Volume 1 Issue 1
International Journal of Medical Sciences and Education (IJMSE)
Vol. 1; Issue: 1 (March 2014)
Date of Publication: 01.03.2014
1 CHRONIC SCLEROSING SIALADENITIS MASQUERADING AS SALIVARY GLAND TUMOUR
Dr. Prashant Sharma1*, Dr. Ritu Mehta2, Dr. Sanjeev K.Agrawal1, Dr.P.M.Parihar3
Abstract: Küttner described 4 cases of chronic sclerosing sialadenitis (CSS) of submandibular gland in 1896 and defined it as a chronic inflammatory salivary gland disease. Although chronic sclerosing sialadenitis is an inflammatory lesion of the salivary glands but sometime mimics malignant masses of salivary glands. We reported a 35-year-old male with a neck swelling of chronic sclerosing sialadenitis and it was initially diagnosed as malignancy.
Keywords: chronic sclerosing sialadenitis, sialoliths, submandibular gland, salivary glands.
PDF Full Text
2 LYMPHANGIOMYOMATOSIS - A RARE INTERSTITIAL LUNG DISEASE (ILD)
Dr. Rishi Kumar Sharma, Dr. Gaurav Chhabra, Dr. S.K.Luhadia
Abstract: We report a case of a 26 years old Female with Lymphangiomyomatosis , a rare multi system disorder. Clinical history was sudden onset of chest pain and was operated for Left Renal Angiomyolipoma 4 years back. Her Chest X-Ray showed Left sided Pneumothorax. Her CT Thorax was suggestive of bilateral diffuse well defined cystic shadows distributed all over lung fields surrounded by normal Lung Parenchyma along with Left Pneumothorax, distinguishing features for pulmonary Lymphangioleiomyomatosis. Lymphangioleiomyomatosis is under diagnosed by clinicians, so awareness of this disorder may be helpful to reduce morbidity and mortality.
Keywords: Lymphangioleiomyomatosis, Pneumothorax, Renal Angiomyolipoma CT-Thorax
PDF Full Text
3.Aetiology and presentation of neonatal septicaemia at tertiary care Hospital of southern Rajasthan
Dr.Deepandra Garg,Dr.Neha Agrawal
Abstract: Objective: Sepsis is the one of the common cause of neonatal mortality. The aetiology of neonatal sepsis has variations according to the various customs and practices in the perinatal and neonatal period and geographical area.This study was designed to analysis the magnitude and aetiological characteristics of neonatal sepsis. Martial and Methods: This descriptive study included 35 full-term neonates of birth weight >2.5 kg admitted in Nursery Balchikitsalaya RNT Medical College, Udaipur (Lodger and intramural). The study was carried out during the month of March to May of year 2006. A structured Performa was used to collect the information for the baseline characteristics like age, gender, birth weight, gestational age, mode of delivery of the neonate and age of onset of illness. Results: Out of 35 full-term neonates with neonatal sepsis were included in the study by consecutive sampling.The most common bacteria grown was coagulase negative staphylococcus (CONS) (28.57%) followed by coagulase positive staphylococcus (21.42%) and streptococcus fecalis (14.28%). Other organism grown in blood culture are a-hemolytic streptococci in one case (7.14%), Klebsiella in one case (7.14%), proteus in one case (7.14%), and E. coli in one case (7.14%).lastly one case of blood culture showed Candida albicans. Conclusion: Most common organisms were coagulase negative staphylococcus (CONS) (28.57%) followed by coagulase positive staphylococcus (21.42%)
Key Words: Neonatal sepsis, Sensitivity and resistance, Antibiotics, organisms.
PDF Full Text
4.Ormeloxifene: Boon to perimenopausal Dysfunctional Uterine Bleeding (DUB) women in avoiding hysterectomies
Dr. S. Fayyaz Shahab, Dr. Shailesh Jain, Dr. Jyoti Jain,Dr.Ujjwala Jain.
