients were discharged without any sequele. All patients except one had 3 organ involvements and one had involvement of 4 organs. All patients who had 3 organs involved were discharged without any sequel after an average admission period of 5 days. Conclusion: Outcome of severe leptospirosis was not determined by the involvement of renal, hepatic and hematological systems. 4 or more organ involvement was associated with increased mortality. Combination of respiratory system involvement with neurological involvement was associated with a bad outcome. Seeking critical care management at 3 organ involvement stage would improve the outcome of the patients.
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A Cross-Sectional Study on Prevalence of Obesity in Adolescents
Introduction: Obesity is a life style related metabolic disorder which has significant impact on health. Obesity is affecting children and adolescents, there is an increase in the prevalence of obesity in our country. Obesity leads to development of metabolic syndrome, diabetes mellitus and coronary heart disease. The objective of the study is to find out the prevalence of obesity and overweight among the adolescent population. Material and Methods: A cross-sectional study was conducted to find out the prevalence of obesity among adolescents in our population at CCM Medical College Bhilai, Durg. We included a total of 500 school children in the age group of 13-17 years from various schools of Bhilai, CG. A written informed consent was obtained from each participant. A pre-designed and pre-tested questionnaire was used to elicit the information for the study. Anthropometric measurements included body weight, height, mid upper arm circumference. Measurements were recorded by the Investigator using standardized procedures [Jelliff, 1966]. Result: In our study, we included a total of 500 adolescents aged between 13-17 years. Body mass index (BMI) was calculated. Out of the 500 adolescents included in our study, 216 had BMI <18.5 kg/m2, 184 had 18.5 - 24.9 kg/m2, 68 had 25-30 kg/m2 and 32 had BMI >30 kg/m2 respectively. The prevalence of obesity was 6.4% and the prevalence of overweight was 13.6%. Conclusion: It is essential to maintain good BMI for a healthy lifestyle, our study shows that a large % of the student body has a BMI outside of the normal range the contributing factors include increased use of technology; lack of exercise, increased consumption of fast food. With the growth in household income, we need to keep the focus on maintaining a good lifestyle.
A Cross-Sectional Study on Prevalence of Obesity in Adolescents
Dr Rupesh Kumar Agrawal; Dr Vishal Agrawal; Dr Anjali Goyal; Dr Deepak Jaiswal; Dr Twinkle Chandrakar
DOI : 10.5281/zenodo.7878454
Introduction: Obesity is a life style related metabolic disorder which has significant impact on health. Obesity is affecting children and adolescents, there is an increase in the prevalence of obesity in our country. Obesity leads to development of metabolic syndrome, diabetes mellitus and coronary heart disease. The objective of the study is to find out the prevalence of obesity and overweight among the adolescent population. Material and Methods: A cross-sectional study was conducted to find out the prevalence of obesity among adolescents in our population at CCM Medical College Bhilai, Durg. We included a total of 500 school children in the age group of 13-17 years from various schools of Bhilai, CG. A written informed consent was obtained from each participant. A pre-designed and pre-tested questionnaire was used to elicit the information for the study. Anthropometric measurements included body weight, height, mid upper arm circumference. Measurements were recorded by the Investigator using standardized procedures [Jelliff, 1966]. Result: In our study, we included a total of 500 adolescents aged between 13-17 years. Body mass index (BMI) was calculated. Out of the 500 adolescents included in our study, 216 had BMI <18.5 kg/m2, 184 had 18.5 - 24.9 kg/m2, 68 had 25-30 kg/m2 and 32 had BMI >30 kg/m2 respectively. The prevalence of obesity was 6.4% and the prevalence of overweight was 13.6%. Conclusion: It is essential to maintain good BMI for a healthy lifestyle, our study shows that a large % of the student body has a BMI outside of the normal range the contributing factors include increased use of technology; lack of exercise, increased consumption of fast food. With the growth in household income, we need to keep the focus on maintaining a good lifestyle.
