International Journal of Medical Sciences and Education (IJMSE)
Vol. 4; Issue: 1 (Jan-March 2017) , Date of Publication: 01.04.2017
COMPARATIVE ANALYSIS BETWEEN BONE MARROW ASPIRATION CYTOLOGY AND BONE MARROW BIOPSY EXAMINATION IN DIAGNOSIS OF LEUKEMIC PATIENTS
Dr. Shubhnita Garg, Dr. Mohammed Khushnood
ABSTRACT
Objective- bone marrow aspiration is main stay in diagnosis of leukemia. Though it is used from long time, sensitivity, diagnostic accuracy is yet not proven. So the objective of our study to find out diagnostic accuracy ,sensitivity ,specificity of bone marrow aspirate (BMA) cytology in diagnosis of leukemia and comparative diagnostic analysis of trephine biopsy with bone marrow aspirate cytology. Material And Method: In our study 30 Patients with suspected diagnosis of leukemia were included. Data was collected prospectively between Jan2015-Jan2016. The cytology smears were stained using appropriate stains. Bone marrow aspirate diagnosis and histo-pathological results of were compared and concordance was assessed. Result: In the present study we included 30 cases of leukemia in which BMA and bone marrow biopsy (BMB) was done, Out of which 19 cases were of chronic leukemia , 5 case were Acute leukemia, with mean age of 29 . Biopsy confirmation of the diagnosis was available in all the cases. Overall diagnostic sensitivity of BMA was 93.3 % for detecting malignancy. There were 02 false negative case were also diagnosed. Cyto-pathological Concordance was high in lymphocytic leukemia. Conclusion: Bone marrow aspiration is a safe and relatively non invasive procedure for diagnosis and evaluation of leukemia.
Keywords: Aspiration cytology, Bone marrow Biopsy, Leukemia.
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CERVICAL LYMPHADENOPATHY : CLINICO-PATHOLOGICAL STUDY OF 148 CASES
Saurabh Gakhar,Tarun Ojha, Kanak Yadav, Abhishek Sharma, Amit singhal , Abhay Sharma
ABSTRACT
Objective-: To study the incidence of disease in cervical lymph nodes by clinical examination and by studying pathology by fine needle aspiration cytology or excision biopsy. Method: This observational study was conducted at department of ENT Mahatma Gandhi medical college and hospital Sitapura Jaipur from June 14 to December 16 for a period of 2 and a half year .Where patients were studied for 2 years and follow up was done for 6 months. Total 148 patients were included in study. Results: Study group has 148 patients. Tuberculosis was the most common cause (44.6%) of cervical lymphadenopathy followed by reactive lymphadenopathy (28.38%); metastatic carcinoma and malignant lymphoma constitutes 18.9% and 8.1% respectively. The most common age group involved was 2nd and 3rd decade. Male patients were mostly affected in the study. The commonest size of nodal swelling was 2 – 4 cms. On examination maximum numbers of nodes affected in tuberculosis were level 5 followed by level 2. Reactive nodes were present mostly in level 2.Metastatic carcinoma submandibular and level 2 nodes were mostly involved. And lymphoma was found to be mostly involving level 2 nodes. FNAC was 90% effective in diagnosing tuberculosis patients and for the rest excision biopsy was done; while FNAC detected metastasis in all patients i.e. excision biopsy was not required. Excision biopsy done in all patients of lymphoma for purpose of immunohistochemistry. Conclusion: Tuberculosis is the most common cause of cervical lymphadenopathy followed by reactive lymphadenopathy and then by neoplastic lesions. FNAC is an effective modality for pathological diagnosis.
Keywords: Tuberculosis, Metastasis, cervical lymphadenopathy.
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RECRUITMENT OF STUDENTS AS VOLUNTEERS IN RESEARCH: A CROSS-SECTIONAL SURVEY OF MEDICAL STUDENTS AND FACULTY TO ASSESS PERCEPTION OF THE ETHICAL PRINCIPLES INVOLVED.
