International Journal of Medical Sciences and Education (IJMSE)
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PREVALENCE PATTERN OF MORBIDITY AND MORTALITY IN VENTILATION ASSOCIATED PNEUMONIA (VAP) PATIENTS OF INTENSIVE CARE UNIT (ICU) IN MAHARASHTRA REGION.
Patil Trilok*
Abstract
Objective: To study the prevalence of morbidity & mortality in ventilation associated pneumonia (VAP) patients of intensive care unit (ICU).Methods: The present study was conducted on 265 admitted patients of ICU during the period of July 2004 to June 2005 in Government Medical College & Hospital. A total of 100 patients on mechanical ventilation were followed-up prospectively. The microbiological test results were reported to the clinician immediately for appropriate antibiotic administration helping the betterment of the patient. Patients were followed-up twice a week on day 4 and day 7. The end-point was betterment with removal of patient from ventilation or death of the patient. Results: Out of the total 100 patients studied, 97 were colonized either with monomicrobial or polymicrobial pathogens. Out of these 97 colonized patients, 57 developed ventilation-associated pneumonia (VAP) with incidence of 58.76% among colonized patients. The overall mortality was 57% of the total studied patients. The mortality in patients colonizing trachea and developing VAP was 54.39%, whereas, the mortality in those only colonizing, but not developing VAP was 41.86%. Maximum 77.4% deaths were in the poisoning cases. Colonization rate among OPP cases was 97.44%, VAP rate was 64.10% and death rate was 43.59%. Conclusion: Knowledge about the colonization in mechanically ventilated patients, developing into VAP and their antimicrobial susceptibility pattern at the institute level by prospective study will definitely be useful in formulating its antibiotic policy and the optimal management of the patients by decreasing the incidence of morbidity and mortality amongst VAP.
Keywords: Ventilation-associated pneumonia, morbidity and mortality, colonization.
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2. DIAGNOSTIC YIELD OF FIBER-OPTIC BRONCHOSCOPY IN SPUTUM SMEAR NEGATIVE AND RADIOLOGICALLY SUSPECTED OLD CASES PULMONARY TUBERCULOSIS
Sharma Shubhkaran, Luhadia S.K., Gupta N.K.
Abstract
Objectives: - To study the diagnostic yield of fiber-optic bronchoscopy in sputum smear negative under RNTCP and radiologically suspected old cases of pulmonary tuberculosis. Material and Methods: - The present study was carried out on 57 patients, who has come with previous history and three tuberculosis sputum smears for Acid Fast Bacilli was negative under RNTCP and chest X-ray suggestive of pulmonary tuberculosis at Department of Tuberculosis and Chest Diseases, RNT Medical College, Udaipur from 1st July, 2005 to 7th July, 2006 (one year). After assessment, Fiber optic bronchoscopy was performed in every case per nasal or oral, to observe the changes in tracheobronchial tree and to obtain specimens. Obtained specimens were subjected to AFB smear examinations, AFB culture, Cytology examinations. Reports were obtained and analyzed accordingly. Results: - Diagnostic yield of fiber optic bronchoscopy for tuberculosis in patients who had history of ATT (n=57). Early positive yield for tuberculosis was 8.8% whereas overall positive diagnostic yield after culture results was 12.3%. Bronchial biopsy histopathology showed fibroid granuloma in one out of 6 patients (16.7%). Conclusion: - In conclusion, bronchoscopic procedures was found to be relatively safe and provided a better choice for the diagnostic of pulmonary tuberculosis in the sputum smear negative under RNTCP and radiologically suspected old cases of pulmonary tuberculosis.
Key words: Sputum smear-negative pulmonary tuberculosis (SSN-PTB), Radiologically suspected pulmonary tuberculosis, fiber- optic bronchoscopy.