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Estimation of Magnesium Level after 14 Days of Oral Magnesium Therapy in Children with Severe Acute Malnutrition
Background: SAM is defined by WHO weight for height or length < –3 SD or bilateral pitting oedema or MUAC < 11.5 cm for children age group between 6 to 59 months. Aims and Objections: To observe the effect of oral magnesium therapy in children with severe acute malnutrition (SAM) on serum magnesium level. Material and Methods: This study was conducted from 2020 in Department of Pediatrics, Kamla Raja Hospital, G.R.M.C., Gwalior. Study design: Cross sectional observational study Sample size: 117. Study population: 6 to 59 months. Duration of study: 2 years. Statistical analysis: SPSS version 25. Methods: Weight, height and MUAC were measure at the time of admission and after 14 days of oral magnesium therapy. Observation and Results: Children comprises of 117. Out of these 40 (34.2%) children were from 6 months to 12 months, 36 (30.8%) were in age group 13 to 29 months41 (35.04%) from age group 25 to 60 months. Out of 117, 61 (52.1%) were male and 56 (47.9%) were female. Mean weight were 7.02±1.85 kg on admission and increased to 7.44±1.95 kg after 14 days of oral magnesium therapy. Mean height were remained the same. The MUAC was 11.17±0.72 on admission and increased to 11.41 cm after oral therapy. Conclusion: Children were low MUAC, loss of subcutaneous fat, lethargy mental status have higher chances of magnesia while age, gender and edema, skin changes have no relation with serum magnesium.
Estimation of Magnesium Level after 14 Days of Oral Magnesium Therapy in Children with Severe Acute Malnutrition
Dr. R.D. Dutt; Dr. Keshav Kumar; Dr. Ajay Gaur; Dr. Chandrakala Dutt; Dr. Ravi Ambey; Dr. Tarushi Dutt
DOI : 10.5281/zenodo.7874526
Background: SAM is defined by WHO weight for height or length < –3 SD or bilateral pitting oedema or MUAC < 11.5 cm for children age group between 6 to 59 months. Aims and Objections: To observe the effect of oral magnesium therapy in children with severe acute malnutrition (SAM) on serum magnesium level. Material and Methods: This study was conducted from 2020 in Department of Pediatrics, Kamla Raja Hospital, G.R.M.C., Gwalior. Study design: Cross sectional observational study Sample size: 117. Study population: 6 to 59 months. Duration of study: 2 years. Statistical analysis: SPSS version 25. Methods: Weight, height and MUAC were measure at the time of admission and after 14 days of oral magnesium therapy. Observation and Results: Children comprises of 117. Out of these 40 (34.2%) children were from 6 months to 12 months, 36 (30.8%) were in age group 13 to 29 months41 (35.04%) from age group 25 to 60 months. Out of 117, 61 (52.1%) were male and 56 (47.9%) were female. Mean weight were 7.02±1.85 kg on admission and increased to 7.44±1.95 kg after 14 days of oral magnesium therapy. Mean height were remained the same. The MUAC was 11.17±0.72 on admission and increased to 11.41 cm after oral therapy. Conclusion: Children were low MUAC, loss of subcutaneous fat, lethargy mental status have higher chances of magnesia while age, gender and edema, skin changes have no relation with serum magnesium.
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Polyhydramnios-Maternal and Foetal Outcomes in Pregnancy
Introduction: Excessive accumulation of liquor amnii causing discomfort to the patient and/or when an imaging help is needed to substantiate the clinical diagnosis of the lie and presentation of the foetus is referred to as polyhydramnios[1]. It develops as a consequence of disturbed equilibrium between production, foetal resorption, and secretion of amniotic fluid[2]. Polyhydramnios is associated with maternal Diabetes Mellitus, increased rate of Caesarean sections due to malpresentations, postpartum haemorrhage, congenital anomalies in new-born, preterm deliveries, increased risk of NICU admissions and still births[3]. Hence our study is prompted to find out maternal and perinatal outcomes in women with polyhydramnios in pregnancy and to improve the maternal and perinatal outcome in polyhydramnios cases. Aims and Objectives: To study the risk factors associated with polyhydramnios affecting polyhydramnios in pregnancies >28wks of gestational age, its clinical presentation, mode of delivery and feto-maternal outcomes in polyhydramnios in a tertiary care centre. Methods: It was a prospective observational study conducted for 2 years from November 2020 to October 2022 at tertiary care centre. The data retrieved from the medical records on polyhydramnios included demographic data, complications of pregnancy, and maternal and neonatal outcomes. Appropriate Statistical analysis was performed. Results: 100 cases of polyhydramnios cases were studied. Majority cases were idiopathic (57%) and had mild polyhydramnios (54%) with AFI of 25-27cm. Most significant risk factor was congenital anomalies (19%). Most common maternal complication was preterm delivery (24%). Other maternal complications were premature rupture of membranes (16%), malpresentations (12%), cord prolapse (4%), cord presentation (4%) and post-partum haemorrhage (2%). 58% cases were delivered by Caesarean section. 19% neonates had various congenital anomalies and 4% babies with major congenital anomalies died. 12% babies were still born due to various causes such as major congenital anomalies in 4 cases, birth asphyxia in 4 cases, abruptio placentae in 2 mothers and cord prolapse intrapartum in 2 cases. Neonatal death rate was 35.29. Conclusion: Polyhydramnios has high maternal and neonatal complications, especially congenital anomalies and preterm delivery that increases risk of significant neonatal complications and a higher rate of Caesarean sections.