Dr Ratinder Jhaj ,Dr Balakrishnan Sadasivam, Dr. Niket Rai, Dr. Satish Chandel
ABSTRACT
Background: Students are an easily accessible and convenient source of volunteers for research by faculty in the medical field and are often invited to volunteer. Are medical students under pressure to participate in faculty research? Moreover, an increasing number of students are carrying out research projects for which they may recruit fellow students as volunteers. Does this dual role of a student as researcher and participant in research pose additional ethical dilemmas? Materials and Methods: In an attempt to answer the above questions and to assess awareness regarding the ethical issues involved in such research, we carried out a questionnaire-based survey of medical students and faculty of a tertiary care Institute in Central India. Results: Out of the 163 respondents, (87.1%) of the faculty, but only 48.4% students, responded that students would feel compelled to volunteer for a faculty who is currently teaching them. A much smaller percentage (38.6% of the faculty and 31.2% students) answered that there would be pressure to participate if the faculty researcher was not currently involved in their teaching. A total of 60% of the faculty and 41.9% of the students felt that if a research project has a student investigator; students will be more willing to participate, while 29% of the faculty replied they would approve such projects more readily as members of an Ethics Committee. Conclusion: Fear of poor marks on refusal to participate and a better student- faculty relation are major incentives for students to volunteer in faculty research. Having student investigators may increase student volunteerism.
Key words: Student volunteers, research, vulnerable
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THE PREVALENCE OF PILL OESOPHAGITIS IN A TERTIARY CARE CENTER.
Dr.Rashmi Modwal, Dr.Anushri Kaul.
ABSTRACT
Background : Pill oesophagitis in a common yet under diagnosed problem and the true incidence can only be found out by holding a high index of suspicion .Material & Methods: An analysis of all cause upper GI endoscopies over a finite time period was done and ones with suggestive symptoms segregated, endoscopic findings studied & pill oesophagitis cases identified. Results: Two hundred cases were subjected to Upper GI Endoscopy of which 47 had suggestive symptom like chest pain, heartburn, dysphagia, odynophagia, anorexia and unexplained poor oral intake. 11 Patients were found to have pill oesophagitis on endoscopy, eight of which had definite history of drug intake whereas other 3 had history of taking some medicine from local practitioner. Conclusions: Pill oesophagitis is an easily treatable, much more easily preventable condition provided the possibility is kept in mind. These patients are at times labelled functional or hysterical as they suddenly start complaining of chest pain when their basic disease was elsewhere and symptoms unrelated.
Key Words: pill oesophagitis, drug, Endoscopy.
PDF FULL TEXT
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ROPIVACAINE AND ROPIVACAINE WITH CLONIDINE IN EPIDURAL BLOCK FOR UROLOGICAL SURGERIES - A COMPARATIVE STUDY
Dr.Varun Kumar Saini, Dr Manish Khandelwal, Dr Gaurav Sharma, Dr Neha Saini
ABSTRACT
Background: Epidural anaesthetic techniques are commonly used for various operative procedures, obstetric analgesia, postoperative pain and chronic pain management. Due to similar analgesic properties, lesser motor blockade and decreased cardiotoxic tendency ropivacaine is increasingly used instead of bupivacaine now a days. Clonidine has been frequently used as an adjunct to local anesthetics because it improves the quality of anesthesia, reduces the dose requirement of the anesthetic agent and provides a more stable cardiovascular course. In this study we included 60 patients undergoing various endoscopic urological surgeries like TURP, URS, OIU and cystoscopy procedures. Material and Methods: Patients were randomly divided in two groups. R-Group: 30 patients received 0.5% ropivacaine 18 ml. RC-Group: 30 patients received 0.5% ropivacaine 18 ml with clonidine 60 μg. Pre-op and intra-op, haemodynamic parameters, onset of block, duration of sensory block and side effects was observed and recorded. Results: Onset of block was faster along with duration of analgesia was significantly longer in RC-group. The objective evidence of block like mean arterial pressure, heart rate, also showed significant change in RC-group. The quality of analgesia was better in RC-group. Level of sedation, side effects were not statistically significant. Conclusion: Clonidine as an adjunct to Ropivacaine by epidural injection improves and augments the onset of block, reduces heart rate and blood pressure. It also prolong the duration and the quality of analgesia, with no more side effects like nausea vomiting and sedation.