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3.ASSESSMENT OF CORRELATION BETWEEN OBESITY AND BARRETT’S ESOPHAGUS IN A POPULATION OF URBAN AREAS OF UDAIPUR
Tambi Shyam Sharan, Khoiwal Rajesh
Abstract
Objectives: - The main risk for Barrett’s esophagus (BE) is considered to be gastro esophageal reflux disease (GERD) . The correlation between obesity and Barrett’s esophagus (BE) in urban areas of Udaipur {Rajasthan} is studied in present study in patient visiting Getanjali medical college, udaipur. Material & method:- A cross-sectional study had been carried out from January 2013 to September 2013 at Getanjali medical college hospital, Udaipur in which 1080 subjects who underwent upper gastrointestinal endoscopy and the prevalence of endoscopically suspected BE (ESBE) was evaluated. Obesity was evaluated by body mass index (BMI, ≥ 25 kg/m2) and waist circumference (WC) (males, ≥ 85 cm; females, ≥ 90 cm). Since the endoscopic diagnosis of short ESBE (<1 cm in extent) is difficult therefore it was excluded from the study.Result:- In present study by generating data and by analyzing it was came out that obesity (BMI, WC) is not independently a risk factor for barrett’s oesophagus result is non significant means (p value >0.05). In contrast the reflex eosophagitis significantly found as a risk factor (p value= 0.00)Conclusion:- RE, but not obesity, may have an independent association with the risk of endoscopically suspected BE (ESBE). Furthermore, obesity measures were not independent risks for RE.
Keywords:- Barrett’s esophagus, Body mass index, obesity, Reflux esophagitis
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4.COMPARISON OF LIGNOCAINE 1.5% ALONE AND LIGNOCAINE 1.5% WITH TRAMADOL FOR POST OPERATIVE EPIDURAL ANALGESIA
Dr Kumar Asnani , Dr Sonu
ABSTRACT
Objective: Aim of this study was to establish new synthetic opioid analgesic Tramadol as better agent for post operative pain relief. Material and Methods: Study consists of 25 patients undergoing lower abdominal surgeries with the epidural anaesthesia supplemented inj. Tramadol for post operative pain relief. Effect of drug on vital parameters, onset and level of block, muscle relaxation were taken as indicators of study. Result: Tramadol when mixed with lignocaine was better tolerated without interfering each other. Duration and quality of anaesthesia was not affected. The age, gender and type of surgery had well correlation in both groups. The vitals as pulse, BP (systolic and diastolic), respiratory rate were raised in-group 2 (lignocaine alone) and significant prolongation of duration of analgesia 544.48±182.94 min in group 1 than 62.44 ± 13.82 min in group 2 was noted. Conclusion: The newer synthetic opioid analgesic tramadol with atypical clinical profile can be used epidural safely with rapid onset, effective and prolonged post operative analgesia allowing cardiovascular, respiratory stability and minimum side effects as well high acceptability.
Keywords: post operative epidural analgesia ,opioid analgesic, postoperative pain relief
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5.A NEW BIOCHEMICAL MARKER : SERUM ADENOSINE DEAMINASE ACTIVITY FOR ASSESSMENT OF SEVERITY IN ULCERATIVE COLITIS PATIENTS
Tambi Shyam Sharan , Khoiwal Rajesh
Abstract
Background: Ulcerative colitis (UC) is a chronic inflammatory disease characterized by recurrent inflammation and ulcerations of colonic mucosa and an inappropriate and delayed healing. It is known as a key enzyme in purine metabolisim and DNA turnover Although ADA has been shown to increase in several inflammatory conditions, there are less studies signifying a change in UC. Material and Methods: This study evaluated the activity of total ADA in serum of 50 patients with UC and 25 healthy controls. Patients’ age, disease duration, drug intake, and other medical history were all noted for each subject. Complete blood count, and ADA were determined for both patients and controls. Results: Serum mean ADA levels were 16.22 + 5.91and 9.24 ± 2.19 U/l for patients with UC in active state and in remission and 9.64 ±3.37 U/l in the healthy control group. Mean serum ADA levels were significantly elevated in active UC patients compared with patients with UC in remission and control groups. Conclusions: Serum ADA levels were found to be elevated in UC patients in active state suggesting a partial role of activated T-cell response in the disease pathophysiology. Further randomized controlled studies are warranted to demonstrate the role of the ADA in UC patients, with a special interest in specifically targeted therapies against ADA for achieving disease remission.
