PARIPEX - INDIAN JOURNAL OF RESEARCH (PIJR) is a double-reviewed monthly print-in published journal since January 2012. The aim of the journal to become a serious vehicle for inspiring and disseminating research papers, articles, case studies, review articles etc in all subject areas by the academicians, research scholars, corporate and practitioners with substantial experience and expertise in their respective fields. This journal is kept wide to provide platform for diversity of intellectual pursuit from all corners of the society for enrichment and enhancement of the group readers. The Journal is been published on every 15th of the month. The Periphery of the Subject areas Includes: Accountings, Finance, Management Accounting, Business, Commerce, Corporate Governance, Financial Accounting, Arts, Fine Arts, Designing, Medical, Bio-medical, Clinical Research, Home Science, Medical Science, Anatomy, Anesthesiology, Ayurveda, Biochemistry, Cardiology, Clinical Research, Clinical Science, Community Medicine, Dental Science, Dermatology, Diabetology, Electrotherapy, Endocrinology, Endodontic, ENT, Epidemiology, Forensic Medicine, Forensic Science, Gastroenterology, General Medicine, General Surgery, Genetics, Gynaecology, Health Science, Healthcare, Hepatobiliary Surgery, Homeopathic, Human Genetics, Immunohaematology, Immunology, Medical Physics, Medical Science, Medicine, Microbiology, Morphology, Neonatology, Nephrology, Neurology, Neurosurgery, Nursing, Gynaecology, Oncology, Ophthalmology, Oral Medicine, Oral Pathology, Orthodontology, Orthopaedics, Paediatrics, Pathology, Periodontology, Pharma, Otolaryngology, Pharmaceutical, Pharmacology, Pharmacy, Physiology, Physiotherapy, Plastic Surgery, Prosthodontics, Psychiatry, Pulmonary Medicine, Radiodiagnosis, Radiology, Rehabilitation Science, Rheumatology, Surgery, Unani Medicine, Urology,Psychology, Human ideology, Sociology, Economics, Education, Engineering, Electronics, Electrical, Information technology, Computer Science, Management, Organization behaviour, Organization psychology, Marketing. etc.
A REVIEW ON THE EFFECT PRE OPERATIVE NUTRITIONAL STATUS IN POST OPERATIVE OUTCOMES OF EMERGENCY LAPAROTOMY
Responses to the surgery cause many hormonal and biochemical changes. When there is a defective immune status and malnutrition, there could be many post- operative complications like surgical site infection, increased length of hospital stays etc Aim: The aim of the study is to correlate pre-operative nutritional status on post- operative outcomes in patients undergoing emergency laparotomy and to assess the relationship between the various parameters. Methodology: This was a cross sectional study conducted among the patients admitted for emergency laparotomy in the department of general surgery, Mahatma Gandhi Medical College and Research Institute, Pondicherry for a period of 18 months. Results: The mean age of the participants is 37.47 ± 16.81. Among the different risk factors, hypoalbuminemia and Nutritional risk Index was significantly associated with the post-operative complications like surgical site infections, re exploration etc. Conclusion: Nutritional Risk Index and Hypoalbuminemia could be an independent predictor for post-operative complications.
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CRITICAL ANALYSIS OF VITAMIN A DEFICIENCY (VAD) INFORMATION IN SCIENCE TEXTBOOKS OF NCERT AND STATE BOARD EDUCATION OF SOUTHERN INDIA
Vitamin A deficiency (VAD) is one of the most important causes of childhood blindness in developing countries. It also adds on to the morbidity from common childhood infections. VAD borne out of two main reasons: persistent inadequate intake of vitamin A that is frequently exacerbated by others dietary circumstances, and a high frequency of infections.[1] Worldwide, around 2.8 million preschool-age children are at risk of blindness from VAD, and many more have serious risk to vision. Roughly 250, 000 to 500, 000 children become blind owing to vitamin A-deficiency every year. In India prevalence of VAD is 0.7%. It is considered under clinical category for public health importance by World Health Organization (WHO). [2]
STUDY OF SERUM URIC ACID LEVEL AS A PROGNOSTIC FACTOR IN CHRONIC KIDNEY DISEASE-A HOSPITAL BASED STUDY
Chronic kidney disease is defined by the presence of kidney damage or decrease kidney function for three or more months irrespective of the cause. The symptoms of worsening kidney function are non-specific, and might include feeling generally unwell and experiencing a reduced appetite . Often, chronic kidney disease is diagnosed as result of screening of people known to be at risk of kidney problems, such as those with high blood pressure or diabetes and those with a blood relative with chronic kidney disease.
IMPORTANCE OF RASAYANA IN IMMUNE DEFICIENCY DISORDERS
Immunodeficiency is a condition in which body’s immune system loses the ability to effectively fight against infectious diseases.It can be caused by lack of one or more components of immune system and can be due to inherited, acquired or drug induced causes.Most of immune disorders are acquired (secondary). In Ayurveda,the concept of Immunity is somewhat nearer to vyadhikshamatva which implies a resistance against the loss of integrity,proportion and interrelationship of dosha and dhatus.Rasayana is a treatment in which the body constituents are prepared to adapt to selective tissue nourishment program.Rasayana increases the essence of each dhatu starting from rasa and enriches ojas.Thus there is tissue regeneration leading to vyadhikshamatva.Rasayana drug act as immunomodulators and thereby balancing immune system.certain daily food items and various drugs like shilajatu,centalla asciatica (mandukaparni),Tinospora cordifolia (Gudoochi),Embilica officianalis(amalaki)etc interact with the functioning of immune system and thereby mitigate immune related disorders.Thus rasayana helps to promote the health of immune deficiency individuals.
A COMPARATIVE STUDY OF UNDERRUNNING OF HAEMORRHOIDS AND OPEN HAEMORRHOIDECTOMY
Haemorrhoids is one of the commonest clinical condition. There has been various surgical methods proposed in the treatment of Haemorrhoids. In this study we compare the efficacy of open Haemorrhoidectomy with Underunning of Haemorrhoids in terms of early and late post op complications.
BIOSYNTHESIS, CHARACTERIZATION AND ANTIMICROBIAL POTENTIAL STUDIES OF COPPER OXIDE NANOPARTICLES PRODUCED FROM CHLORELLA VULGARIS
The applications of nanoparticles are gaining a significant role in the current scenario as they show excellent anti-bacterial and antibacterial and antitumor activities. Biosynthetic methods of nanoparticles have emerged as a simple alternative to more complex chemical synthetic procedures to obtain nanomaterials. In the present scenario, algae are being used largely for the nanoparticles synthesis. In the present study, copper oxide nanoparticles (Cuo NPs) are biosynthesized by using Chlorella vulgaris, a marine alga. Further, the characterization, optimization and antimicrobial studies of the nanoparticles were carried out. The biosynthesized Cuo NPs were confirmed visually by the appearance of dark brown colour formation in the mixture added with copper acetate. The existence of nanoparticles was confirmed by UV visible spectroscopy at 540 nm. Biosynthesized nanoparticles were characterized by SEM, EDAX and XRD. Further, antimicrobial potential studies of synthesized Cuo NPs were carried out against selected bacteria and fungi.