Polyhydramnios-Maternal and Foetal Outcomes in Pregnancy
Vijay Y Kalyankar; Shrinivas N Gadappa; Bhakti V Kalyankar; Apurva Khatokar
DOI : 10.5281/zenodo.7898848
Introduction: Excessive accumulation of liquor amnii causing discomfort to the patient and/or when an imaging help is needed to substantiate the clinical diagnosis of the lie and presentation of the foetus is referred to as polyhydramnios[1]. It develops as a consequence of disturbed equilibrium between production, foetal resorption, and secretion of amniotic fluid[2]. Polyhydramnios is associated with maternal Diabetes Mellitus, increased rate of Caesarean sections due to malpresentations, postpartum haemorrhage, congenital anomalies in new-born, preterm deliveries, increased risk of NICU admissions and still births[3]. Hence our study is prompted to find out maternal and perinatal outcomes in women with polyhydramnios in pregnancy and to improve the maternal and perinatal outcome in polyhydramnios cases. Aims and Objectives: To study the risk factors associated with polyhydramnios affecting polyhydramnios in pregnancies >28wks of gestational age, its clinical presentation, mode of delivery and feto-maternal outcomes in polyhydramnios in a tertiary care centre. Methods: It was a prospective observational study conducted for 2 years from November 2020 to October 2022 at tertiary care centre. The data retrieved from the medical records on polyhydramnios included demographic data, complications of pregnancy, and maternal and neonatal outcomes. Appropriate Statistical analysis was performed. Results: 100 cases of polyhydramnios cases were studied. Majority cases were idiopathic (57%) and had mild polyhydramnios (54%) with AFI of 25-27cm. Most significant risk factor was congenital anomalies (19%). Most common maternal complication was preterm delivery (24%). Other maternal complications were premature rupture of membranes (16%), malpresentations (12%), cord prolapse (4%), cord presentation (4%) and post-partum haemorrhage (2%). 58% cases were delivered by Caesarean section. 19% neonates had various congenital anomalies and 4% babies with major congenital anomalies died. 12% babies were still born due to various causes such as major congenital anomalies in 4 cases, birth asphyxia in 4 cases, abruptio placentae in 2 mothers and cord prolapse intrapartum in 2 cases. Neonatal death rate was 35.29. Conclusion: Polyhydramnios has high maternal and neonatal complications, especially congenital anomalies and preterm delivery that increases risk of significant neonatal complications and a higher rate of Caesarean sections.
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Study of Clinical Spectrum of Abruptio Placentae and its Management at a Tertiary Care Hospital
Introduction: Placental abruption contributes almost 30% of all cases of antepartum haemorrhage. Both mother and foetus are at huge risk of maternal and perinatal morbidity and mortality. Aims And Objectives: To study the maternal and perinatal outcome incases of abruptio placentae at a tertiary care Hospital. Methods: This was a prospective observational study carried out in cases of abruptio placentae during a 2 year study period. Results: In present study, total 200 cases of abruption were observed. Most common age group in present study was 21-25 years. Abruptio placentae was common in gestational age above 37 weeks. In present study, 53% were vaginal deliveries, 45 % were delivered by LSCS, 2% by instrumental deliveries. Most common indication for LSCS was foetal distress(62.22%). In majority of (70%) of cases abruption was mixed type. (59.5%) cases had grade 2 abruption. Postpartum haemorrhage occurred in 30% cases and haemorrhagic shock was observed in 20% cases.89.5% cases required packed RBC transfusion. There were 4 cases of maternal mortality.65%babies required NICU admission, 30% were still births. 10% cases of perinatal mortality were there. Conclusion: Placental abruption is unpredictable and non-preventable, but maternal and perinatal morbidity and mortality can be reduced by adequate antenatal care, early detection and monitoring of risk factors, timely management at tertiary care level.