Keywords: Clonidine, Epidural block, Ropivacaine, Urological Surgeries
PDF FULL TEXT
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SENSITIZING RESIDENTS OF A TERTIARY CARE HOSPITAL TO PRE-TEST COUNSELING FOR HIV: A TOOL TO IMPROVE COMMUNICATION SKILL FOR A BETTER DOCTOR PATIENT RELATIONSHIP
Dr.Poonam S.Loomba,Dr.Rup Jyoti Chandak
ABSTRACT
Background: CDC recommends that HIV testing as a routine part of care in order to increase the number of people who know their HIV status, so that steps can be taken to reduce transmission and to decrease morbidity. Pre test counseling plays an important role in HIV counseling. Unfortunately residents do not know the correct procedure and lack the communication skills to carry out counseling.Aim and Objectives: To improve the communication skills of residents regarding HIV pre test counseling by training them on the correct procedure.Material and Method: 15 residents were enrolled in the study. 300 patients were assessed regarding the quality of pre test counseling using a 5 point Likert scale. The residents then underwent training on the correct procedure after which they did counseling for 20 patients each. A feedback was then taken from these patients regarding the quality of counseling and the data analyzed.Results: The pre intervention knowledge regarding HIV test counseling of the residents was very poor and the patient satisfaction score from 300 patients was low with an overall average score of 2.455. Following training of the residents on the correct procedure and how to communicate with the patients, there was an increase in patient satisfaction with an average score of 4.075. Conclusions: Training the residents on pre-test HIV counseling results in residents getting sensitized to the correct procedure and improving their communication skills and increased patient satisfaction
KEYWORDS:counseling, HIV,residents,training
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SEROPOSITIVITY OF CHIKUNGUNYA, CO-EXISTENCE OF CHIKUNGUNYA VIRUS WITH DENGUE VIRUS: A STUDY AT A TERTIARY CARE HOSPITAL, UDAIPUR, RAJASTHAN
Dr Anshu Sharma, Deepa Upadhyay, Dr Taruna Swami
ABSTRACT
Introduction: Diseases due to Arboviruses are one of the major public health problems and a major constituent of emerging infectious diseases worldwide. Out of many Arboviruses Chikungunya virus and Dengue virus are the two most rapidly spreading and medical health important. Both the diseases have some common signs and symptoms. Objectives: To study the Seropositivity of Chikungunya virus and observation of Co-existence of Chikungunya virus with Dengue virus.Materials and Methods: 355 serum samples from patients with febrile illness attending to the inpatient and outpatient department were processed by Chikungunya IgM Capture ELISA and Dengue IgM Capture ELISA.Results: Of 355 serum samples, febrile illness was higher in males (54.64%) than in females (45.36%), with male to female ratio 1.2:1. Most affected age group from febrile illness belongs to 21-30 years (36.34%), followed by age group 31-40 (22.82%). 3 (0.84%) were sero-positive, 17 (4.78%) were equivocal and 335 (94.37%) were negative for Chikungunya virus. Of the affected cases with Chikungunya 66.66% were males and 33.34% were females. All the affected cases were belong to age group 31-40 years. Co-existence of CHIK V and DEN V was found in only 0.28% samples.Conclusion: The present study highlights the fact that Chikungunya virus infection is an important cause of febrile illness and emphasizes the need of continuous surveillance for Chikungunya virus disease using multiple diagnostic tests. In the present study Chikungunya Seropositivity is less as compared to other studies whereas Co-existence of Chikungunya with Dengue virus (0.28%) suggests possibilities of both arboviruses in this region.
Keywords: Chikungunya virus, Dengue virus, ELISA.
