International Journal of Scientific Research
IJSR - International Journal of Scientific Research is a Double Reviewed,Peer Reviewed monthly print journal, accepts intensive and exclusive research works in all spheres of Medical Science from Academicians, Professors, residents in their respective medico field. The journal aims to disseminate high quality research work in the form of Original Research Papers, Case Reports, Review Reports, etc to the medical fraternity. The quality papers published are inline and acceptable by Medical Council of India (MCI), Other Statutory Authorities in India and across the World. The journal releases on every 1st of the Month.
CONTROL OF GIARDIASIS AND EFFECTIVE TREATMENT IN HUMAN
Introduction-Giardiasis has a global distribution, common in both children and adults and transmitted via the fecal-oral route through direct or indirect ingestion of cysts..Giardia has been included in the "neglected diseases initiative" by the World Health Organization. Objective-In this article, we have evaluated the Giardiasis control method and effective treatment. Material and Method-The most common prescription drugs prescribed for giardiasis are metronidazole, tinidazole, and nitazoxanide. The medicine will kill off the protozoan organism. A selection of drugs are available to treat infections with Giardia in humans. Conclusions-Our understanding of the pathogenesis of infections with Giardia has improved and we are a little closer to being able to say why clinical disease occurs in some individuals but may not be apparent in others. In this regard, such interventions will require the cooperation of government agencies to improve basic infrastructure in disadvantaged communities.
Copyright (c) 2020 International Journal of Scientific Research
ASSESSMENT OF INDICES USED FOR SEXUAL DIMORPHISM OF SKULL
Introduction: Skull is the preferred bone for identification of sex of the deceased as it resists decomposition, mutilation and fire. Cranial Index, Nasal Index and Orbital Index are commonly used for sexual dimorphism of skull. Objective: To know the reliability of these indices for sexual dimorphism of the skull. Materials and Method: The study was performed on 98 adult Indian skulls consisting of 60 male and 38 female skulls of known age and sex. Parameters measured were Cranial Index (CI), Nasal Index (NI) and Orbital Index (OI) which were expressed in descriptive statistics i.e. mean, range and standard deviation. For all the three indices, ‘identification points’ and ‘demarking points’ were calculated and then percentage of skulls identified by these points were recorded. Results- In the present study, mean CI in male and female skulls was 74.68±4.21 and 77.12±4.92 respectively while their NI was 50.76±5.61 and 56.86±6.65 respectively. In male skulls the mean OI was 87.47±8.09, while it was 87.88±5.55 in female skulls. The identification points and demarking points were calculated for all these three indices. Conclusion: None of the three indices namely CI, NI or OI were promising individually in identifying sex as a very low percentage of skulls could be identified. The study concludes that the reliability of these three cranial indices is doubtful in sexual dimorphism of the skull.
HISTOMORPHOLOGY OF CHRONIC HYPOPHYSITIS - A RARE CASE REPORT
Chronic hypophysitis is extremely rare entity & usually presents with inflammation of the pituitary gland. Most commonly presents with headaches and visual disturbances. Hypophysitis is rare & its etiology is not fully understood. It commonly affect females during pregnancy or in the postpartum period. Its clinical presentation (hypopituitarism, mass effect,hyperprolactinemia) & radiological findings may mimic pituitary adenoma. Complete laboratory evaluation with imaging is required to refine the diagnosis. The definitve diagnosis of chronic hypophysitis cannot be made without histopathology.
WARTS, HPV AND HOST IMMUNITY : A COMPLEX RELATION
A complex relationship between warts, Human papilloma Virus (HPV) and the human host immunity is an area which needs further exploration than what we know now.[1],[2] Skin possesses many connected linked defense mechanisms that include an intact stratum corneum, complement mediated phagocytosis and the adaptive immunity. HPV gains entry through minor skin defects to infect the basal epithelial layer. HPV infections are unlike the short lived acute viral infection influenza which induces a strong immune response. By the property of antigenic variation, genome integration and by residing in sites which are not reachable to immunity cells, HPV can escape detection.
INTENSIVE CARE UNIT SPECIALITY SPECIFIC UTILISATION PATTERN AND OUTCOME AT A TERTIARY CARE HOSPITAL: A RETROSPECTIVE OBSERVATIONAL STUDY
Introduction: The patterns for ICU admissions have been evolving and are quite diverse. Our study is aimed at contributing to the pool of data available about Indian ICU admission patterns. Methodology: This study was conducted as a retrospective analysis of all patients admitted to our ICU during a 6 months duration. Data was collected from ICU admission and discharge register and analysed with MS Excel. Result: A total of 1312 patients were admitted to our ICU during study period of 6 months. Overall mortality during ICU stay was 211/1312 (16.08%). Conclusion: There is wide variation among number of ICU admissions, mortality and speciality wise utilization in different ICUs. Reasons for the same are multifactorial like patient pattern, availability of other care areas, appreciation of need of ICU services by different specialities etc.
AN IMMEDIATE IMPLANT PLACEMENT APPROACH IN A FAILED PROSTHESIS : A CASE REPORT
Immediate dental implant placement comprises the installation of implants immediately after tooth extraction, eliminating the necessity of having to wait for the alveoli to heal. If performed successfully, patients benefit from fewer surgical procedures and a faster permanent tooth solution making this technique a popular alternative to conventional implant placement.
RETROSPECTIVE ANALYSIS OF INFLUENZA A H1N1 (SWINE FLU) AT TERTIARY CARE CENTER
Background : Influenza A H1N1is an infectious disease caused by RNA viruses of the family Orthomyxoviridae (the influenza viruses). Methods: Retrospective study was conducted on all the suspected cases of Influenza A H1N1 (Swine Flu) from October 2018 to September 2019 in the Department of Microbiology, Government Medical College, Kota, Rajasthan, India. Results: Out of 3979 suspected cases, 606 were tested positive among which 51.32% were males and 48.68% were females. Maximum prevalence was noted among age group 0-10 years (18.67%) followed by 41-50 years of age group (18.26%).. There might exists a relation between the humidity and the virus activity. Interpretation and Conclusion: Conscientious screening and expeditious management and other preventive measures for identifying the suspected cases and isolating them will go a long way in curtailing the recurrence of this epidemic.
A RANDOMIZED COMPARATIVE STUDY OF NITROGLYCERIN AND ESMOLOL FOR CONTROLLED HYPOTENSION IN FUNCTIONAL ENDOSCOPIC SINUS SURGERIES.
Background : Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive procedure for disease of Nose and Paranasal sinuses like chronic sinusits and polyps rhinosinusitis. Intraoperative bleeding causes poor visibility of surgical field is a major concern during FESS and this may results in many complication . Controlled hypotension is a technique where in arterial blood pressure is lowered in deliberate but controlled manner to minimize blood loss and enhance operative field visibility. Aim: To compare the hypotensive efficacies of intravenous Esmolol and intravenous Nitroglycerin in Functional Endoscopic Sinus Surgeries under general anaesthesia.In term of changes in heart rate ,systolic blood pressure, diastolic blood pressure ,mean arterial pressure, duration of surgery and operative field visibility assessment by surgeon by using Fromme scale. Methods: This study was conducted on total 60 patients, divided into two groups. Group Nitroglycerin (NTG) 30 patients , Group Esmolol (ESM) 30 patients.Patients between ASA grade I&II, age 18-60 years undergoing Functional Endoscopic Sinus Surgery under GA , Either injection Esmolol 100-300 mcg/kg/min and NTG groups 0.5 -10 mcg/kg/min through infusion pumps. All patient s were premedicated with Ondansetron (0.1mg/kg )IV,Midazolam(0.02mg/kg)IV,Glycopyrrolate(0.01mg/kg) and Fentanyl (2µg/kg) and then induced with Propofol 2mg/kg IV. Laryngoscopy and intubation was facilitated by Succinylcholine 2 mg/kg IV. Anaesthesia was maintained with Isoflurane vapour in balanced Nitrous oxide and Oxygen mixture and Vecuronium 1mg IV every 10-20 min for musle relaxation. Heart rate, Systolic Blood Pressure , Diastolic and Mean Arterial Blood pressure were assessed at 5min,10min,15min and so on upto 60 min. Result: Introperative Heart rate was less in Esmolol(ESM) as compared to Nitroglycerine(NTG) group. Both drugs produced desired hypotension but ideal operating conditions were achieved at a higher MAP of 80.74±2.6 mm Hg in ESM groups ,while same operating conditions, were achieved at lower MAP of 73.49±2.07 mm Hg in NTG group. Conclusion: Both drugs are safe and effective in providing optimal operating conditions but Esmolol is superior agent to NTG for controlled hypotension in FESS under general anaesthesia as it minimizes surgical blood loss, enhance operative visibility and reduces duration of surgery with minimal reduction in MAP . Absence of reflex tachycardia was added advantages of Esmolol over Nitroglycerin.
RELATIONSHIP BETWEEN PERIODONTAL DISEASE AND OBESITY- A CLINICAL STUDY
Background- Obesity and periodontal disease are common chronic disease. This study attempts to study relationship between obesity oral bacteria and periodontal disease. Method- Study included 350 subjects with age ranging 18-60 years. They were divided into 4 groups. Clinical parameters included Plaque Index, Gingival Index, Probing Pocket Depth and Clinical Attachment Loss. Anthropometric measurements like weight, height, waist circumferences and waist-hip ratio were evaluated. Results- Comparing obesity and clinical periodontal parameters: Group-I (healthy) and Group-II (obese-I) were not statistically significant, whereas relationship between Group-1 (healthy) and Group-III (obese-II) as well as Group-1(healthy) and Group-IV (obese-III) were statistically significant . Conclusion- Adipose tissue may serve as a reservoir for inflammatory cytokines, increasing body fat has likelihood, of stimulating active host inflammatory response in periodontal disease.
RETROPERITONEAL HYDATID DISEASE ADJACENT TO DESCENDING COLON : A CASE REPORT
A 65 yrs old male reported in OPD with complaint of lump in abdomen and recurrent abdominal pain. On abdominal examination revealed a mass in left ileac fossa which was mobile, non tender and firm in consistency. On ultrasonography of abdomen suggestive of heterogenous mass in left iliac fossa likely arising from descending colon with multiple lesions in liver suggestive of haemangioma.
A STUDY ON FUNCTIONING OF THE NUTRITIONAL SERVICES IN ANGANWADIS FOR 0 – 3 YEARS CHILDREN UNDER ICDS PROGRAMME IN DELHI FROM USER'S PERSPECTIVE.
INTRODUCTION: Nutritional services under the ICDS programme aims to improve nutritional status of children in India. Perception of the user regarding the nutritional services provided by the anganwadi, reasons for non-utilization of services is important to understand to achieve its aim. OBJECTIVE: To assess perceptions of users regarding nutritional services provided in anganwadi of urban area and reasons for non-utilization of the nutritional services by anganwadi among non-users. METHDOLOGY: Cross sectional and descriptive study conducted at Mehrauli Project of South District and Hastsal Project of West District. Mothers were interviewed based on the pre-tested interview schedule. RESULTS: Significant differences were observed in profile of user and non-user, population with years of stay less than 2 years are utilizing the services less as compared to those who have comparatively more years of stay in the area. Utilization of anganwadi services is less among families with children in age group up to 12months, lower birth order and families with relatively higher monthly income of household. Awareness about anganwadi services for pregnant women was low (83.3% for supplementary nutrition and 68% for NHE). Utilization of supplementary nutrition and NHE services for pregnant women was also low 57.5% and 9.6% respectively. Among the non-users 34% were not aware of the location of AWC and awareness level for the growth monitoring services was 57.5% and 62.7% for supplementary nutrition / Take Home Rations. Among users 23 (13%) were not aware of importance of growth monitoring and 17 (9%) were not aware about importance of SNP/THR. Awareness among the user about feeding the child during illness and after illness was 72.8% as compared to 33% in the non-user. CONCLUSION AND RECOMMENDATION: Active efforts to include the migrant young population, families with relatively higher household monthly income in the nutrition and health services for growth monitoring to enable detection of under or over-nutrition in these children and appropriate advice for corrective measures.
A STUDY ON STATUS OF ENVIRONMENTAL LABELS AND RECYCLING SYMBOLS ON PROCURED SURGICAL CONSUMABLES IN A TERTIARY CARE GOVERNMENT HOSPITAL.
Aim: A Study on status of environmental labels and recycling symbols on procured surgical consumables in a Tertiary Care Government Hospital. Objectives: To study the status of eco label-l and recycling symbols on surgical consumables, and procurement rules with respect to green procurement rules. Methodology: Study was conducted at central store of a tertiary care Government hospital. It was cross sectional, observational and descriptive type of study for 4 weeks duration. Observational checklist with parameters like availability of Eco label-I and recycling symbols on surgical consumables and cost of consumables, policy for procurement of consumables. Results: Out 81 items observed only 1 (1.23%) item had Eco label-1 and 23 (28%) items had recycle symbols. There was a procurement policy as per government financial rules 2017. Conclusion: A policy for green procurement is need of the hour. Policy decisions at central level should consider Eco-labels/environmental parameters for procurement.
CYST OF PERIODONTAL ORGIN: A CASE REPORT
Lateral periodontal cyst is a rare odontogenic cyst of developmental origin. It occurs on the lateral periodontal region on a vital tooth and has specific histologic features was successfully enucleated.
COMPARISON OF CLONIDINE OR FENTANYL AS AN ADJUVANT TO BUPVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERIES: A RANDOMIZED DOUBLE BLIND, CONTROLLED INTERVENTIONAL STUDY
Background The popularity of supraclavicular brachial plexus block in upper limb surgery in recent years are due to better understanding of using adjuvant to local anaesthetics, its advantages and in avoidance of the hazards of general anaesthesia. Aim To compare anaesthetic and analgesic properties of clonidine or fentanyl as an adjuvant to bupivacaine in supraclavicular brachial plexus block in upper limb surgeries. Method A total number of 90 patients (ASA class 1 and II) were selected randomly into three groups, thirty in each group. Group-A (control group) received bupivacaine (0.25%) 28ml and 2ml 0.9% Ns, total of 30ml. Group-B (study group) received fentanyl (100μg) 2ml and bupivacaine (0.25%) 28ml, total of 30ml. Group-C (study group) received clonidine (150μg) 2ml and bupivacaine (0.25%) 28ml, total of 30ml.The parameters including pulse rate, non invasive systolic and diastolic blood pressure, respiratory rate, SpO2, onset and duration of motor and sensory block, postoperative pain score in VAS, duration of analgesia, first analgesic demand, side effects were assessed and recorded. Result The difference in onset of sensory & motor block (early in clonidine group), duration of sensory & motor block and duration of analgesia (prolonged in clonidine group) was found to be statistically significant between all the groups (p<0.05). But intensity of pain measured by VAS in group A was highest at 18 hrs group-B and group-C expressed highest at 24 hours of postoperative period with group C showing lower VAS. Duration of analgesia (time from supraclavicular block to first analgesic demand) in study group-C had significantly longer mean duration than that produced by Group B and control group-A (18.2 ± 2.5 vs 15.4 ± 1.2 and 8.2 ± 1.3 hours P<0.001). Conclusion Clonidine and bupivacaine combination is a better alternative to fentanyl and bupivacaine in respect of quality of anaesthesia and duration of analgesia.
A STUDY TO ASSESS KNOWLEDGE, ATTITUDE AND AWARENESS ON ORGAN DONATION AMONG ADULT POPULATION IN INDIA
An organ transplant is a surgical operation in which a failing or damaged organ in the human body is removed and replaced with a functioning one. The donated organ may be from a deceased donor, a living donor, or an animal. Living organ donation involves the donation of one of a paired organ or a portion of an organ and the donor organ system is still able to function after the donation. The removal of organ from a deceased person must follow legal and ethical requirements and as per the regulation, definition of death and consent for donation the organ should be removed. There is great need to assess the knowledge attitude & Awareness regarding organ donation among adult population in India. Aims & Objectives: To report the levels of knowledge, attitudes and practices regarding organ donation among general public in an urban setting in India. Materials & Methods:A community based cross-sectional study was conducted among 600 randomly selected adult population in a tertiary care private-setup multi-specialty hospital based in an Urban location in Western India. Data regarding knowledge, attitude, and practice were collected through pretested semi-structured questionnaire. Results: Mean (S.D.) age of the study participants was 38 (15) years and 50.7% were female. However, 49.75%, 58% & 47.8% had adequate knowledge, Attitude & Awareness regarding organ donation. Conclusion:Less than one-half of the study population had adequate knowledge, Attitude & Awareness regarding organ donation. Keywords: Knowledge, Attitude, Awareness, Organ Donation.
PERCEPTION OF STUDENTS REGARDING COMMUNITY MEDICINE CURRICULUM AND IT'S DETERMINANTS IN A MEDICAL COLLEGE OF WEST BENGAL, INDIA
Background: Community based experience encouraged a career in general practice and gave better orientation towards patient care. Objective: To assess the strength and weaknesses of CM curriculum, to identify the influencing factors and to document students’ suggestion regarding the modification needed. Methods: A cross-sectional study was conducted in a medical college of West Bengal in 2018 among final year students. Predesigned, semi structured questionnaire was used for data collection. Collected data were entered in MS excel spreadsheet and analyzed with the help of SPSS 22.0 version. Results: Strength of the curriculum were research work, faculty, classroom discussion, easy course and practical session. There was significant difference in perception score among different gender, caste, present residence and career preferences. Conclusion: Based on the students’ suggestion, training of existing teaching staff and more community-based learning are needed at this hour.
EXTRA-NEURAL PERINEURIOMA OF MANDIBLE : A RARE PRESENTATION
Perineurioma is a soft tissue tumor composed of cells resembling normal perineurium.Lazarus and Trombetta first described it in 1978 on the basis of ultrastructural findings. All perineuriomas express antigens that are identical to normal perineurium of nerve. Soft tissue perineurioma is most commonly seen in extremities and trunk. It has been very rarely described in gingiva, mandible, lips, retrotonsillar mucosa and maxillary vestibule. We present a case of soft tissue type perineurioma arising in mandible, an extremely rare site.
STUDY OF MALNUTRITION AMONG 0 – 3 YEARS OF CHILDREN IN URBAN SLUM OF JAIPUR
Background: Malnutrition is prevalent in developing countries like India and is mostly seen in lower socio economic strata due to illiteracy and other factors affecting it. Aims and Objective: to assess the malnutrition and its correlation with socio economic status of family and educational status of mother Material and Method: Based on reported prevalence of wasting 23% in NFHS-3 (2005-06 ) sample size was arrived N=1.96 X 1.96 Pq/L2 Results: In present study 54% of the families were of nuclear type and majority of families belonged to Socio-economic class-5 (63.66%), 60% mothers were illiterate. 37% children showed malnutrition as per IAP classification and 59.66% showed stunting while 53% children showed malnutrition as per mid arm circumference measurements. Conclusion: Proportion of boys who are stunted is more as compared to girls, showing some sort of gender bias. Secondly proportion of children who are stunted is more in lower socioeconomic class and in illiterate mother.
A STUDY OF PREVALENCE OF HYPERURICEMIA & METABOLIC SYNDROME & THEIR ASSOCIATION IN TYPE 2 DIABETES MELLITUS IN DSP HOSPITAL
Diabetes is a syndrome of hyperglycemia and disturbances of carbohydrate, fat and protein metabolism associated with absolute or relative deficiencies in insulin secretion. To find our correlation between hyperuricemia and Metabolic Syndrome in Type 2 Diabetes Mellitus. 300 patients of type 2 diabetes were selected at Department of Medicine , DSP hospital from October 2017 to September 2018. The results demonstrate the prevalence of metabolic syndrome in type 2 diabetes as 55%.Increased serum uric acid levels were also significantly associated with occurrence of metabolic syndrome in diabetic patients. Physicians should recognize the metabolic syndrome and hyperuricemia as a frequent co-morbidity of Diabetes and treat it to prevent serious complications.
NON RIGID CONNECTORS IN FIXED PROSTHODONTICS: A STRESS BREAKER FOR PIER ABUTMENT
Many times a dentist comes across a situation in which his clinical expertise and knowledge can play an important role in treatment planning. One such situation is case of a pier abutment. Pier abutment is an abutment with edentulous apace on either side of it. Pier abutments act as a Class I fulcrum lever in a fixed partial denture with rigid connectors. Class I lever causing stress on the terminal abutments and failure of the Fixed Dental Prosthesis (FDP). This article describes the management of pier abutment with a simple method using customized semi precision attachments.
ECOFRIENDLY SYNTHESIS AND CHARACTERIZATION OF SILVER NANOPARTICLES USING PEEL EXTRACTS OF CITRUS RETICULATA
Objective: Nanoparticles synthesized using variety of hazardous chemical methods which are not environmentally friendly. Hence, the present study was designed to synthesize silver nanoparticles biologically using peel extract of Citrus reticulata and characterization of biosynthesized silver nanoparticle. Methods: In our study silver nanoparticles were synthesized with peel extract of Citrus reticulata fruit and aqueous solution of 1 mM silver nitrate solution and then characterized using UV-Visble, Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and Scanning electron microscopic (SEM) methods. Absorption maxima for silver colloidal solution showed at 420 nm in a UV-visible spectrum. The functional biomolecules such as carboxyl groups responsible for the silver nanoparticles formation were characterized by FTIR. Results: The x-ray diffraction results revealed that the crystallization of the bioorganic phase occurs on the surface of the silver nanoparticles or vice-versa. The broadening of peaks in the x-ray diffraction patterns was ascribed to particle size effects. In our study, presence of elemental silver was proven by EDX analysis and x-ray diffration evidenced that the silver ions have been reduced to elemental silver. In conclusion, our study demonstrated simple benign, cost-effective biosynthesis methods of silver nanoparticles using peel extract of Citrus reticulata fruits. Conclusion: our findings could be explored for industrial production of nanoparticles and their use in biomedical and pharmacy applications.
INK SMUDGED PROBE:AN UNUSUAL CAUSE OF FALSE LOW PULSE OXIMETRY READING
Pulse oximetry is a simple, accurate, universal, non invasive method of measuring arterial oxygen saturation. However, this technique is not devoid of limitations and therefore can show erroneous readings. We herewith discuss an interesting case of false low saturation reading in a patient due to ink smudging of the probe, in a case of emergency LSCS under general anaesthesia.
EFFECT OF ADDING ULTRA-LOW-DOSE NALOXONE TO FENTANYL AND LIDOCAINE COMBINATION FOR PERIBULBAR ANESTHESIA
Successful peribulbar block with adding adjuvants like fentanyl and naloxone in ultra-low dose will provide a safe, quality of anaesthesia intraoperatively and good and prolonged postoperative analgesia. We conducted a randomized double blinded study to evaluate the quality of the block and the duration of postoperative analgesia when ultra-low-dose of naloxone added to fentanyl and lidocaine for peribulbar anesthesia. There was no significant difference between the two study groups regarding the total injected volume, onset, and best akinesia score. Adding low dose naloxone with fentanyl significantly prolong post op analgesic duration without altering onset , quality and duration of block without any significant side effect.
UTILIZATION OF MATERNAL HEALTH CARE SERVICES IN A BLOCK OF BANKURA DISTRICT IN WEST BENGAL: A CROSS- SECTIONAL STUDY
Introduction: Pregnancy is a physiological process but it may become a life threatening condition in absence of proper medical care. Current maternal mortality rate in India is 132 per 100,000 live births. Mothers and children constitute an important and priority group especially India. The deprivation of women’s health can be recognized in the field of reproductive health. Maternal health care service is a potentially most effective health intervention for preventing maternal morbidity and mortality in particular places where the general health status of women was low. With this aspect objective of this study were as follow: To study the socio-demographic characteristics of recently delivered mothers of Gangajalghati block. To find out the utilization of antenatal, intranatal and postnatal care services among the study subjects. Material &Methods: Community based cross-sectional study conducted among 420 women who had delivered and completed puerperium period in last one year over a period of 12 months. From 30 sub- centres in this block, 14 mothers were selected from each one. Results: Mean age of study women 22.5 ± 3.6years, range 17- 41years. Mean age at marriage and Mean age at first pregnancy of study women were 18.1± 1.5 years (range 15-29years) and 19.4 ± 2.0 years (range 16-35years) respectively. Antenatal registration was done 78.3% of study women within 12 weeks of gestation. Among the Multipara spacing of birth (>3yrs) was adequate in majority of the study women i.e. (57.4%). Four antenatal visits were done by of most of the study women (79.4%). However 16.7 % of study women delivered at home. Four postnatal visits were done only 42.4 % of study women while 5.6% of study women had not received any postnatal visits. Conclusion: This study revealed that antenatal services had taken most of the study subjects but still 16% of women did not availed the institutional delivery. Less than half of women were received adequate post natal services. Recommended for improvement of institutional delivery as well as all mothers received the adequate post natal services at the block.
EVALUATION OF CD4 T-CELL COUNTS IN HIV/TB COINFECTED PATIENTS BEFORE AND AFTER ANTI-TUBERCULAR TREATMENT.