Study of Clinical Spectrum of Abruptio Placentae and its Management at a Tertiary Care Hospital
Dr Sayali Mone; Dr Prashant Bhingare; Dr Shrinivas Gadappa; Dr.Sonali Deshpande; Dr. M. Kavya
DOI : 10.5281/zenodo.7899125
Introduction: Placental abruption contributes almost 30% of all cases of antepartum haemorrhage. Both mother and foetus are at huge risk of maternal and perinatal morbidity and mortality. Aims And Objectives: To study the maternal and perinatal outcome incases of abruptio placentae at a tertiary care Hospital. Methods: This was a prospective observational study carried out in cases of abruptio placentae during a 2 year study period. Results: In present study, total 200 cases of abruption were observed. Most common age group in present study was 21-25 years. Abruptio placentae was common in gestational age above 37 weeks. In present study, 53% were vaginal deliveries, 45 % were delivered by LSCS, 2% by instrumental deliveries. Most common indication for LSCS was foetal distress(62.22%). In majority of (70%) of cases abruption was mixed type. (59.5%) cases had grade 2 abruption. Postpartum haemorrhage occurred in 30% cases and haemorrhagic shock was observed in 20% cases.89.5% cases required packed RBC transfusion. There were 4 cases of maternal mortality.65%babies required NICU admission, 30% were still births. 10% cases of perinatal mortality were there. Conclusion: Placental abruption is unpredictable and non-preventable, but maternal and perinatal morbidity and mortality can be reduced by adequate antenatal care, early detection and monitoring of risk factors, timely management at tertiary care level.
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Clinical Profile and Outcome of Renal Transplant Patients with Covid 19
INTRODUCTION : COVID 19 a pandemic caused by SARS CoV 2 has caused a wide impact globally. Clinical spectrum of COVID 19 ranges widely including asymptomatic infection, mild upper respiratory tract infection, severe pneumonia, ARDS, MODS and even death. According to Centres for disease control and prevention(CDC) immune compromised patients including patients on immune suppression post organ transplantation are high risk for severe disease from infection with SARS CoV 2. MATERIALS AND METHODS: A study was conducted on 24 Post renal transplant patients infected with COVID 19 who were admitted in hospitals attached to BMCRI. History was taken, general and systemic examination was done. Patients’ demographic data, clinical history and examination, lab investigations and radiological investigations, treatment given were assessed. Patients were categorized into mild, moderate and severe illness and followed up daily until outcome. RESULTS: The study included 24Post renal transplant patients infected with COVID 19, of which2 were females and 22 males. Of which mean age was 43.83 with standard deviation of 12.67.9 patients had mild, 4 had moderate and 11patient had severe disease. Of all the patients 10 died and 14 discharged. 2 patients were asymptomatic, most common symptom was cough(19) followed by fever (18). In severe patients inflammatory markers were elevated, with mean values D dimer 1.67, CRP-183, LDH-616. Mean Urea(106.4) and creatinine (2.39)values were higher in severe disease. Higher D dimer and CRP associated with worse outcome. CONCLUSION: With increasing number of renal transplants being performed, immune compromised state as a risk factor of COVID 19 infection, understanding clinical profile of these patients is necessary. Our study reveals that higher inflammatory markers were significantly associated with severity of the COVID 19 disease and mortality.
Clinical Profile and Outcome of Renal Transplant Patients with Covid 19
Dr Suraj Chavan; Dr Raveendra K R; Dr. Chandan J; Dr Ritu Rathod; Dr Sagar Chavan
DOI : 10.5281/zenodo.7899395
INTRODUCTION : COVID 19 a pandemic caused by SARS CoV 2 has caused a wide impact globally. Clinical spectrum of COVID 19 ranges widely including asymptomatic infection, mild upper respiratory tract infection, severe pneumonia, ARDS, MODS and even death. According to Centres for disease control and prevention(CDC) immune compromised patients including patients on immune suppression post organ transplantation are high risk for severe disease from infection with SARS CoV 2. MATERIALS AND METHODS: A study was conducted on 24 Post renal transplant patients infected with COVID 19 who were admitted in hospitals attached to BMCRI. History was taken, general and systemic examination was done. Patients’ demographic data, clinical history and examination, lab investigations and radiological investigations, treatment given were assessed. Patients were categorized into mild, moderate and severe illness and followed up daily until outcome. RESULTS: The study included 24Post renal transplant patients infected with COVID 19, of which2 were females and 22 males. Of which mean age was 43.83 with standard deviation of 12.67.9 patients had mild, 4 had moderate and 11patient had severe disease. Of all the patients 10 died and 14 discharged. 2 patients were asymptomatic, most common symptom was cough(19) followed by fever (18). In severe patients inflammatory markers were elevated, with mean values D dimer 1.67, CRP-183, LDH-616. Mean Urea(106.4) and creatinine (2.39)values were higher in severe disease. Higher D dimer and CRP associated with worse outcome. CONCLUSION: With increasing number of renal transplants being performed, immune compromised state as a risk factor of COVID 19 infection, understanding clinical profile of these patients is necessary. Our study reveals that higher inflammatory markers were significantly associated with severity of the COVID 19 disease and mortality.