PDF FULL TEXT
_____________________________________________________________
Dr. Shubhnita Garg, Dr. Mohammed Khushnood
ABSTRACT
Objective- bone marrow aspiration is main stay in diagnosis of leukemia. Though it is used from long time, sensitivity, diagnostic accuracy is yet not proven. So the objective of our study to find out diagnostic accuracy ,sensitivity ,specificity of bone marrow aspirate (BMA) cytology in diagnosis of leukemia and comparative diagnostic analysis of trephine biopsy with bone marrow aspirate cytology. Material And Method: In our study 30 Patients with suspected diagnosis of leukemia were included. Data was collected prospectively between Jan2015-Jan2016. The cytology smears were stained using appropriate stains. Bone marrow aspirate diagnosis and histo-pathological results of were compared and concordance was assessed. Result: In the present study we included 30 cases of leukemia in which BMA and bone marrow biopsy (BMB) was done, Out of which 19 cases were of chronic leukemia , 5 case were Acute leukemia, with mean age of 29 . Biopsy confirmation of the diagnosis was available in all the cases. Overall diagnostic sensitivity of BMA was 93.3 % for detecting malignancy. There were 02 false negative case were also diagnosed. Cyto-pathological Concordance was high in lymphocytic leukemia. Conclusion: Bone marrow aspiration is a safe and relatively non invasive procedure for diagnosis and evaluation of leukemia.
Keywords: Aspiration cytology, Bone marrow Biopsy, Leukemia.
PDF FULL TEXT
_____________________________________________________________
CERVICAL LYMPHADENOPATHY : CLINICO-PATHOLOGICAL STUDY OF 148 CASES
Saurabh Gakhar,Tarun Ojha, Kanak Yadav, Abhishek Sharma, Amit singhal , Abhay Sharma
ABSTRACT
Objective-: To study the incidence of disease in cervical lymph nodes by clinical examination and by studying pathology by fine needle aspiration cytology or excision biopsy. Method: This observational study was conducted at department of ENT Mahatma Gandhi medical college and hospital Sitapura Jaipur from June 14 to December 16 for a period of 2 and a half year .Where patients were studied for 2 years and follow up was done for 6 months. Total 148 patients were included in study. Results: Study group has 148 patients. Tuberculosis was the most common cause (44.6%) of cervical lymphadenopathy followed by reactive lymphadenopathy (28.38%); metastatic carcinoma and malignant lymphoma constitutes 18.9% and 8.1% respectively. The most common age group involved was 2nd and 3rd decade. Male patients were mostly affected in the study. The commonest size of nodal swelling was 2 – 4 cms. On examination maximum numbers of nodes affected in tuberculosis were level 5 followed by level 2. Reactive nodes were present mostly in level 2.Metastatic carcinoma submandibular and level 2 nodes were mostly involved. And lymphoma was found to be mostly involving level 2 nodes. FNAC was 90% effective in diagnosing tuberculosis patients and for the rest excision biopsy was done; while FNAC detected metastasis in all patients i.e. excision biopsy was not required. Excision biopsy done in all patients of lymphoma for purpose of immunohistochemistry. Conclusion: Tuberculosis is the most common cause of cervical lymphadenopathy followed by reactive lymphadenopathy and then by neoplastic lesions. FNAC is an effective modality for pathological diagnosis.
Keywords: Tuberculosis, Metastasis, cervical lymphadenopathy.
PDF FULL TEXT
_____________________________________________________________
RECRUITMENT OF STUDENTS AS VOLUNTEERS IN RESEARCH: A CROSS-SECTIONAL SURVEY OF MEDICAL STUDENTS AND FACULTY TO ASSESS PERCEPTION OF THE ETHICAL PRINCIPLES INVOLVED.