Tuberculosis (TB) is a common coinfection in Human Immunodeficiency virus (HIV) infected patients worldwide, especially in developing countries. This coinfection has dreadful social and economic impact across the globe. A decrease in CD4 T-cell counts in HIV-TB coinfection leads to increase in morbidity and mortality. This retrospective study was conducted to evaluate CD4 T-cell counts in coinfected patients of HIV and TB before and after anti tubercular treatment (ATT). Of the 186 coinfected patients observed ,160 had pulmonary tuberculosis (PTB) and 26 had extra-pulmonary tuberculosis (EPTB). The mean CD4 counts before ATT in PTB patients is 266 cells/µl and EPTB patients is 248 cells/µl and after the completion of ATT in PTB is 332 cells/µl and 397 cells/µl in EPTB patients. There was statistically significant increase in CD4 T-cell counts in both PTB and EPTB cases coinfected with HIV after ATT.
USE OF ROLE PLAY AS AN EDUCATIONAL TOOL IN PATHOLOGY
In this cross-sectional educational study, second-year MBBS students and teachers were oriented about the study. 62 students (30 females: 48.38% and 32 males: 51.62%) gave written informed consent for participation in the study. Question bank, check lists and script for role play were prepared and validated by the participants, faculty members and experts. The lottery system was used to randomly allocate students into two groups comprising 31 students each – Group A and Group B. Participants in Group A witnessed a role play (mock viva voce examination) before they themselves faced a viva voce examination; while those in Group B faced conventional viva voce examination by the same examiner, who used the same 5 gross pathology specimens. After one month, a formative assessment examination was conducted, wherein Group A students obtained significantly higher scores (Z=2.055; p=0.039) in the viva voce examination as compared their Group B counterparts.
PROSPECTIVE OBSERVATIONAL STUDY OF OPHTHALMIC MANIFESTATIONS AND FIELD DEFECTS IN INTRACRANIAL TUMOURS
AIM OF THE STUDY: To study the various ophthalmologic manifestations in patients with intracranial space occupying lesions. To study the visual field defects caused by intracranial space occupying lesions. MATERIAL AND METHOD: The study was done on patients who underwent detailed ocular, neurological and systemic examination which also included CT/MRI proven cases of intracranial tumours. RESULTS: Patients in the age group of 30 to 40 years were affected. Headache was the most usual symptom followed by defective vision. Papilledema was appreciated in the most of the fundus examination . 6th cranial nerve was frequently affected. Peri chiasmal tumours was found to be the to be most regular site of tumour . Visual field defect corresponded with site of tumour.
Hand hygiene is a milestone of infectious disease control and its promotion has been recognized as an important public health measure. Due to constant relationship with patients, nurses play a paramount role in proper execution of hand hygiene. A study was conducted to assess the knowledge of nursing students and their performance was measured before and after the workshop. The knowledge score regarding hand hygiene was significantly improved from 4.34±1.5 to 8.84±0.9. Emphasis on infection control to lower hospital acquired infections (HAI) should be considered as an important aspect and must be included as educational priority.
MANAGEMENT OF A CASE OF KAWASAKI DISEASE
Kawasaki disease (KD) is an acute systemic vascular disease that affects mostly medium sized and small vessels [1]. It is usually a self-limited disease with the highest incidence occurring in children under five years of age. We present a case of a 14 year old boy who presented with fever and rash in the lower part of the trunks and legs. Clinical examination revealed the presence of cervical lymphadenopathy, conjunctivitis and strawberry tongue. After making a clinical diagnosis of Kawasaki disease, the patient was successfully treated with intravenous immunoglobulin and aspirin. Proper diagnosis based on clinical findings, proper investigations and follow-ups are important to treat and prevent associated complications of the disease especially coronary aneurysm.
SUCCESSFUL MANAGEMENT OF A CASE OF PREGNANCY WITH SJOGREN SYNDROME
Auto immune disorders are common among women of child bearing age. Pregnancies complicated by these disorders have a high clinical impact on both the pregnancy and the disease. Sjogren syndrome can either present alone as primary Sjogren syndrome or can present in association with any other auto immune disorder as secondary sjogren syndrome. Laboratory diagnosis of Sjögren syndrome is usually made by the following markers: antinuclear antibodies (most frequently detected), anti SS-A (also called anti- Ro; most specific), anti-SS-B (also called anti-La), and cryoglobu­lins and hypocomplementemia (main prognostic markers). Sjogren syndrome is likely to worsen during pregnancy. Pregnancy can be complicated with spontaneous abortions , fetal loss and specifically fetal congenital heart block. We have reported a case of pregnancy with bad obstetric history which was diagnosed to have sjogren syndrome and was successfully managed.
EVALUATING THE ANXIETY LEVELS IN PATIENTS UNDERGOING DENTAL EXTRACTION USING BLOOD PRESSURE
Anxiety is defined as a feeling of apprehension, uneasiness, uncertainty or dread resulting from a real or perceived threat. The major obstacle in pursuing dental extraction is the anxiety towards dental treatment in patients undergoing extraction. Hence, it is very important to evaluate and manage anxiety during dental extraction. AIM To evaluate the changes in the anxiety levels of the patients undergoing dental extraction. MATERIALS AND METHODS The prospective clinical study was conducted on 325 patients who underwent extraction in the department of Oral and Maxillofacial Surgery, Vivekanandha dental college, Namakkal, Tamil Nadu. Anxiety analysis was carried out with the help of hemodynamic changes (Systolic blood pressure- SBP and Diastolic blood pressure -DBP ) at 5 occasions:Before starting the procedure, After administration of local anesthesia, Immediately after extraction, 5 minutes after extraction and finally, 10 minutes after extraction. Data collected were statistically analysed and results were obtained. RESULT: The blood pressure samples collected immediately after entering the clinic, after administration of local anaesthesia and immediately after extraction were relatively high. CONCLUSION: For any treatment to be successful dentist should be more considerate about feelings of patient of which anxiety is one of the important factor to be dealt with.
RETROSPECTIVE STUDY ON PREVALENCE OF ANEMIA AMONG PREGNANT WOMEN REGISTERED IN A URBAN HEALTH TRAINING CENTRE IN KRISHNA COLONY, KATHUA, J&K.
Introduction: Anemia in pregnancy is one of the major risk factor. The prevalence of anemia in Indian females is approximately, 52%. It is associated with an increased risk of maternal deaths in case of severe anemia, low birth weight, premature delivery, risk of birth asphyxia and intrauterine fetal death. Thus anemia is considered as one of the most frequent complications of pregnancy and there is need of early detection. Methods: Retrospective record based study conducted at Urban Health Training Centre Krishna Colony, Kathua, J&K. Data regarding pregnancy were collected from 1st March 2018 to 1st March 2019 by referring the records maintained by the ANMs at UHTC. Data was analysed using SPSS 20. Results: A total of 196 pregnant women were registered at UHTC for ANC care during this one year period. Majority (50.5%) belonged to the age group of 21-25 years and 9 females were of the age group 15-20 years. Prevalence of anemia in the present study was found to be 73.4% among which 62 cases were mild form, 79 cases were moderate form and only 3 cases were of severe form with hemoglobin level below 7g/dl. Conclusions: The prevalence of anemia in pregnancy at booking is still high. Preconception care, including iron and folic acid supplementation, is advocated to reduce this problem. Early antenatal registration and improved antenatal care are also necessary for early diagnosis and treatment of the condition. All this would ensure safe motherhood.
DENTURE IDENTIFICATION SYSTEM USING AADHAR NUMBER FOR ALL INDIAN POPULATION – A CASE REPORT
Dentures are not only used to restore the functions of oral cavity, it also plays an effective role in forensic dentistry. Denture labeling system helps in identification of individuals in natural disaster, accidents and is also important for medico legal purpose. various types of denture labeling methods are available, many techniques do not permit to incorporate large amount of information. This case report describes the technique for inclusion of aadhar number which is issued by government of India, a unique identification number for every Indian that could be globally recognized. The aadhar number and quick read code printed in paper for incorporation. This method is less time consuming, durable, cost effective, unique to every Indian and provides all necessary information. A standardized denture labeling method is not followed in India , this case report proposes a standardized identification method for denture labeling.
AN UNUSUAL CAUSE FOR TRANSVERSE COLON STRICTURE – SEALED OFF PERFORATION: A CASE REPORT
Intestinal obstruction secondary to transverse colon stricture is a very rare finding in adults. Transverse colon stricture secondary to perforation is even so rare finding. A fifty-five-year-old male patient presented with chronic abdominal distension. Clinical findings were distended abdomen with distended bowel loops and no tenderness. CECT abdomen suggested sigmoid volvulus. Upper GI endoscopy suggested narrowing at d1, d2 junction and colonoscopy suggested ascending colon stricture. Intra operative we found transverse colon stricture with adhesions to caecum and small bowel loops. Adhesiolysis and resection anastomosis done. Thus even with modern diagnostic modalities intra operative findings can still surprise you, leaving you guessing about the possible etiology at the end.
DIURNAL VARIATION OF THYROID DYSFUNCTION IN FASTING, POSTMEAL & RANDOM BLOOD SAMPLES IN PROLONGED DIABETICS
BACKGROUND: Diabetes mellitus (DM) and thyroid dysfunction (TD) are the two most common endocrine disorders in clinical practice . Patients with diabetes mellitus are at an increased risk of developing thyroid diseases.[1] The frequency of thyroid dysfunction in diabetic patients is higher than that of the general population and up to a third of patients with diabetes (DM) ultimately develop thyroid dysfunction. Thyroid dysfunction may impair metabolic control and add to cardiovascular disease risk in prolonged diabetic patients.[2] The objective of this study was to investigate the prevalence of Thyroid dysfunction in patients with diabetes mellitus. AIMS: Our aim is to study Pearsons correlation between thyroid dysfunction in diabetes mellitus and to examine thyroid disease screening strategies in routine diabetes care, in diabetic patients (fasting,postmeal,Random blood samples) attending clinical biochemistry OPD at tertiary care Unit, IGGMC,Nagpur. Materials & Methods – This study include about 150 patients attending the clinical Biochemistry OPD, IGGMC, Nagpur. All Diabetic patients ( more than 5 yrs) who were attending biochemistry OPD for routine Blood sugar tests were selected for this study. History was taken as per designed proforma and consent form was obtained. We collect 50 Fasting Blood samples ,50 Postmeal & 50 Random blood samples from known Diabetic patients .Collected sample was analysed for Blood sugar as well as thyroid test ie T3,T4 & TSH. Blood sugar test was run on Autoanalyser EM 460 in clinical Biochemistry Laboratory,IGGMC,Nagpur. Thyroid tests was run on Elisa reader & washer Serum values of Thyroid stimulating hormone (TSH), thyroxine (T4) and tri-iodo thyronine (T3) were assayed by ELISA tests and values were compared & correlated with Blood sugar level in Diabetics in all groups Fasting,Postmeal as well as Random Blood samples. The data was analysed & Pearsons Correlation was obtained. Student's T-test was used & . P value <0.05 was considered statistically significant. RESULTS: Results of our study shows Positive Pearsons correlation between TSH level & Blood sugar in Fasting, Postmeal & Random Blood samples of all Diabetic Patients while there is Negative Pearsons correlation between T3,T4 in all Diabetics. P value is found to be statistically significant in all groups (cases) CONCLUSIONS: We conclude that screening for thyroid disease among patients with diabetes mellitus should be routinely performed considering the prevalence of new cases diagnosed and the classical risk factors such as hypertension and dyslipidemia, arising from an undiagnosed thyroid dysfunction.
DIAGNOSTIC APPROACH TO VATAJA HRIDROGA – A PRELIMINARY STUDY
Vataja Hridroga is a type of Hridroga (cardiovascular disease) that can be clearly differentiated based on pathognomic symptoms as mentioned in Ayurveda. It manifests with cardinal feature of Ruja in Urah pradesha (pain in the chest region) associated with other sign and symptoms Alpanidrata, Shvasavrodha, Darah, Hrutdrava, Stambha, Stabadha, Akasmat Deenata, Shoka, Bhaya, Shabdasehshnuta, Shunyata, Vepathu and Vestana. There is lacuna in Ayurveda to assess the symptoms of disease with standard parameter. Assessment is essential for diagnosis of disease. In the present article, study has been carried out to make a classical diagnostic frame of Vataja Hridroga by preliminary approach of grading system. Based on appropriate meaning of Lakshanas (signs and symptoms) enunciated in classical texts the grading was prepared and literary resources were analyzed in this study.
A RARE CASE OF CEREBELLOPONTINE ANGLE EMBRYONAL TUMOR
Background: Embryonal tumors comprise a group of aggressive, poorly differentiated tumors occurring in central nervous system. Primary cerebellopontine angle (CPA) embryonal tumor is an extremely rare entity. It is important to have knowledge of this pathology and to be able to differentiate it from other commonly occurring CPA tumors, such as vestibular and trigeminal schwannomas. This distinction is essential because of the difference in the overall treatment plan and prognosis. Case Description: This report describes a case of 4 year old girl who presented with headache and vomiting to our department. MRI findings suggested medulloblastoma and patient underwent surgery. Histopathology confirmed our diagnosis. Conclusion: We discuss the importance of detecting this rare entity and distinguishing it from commonly occurring tumors in the CP angle region.
RELATIONSHIP BETWEEN CORONARY DOMINANCE AND CORONARY ARTERIAL DISEASE-AN ANGIOGRAPHIC STUDY
PURPOSE: With ever increasing load of coronary arterial disease on population of developed as well as developing countries, it has become mandatory to have a detailed knowledge about coronary arteries. Since adequate literature regarding coronary arteries and its association with coronary artery disease in people living in and around puducherry is not available, a study of coronary arteries by coronary angiogram was undertaken. AIMS AND OBJECTIVES: To study the dominance pattern of coronary arteries and its association with coronary artery disease MATERIALS AND METHODS: 200 adult coronary angiogram were studied during angiography.The origin of posterior interventricular artery was taken as the basis of dominance.coronary artery disease is considered significant if the stenosis is >70% in the luminal diameter of anterior interventricularartery,right coronary artery and circumflex artery. RESULTS: In this study, the right, left and co dominance were found to be 59%, 17.5%, and 23.5% respectively. Out of 200 subjects 112 had CAD ((56%).CAD was seen in 65.7% of patients with left dominance, 57.4% of patients with co dominance and 52.5% of patients with right dominance. The association was not statistically significant. CONCLUSION: The majority of hearts are right dominant. CAD was more common in those with left dominance there was no statistically significant association between coronary dominance and coronary artery disease.
GIANT NEGLECTED BASAL CELL CARCINOMA OF THE FACE -A CASE REPORT.
Although tumors of the face are considered to be easily recognizable, neglected cases are still encountered even in 21stcentury. The reasons for the delay in reporting to a surgeon are, old age, a low social economical status, becoming used to aslow growing tumor, fear of diagnosis and treatment. When reported, the treatment of such advanced tumors is usually challenging. The management of such cases demands multidisciplinary approach and teamwork. Basal Cell Carcinoma (BCC) is the most common skin cancer of the face in the elderly and is often neglected by the patient. A 72-year-old female presented to the department of General Surgery Mahatma Gandhi Medical College and Research Institute with a Giant BCC on the right side of the face with involvement of right eye. She underwent wide local excision and reconstruction.
EVALUATION OF CRANIOVERTEBRAL JUNCTION ANOMALIES USING CT AND MRI
AIM:Role of CT and MRI in evaluation of craniovertebral junction anomalies. OBJECTIVES: To study the different radiological Investigations of CVJ anomaly.To study the incidence of various Bony & Soft tissue CVJ Anomalies. To analyse the various etiological factors contributing to CVJ Anomalies. MATERIALS AND METHODS :A prospective study of 23 patients referred from outpatient and emergency department of SBKS Medical college during August 2019 to January 2020 were studied using CT scan and MRI. CONCLUSION:MRI is the imaging modality of choice for CVJ evaluation for its superior soft tissue characterization. 3-D reconstructed CT images are better for bony abnormalities at CVJ including lucent fracture lines, displacement of fractured fragments, dislocation, assimilation etc.
EFFECTIVENESS OF ALCOHOL BASED HAND RUB AND ANTISEPTIC SOAP HAND WASHING ON REDUCTION OF BACTERIOLOGICAL GROWTH AMONG B.SC NURSING STUDENTS POSTED IN MEDICAL WARD
Hands are regarded as a major source of transmitting infection. It has been estimated that there are not less than 10000 organisms per cm2 of normal skin. This includes both nonpathogenic resident flora as well as pathogenic transient flora. Hand washing is emphasised as the single most important measure to prevent cross transmission of micro­organisms and thus to prevent nosocomial infections. It is an important aspect of our everyday routine, and is of particular importance in the routines of health care professionals. The objective of the study is to assess the effectiveness of Alcohol based hand rub and antiseptic soap hand washing on reduction of bacteriological growth among B.Sc nursing students posted in Medical ward. Two group pre-test post-test design) was used in the present study.Sample were selected using Purposive sampling technique. The tool consist of demographic variables and self structured rating scale,scanty growth (<20 colony), moderate growth (20-50 colony), Heavy growth (>50) to assess the bacteriological growth. Reliability was calculated by using split half method. Analysis of the data was done using descriptive and inferential statistics.
AN EPITHELIAL CYST OF SPLEEN- A RARE CLINICAL ENTITY: A CASE REPORT
Splenic cysts are very rare clinical entity. They can be classified in many types. According to one classification splenic cysts are classified as primary and secondary cyst. Primary cysts are again classified as parasitic and non-parasitic. Non parasitic is further classified as congenital and neoplastic. Congenital cysts are again classified as cystic haemangioma, cystic lymphangioma, epithelial cyst or dermoid cyst. Secondary cysts are also called as pseudo cyst or posttraumatic cyst. Here we are discussing a case of splenic cyst which was diagnosed as epithelial cyst which is a type of primary non parasitic congenital cyst. The patient presented with abdominal pain and nausea and vomiting. USG and CT scan were suggestive of cystic lesion originating from spleen with multiple septa. Patient was given pneumococcal and meningococcal vaccine 2 weeks prior and was operated for laparoscopic splenectomy.
A STUDY TO DETERMINE THE EFFECT OF PERCEIVED NURSE - PARENT SUPPORT ON PARENTAL STRESS LEVEL OF HOSPITALIZED CHILDREN IN THE PAEDIATRIC WARDS OF A SELECTED TERTIARY HOSPITAL, PUNE
Nurses are in constant contact with the parents as they give care to the child 24 hrs and experience the parental anxiety. They should accept the parents behavior and demonstrate a sympathetic understanding and permissive guidance. The nursing staff, both individually and as a group, provides an important environmental context for the parents of children who are hospitalized for an illness. During the period of acute illness and hospitalization, the environment created by the nursing staff defines a large part of the reality for parents .
CORRELATION STUDY OF BLOOD G6PD LEVELS WITH DYSLIPIDEMIA IN TYPE 2 DIABETES MELLITUS
Glucose -6-phosphate dehydrogenase (G6PD) is the rate limiting enzyme of pentose phosphate pathway which produce NADPH , involved in lipid biosynthesis. Insulin is an anabolic hormone having profound influence on various key enzymes involved in lipid metabolism. The current study was designed to evaluate serum G6PD activity and its association with dyslipidemia in Type 2 DM. Total 100 diabetic patients and 100 age and sex matched healthy controls were included in the study. Blood G6PD was measured by chemical method. Estimation of cholesterol , TG , HDL, LDL was done in autoanalyzer . Statistical analysis was done by SPSS Version 20 software. Mean G6PD levels was significantly higher in diabetic cases . Increased G6PD levels correlates positively with TC,TG,LDL, however HDL shows a negative correlation. Increased activity of G6PD in diabetic cases, alters lipid homeostasis which leads to atherogenic abnormalities. Estimation of serum G6PD & its correlation with dyslipidemia can highlight its role in regulating lipid status in diabetes mellitus patients .
ANTI AGEING ASPECTS AND ITS SEEKING BEHAVIOUR IN URBAN GERIATRIC POPULATION
The golden quote on aging -“Ageing has an wonderful beauty and we should have respect for it by Eartha Kitt” has lost its significance as the actual reflection of old age has changed to “I’m not old , I’m just young for a long time” The demographic profile worldwide has shown greater proportion by geriatric population . The elderly people contribution to the society in terms of economy as well research purpose is growing broad due to better health care offered to improve the life expectancy as well as decreasing the morbidity.[1-2] Ageing is an ineluctable , continuous process which can be masked or delayed at cutaneous level by numerous aspects both invasive and non –invasive. The major changes attributed by general population as signs of ageing are wrinkling, diffuse hair loss and unwanted fat accumulation.
CANDIDA SPECIATION AND ANTIFUNGAL SUSCEPTIBILITY PATTERN FROM CLINICAL SAMPLES IN A TERTIARY CARE CENTRE.
Introduction: Candida can cause life threatening invasive to non life threatening mucocutaneous diseases. It is a known commensal that colonizes skin, gastrointestinal tract and reproductive tract. The pathogenesis and prognosis of candidial infections are affected by the host immune status and they differ greatly according to disease presentations. Material Methods: 104 Candida isolates from various clinical specimens over a period of 6 months were identified by standard laboratory protocols and their antifungal susceptibility was done. Results: Candida species isolated were C.albicans – 54, C.tropicalis – 35, C. krusei – 09, C. glabrata & C. dubliensis – 03 each. All the species were highly sensitive to Nystatin and Itraconazole, moderately sensitive to Ketoconazole, Fluconazole and Amphotericin B. Discussion: The present study highlights the speciation of candida species by conventional techniques along with CHROM agar and increase in resistance to various antifungal agents amongst Candida albicans and NAC group.
A SINGLE INSTITUTIONAL EPIDEMIOLOGICAL STUDY OF PATIENTS OF NON SMALL CELL LUNG CARCINOMA WITH BRAIN METASTASIS AT PRESENTATION
Brain metastasis is a dreaded complication among patients of different cancers, including lung cancer. Approximately 16 to 22% of patients with lung cancer develop brain metastases. Non small cell lung carcinoma (NSCLC) accounts for the maximum proportion of all lung cancer cases. Brain metastases during presentation carries a poorer prognosis than metachronous brain metastases in NSCLC cases. This study was aimed to retrospectively analyze the epidemiological pattern of NSCLC patients presenting with brain metastases, attending a tertiary health care centre during a period of one year. Total 22 patients, out of 198 NSCLC cases had brain metastases at presentation. There was not much difference in rate of brain metastases between male and female. Rate of brain metastases at presentation was more in case of adenocarcinoma, than in squamous cell carcinoma, though the difference was not statistically significant.
A COMPARATIVE STUDY ON THE EFFICACY OF TOTAL CONTACT CASTING (TCC) VERSUS PATELLAR TENDON BEARING (PTB) CASTING WITH BOHLER'S WALKING IRON IN TREATMENT OF NEUROPATHIC PLANTAR FOOT ULCER
Introduction: Neuropathic plantar ulceration is one of the serious hazards to the person with anaesthetic feet. The entire history of a plantar trophic ulcer is dominated by mechanical factors. Apart from Total Contact Casting (TCC) there are several offloading techniques and custom-made orthoses readily available including a simple customized Patellar Tendon Bearing (PTB) cast, PTB cast along with Bohler’s walking iron (BWI) with may enhance the mobility, increasing patient’s self-esteem and finally reduce the disability. Material and methods: In this prospective parallel group randomized controlled open level trial, conducted in the Department of Physical Medicine and Rehabilitation, IPGME&R, SSKM Hospital, Kolkata between 15th January, 2012 to 14th July, 2013 (Eighteen months) 54 (27 in each group) patients with neuropathic plantar foot ulcer, residents of Kolkata and surrounding districts, attending the Physical Medicine and Rehabilitation OPD at IPGME&R, SSKM Hospital, Kolkata were included and studied if they fulfilled the inclusion and exclusion criteria after getting Institutional Ethics Committee clearance and informed written consent. Results: The combined results of these studies yields an average rate of successful healing of 75.5% after an average of 38.7 days in the cast but for the lack of literature we found difficulty to compare our results in case of PTB casting with Bohler’s walking iron as it has not been extensively studied like TCC. The results of our study indicate that pressure off-loading using the TCC and PTB casting with Bohler’s walking iron are equally effective in the treatment of neuropathic plantar foot ulcer. Conclusion: Both TCC and PTB casting with Bohler’s walking iron are helpful to reduce ulcer depth, and ulcer area which are statistically significant (p value < 0.001). Approximately 30% of the ulcer healed quite well in both the groups after the period of 3 weeks of treatment but majority of the ulcer (85.2% in TCC group & 77.8% in PTB casting with Bohler’s walking iron group) healed at the end of the study by both form of treatment.