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Spectrum of Direct Maternal Deaths: An Autopsy Study in a Tertiary Care Hospital
BACKGROUND: - Maternal deaths have always been a challenge worldwide. Autopsy based study in cases of maternal mortality serves as an indispensable tool to analyse causes of maternal mortality. AIMS: - To study incidence of varying direct causes of maternal deaths. To study the precedent risk factors and analysis of direct causes of maternal deaths with variables like age, trimester of pregnancy, gravidity, duration of hospital stays, etc. To compare clinical diagnosis with autopsy diagnosis. DESIGN: This study is retrospective observational study over 6 years and 1 year of prospective observational study in the department of Pathology at a tertiary care centre. MATERIALS AND METHODS: - Autopsy records of 75 maternal mortality cases where pathology autopsy was performed in this period were studied. The available gross specimens and histopathology slides were retrieved and studied. RESULTS: - Most common direct cause of maternal death in this study was found to be peripartum dilated cardiomyopathy (26.65%), followed by DIC (14.6%). Maternal deaths were found to be more prevalent in age group 21-25 years (32.42%), multigravida & multiparous. Most of the maternal deaths were in postpartum period (57.76%) and in third trimester (6.46%) if antepartum, with vaginal mode of delivery. Hospital stay was between 24 hours to 1 week. CONCLUSION: -Peripartum dilated cardiomyopathy was most common frequent maternal death in this study. Since the most frequent etiologies that lead to maternal death are preventable, more autopsy studies can be of great help in eliminating these.
Spectrum of Direct Maternal Deaths: An Autopsy Study in a Tertiary Care Hospital
Dr Kusum Jashnani; Dr Sakshi Munot(Agrawal); Dr Lalita Yoganand Patil; Dr Radhika
DOI : 10.5281/zenodo.7899713
BACKGROUND: - Maternal deaths have always been a challenge worldwide. Autopsy based study in cases of maternal mortality serves as an indispensable tool to analyse causes of maternal mortality. AIMS: - To study incidence of varying direct causes of maternal deaths. To study the precedent risk factors and analysis of direct causes of maternal deaths with variables like age, trimester of pregnancy, gravidity, duration of hospital stays, etc. To compare clinical diagnosis with autopsy diagnosis. DESIGN: This study is retrospective observational study over 6 years and 1 year of prospective observational study in the department of Pathology at a tertiary care centre. MATERIALS AND METHODS: - Autopsy records of 75 maternal mortality cases where pathology autopsy was performed in this period were studied. The available gross specimens and histopathology slides were retrieved and studied. RESULTS: - Most common direct cause of maternal death in this study was found to be peripartum dilated cardiomyopathy (26.65%), followed by DIC (14.6%). Maternal deaths were found to be more prevalent in age group 21-25 years (32.42%), multigravida & multiparous. Most of the maternal deaths were in postpartum period (57.76%) and in third trimester (6.46%) if antepartum, with vaginal mode of delivery. Hospital stay was between 24 hours to 1 week. CONCLUSION: -Peripartum dilated cardiomyopathy was most common frequent maternal death in this study. Since the most frequent etiologies that lead to maternal death are preventable, more autopsy studies can be of great help in eliminating these.