Background Getting inked or tattooed is a recent trend in the youth of India. Tattooing is done in India both in professional and non-professional setup using both manual and electronic machines. These young tattooed individuals form part of the blood donor pool. This study was done to detect any difference among tattooed and non-tattooed blood donors regarding their TTI status and to find any relation between sizes, location, and source of tattoo with respect to the TTI status. Methods 70 tattooed blood donors presenting in Department of Transfusion Medicine, Christian Medical College, Ludhiana who fulfilled the criteria for blood donation were compared for TTI with 70 non tattooed individuals matched for age, gender using Enhanced Chemiluminescence (VITROS ECiQ, Ortho Clinical Diagnostics) and ID NAT (Procleix Ultrio Plus, Hemogenomics) from 1st January, 2016 to 15th April, 2016.. The tattooed group was analysed with respect to TTI reactivity and the following variables; size of tattoo, location of tattoo, made by professional or non-professional tattoo artist, usage of disposable new needle or new dye, using a structured questionnaire. Results Amongst 70 pairs of age, gender and place of donation matched healthy blood donors, 17.1 % (12) of tattooed individuals were positive for TTI as compared to the 4.2% (3) of non-tattooed individuals. This difference was found to be statistically significant (p= 0.026) with an associated relative risk = 4.00 (95% CI= 1.179 to 13.566). Amongst the tattooed cohort, 7.2% (4) individuals who got the tattoo from a professional tattoo artist developed TTI, as compared to 53.3 % (8) individuals who went to non-professional tattoo artists. The difference was statistically highly significant (p=0.000). The nature of instrument showed a statistically significant difference (p= 0.002) with 12.3 % (8) individuals who got it made through electronic machine developing TTI as compared to 80% (4) who got it done using manual method. The relation between new and disposable needle along with new dye could not be studied as majority of tattooed donors could not recall accurately. The relation between size and location of tattoo demonstrated no significant relation with development of TTI. Summary /Conclusions Getting a tattoo showed a statistically significant relation with developing a TTI in an age, gender and place of donation matched cohort. Amongst the tattooed individuals, getting tattoo from a non-professional artist and using a manual method of tattooing demonstrated a statistically significant relation with developing TTI. Further studies using a much larger sample size is needed to formulate a policy at a national level.
A STUDY ON CORRELATION BETWEEN ESTROGEN RECEPTOR, PROGESTERONE RECEPTOR, HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR-2 STATUS AND OTHER PROGNOSTIC FACTORS IN CARCINOMA BREAST
The study aimed to evaluate the correlation of prognostic factors such as age, BMI, ER, PR, HER2 receptor status in-patients with carcinoma of breast to study the correlation between hormonal receptors status and other prognostic factors with lymphovascular invasion in carcinoma breast. A total of 160 patients with carcinoma breast presented to Madras Medical College, Rajiv Gandhi Government General Hospital from February 2019 to November 2019 were chosen & recorded along with Data were processed using SPSS software. It was found that an increase in the incidence of breast carcinoma is high in the peri-menopausal age group (40–50) years of age. From this study, we conclude that Positive receptor status (ER, PR and, HER2NEU) is found in the majority of the women with normal BMI and negative receptor status is associated with obese patients. Positive receptor status (ER, PR) is associated with decreased lymphovascular invasion and negative receptor status is associated with increased lymphovascular invasion. Normal BMI is associated with decreased lymphovascular invasion in both pre and post-menopausal women in contrast to obese patients. It can also be concluded that lymph node with lymphovascular invasion HER 2 NEU with lymphovascular invasion is Statistically insignificant.
AVAILABILITY AND UTILITY OF FIRST AID BOX IN SAVING THE LIFE OF PEOPLE IN BUSES PASSING THROUGH TRICITY, CHANDIGARH
Background: Prompt first aid provision at the place of accidents can reverse unpleasant consequences of victim’s health and life [1]. Method: An exploratory study was conducted for four months (Jan 2019 to Apr 2019) to assess the availability and utility of first aid box in saving the lives of people in buses running through Tricity, Chandigarh. In this study, a total of 600 drivers and conductors of buses were interviewed. Results: Of the total 300 buses, 228 (76%) buses contained first aid box placed at accessible and prominent place and out of those 228 buses, the content of first aid box was available in only 167 (55.7%) buses. Only 228 (38%) drivers and conductors had used first aid box at the times of emergency while 270 (45%) drivers and conductors knew that contents of first aid box were changed periodically. Conclusion: The availability of first aid boxes and its contents in buses has though increased; still there is need to increase the use of its contents at the time of exigency.
CAREGIVER BURDEN AMONG THE CAREGIVERS OF OLDER ADULTS WITH PALLIATIVE CARE NEEDS
AIM: To examine caregiver burden among caregivers of hospitalised geriatric patients with palliative care design. METHODOLOGY: Caregivers of 330 geriatric patients with various chronic end stage diseases. They were assessed using BSFC-s questionnaire. RESULTS: Majority of caregivers were spouses (26%). Mean age group being 68.2 years. The caregiver burden across the categories was more than 60% across all the questions asked in the BSFC-s questionnaire. Maximum in the caregiver with end stage renal disease (60.3%) and minimum in the caregivers of frail elderly (50.2%). CONCLUSION: Caregiver burden was common in caregivers of geriatric patients with end stage chronic diseases. Burden was associated with the caregiver’s report of need for greater help with daily tasks but not with objective measures of the patient’s need for assistance, such as symptoms or functional status, suggesting that burden may be a measure of the caregiver’s ability to adapt to the care giving role.
A HOSPITAL BASED PROSPECTIVE STUDY ANALYSING THE CLINICAL AND PROGNOSTIC DIFFERENCES IN ACUTE MYOCARDIAL INFARCTION IN ELDERLY VERSUS YOUNG
INTRODUCTION:- The normal physiologic and pathologic changes associated with aging make the elderly population vulnerable to cardiovascular diseases irrespective of the presence or absence of the other cardiovascular disease risk factors. The ageing changes can play a determinative role that affects pathophysiology, presentation, and management of Myocardial infarction to be different in elderly as compared to the young. MATERIALS & METHODS:- The study included 100 cases of acute MI admitted in our hospital with 57 patients in group 1 elderly ( age >/= 65 years) and 43 patients in group 2 young ( age < 65 years ). Data regarding the complete clinical profile of the patient was collected and analysis done by using the Student’s t test & SPSS software. RESULTS:- Around 61% of elderly patients presented to the hospital with atypical symptoms. When compared to the young (11.62%), more percentage of elderly patients (26.3 %) came with cardiogenic shock on admission. Arrythmias post thrombolysis was more in the elderly (35.08% vs 21% in young). The mortality rates following an acute MI were higher among the elderly when compared to the young (33.33% vs 13.9%). CONCLUSIONS:- Owing to the difference in the risk factors, clinical presentation and the prognosis, treatment of MI in the elderly is difficult and challenging due to comorbidities associated. Considering the subtle features of MI in the older population, a needful watch is necessary in this group of patients so as to decrease the mortality rate due to cardiovascular diseases.
PSEUDOMONAS AERUGINOSA; MICROBIOLOGICAL PROFILE AND ANTIMICROBIAL SENSITIVITY PATTERN IN CHRONIC SUPPURATIVE OTITIS MEDIA
Introduction: Chronic Suppurative Otitis Media (CSOM) is a potentially serious disease because of its complications. The incidence of CSOM is increasing in the developing countries because of the poor hygiene practices and lack of health education. Pseudomonas aeruginosa is a Gram-negative bacterium belonging to the family Pseudomonadaceae that is able to survive in a wide range of environments. Aim: To determine the microbiological profile and antimicrobial sensitivity pattern of Pseudomonas aeruginosa from discharge in CSOM. Material and method: This study was conducted over a time period of 6 months. All bacterial isolates were identified by conventional microbiological methods. Antimicrobial sensitivity testing of the isolates was done by Kirby-Bauer disc diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Result: Pseudomonas aeruginosa (58.6 %) was the most prevalent bacteria isolated, followed by staphylococcus aureus (19.57%).Most sensitive antibiotic against Pseudomonas aeruginosa was Piperacillin – Tazobactum (76.5%) followed by Meropenam (65.8%) and cephalosporins such as cephalexin, cefuroxime. Amoxyllin-clavulanic acid shows complete resistance towards Pseudomonas aeruginosa. Conclusion: It is important to evaluate bacteriologic profile and antimicrobial susceptibility pattern periodically for efficacious treatment in CSOM patients
ETIOLOGY OF HYPONATREMIA IN GERIATRIC AGE GROUP PRESENTING WITH ALTERED SENSORIUM IN WESTERN RAJASTHAN.