ASSOCIATION OF ABO AND RH BLOOD GROUP WITH TRANSFUSION TRANSMITTED INFECTIONS (TTI) AMONG VOLUNTARY NON-REMUNERATED BLOOD DONORS: A RETROSPECTIVE STUDY IN A TERTIARY CARE MEDICAL COLLEGE FROM NORTH INDIA
Background: A total of thirty five (35) blood group systems has been discovered till date. It has been illustrated in the various transfusion literatures that particular disease is associated with particular type of blood group systems. The present study was conducted with the aim to determine the pattern of distribution and to detect any association of transfusion transmitted infections (TTI) with ABO and Rh blood groups. Materials and Methods: A retrospective study was done at the blood bank Shaheed Hasan Khan Mewati (SHKM) Government Medical College Nalhar Haryana, India over a period of 6 year 5 month (August 2013 to December 2019) . A total of 28,812 healthy donors were included in the study. All the donor blood unit were screened for HbsAg, HIV, HCV, Syphilis and Malaria. Results: The most common blood group was B (39.91%). The total seroreactivity of TTI was 3.8% ( 1096 out of 28,812). Out of the total, 2.88% (831 out of 28,812) cases were reactive for HBsAg, 0.29% (86 out of 28,812) for HIV, 0.565% ( 163 out of 28,812) for anti HCV, 0.0138% (4 out of 28,812) for syphilis and 0.0416% (12 out of 28,812) for Malaria. Maximum seroreactivity was seen in blood group B (5.0%) followed by A (3.6%) and O group (3.1 %) and then AB (1.1%). A significant association was seen between Rh positive blood group and HBsAg seropositivity (P value of 0.0459). There was significant association between syphilis infection and AB blood group with a p value of 0.0331 among syphilis positive donors. Conclusion: This study provides the prevalence of ABO and Rh blood group and also their association with the transfusion transmitted infections (TTI). This study shows a significant association between Rh positive blood group and HBsAg and also significant association was seen between AB blood group and syphilis infection.
ENDODONTIC MANAGEMENT OF SEPARATED INSTRUMENT AND PERFORATION IN TOOTH WITH CALCIFIC METAMORPHOSIS: A CASE REPORT.
The successful endodontic treatment of depends on ability to negotiate the canal to its apical terminus, thorough debridement or disinfection and obturation of the prepared canal space. In situations such as Calcific Metamorphosis, calcific deposits block the access to the canal, and falls under difficult category cases. One should have the thorough knowledge about such anatomical and pathological variations so that the complications can be avoided. Present case reports endodontic management of maxillary right central incisor with calcific metamorphosis with previously failed endodontic treatment having separated root canal instrument and canal perforation. Even though there was separated instrument and perforation site, the proper management increases the prognosis of the tooth.
GIANT BREAST LIPOMA- AN UNUSUAL PRESENTATION.
Lipomas are benign mesenchymal tumors that develop in areas that are abundant in adipose tissue. Lipomas rarely occur in breasts, hence posing diagnostic uncertainty. We report the case of a 70-year-old female with a giant tumor of the right breast which compromised most of its mass causing breast asymmetry. After surgical resection the diagnosis resulted a benign lipoma. The case prompted this report due to its challenging size location and diagnosis.
A METHODICAL APPROACH FOR RESTORATION OF LOST VERTICAL DIMENSION BY ADVOCATING HOBO'S TWIN STAGE TECHNIQUE – A CASE REPORT
Statement of Problem Restoration of occlusal harmony in patients with worn dentition and reduced vertical dimension is a demanding situation as every case is unique in itself. There is great apprehension involved in clinicians due to widely divergent views regarding the choice of an appropriate occlusal scheme. Rehabilitating the lost vertical dimension in a graduated and structured fashion will not only bring back the harmony of the stomatognathic system but also plod the adverse diversifications on the muscles and orthopedic instability of the temporomandibular joints. Purpose To restore the vertical dimension by adapting a less cumbersome and precise technique that uplifts both functionality and esthetics. Material and Methods The case report humbly represents the rehabilitation of a 47 year old female patient with severe worn out dentition. Assessment of lost vertical clinically and adjudging the space to be distributed among both the arches through the metal fused to porcelain restorations, by advocating Hobo’s Twin stage technique to achieve disclusion and a canine guided occlusal scheme. Results A stable occlusion was achieved, with the desired amounts of disclusion of more than 1mm on protrusive and nonworking sides, and about 0.5mm on working sides during eccentric movements with a pleasing esthetics, with more than 9 months follow up deciphering uneventful occurrences. Conclusion The technique adapted requires very less complicated armamentarium, calculated condylar guidances, methodical method of achieving anterior guidance with sequential technique gives a very predictable outcome.
AYURVEDIC UNDERSTANDING AND MANAGEMENT OF CHONDROMALACIA IN PATELLA: A CASE STUDY
Chondromalacia Patella is a disease in which the hyaline cartilage of patella is genetically soften and easily wears away. It more commonly occurs in women than men and it is attributed to increased Q angles in women. Active young adults who participate in running sports or workers who increase stress in their patella femoral joint by repeated stair climbing and/or kneeling have a higher incidence. A 26 year old female who is not a K/C/O DM and HTN was admitted in Sri Jayendra Saraswathi Ayurveda Hospital on 20/01/2020 with a confirmed diagnosis of Chondromalacia Patella. The patient was presented with complaints like pain in the anterior part of the right knee joint associated with stiffness, swelling, burning sensation, crepitus and difficulty in walking since 1 year. The condition was diagnosed as Janu Sandhigata Vata in the sama avastha. Initially the treatment was started with amapachanam and agni deepanam followed by and brumhana line of management for 17 days. Significant improvements were observed in various subjective and objective parameters after the treatment. The patient was discharged with oral medications in the form of for 2 weeks and advised for follow up.
A CLINICAL STUDY ON MANAGEMENT OF CONTRACTURES OF UPPER LIMB FOLLOWING BURN
Introduction - Post burn contracture is a common sequele occurring after burn as a result of which thousands of victims of burn are handicapped every year. Upper limb contractures are also occurring more commonly because it is most mobile part of body and likely to be involved in burn. Aim of the study: To study various operative strategies for management of patients presenting with post burn contractures of upper limb i.e axilla,elbow and hand. Methods : 80 patients presenting with post burn contracture were treated in our hospital. Observation & Results : In our study , the youngest member was a 2yr old girl, and the oldest was a 70yr old man .Max no. of pts 22(27.5%) were in the age group of 21-30 yrs. In our study out of 80 patients of postburn contracture, axillary contracture was present in 20 patients(25%), elbow contracture in 10patients(12.5%), wrist contracture in 8patients(10%),finger contracture in 38patients(47.5%), while complicated contracture was present in 4patients(5%). Operative procedure constituted of mainly Release with single or multiple Z-plasty in 15patients(18.75%) Release with K-wire fixation/skin grafting in 56 patients (70%),Local flap (Cross finger) in 02 patients, Abdominal/ Groin flap in 07 patients (8.75%). In our study of 80 pts, 2 pts(20%) had flap tip necrosis, 06 pt(60%) had a graft failure, 02 pts(20%) developed re-contracture while 87.5% of pts had no complications.There was no mortality in our study. Conclusion : In the present study of 80 cases of management of post burn contractures of upper limb it is reasonable to conclude that prevention of contracture is of utmost importance. The results were satisfactory in our study in most cases with regards to quality to coverage, & range of motion.
CASE STUDY: RARE CASE OF CRIBRIFORM MORULAR VARIANT OF PAPILLARY CARCINOMA OF THYROID IN PEDIATRIC AGE GROUP.
Introduction: Thyroid carcinoma in pediatric age group are as such rare. Papillary thyroid carcinoma is most common amongst them. Though thyroid tumours in pediatric age group are aggressive; they have better prognosis than adults. Materials and methods: We discuss a case of 8 years old female child of carcinoma thyroid who was operated for total thyroidectomy and bilateral neck dissection.
A STUDY ON FUNCTIONING OF THE NUTRITIONAL SERVICES IN ANGANWADIS FOR 0 – 3 YEARS CHILDREN UNDER ICDS PROGRAMME IN DELHI FROM PROVIDER'S PERSPECTIVE.
INTRODUCTION Pregnant and lactating women and children under three years have high nutritional requirements due to rapid growth both physical and mental/cognitive, of the developing foetus/neonate/infant/young child. Providing a safe and hygienic environment, Anganwadi worker training, workload, status and remuneration, inadequacy and uneven distribution of staff and low prioritization of monitoring and evaluation activities are the factors which are responsible for quality of ICDS services. OBJECTIVES To study availability and functional adequacy of infrastructure for providing nutritional services in anganwadi of urban area METHDOLOGY The study was conducted at Mehrauli and Hastsal Project of Delhi. The study population includes Anganwadi supervisor and Anganwadi worker of all the Anganwadis in the study areas. It was a cross sectional and descriptive type of study. Variables of study was manpower available at AWC and Infrastructure at AWC were assessed by the researcher visiting each anganwadi centre and observation of AWC/questions from Anganwadi staff. Data was collected by observational checklist and interview schedule. RESULTS All AWC of both project areas have been operational since five to more than 20 years. While all AWC had provision of safe drinking water, toilet facility was available in only 31.58% of AWC. Out of 57 AWCs covered in this study 21AWC from Mehrauli have functional Dial Salter balance with place to hang it. Training regarding handling of children with handicap/disability and child nutrition in both areas was given to some AWW. Anganwadi Supervisor in Hastsal reported that a panel of AWW was on ad hoc basis and 2 AWW were posted in new ICDS project from the month of data collection however in Mehrauli there was no list of on panel AWW. Mother held ‘Mother and Child Protection card’ was not present in any AWC. Anganwadi Supervisors’ were able to plot the weight correctly. All 51 AWW were able to identify correctly Weight within normal, moderately undernourished and severely undernourished range as per WHO norms. Visit of supervisors were to disseminate regular instructions and MPR and provide supportive supervision/guidance if required by AWWs. CONCLUSION AND RECOMMENDATION Infrastructure norms for AWC especially for space for multiple activity room and storage space may need to be different for rural and urban. Coordination between the AWW and the health staff for convergence of needed health and nutrition services including referral should be enhanced for improving health and nutritional status of the children.
EFFECT OF SEROTONIN ON MOOD CHANGES IN FIRST YEAR MEDICAL STUDENTS.
Mood is the behavioral and emotional state of mind. It is documented that serotonin is neurotransmitter plays a pivotal role in mood regulation and has image feelings of well-being and happiness been studied as mood changer during various responses. The present study was performed to evaluate the relationship between serotonin levels and mood changes among first year medical students. The study revealed that a relationship does indeed exist between serotonin levels and various responses related to mood change and overall feeling of well being. This study hopes that further clinical implications may be done in cases of mood changes and mood disorders by monitoring and treating serotonin deficiency in these patients.
COMPARISON OF LAPAROSCOPIC VS OPEN HYDATID CYST DEROOFING & OMENTOPLASTY
Introduction:- Hydatid cyst is zoonotic infection and treatment is mandatory to avoid complications. Surgery remains the first choice in the treatment. Open or laparoscopic approaches are available. However, comparative studies are limited. Materials and method:- Data of patients who underwent deroofing and omentoplasty for hydatid cyst between January 2013 to January 2018 were evaluated retrospectively. Recurrent cases and the patients with previous hepatobiliary surgery were excluded. 8 patients were undergoing laparoscopic surgery (group A) and 8 underwent for open surgery (group B). Cyst characteristics, operative time, duration of drain, postoperative complications were evaluated. Results:- Groups were similar in terms of cyst characteristics. Mean Operative duration for group A was 92 mins and for group B, it was 74 mins. Mean Postoperative pain score according to VAS is 2 for group A and 4 for open surgery. Mean Hospital stay for group A was 6 days for group A and 14 days for group B. No other significant postoperative complications present except only 1 patient present with wound infection in group B. No recurrences were found in any groups. Conclusions:- Laparoscopy is a safe and feasible approach for surgical treatment of liver hydatid cyst.
A STUDY OF SERUM MAGNESIUM PROFILE IN TYPE – 2 DIABETES MELLITUS
Serum hyperglycaemia resulting from defects in insulin secretion, insulin action (may be due to failure of complex insulin – receptor interaction) or both. According to the International Diabetes Federation (IDF), diabetes has affected at least 300 million people worldwide, and this number is expected to reach 450 million by the year 2030. There are mainly two types of diabetes Type–1 and Type-2, the latter type of diabetes mellitus is the most common form of diabetes accounting for 90% of the cases. In India, the scenario is not different when compared to the world scenario. The best strategies are not able to prevent the complications suggesting that alternative treatment strategies are needed. Insulin-dependent uptake of glucose is reduced in magnesium deficiency. Magnesium supplementation improves glucose tolerance. So one such treatment strategy under research is supplementation of magnesium and its role in primary prevention of diabetes and slowing the progression of complications that is related to the dreaded disease. So before anything it is best to understand the profile of serum magnesium in type 2 Diabetes mellitus. So this study is dedicated for this above said cause.
HEMODYNAMIC RESPONSE AND VASOPRESSOR REQUIREMENT AFTER SPINAL ANESTHESIA IN PREECLAMPTIC AND NON-PREECLAMPTIC PATIENTS UNDERGOING CAESERIAN SECTION: A PROSPECTIVE COMPARATIVE STUDY
Introduction: Risk benefit analysis favours spinal anesthesia over general anesthesia in pregnant patients undergoing caesarean section. Hypotension is a known complication after spinal anesthesia. However, it is short lived and easily treatable. The aim of this study is to evaluate and compare hemodynamic response in healthy and preeclamptic patients receiving spinal anesthesia and also to assess ephedrine requirement in both the groups. Methods: A total of 200 patients were recruited after fulfilling inclusion and exclusion criteria. Patients were divided in two groups depending on presence or absence of preeclampsia. Subarachnoid block was given at L3-L4 level at the time of surgery. Hemodynamic parameters, APGAR score; neonatal birth weight was noted as per protocol. Ephedrine was given to maintain blood pressure more than 90 mmHg. Results: Demographic variables were comparable in both groups. The decrease in diastolic blood pressure, mean arterial pressure was significantly lower in non preeclamptic group with p value of 0.005 and <0.001 respectively. The APGAR score was 8.88±0.71 in healthy and 8.89±0.40 in preeclamptic group. Conclusion: Hypotension after spinal anesthesia can be easily treated in preeclampsia and healthy group. So when properly administered, spinal anaesthesia is safe in controlled preeclamptic parturients without having any adverse effect on neonatal outcome.
CASE REPORT ON RUPRTURED SPLENIC HAEMATOMA-A RARE COMPLICATION OF MALARIA
Splenic haematoma rupture is extremely rare complication of malaria reported in 1-2% cases.Most common causes of splenic haematoma is blunt abdominal trauma,though splenic haematoma may caused by tropical infection and malaria is most common among them.Establishment of a preoperative diagnosis using noninvasive imaging modalities can be beneficial.This case report is on patient present with abdominal pain and diagnosed as ruptured splenic haematoma.
STUDY ON ELEVATED C- REACTIVE PROTEIN ( CRP) LEVEL IN PATIENTS OF DIFFERENT SPECIALTY WARDS OF A TERTIARY HEALTH CARE CENTER.
Objective- To understand the importance of CRP test in diagnosis of neonatal sepsis, Rheumatoid arthritis and other inflammatory presentation brought to Medical college hospital . Introduction- One hundred samples of patients were screened for CRP those who are having various ailments in the Medical college hospital , we have screened the serum samples by latex agglutination test. CRP appears and disappears more quickly than changes in ESR. Therefore the CRP is considered the useful nonspecific biochemical marker of inflammation measurement. CRP contributes importantly to various disease diagnosis. Results & Observation- The study is based on 100 samples collected from different specialty in duration of three months. Neonatal sepsis is confirmed in two cases out of four .The study was useful in finding out indication of arthritis in 20% cases of orthopedic dept. The study was also useful in ascertaining the impact of drugs used in post -surgery cases and also in cases of general medicine.
IMAGING FEATURES OF VARIOUS CEREBELLO-PONTINE ANGLE LESIONS
Introduction: Cerebellopontine angle (CPA) tumours usually are classified into intra-axial, extra-axial, skull base tumours. Although vestibular schwannomas and meningiomas constitute the vast majority of the cerebellopontine angle (CPA) lesions, a large variety of unusual lesions can also be encountered in the CPA. In the present study, the CT and MRI imaging features of various cerebellopontine angle tumours are evaluated. Material and Methods: All patients with clinical suspicion of cerebellopontine (CP) angle tumours are subjected to scan on the 1.5T MR imaging system. Special sequences such as DWI, MR spectroscopy were performed. Results: Acoustic schwannomas, which are also known as Vestibular schwannomas, and meningiomas are the two most frequent lesions and account for approximately 85%-90% of all CPA tumours. The other 10%-15% includes a large variety of lesions that will be recognised more frequently because of the remarkable sensitivity and accuracy of magnetic resonance imaging in the evaluation of a CPA syndrome. Computerised tomography (CT) and magnetic resonance imaging (MRI) are the primary modalities for diagnosis of cerebellopontine lesions. MRI is considered superior in differentiating the different types of Cerebellopontine angle (CPA) masses. Knowledge of typical signal characteristics and more specific features such as a hemispheric or ice-cream cone shape, a dural tail, adjacent hyperostosis, extension into one or more skull base foramina, and enlargement of the internal auditory canal (IAC) helps in limiting the differentials considered. Recent advanced MRI techniques that include diffusion-weighted imaging (DWI), MR spectroscopy, and MR perfusion can help provide a more specific diagnosis. Conclusion: MRI is the most sensitive noninvasive modality to characterise CP angle tumours. MRI identifies the exact location and extension of the lesions based on their signal characteristics and contrast enhancement pattern.
A CASE REPORT OF ANEURYSMAL BONE CYST PROXIMAL TIBIA TREATED WITH INTRA- LESIONAL CURETTAGE AND BONE GRAFT CEMENT
INTRODUCTION: Aneurysmal bone cyst, abbreviated ABC, is an osteolytic bone neoplasm characterized by several sponge-like blood or serum filled, generally non-endothelialized spaces of various diameters.[1].The term is a misnomer, as the lesion is neither an aneurysm nor a cyst.[1]. Aneurysmal bone cysts (ABCs) are benign bone lesions arising predominantly in the pediatric population more often in females (2:1), usually before the age of 20 years, and most commonly in long bones metaphysis origin that can cause local pain, swelling, and pathologic fracture. Primary lesions, which constitute roughly two thirds of all ABCs, are thought to be neoplastic in nature due to translocation t(16;17)(q22;p13) leading to juxtaposition of promoter region CDH11 on 16q22, with one third of ABCs arising secondary to other tumors. Diagnosis is made with various imaging modalities, which exhibit characteristic features such as “fluid-fluid levels,” Currently, the standard of care and most widely employed treatment is intralesional curettage and bone grafting .
Carpal tunnel syndrome is the most common entrapment neuropathy. Symptomns and signs are caused by compression of the median nerve in carpal tunnel. Disorder is commonly diagnosed clinically and is supported by electrodiagnostic studies as objective method of diagnosis. There has been recent development of nerve imaging in diagnosis, but their exact benefit is still unknown. There also has been development of wide treatment options including both non-surgical and surgical. This review addresses the carpal tunnel syndrome in detail including recent developments in diagnosis and treatment.
CURRENT CLINICAL APPLICATION OF PLATELET- RICH PLASMA (PRP) IN REPRODUCTIVE MEDICINE & A PILOT STUDY OF INSTILLATION OF AUTOLOGOUS PRP FOR SUBOPTIMAL ENDOMETRIUM IN FROZEN EMBRYO TRANSFER (FET) CYCLES .
The purpose of this paper is to review the current clinical uses of platelet- rich plasma (PRP) in the field of Reproductive Medicine .All relevant articles published from January 2000 to December 2019 were reviewed and analysed.The article on PRP in field of Reproductive Medicine were mainly case series, pilot studies , or case reports .PRP is currently considered a new therapeutic modality for some disorders that are refractory to conventional drugs . The pilot study was to elevate the effectiveness of intrauterine infusion platelet- rich plasma (PRP) in infertile women undergoing frozen embryo transfer cycles with suboptimal endometrium. Material & methods- Instillation of autologous PRP was done in 20 women between 24 & 38 years over 8 months ,with suboptimal endometrial growth , patients with repeated cycle cancellations in addition to Estradiol valerate . Frozen embryo transfer was performed when the endometrium reached an optimal pattern in term of thickness, appearance & vascularity. Results- The mean pre- PRP endometrial thickness(ET) was 5mm which significantly increased to 7mm post-PRP.There was a significant increase in vascularity ,seen by the number of vascular signals seen on Power Doppler , reaching the zones 3 & 4 of endometrium .The positive beta Human Chorionic Gonadotropin (hCG) rate was 70.58%& the clinical pregnancy rate was 58.82%.A total of 2 women are in the second trimester , 8 are in the first trimester with a healthy intrauterine pregnancy , one patient had an ectopic gestation, , and one had a biochemical pregnancy . Conclusion: This study suggest that the use of autologous PRP holds promise in treatment of women with suboptimal ET and vascularity in embryo transfer, It would help to reduce the incidence of cycle cancellations and thus even help reduce the financial & psychological burden of repeated cancelled cycles .
EVALUATION OF SURGICAL OUTCOME OF DISTAL RADIUS FRACTURE (VOLAR BARTON'S) TREATED BY BUTTRESS PLATE.
Background: Volar Barton’s fracture is a common problem among the distal radius fracture. Volar articular margin is displaced and inherently unstable fracture. Objectives: Aim of this study is to assess outcome after stabilization of the fracture with locking buttress plate in terms of stability, functional recovery and operative complications. Method: This study was carried out in the department of Orthopaedics of Bangabandhu Sheikh Mujib Medical University, Bangladesh for the duration of 2.5 years. Within this period 30 patients of Volar Barton’s fracture were selected as per inclusion and exclusion criteria. Results: In the final follow-up 6.7% had excellent scores, 73.3% had good scores and 20% fair scores on the basis of anatomical outcome. However, 90% had satisfactory functional outcomes on the basis of modified Mayo’s wrist scoring system. Conclusion: The Volar buttress plate is found to be an effective technique of fixation. The Volar locking buttress plate maintains articular congruity, radial length and alignment.
EFFECT OF AEROBIC TRAINING ON CARDIORESPIRATORY FITNESS IN PHYSIOTHERAPY STUDENTS
Background: The aim of the study was to study the effect of aerobic training on cardiorespiratory fitness in physiotherapy students. This was an analytical type of study using Chester’s treadmill walk test as an outcome measure. This test consists of 6 levels and had been carried out before and after the intervention which consists of treadmill training for 8 weeks after which the pre and post fitness levels of physiotherapists was assessed. Objective: To study the effect of endurance training on cardiorespiratory fitness in physiotherapy students. To assess the cardiorespiratory fitness using Chester’s Treadmill Walk Test. To check the changes in VO2max , heartrate, and blood pressure post the intervention strategy. Methodology: 25 Participants were selected by Convenient Sampling who were college students from Dr. A.P.J. Abdul Kalam College of physiotherapy, PIMS, Loni. The participants included were between age group of 18-25 years who were not able to complete the Chester Treadmill Walk test for 12 minutes. After which those who were included were given a 8 weeks treadmill training intervention and then post testing was carried out again using the same test and then conclusion was carried out accordingly. Results: The outcome measures considered were VO2max, heartrate and blood pressure. According to the ACSM’s Guidelines, aerobic training was given to 25 samples for 8 weeks. After which the participants were again tested using the same test. The student paired “t” test value of heartrate prior to intervention was 33.81 and post intervention was 8.34 and the student paired “t” test value for systolic blood pressure was 2.16 and diastolic blood pressure was 2.22. The student paired “t” test value of VO2max was 4.03. Based on the readings of the “t” test values mentioned above, proves that there is significant increase in VO2max post the aerobic training intervention Discussion and conclusion: The results of the study supports that endurance training is effective and helps increasing cardiorespiratory fitness level in Physiotherapy students. It shows that there is a significant increase in VO2max which was calculated using the formula for Chester Treadmill Walk Test after the aerobic training intervention was given for 8 weeks based on the ACSM’s Guidelines.
EFFECT OF BUTEYKO BREATHING TECHNIQUE ON PEAK EXPIRATORY FLOW RATE IN BRONCHIAL ASTHMA
Background: Asthma is a chronic inflammatory disorder of the airways causing airflow Limitation. There are various breathing exercises to improve ventilation. The Buteyko Breathing Technique (BBT) helps to decrease the number and severity of attacks as well as improvement in lung function. The aim of the study was to assess the effect of BBT on Peak Expiratory Flow Rate (PEFR) in bronchial asthma. Methodology: 20 participants with age group 40-70 years were selected. The BBT continued twice daily for 4 weeks. PEFR was assessed before and after intervention by Peak expiratory flow meter. The results were analysed using the student’s paired ‘t’ test. Result: The mean of PEFR value was 103±33.888 pre intervention and 141.5±49.340 post intervention and showed significant improvement in PEFR in 4 weeks. Conclusion: The study concluded that BBT significantly increases PEFR 4 weeks and decrease the severity of asthma attacks.
A STUDY OF GROWTH OF CHILDREN WITH SICKLE CELL DISEASE IN A SMALL DISTRICT IN CENTRAL INDIA- A CROSS SECTIONAL STUDY.