Keywords: Adenosine deaminase, Ulcerative colitis, Disease activity
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6.CLINICAL EVALUATION OF FLEXIBLE FIBEROPTIC BRONCHOSCOPE IN DIAGNOSIS OF NEW CASES OF SPUTUM SMEAR-NEGATIVE PULMONARY TUBERCULOSIS (SSN-PTB)
Sharma Shubhkaran , Luhadia S.K., Gupta N.K.
ABSTRACT
Background: A bronchoscopy are very useful for diagnosing of Sputum smear-negative pulmonary tuberculosis (SSN-PTB). Our aim is to find out the diagnostic yield of fiberoptic bronchoscopy in sputum smear negative under RNTCP and radiologically suspected new cases of pulmonary tuberculosis and the complications of fiberoptic bronchoscopy. Material and Methods: It is a cross-sectional prospective study in which consecutive 43 patients were enrolled in the present study, at Department of Tuberculosis and Chest Diseases, RNT Medical College, Udaipur from 1st July, 2005 to 7th July, 2006. The patients whose three-sputum smear for Acid Fast Bacilli was negative and chest X-ray suggestive of pulmonary tuberculosis were included into the study. Patient’s history, observations on physical examination and relevant investigations were noted. Fiberoptic bronchoscopy was carried out. Results: The diagnostic yield of fiber optic bronchoscopy for tuberculosis in new cases. Positive early diagnosis was done in 5 cases (11.6%) whereas, overall yield for AFB after bronchial aspirate culture was 8 out of 43 patients (18.6%). Conclusions: Our study suggests that fibre-optic bronchoscopy can provide excellent material for diagnosis of suspected cases of pulmonary tuberculosis when smears of expectorated sputum do not reveal mycobacteria. Fibre-optic bronchoscopy combined with transbronchial lung biopsy helps in early diagnosis of smear negative pulmonary tuberculosis and can differentiation of other disorders which clinical picture mimics tuberculosis.
Key words: Sputum smear-negative pulmonary tuberculosis (SSN-PTB), Fiberoptic bronchoscopy,
PDF Full Text
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7.PREVALENCE OF ERUPTION STATUS OF THIRD MOLARS IN COLLEGE STUDENTS OF BIKANER (INDIA)
Saini Pankaj, Pankaj Jai Prakash, Sharma Vijay Kumar , Katara Priyanka
ABSTRACT
Background: Generally, eruption of third molars occurs between the age of 18 and 24 years with a wide variation. The prevalence rate of non-erupted third molars widely varies and it is influenced by age, sex and ethnic origin. The failure of third molar eruption is a quite common condition and the extraction of impacted third molar teeth is carried out as routine surgical procedure in dental departments. The present study was aimed to determine the number of third molars per person with their eruption status. Material and Methods: A sample size of 180 students between the age group 17-25 years was selected by multistage random sampling. All the participants were interviewed, examined and intra-oral X-rays of lower third molar tooth were taken. Results: The results showed that 3.33% of third molars are congenitally missing. Approximately 94% of the subjects had all four third molars, 2.78% had three molars, 1.11% had two third molars and 0.5% had one third molar with 1.67% having agenesis of all third molars. The third molar agenesis showed predilection for maxilla (4.72%) than mandible (1.94%). Sex, religion and socio-economic status had no effect on the eruption of third molar teeth. Conclusion: The present study showed that 33.62% of third molars were fully erupted, 40.09% partially erupted and 26.29% were remained unerupted. About 3.33% third molars were congenitally missing.
Key words: Third molar, tooth eruption, prevalence.