INTRODUCTION Hyponatremia is most common electrolyte imbalance in geriatric patients. Determining etiologies of such patients would help in identifying candidates for future prevention. METHOD AND MATERIAL We had studied 50 patients of hyponatremia with altered sensorium in geriatric age group. These patients were evaluated for the underlying cause of hyponatremia and hormones involved in hyponatremia. RESULTS Most common cause was CVA (32%), followed by CHF (30%), diuretics (28%), renal failure (26%) , hypothyroidism (10%), pneumonia (10% ), adrenal insufficiency (10%), liver disease (8%) and ICSOL (2%). Among hormones, vasopression was raised in 96% patients, glucocorticoid and minrealocorticoid was diminished in 10% patients and aldosterone was diminished in 6% patients. DISCUSSION – Hyponatremia is a common problem in hospital more so in critically ill ICU patients. The possible cause of hyponatremia should always be sought as an outcome in severe hyponatremia is governed by etiology and not by serum level of sodium.
BENEFITS OF THYMECTOMY IN MYASTHENIA GRAVIS
In recent years, thymectomy has become a widespread procedure in the treatment of myasthenia gravis (MG). Likelihood of remission was highest in preoperative mild disease classification (Osserman classification 1, 2A). In absence of thymoma or hyperplasia, there was no relationship between age and gender in remission with thymectomy. In MG treatment, randomized trials that compare conservative treatment with thymectomy have started, recently. As with non-randomized trials, remission with thymectomy in MG treatment was better than conservative treatment with only medication. There are four major methods for the surgical approach: transcervical, minimally invasive, transsternal, and combined transcervical transsternal thymectomy. Transsternal approach with thymectomy is the accepted standard surgical approach for many years. In recent years, the incidence of thymectomy has been increasing with minimally invasive techniques using thoracoscopic and robotic methods. There are not any randomized, controlled studies which are comparing surgical techniques. However, when comparing non-randomized trials, it is seen that minimally invasive thymectomy approaches give similar results to more aggressive approaches.
A COMPARATIVE STUDY OF EFFECTS OF FENTANYL &DEXMEDETOMIDINE AS ADDITIVES TO 0.75% ROPIVACAINE FOR EPIDURAL ANESTHESIA IN LOWER LIMB SURGERIES.
AIM: To evaluate the clinical effects & adverse events when fentanyl & dexmedetomidine are used as additives to 0.75% Ropivacaine for epidural anesthesia. METHODS: Institutional ethical committee clearance was obtained.A total of 80 patients of both sex,aged 18-60 years,ASA grade I,II posted for elective lower limb surgeries were divided into two groups(n=40) by open label randomization method.Group RF received 1μg/kg Fentanyl & group RD received 1μg/kg Dexmedetomidine along with 15 ml Ropivacaine 0.75% in both groups. Onset of complete motor & sensory blockade,duration of analgesia, two segmental dermatomal regression & adverse effects were recorded. Data was analysed using Fisher’s exact test & Chi-square test. Value of P<0.05 is considered significant and P<0.001 as highly significant. RESULTS: The demographic profile was comparable in both the groups. Onset of sensory analgesia at T10 (10.04±0.86 vs 13.76±1.42) & onset of complete motor blockade (16.5±1.24 vs 20.4±1.32) was significantly earlier in RD group as compared to RF group. Duration of motor and sensory block was significantly longer in group RD (194.2. ± 20.73 and 150.42 ± 5.18 min) as compared to group RF (162.32 ± 22.38 and 122.4 ± 3.46 min).Incidence of bradycardia,hypotension & dry mouth was significantly higher in the RD group whereas incidence of nausea & vomiting was significantly higher in RF group with P < 0.05. CONCLUSION : Epidural anesthesia with dexmedetomidine as an additive to 0.75% ropivacaine is more effective with respect to earlier onset & prolonged duration of sensory & motor blockade when compared to fentanyl.
SPECTRUM OF FOREIGN BODIES IN EAR, NOSE & THROAT AT TMC & DR. BRAM TEACHING HOSPITAL – A RECORD BASED STUDY
INTRODUCTION: Foreign bodies (FB) lodging in ear, nose & throat is commonly encountered in ENT practice. Adequate knowledge & skill about FB removal is a must in order to avoid possible complications. OBJECTIVE: Categorizing the FB encountered, clinical features & management. METHOD: Record-based study. RESULTS: Overall 710 patients’ data from the previous medical records were scrutinized for the study, out of males were 400(56.33%) & females were 310(46.33%) with a sex ratio of male: female as 1.2:1. FB ear accounting 320 patients (45%) followed by FB in pharynx/esophagus with a total of 191 patients (26.9%). Clinical presentation of FB ear cases shows more cases presenting with earache(56.25%). Age wise distribution shows between 11-20Y, total 211 cases (29.71%).CONCLUSION: More cases of FB in ENT around second decade of life with decreasing trend as the age increases while nasal FB more common around pediatric age-group.
PLASMA RICH FIBRIN AND BONE GRAFT IN MANAGEMENT OF DENTIGEROUS CYST
Developmental odontogenic cysts are dentigerous cysts. Generally presented as an unanticipated and asymptomatic unilocular radiolucencies of unerupted, embedded and impacted tooth crowns of posterior mandible. Tooth bearing cyst with rapid growth rate arising from epithelial remnants of the tooth forming organ. Follicular compression by developing tooth causes venous flow obstruction leading to fluid accumulation between unerupted tooth and follicular epithelium. Recent bone regenerative techniques for cystic lesions are established. Hence, we here present a case of most common surgically enucleated dentigerous cyst with novel technique of plasma rich fibrin and bone graft for promoting faster osseous regeneration along with repair of soft and hard tissues post - operatively. This is the first case in literature where a dentigerous cyst is managed surgically with enucleation followed by placement of plasma rich fibrin and bone graft.
CLINICAL SPECTRUM OF DERMATOSIS IN PAEDIATRIC POPULATION IN TERTIARY CARE HOSPITAL
Context: Background: Skin diseases are common in children, the incidence being 23% all over the world. The pattern of skin disease is a consequence of poor hygiene, illiteracy in many parts of India. The evaluation for skin disorders is an important component of primary health care practice for all. Aim: To study the clinical spectrum of dermatosis in paediatric population in tertiary care hospital Methods and Material: A total of 273 children were included in the study from central india. All the patients were subjected to detailed history taking and meticulous examination as per the proforma after getting the informed consent. The clinical manifestations in relation to pediatric dermatoses were recorded. The data obtained were subjected to descriptive analysis using SPSS software. Statistical analysis used: Chi square test Results: Out of the 273 patients observed, 152 (55.6%) were males and 121 (44.4%) females. Adolescent group constituted highest percentage (28.2%) followed by toddler which constitutes 21.6% of total pediatric patients. Bacterial infections were the most common infection noted in the study. Conclusion: The majority of the study population (28.2%) belong to adolescent age group. Of them, Males outnumbered Females. Bacterial infections were the most common infection noted in the study, followed by atopic dermatitis and acne.