Abstract: Aim and objective: To observe effect of ormeloxifene for treatment of perimenopausal Dysfunctional Uterine Bleeding (DUB) women and follow up in terms of avoiding hysterectomies and to compare ormeloxifene with norethisterone in terms of relief of symptoms, patient acceptability and complications. Material and Methods: 300 cases of DUB from two hospitals who have completed child bearing and are between 40-55 years were given Ormeloxifene and Norethisterone during period January 2009 to December 2012 (3 years).Ormeloxifene group (n=150) received 60 mg twice weekly for 12 weeks followed by once weekly for 3 months initially. Norethisterone (n=150) group received 5mg twice a day for 12 days in every cycle for 6 months. Results: 123(82%) women in the ormeloxifene administered patients and 45(30%) of norethisterone group had marked relief of symptoms with significant reduction of blood clots, reduction of Pictorial Blood Assessment Chart (PBAC) scores ( =25.36,P value=0.0001, extremely significant). Side effects/complications included amenorrhea (=0.614, P value=0.433, not significant), irregular periods (=0.614, P value=0.1102, not significant). 54(36%) of ormeloxifene group and 36(24%) had bout of bleeding after treatment was stopped (=1.190, P value=0.2752, not significant). Dosage schedule of ormeloxifene administration facilitated compliance and acceptability. Conclusion: Ormeloxifene has better compliance and acceptability with marked relief in symptoms. Women who underwent hysterectomy after treatment were significantly less in ormeloxifene group. Though the study size is small, it highlights the role of ormeloxifene in reducing menorrhagia and avoiding surgery in perimenopausal women with proper follow up.
Keywords: ormeloxifene , hysterectomy.
PDF Full Text
5.The study of socioeconomic factor affecting breast feeding practice among family of rural area of Jaipur
Dr. Veerbhan Singh, Dr. Archana Paliwal, Dr. Indu Mohan, Dr. S. L. Bhardwaj ,Dr.Ram Chandra Choudhary , Dr. Bhupendra Nath Sharma
Abstract: Objectives: To study the socio-economic factors influencing initiation and duration of breast feeding. Material and methods: A cross-sectional prevalence based study was conducted on 400 mothers and their infants residing in the rural area of Jaipur within six months (Jan13 to June-13). Information was collected and analyzed on occupation, socio-economic status, literacy status and type of work, type of family, residential environment, life-style. Information regarding infant’s anthropometric measurements, feeding practices, weaning and immunization status are also obtained. Results: According to socioeconomic classification, maximum mothers belongs to class III 155(38.75%), followed by 81(20.25%) mothers from socio-economic class V, 73(18.25%) mothers were from socio-economic class IV, 49(12.25%) were from socio-economic class II and 42(10.5%) mothers were from socio-economic class VI. Literacy wise,148(37%) mothers were illiterate, 95(23.75%) mothers were educated up to primary level followed by 74(18.5%) educated up to middle, 45(11.25%) educated up to secondary level, 16 (4%) mothers educated up to higher secondary and rest 22(5.5%) mothers were graduate and above. Conclusion: Multiple health problems was encountered in the survey area dominated by twin problems of malnutrition along with infective diseases which are associated with socioeconomic factors like mothers illiteracy, mother working conditions, family income and socio- economic status. Looking forth on these matters socioeconomic status is an important factor affecting the care of infants in terms breast feeding, weaning and personal hygiene.
Keywords: socio-economic factors, breast feeding practice, occupation, literacy status.