Background: Sickle cell disease is highly prevalent in some specific castes in some districts of Central India where the growth of child is often delayed. Few data are available in this context and on the issue using the World Health Organization growth norms. Hence we conducted the present study with the aim of describing the growth of affected children aged less than 5 years. Methodology: An observational cross-sectional study was conducted from January 2019 to December 2019 for a period of 1 year, at the sickle cell centre in a tertiary care hospital in central India. The sample included 75 children with SCD aged 2 to 5 years old in steady state. Anthropometric measurements and socio-demographic data were collected and analyzed. All statistical tests were two-tailed with p<0.05 considered significant. Results: Median age of study population was 3.57 years. Low weight, height and weight for height Z-scores (<-2SD) were observed. Regression analysis indicated an association of low height-for-age and of low Body Mass Index (BMI)-for-age with age. Conclusion: This study demonstrates unexpectedly lower mean Z-score for weight, height and weight for height than reported while using WHO norms.
ROLE OF MRI IN STUDYING THE OUTCOME OF PAEDIATRIC STROKE.
Objectives The objective of the study was to study the role of MRI in studying the outcome of Paediatric stroke. Materials and Methods This was an observational study with a prospective design conducted in the department of Radio-diagnosis in a tertiary teaching hospital in Central India on cases of Paediatric stroke sent by the department of Paediatrics for MRI. Results: A total of 60 cases were studied out of which 40 were males and 20 were females. Mean age of presentation was 5.96 years. Stroke more prevalent in males by 2:1. 50% were arterial ischemic strokes and 25% were hemorrhagic strokes while 17% were non-stroke or stroke mimickers. In the outcome, hemorrhagic stroke was more fatal with maximum death rate of 25% as against 10% in acute ischemic stroke. Rate of disability overall was 67% and recurrence was 18%.
ROLE OF MICROVESSEL DENSITY IN TRANSITIONAL CELL CARCINOMAS OF URINARY BLADDER
Introduction: Bladder carcinoma is a neoplasm arising from the lining transitional epithelium. More than 90% of bladder cancer cases are urothelial (transitional cell) carcinomas. Out of various prognostic factors, grade and stage are important. The non-muscle-invasive disease in spite of lower stage has a high recurrence of about 50–70% of the patients. Thus additional Prognostic factors play a role in determining the recurrence. Microvessel density is one such factor which is associated with recurrence. In this study, microvessel density is calculated using CD 34 and compared with standard clinicopathological variables. Materials and Methods: This study is an observational study of randomly selected 50 cases of Transitional cell carcinomas of urinary bladder that were submitted for histopathological evaluation during the period of 2 years in our institution. The slides were reviewed from the archive and histopathological parameters assessed. Immunohistochemical analysis was done with CD 34 and microvessel density (MVD) was calculated by counting the hot spots in 200X power. The results were compared with clinicopathological parameters. Results: The mean MVD values showed statistically significant increase in male gender and non-papillary tumours. The increase shows no statistical significance in multiple tumours, high grade and in recurrent tumours. The mean MVD values showed a decrease with increasing stage, size and infiltration and this association was statistically insignificant. Conclusion: Though MVD values were reducing with stage, patients with high microvessel density (>50) presented with recurrence. Thus evaluating microvessel density can be an adjuvant factor in determining the prognosis of the patients.
REVERSIBLE RENAL FAILURE IN 88 YEAR OLD FEMALE -PPI THE CULPRIT
Granulomatous interstitial nephritis (GIN) is rare entity detected in 0.5-0.9 % of renal biopsies and a proton‑pump inhibitor‑induced GIN is infrequent. Our patient, a 80‑year‑old female (2019), on antihypertensive with normal renal function, after 30 days of rabeprazole presented with raised serum creatinine (6.5mg/dl), biopsy revealed GIN, workup for secondary causes were negative, on detailed inquiry, the patient was receiving rabeprazole for the last 1 month on the prescription of her primary physician for dyspeptic symptoms. On stopping rabeprazole, serum creatinine reduced to baseline (1 mg/dl) at 15 days, confirming the diagnosis of rabeprazole‑induced GIN.
TROCHANTERIC NON-UNION TREATED WITH HOOK-PLATE AND CABLE SYSTEM ALONG WITH TOTAL HIP REPLACEMENT
Introduction: Trochanteric fracture fixations sometime fail due to various reasons like implant failure or osteoporosis. Treatment in such a situations is difficult as the surgeon faces multiple challenges like bad bone stock, cartilage damage in the femoral head due to screw cut out, weak musculature and need for early mobilization considering the age and comorbidities of such patients. The purpose of the study is to evaluate the outcome of Trochanteric fixation along with a distal loading stem for hip replacement. Materials and methods: We conducted a prospective study to follow-up 12 patients who have undergone trochanteric fixation with locking plates with cables and screws for trochanteric fixation failures with osteochondral damage in the hip joint from the previous fixation device. Results: The patients were assessed with Harris hip scores which improved from 42 preop to 94 postop (p <0.001). No patient had significant pain or abductor lurch postoperatively (p <0.001). Active abduction increased from 0 deg preop to 28 degree postoperatively (p <0.001). Though bony union was not complete in 3 out of 12 patients fibrous union allowed the patients to be ambulant without symptoms. Conclusion: Trochanteric hook plate gives sufficient fixation strength for trochanteric fixations along with a distal loading stem in total hip replacement in patients where trochanteric fixation failure has occurred and the fixation device has caused and osteochondral damage to the acetabulum.
IMAGING OF CAVERNOUS SINUS AND ITS PATHOLOGIES
This article reviews the normal anatomy of the Cavernous sinus (CS) and the imaging findings of different lesions involving it. CS lesions may arise from different components of the CS or from adjacent structures and spaces. They can be classified as neoplastic, inflammatory, infectious, vascular and congenital. MRI is the imaging modality of choice and helps in differentiating different pathologies and come to a single best diagnosis.CT helps in identifying aneurysms and bone involvement better in selected cases. These lesions are more commonly seen in the older age group and in the female gender. Meningiomas,Schwannomas,meningitis and pituitary macroadenomas are the common lesions encountered in this study.Cavernous angioma ,perineural spread from nasopharyngeal carcinoma are the few rare cases seen.
ETIOLOGICAL FACTORS OF NEONATAL SEIZURES AND THEIR OUTCOME AT A TERTIARY CARE HOSPITAL
Introduction: Neonatal Seizures is still a common global health problem despite huge growth in healthcare sciences, difficult to diagnose and treat, associated with higher rate of morbidity and mortality. The purpose of this study was to find the commonest etiological factors of neonatal seizures in this region and determining its outcome. Materials and Methods: A total of one hundred and four neonates presented with seizures were advised to undergo required investigations. Detailed clinical history and examination findings were noted. Results: Incidence of neonatal seizures is 11.9%. Out of 104 neonatal seizures, 58 (55.7%) were females and 46 (44.2%) were males. Majority of neonates had seizures in first three days, it was 67.3%. Predominant cause was birth asphyxia and 23% had septicaemia. Mortality rate was 16.3%. Conclusion: Most of the etiologies of neonatal seizures can be rapidly reversed by appropriate management and also long term sequelae can be prevented.
GORLIN-GOLTZ SYNDROME- REPORT OF TWO CASES.
Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin-Goltz syndrome or Basal cell nevus syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms. Early diagnosis and treatment of this syndrome as well as family screening and genetic counselling are essential for the patients affected with this syndrome. This syndrome may be diagnosed early by a dentist by routine radiographic examinations in the first decade of life, since the odontogenic keratocysts(OKC) are usually one of the first manifestations of the syndrome. Here, we present two cases of Nevoid basal cell carcinoma syndrome reported to our college.
DIFFUSE LARGE B CELL LYMPHOMA- A CASE REPORT AND REVIEW OF LITERATURE.
Diffuse large B‑cell lymphoma (DLBCL) is the most frequently diagnosed type of Non -Hodgkin’s lymphoma (NHL) in the human body and is most frequent type of NHL of oral cavity. It is an aggressive, rapidly growing neoplasm of large lymphoid cells. In the oral cavity, the majority of cases occur in the Waldeyer’s ring, followed by the buccal mucosa, tongue, floor of the mouth, and retromolar area. The representative symptoms in the oral cavity include nonspecific swelling, dental extraction wounds that do not heal, ulceration, and aposteme, and DLBCL may be misdiagnosed as osteomyelitis, periodontosis, and pyogenic granuloma, as well as malignant tumors such as squamous cell carcinoma. Here, we present a case of a 55‑year‑old female patient who developed DLBCL in oral cavity.
A PRELIMINARY SURVEY AWARENESS OF CORRELATION BETWEEN PERIODONTAL DISEASE AND GENERAL HEALTH AMONG QUALIFIED HEALTH PROVIDERS IN URBAN AND RURAL AREA OF MORADABAD
Purpose: Relationship between periodontal health and general health has been established in a number of studies. However, the level of awareness of periodontal concepts and knowledge among general medical practitioners and its relationship with general health among general practitioners remains an unexplored area. Methods: A total of 1000 general medical practitioners of Moradabad were included in the assessment. Level of awareness of periodontal disease and treatment concepts was assessed and graded as good, fair and poor. Fifteen questions related to association of periodontal disease with general health were enquired and associated with grade of awareness regarding periodontal disease and treatment concepts. Results: 93.7% had fair and 5.8% had good knowledge about periodontal disease, 94.2% had fair and 3.6% had good knowledge about concepts of treatment. Out of 15 items assessed, on 8, correct responses was obtained from <50% respondents. Knowledge about periodontal disease and treatment concepts was significantly associated with awareness regarding periodontal disease and general health. Conclusions: Good to fair knowledge about periodontal disease and periodontal treatment concepts was present in majority of medical practitioners. Level of knowledge of periodontal disease and its treatment concepts was significantly associated with awareness regarding periodontal disease and general health.
EVALUATION OF PATIENT BEHAVIOR, INSTRUMENTATION TIME AND QUALITY OF OBTURATION OF KEDO S ROTARY FILES IN PRIMARY MOLARS: AN IN VIVO STUDY
Introduction: Complex root morphology of primary molars makes the endodontic treatment difficult and sometimes impractical. Advancing technology has brought rotary system to reduce manual agility and improve the quality of treatment in Paediatric Dentistry. Aim: To evaluate the behaviour of patient, instrumentation time and quality of obturation with rotary Kedo-S files in deciduous molar. Methods: An evaluative study was conducted, in which twenty pulpectomies were performed on deciduous molars in twenty patients using Kedo-S rotary files. Patients showing definitely positive (++) and positive (+) behaviour according to Frankel behavioural rating were included in the study. The behaviour of the patient, instrumentation time, and obturation time was assessed clinically. Obturation quality was assessed radiographically. Results: 19 patients has no change in behaviour from the initial behaviour. Instrumentation time was 8.486+/- 1.232 minutes and overall Obturation had good success. Conclusion: Kedo-S has good obturation quality and patient acceptance.
OTITIS EXTERNA IN PATIENT ATTENDING ENT OPD IN A TERTIARY CARE CENTRE.
Acute otitis externa is defined as diffuse inflammation of the external auditory canal. It is often associated with high humidity, warm temperatures, swimming, local trauma and use of hearing aid or hearing protectors. METHODS: This is a prospective observational study conducted on 62 patients in ENT Department, SMGS Hospital GMC Jammu, over a period of 3 months from November 2019 to January 2020 after taking ethical clearance from the institutional ethical committee. RESULTS: Out of the 62 patients, 37 patients (59.6%) were male and 25 patients (40.3%) were female. Maximum number of patients reported in the age group of 31-40 and 41-50 years i;e 19% in each group. 83% had unilateral otitis externa and 16% had bilateral disease. 56.4% of the patients presented with diffuse otitis externa, 38% with localised and 4.8% with necrotizing type of otitis externa. CONCLUSION: Otitis externa is a common and preventable condition of the external auditory canal. It can be prevented by avoiding the precipitating factor and seeking treatment in the early stage of the disease.
PRE HYPERTENSION AMONG FIRST YEAR MBBS STUDENTS
Pre-hypertension is not a disease category rather it is a designation chosen to identify individuals at high risk of developing hypertension, so that both patients and clinicians are alerted to this risk and encouraged to intervene and prevent the disease from developing. It is a major risk factor for stroke and coronary heart diseases which is a contributor to onset and progression of chronic heart failure and chronic kidney failure in coming times, associated with many adverse outcomes. Method: The study type is cross sectional, conducted among 100 first year MBBS students. Blood pressure was measured in sitting posture using a standard sphygmomanometer by auscultatory method at interval of 5 minutes and mean of three readings were taken. Blood pressure was classified as per the Joint National Committee (JNC-VII). Statistical analysis was done to find out the prevalence of pre-hypertension among first year MBBS students. Results: The overall prevalence of pre-hypertension came out to be 51%. Among gender the difference was significant with 63.15% (36) prevalence among males and 34.88% (15) prevalence among females.
PRESCRIPTION TREND OF TOPICAL CORTICOSTEROIDS IN OUTPATIENT OF DERMATOLOGY IN A TERTIARY CARE HOSPITAL IN AURANGABAD, MAHARASHTRA
Background: Skin diseases amounts for a large fraction of patients attending the outpatient of dermatology and topical corticosteroids (TCS) are being commonly prescribed, the data related to drug usage patterns of TCS in skin conditions are particularly lacking. Hence it is vital to study the drug prescribing patterns of TCS in skin diseases. Objective: To study the demographic details and drug prescription pattern of TCS in patients with skin diseases. Materials and Methods: A cross-sectional study conducted in the Dermatology Department, MGM Medical College, and Aurangabad over a period of 6 months. The patients with skin diseases who were prescribed TCS were included. The data was collected by direct observation in a specially designed Performa containing relevant detail such as demography, skin conditions and drug used. The data were analyzed as counts and percentages. Result: Majority of the patients were under the age of less than 20 years (38%) followed by those between the ages of 21 years to 40 years (36%). Female patients (57.4%) were more. Patients from rural and urban areas were almost equal. Most common condition identified was dermatitis (36.2%) followed by Psoriasis (24.5%). Clobetasol propionate (38.8%), mometasone furoate (12%) and betamethasone dipropionate (15.7%) were the commonly prescribed TCS. 38% molecules were of superpotent class while 29 % from potent class. Maximum dosage form was cream and ointment. Common concomitant drugs used were Antihistaminics (24%) and Antibiotics(36%). Fixed dose combinations (FDC) of TCS were commonly with fusidic acid and salicylic acid. Average drug per prescription was 2.85. Conclusion: Prescription pattern provides critical feedback to prescribing physician by focusing on rationalizing drug therapy. FDC of TCS with salicylic acid and fusidic acids are rational and approved by CDSCO.
AN ISOLATED FRACTURE OF THE STYLOID PROCESS OF THE TEMPORAL BONE: A RARE OCCURRENCE - A CASE REPORT
Styloid process is a long pointed cylindrical bone seen bilaterally on the temporal bone just below the auditory meatus. This process is about 25 mm in length. It acts as an important anchorage point for many muscles and ligaments which help in stabilising the mandible and assist in swallowing. Since the process is quite secure due to the attachments, an isolated traumatic fracture of the styloid process is a rare condition. An isolated fracture of the styloid process poses a challenge for diagnosis as the symptoms mimic temporomandibular joint disorder. This article is a case report of such an isolated traumatic fracture of the styloid process which was misdiagnosed as temporomandibular joint disorder.
COMPARATIVE EVALUATION OF THE EFFECT OF VARIOUS STORAGE MEDIA ON THE FRACTURE RESISTANCE OF RE ATTACHED TOOTH FRAGMENTS WITH FLOWABLE COMPOSITE -AN IN VITRO STUDY
INTRODUCTION: Fracture of an anterior tooth due to trauma is a common occurrence, with an incidence of 18-22% of all injuries to the dental hard tissues. About 28-44% of these cases are uncomplicated fractures, i.e. they do not involve the dental pulp. Fragment reattachment can be considered as a valid treatment option in such situations. However, the ideal storage medium for fragments before reattachment needs to be explored. Aim: - To compare the fracture resistance of Incisor tooth fragments stored in five storage media i.e. Milk, contact lens solution, Hanks Balanced Salt Solution, Control group (Open Air), Coconut Water before reattaching them with flowable composite. Materials and Methods: - Sixty freshly extracted Maxillary Incisors were divided into five groups. Teeth were mounted in acrylic block till cervical margin ,exposing only the crown portions and were intentionally fractured at incisal third using Universal Testing Machine, fractured fragments were stored in Milk (Group I), Contact lens solution (Group II), and Hanks Balanced Salt solution (Group III), Open air (Group IV), Coconut water (Group V) for 2 hours. The fractured fragments were re-attached using simple reattachment technique with flowable composite and tested on the Universal Testing Machine for fracture resistance, Statistical analysis: Statistical analysis was performed using one‑way analysis of variance and post hoc Tukey’s test. Results: There was a statistically significant difference (P < 0.05) in fracture resistance values between the groups. The highest fracture resistance value was demonstrated by Group III (Hanks balanced salt solution), whereas the least fracture resistance values were observed in Group IV (open air). Conclusion: Along with HBSS, Coconut water can be considered a viable alternative.
MICROALBUMIN STATUS AS AN EARLY BIOMARKER IN RELATION TO OTHERS IN KIDNEY DISEASE- A COMPARATIVE STUDY
To study efficacy of microalbumin status as an early biomarker in kidney disorder in relation and along with other biomarkers Methods-A comparative study was done in different 55 patients presented with symptoms of kidney disease at different stages. Four groups of 55 patients were studied. Group-I of diabetic patients, Group-II of Chronic Kidney Disease (CKD), Group-III of Acute Kidney injury (AKD) and Group-IV of patients under dialysis conditions. A detailed history and clinical examination were done. Result- All the selected biomarkers included in study seems to be increased from Group I to Group IV, (except calcium) and microalbumine was found to be effective early stage biomarker. Summary: blood urea and creatinine level of patients with CKD was done as routine test and Microalbumine was suggested to consider as early stage effective biomarker which can predict at hypertensive and diabetic case.
COMPARATIVE STUDY ON THE EFFECTIVENESS OF VIDEO- ASSISTED TEACHING VERSUS DEMONSTRATION ON HAND WASHING TECHNIQUES IN TERMS OF KNOWLEDGE AND COMPLIANCE AMONG PRIMARY SCHOOL CHILDREN (6-12YR)
One of the basic and most effective ways of preventing the spread of infection is by proper hand hygiene which involves an active process of practically performing hand washing, antiseptic hand-wash, and alcohol-based hand rub. There are various ways infection is spread and considering the active population of students in a given unit the spread of infection is higher if preventive measures are not enforced. The present study was done to assess the knowledge and practice of primary school children, to administer the video and demonstration on hand washing techniques to evaluate the effectiveness of video assisted teaching and demonstration on hand washing techniques among the primary school children. Evaluative research approach and two groups pre-test post test design was adopted to find out the effectiveness of video and demonstration on hand washing techniques. The total sample was 100 primary school children aged 6-12 years .Convenient sampling technique was used to select the sample. Data was collected through structured questionnaire. Video and demonstration was developed and distributed to enhance the knowledge and practice of primary school children on hand washing techniques. Result shows the increased need for awareness about correct hand washing techniques
RELATIONSHIP BETWEEN OBESITY AND PERIODONTITIS: AN EPIDEMIOLOGICAL STUDY
Aim: The aim of the study was to evaluate the relationship between obesity and periodontitis. Materials and Methods: A total of 200 subjects aged between 20- 60 years were recruited from Department of Periodontics, shree bankey bihari dental College and Hospital, ghaziabad. Periodontal status of the subjects was recorded. Body mass index were used as measure to assess obesity. Other variables like age, gender, were also recorded. Results: When evaluation was done for prevalence of periodontal disease according to BMI in obese and non-obese, The result obtained showed that out of 200 patient in the distribution of pocket depth and clinical attachment loss who are non obese were 106 out of which only 30 patient (28.3%)were affected by periodontal disease as compared to 94 obese patient out of which 70 patient(74.4%) were affected by periodontal disease. Conclusion: The prevalence of periodontal disease is higher among obese subjects. Obesity could be a potential risk factor for periodontal disease in all age groups.
PECTORALIS MAJOR MYOCUTANEOUS FLAP FOR RECONSTRUCTION OF FACIAL CONTOUR DEFECT FOLLOWING TOTAL PAROTIDECTOMY – AN INSTITUTIONAL STUDY
Parotidectomy creates both aesthetic and functional issues creating a unique challenge for reconstruction to each surgeon. In this era of free flaps, pectoralis major myocutaneous flap still remains a versatile flap among head and neck cancer patients. A retrospective study was conducted at a tertiary hospital to evaluate the results of postparotidectomy defect reconstruction with PMMC flap. This study outlines our experience in reconstruction of postparotidectomy defects with PMMC at our institute.
DR. IGNAZ SEMMELWEIS (1818-1865): THE SAVIOR OF MOTHERS
Infectious disease has been a leading cause of death in humans since the first recorded tabulations. Major pandemics of bubonic and pneumonic plague, cholera, smallpox, measles, tuberculosis, syphilis, gonorrhea and influenza have devastated the human population. In the immediately post natal period, the placental site is a large open wound - easily invaded by ascending bacteria. That puerperal women were at risk of a fever that could be fatal was common knowledge. Puerperal sepsis (childbed fever) was known since 1500 BC but it was the Hungarian obstetrician Ignaz Semmelwies who discovered its cause and first took preventive measures against the spread of this serious infection.
TO STUDY STATUS OF GLYCEMIC CONTROL AND ITS IMPACTS ON PREVALANCE OF URINARY TRACT INFECTION IN DIABETIC PATIENTS
Urinary Tract Infections are Second most common Infectious complain in Outpatient Primary Care Clinics. It has been estimated that UTI accounts for 7million hospital visits per year. An association between UTI and Diabetics was first noticed in Autopsy series in 1940. Many Autopsy Studies have shown an increased prevalence of UTI in Diabetics. Poor circulation in Diabetics, Dysfunctional bladder and poor ability of WBC to fight against infection causes UTI. Women are about two to three times more likely to have bacteria in the bladder compared to male. Risk of infections spreading upward is also common in Diabetics. Therefore, improved control of Glycemia in Diabetics may help in controlling UTI. The Objectives of Study were: To Assess Status of Glycemic control in Diabetic patients To Study Impact of Glycemic control on Prevalence of Urinary Tract Infection in Diabetic patients. To identify Common Isolates in Urine Culture of Diabetic patients. To Identify Common Antibiotic sensitive to treat Urinary Tract Infection in Diabetic patients.
PAP SMEAR IS A TOOL IN FIGHT: PAP SMEAR AS A SCREENING MODALITY FOR CERVICAL CANCER
Objective: To investigate the prevalence of abnormal Papanicolou smear collected from cytology laboratory. These samples have been taken from the women who attended the gynecological clinics and opportunistic screening done. Material and methods:Source of Data: Paper smear collection was done in Kamla Raja Madhav Dispensary OPD, G.R. Medical College & J.A. Group of Hospitals, Gwalior (M.P.). Methods of collection of Data: A prospective study with study period of 18 months. Sample size was 500 cases who fulfilled selection criteria. Inclusioncriteria:1. Recurrent episodes of white discharge per vagina, 2. Intermenstrual bleeding, post-coital bleeding or post menopausal bleeding, 3. Suspicious looking cervix (leukoplakia, cervical ectopy etc.). Exclusion criteria:1. Pregnant women, 2. Clinically visible growth on cervix, 3. Unmarried Procedure: Written and informed consent were obtained from all the participants after brief explanation of the procedure. Results:Maximum cases (65%) were from rural area.Majority of the study group were Para 2 (27%) and para 3 (29%) Severity of cervical lesions increased with higher parity. Mean age of marriage was 17.8(2.4) years. Maximum no. of high grade preinvasive (25%) and invasive lesion (1.2%) were found in women married before18 years. Dysplasia and malignancy were significantly associated with consummation of marriage at early age. Non users of contraceptive were associated with high incidence of high grade preinvasive lesion (32%) & invasive lesion (1.2%). Leucorrhea was the leading clinical complaint (80%) while erosion of cervix was the commonest clinical finding. Overall incidence of CIN ( cervical intraepithelial neoplasia) was 44.5%. CIN-I was found in 24%,CIN-II in 14%, CIN-III in 6.5% and invasive carcinoma in 0.8%. Conclusion:Low educational level and low socioeconomic status leading to poor genital hygiene, marital status and early age of marriage explaining earlier and longer sexual life, high parity with unattended delivery and presence of infection were the main contributing factors for incidence of dysplasia and invasive carcinoma.