SCRUB TYPHUS AMONG INPATIENTS IN A TERTIARY CARE HOSPITAL IN SOUTHERN RAJASTHAN – A CLINICO-EPIDEMIOLOGICAL STUDY
Background : Scrub typhus or tsutsugamushi disease is a febrile illness caused by Orientia tsutsugamushi. Increased incidence of this fever had been reported in recent past. The present study was conducted to find out the clinical features, complications, response to treatment and outcome of patients suffering from scrub typhus in a tertiary health care institute in south-east Rajasthan, India. Methods: A hospital based prospective observational study of patients of acute febrile illness performed at tertiary health care institute in south-east Rajasthan. patients of acute febrile illness of more than 14 years of age, admitted in medicine department during November 2018 to October 2019, with IgM ELISA positive for Scrub Typhus were enrolled in the study as study participants. All such patients underwent detailed clinical examination and investigation. Results : A total of 134 patients were diagnosed with scrub typhus, with females more than males and most common age group was 31 to 40 years(29.9%). Most common presenting symptom was fever (100%) followed by Headache(80.59%) and Dry Cough(66.42%) while Rash was present in only 14.18%. ESCHAR which is pathognomic of scrub typhus was found in 46.27% patients. Most common complication was pneumonia (39.6%) followed by hepatitis (35.8%),MODS (29%), ARDS(23.1%), septic shock (17.2%), acute kidney injury(9%) and all of them were significantly associated with mortality(p<0.05). Mortality was observed in 6.7% of cases. Conclusion : Scrub typhus is an important cause of acute febrile illness with multisystem involvement in south eastern belt of Rajasthan. A high index of suspicion is needed in patients presenting with fever especially during monsoon and post monsoon season. In resource limited settings and pending laboratory confirmation we should implement a ‘suspect and treat’ strategy and initiate prompt treatment with Doxycycline or Azithromycin, to prevent serious morbidity and fatality in this potentially treatable and curable disease.
TO STUDY THE EFFECT OF HYPERCHOLESTEROLAEMIA ON ASTHMA
Background: Asthma is one of the few diseases recognized in one or the other form since the pre-Biblical times. There is an increased interest in asthma in the recent past hugely because of the recognition of an increased morbidity and mortality. Aims and Objective: to know association between blood cholesterol level and bronchial asthma. Material and Methods: The present study was undertaken in department of biochemistry, Patna Medical College, Patna cases were taken from the patients attending outdoor and admitted indoor patients from the department of medicine of Patna Medical College and Hospital, Patna. Fasting lipid profile estimation was done on 100 cases of bronchial asthma and 50 healthy individuals as controlled. Result: In present study elevated level of total cholesterol is observed in asthmatic group which is 198.72±42.2mg/dl, And elevated level of LDL is also observed in asthmatic group which is 123.42±24.3mg/dl, But level of HDL is decreased in asthmatics group which is 38.63±15.2mg/dl. Conclusion: Thus in present study elevated level of total cholesterol and LDL is associated with increases incidence of asthma whereas increased level of HDL is associated with decrease incidence of asthma.
TO STUDY THE SENSITIVITY AND SPECIFICITYOF TRANSVAGINAL SONOGRAPHY AS COMPARED TO HYSTEROSCOPY IN PATIENTS OF ABNORMAL UTERINE BLEEDING
Abnormal Uterine Bleeding is a common symptom in perimenopausal age group ,often requiring OPD visit .Eventhough the hysteroscopy holds the gold standard investigation , being invasive ,costly and more skillful makes it a second choice amongst gynaecologist , TVS can be useful in OPD settings for evaluation prior to any invasive investigation , in our study we found that in perimenopausal women the investigation was significantly effective in evaluating AUB .
ROLE OF HBA1C & ADMISSION BLOOD SUGAR ON MORTALITY IN PATIENTS WITH ISCHEMIC STROKE
Background: In ICU patients with ischemic stroke one of the common reasons for their mortality is found to be Hyperglycemia. Diabetes Mellitus itself is a risk factor that can initiate & propagate vascular events in conjunction with atherosclerosis in Ischemic stroke. The aim of this study was to evaluate relationship between admission blood sugar and HbA1c with mortality in patients with Ischemic stroke over a period of 28 days. Materials & Methods: This is a retrospective study where data was collected from medical records of 50 diabetic patients admitted to ICU with ischemic stroke dated from April 2019 to September 2019. Patients were further categorized depending upon their duration of stay in the hospital with cut-off of 10 days; Furthermore, a cut-off of “28 days- mortality” was taken into consideration. Patients, who were already diagnosed with diabetes and who got admitted in medical ICU were taken as study subjects. Results: Mortality was significantly higher in patients with higher admission blood sugar values of more than 250mg/dl & lower when value was below 150mg/dl. It was noted that the survivors (72%) had their mean admission blood sugar values close to 260mg/dl whereas non-survivors (28%) mean admission blood sugar level was found to be 343mg/dl. It was also noted that patients with good glycemic control (HbA1C < 8) had better chances for survival. The survivors (72%) had mean HbA1c level of 9.06 and non-survivors (28%) had mean HbA1c level of 10.67. Both the mean values being so close to each other with difference of just 1% further emphasizes the fact that with each 1% increase in HbA1C the mortality risk rises by 10 fold. Conclusion: A significant association was confirmed between admission blood sugar levels & mortality in diabetic patients with Ischemic stroke. Furthermore, this association was found to be affected by HbA1c i.e. chronic glycemic status.
UNICYSTIC MURAL AMELOBLASTOMA. A CASE REPORT AND REVIEW OF CLINICOPATHOLOGIC FEATURES
Unicystic ameloblastoma refers to those cystic lesions that show clinical, radiological or gross features of a jaw cyst but on histological examination a typical unicystic ameloblastoma have epithelium lining cyst with or without luminal and or mural tumor proliferation. Unicystic ameloblastoma is a less encountered variant of the ameloblastoma and is believed to be less aggressive. This case report presents a case of unicystic ameloblastoma that involved the right posterior mandible of a 35-year-old male, and with no reported recurrence after one year follow-up.
TIMOLOL IN GLAUCOMA: REPORT FROM A TERTIARY CARE HOSPITAL
Glaucoma is the cause for 8.0% cases of preventable blindness cases as per lancet report of 2017. The disease is divided primarily into primary and secondary types, of which the commonest being primary with no exact etiology. Despite availability of more efficacious glaucoma medications with few side effects and findings of clinical trials underscoring the importance of intraocular pressure reduction in POAG patients, many patients with POAG continue to go untreated. Retrospective observational study where consecutive cases of Glaucoma treated at the department of Ophthalmology from January 2014 to December 2018 were analyzed for demographic profiles, diagnosis on type of glaucoma, treatment with Timolol alone or in combination. The most common diagnosis was Primary Open Angle Glaucoma found in 123 patients. Drug treatment with Timolol alone accounted for 59 cases (11.21 %) of the total cases treated for glaucoma. To promote patient adherence, Timolol is also used in combination with other drugs to lower intraocular tension.
MANAGEMENT OF MASHAKA (MOLE) BY AGNIKARMA – A CASE REPORT.