PDF Full Text
6. The study of the organisms colonizing trachea in mechanically ventilated patients admitted in the Intensive Care Unit (ICU)
Abstract: Objectives: To isolate and identify the organisms colonizing trachea in mechanically ventilated patients admitted in the Intensive Care Unit (ICU).Methods: The present study was conducted on 265 patients were admitted in the ICU during from July 2004 to June 2005 in Government Medical College & Hospital, Aurangabad (Maharashtra). A total of 100 patients on mechanical ventilation with intubation tube fulfilling the inclusion criteria were followed-up prospectively. The patterns of tracheal colonization were studied in these patients. Patients were followed-up twice a week on day 4 and day 7. The antibiotic sensitivity testing of the isolated organisms were carried on Mueller-Hinton Agar (MHA) Results: In all total 361 isolates of organisms were identified from the 229 processed samples of endotracheal aspirates (EA) of mechanical ventilation. Pseudomonas aeruginosa was the most commonly isolated organism, present in 135 (37.4%), followed by Klebsiella pneumonia in 103 (28.5%),Staphylococcus epidermidis in 53 (14.7%), Staphylococcus aureus in 10 (4.36%)among the 229 positive culture samples.The isolation rate of Pseudomonas aeruginosa increased with the duration of ventilation from 18.5% on day 1 to 46.7 % on day 7. Conclusion: One aspect been proven beyond doubt is that, the microorganisms, either exogenous or endogenous, colonize the normally sterile trachea of mechanically ventilated patients before the development of VAP. Nevertheless, the optimal management of patients with VAP requires collaboration amongst critical care specialists and microbiologists.
Keywords: Ventilation-associated pneumonia, endotracheal aspirates, mechanical ventilation, Microorganisms.
PDF Full Text
7. ELECTROLYTES IMBALANCE IN TRAUMATIC BRAIN INJURY PATIENTS
Dr Sanjay K.Gupta1*, Dr Jitendra Ahuja, Dr Arvind Sharma
Abstract: Objectives: The role of electrolyte imbalance is being delineated in severe cranial trauma and is an essential investigations for its therapeutic managements. This study is designed to uncover the prevalence of electrolyte imbalance in traumatic brain injury (TBI) patients. Material and Methods: 50 consecutive patients with head injury and 50 trauma patients without clinical and radiological evidence of head injury were admitted to the emergency service of Geetanjali Medical College, Udaipur during 2 month period. We measured serum level of Magnesium, phosphorus, calcium, potassium and sodium and calculate APACHE score for prognosis at admission. We compared all electrolyte values in two groups taking head injury patient as case and trauma patient without head injury as control. Results: Different Electrolyte levels at admission in group 1 vs. group 2 were as follows (mean ±SD): Na levels were 138.85±5.68 vs. 140.62±5.89 in groups 1 and 2, respectively. K levels were not very significant between both groups group 1 vs group 2 (4.23±0.62 mmol/L vs. 4.384±0.54mmol/L; (p, .20). Phosphorus 2.971 ±0.91 vs. 3.48±0.91 (p, .01). Mg, 2.1086±0.44 vs. 2.96±0.68 (p, .01). Ca levels were 8.17±0.74 vs. 8.68±1.12mg/dl for groups 1 and group 2, respectively (p=0.008). Conclusion: We conclude that patients with brain injury are at a high risk for the development of electrolyte imbalance including hyponatremia, hypocalemia, hypophosphatemia as well as hypokalemia and (to a lesser degree) Hypomagnesemia.
Keywords: Traumatic Brain Injury, hyponatremia, hypocalcemia, hypophosphatemia, Hypomagnesemia.
PDF Full Text
8.ASSESSMENT OF METABOLIC SYNDROME AMONG PATIENTS OF PSORIASIS AT TERTIARY CARE CENTER
Dr. Jayesh Rashik Lal Shah
Abstract:Objectives: Psoriasis is a common skin disease with a variable prevalence across different regions of the world, depending upon racial, geographical and environmental factors. According to various published reports, its prevalence varies from 0.9 to 8.5%.Material & Methods: The present prospective study was conducted at department of dermatology of our tertiary care hospital. It was a non-interventional hospital-based cross-sectional study, which was conducted over a period of 11 months. The study was approved by the Institutional Ethical Committee. During the study period, fifty psoriasis patients satisfying the following inclusion criteria were enrolled.Results: In present study, Metabolic syndrome was more prevalent in psoriasis patients than controls but the difference was not significant statistically (30% vs 16%, p=0.0979). Although psoriasis patients had higher prevalence of hypertriglyceridemia, hyperglycemia, hypertension and central obesity than controls, but the difference was statistically insignificant. The prevalence of low high-density lipoprotein (HDL) cholesterol was significantly higher in cases compared to controls (40% vs 18%, OR 3.0370, p=0.0159).calemia, hypophosphatemia as well as hypokalemia and (to a lesser degree) Hypomagnesemia. Conclusion: Metabolic syndrome and dyslipidemia are common in psoriasis patients, which signify the need for routine screening of metabolic syndrome in those patients.