PATIENTS WITH ACUTE MYOCARDIAL INFARCTION PRESENTING TO EMERGENCY ROOM WITH ATYPICAL SYMPTOMS
Introduction: Chest pain is the most common presentation of acute coronary syndrome presenting to Emergency department. Few patients may present with atypical symptoms and pose a great challenge to the Emergency physicians. Diagnosis has to be made early since maximal mortality occurs within first few hours if treatment is not instituted early. A cross sectional study was conducted in our hospital to study the proportion of atypical symptoms in patients with acute coronary syndrome. Methods: A cross sectional study was conducted in our hospital from August 2016 to September 2017. All patients aged >20 years presenting to Emergency department and fulfilling the following diagnostic criteria were included. The WHO diagnostic criteria were used for diagnosis of Acute coronary Syndrome(9). 1) Clinical history of Ischemic type of chest pain 2) Changes in serial ECG tracings a)ST-segment elevation of more than 1mm in 2 limb leads. b) ST-segment elevation of more than 2 mm in 2 or more contiguous chest leads. c) ST segment depression >0.5mm at J point in >2contiguous leads with positive troponin I. 3) Positive serum cardiac biomarkers (troponin I). The diagnosis was confirmed if 2 out of 3 above components were positive. ECG was done for all patients presenting to ER with symptoms suggestive of acute coronary syndrome. Cardiac enzymes were sent in patients with nonspecific ECG changes. Results: 323 patients were included in our study. Out of which, 269 patients presented with typical chest pain symptoms and 54 (16.71%) patients presented with atypical chest pain symptoms . The incidence in male and female population was 44.4% and 55.5% respectively. The incidence of atypical symptoms increased with increasing age and was highest in the age group of 71-80 years. Conclusion: It is crucial to consider acute coronary syndrome as a differential diagnosis in patients with atypical presentation and Emergency physicians should have a knowledge of various atypical presentations. As missed Myocardial infarction has dire consequences, continued efforts are required to reduce incidence, overall mortality and morbidity.
ASSESSMENT OF SEVERITY OF ORGANOPHOSPHOROUS COMPOUND WITH PROGNOSTIC SIGNIFICANCE OF CREATINE PHOSPHOKINASE LEVELS
Organophosphorous poisoning (OP poisoning) is common poisoning specially in developing countries like India. Laboratory parameter like erythrocyte cholinesterase activity has been used to support clinical diagnosis and to predict prognosis and it is expensive. Pseudo cholinesterase is cheaper alternative but it is less reliable. CPK is a cheaper investigation and is easily performed in all laboratories. Hence this study was done to evaluate role of Creatine phosphokinase levels to support clinical diagnosis as well as predicting prognosis in acute OP compound poisoning. Material and Methods: It was a prospective observational study which included 50 patients who presented within 6 hours of consumption of OP compound after considering inclusion and exclusion criteria. Patients were categorized into mild, moderate and severe poisoning according to POP score and initial CPK levels were noted. Data expressed in percentages and Chi-square test was used to know statistical significance. Results: Out of 50 patients, 28 (56%) had mild, 16 (32%) had moderate and 6(12%) had severe poisoning. Initial CPK levels were positively correlated with POP score. Four deaths occurred in our study, out of which one had moderate poisoning and three patients had severe poisoning. Conclusion: Initial CPK levels correlated with severity of OP compound poisoning and mortality.
MENSTRUAL HYGIENE PRACTICES AMONG TRIBAL WOMEN: A PHENOMENOLOGICAL APPROACH
Menstruation is a natural phenomenon which is common to all women in this universe. Globally all women of reproductive age practice to deal with menstruation. These vary greatly with geographical boundaries, personal preferences, available resources, education, economic status, traditions and culture. This study was conducted to explore the socio cultural realities co existing with menstrual hygiene practices among tribal women. A phenomenological design was used to assess the practices of menstrual hygiene among tribal women of Vellore, Tamil Nadu among 10 samples who were selected using purposive sampling technique. Data was collected using open ended leading questions. The data were analyzed based upon Van Colaizzi framework and the themes identified were Fear and Anxiety during menarche, Lack of Awareness regarding Menstruation, Menstruation as Distress to the body, Sense of Cleanliness during Menstruation, Convictions on Rituals and Habits, Belief in Home Remedies, Isolation during menstruation. The overall study findings revealed that the women in the tribal communities had varying degrees of menstrual hygiene practices which were both healthy and harmful to reproductive health. It underscores the vital role of the nurse to create conscious awareness and clear understanding of menstruation. Menstrual hygiene should be promoted by nurses to improve women’s health and welfare.
LAPAROSCOPIC REPAIR OF PARACECAL HERNIA: A CASE REPORT
Introduction Paracecal hernia is a rare type of internal hernia. Internal herniations is a rare cause of small bowel obstruction ranging from 0.6 to 5.8 %.Clinical presentation of the paracecal hernia are non specific , delay in the diagnosis may lead to strangulation. We report a case of paracecal hernia successfully operated by laparoscopy, along with review of literature . Case report Presenting a case of 54 yr old male, who came with complaints of abdominal pain with obstipation for two days . CECT reported intestinal obstruction, pericolic hernia with proximal and mid ileal loops herniating. Laparoscopic surgery was done with successful reduction of the incarcerated intestinal loops. Conclusion Clinical symptoms of paracecal hernia are vague , hence high index of suspicion and early intervention prevents strangulation and ischemia of the bowel. Minimal invasive surgery is a better surgical option for paracecal hernia to reduce morbidity and early recovery.
A COMPARISON OF THE SEDATIVE, HEMODYNAMIC, AND RESPIRATORY EFFECTS OF DEXMEDETOMIDINE AND PROPOFOL IN CHILDREN UNDERGOING MAGNETIC RESONANCE IMAGING
Sedation of children for MRI is usually associated with inadequate or failed sedation because of difficulty in achieving complete immobility while maintaining hemodynamic and respiratory stability. 30 children each in two groups Group D receiving intravenous (iv) dexmedetomidine a potent, highly selective α2adrenoreceptor agonist and Group P receiving iv propofol were compared for efficacy in MRI sedation. Dexmedetomidine was effective in 78.5% of cases with 21.5% of children required additional medications. Side effects occurred in approximately 25% of cases, bradycardia (3.9%) and hypotension (18.4%) that resolved spontaneously. In group P, the onset of sedation, recovery, and discharge time were significantly shorter than in group D (P< 0.05). The level of consciousness was the same in both groups at the time of discharge. The duration of drug infusion was not different between groups (P> 0.05). 100% of the children in both treatments completed their MRI scans without interruption or interventions (i.e., no failures) and without complications. Heart rate and systolic blood pressure changes were transient and statistically significant, but not of sufficient magnitude to warrant interventions.
COMPARATIVE STUDY OF INHALATION OF SALBUTAMOL VIA METERED DOSE INHALER WITH SPACER AND VIA NEBULISER IN ACUTE BRONCHIAL ASTHMA
Background: Effective management of Acute bronchial asthma may reduce the mortality and morbidity in adults which can be achieved by educating the patient with aerosol inhalation devices. Now a days salbutamol administration with metered- dose inhaler and spacer play a unique role in treatment of acute asthma. Objective: Our study analyse the efficacy of salbutamol administered by a nebuliser compared to metered- dose inhaler and spacer in adults with Acute asthma. Materials and Methods: The study was conducted on 52 patients admitted in the Medical ward of tertiary care hospital. We categorised them into two groups. Group I received salbutamol Via MDI with spacer and Group II received salbutamol via nebuliser. Approval from the hospital ethical committee was obtained. The study was a cohort study conducted for a period of 6 months from May 2012 to October 2012. Results : There is stastistically significant improvement in PEFR , FEV1 and FVC at 30 mts and at end of treatment with the MDI-Spacer group than with the nebulised group. There is no statistically significant difference between MDI-spacer and nebuliser groups in the heart rate and respiratory rate at 30 minutes and at the end of treatment. Change in oxygen saturation at 30mts was 3.92±0.404 (MDI-Spacer) and 2.23±0.430 (nebulised group) .It was significant with p<0.001 at 30mts.At the end of treatment the corresponding values were 2.23±0.430(MDI-spacer) and 2.12± .33)(nebulised group). There was no statistically significant difference (p 0.304). The requirement of salbutamol in MDI-spacer is significantly lower than nebulizer as suggested by p value less than .001.We concluded there was no significant difference between the two groups, moreover MDI with spacer was better than nebuliser for the treatment of severe acute asthma attack in adults. Conclusion: Our study supported and confirmed the evidence that MDI with spacer is as effective as nebuliser in the management of acute asthma.
DOUBLE SETON IN THE MANAGEMENT OF COMPLEX ANAL FISTULAS: A NOVEL APPROACH
Aims & Objectives: To determine the surgical outcome in terms of fecal incontinence and recurrence rate, in patients with complex ﬁstula in ano managed with a novel technique of dual seton at a tertiary care hospital.Methods: This is a prospective case series of patients presenting with complex anal ﬁstula, managed with double seton from January 2017 to January 2019. Results: Twenty five patients were treated during the study period with the age (mean±standard deviation) of 40.04 ± 8.36 years. In our study, we found 0% incontinence and 0% recurrence rate in 25 patients, treated with the new technique of double seton placement for complex anal fistulae. Conclusion: The double seton technique is a safe, low-cost, novel, precise, and a cost-eﬀective option for the treatment of complex fistulae-in-ano with an excellent outcome, in regards of anal incontinence and recurrence.
A COMPARATIVE STUDY OF INTRAVENOUS DEXMEDETOMIDINE AND INTRAVENOUS TRAMADOL FOR POST SPINAL ANAESTHESIA SHIVERING
Introduction: Shivering is a natural protective phenomenon. The main causes of intra/post-operative shivering are temperature loss, increased sympathetic tone, pain, and systemic release of pyrogens. Spinal anaesthesia significantly impairs the thermoregulation system by inhibiting tonic vasoconstriction, which plays a significant role in temperature regulation. Several drugs have been studied for the prophylaxis as well as treatment of shivering. Tramadol, an opioid receptor agonist, has also proved to be effective in the treatment of shivering after general anesthesia, On the other hand Dexmedetomidine, a congener of clonidine, has been used as a sedative agent and is known to reduce the shivering threshold. The aim of the study was to compare the efficacy of dexmedetomidine and tramadol in the treatment of post-spinal anesthesia shivering as well as their side-effect profile. Materials and methods: The present study was carried out in the Department of Anaesthesiology and Critical Care, Government Medical College, Kota. This is a Prospective Randomized Comparative Study. Patients aged 18-65 years, American Society of Anesthesiologists I & II and scheduled to undergo elective surgeries under spinal anesthesia and developing shivering grade 3 or grade 4 were included in the study. We made two groups of cases i.e. Group T (TRAMADOL) and Group D (DEXMEDETOMIDINE). sample size was 64, which was divided into two groups of 32 each. Standard protocol followed to administering spinal anaesthesia. On occurrence of shivering its intensity graded using a four point scale as per Wrench.. All data were collected and analysed with the help of suitable statistical parameters. Results: Our study results in that dexmedetomidine is more effective in the treatment than tramadol for treatment of postspinal anaesthesia shivering.
THE RATE AND INDICATIONS OF CAESAREAN SECTIONS IN TERTIARY CARE HOSPITAL IN KASHMIR
OBJECTIVE :The main objective of the study was to analyze the rate and indications of caesarean sections in our hospital, which is a lone tertiary care hospital of Kashmir. MATERIAL AND METHOD: Our study was a retrospective study conducted in Department of obstetrics and Gyneacology, Lalla Ded hospital, Government Medical College, Srinagar Kashmir from July 2019 to December 2019. RESULTS: A total of 10,866 births occurred in the study period, out of which 7210 ( 66.35%) were caesarean deliveries. Majority of caesarean deliveries were done as emergency cases (92.45%) while as only 7.54% of cases were done on elective basis. 65.54% of patients belonged to age group 31-40 years. Majority of cases were primigravida (53.93%) while as 38.2% were G2-G4. Our study reported the primary caesarean rate of 70.31% while as repeat caesareans were 29.68%. Fetal distress was the leading indication for caesarean section (32.76%) followed by previous one scar (16.85%).CONCLUSION: The rate of caesarean deliveries in our hospital was 66.35% with fetal distress followed by previous one caesarean as most common indication.
A COMPARATIVE STUDY OF INTRATHECAL ISOBARIC BUPIVACAINE (0.5%), LEVOBUPIVACAINE (0.5%) AND ROPIVACAINE (0.5%) IN PATIENTS UNDERGOING TURP.
This study was done to compare the anesthetic efficacy and safety of three local anesthetic agents : racemic bupivacaine and its two isomers : ropivacaine and levobupivacaine, in patients undergoing transurethral resection of prostate. One hundred-sixty two patients, ASA I-III, were randomized to receive an intrathecal injection of one of three local anesthetic solutions. Group B (n = 54) received 2 ml of isobaric bupivacaine 5 mg/ml(10 mg). Group R (n = 54) received 2 ml of isobaric ropivacaine 5 mg/ml (10 mg). Group L (n = 54) received 2 ml of isobaric levobupivacaine 5 mg/ml (10 mg). The onset and duration of sensory block at dermatome level T10,time to achieve highest level of sensory block, regression of sensory block up to L-1 as well as the onset, and duration of motor block were recorded, as were any adverse effects, such as bradycardia , hypotension, hypoxia, tremor, nausea and/or vomiting.The onset of motor block was significantly faster in the bupivacaine group compared with that in the ropivacaine group and almost the same of that in the levobupivacaine group (P < 0.05). Ropivacaine presented a shorter duration of both motor and sensory block than bupivacaine and levobupivacaine (P < 0.05). Bupivacaine required more often the use of a vasoactive drug (ephedrine) compared to both ropivacaine and levobupivacaine and of a sympathomimetic drug (atropine) compared to the ropivacaine group.
COMMUNITY BASED STUDY OF SCRUB TYPHUS AWARENESS AMONG RESIDENTS OF URBAN FIELD PRACTICE AREA IN CENTRAL INDIA
Background: Scrub typhus is a re-emerging disease in India prevalent in rural and urban India, which is causing life-threatening illnesses. Methodology: Descriptive cross - sectional study was conducted in the urban field practice area of tertiary health care centre of central India. Study subjects were the adult residents of the adopted families present in the house during the time of survey. Pre tested questionnaire was used to obtain data from totaln419 study participants. Data was analysed to obtain percentages Results: 66.34% study participants had heard about scrub typhus. 61.81% had awareness that it is caused due to an infection. Conclusion: Study participants were aware about scrub typhus but detailed awareness of transmission and prevention was not present.
A STUDY ABOUT COMPARISON OF TREATMENT OUTCOMES IN CASES OF INGUINAL HERNIA MANAGED BY DIFFERENT METHODS OF SURGICAL REPAIR
Introduction : Hernia generally means weakness or defect of the body wall muscle fibers that provide a space for protrusion of internal organs. Prevalence of the inguinal hernia is nearly 5% worldwide . This study aims to evaluate and compare the results of inguinal herniorrhaphy with mesh in classic and preperitoneal method because of the high incidence of complications after inguinal herniorrhaphy and the variety of reconstructive procedures in randomly general hospitals. Methods: Case sheets of 200 patients were selected which were proven cases of Inguinal Hernia during a period of 4 months from year Aug 2019 to Nov 2019. Subjects included both the genders , all age groups including pediatric and geriatric age group and all classes of socio economic strata.Patients were assigned to two treatment groups. Duration for surgeries was approximately between 40 mins and 60 minutes. The patients underwent a surgical repair in inguinal hernia with classic versus preperitoneal methods under spinal anesthesia. Results: The rate of recurrence was 9% in the classic group and 2% in the preperitoneal group. This difference was significant t (
EXPLORING THE REASONS FOR INCOMPLETE IMMUNIZATION IN THE RURAL AREA OF HIGH-PERFORMANCE STATE OF INDIA
Introduction-Incomplete immunization among under five children is one of the major public health problems in India. Objectives- To explore the reasons behind incomplete immunization among under five children. Material & methods- It was a qualitative study conducted during May 2017-Oct.2017(6 months). In-depth interviews and Focus group discussions (FGDs) were conducted among parents of unimmunized and partially immunized children and healthcare workers (ASHAs and AWWs). Study tool was semi-structured interview guide. Analysis was done using thematic analysis. Ethical clearance and informed consent was obtained before conducting the study. Results- A total of 15 in depth interviews (8 mothers,1 father and 6 key informants) and two FGDs were conducted. Major key areas came out to be lack of knowledge regarding benefits of immunization, side -effects due to immunization, rumors and fake videos, resistance from husband & in-laws, migration of mothers and loss of immunization card. Conclusion- There is an urgent need of awareness regarding benefits, possible side effects and contraindications of immunization.
This cross-sectional comparative study was conducted on First MBBS and other (second and third year) MBBS students, who were first oriented about the new competency-based medical curriculum for the MBBS course. The same set of ten feedback questions were administered to all students who were willing to give their feedback. The difference between First MBBS and other MBBS student in responses to question on whether periodic assessments envisaged under the new curriculum will improve examination scores was significant (p=0.001). Difference between the two groups in response to question on benefit of timely feedbacks from teachers was significant (p=0.005) and that about the new curriculum requiring participation in all academic activities was highly significant (p<0.001). The feedback from First MBBS students for other seven questions was also relatively more positive, as compared to that of other MBBS students.
ACUTE FULMINANT HEPATIC FAILURE IN DENGUE INFECTION: A RARE COMPLICATION
Dengue fever is a mosquito borne illness caused by Dengue virus. Liver involvement in Dengue is very common and can cause a mild to moderate rise in transaminases but can rarely cause acute fulminant heaptic failure. We present one such case of a 30 year old Hypothyroid, Diabetic and morbidly obese female from Western India who presented with typical manifestations of Dengue fever. Basic laboratory parameters were normal on admission. Initially she responded to treatment but following that she developed acute fulminant hepatic failure and renal failure to which she finally succumbed. This case reveals one of the very rare and fatal complication of Dengue infection in the form of acute fulminant hepatic failure. Other factors including race, diabetes, haemoglobinopathies, pre-existing liver damage and the use of hepatotoxic drugs may also play a role [188].
DETERMINATION OF ACCURACY OF ELECTRONIC APEX LOCATOR IN THE FUNCTION OF DIFFERENT EMPLOYMENT PROTOCOLS IN VITAL AND NON VITAL TEETH : AN IN-VIVO STUDY
Introduction: Accurate working length determination is a crucial factor that influences the outcome of root canal therapy. Root canal length determination is commonly performed using radiographic methods or apex locator. Aim: Determination of accuracy of electronic apex locator in the function of different employment protocols in vital and non vital teeth. Methodology: 20 patients are selected for root canal treatment. The patients are divided into 2 groups based on vital and non vital teeth. Working length determination is done by using an apex locator. The accuracy of working length determined is confirmed using digital radiography. The tooth to be treated is anaesthetised and isolated with rubber dam. Access opening is done and a 10k file is used for determining the working length using an electronic apex locator. As the file progress in, the reading is noted. Two employment protocols are used: 1. File stops at the apex and coming back to 0.5. 2. File goes beyond zero and coming back to 0.5. Result: There is no statistical significant difference between the two protocols regardless of the conditions used. Protocol 2 showed favourable results when compared with protocol 1
COMPARATIVE STUDY BETWEEN RGU AND SONOURETHROGRAPHY IN EVALUATION OF ANTERIOR MALE URETHRA
Background: RGU is the gold standard investigation for assessment of male anterior urethra. SUG is an infrequently used technique for this purpose. Each has its merits and demerits. Aim and objectives:The aim of the study was to compare the best modality between RGU and SUG in evaluation of anterior urethral strictures. Materials and methods: This study was conducted in the Department of Radio Diagnosis at NRI General Hospital, Chinakakani, Guntur from 2016-2017.A total of 40 pateints attending urology OPD in the age group 20 to 70 years with complaints suggestive of lower urinary symptoms were studied. Results from both studies were compared for testing the accuracy, ease of performing the study and advantage to the patient. Results: Out of 40 patients on RGU, 15 patients were normal, 23 patients had strictures. One patient had a urethral tumour and one patient had a false passage in the penile urethra. A total of 24 strictures were demonstrated on SUG. In one of these cases, RGU was normal. Strictures were assessed for location and number. Periurethral fibrosis on SUG. RGU was deemed to be the gold standard test against which SUG results were assessed. SUG showed a sensitivity of 100% and specificity of 93.3%. The positive predictive value was 96.1% and the negative predictive value was 100%. Out of 24 cases of strictures detected by SUG, 4 cases showed evidence of Spongiofibrosis which can be evaluated by SUG alone. Conclusion: Conventional RGU is the gold standard imaging test for urethral strictures even in the advanced CT and MRI era. Our study with SUG also showed results on par with RGU with the modality being equally efficient in detection of anterior urethral strictures.
A COMPARATIVE LABORATORY DIAGNOSIS OF MALARIA: MICROSCOPY VERSUS RAPID DIAGNOSTIC TEST KITS
Introduction: Malaria is one of the highest killer diseases affecting most tropical countries. It affects over 500 million people worldwide and over one million children die annually from malaria. Over the years many new tests have been developed in an attempt to improve the diagnosis of malaria, but conventional method by smear microscopy remains the gold standard against which all other tests have been evaluated. Rapid diagnostic tests (RDTs) for malaria could be considered for most patients in endemic regions. Objective: To compare microscopy and rapid diagnostic tests (RDTs) in the diagnosis of malaria. Material & Methods: Blood samples of 7434 clinically suspected cases of malaria of all ages and both sexes were collected between June 2018 and November 2018 at a tertiary care teaching hospital in Southern Rajasthan. One step malaria antigen rapid test was done in all the patients. Patients who were positive on rapid diagnostic kit, thick and thin smear was prepared among those. Results were simply presented as percentage positive of the total number of patients under study. Results: Out of 7434 samples, 400 samples were positive in rapid card test (antigen detection) and out of 400 samples, 240 samples are positive for malaria in microscopy examination. Out of total 400 rapid card test positive samples 208 (52%) patients were male and 192 (48%) were female patients while out of total 240 microscopy positive samples 129 (53.75%) patients were male and 111 (46.25%) were female patients. In present study 51% were P. falciparum, 37.5% P. vivax and 11.5% mixed infection by rapid card test (n=400) while in the microscopy out of 240, 48.75% were P. falciparum, 39.58% were P. vivax and 11.66% were mixed infection.
KNOWLEDGE OF PRIMARY SCHOOL TEACHERS REGARDING BEHAVIORAL PROBLEM AMONG SCHOOL CHILDREN'S
Teachers have difficulties managing children’s behavioural problems Teachers reported under listening talking and counselling as a first option to deal with child behavioural problems An understanding of the emotional development of children is essential, Different components of a healthy personality develop at various periods in the process of growing. As the child passes from infancy to toddler stage, he uses his increasing ability to help himself and to develop his sense of autonomy. The preschool child watches adults and attempt to imitate their behaviour. He develops a sense of initiative controlled by conscience between the age of six and thirteen years the child develops a sense of industry and a desire to engage in task in the real world.5 Teachers have been utilized for school health programs in health status assessment and health education. Since there is considerable shortage of mental health professionals, school teachers can make important contributions in the promotion of mental health of children. The opportunity that teachers have for interpersonal relationship greatly contribute to the mental health of children.16 The research approach used for the study was quantitative approach, design was non experimental, descriptive survey research design, by using non-probability Purposive sampling technique 60 primary school teachers were selected for the study. Structured knowledge questionnaire were used to assess the knowledge of primary school teachers regarding behavioural problem. The result of the study revealed that 50% of primary school teachers were having poor knowledge, while 41.67% were having average knowledge and 8.33% were having good knowledge. There was a significant association between knowledge scores regarding behavioural problem with their selected socio-demographic Variables like Age, Gender, Religion, Educational status, Year of experience, Teaching class (Standard) and Source of information. The calculated Chi-square values were higher than tabulated value.
AN UNUSUAL LARYNGEAL FOREIGN BODY IN AN ADULT
Foreign body in the aerodigestive tract is an emergency condition that contribute significantly to high morbidity and mortality all over the world. The spectrum of presentation however varies widely from sudden death due to complete respiratory obstruction to accidental finding during routine investigation. Laryngeal foreign bodies may present with less severe symptoms as compared with lower respiratory tract foreign bodies, resulting in misdiagnosis, confusion and delayed diagnosis. Here we present a case report of a 58 years old male who presented with complaint of episodes of difficulty in breathing on exertion since 10 days, with no history suggestive of probable foreign body aspiration. On investigations, the complaints turned out to be due to laryngeal foreign body.
ROLE OF PROPHYLACTIC ANTIBIOTICS IN PREVALENCE OF SEPSIS IN ACUTE LIVER FAILURE
The major cause of death in ALF is sepsis accounting for 24-49% of deaths in Indian patient population which is common. Hence we aimed to study the prevalence of sepsis in ALF and the role of prophylactic antibiotics in limiting the incidence of infections in ALF and improving related mortality. Total 46 patients of ALF were divided into 2 main groups with SIRS>=2 and SIRS<2 at the time of admission based on the number of SIRS components. Patients with SIRS>=2 were studied for the prevalence of sepsis in ALF. Group of patients with SIRS<2 were studied for the incidence of sepsis and the role of prophylactic antibiotics in ALF dividing both the groups into further control group who received prophylactic antibiotics and the test group who were treated with antibiotics only on deteriorating due to sepsis and on every episode of worsening. Role of prophylactic antibiotics was studied by documenting serial infections and mortality in control group and comparing with the test group without prophylactic antibiotics.