Ayurveda is a science where a medical and surgical procedure are described a years back. Agnikarma is the one of minor surgical procedure in Ayurveda which is done by the application of Agni, heat. Masaka is painless, hard black eruption on the skin. It can be compared with mole in modern science. In the case patient of 24 years male came with complain of mass in forehead. Mass was diagnosed with mashaka (mole) on clinical basis. Agnikarma was done for the mass. After 2 week lesion was healed up with no any complain of bleeding, infection of wound, pain and scar. Since there is no chance of reoccurrence, Agni karma is the best methods of the treatment of Mashaka (mole).
CORRELATION BETWEEN SERUM FERRITIN AND GLYCEMIC CONTROL IN PATIENTS OF TYPE 2 DIABETES MELLITUS
Introduction T2DM and its link with inflammation has been researched in recent times. There is also evidence of interaction between glucose homeostasis and iron metabolism. Some studies show that serum ferritin, an acute phase reactant and indicator of body iron stores, is associated with glucose intolerance, T2DM as well as micro and macro vascular complications of diabetes. This study was carried out to evaluate the relationship between serum ferritin and glycemic status in diabetic patients. Materials and Methods 100 individuals with type 2 diabetes (M: F=48:52, mean age 56.08 ± 9.52 years, BMI 24.85 ± 4.03 kg/m2), who visited a tertiary care hospital, and 100 age and gender matched controls were included. Exclusion criteria included the factors affecting serum ferritin levels like anaemia, chronic liver or kidney disease. Serum ferritin, HbA1c, FBS, PPBS were measured. Results The mean Serum ferritin was significantly higher (p<0.01) (189.61 ± 156.99 ng/ml) in diabetic patients when compared to controls (88.74 ± 47.28 ng/ml). Serum ferritin had a positive correlation with HbA1c (r=0.85), FBS (r=0.91) and PPBS (r=0.77). Serum ferritin was significantly related to diabetes duration (p<0.05). Conclusion Diabetics have elevated ferritin levels which correlate with their glycemic status (HbA1c, FBS, PPBS). It may thus be used as a marker for glycemic control in diabetes.
A CLINICAL STUDY ON THE EFFECT OF TAKRADHARA (SHIRODHARA) IN SUBCLINICAL HYPOTHYROIDISM
Takradhara is a procedure, where medicated butter milk is poured over head or body in a specified manner this study has been planned to assess the effect of Takradhara in patients with SCH as an initial phase. Method: The study population was 30 patients from OPD and IPD from the Swasthavritta department Govt. Ayurveda College Tripunithura, Ernakulam. Purposive sampling method is using to selection of sample. Duration of Takradhara treatment was 7 days. Assessment was done before treatment and Follow up will be done 30th, 60th and 90th days (After treatment 24th, 54th, 84rd days) Result & Discussion After 7 days of Takradhara treatment, assessment was done during follow up periods, there was significant levels of reduction in TSH ,Here p-values less than the significance level 0.05 (P<0.05) Conclusion: Takradhara treatment was effective in normalizing the raised TSH levels and in relieving the associated symptoms
ASSOCIATION OF KIDNEY FUNCTIONS WITH 30 DAY POST STROKE MORTALITY
Background: Renal impairment most witnessed in hospitalized stroke patients, affecting the outcome of patients, as well as causing difficulties in their management. Association of renal dysfunction in post stroke mortality is important in outcome studies and risk standardization in hospital readmission rates. This study was designed and conducted with aim to evaluate the prevalence of renal dysfunction in patients after stroke and the 30 day mortality impact in post stroke patients. Materials and methods: This was a retrospective study where data was collected from medical records of 40 patients admitted to ICU with a diagnosis of stroke dated from January 2018 to December 2019. The data were analyzed in the terms of demographic details, risk factors for stroke, pulse rate, mean arterial pressure, pulse pressure, plasma glucose and renal function tests at the admission. Estimated glomerular filtration rate was calculated by Chronic Kidney Disease Epidemiology Collaboration. All patients records were traced upto 30 days post stroke. Results: The statistical analysis were done with SPSS version 24.0. Time of survival was evaluated with multivariate Cox proportional hazard analysis. Results were expressed as hazard ratio (HR) and its 95% confidence interval (95% CI). A total of 23 patients expired during 30 day period of time following stroke. The independent predictors of death remained: age, eGFR <60 ml/min/1.73 m2, proteinuria and glucose at a concentration >100 mg/dl. Conclusion: In patients with stroke, the impaired kidney function expressed by low eGFR with or without the presence of proteinuria is a powerful and an independent prognostic factor for short-term survival.
A COMPARATIVE STUDY OF THE EFFECTS OF INTRATHECAL HYPERBARIC BUPIVACAINE WITH BUPRENORPHINE AND HYPERBARIC BUPIVACAINE WITH FENTANYL IN SPINAL ANAESTHESIA FOR LOWER ABDOMINAL AND LOWER LIMB SURGERIES
BACKGROUND: Spinal anaesthesia is the most commonly used technique for lower abdominal, lower limb surgeries. In clinical practice both Fentanyl and buprenorphine have been used as adjuvants with bupivacaine for spinal anesthesia. So, this present study has been conducted to assess the better drug between these two adjuvants with regard to post-operative analgesia and haemodynamic stability. OBJECTIVE: To study the effects of 0.5% hyperbaric bupivacaine with buprenorphine and 0.5% hyperbaric bupivacaine with fentanyl in spinal anaesthesia for lower abdominal and lower limb surgeries. SETTINGS & DESIGN: This comparative study included 50 patients in two groups, of ASA class I & II undergoing lower abdominal and lower limb surgeries under spinal anesthesia after approval from hospital ethics committee with written informed consent of patients. MATERIALS AND METHODS: Patients were categorized into two groups (n=50) A & B. Group A received 75μg of buprenorphine and Group B received 25μg of fentanyl as adjuvants to 15mg of 0.5% hyperbaric bupivacaine (3.0ml). Onset of sensory block and motor block, two segment regression, time of sensory and motor block, duration of sensory & motor block, duration of analgesia, haemodynamic changes and side effects were recorded. RESULTS: There was no significant difference in onset of sensory block in two groups (P>0.05), but onset of motor block was significantly earlier in buprenorphine group. Two segment regression time, duration of sensory & motor block, duration of analgesia were significantly longer for group A as compared to group B (P< 0.05). CONCLUSION: The duration of sensory block, motor block and duration of post-operative analgesia was better in buprenorphine group in comparison to fentanyl group. Both the drugs prolong the duration of analgesia on giving intrathecally along with bupivacaine heavy. These drugs can be used to prolong duration of analgesia in lower abdominal and lower limb surgeries without having any significant side effect.
HLH (HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS): A RARE COMPLICATION OF ENTERIC FEVER- A CASE REPORT
Typhoid fever is a systemic infection with protean manifestations caused by Salmonella and leads to various life threatening complications, of which HLH (Hemophagocytic Lymphohistiocytosis) is one such uncommon complication. We report a case of HLH in enteric fever who presented with fever and petechial rash.