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Recognizing Histological Patterns in the Endometrial Scrape Cytology of Hysterectomy Specimens
Background: There is an absence of standardized diagnostic criteria for endometrial cytology. Aims: This study aims at recognizing various patterns seen in endometrial scrape cytology from hysterectomy specimens against histopathological features. The dependability of these patterns for accurate cytological diagnosis of endometrial pathology was assessed. Materials and methods: 106 uteri in two separate batches of 50 and 56 received consecutively in surgical pathology laboratory were grossed and their features documented. Each endometrium was scraped by a scalpel, subsequently two H&E and two PAP smears were prepared. Inadequate smears and specimens which were received cut-opened were excluded. The cytological findings were broadly categorized into benign endometrium (including phases of menstrual cycle, endometritis and atrophic endometrium), decidual change, pill endometrium, endometrial hyperplasia, suspicious of malignancy and malignancy. Sensitivity, specificity, likelihood ratio, pre-test odds, post-test odds and diagnostic odds ratio were calculated for hyperplasia/malignancy and only malignancy. Results: The cytological evaluation for endometrial malignancy showed sensitivity, specificity of 66.7% and 99% respectively. The pre-test odds were 3%. For positive results, the likelihood ratio and the post-test odds were 69 and 67% respectively. The likelihood ratio was 0.34 with a post-test odds of 1% for negative results. The diagnostic odds ratio was 204. Conclusions: Endometrial hyperplasia was missed in cytology because the cellularity in comparison to benign endometrium was not different. Enlarged vesicular nuclei with prominent nucleoli were seen on review. One cytologic misdiagnosis of adenocarcinoma as benign endometrium was owing to low cellularity wherein the patterns were not seen.
Recognizing Histological Patterns in the Endometrial Scrape Cytology of Hysterectomy Specimens
Dr. Kusum Jashnani; Dr. Sneha Debbarma; Dr. Shivangi Trivedi
DOI : 10.5281/zenodo.7899798
Background: There is an absence of standardized diagnostic criteria for endometrial cytology. Aims: This study aims at recognizing various patterns seen in endometrial scrape cytology from hysterectomy specimens against histopathological features. The dependability of these patterns for accurate cytological diagnosis of endometrial pathology was assessed. Materials and methods: 106 uteri in two separate batches of 50 and 56 received consecutively in surgical pathology laboratory were grossed and their features documented. Each endometrium was scraped by a scalpel, subsequently two H&E and two PAP smears were prepared. Inadequate smears and specimens which were received cut-opened were excluded. The cytological findings were broadly categorized into benign endometrium (including phases of menstrual cycle, endometritis and atrophic endometrium), decidual change, pill endometrium, endometrial hyperplasia, suspicious of malignancy and malignancy. Sensitivity, specificity, likelihood ratio, pre-test odds, post-test odds and diagnostic odds ratio were calculated for hyperplasia/malignancy and only malignancy. Results: The cytological evaluation for endometrial malignancy showed sensitivity, specificity of 66.7% and 99% respectively. The pre-test odds were 3%. For positive results, the likelihood ratio and the post-test odds were 69 and 67% respectively. The likelihood ratio was 0.34 with a post-test odds of 1% for negative results. The diagnostic odds ratio was 204. Conclusions: Endometrial hyperplasia was missed in cytology because the cellularity in comparison to benign endometrium was not different. Enlarged vesicular nuclei with prominent nucleoli were seen on review. One cytologic misdiagnosis of adenocarcinoma as benign endometrium was owing to low cellularity wherein the patterns were not seen.
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A Study of Maternal Outcome in Complicated Eclampsia
Objective: To study sociodemographic parameters & various maternal complication in eclampsia patient. Method: A Prospective observational study was conducted in department of Obstetrics and Gynecology in Government medical college, Aurangabad. Result: It was observed that majority of the cases, 72% were between 20-25 years of age group , 46% were belonging to lower class, 54% cases were from rural residence, 64% cases were Unbooked hence 68.42% were referred without basic treatment. 82% cases had antepartum eclampsia, 14% had postpartum & 4% had intrapartum eclampsia encountered out of which 52% cases had undergone lower segment caesarean section. The most common complication encountered was Abruptio placenta followed by Pulmonary edema others include PRESS, HELLP syndrome with 6 maternal mortalities. Most cases required ICU management. 26% cases required Mechanical ventilation. Conclusion: Provision of quality antenatal health care services, timely reffral with treatment and delivery, intensive monitoring in the intrapartum and postpartum period have the potential to improve maternal and to prevent the occurrence of eclampsia as a whole.