Dr Ratinder Jhaj ,Dr Balakrishnan Sadasivam, Dr. Niket Rai, Dr. Satish Chandel
ABSTRACT
Background: Students are an easily accessible and convenient source of volunteers for research by faculty in the medical field and are often invited to volunteer. Are medical students under pressure to participate in faculty research? Moreover, an increasing number of students are carrying out research projects for which they may recruit fellow students as volunteers. Does this dual role of a student as researcher and participant in research pose additional ethical dilemmas? Materials and Methods: In an attempt to answer the above questions and to assess awareness regarding the ethical issues involved in such research, we carried out a questionnaire-based survey of medical students and faculty of a tertiary care Institute in Central India. Results: Out of the 163 respondents, (87.1%) of the faculty, but only 48.4% students, responded that students would feel compelled to volunteer for a faculty who is currently teaching them. A much smaller percentage (38.6% of the faculty and 31.2% students) answered that there would be pressure to participate if the faculty researcher was not currently involved in their teaching. A total of 60% of the faculty and 41.9% of the students felt that if a research project has a student investigator; students will be more willing to participate, while 29% of the faculty replied they would approve such projects more readily as members of an Ethics Committee. Conclusion: Fear of poor marks on refusal to participate and a better student- faculty relation are major incentives for students to volunteer in faculty research. Having student investigators may increase student volunteerism.
Key words: Student volunteers, research, vulnerable
PDF FULL TEXT
_____________________________________________________________
THE PREVALENCE OF PILL OESOPHAGITIS IN A TERTIARY CARE CENTER.
Dr.Rashmi Modwal, Dr.Anushri Kaul.
ABSTRACT
Background : Pill oesophagitis in a common yet under diagnosed problem and the true incidence can only be found out by holding a high index of suspicion .Material & Methods: An analysis of all cause upper GI endoscopies over a finite time period was done and ones with suggestive symptoms segregated, endoscopic findings studied & pill oesophagitis cases identified. Results: Two hundred cases were subjected to Upper GI Endoscopy of which 47 had suggestive symptom like chest pain, heartburn, dysphagia, odynophagia, anorexia and unexplained poor oral intake. 11 Patients were found to have pill oesophagitis on endoscopy, eight of which had definite history of drug intake whereas other 3 had history of taking some medicine from local practitioner. Conclusions: Pill oesophagitis is an easily treatable, much more easily preventable condition provided the possibility is kept in mind. These patients are at times labelled functional or hysterical as they suddenly start complaining of chest pain when their basic disease was elsewhere and symptoms unrelated.
Key Words: pill oesophagitis, drug, Endoscopy.
PDF FULL TEXT
_____________________________________________________________
ROPIVACAINE AND ROPIVACAINE WITH CLONIDINE IN EPIDURAL BLOCK FOR UROLOGICAL SURGERIES - A COMPARATIVE STUDY
Dr.Varun Kumar Saini, Dr Manish Khandelwal, Dr Gaurav Sharma, Dr Neha Saini
ABSTRACT
Background: Epidural anaesthetic techniques are commonly used for various operative procedures, obstetric analgesia, postoperative pain and chronic pain management. Due to similar analgesic properties, lesser motor blockade and decreased cardiotoxic tendency ropivacaine is increasingly used instead of bupivacaine now a days. Clonidine has been frequently used as an adjunct to local anesthetics because it improves the quality of anesthesia, reduces the dose requirement of the anesthetic agent and provides a more stable cardiovascular course. In this study we included 60 patients undergoing various endoscopic urological surgeries like TURP, URS, OIU and cystoscopy procedures. Material and Methods: Patients were randomly divided in two groups. R-Group: 30 patients received 0.5% ropivacaine 18 ml. RC-Group: 30 patients received 0.5% ropivacaine 18 ml with clonidine 60 μg. Pre-op and intra-op, haemodynamic parameters, onset of block, duration of sensory block and side effects was observed and recorded. Results: Onset of block was faster along with duration of analgesia was significantly longer in RC-group. The objective evidence of block like mean arterial pressure, heart rate, also showed significant change in RC-group. The quality of analgesia was better in RC-group. Level of sedation, side effects were not statistically significant. Conclusion: Clonidine as an adjunct to Ropivacaine by epidural injection improves and augments the onset of block, reduces heart rate and blood pressure. It also prolong the duration and the quality of analgesia, with no more side effects like nausea vomiting and sedation.