COMPARISON OF DEXMEDETOMIDINE AND CLONIDINE AS AN ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK
Background and aims:-Adjuvants are often used with local anaesthetics in supraclavicular brachial plexus block(SBPB) for its synergistic effect by prolonging the duration of sensory and motor block. Alpha 2 agonists, clonidine and dexmedetomidine are combined with local anaesthetics to extend the duration of regional anaesthesia.The purpose of this study was to compare the effects of clonidine and dexmedetomidine as an adjuvant to bupivacaine(0.25%) in Supraclavicular brachial plexus block(SBPB) with respect to the hemodynamic variations;onset,duration of sensory and motor block along with duration of analgesia. Methodology:-A randomized double blind prospective study involving 75 patients aged between 18 and 60yrs of ASA status I and II undergoing upper limb surgeries under SBPB was carried out at SMCH.The patients were randomly divided into three groups:Group B–received 35 ml of 0.25% Bupivacaine with 2ml of 0.9% normal saline,GroupC–received 35 ml of 0.25 % Bupivacaine with Clonidine 1μg/kg mixed with 0.9% normal saline to make total volume of 2ml and GroupD–received 35ml of Bupivacaine 0.25% with Dexmedetomidine 1μg/kg mixed with 0.9% normal saline to make a total volume of 2ml.Heart rate,systolic and diastolic blood pressure; onset and duration of sensory blocks, motor blocks and duration of analgesia;sedation and adverse effects,if any,were assessed. Results:The groups were comparable with respect to age,sex,weight,ASA status and surgical characteristics.The mean onset of sensory and motor blockade and mean duration of sensory and motor blockade were faster and prolonged in Group D in comparison to Group C and Group B which were statistically highly significant(p<0.001).Hypotension,bradycardia, sedation and decreased respiratory rate were seen in few patients in Dexmedetomidine group. Conclusion: We conclude that dexmedetomidine can be a better alternative to clonidine when administered with Bupivacaine as an adjuvant for SBPB for upper limb surgeries.
INFLUENCE OF ATMOSPHERIC TEMPERATURE, HUMIDITY AND PRESSURE ON THE INCIDENCES OF IDIOPATHIC EPISTAXIS
Background: Epistaxis or nose bleed is one of the most common Otorhinological emergencies we face today during our clinical practice which becomes life threatening in cases of severe bleeding. With this study we have determined the relationship between the occurrence of idiopathic epistaxis and the 3 atmospheric parameters i.e. atmospheric temperature, humidity and pressure. Materials and methods: A one year (August 2017 to July 2018) prospective observational study was done correlating atmospheric temperature, humidity and pressure and the incidences of idiopathic epistaxis in patients visiting Department of Otorhinolaryngology, Silchar Medical College and Hospital, Assam, India. We obtained data regarding sex, age, location during presentation and associated factors. Only those patients without any known cause of epistaxis were included in this study. The exclusion criteria were patients with obvious causes for epistaxis, patients with trauma, coagulopathies, tumours and systemic causes. The climate data were obtained from the Indian Meteorological Department (IMD). The statistical analysis of the correlation between atmospheric parameter values and incidences of epistaxis was obtained through the Pearson's correlation coefficient, by establishing a value of “r”. Results: Idiopathic epistaxis is common in the fourth decade of life. There is slight male preponderance. The frequency of idiopathic epistaxis is higher during the colder months. Conclusion: Meteorological factors play an important role in the etiopathogenesis of idiopathic epistaxis and should be considered a risk factor. Improved protection and proper humidification during the colder season could lead to a reduction in the incidence of idiopathic epistaxis.
A COMPARATIVE STUDY BETWEEN INTRAVENOUS DEXMEDETOMIDINE AND 50% MAGNESIUM SULFATE IN ATTENUATION OF CARDIOVASCULAR RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION.
INTRODUCTION: Hypertension and tachycardia subsequent to tracheal intubation have been well documented. In susceptible patients it can cause increase in perioperative morbidity and mortality. Many agents have been used to attenuate these undesirable hemodynamic responses to laryngoscopy and intubation with varying success. Dexmedetomidine increases the hemodynamic stability by altering the stress induced sympatho-adrenal responses to laryngoscopy and intubation during surgery and emergence from anesthesia. On the other hand, magnesium sulfate can significantly attenuate the release of catecholamines at the time of laryngoscopy and tracheal intubation. AIM: The present study was aimed to compare Inj, Dexmedetomidine 1µg/kg and Magnesium sulfate 50mg/kg in attenuation of cardiovascular response to laryngoscopy and intubation. METHODS: A randomized prospective study was conducted in Silchar Medical College and Hospital, Silchar, Assam after obtaining Institutional Ethical Committee clearance and written informed consent from the patients. INCLUSION CRITERIA: Patients between age 18-60 years, of both sexes, ASA grade I&II and scheduled for elective surgical procedure under general anesthesia EXCLUSION CRITERIA: Refusal to informed consent, anticipated difficult airway, ASA grade III&IV, history of allergy to study drug, pregnant and lactating mother, any disorders of cardiovascular system, respiratory system, renal system, hepatic and neuromuscular conditions and duration of surgery less than 60mins. 100 patients were randomly allocated to two groups of 50 patients each. Group A received inj. dexmedetomidine (1.0μg / kg) and Group B received inj. Magnesium sulfate (50 mg/kg). Hemodynamic parameters of patients (HR, SBP, DBP, and MAP) were recorded immediately before anesthesia induction, just before intubation, just after intubation, at 2min, 5min and 10 minutes for the study purpose. All analyses were done by using two tailed test; p-value<0.05 was considered significant and <0.001 as highly significant. RESULTS: There was no significant difference between the groups with regard to demographic variables. The mean fall in HR, SBP, DBP and MAP values at 2 and 5 minutes of intubation were statistically highly significant (p=0.000) in group A as compared to group B. DISCUSSION: The results were compared with various other similar studies which had analyzed the effect of dexmedetomidine and magnesium sulfate for attenuation of cardiovascular response during laryngoscopy and intubation and our results correlated with those studies.
BONE BREAKING FEVER – BREAKING NORMS DREADLY DENGUE FEVER NO LONGER A SEVEN DAY FEVER
Dengue hemorrhagic fever is caused by dengue virus of 4 serotypes.Dengue 1,2,3,4 and belong to family of flaviviridae. Japan was not only the target of atomic bomb during the world war-2 but also a large dengue epidemic bomb. Between 1942 and 1944 in Nagasaki-japan a total of 23338 cases were reported. Because of the increase of air travel to tropics and subtropics,the dengue virus infection has spread from japan to other south east asian countries.
What is it ? The hypothesis asumes that 1 Dietary cholesterol / saturated fat increases serum cholesterol. 2 Increased serum cholesterol increases risk of Coronary Artery Disease . Based on this hypothesis physicians all across the globe advise - 3 Decrease cholesterol (statins) so as to decreases risk of CAD. 4 Cholesterol is a health hazard and should be maintained at lowest possible level . Let us peep into the history to understand how this hypothesis was conceived
COMPLETE HEART BLOCK IN AWMI: REVASCULARISATION OR PACEMAKER IMPLANTATION
Complete heart block can be either congenital or acquired. Among acquired causes common ones are drugs, degenerative diseases, infectious causes, rheumatic diseases, infiltrative processes, neuromuscular disorders, ischemic causes, metabolic causes,toxins and iatrogenic causes. RCA occlusion has high incidence of AV block which resolves promptly after revascularization. AV block in the setting of LAD territory occlusion has a more ominous prognosis. We revascularized LAD and prevented the implantation of Pacemaker
A CLINICAL COMPARATIVE STUDY OF EFFECT OF PROPOFOL, ETOMIDATE AND COMBINATION OF PROPOFOL AND ETOMIDATE ON ATTENUATION OF HAEMODYNAMIC RESPONSE TO ENDOTRACHEAL INTUBATION
Aim and objective: The aim of this study was to compare the effect of Propofol and Etomidate separately and in a combination with reduced doses of the two drugs in attenuating the hemodynamic response following laryngoscopy and intubation. Methods: After taking ethical committee clearance, A prospective randomized double blinded study involving 90 patients aged 18-60 years of either sex and ASA physical status I or II scheduled for elective surgery under general anesthesia were randomly placed into three groups. Group A induced with Inj.Propofol (2.5 mg/kg), Group B with Inj.Etomidate (0.3 mg/kg) and Group C with Inj.Propofol (1.5 mg/kg) plus Inj.Etomidate (0.15 mg/kg). Heart rate (HR), mean arterial pressure (MAP) were recorded at baseline, after induction, before intubation, immediately after intubation and then at 1min, 3 min, 5 min and 10 min. ANNOVA and chi-square test were used for statistical analysis. Result: Heart rate in all study groups decreases after induction and it was more in group A compared to group C (p<0.045) and after intubation HR increases in all three groups but this increase was greater in group B than A and C (p˂0.000, p˂0.001). MAP among all three groups decreases after induction and it was more in group A than group B and C (p˂0.000, p˂0.000). MAP was increased after intubation in all groups, more in group B than A and C(p˂0.000,p˂0.010). Conclusion: The combination of propofol plus Etomidate has better hemodynamic stability than propofol and etomidate alone.