Keywords: Psoriasis, Metabolic syndrome, Obesity, Hypertension, Dyslipidemia.
PDF Full Text
9. Vascular complications and their correlation with microalbuminuria and common carotid artery intima media thickness in Indian type 2 diabetics.
Manoj Saluja, S.R. Meena, Manoj Dhaka
Abstract: Background: Atherosclerosis being most important entity in diabetic patients controls various vascular complications. Microalbuminuria which commonly assumed to be marker of renal injury also plays an important role in assessing cardiovascular morbidities. Common carotid artery intima media thickness which is marker of atherosclerotic changes also used for assessing cardiovascular changes in diabetics. Study design: This is a case control study conducted at govt. medical college, Kota. The study population comprised of normotensive type II diabetic patients (n=50) of both sexes between 30-70 yrs of age. Normontensive non-diabetic persons served as controls (n=50). Observations: The mean age in study population was 53.75±9.67 yrs for males and 49.80±11.73 for females, whereas the mean age in controls was 50.15±7.20 yrs and 49.33±9.33 yrs respectively. The degree of microalbuminuria in type II diabetic population was significantly higher & increased with advancing age. Microalbuminuria was greater in those with higher BMI levels and advancing age. The common carotid artery intima media thickness (CCAIMT) increased with advancing age in both the groups although the mean values were significantly higher among diabetic population as compared to controls (0.98±0.07 vs 0.71±0.04). Summary: Degree of urinary albumin excretion in type II diabetes patients has significant relation with CCAIMT values.
Keywords: Microalbuminuria, Vascular complication, carotid intima media thickness.
PDF Full Text
A prospective study of cytopathological analysis of peritoneal washings among patients of ovarian neoplasms and correlation with histopathological parameters
Abstract: Background: Ovarian neoplasms are the sixth most common malignancy (30%) reported around the globe. In Indian women, its incidence comes after cervical cancer. Early detection by cytopathological studies may reduce the high mortality rates of ovarian neoplasms. Material & Methods: The present prospective observational study was conducted at the department of pathology of our tertiary care hospital. The sample of peritoneal washings was collected from patients who were clinically diagnosed with ovarian tumors, which later on proved by histopathology and presenting with an abdominal lump or a mass along with concomitant ascites.
Results: Out of the total 84% samples of benign tumors, 80% were true negative on cytology and 4% were false positive. Among them 23 patients had serous cystadenomas, mucinous cystadenomas were found in 8 patients, dermoid cysts were present in 6 patients and fibromas were present in 2 patients. There was only one case of mucinous cystadenoma with Brenner tumor. Among the two false-positive samples, one was of tubercular salpingo-oophoritis and another was a sample of non-specific chronic salpingo-oophoritis. Out of the total 16% cases of malignant tumors, the most common were serous cystadenocarcinomas, which were found among 2 patients. We also found two cases of Krukenberg tumors, along with one patient of mucinous cystadenocarcinomas and endometrioid carcinoma of ovaries respectively. Conclusion: The peritoneal washings cytopathology for detecting the ovarian neoplasms is highly specific (96.7%) and highly sensitive (88.8%) with a positive predictive value of 89.8% and a negative predictive value of 97.1%. The accuracy of peritoneal washings cytopathology was found to be 95.7%.
Keywords: Ovarian neoplasm, peritoneal washings cytopathology, benign tumors.
PDF Full Text