CONVENTIONAL NASOTRACHEAL INTUBATION VERSUS RED RUBBER CATHETER-GUIDED NASOTRACHEAL INTUBATION- RANDOMIZED STUDY
Introduction: Various techniques have been formulated and suggested to reduce the trauma of nasotracheal intubation. Hence the evaluation is done between Conventional Nasotracheal intubation versus red rubber catheter-guided nasotracheal intubation. Methods: Paediatric age group presenting for elective surgery were randomized to undergo red rubber catheter-guided nasotracheal intubation or to have the nasotracheal tube alone inserted after administering of general anaesthesia and paralysis of patient with vecuronium. The nares were prepared with topical vasoconstrictor. The nasotracheal tube was softened with lubricant jelly. In the catheter guided group, the nasotracheal tube tip was fitted to the trailing end of the red rubber catheter, and the two were advanced together. The red-rubber catheter and the two were advanced together. The red rubber catheter was retrieved from the nasopharynx, disconnected, and removed. In the other group, the nasotracheal tube was advanced blindly into the nasopharynx. In both the groups, intubation was successfully completed during direct laryngoscopy using Magill forceps. A observer who is blinded will swab the pharynx and rated the severity of bleeding. Results: Age, weight, difficulty of intubation, and snoring history, are same in two groups. Anticipated bleeding was lower using the red rubber catheter technique (10vs.29%,P=0.013), which took longer time interval to perform(74vs.56 s,P=0.02) Conclusions: Although the incidence of bleeding in both groups was similar, severity of bleeding was reduced in the catheter guided group during nasotracheal intubation. Use of a red rubber catheter may reduce the trauma associated with nasotracheal intubation.
EVALUATION OF EFFICACY OF DEXMEDETOMIDINE AS AN ADJUVANT TO LIGNOCAINE DURING INTRAVENOUS REGIONAL ANAESTHESIA
Background and Aim- Intravenous regional anaesthesia (IVRA) is technically, reliable, simple and safe method of providing anaesthesia for minor surgical procedures over the upper extremities. Various local anaesthetic agents like lignocaine, bupivacaine, mepivacaine and procaine have been used for IVRA. The purpose and aim of the present study was to assess the efficacy of 0.5µg/kg dexmedetomidine as an adjuvant to lignocaine during IVRA with regard to Onset & duration of sensory block and motor block ,Efficacy , duration of analgesia,Degree of sedation ,Incidence of tourniquet pain , Haemodynamic variables and patient acceptance . Method-Total 60 patients of ASA grade I&II scheduled for elective surgery of upper limb, were randomized into two groups for IVRA .Group L Patients were received 0.9% normal saline plus 3mg/kg lignocaine (0.5%) diluted with normal saline upto total dose of 40 ml and Group LD Patients were received 0.5µg/kg dexmedetomidine plus 3mg/kg lignocaine (0.5%) diluted with normal saline up to total dose of 40 ml. All patient in two groups were assessed for sensory block, motor block, sedation and monitored for hemodynamics, intraoperative and postoperative analgesia using VAS score and side effect if any. Results VAS Score was significant lower, when compared both groups, there was a significant shorter sensory onset and longer recovery time observed in LD group and onset of motor block faster and regression of motor block was slower in LD group in IVRA. Sedartion Score more in group LD significantly and number of rescue analgesia given in postop was lower in group LD. Conclusion- Dexmedetomidine addition to lignocaine in IVRA improved the quality of both sensory and motor block with good quality of analgesia. It enhanced the duration of postoperative analgesia and was not associated with haemodynamic instability or any other complications.
HIGH PERFORMANCE LIQUID CHROMATOGRAPHY (HPLC) STUDY IN PATIENTS SUFFERING FROM HAEMOGLOBINOPATHIES AT A TERTIARY CARE HOSPITAL - AN ORIGINAL ARTICLE.
Introduction: Haemoglobinopathies are a group of disorders of hemoglobin. Inherited abnormalities of Hemoglobin synthesis may be divided into two groups: (1) Structurally abnormal hemoglobin variants. (2) One or more of the normal hemoglobin are synthesized at reduced rate. Aims and Objectives: To assess the pattern of Thalassemia syndrome and Other Haemoglobinopathies by HPLC (High Performance Liquid Chromatography) method in patients of Civil Hospital, Ahmedabad. To study age and gender wise distribution of Haemoglobinopathies in patients of Civil Hospital, Ahmedabad. To study the incidence of Haemoglobinopathies in different castes in patients of Civil Hospital, Ahmedabad according to the caste. To compare the results of present study with the results of other authors similar studies. Material and Method: The study has been carried out as “Time bound study” to find the pattern of β-Thalassemia and Other Hemoglobinopathies for a period of two years from October 2015 to November 2017. Observation and Result: Most common HPLC findings in this study was Beta thalassemia Minor (38.47%) followed by Sickle cell trait (21.43%), Sickle cell disease (17.14%), Beta Thalassemia Major (5.71%), Sickle-β thalassaemia (5.71%) and Beta Thal. Intermedia (4.29%). Conclusion: HPLC is easy, reproducible & accurate in most cases of haemoglobinopathies.
STUDY OF USAGE AND IMPACT OF CELL PHONE IN FIRST YEAR MEDICOS OF NMCH, PATNA
Excessive usage and dependence on cell phone affects our health. It is important to know these effects in young medicos who are the future of our health system. This study was aimed to assess any change in efficiency of the first year medicos based on their cell phone usage time. Questionnaire regarding that was provided to the first year medicos selected for study. Out of 50 students selected for study, 46% used cell phone during class hours and 94% during normal sleeping time. They showed symptoms like fatigue daytime sleepiness, etc. When students gave up their phone for a day they showed signs of possible addiction like anxiety, restlessness, etc. Thus cell phone usage during class hours and normal sleeping time may contribute to daytime sleepiness and affects the cognitive and learning abilities of young medicos.
THE ROLE OF ORAL PGE1 IN INDUCTION OF LABOUR AND THE OUTCOME OF PREGNANCY
Objective: It is a prospective randomized study to see the efficacy of PGE1 in cases of PROM from 28wks to term gestational age evaluating the mode of delivery with perinatal and maternal outcome. This study was conducted at Mahavir Institute of Medical Sciences, Vikarabad during 1/1/2018 to 30/12/2018. Methodology: Women with PROM history with unfavourable cervix misoprostol 25micrograms orally 4th hrly up to a maximum of 6 doses given. Bishops score was assessed and labour augmented using oxytocin as and when required. Contractions monitored with CTG. Vaginal examination done 4-6hrly to assess the progress of labour. All the women were monitored with continuous CTG. Primary (time interval from induction to delivery, percentage of women delivered within 24 hrs. vaginally, rate of LSCS) and Secondary (need of oxytocin acceleration, neonatal morbidity and mortality, maternal morbidity and mortality) outcomes noted. Results: Out of 100 cases 81 delivered vaginally, 19 cases LSCS done. In term PROM cases -100% survival. Among preterm PROM 21/100, 2 were IUD on admission, 3 neonatal deaths. Total perinatal mortality 3% in 100 cases of PROM No. of NICU admissions 10/100-10%. According to birth weights IUD babies were 750, 800gms. NND two were<1.2kg. NND 1baby was 1.8kg. Mean birth weight of NND –1.2kg. Birth weight of >1.8kgs all the babies survived. Conclusion: PGE1 Misoprostol is effective for cervical ripening and inducing labour in PROM cases as seen in our study with 100% perinatal survival in term PROM and LSCS rate of 19%. In our study we did not have PPH or hyper stimulation. Hence low dose PGE1 25 micrograms is efficient and cost effective as an inducing agent orally also.
CLINICAL OUTCOME OF END TO SIDE VERSUS SIDE TO SIDE ARTERIOVENOUS FISTULA FOR DIALYSIS ACCESS AMONG CHRONIC RENAL FAILURE PATIENTS.
Introduction: Arteriovenous Fistula (AVFs) is the gold standard for hemodialysis & it is the best modality for hemodialysis access. Anastomotic creation of autogenous arteriovenous fistulas can be performed in different ways; side to side (STS) or end to side (ETS). However, there is a paucity of evidence to recommend them. In this study aimed to describe clinical outcome to AVF surgery for improving early patency rates. Objectives: To compare the results of both surgical techniques for creation of arteriovenous fistula (AVF); End to side (ETS) versus Side to side (STS) artery techniques. Materials and Methods: This is prospective randomised control trial study that is going to be conducted at in department of Cardiovascular and Thorasic Surgery , pt. J. N. M. Medical college Raipur. Patients were divided into two groups according to use of End to side (ETS) & Side to side (STS) technique between May 2019 to June 2019 (2 Monhs) , with six month postoperative follow up period. Group I consisted of 25 patients with End to side & Group II consisted of 25 patients with Side to side technique. Both groups were followed for duration of 6 months to assess patency. For evaluating the quantitive variables, t-test was used while qualitative variables were measured using the chi-square and Fisher’s exact tests. Results: In this study were included with 25 patients in End to Side (ETS) group and 25 patients in Side to Side (STS) group. Co-morbidities was not found to be significantly associated with the both groups. There were also type of fistula was not found to be significant associated with ETS & STS groups. In the six months duration, 5 patients (20%) in the STS group and 4 patients (16%) in the ETS group experienced a non working AVF. The total failure rate was 18% and during the 6 months of follow up no significant difference was detected in the patency rate. Conclusion: Similar patency rates between ETS and STS fistula configuration, however, type of fistula was not significantly associated with the STS technique.
MYRIAD CLINICAL PRESENTATIONS OF LUNG CANCER: A SINGLE CENTRE CROSS-SECTIONAL STUDY AT A TERTIARY CARE CENTRE IN WEST INDIA
Background: Lung cancer is the leading cause of cancer death globally and is now considered as the commonest fatal malignancy in the developed world. India contributes to 20% of all deaths due to lung cancer in the world. Methods: To study the clinical and paraneoplastic presentations of lung cancer, we carried out a single centre, cross sectional observational study on a cohort of 100 patients of freshly detected Lung cancer. Results: Mean age of the subjects was 56.36 years and 30% of the cases were above 60 years of age. Majority (63%) of them were males and smokers (59%). Most common presenting symptoms were cough (22.21%), chest pain (16.13%), fever (14.37%), dyspnoea (11%) and hemoptysis (5.22%). Paraneoplastic syndromes comprised of anemia and leucopenia (20%) cases followed CNS manifestation (in 8%) cases. No association was observed between type of lung carcinoma and paraneoplastic syndrome. Conclusion: Our study confirms the high prevalence of lung cancer in male smokers with predominantly respiratory complaints. Paraneoplastic syndromes are not a rare entity in such patients and a high level of clinical suspicion is required for early detection of such cases.
A STUDY TO ASSESS THE KNOWLEDGE AND ATTITUDE REGARDING NEONATAL JAUNDICE AMONG THE MOTHERS IN SELECTED VILLAGES OF AMBALA, HARYANA.
Background: Neonatal jaundice refers to yellow discoloration of the skin and the sclera (whites of the eyes) and other tissues of a newborn infant that results from accumulation of bilirubin in the skin and mucous membranes. Objective: to assess the knowledge and attitude regarding neonatal jaundice among mothers, determine the correlation between knowledge and attitude score of mothers regarding neonatal jaundice. Method: The research approach adopted for the study was Quantitative Research Approach. The research design adopted for the study was Descriptive Survey Design. Total 350 mothers were selected by using purposive sampling technique from selected villages. The tools developed and used for data collection were structured knowledge questionnaire and five point likert attitude scale,tools were prepared by focusing on knowledge and attitude respectively. Results: The study revealed that the mean of knowledge score of the mothers regarding neonatal jaundice was (10) with standard deviation (2.80) and mean of attitude score was (64.49) with standard deviation (7.40) respectively. The study concluded that nearly half of mothers residing in rural areas had below average level of knowledge 158 (45.1%) and majority of mothers had moderately favorable level of attitude 320 (91.4%) regarding neonatal jaundice. There was weak positive correlation between knowledge and attitude score.
SIGNIFICANCE OF VENTRICULAR REPOLARIZATION ABNORMALITIES IN DENGUE VIRAL FEVER
Infection by Dengue virus (DENV) is an arboviral disease affecting large no of population every year especially in underdeveloped and developing countries. In India every year, lacks of people suffer from it and mortality is well known in both DHS &DSStype of manifestations. Vector responsible is a mosquito, Aedes aegypti and/or Aedes albopictus. It breeds in fresh water bodies. Disease presents as fever with accompanying symptoms like, body ache, headache, nausea, vomiting, hemorrhagic spots or bleedings from various sites. Most common laboratory findings are leucopenia and thrombocytopenia. ECG changes do occur in this disease in relation to myocardial edema, however little importance has been given regarding ventricular repolarization so far. This study has been aimed to evaluate the QTc and QT interval dispersion to recognize ventricular repolarization changes in patients suffering from Dengue viral fever and to assess the grade of severity in relation to prognosis and referring a case to higher center for necessary evaluation and management of dengue fever and its complications. Fifty consecutive patients were included in study during dengue epidemic period. ECG of fifty age and sex matched normal individuals recorded as control group. Routine laboratory tests were performed along with 12 lead ECG. Interval values of QT, QT and QT dispersion were specially calculated with care in addition to other variables. QTc and QT intervals of both groups were compared for statistical significance and values of case group were found significantly higher (p-value <0.05), for QTc values. No significant difference detected in QT values while QT dispersion found to have week correlation in this study. This was concluded that ventricular repolarization do suffer in dengue fever, as disease is affecting multiple organs including heart causing temporary myocardial injury and edema. It is worthwhile to record 12 lead ECG in all cases of dengue fever which is otherwise not a routine investigation unless patients develop complications.
INFARCTED ANGIECTATIC SINONASAL POLYP MASAQUERADING MALIGNANCY
A 44 years female presented with nasal obstruction, headache, left nostril bleeding since 8 months. History of difficulty in breathing was present. Clinically a polypoidal mass seen in left nostril at the level of middle turbinate arising from middle meatus. Mass was friable posteriorly and was bleeding on touch. CECT showed a large lobulated soft tissue mass of size 4.7 x 3.6 cm in left maxillary sinus with significant deviation and erosion of nasal septum involving turbinates and extending in ethmoid sinus destructing maxillary sinus wall along with mucosal thickening of all sinuses. After necessary base line investigation a biopsy was taken. Biopsy revealed only necrotic material. There after two successive biopsy also showed the only necrotic material. Owing to inconclusive biopsy report. Complete excision of mass through Caldwell Lucs approach was done and specimen sent for histopathological examination. Specimen was processed in toto and total 61 blocks were prepared. None of the slides from 61 blocks showed evidence of malignancy. Final diagnosis was offered as Infarcted angiectatic inflammatory sinonasal polyp.
PRESCRIBING PATTERN OF ANTIMICROBIAL AGENTS IN MEDICAL INTENSIVE CARE UNIT OF A SUBURBAN TERTIARY CARE TEACHING HOSPITAL IN NORTH INDIA
Background : This prospective observational study was conducted to evaluate prescribing pattern of antimicrobial agents (AMAs) in the Medical intensive care unit (MICU) of a suburban tertiary care teaching hospital in Haryana. The ultimate aim is to achieve rational prescription of AMAs so as to reduce resistance against AMAs. Methods : Records of 115 patients of MICU were evaluated over a period of one year from September 2018 to August 2019. Results : 24% of prescribed drugs in MICU were AMAs. Average number of AMAs used per patient were 3%. The most commonly prescribed AMAs were Cephalosporins (72%) followed by Amikacin (42%) and Piperacillin/Tazobactam (37%). Out of all prescribed AMAs 74% were from the essential drug list. Conclusion : There is a need for forming guidelines at local level for rational prescribing of AMAs based on national guidelines. This will further help in preventing antimicrobial resisitance.
INCIDENCE OF STROKE IN ADULTS ACCORDING TO AGE, SEX AND SUBTYPES IN URBAN INDIAN POPULATION
Introduction: In a developing country like India, it is imperative to study the effects of age and gender on the incidence of stroke as it has important implications in making health policy decisions. Methods: We evaluated the incidence of stroke in patients over 15 years of age at Navi Mumbai, India during the period 2013-19 in Navi Mumbai, India. Outcomes studied were incidence of stroke stratified by age, sex, and stroke subtype. Results: Out of a total of 1377 patients, 1246 were ischemic and 131 haemorrhagic. The mean age was 49.06 years and 53% were males. Nearly half of the strokes occurred in 46-65 years group, and one-thirds in over 65 years of age. 21% bleeds and 16% of infarcts occurred under 45years of age. Younger females had lesser risk stroke as compared to males but females above 65years had a significantly greater risk of infarct (P value <0.005).The risk of intracerebral bleed in males under 45 years was significantly more than that of females (p value <0.001). Conclusion: Incidence of stroke increases with age, peaking in the highly productive age group of 46-65 years. The risk of any stroke was lower in younger women as compared to men, but elderly women (>65 years of age) were more prone to ischemic stroke than elderly males. Intracerebral haemorrhage occurred significantly more often in men than women under the age of 45years. These findings have important implications for public health policy and sociocultural changes.
COMPARATIVE EVALUATION OF INCORPORATING THREE DIFFERENT NANO BIOMATERIALS IN HYDROGEN PEROXIDE GEL ON MICROHARDNESS OF BLEACHED ENAMEL AN IN-VITRO STUDY
Background: A good aesthetic smile is one of the most important factors to attain positive life style. Among various aesthetic treatment modalities available, bleaching gained immense response in aesthetic enhancement. But in some cases, bleaching alone does not fulfill the aesthetic demands which require additional procedures like composites restorations, laminates, veneers etc. However, some of the studies reported that bleaching can alter the microhardness of the tooth, resulting in deficient bonding and demineralisation. The current study was to evaluate the change in microhardness of enamel specimens bleached with 40% hydrogen peroxide gel incorporated with three different nano remineralising agents. Materials and Methods : 30 enamel specimens (5x5x4mm) were obtained from 15 molars and incorporated in acrylic resin mold which were divided into 5 groups (6 per group ).After attaining baseline Knoop microhardness values enamel specimens were subjected to bleaching treatment .Group 1 – control(with no bleaching ) ,Group 2 – Bleaching with 40 % hydrogen peroxide gel, Group 3 – Bleaching with 40 % hydrogen peroxide gel incorporated with Nano calcium chloride, Group/ 4 - Bleaching with 40 % hydrogen peroxide gel incorporated with Nano sodium fluoride, Group 5 - Bleaching with 40 % hydrogen peroxide gel incorporated with Nano hydroxyapatite .Post treatment knoop microhardness values are evaluated and difference between baseline and post treatment microhardness values were obtained. Statistical analysis: Statistical analysis was performed using one‑way analysis of variance and post hoc Tukey’s test. Results: By the obtained values results have been showed that Significant differences were observed between bleaching groups of with and without incorporation of remineralizing agents . The enamel microhardness change in Groups 1, 3, 4, and 5 were significantly lower than that of Group 2 (p < 0.001) Conclusion: : Within the limitations of this study, it can be concluded that incorporation of each one of the three tested biomaterials as remineralizing agents might be effective in decreasing enamel microhardness changes subsequent to in-office bleaching
A CASE STUDY ON AYURVEDIC MANAGEMENT OF KAMALA W.S.R. TO JAUNDICE
Jaundice is a clinical manifestation of disorders of underlying bilirubin metabolism, hepatocellular dysfunction, or biliary obstruction. Jaundice occurs in settings of cholestasis or inability to effectively secrete bile as well as disorders of bilirubin metabolism and hepatocellular dysfunction. Clinical signs of jaundice occur when the serum bilirubin level exceeds 2.5 to 3 mg/dL. This paper discusses a patient seen in the OPD of Prasuti Tantra department at SBLD Ayurveda Vishwa Bharti College and hospital Sardarshahar Churu. Her chief complaints Yellowish discoloration of skin, icterus, Yellowish discoloration of urine, Anorexia, since 10 days. The patient was suffering with hereditary spherocytosis and was on folic acid 5 mg. This patient was effectively treated by the combination of Kutaki churna, Triphala, Trivrita churna, Bhunimba churna, Arogya vardhini vati,Phalatrikadi kashaya, Pitta pramathi hima. All the symptoms showed highly significant results. Hence it can be concluded that these medicines are very effective in patients of jaundice.
A COMPREHENSIVE REVIEW ON LOW LEVEL LASER THERAPY (LLLT) BIOSTIMULATION & INTRABONY DEFECTS IN PERIODONTAL REGENERATION
Intrabony defect regeneration is achieved by various regenerative techniques one of which is Low Level Laser Therapy (LLLT) biostimulation along with open flap debridement (OFD). Conversely, LLLT through its biostimulatory effects it promotes faster wound healing through fibroblast proliferation and release of various growth factors and improves vascularity. It also induces advanced new bone formation and matrix production from osteoblastic cells. Additionally, it causes less post-operative pain, hematoma and good patient compliance compared to conventional therapy.
ROLE OF USG IN PATIENTS WITH ACUTE ABDOMEN IN A TERTIARY CARE CENTRE IN WEST BENGAL
Introduction: Acute abdomen is the common cause of emergency admissions. USG plays an important role in the diagnosis of disease. Methods: In this study 230 patients was taken with complaints of severe abdominal pain except those with a history of trauma or with a history of chronic abdominal pain. Clinical history, physical examination, ultrasonography, other imaging methods and histo-pathological examination were used to come to a final conclusion. Result: In this study ultrasonography was diagnostic in 94.7% of patients. 1.7% patients were misdiagnosed and in 3.47%patients other investigations were required for the confirmation of diagnosis. The sensitivity of ultrasound in diagnosing renal calculus,calculus cholecystitis, liver abscess, mesenteric lymphadenitis, and ovarian cyst was 100% and in acute appendicitis and acute pancreatitis it was 96.6% and 82.4% respectively. Conclusion: Ultrasonography is superior in organ system imaging. It helps in showing organ specific lesions which is helpful in follow up and response to treatment. Ultrasonography is also helpful in diagnosing alternative disease and to reduce negative surgical rate.
COMPUTED TOMOGRAPHY PULMONARY ANGIOGRAPHY (CTPA) USING OPTIMIZED SCAN PROTOCOL – A REVIEW
Pulmonary embolism (PE) is the third most common cause of death in cardiovascular related mortality. CT pulmonary angiography is the diagnostic imaging of choice in PE. However the recent advancement in MDCT has resulted in use of reduced contrast medium (CM) volume when compared to its standard volume. The aim was to undertake a review about the image quality in CTPA using altered scan protocol, especially by using low volume contrast medium. A literature search was conducted using PubMed and Google Scholar up to January 2020 with the following key words “CT pulmonary angiography using low volume contrast medium”, “CTPA with altered scan protocol”, “CTPA using low kVp and low volume of contrast medium”. A total of 17 studies met the inclusion criteria and were included in the analysis. Based on the results of study, it can be concluded that due to the recent advancement in MDCT, use of low or reduced volume of contrast medium and with a few required adequate modifications in the scan protocol it was possible to achieve the required diagnostic standard enhancement in the pulmonary arteries and thus were able to get an adequate diagnostic image quality in CTPA.
THE EFFICACY OF NEW SCORING SYSTEM TO PREDICT BURST ABDOMEN.
INTRODUCTION: The frequency of burst abdomen in the international data ranged from 0.4% to 3.5%.1-3 and in India it is about 4.8-6.6% 4-5 . Wound dehiscence is the partial or complete disruption of an abdominal wound closure with or without the protrusion or evisceration of abdominal contents. Dehiscence of the wound occurs before the cutaneous healing. It is associated with the mortality of-19-45%6. Because of its high mortality, it is essential to use preventive steps in the peri-operative period. The major risk factors for burst abdomen are-Malnutrition, obesity, anemia, infection, cough, distention of abdomen, malignancy, diabetes mellitus and immunocompromised state. Frequency of burst abdomen is higher following emergency laparotomies (14.89%) than elective laparotomy (2.7%). Prophylactic reinforced tension suturing prevents burst abdomen. MATERIALS AND METHODS: The study conducted includes 144 patients who underwent laparotomy under emergency and elective basis. Pre-operative and post-operative examination was done and scoring was done for 13 indices. Patients were followed up for 11 days post-operatively and daily examination of the operated site was done. RESULT- In the study of 144 patients 122 were operated on emergency basis and 22 on elective basis. Out of total cases 84 patients had score of more than 10(high risk) and 60 patients with low risk. Out of the high risk cases 18 had burst abdomen.
EFFECTIVENESS OF HERBAL MOUTHRINSE IN MAINTAINING SALIVARY AND PLAQUE p H ; A RANDOMIZED CONTROLLED TRIAL
Introduction: Antibiotics and antimicrobial agents provide an invaluable tool for a control of infection in modern dentistry and present in oral care products have been shown to be effective in inhibiting the growth of oral bacteria and the bio film.Hence this study was conducted to evaluate salivary and plaque p H of commercially available herbal rinses and compare with bench mark chlorhexidine at different intervals .