OBSESSIVE COMPULSIVE DISORDER AND ITS AYURVEDIC PERSPECTIVES
Obsessive compulsive disorder is a heterogeneous and multidimensional psychiatric disorder. It is characterized mainly by obsessive thoughts and / or compulsive actions. Obsessions are recurrent and intrusive thoughts, feelings and ideas or sensations. Compulsions are conscious repetitive behaviors or actions such as checking, counting or avoiding. In the view Aayurvedic literatures, OCD can be considered as various stages mano vaishamya, mano vibhrama and budhi vibhrama. Almost all the factors described in the context of unmaada are deranged in the case of OCD. Although there are many effective treatments for OCD, up to a third of patients have treatment resistant OCD in modern concern. In ayurvedic view by drug therapy and ayurvedic psychotherapy yields good results in OCD.
A COMPARATIVE STUDY OF INDUCTION WITH LOW DOSE KETAMINE-PROPOFOL VERSUS FENTANYLPROPOFOL IN ATTENUATING THE HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND INTUBATION IN PATIENTS UNDERGOING GENERAL ANAESTHESIA
Background and Aims: The use of drugs to attenuate the haemodynamic response to laryngoscopy and endotracheal intubation is the standard of care during elective surgery. This study was conducted to compare the effect of two drug combinations using ketamine-propofol and fentanyl-propofol in attenuating haemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing general anaesthesia, duration of analgesia and side effects if any. Methods: After taking ethical committee clearance a randomized single blind prospective study involving 100 patients(18-60 years)of ASA-I and II undergoing GA for elective surgeries, were divided into 2 groups: Group K received Inj.Ketamine 0.5 mg/kg+inj.Propofol 2 mg/kg, Group F received Inj.Fentanyl 1.0 μg/kg+inj.Propofol 2 mg/kg. Haemodynamic parameters HR, SBP and DBP were recorded at baseline, after study drug, at 1min, 3min, 5 min, 10 min, 20 min after intubation and so on till completion of surgery. Pain score was assessed by Visual Analogue Scale (VAS) score. Student’s unpaired t-test and chi-square test tests were used for statistical analysis. Results: Upon induction with study drugs there was fall in SBP and DBP in both the groups but more in group F (p-value<0.0204 for SBP, p-value<0.0002 for DBP). On induction HR reduced in group F but it was slightly raised in group K (p-value<0.0001). After endotracheal intubation, at 1 minute, BP and HR increased significantly and reached above the baseline in group K but it remained below the baseline in group F(p-value<0.0001for HR and DBP,p-value<0.0158 for SBP). During maintenance phase group K showed more stable haemodynamics as compared to group F. The mean duration analgesia is significantly shorter 83.1 ± 10.814 mins for Group F and for Group K it is 91.64 ± 8.998 mins (P value< 0.0001). Conclusion: Fentanyl is superior to Ketamine in attenuating haemodynamic response to laryngoscopy and intubation. The duration of analgesia was shorter and rescue analgesia requirement was earlier in fentanyl group as compared to ketamine group and few untoward side effects were seen in both the groups.
“THE COMPARISON OF THE EFFECTS OF FENTANYL, ESMOLOL AND DEXMEDETOMIDINE FOR PREVENTION OF HAEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION”
Introduction : The aim of this study was to evaluate and compare the effects of Fentanyl, Esmolol and Dexmedetomidine for prevention of haemodynamic response to laryngoscopy and endotracheal intubation. Material and method: This study was carried out in 90, ASA grade I and II patients, aged 18 to 60 years who were scheduled for elective surgery under general anaesthesia and were divided into 3 groups of 30 each. Group A- received inj. Dexmedetomidine 1μg/kg diluted to 20 ml with normal saline, Group B - received inj. Fentanyl 2μg/kg, Group C received inj. Esmolol 2 mg/kg IV. Haemodynamic parameters like heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, SpO2 were recorded. Results: There was an increase in heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure during laryngoscopy and after endotracheal intubation in all the groups but increase was minimal in Dexmedetomidine group than Esmolol and Fentanyl group(P<0.05). Conclusion: Dexmedetomidine given 3 minutes prior to laryngoscopy and intubation is safe and more effective than Esmolol and Fentanyl in attenuating the haemodynamic response to direct laryngoscopy and endotracheal intubation.
INTRATHECALLY BUPRENORPHINE WITH 0.5% HEAVY BUPIVACAINE FOR POSTOPERATIVE ANALGESIA IN CESAREAN SECTION: A RANDOMISED CONTROL TRIAL.
This study was aimed to evaluate the effect of addition of intrathecal Buprenorphine to Bupivacaine heavy 0.5% on post operative analgesia in caesarian sections and the side effects associated with use of Buprenorphine. Method: Sixty patients posted for elective caesarian sections were randomly divided in two groups of 30 patients each. Patient received either 1.7 ml 0.5% Bupivacaine with + 0.3ml NS (Group A) or 1.7 ml 0.5% Bupivacaine with 90 mcg (0.3ml) buprenorphine (Group B) intrathecally. Results: Onset of analgesia was 3.2±0.2 min in group A while in group B 1.9±.1.42 min. Duration of postoperative analgesia was significantly prolonged in Group B (661.63±96.33min) than Group A (180.60±20.86min). Addition of buprenorphine 90μg to intrathecal bupivacaine prolonged the duration of postoperative analgesia after LSCS without effect of on neonatal Apgar score and with minimal maternal side effect.
A CASE STUDY - CLINICAL APPROACH WHILE TREATING A SKIN DISORDER
Skin disorders have different etiological factors. Patients come to us with variety of complaints. In short, we Vaidyas, observe different Sampraptis and hence one may get confused while naming a particular disease. But, only name alone cannot provide you a treatment approach especially in Ayurvedic treatment. A proper Ayurvedic Nidan is nothing but to know proper Doshawastha irrespective of name of skin disorder. This paper will enlighten clinical fundamentals while treating a skin disorder with the help of case study.
AYURVEDIC APPROACH IN MANAGEMENT OF DADRU KUSHTHA
Skin is the largest organ of human body also it protects the body from invading pathogens. In Ayurveda all the skin diseases are considered under the Vyadhi Kushtha. All kushtha have Tridosha involvement but according to the types of kushtha their is predominance of particular doshas. Dadru kushtha is a type of kshudra kushtha according to Acharya Charaka, while Acharya Vagbhata and Acharya Sushruta mentioned it under Mahakushtha. Pitta-Kapha dosha are predominant in Dadru Kushtha. The present Case study is management of Dadru Kushtha through Ayurveda. A 28 year old female patient presented with erythamatous lesions over B/L lower limb (below knee) with severe itching, burning sensation, redness, irregular bowel evacuation since 1 month. She has taken allopathic medicine and got temporary relief. Ayurvedic treatment involved Arogyavardhini vati, Gandhaka Rasyana, Nimba Tail and Raktamokshana by Jalloukavacharana. A significant relief was seen in 4 weeks.