Keywords: Clonidine, Epidural block, Ropivacaine, Urological Surgeries
PDF FULL TEXT
_____________________________________________________________
SENSITIZING RESIDENTS OF A TERTIARY CARE HOSPITAL TO PRE-TEST COUNSELING FOR HIV: A TOOL TO IMPROVE COMMUNICATION SKILL FOR A BETTER DOCTOR PATIENT RELATIONSHIP
Dr.Poonam S.Loomba,Dr.Rup Jyoti Chandak
ABSTRACT
Background: CDC recommends that HIV testing as a routine part of care in order to increase the number of people who know their HIV status, so that steps can be taken to reduce transmission and to decrease morbidity. Pre test counseling plays an important role in HIV counseling. Unfortunately residents do not know the correct procedure and lack the communication skills to carry out counseling.Aim and Objectives: To improve the communication skills of residents regarding HIV pre test counseling by training them on the correct procedure.Material and Method: 15 residents were enrolled in the study. 300 patients were assessed regarding the quality of pre test counseling using a 5 point Likert scale. The residents then underwent training on the correct procedure after which they did counseling for 20 patients each. A feedback was then taken from these patients regarding the quality of counseling and the data analyzed.Results: The pre intervention knowledge regarding HIV test counseling of the residents was very poor and the patient satisfaction score from 300 patients was low with an overall average score of 2.455. Following training of the residents on the correct procedure and how to communicate with the patients, there was an increase in patient satisfaction with an average score of 4.075. Conclusions: Training the residents on pre-test HIV counseling results in residents getting sensitized to the correct procedure and improving their communication skills and increased patient satisfaction
KEYWORDS:counseling, HIV,residents,training
PDF FULL TEXT
_____________________________________________________________
SEROPOSITIVITY OF CHIKUNGUNYA, CO-EXISTENCE OF CHIKUNGUNYA VIRUS WITH DENGUE VIRUS: A STUDY AT A TERTIARY CARE HOSPITAL, UDAIPUR, RAJASTHAN
Dr Anshu Sharma, Deepa Upadhyay, Dr Taruna Swami
ABSTRACT
Introduction: Diseases due to Arboviruses are one of the major public health problems and a major constituent of emerging infectious diseases worldwide. Out of many Arboviruses Chikungunya virus and Dengue virus are the two most rapidly spreading and medical health important. Both the diseases have some common signs and symptoms. Objectives: To study the Seropositivity of Chikungunya virus and observation of Co-existence of Chikungunya virus with Dengue virus.Materials and Methods: 355 serum samples from patients with febrile illness attending to the inpatient and outpatient department were processed by Chikungunya IgM Capture ELISA and Dengue IgM Capture ELISA.Results: Of 355 serum samples, febrile illness was higher in males (54.64%) than in females (45.36%), with male to female ratio 1.2:1. Most affected age group from febrile illness belongs to 21-30 years (36.34%), followed by age group 31-40 (22.82%). 3 (0.84%) were sero-positive, 17 (4.78%) were equivocal and 335 (94.37%) were negative for Chikungunya virus. Of the affected cases with Chikungunya 66.66% were males and 33.34% were females. All the affected cases were belong to age group 31-40 years. Co-existence of CHIK V and DEN V was found in only 0.28% samples.Conclusion: The present study highlights the fact that Chikungunya virus infection is an important cause of febrile illness and emphasizes the need of continuous surveillance for Chikungunya virus disease using multiple diagnostic tests. In the present study Chikungunya Seropositivity is less as compared to other studies whereas Co-existence of Chikungunya with Dengue virus (0.28%) suggests possibilities of both arboviruses in this region.
Keywords: Chikungunya virus, Dengue virus, ELISA.
PDF FULL TEXT
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