A PERTINENT APPROACH OF DENTAL PLAQUE DETECTION, FLUORESCENCE PLAQUE DETECTING SYSTEM Vs DISCLOSING AGENT – A COMPARATIVE QUESTIONNAIRE STUDY
OBJECTIVE: The purpose of this study is to find out whether the newly arising plaque detecting techniques are better over the traditional technique i.e disclosing agents and check their efficacy METHOD: A Comparative Study has been conducted with using the new flouroscent plaque detecting device and the traditional old method using disclosing agent. A sample size of 520 under graduate students were taken and plaque has been examined using Q scan plus and disclosing agent. Then a questionnaire has been prepared based on the ideal properties of plaque detection and asked the subjects to fill after the examination. RESULTS: The clinical assessment and statistical analysis using chi-square test , by using fluorescent plaque detection technique showed higher grades in every positive aspect that a disclosing agent should primarily have compared to old traditional technique using disclosing solution. CONCLUSION: It can be concluded that fluorescent plaque detection technique is superior to disclosing solution in every aspect and its very easy to use, without any residual stains, faster and also known to have higher specificity according to this study based on the responses. There is no question of allergic reactions using this technique.
ASSOCIATION OF SERUM URIC ACID LEVEL AND ESTIMATED GLOMERULAR FILTRATION RATE IN CHRONIC KIDNEY DISEASE PATIENTS
Background: Chronic kidney disease (CKD) is defined as irreversible loss of kidney function or estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73m2 for a period of 3 months or more. Uric acid (UA) is an end product of purine metabolism which is widely recognized as an independent risk factor of cardiovascular disease. Aims: This case control study was plan to assessed the correlation of serum Uric Acid with estimated Glomerular Filtration Rate (eGFR) in CKD patients. Methodology: In the study 50 diagnosed patients of CKD (stage 4 and 5), age between 20 to 60 years were enrolled. 50 age and sex matched healthy subjects constituted the control group. Serum Urea, Creatinine and uric acid were estimated for all the enrolled subjects. eGFR was calculated by Cockeroft and Gault formula. Results were compared between CKD patients and control group by applying suitable statistical test. Result: Mean eGFR was significantly lower in CKD group (10.28± 4.18 ml/min/1.73m2, p <0.0001) as compared to healthy subjects. Mean serum uric acid were significantly higher in CKD patients (8.02 ± 1.84 mg/dl, p <0.0001) as compared to healthy subjects. A significant negative correlation was observed between Serum uric acid and eGFR on applying Spearmanns’s correlation (r = -0.463, p <0.0001). Conclusion: High level of serum uric acid was found to be associated with significant fall in eGFR. Finding of the study suggest a strong association of hyperuricemia with progression of CKD. Therefore, uric acid can be considered as an independent risk factor for development of end stage renal disease (ESRD).
CLINICO - EPIDEMIOLOGICAL STUDY IN PATIENTS WITH NEUROCYSTICERCOSIS AT TERTIARY CARE HOSPITAL IN VIZIANAGARAM, ANDHRA PRADESH.
INTRODUCTION: Neurocysticercosis is the most common parasitic disease of Nervous system, with a prevalence of 50 million people worldwide, 50,000 deaths worldwide annually. Clinical manifestations of Neurocysticercosis are varied due to individual differences in the number, size, and topography of lesions and in the severity of the host‘s immune response to the parasites It is the major cause of young and adult onset epilepsy in tropical countries. OBJECTIVES :To study the Demographic Profile and Clinical profile of Neurocysticercosis. MATERIALS AND METHOD: This is a Prospective Type of study in tertiary Centre for a duration of one yr from June 2017 to May 2018 To study the Demographic Profile, Clinical profile of Neurocysticercosis. Based on revised criteria for the diagnosis of Neurocystecercosis, cases were separated into Definitive Cases, and Probable Cases of Neurocystecercos .Diagnostic criteria of neurocysticercosis was done based on Histological confirmation of parasite from biopsy of brain or spinal cord lesion .Cystic lesion showing the scolex on CT or MRI. Direct visualization of subretinal parasites on fundoscopy. Positive serum immunoelectrotransfer blot(EITB) for the detection of anticysticercal antibodies. Resolution of intracranial cystic lesions after therapy with albendazole. Spontaneous resolution of small single enhancing lesion. Clinical manifestations suggestive of NCC. Positive CSF enzyme linked immunosorbent assay (ELISA) RESULTS: In the present study, Maximum number of patients encountered are in the age group of 21 to 30 yrs (31.11%), followed by 41-50 yrs(20.00%), and the mean age of cases was 32.8yrs. Of which 62% are male and 38% are female. 93%of cases have clinical presentation of seizures. STUDY ON DEMOGRAPHIC AND CLINICAL PROFILE ONEUROCYSTICERCOSIS The Most common site Of lesion on Ct is in parietal lobe 58%, 31% frontal lobe, 24% multiple lobes. Pattern of seizures is simple partial in 51% cases,29% gtcs 11%complex partial . No of lesion seen On imaging are single in 60% cases, multiple lesions in 40% cases. All the 45 patients are Non-vegetarians, and only 8 patients(17.77%) were pork eaters. CONCLUSIONS: Neurocysticercosis is the most common parasitic infection of the brain. Most common clinical manifestation is Seizures Commonly presenting as Ring Enhancing lesion. All cases of young and adult onset Epilepsy in Tropical countries should be evaluated for Neurocysticercosis.
EVALUATION OF IN VITRO ANTI-ARTHRITIC ACTIVITY OF BOSWELLIA SERRATA AND ALOE BARBADENSIS AGAINST THE DENATURATION OF PROTEIN
Anti-denaturation effects of plant extracts in heat treated Egg Albumin and Bovine Serum Albumin (BSA), are potential therapeutic parameters for finding anti-inflammatory compounds without the use of animal for preliminary pharmacological screening. Boswellia Serrata [BS] and Aloe Barbadensis [AB] can bring natural compounds with significant anti-arthritic effects. So our aim was to investigate in vitro anti-arthrtic activity of aqueous extract of BS and AB and their combinations by using denaturation of protein methods. The extract at different concentrations was incubated with egg albumin and bovine serum albumin in controlled experimental conditions and subjected to determination of absorbance to assess the anti-inflammatory property. Methotrexate was used as the reference standard drug. The present finding exhibited a concentration dependent inhibition of protein (albumin) denaturation by B. Serrata and A. Barbadensis extracts. The effect of Methotrexate was found to be less than extracts. In conclusion it can be concluded that B. Serrata and A. Barbadensis extracts possessed in vitro anti-arthritic effect against the denaturation of protein and B. Serrata was stronger than A. Barbadensis. Also combination of B. Serrata and A. Barbadensis extracts had potent synergistic effect on inhibition of protein (albumin) denaturation.
BURDEN OF OCULAR MANIFESTATIONS IN PATIENTS OF RHEUMATOID ARTHRITIS IN TERTIARY CARE CENTRE OF KUMAON REGION , UTTARAKHAND.
Rheumatoid arthritis is a chronic systemic inflammatory disease marked by a symmetric, peripheral polyarthritis. It is associated with various extra-articular organ manifestations including subcutaneous nodules, pericarditis, major cutaneous vasculitis, ocular manifestations, hematological abnormalities etc. The well documented ocular manifestations of RA include kerato-conjunctivitis sicca , anterior uveitis, episcleritis, scleritis, scleromalacia perforans, peripheral ulcerative keratitis, corneal filamentary keratitis, retinal vasculitis. The Aim of our study was to identify the rheumatoid arthritis patients with ocular involvement presenting at tertiary care centre of Kumaon region of Uttarakhand. We examined 97 patients with diagnosis of RA. The ocular examintaion included; best corrected visual acuity, slit lamp examination, Schirmer’s test, tear break-up time,indirect ophthalmoscopy and fundus photography in patients with retinal involvement. In this study, the most common manifestation associated with RA was keratoconjunctivitis sicca followed by filamentary keratitis(7.86%) and uveitis (7.86%), scleritis (5%), episcleritis(3%). The least common was panophthalmitis (0.1%). Ocular manifestation among RA patients was found to be very common, i.e. 91.75% (89 cases, out which 62 were females).
ASSESSMENT OF OCULAR SURFACE DISEASE IN PATIENTS WITH PSEUDOEXFOLIATION SYNDROME
Purpose: Pseudoexfoliation is thought to affect tear secretion and tear film stability by altering cell morphology in conjunctiva. Aim of this study is to assess abnormalities in tear film in patients with pseudoexfoliation material on iris and lens. Material & Methodology: This is a prospective study conducted from September, 2017 for 6 months on patients attending Ophthalmology OPD of CAIMS, Karimnagar. Subjects of study are divided into 2 groups. Group I consists of 50 normal subjects without any PXF material, serving as controls. Group II consists of 50 patients with PXF, atleast in one eye. Patients with known previous ocular surgeries, PXF glaucoma, adnexal abnormalities, other OSDs, those using any topical medications are excluded. Tear film stability is assessed using Schirmer’s II test, TBUT test. Results: Average Schirmer’s and TBUT in Group I (with no PXF) were 17.4+/-3mm and 12.75+/-0.5s respectively, whereas in Group II (with PXF), they were 10.13+/-0.8mm and 6.9+/-0.7s respectively. The differences are clinically and statistically significant. Conclusion: Tear film stability is disturbed in Pseudoexfoliation
EFFECT OF SITE AND SIZE OF PERFORATION OF TYMPANIC MEMBRANE ON HEARING LEVEL
Chronic suppurative otitis media occurs as a result of persistent and recurrent middle ear cleft infection. The most common characteristics being perforation and otorrhea. Commonly perforations are a sequel to chronic middle ear infections, grommet extrusion or trauma. Causes and pathogenesis of CSOM are acute otitis media, viral or bacterial infection, familial disposition and immunological factors.
MANAGING A COUNTER-WING ROTATED MAXILLARY CENTRAL INCISOR IN MIXED DENTITION: A CASE REPORT.
Supernumerary teeth are characterized by presence of extra number of teeth in relation to the normal dentition. Its presence invariably has it effect of the erupting teeth in mixed dentition. Early diagnosis and treatment can reduce its effect as compared to established dentition. Although a plethora of treatment strategies are available in literature for treatment of supernumerary teeth orthodontically. Using simple and effective treatment options does not complicate the process particularly in tiny oral cavities. This case report discuses the management of supernumerary teeth in maxillary arch in a mixed dentition scenario.
A STUDY ON INCIDENCE OF ACUTE INTRAOCULAR PRESSURE ELEVATION IN DIABETIC PATIENTS TREATED WITH LASER PHOTOCOAGULATION IN TERTIARY CARE HOSPITAL.
AIM: This study was undertaken to determine the acute changes in IOP following laser photocoagulation used in the treatment of diabetic retinopathy. METHODS AND METHODOLOGY: This study was conducted at the Department of Ophthalmology, Chalmeda Ananda Rao Institute Of Medical Sciences from July 2017 to June 2018 . This study was intended to see the onset and duration of intraocular pressure spikes in diabetic retinopathy patients after green laser photocoagulation. RESULTS: Out of 45 patients, 6 patients had severe non proliferative diabetic retinopathy with maculopathy, 39 having proliferative DR. Out of 6 NPDR patients, 3 (50%) developed immediate post laser angle closure (Schaffer's grade 1) which persisted for 3 days and other 3 had shown no change in angle structure. Out of 39 PDR patients, 12(30.7%) had post laser angle closure.These results are clinically and statistically significant.Overall 33.33% of patients showed raised intraocular pressure following PRP. CONCLUSION:The present study clearly shows that after extensive laser photocoagulation in diabetic retinopathy patients, elevation in IOP may appear immediately or 1-2 hours or 1-2 days later and this last for 2-3 days
SPLEEN STIFFNESS IN CHRONIC LIVER DISEASE USING ACOUSTIC RADIATION FORCE IMPULSE IMAGING – A REVIEW
Cirrhosis is the common endpoint of chronic liver disease affecting more than one third of the population all over the world causing significant morbidity and mortality. Complications of cirrhosis include portal hypertension, esophageal varices, variceal bleeding, ascites. Till date screening upper GI endoscopy is used as a prophylactic measure in all cirrhotic patients which also helps in choosing the treatment option that the patient should undergo. However in view of its inherent invasive complications sonoelastography has come in to picture for measuring spleen stiffness which would act as a radiological parameter for early detection of complications associated with chronic liver disease. The aim was to undertake a review about the significance of spleen stiffness measurement as a radiological predictor in chronic liver disease patients. A literature search was conducted using Pub Med and Google Scholar up to January 2020 with the following key words “spleen stiffness”, “ARFI”, “ARFI in spleen stiffness” and “ARFI in cirrhotic liver disease”. A total of 14 studies met the inclusion criteria and were included in the analysis. Based on the results of the study, it can be concluded that spleen stiffness using acoustic radiation force impulse imaging can act as a early radiological predictor for detection of complications associated with chronic liver disease patients.
COMPARISON OF POSTURAL BALANCE BETWEEN THE OLDER ADULTS WITH NORMAL (EUTHYROID) VERSUS HYPOTHYROID STATUS- A PROSPECTIVE COHORT STUDY
Background: The risk of impaired postural balance and falls with potentially life threatening injuries (e.g. brain injury, hip fractures) is high in the older adults. Hypothyroidism is associated with impaired neuromuscular function. Objective: To assess the effects of hypothyroidism on postural balance in the older adults. Methods: Older adults (≥65 years) participants with either normal (Euthyroid) or hypothyroid status were enrolled in a prospective observational study. The BRIEF BESTest (BBT) was used for assessing balance. The primary outcome was the total BBT scores between the two groups of participants. Results: 66 participants (33 per group) were recruited over 12 months. The mean (±SD) age, weight and height of hypothyroid vs euthyroid group participants was 76.39 (±6.48) vs 76.18 (±7.94) years, 67.33 (±6.49) vs 64.15 (±5.14) kg and 170.53 (±10.00) vs 166.83 (±13.86) cm respectively. The mean (±SD) total BBT scores were significantly lower [10.818(±2.66) vs 12.515 (±3.52), p=0.039] in the hypothyroid vs euthyroid group participants respectively. Of the individual BBT components, anticipatory postural adjustment (left side), reactive postural response (both sides), and sensory orientation scores were significantly less in hypothyroid participants. Conclusion: Hypothyroidism was associated with adverse effect on balance in the older adults.
EFFICACY OF RANIBIZUMAB IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY ASSOCIATED WITH RETINAL PIGMENT EPITHELIAL DETACHMENT: A RETROSPECTIVE STUDY.
AIM: To evaluate the efficacy of intravitreal ranibizumab in chronic central serous chorioretinopathy associated with retinal pigment epithelial detachment. METHODS: In this retrospective study a total of 21 patients diagnosed with chronic central serous chorioretinopathy with pigment epithelial detachment were treated with intravitreal ranibizumab from Jan 2017 to Nov 2019 at Malda medical college, West Bengal, India. From the history sheet we were noted each patient's best spectacle corrected visual acuity. Measurement of central macular thickness and subfoveal choroidal thickness were recorded from OCT report. After getting informed consent all patient received intravitreal ranibizumab injection at monthly interval until central macular thickness reduced to normal. Patient were followed up monthly interval for at least 6 months by measuring best corrected visual acuity and central macular thickness as well as subfoveal choroidal thickness. We were taken these data specially of 3 and 6 months for analysis. This data was analyzed statically by pair T test to determine the effectiveness of intravitreal ranibizumab in this condition. RESULTS: all patients showed statically significant improvement within 3 months in terms of best corrected visual acuity, central macular thickness as well as choroidal thickness (p=<0.001) and these were well maintained at 6 months. CONCLUSION: Intravitreal ranibizumab is a good therapeutic option in patients of chronic central retinopathy when it also associated with retinal pigment epithelial detachment.
A COMPARATIVE STUDY OF EFFECTS OF INTRATHECAL 4.0 CC OF 0.75% ISOBARIC ROPIVACAINE AND 3.5 CC OF 0.50% ISOBARIC ROPIVACAINE WITH 30 MCG CLONIDINE PLUS 0.3 CC OF STERILE NORMAL SALINE IN BENIGN PROSTATE HYPERPLASIA PATIENTS UNDERGOING TRANS URETHERAL RESECTION OF PROSTATE
Introduction: Spinal anaesthesia is a popular and common technique used worldwide. A newly introduced long acting amide linked local anaesthetic called `ROPIVACAINE, produces less motor blockade and is of shorter duration than bupivacaine. Intrathecal clonidine is being extensively evaluated as an alternative to neuraxial opoids for control of pain and has proven to be a potent analgesic. A very important advantage of ropivacaine over bupivacaine is less cardiovascular toxicity. Aims and objectives: present study was planned to investigate the effects, ( onset of action, duration of action, quality of sensory and motor block, haemodyamic stability and post-operative analgesia ) of intrathecal 4.0 cc of 0.75% isobaric ropivacaine and 3.5 cc of 0.50% isobaric ropivacaine with 30 mcg clonidine plus 0.3 cc of sterile normal saline in benign prostate hyperplasia patients undergoing trans uretheral resection of prostate. Materials and methods: this Prospective, randomized, double blind, comparative study was conducted at the Department of anaesthesiology and Critical Care, Government Medical College and Associated Group of Hospitals, Kota in patients posted for elective trans urethral resection of prostate with benign prostate hyperplasia. We made two groups of cases i.e. Group R (ROPIVACAINE) and Group RC (ROPIVACAINE WITH CLONIDINE). sample size was 80, which was divided into two groups of 40 each. Standard protocol followed to administering spinal anaesthesia. All data were collected and analysed with the help of suitable statistical parameters. Results: Our study results in that combination of clonidine (30 mcg) as an adjuvant with 0.50% isobaric ropivacaine (17.5 mg) in subarachanoid blockade for trans urethral resection of prostate results in prolonged duration of sensory blockade and extended postoperative analgesia compared to plain 0.75% isobaric ropivacaine (30 mg).
A COMPARATIVE STUDY – CLINICORADIOGRAPHICAL PROFILE OF PULMONARY TUBERCULOSIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS & NON DIABETIC PATIENTS
Tuberculosis is a communicable disease that is a major cause of ill health, and one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent (ranking above HIV/AIDS). CBNAAT marks an important development in the field of rapid molecular tuberculosis diagnosis. Diabetes triples the risk of developing tuberculosis, and poor glycemic control adversely affects tuberculosis treatment outcomes with effects such as prolongation of culture conversion, treatment failure, relapse, and death.
In present time, Carbapenem resistance is an emerging problem throughout the World and is an important threat to public health as well as treatment challenge to clinicians.
INCIDENCE OF DEVELOPMENT OF HYPOTHYROIDISM FOLLOWING HEMITHYROIDECTOMY
Objective: To investigate the incidence, time to onset, and risk factors for the development of hypothyroidism after hemithyroidectomy. Background: The incidence and risk factors for hypothyroidism in patients undergoing partial thyroid surgery remains unclear. Hypothyroidism is an under-appreciated sequel of hemithyroidectomy. The early recognition of this postoperative complication m ay prevent symptom s of hypothyroidism and recurrent thyroid disease. Methods: We conducted a prospective observational study of patients undergoing hemithyroidectomy from July 2010 to July 2011 at department of General Surgery, CSM Medical University, Lucknow. Patients were analyzed for age, sex, family history of thyroid disease, pre and postoperative thyroid stimulating hormone (TSH), histological diagnosis, size of residual thyroid gland, histological evidence of thyroiditis, and time period to develop hypothyroidism. Results: Hypothyroidism was diagnosed in 22.7% of 26 patients. The mean time to diagnosis was within 4.5 months. Patients with postoperative hypothyroidism had a higher incidence of a high-norm al preoperative TSH level. Age, gender, family history of thyroid disease, thyroid pathology, and weight of resected tissue were not significant risk factors for hypothyroidism. Conclusions: An incidence of 22.7% is higher than anticipated and all patients should have postoperative thyroid function assessment. However, a high-norm al preoperative TSH levels is indications for close monitoring.
A STUDY TO ASSESS KNOWLEDGE AND EXPRESSED PRACTICES REGARDING CONSUMPTION OF JUNK FOOD AMONG SCHOOL GOING CHILDREN
Background: Present children are the investments of community in the future. Accurate nutrition in child’s life will be the most important factor in preparing health, growth and development of children in their future. Growth rate is high in primary years of life and lack of necessary knowledge about nutrition is influencing factors for malnutrition incidence in children. Now days, changing dietary patterns in recent decades, nutritious snacks are substituted by junk food. Many children like to eat junk food but they do not know about harmful effects of junk food on their health. Objective: To assess the knowledge and expressed practices regarding consumption of junk food among school going children. Methods: A non-experimental descriptive study was conducted on 200 school going children, selected by convenient sampling technique Structured Knowledge Questionnaire and Structured Practice Checklist were used to collect the data. Result: study shows that more than half of the school going children were (55%) having good very good knowledge and (5%) were having below average knowledge. Only (30.5%) children were following healthy practices. The mean of knowledge score is higher (22.62%) than mean score of expressed practices (18.64). Conclusion: In the nutshell, present study reveals that the half of the school going children had very good knowledge even one third of them having unhealthy expressed practices regarding consumptions of junk food.
COMPARATIVE STUDY OF CANAL TRANSPORTATION, CENTERING ABILITY AND VOLUMETRIC CHANGES OF DIFFERENT NICKEL-TITANIUM ROTARY SYSTEM USING CONE BEAM COMPUTED TOMOGRAPHY-AN IN VITRO STUDY
Aim: To evaluateand compare the effect of different Nickel-Titanium system-Twisted File Adaptive (TFA), WaveOne and ProTaper Next (PTN) on canal transportation, centering ability and volumetric changes of mesiobuccalroot canal of mandibular molars via cone beam computed tomography (CBCT) imaging. Method: Mesiobuccal root canals of 30 mandibular molars with angle of curvature ranging from 10-20˚ were divided randomly into three groups of 10 each. Canals were prepared to a tip size 25 using TFA, WaveOne and PTN. Pre and post instrumentation scans were performed to compare canal transportation and centering ability at level of2mm, 5mm and 8mm from CEJusing 3D CBCT images. Volumetric changes were estimated by comparing the difference in volume of root canals recorded before and after instrumentation of canal. One way ANOVA was used to compare canal transportation, centering ratio and volumetric changes between groups. All statistical procedures were performed with significance level set at 5%. Results:The result demonstrated that Gp I (TFA) and Gp II (WO) showed statistically significant difference in canal transportation at all three levels. Gp I and Gp II showed significant difference at coronal level only. All file systems based on different kinematics remained well centered in canal at all levels. There was no significant difference in volumetric changes among three Ni-Ti file systems. Conclusion:PTN and TFN had similar results regarding canal transportation. WaveOne caused more canal transportation. All file system remain well centered. No significant difference in volumetric changes in root canals instrumented using three different Ni-Ti file systems.
CURRENT STATUS OF ULTRASONOGRAPHY IN THE EVALUATION OF THE RETROPERITONEAL MASSES : A REVIEW
Masses arising from the retroperitoneum are broadly classified into Primary retroperitoneal masses and masses arising from the retroperitoneal organs. Patients usually present with non – specific signs and symptoms and physical examination is also inconclusive in many cases. Ultrasonography (USG), Computed tomography (MDCT) and Magnetic resonance imaging (MRI) are the common imaging modalities available to evaluate any mass in the abdomen. In this review we evaluate the usefulness of ultrasonography to characterize the retroperitoneal masses because the imaging study has to be appropriate according to the diagnostic need and socioeconomic situation especially in the rural India setup.
MODIFIABLE RISK FACTORS IN STROKE: A CASE-CONTROL STUDY
Introduction: Reducing the burden of stroke in the population requires identification of modifiable risk factors. The present study was conducted to assess the prevalence of various risk factors for stroke in the patients admitted to our hospital. Methodology: Consecutive indoor patient admitted for stroke in ward or Intensive Care Unit (ICU) were included and were compared with controls, which where selected from the patients admitted in ward who had no history of stroke. Results: During the study period, we included 92 cases of stroke and 92 controls. We found a significantly higher proportion of obese in the stroke group as compared to the control group (28% vs 3%). A significantly higher proportion of stroke cases had a sedentary lifestyle as compared to controls (78% vs 39%, p value < 0.05). On obtaining detailed dietary intake history, a significantly lower proportion of stroke cases had fruits and vegetable consumption at least 400 gm/day, a significantly higher proportion of stroke cases had oil/ghee consumption more than 40 gm/day and salt more than 5 gm/day. Personal history revealed a significantly higher proportion of smoking, consuming smokeless tobacco and alcohol among stroke cases as compared to controls. Diabetes mellitus and hypertension cases were also significantly more commonly observed among stroke cases as compared to controls. Conclusions: Identifying the risk factors and controlling them early is the only plausible way of reducing the burden of stroke in India.
A NOVEL DIAGNOSTIC APPROACH IN RESTORATIVE DENTISTRY AND ENDODONTICS – AN UPDATE.