A Study of Maternal Outcome in Complicated Eclampsia
Dr Yogita Deore; Dr. Sanjay Pagare; Dr Shrinivas Gadappa; Dr. Sonali Deshpande; Dr. Swati Badgire
DOI : 10.5281/zenodo.7899828
Objective: To study sociodemographic parameters & various maternal complication in eclampsia patient. Method: A Prospective observational study was conducted in department of Obstetrics and Gynecology in Government medical college, Aurangabad. Result: It was observed that majority of the cases, 72% were between 20-25 years of age group , 46% were belonging to lower class, 54% cases were from rural residence, 64% cases were Unbooked hence 68.42% were referred without basic treatment. 82% cases had antepartum eclampsia, 14% had postpartum & 4% had intrapartum eclampsia encountered out of which 52% cases had undergone lower segment caesarean section. The most common complication encountered was Abruptio placenta followed by Pulmonary edema others include PRESS, HELLP syndrome with 6 maternal mortalities. Most cases required ICU management. 26% cases required Mechanical ventilation. Conclusion: Provision of quality antenatal health care services, timely reffral with treatment and delivery, intensive monitoring in the intrapartum and postpartum period have the potential to improve maternal and to prevent the occurrence of eclampsia as a whole.
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Prevalence and Correlates of Soil Transmitted Helminthic Parasitic Infections among Patients in A Tertiary Care Centre in Dibrugarh, Assam
Background: Helminthic infections are a major public health issue in developing countries, affecting millions of people worldwide. Previous studies have reported high prevalence rates of helminth infections, particularly in children and vulnerable populations.Helminth infections continue to pose a significant public health challenge in developing countries, particularly among children and vulnerable populations. Materials and methods: This cross-sectional study aimed to evaluate the prevalence and distribution of helminth infections in a population of 2200 individuals and investigate possible associations with gender, age inpatient and outpatient. Results: We found a helminth prevalence of 3.86%, with Ascaris lumbricoides being the most common parasite identified, followed by Ankylostoma duodenale, Trichuris trichuria, Strongyl oides stercoralis, and Enterobius vermicularis. Mixed infections were observed in 10.9% of the cases, with Ankylostoma duodenale and Strongy loides stercoralis being the most common combination. Males constituted 62.35% of the infected cases, and inpatient cases constituted 85.85% of the infected cases. The highest number of cases was found in the age group of 10-14 years. Our study highlights the significant burden of helminth infections in the population and underscores the need for effective prevention and control strategies. Conclusion: Our study highlights the significant burden of helminth infections in the population, particularly in developing countries. Effective prevention and control strategies, tailored to specific risk factors, are urgently needed to reduce the morbidity and mortality associated with these infections.
Prevalence and Correlates of Soil Transmitted Helminthic Parasitic Infections among Patients in A Tertiary Care Centre in Dibrugarh, Assam
Dr. Pranab Jyoti Patra; Dr. Jayanta Kumar Das; Dr. Prapti Bora; Prof. Dr. Chimanjita Phukan
DOI : 10.5281/zenodo.7899838
Background: Helminthic infections are a major public health issue in developing countries, affecting millions of people worldwide. Previous studies have reported high prevalence rates of helminth infections, particularly in children and vulnerable populations.Helminth infections continue to pose a significant public health challenge in developing countries, particularly among children and vulnerable populations. Materials and methods: This cross-sectional study aimed to evaluate the prevalence and distribution of helminth infections in a population of 2200 individuals and investigate possible associations with gender, age inpatient and outpatient. Results: We found a helminth prevalence of 3.86%, with Ascaris lumbricoides being the most common parasite identified, followed by Ankylostoma duodenale, Trichuris trichuria, Strongyl oides stercoralis, and Enterobius vermicularis. Mixed infections were observed in 10.9% of the cases, with Ankylostoma duodenale and Strongy loides stercoralis being the most common combination. Males constituted 62.35% of the infected cases, and inpatient cases constituted 85.85% of the infected cases. The highest number of cases was found in the age group of 10-14 years. Our study highlights the significant burden of helminth infections in the population and underscores the need for effective prevention and control strategies. Conclusion: Our study highlights the significant burden of helminth infections in the population, particularly in developing countries. Effective prevention and control strategies, tailored to specific risk factors, are urgently needed to reduce the morbidity and mortality associated with these infections.