CLINICAL PROFILE AND CORRELATION OF SERUM BNP LEVEL AT ADMISSION WITH ICU STAY DURATION IN PATIENTS OF ACUTE DECOMPENSATED HEART FAILURE
BACKGROUNDS: Serum BNP levels have been established for diagnosis of HF in proportion to severity of symptoms, degree of LV dysfunction with other comorbidity and predict morbidity and mortality in HF pts. Methods: A Case series descriptive study of 50 patients admitted in ICU of HSK Hospital, Bagalkot in duration of 3 months of study period with HF (according to symptoms and LV dysfunction) and perform spot test of serum BNP level(reference value >100pg/ml) and correlate with pts ICU stay duration. Results: Study comprised of 50 HF pts. In this study mean age of 63 yr pts and their association distribution with BNP level was 1100 pg/ml and 4 days of mean ICU stay by using Pearson Chi-Square test (X2-0.996b). High level of BNP with other comorbities also prolong the duration of ICU stay. Conclusion: This Study shows that in patients with heart failure, raise BNP level is associated with long ICU stay in hospital. So, it can use as predictor for in hospital treatment. Further this Study shows possibility of associated complications with various comorbidities in heart failure patients, who had raised BNP levels. So, it can use as a prognostic indicator.
AYURVEDIC MANAGEMENT OF PID (PARIPLUTA YONIVAYAPAD) - A CASE STUDY.
In our classics, acharya’s have mentioned twenty Yonivayapad which attribute as a major cause in affecting the normalcy of the female reproductive tract. In which Paripluta Yonivayapad can be correlated with the pelvic inflammatory disease. The Pelvic inflammatory disease is the disease of upper genital tract. Today’s era pelvic inflammatory disease is rising in an alarming way and its recurrence decreases the fertility rate. If it goes untreated it causes infertility, chronic pain, fallopian tube blockage which leads to ectopic pregnancy likely. Aim: Evaluation of proper management of disease not only to cure but to reduce recurrence rate through Ayurvedic management. Materials and Methods: In this article, a case report of patient age 33 years married since 6 years, nulligravida with c/o lower abdominal pain which aggregates before and during menses since one and half years along with vaginal discharge. Treatment planned was Shodhana Chikitsa through Virechana and Basti, while shamana chikitsa through Pushyanug Churna, Kanchnar Guggul and Chandraprabha Vati and sthanik chikitsa Yonidhavana through Dashmula Kwath. Result: Patient symptoms were reduce, hence it can be stated that pelvic inflammatory diseases can be treated through proper Ayurvedic management.
ANALYSIS TO OPTIMIZE PERFORMANCE OF UNSTRUCTURED DATA FROM CLOUD ENVIRONMENT
Vast amount of digital information build up are of different types and complex that is labeled as Big Data. The knowledge increased from Big Data adds value through Big Data Analytics (BDA). Essential part of BDA is Cost minimization and it can be attained by monitoring the system performance in the cloud. As the established methods of data management not properly supported by the cloud. For these reasons it was needed to look for some methodology to obtain solution and to optimize the performance. Therefore there is a need to develop Performance Optimization algorithms for the NoSQL database under consideration. The main objective of proposed study is to improve performance of unstructured data stored in the cloud environment using some methodologies tools.
AGRICULTURE AND AGRICULTURISTS IN ANCIENT PERIOD AT TIRUNELVELI REGION – HISTORICAL STUDY
Agriculture was the main occupation of the Tamils and that was compelled them to assign greater veneration to that profession. Agriculture was a prime need of the people for having their food stuffs. Agriculture was the back-bone of the Indian Economy; it has been highly honored and respected by the common people of TamilNadu State. Tirunelveli District was not an exception. Most of the people of this region directly or indirectly depended upon agriculture. Majority of the people lived in a rustic life in the villages. The cultivation of paddy and vegetables being principal items of food of the people of this region, compelled to engage themselves in Agriculture operations. That also compels one to have a portrayal of the agriculture and agriculturists of the Tamil country during the period mentioned earlier. This papers gives explanations about the glory of Tirunelveli District, land, soil and season of Tirunelveli District. And also this paper pointed out the elucidation on Agricultural implements, Ploughing, Irrigational System, Rivers, Tanks, Peasant community, Profesionals and Labourers and Taxation in Tirunelveli District.
A STUDY ON MIGRATION OF LABOURS WITH REFERENCE TO TIRUPUR DISTRICT
Temporary migrants from Uttar Pradesh, Bihar and Jharkhand move out of the state for work. Comparison between temporary and permanent labour migration shows that temporary labour migration is seven times higher than permanent labour migration rate. A regional pattern in temporary labour migration is evident in Tirupur, Coimbatore, Erode District 2018-2019. labour migration is mainly a survival strategy in the country, which is different from the phenomenon of permanent labour migration.
VARIOUS CRITICAL FACTORS REQUIRED CARE FOR MAINTENANCE OF MODERNIZATION ON ART EDUCATION IN INDIA
Modernization process took place on Art Education in India was a continuation of similar processes took place in various venues all over the world, beginning from the Florentine School which supported many major artists like Michelangelo. There is a straight clear path definable from 15th century developments through Salon de Refuses in Paris, and establishments of various schools all over the World to modern developments in India. In India British promoted art production in the lines of their tastes and educated Indian Artists productions to suits their tastes. In the past there was several developments lead promotion of an art education system which has roots with Bauhaus school of Europe. Starting from initiation of Kalabhavana by Tagore, also we fell in to the line of progress. It requires special care to keep the attitude of modernization while evaluating all different affecting faculties including changes in our walks of lives.
AMBEDKAR'S THOUGHTS OF ECONOMICS: AN ANALYSIS
Dadasaheb Dr. B.R Ambedkar was among the most excellent intellectuals of India in the 20th century.His one of the multidimensional personalities having great noteworthy contribution in economics is significant. His gives some economics thoughts “Small Holdings in India and Their Remedies: Ambedkar wrote in “Small Holdings in India and Their Remedies” in 1918, Ambedkar considered the problem of small landholdings in India and their fragmentation. Ambedkar argued that the real challenge lay in raising the stock of capital and that will be possible only if there is greater savings in the economy. was internal stability and he was convinced that only an automatic system based on gold standard with gold currency could achieve this desirable end. Further on, he says immediate efforts to rectify the inequalities in the general system of taxation. Thus Ambedkar thought on public Finance and agriculture has vital relevance and still applicable as positive solution for current economic problems in India.
PROFITABILITY OF SELECT SAMPLE VENTURE CAPITAL INSTITUTIONS IN INDIA: A COMPARATIVE ANALYSIS
Profit refers to the total income earned by an enterprise during the specific period of time. Ability refers to the earning power or operating performance of the concern in its investment. The compound term profitability refers to the operating efficiency of the enterprise. Profitability is the profit making ability which can be considered as an important factor for perpetual existence of firms. Profitability also maximizes the values of stakeholders as well as investors. Any business enterprise can discharge its obligations to various segments of the society only through earning profit. In this research paper the researcher made an attempt to present the analysis on profitability of select sample venture capital institutions of India and those of abroad operating in India. Profitability ratios considered for the purpose of analysis are earnings before interest and tax to capital employed, profit after tax to shareholders fund and earnings per share.