Despite all the dental information acquired over centuries and the importance of proteome research, cross-link between these two areas only emerged around mid-nineties. Proteomic tools help dentistry in the identification of risk factors, early diagnosis, prevention, and systemic control that promotes the evolution of treatment in all dental specialties. It is a remarkable tool that can revolutionize the treatment of oral disease in all the context’s leading to changes in treatment philosophy. A literature review is done using electronic databases, such as “PubMed,” “Google Scholar,” and “Scopus,” using keywords “Proteomics,” and “Mass Spectrometry”. Furthermore, an advanced or refined search was carried out using the keywords “Proteins,” “Enamel,” “Dentin,” “Cementum,” “Periodontal ligament” and “pulp”. The idea is to make dentistry a more individualized area, with the need for minimal interventions. Proteomics tools bring a drastic change in diagnosis, treatment, and prevention of dental diseases.
MYCOLOGICAL STUDY OF VARIOUS PULMONARY INFECTIONS IN DIABETIC PATIENTS.
Aim: To isolate and identify the fungal isolates from various clinically diagnosed cases of pulmonary infections with history of diabetes mellitus. Material and Methods: Sputum samples from various clinically diagnosed cases of pulmonary infections with history of diabetes mellitus were studied for fungal isolates. Samples were tested in the laboratory for fungus by potassium hydroxide preparation (KOH preparation) and fungal culture. Results: Out of the total of 100 sputum samples , sixty two samples (62%) were positive for fungus. Out of these positive samples, Aspergillus species (50%) was found to be the commonest isolate followed by Candida species (38.7%), Rhizopus species (9.7%) and Mucor species (1.6%). Conclusion: Following Aspergillus species and Candida species, the third leading fungal isolate in various pulmonary infections is Rhizopus species, especially in diabetic patients. Mycological examination aids in the diagnosis of various pulmonary infections for their effective management.
COMPARATIVE STUDY OF OUTCOMES OF CORING, DUAL SETON AND LIGATION OF INTERSPHINCTERIC FISTULA TRACT (LIFT) PROCEDURE IN MANAGEMENT OF HIGH FISTULA-IN-ANO
INTRODUCTION: A fistula-in-ano is an abnormal tract or cavity establishing a communication between rectum or anal canal and the perianal area. Surgery is the treatment of choice with the goals of draining infection, eradicating the fistulous tract and avoiding persistent or recurrent disease while preserving anal sphincter function. Various surgical options available include fistulotomy / fistulectomy with seton wire placement, advanced flaps, fistula plugs, fibrin glue and more recently newer techniques such as Ligation of the intersphincteric fistula tract (LIFT), Video-assisted anal fistula treatment (VAAFT) and FILAC technique (Fistula–Tract Laser Closure).The present study was conducted to assess and compare the outcome of LIFT procedure, Dual Seton placement and Coring out in complex fistula-in-ano. MATERIALS AND METHOD: In our study, we have evaluated the record of the 50 cases operated for high and complex fistula between June 2017 to June 2019 .Out of 50cases, 5 cases has undergone for coring out of fistula tract with closure of internal opening,20 cases were operated for LIFT procedure, and 25 cases were treated by DUAL seton. All cases were done under spinal anesthesia. All cases were done in the Lithotomy position. Basic stapes in all the 3 above procedures included diluted hydrogen peroxide and Methylene Blue dye injection through the external opening to determine the patency of the tract. H2O2 was mixed along with Methylene Blue before injection to increase the chance of identifying internal opening.In present study we compare the various aspects in the treatment of complex fistula in ano using various modalities such as coring, DUAL Setons and lift procedure. RESULTS: In our study healing rate in LIFT procedure is 90% and incontinence rate is 0%, anal stricture rate is 0%.and Recurrence is 10% and for seton placement the recurrence rate is nil compared to 60% recurrence in coring. CONCLUSIONS: In our study of patients having complex fistula-in-ano, out of the three procedures Dual seton have least recurrence rates(0%) at the cost of prolonged morbidity, LIFT procedure has low recurrence rate(10%) much better than the Coring which has a very high recurrence rate (60%) with similar morbidity.
A CASE OF MULTIPLE INTRACRANIAL MENINGIOMAS
Meningiomas are the most common primary brain tumors in adults. Multiple meningiomas (MMs) or meningiomatosis are defined by the presence of at least two lesions that appear simultaneously or not, at different intracranial locations, without the association of neurofibromatosis. They present 1–9 % of meningiomas with a female predominance. The occurrence of multiple meningiomas is not clear. There are two main hypotheses for their development, one that supports the independent evolution of these tumors and the other, completely opposite, that suggests the propagation of tumor cells of a unique clone transformation, through cerebrospinal fluid. We present a case of a 60-year-old male patient who presented to the emergency department with weakness of right upper and lower limb. The patient was diagnosed with multiple meningiomas based on the magnetic resonance imaging of the brain. Multiple meningiomas is extremely rare in males.
SERO-PREVALENCE OF DENGUE AND CHIKUNGUNYA COINFECTION WITH SEASONAL VARIATIONS IN TERTIARY CARE HOSPITAL, AJMER, RAJASTHAN
Background-Dengue and chikungunya fever are vector borne arboviral diseases that have been circulating globally in the various tropical and sub tropical regions. India being an endemic country for dengue and chikungunya, every or alternative year. Circulation of both the viruses along with presence of common mosquito vector (Aedes aegypti and albopictus) Aims and objectives: To study seroprevalance of dengue and chikungunya co-infection ,early diagnosis and their seasonal trends .Materials and methods-This was a prospective laboratory based study conducted at JLN Medical College and associated group of Hospitals, Ajmer from March 2018 to October 2019 . Clinically suspected patients of dengue and/or chikungunya from all the outpatient and inpatient departments were enrolled as cases.Serum samples were tested for the IgM antibodies of dengue and chikungunya both by ELISA method.Results-Out of 965 samples ,156(16.16%) found only dengue antibodies,88(9.11%) only chikungunya antibodies and 83(8.6%) both antibodies . If the co-infection concluded than the total number of dengue and chikungunya positive were 239(24.76%) and 171(17.72%) respectively . Majority of the patients belonged to the age group of 21-30 years, followed by 31-40 years with preponderance of males over females. Maximum number of patients were reported in post monsoon.Conclusion-As the clinical features of dengue and chikungunya virus infections are mostly similar, so it is advisable to test for both viruses . Fever and headache were the universal symptoms observed in Dengue, Chikungunya and co-infection . Present study shows that occurrence of dengue, chikungunya and their co-infection were more in post-monsoon season, middle age group and in males than females,so vector control ,personal protective measures and early diagnosis is very important to reduce mortality rate .
ROLE OF MR SPECTROSCOPY IN BETTER CHARECTERISATION OF RING ENHANCING LESIONS OF BRAIN- A NARRATIVE REVIEW
MR Spectroscopy identifies various metabolites in the ring enhancing lesions of brain thus enabling it to be widely used and to predict the functional changes of the brain lesion. Prognostic implication are also provided by MRS. The purpose of this review is to observe the intracranial ring enhancing lesions and thus giving a differential diagnosis with advanced MRI techniques, like MR Spectroscopy. Out of all ring enhancing lesions, Tuberculoma is found to be most common and shows a lipid lactate peak in MR Spectroscopy. Hence, MRS is used for better characterisation and accurate diagnosis of the ring enhancing lesions of brain which resemble each other in conventional MRI.
STUDY OF POST CAESERIAN SECTION WOUND INFECTION AND MICROBIOLOGICAL EPIDEOMOLOGY IN TERTIARY CARE CENTRE, WESTERN RAJASTHAN.
To determine the incidence, risk factors and common bacterial pathogens in surgical site infection (SSI) following C-section in a tertiary care centre. A hospital based prospective study conducted for a period of 6 months. 62 women were studied whose C-section was complicated by SSI within 5 days postoperatively; Risk factors for SSI were identified and microbiological pattern was studied. During this study period post caesarian SSI incidence was 0.34%. In this study post C-section SSI found as high as 43.55%, in lower socio economic status; Among all patients, un-booked were 62.90%, Referred patients were as high as 67.74%. SSI developed in 69.35% patients without preoperative antibiotic prophylaxis. C-section done in PROM in 64.50% and as an elective emergency 79.03%, blood transfusion needed in 59.68% and type of incision being transverse(Pfannenstiel) in 88.71%. subcutaneous suture technique used in 75.81% and secondary healing occurred in 67.74%. Most common organism grown was CoNS(coagulase negative staphylococcus) 29.03% in SSI.
ROLE OF FNAC IN EVALUATION OF BREAST LUMP
BACKGROUND: In India breast carcinoma is increasingly becoming a common medical problem for women. Hence early detection is important in distinguishing non neoplastic and neoplastic breast lesions prior to definitive management. AIM: To analyze the cytomorphological spectrum of palpable breast lump by FNAC and subsequently compare results with published studies in literature. METHODS: This is a cross sectional study conducted in the department of pathology, Shimoga institute of medical sciences, Shimoga, Karnataka from 1st October 2018 to 30th September 2019. It includes 130 patients presenting with palpable breast lump and they were subjected to FNAC. RESULTS: Among 130 cases of breast lump, 105 benign lesions and 25 malignant lesions were studied. Fibroadenoma was the most common benign lesion and infiltrating ductal carcinoma was the malignant lesion. CONCLUSION: FNAC is simple and rapid method in diagnosing and distinguishing neoplastic and non neoplastic breast lesions.
ISOLATION OF RARE DEN 4 SEROTYPE FROM A TERTIARY CARE HOSPITAL IN NCR REGION
The objective of this research was to investigate serotype diversity pattern of dengue virus by using Real Time RT-PCR. A total of 246 clinically suspected cases of Dengue were selected based on WHO 2009 Dengue case classification. Acute phase blood samples were tested for NS1 antigen, IgM and IgG antibody and samples positive by one of the parameters: NS1 Ag and/or IgM Ab/IgG Ab were further subjected to Real time RT-PCR. Of the 246 clinically suspected cases of Dengue, 68 (27.6%) were positive for NS1 Ag and/or IgM Ab/IgG Ab and of these, 30 (44%) samples were positive by Real time RT-PCR. All the 4 Dengue serotypes were found to co-circulate in this region of which 3 cases (10%) were positive for the rare DEN- 4 serotype. Co-circulation of all four dengue serotypes in the studied region emphasises the need of molecular monitoring of circulating DENV serotypes.
ROLE OF MDCT ANGIOGRAPHY IN HAEMOPTYSIS PATIENTS - A REVIEW
Haemoptysis is expectoration of blood from the respiratory tract. In patients with mild haemoptysis it is self limiting.1 Haemoptysis is a life-threatening condition in patients with massive haemoptysis (5%), needs urgent investigations and treatment. Multi–detector computed tomography (MDCT) angiography is a very useful noninvasive imaging modality of haemoptysis. This article aims to provide a comprehensive review on MDCT along with thin-section axial scans and complex reformatted images allows in identifying the underlying cause of haemoptysis, site of bleeding, and vascular anatomy of the respiratory system to localise the bleeding vessel. Treatment options for massive haemoptysis through bronchial artery embolization are summarized. Based on the review of multiple studies, it can be concluded that MDCT Angiography has a major role in diagnosis and management of haemoptysis.
EXTENSIVE FOURNIER'S GANGRENE MANAGED AGGRESSIVELY WITHOUT ANY FLAP COVER - A CASE REPORT
Fournier’s gangrene(FG) is a rare disease and one among many surgical emergencies. FG is a rapid progressive infection leading to necrosis of the subcutaneous tissue. It requires aggressive management for a better outcome. Here we present a 40 year old male, non diabetic brought to casualty with extensive gangrene and in shock at presentation. He was managed aggresively and followed up by secondary closure of raw area without flap cover with a good outcome.
A STUDY ON ROLE OF SERUM BILIRUBIN AS A PREDICTOR IN DIAGNOSIS OF GANGRENOUS OR PERFORATED APPENDIX
Aim: To find the association of hyperbilirubinemia in perforated and gangrenous appendix Methods: In this prospective study, 50 patients with acute appendicitis were included. Patients were evaluated by detailed history, routine examination on initial contact with patients. Bilirubin and other blood parameters were evaluated. Results: In 50 patients, 30 were male and 20 were female patients. 23 patients (46%) were had Acute appendicitis and 27 patients (54%) had Perforated /gangrenous appendicitis. Bilirubin level in acute appendicitis was 1.0mg/dl and in perforated/gangrenous appendicitis was 1.4mg/dl. Conclusion: Hyperbilirubinemia was significantly higher in gangrenous and perforated appendicitis than those patients with acute appendicitis. Serum Bilirubin is an important adjunct in diagnosing the presence of gangrenous and perforated appendicitis.
A PROSPECTIVE STUDY OF APPENDICITIS AT KAPV GOVERNMENT MEDICAL COLLEGE,TRICHY
INTRODUCTION Acute appendicitis is a common gastrointestinal disease affecting 5.7/per 100000 individuals each year with the highest incidence in children and adolescents. The medical profession has gained much experience in managing patients with acute appendicitis ever since Fitz’s first report in 1886. Large heterogeneity exists, however, between existing intercontinental, European and national guidelines regarding diagnosing and managing acute appendicitis. The variation of incidence is due to variations in ethnicity, sex, age, obesity and season of the year. Based upon the entrenched idea that appendicitis is an irreversible progressive disease eventually leading to perforation, removal of the appendix is the gold standard of treatment. For instance, in the Netherlands, pre-operative imaging studies are promoted and considered mandatory in order to prevent negative appendectomies according to national guidelines, whereas in guidelines of other countries, it is not promoted nor considered mandatory. Another example is the inconsistency regarding the management of an unexpected “normal appendix” during diagnostic laparoscopy. Approximately one-third of patients with appendicitis will experience a perforation of their appendix before their appendectomy.We conducted the study in patients who come with right iliac fossa pain and the datas concluded with appendicitis in this study at KAPV government medical college trichy, to concern about to reduce the rate of normal appendicectomy. MATERIALS AND METHODS It was a prospective comparative study involving 100 adult patients undergoing surgery for appendicectomy at KAPV government medical college trichy. CONCLUSION: The surgical removal of normal appendix should be reduced based on clinical findings and laboratory results ,according to our statistics at kapv medical college.
A STUDY OF 100 CASES OF ARRHYTHMIAS IN FIRST WEEK OF ACUTE MYOCARDIAL INFARCTION
Aim: To study the incidence of arrhythmias in the first week of Acute Myocardial Infarction (AMI) with respect to type of arrhythmia, age distribution, sex and location of infarction, various risk factors in a patient population from western India and to evaluate its prognostic value and relation of complications with incidence of arrhythmias. Study Design: A prospective clinical study consisting of 100 patients was undertaken to investigate the relationship of arrhythmia with site of AMI, timing, complications and outcome in terms of mortality and morbidity. Materials and Methods: Hundred cases of AMI with arrhythmia admitted in ICCU of Seth Vadilal Sarabhai General Hospital, Ahmedabad were taken in the study. Results: Among 100 cases, maximum incidence (38%) was found in 6th decade. Incidence of arrhythmias was higher in males (76%) than females (24%). Anterior wall infarcts (57%) were more common than inferior wall (36%). Ventricular Premature Contraction (VPC) was the commonest arrhythmia is anterior wall MI (43.85%) and in inferior wall MI (19.4%). Conclusion: Hence, in one of the largest study of this kind in a patient population of Western India, we established VPC’s as the most common arrhythmia in AMI patients. Older patients (sixth decade) and males are affected more commonly. Ventricular tachycardia is more fatal in acute inferior wall MI.
THE INCIDENCE, CLINICO-PATHOLOGICAL FEATURES AND MANAGEMENT OF PRIMARY DISEASES OF SALIVARY GLANDS
Background: Primary diseases of salivary glands have highly heterogeneous clinical and pathological features accordingly their management. Globally a lot of studies have been done, but till now there is no uniformly globally accepted study. Objective: The objective were (1) to find out incidence of primary diseases of salivary glands (2) clinical and pathological presentation of disease (3)effectiveness of various modalities of treatment and there outcome. Materials and methods: this is a prospective study of primary diseases of salivary glands in sasoon general hospital, pune Maharashtra. Datas collected from general surgery, dental and ENT departments. Results: out of total 48 cases there were 19 tumors, 20 cystic lesions, 8 sialolithiasis and 1 sialadenitis. Thesis cases were analyzed according to the parameter of age, sex, location, clinical features, radiographic findings, histopathological appearance, and medical modalities used to treat and there outcome. These were compared with the studies conducted in the other parts of the world. Conclusion: in conclusion, the data and results obtained here were similar to previously published articles and literatures in other countries and other parts of India and world. However, some differences were observed, these differences may be due to racial factors, pathology centers of sample collection and duration and timing of studies.
EFFECTIVENESS OF CAPACITY BUILDING PROGRAM ON USE OF ASSESSMENT SCALES FOR CRITICALLY ILL PATIENTS IN TERMS OF KNOWLEDGE OF NURSES
Nursing is a scientifically rigorous discipline which requires updated information on a regular basis to ensure that best possible care is provided to the patients.The aim of the study is to evaluate the Effectiveness of Capacity Building Program regarding the use of Assessment Scales for critically ill patients in terms of Knowledge of Nurses. Pre-Experimental study using One Group Pre-test Post-test design with total enumeration sampling technique was used to enroll 36 Nurses who directly involved in patient care in the Liver Coma ICU, ILBS. A Structured Knowledge Questionnaire was prepared to assess the Knowledge of Nurses regarding the use of Assessment Scales (Glasgow Coma Scale, Pupil Reaction Scale and Modified Ramsay Sedation Scale). The Mean Post-test Knowledge Scores were significantly higher than the Mean Pre-test Knowledge Scores. Study concluded that the Capacity Building Program was effective in enhancing the Knowledge of Nurses regarding the use of Assessment Scales.
HISTOPATHOLOGICAL FINDING IN LIP BIOPSY OF PATIENT SUSPECTED WITH AUTO IMMUNE DISEASE PRESENTING WITH FETAL LOSS: A RARE Case study at RIMS
Sjögren syndrome is chronic, systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands. It is an elaborate involvement of the lacrimal and salivary glands, which eventually lead to keratoconjunctivitis sicca and xerostomia. It may occur in two forms - Primary and secondary, which is associated with another autoimmune disease, most commonly rheumatoid arthritis. Numerous criteria were proposed for diagnosis of Sjögren syndrome. Most widely accepted are American and European group developed international classification criteria for Sjögrens syndrome. These criteria include ocular symptoms, oral symptoms, ocular signs, histopathology, salivary gland involvement and sialography. The classification requires four of the six items, one of which must be positive minor salivary gland biopsy or a positive antibody test. Early diagnosis is important to prevent further complications. The aim of this paper is to emphasis on oral changes, advanced diagnosis, and management of Sjögren's syndrome.
PREVALENCE OF PERIODONTAL DISEASES IN TARAKESWAR MUNICIPALITY, WEST BENGAL- A CROSS-SECTIONAL STUDY
Periodontal diseases are mainly inflammatory condition caused by specific micro-organisms in dental plaque which leads to loss of periodontal attachments, including destruction of periodontal ligament and adjacent supporting bone. This cross sectional study under taken to assess the prevalence of periodontal disease in Tarakeswar municipality, Hooghly by using modified CPI index. The total study population consists of 275 subjects which were randomly selected from 15 wards of Tarakeswar municipality. According to WHO 30-60 years are group is the standard age group for surveillance of oral health conditions in adults. Informed consent was obtained from each individual. It was observed that out of 276 patient’s 202 patients having bleeding on probing. It was observed that 73.2% of the populations were affected by bleeding gums. The poor periodontal condition is observed among semi-urban area of West Bengal like Tarakeswar Municipality.
TRAUMATIC T2 FRACTURE PRESENTING AS PATHOLOGICAL FRACTURE
Complete T2 ASIA lesion due to old traumatic fracture presenting as a pathological fracture is an unusual presentation requiring multidisciplinary and holistic approach. Mixed lytic and sclerotic lesions of vertebra is commonly a feature of pathological fracture,but can sometimes be associated with traumatic fracture. Being aware of this as a potential differential diagnosis of such bony lesion on CT scan, although rare, significantly obviates the delay in diagnosis and management.
A CONSERVATIVE PROSTHODONTIC APPROACH FOR THE MANAGEMENT OF FLABBY RIDGE
Flabby ridge is a common clinical finding affecting the alveolar ridges of the mandibular or maxillary arches. Patients with flabby tissue require impression procedures which will record the entire denture bearing area in a functional form and the flabby tissue in undisplaced form. The presence of displaceable denture-bearing tissues often presents a difficulty when making complete dentures unless managed appropriately. This case report describes simple and practical approach of completely edentulous patients with localized hyperplastic ridge.
A RETROSPECTIVE STUDY ON CLINICAL PATTERN OF DERMATOPHYTOSIS IN A TERTIARY CARE HOSPITAL, CHENNAI.
BACKGROUND: Dermatophytes are one of the major causative organisms of superficial fungal infections.Dermatophytosis is the most common superficial fungal skin infection among patients attending a dermatology clinic. AIM: To analyse the clinical presentation and demographic characteristics of patients with dermatophytosis. METHOD: A retrospective analysis of the data was conducted among the patients who attended Dermatology OPD in a Tertiary Care Hospital in Chennai between May 2016 to April 2018. RESULTS: A total of 1549 patients were diagnosed and treated for dermatophytosis among which 877 were males, 672 were females and among them 108 were children (less than 14 yrs of both sexes). 33.83 % of patients were in the age group of 21 – 30 years, followed by 22.60 % of patients in 11 – 20 years.Tinea corporis was seen in 56.48% of patients followed by Tinea cruris in 25.44 % of patients. CONCLUSION:Tinea corporis was the most common clinical presentation followed by Tinea cruris.Prevalence rate of dermatophytosis is more among males than females, but the rate varies among various geographic regions. Elaborate studies are required in future regarding the epidemiology of the disease which play an equally important role to topical and systemic therapy in the management of the disease.
A RARE CASE OF SECONDARY ABDOMINAL PREGNANCY AFTER SELFADMINISTERED MEDICAL ABORTION PILLS - A CASE REPORT
Background: Abdominal pregnancy accounts for up to 1-1.4% of all ectopic pregnancies. Most often the diagnosis is missed and the condition may remain undetected until advanced gestational age and often results in severe life-threatening haemorrhage. Case Presentation: Our case was a 30-year-old Gravida 4, para 3 who came with the complaints of persistent nausea, vomiting and continuous lower abdominal pain, one and a half months after undergoing medical termination of pregnancy(MTP) along with laparoscopic tubal sterilisation. She had concealed a history of self-administered medical abortion pills 3 months back. USG revealed a live extra uterine pregnancy of 19 weeks gestation in Pouch of Douglas. Laparotomy was done and the secondary abdominal pregnancy along with the entire placenta could be removed due to its favourable location. Conclusion: Abdominal pregnancy after self-administration of medical abortion pills and being further missed during laparoscopic tubal sterilisation is an extremely rare event. Sonographic confirmation of intrauterine pregnancy before administration of medical abortion and tracing the fallopian tube in its entire length, at the time of performing laparoscopic tubal sterilization, will help prevent the missed or delayed diagnosis of such life threatening condition.
HEPATITIS B AND C : SEROPREVALENCE, COINFECTION, RISK FACTORS AND PREVENTION : A GLOBAL HEALTH CONCERN
BACKGROUND/OBJECTIVES:Chronic hepatitis B (HBV) and C virus (HCV) infections represent serious global and public health problem. An estimate of 400 million persons are carriers of HBV worldwide, 75% of whom reside in Asia and the western pacific. Likewise, HCV infection is estimated at approximately 170 million people globally.Hepatitis B virus was first isolated in 1963and hepatitis C virus (HCV) was identified in 1989. The present study was carried out to estimate the seroprevalence, co-infection,analysis of associated risk factors and prevention of Hepatitis B & Hepatitis C virus infection in ChattrapatiShivajiSubharti Hospital, Meerut. METHODS:This was a prospective study which includedserum samples collected over a period of 1 year from patients attending OPDs and admitted in various in-patient units (wards and ICUs) whichwere subjected to detection of HBsAg and Anti-HCV Ab using rapidimmunochromatographic tests and Enzyme Linked Immunosorbent Assay (ELISA). RESULTS: Out of total 11,311 samples,367 (3.24%) were positive for HBsAg and 612 (5.14%) were positive for Anti HCV Ab. Maximum cases of hepatitis B (85.02%) and Hepatitis C(87.91%) virus infection were diagnosed among IPD patients.Co-infection was seen in 25 (2.55%)cases.In maximum cases of Co-infection the risk factor associated was Blood or blood product transfusion(32%). CONCLUSION:Since HBV and HCV infections have high mortality, population at risk should be screened to know the burden of hepatitis virus infections nationwide to make the plans and policies for disease prevention. The prevention of HCV and HBV infection can be achieved by screening of blood and blood products, vaccinaton against Hepatitis B and creating awareness about risk factors.