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Learning Art of Operative Vaginal Delivery at Tertiary Care Centre
Introduction: Operative vaginal delivery is now decreased due to medical litigation and due to lack of expertise and under training of residents. Here complication of operative vaginal delivery are all taught by lecturer and assistant professor. IVD is done by postgraduate residents under the guidance of lecturer, if any difficulty or complication is overtaken by Head of unit. Objective: To compare the fetomaternal outcome in vacuum assisted vaginal delivery and forceps assisted vaginal delivery. Study design: This prospective study was carried out in patients undergoing instrumental vaginal delivery during the study period. Subjects & methodology: This study was conducted at the Department of Obstetrics and Gynecology, Government medical college, Aurangabad during 2 years. (from 2020 to 2022) patients requiring operative vaginal delivery. Most common age group in present study was 18- 25 years in both groups ( 56.31 % vacuum,64.95 %- forceps). Instrumental vaginal deliveries were common in patients with >37 weeks of gestation. In present study most common indication for Instrumental vaginal delivery (vacuum & forceps) was foetal distress ( 48.54 and 47.42 %) followed by maternal exhausation (5.8 snd 48.64%). Facial injuries and abrasions was most common neonatal complication in present study (12%). Conclusion: Results of the present study indicate that both modes of instrumental vaginal delivery are safe with respect to maternal morbidity and neonatal trauma.
Learning Art of Operative Vaginal Delivery at Tertiary Care Centre
Dr Priya Yadav; Dr Prashant Bhingare; Dr Shrinivas Gadappa
DOI : 10.5281/zenodo.7899874
Introduction: Operative vaginal delivery is now decreased due to medical litigation and due to lack of expertise and under training of residents. Here complication of operative vaginal delivery are all taught by lecturer and assistant professor. IVD is done by postgraduate residents under the guidance of lecturer, if any difficulty or complication is overtaken by Head of unit. Objective: To compare the fetomaternal outcome in vacuum assisted vaginal delivery and forceps assisted vaginal delivery. Study design: This prospective study was carried out in patients undergoing instrumental vaginal delivery during the study period. Subjects & methodology: This study was conducted at the Department of Obstetrics and Gynecology, Government medical college, Aurangabad during 2 years. (from 2020 to 2022) patients requiring operative vaginal delivery. Most common age group in present study was 18- 25 years in both groups ( 56.31 % vacuum,64.95 %- forceps). Instrumental vaginal deliveries were common in patients with >37 weeks of gestation. In present study most common indication for Instrumental vaginal delivery (vacuum & forceps) was foetal distress ( 48.54 and 47.42 %) followed by maternal exhausation (5.8 snd 48.64%). Facial injuries and abrasions was most common neonatal complication in present study (12%). Conclusion: Results of the present study indicate that both modes of instrumental vaginal delivery are safe with respect to maternal morbidity and neonatal trauma.
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Comparative Study of Maternal and Neonatal Outcomes in Second Stage LSCS Vs First Stage LSCS in Tertiary Care Centre
Introduction: Caesarean section is probably the most common surgical procedure carried out in obstetrics. The rates of caesarean sections have risen steadily in the past few decades. Caesarean section in the second stage of labour is a more challenging surgical procedure and has adverse feto-maternal outcomes than performed in the first stage or before labour. The present study was done at our tertiary care centre to compare complications of Caesarean Section in the First Stage and Second Stage of Labour and the strategy to reduce maternal and neonatal complications. Objective: To study the indications of first stage of LSCS and second stage of LSCS and to study Maternal and neonatal outcome in first stage and second stage of LSCS. Methods: Prospective observational study in tertiary institute from November 2020 to October2022 in department of OBGY, GMCH, Aurangabad, Maharashtra. Institutional Ethical committee approval was taken. 200 women willing to participate in the study are chosen as per the inclusion and exclusion criteria. Among these 100 women of first stage LSCS and 100 women of second stage LSCS. Results: In present study, most of women were unbooked (62.5%) and from rural area (58%),belongs to 21-25 years age group (55.5%) and 53% had normal BMI range (>18-25) with 54% had socio-economic class IV. As compare to first stage, Second stage LSCS had more intraoperative and postoperative maternal complications like excessive blood loss (P value 0.035)., uterine artery ligation (P value<0.001), extension of uterine incision (P value 0.009), blood transfusion requirement (P value 0.017), more operative time(P value0.006), prolonged hospital stay(Pvalue0.004).In Neonatal outcomes, NICU admission were more in second stage LSCS than first stage LSCS. Conclusion: Second stage LSCS has significant neonatal morbidities as well as maternal morbidities. The rate of complications of second stage LSCS can be minimized by use of partograph in labour, consistent monitoring of labour and timely intervention and it should be handled and operated by experienced obstetricians.