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8.COMPARATIVE STUDY OF EVACUATION OF CHRONIC SUBDURAL HAEMATOMA BY TWO BURR HOLE TECHNIQUE VERSUS SINGLE BURR HOLE WITH PRACTICAL EXCISION OF MEMBRANE TECHNIQUE
Gupta Sanjay K. , Jhanwar Atul
ABSTRACT:
OBJECTIVES: Present study was planned to compare the postoperative outcome of surgical evacuation of chronic subdural haematoma through two burr hole technique versus single burr hole with partial excision of membrane technique. METHODS: All patients admitted in neurosurgery ward Geetanjali Medical college and hospital Udaipur were evaluated by taking detailed history, clinical examination and investigations. After confirmation of Ch. SDH by CT/MRI scan patients were operated. Initial 50 patient were operated by two burr hole technique and last 50 patient were operated by using single burr hole with parted excision of membrane technique. RESULTS: 50 patients were operated by Two Burr Hole technique the duration of operation ranged from 15 to 40 min. Most of the symptoms relieved postoperatively within 6 hours to 6 days. Hospital stay found with average of 6.5 days. During follow-up 3 patients showed recurrence. The results after 3 months follow up was excellent 86 % .50 patients were treated with Single burr hole with partial excision of membrane technique techniques. The duration of operation ranged from 10-30 minutes. Most of the symptoms relieved within 6 hours to 6 days. Hospital stay of patients was with average of 5 days. Two patients, showed re-accumulation of Ch. SDH During follow up. The result after 3 months follow up was excellent in 90 %.CONCLUSIONS: With this study, we have reached to the conclusion that single burr hole evacuation of Ch. SDH with partial excision of membrane technique is simple, safe, less time consuming and effective treatment of Ch. SDH.
Keywords: Chronic Subdural Haematoma, two burr hole technique , single burr hole technique.
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9 ASSESSMENT OF CUTANEOUS MANIFESTATIONS AMONG PATIENTS OF DIABETES MELLITUS
Dr. Jayesh Rashik Lal Shah
ABSTRACT:
Background: Present Background: Diabetes mellitus affects individuals of all ages and in all socio-economic segments of the population. The International Diabetes Federation (IDF) estimates the total number of diabetic subjects to be around 40.9 million in India and this is further set to raise to 69.9 million by the year 2025.Material & Methods: The present prospective study was conducted at department of dermatology of our tertiary care hospital. A convenient (non random) sample of 100 cases of type 1 and type 2 diabetes mellitus with cutaneous manifestations attending skin outpatient and inpatient department and other patients admitted for period of 6 months from September 2018 to February 2019. Results: In present study, The common skin disorders were cutaneous manifestations (67%), dermatosis more commonly associated with diabetes (36%), neuropathic and ischemic diabetic skin disease (11%).Conclusion: Most common cutaneous manifestation was cutaneous infections followed by dermatosis more commonly associated with diabetes. Among cutaneous infections fungal infections were more common followed by bacterial infections. Cutaneous infections were more common in patients with poor glycaemic control and the association was found to be statistically significant.
Keywords: Diabetes, Cutaneous infections, Dermatosis.
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EVALUATION OF CLINICO-EPIDEMIOLOGICAL PROFILE OF ACUTE VIRAL HEPATITIS AMONG PAEDIATRIC AGE GROUP PATIENTS AT TERTIARY CARE CENTRE
Dr. Jayant R. Deore
ABSTRACT:
Background: Viral hepatitis keeps on being a significant medical issue worldwide and in India. This issue is brought about by the 5 pathogenic hepatotropic infections perceived to date: hepatitis A (HAV), E(HEV), C(HCV), B(HBV), and D(HDV) infections. Be that as it may, the most successive viral operators of acute viral hepatitis with significant wellbeing trouble in India are hepatitis A infection and hepatitis E infections. Material & Methods: The present prospective study was conducted at the department of pediatrics of our tertiary care hospital. The study was an observational study conducted for a period of one year. A total of 100 children who were of aged 1 to 16 years and who were diagnosed with two or more symptoms of loss of appetite, nausea, vomiting, pain abdomen, itching, and jaundice enrolled for study. along with patients who had positive serum levels of IgM HAV, IgM HEV and IgM HCV and hepatitis B surface antigen [HBsAg) were enrolled for the study. Results: In the present study, out of total study participants, based on the signs and symptoms, the most common presenting symptom was jaundice present in92% patients which were followed by hepatomegaly present in83% patients, which was followed by dark urine present in 82% patients which was followed by loss of appetite present in 82% patients. Out of the total study participants, nausea was present among 76% patients which was followed by vomiting present in73% patients, which was followed by fever present in 70% patients which were followed pain abdomen present in 82% patients. Out of total study participants, loose stools were present among 54% patients which were followed by itching present in38% patients, which was followed by Splenomegaly present in 21% patients which was followed by ascites present in 14% patients. Conclusion: It's critical to make mindfulness in the general public with respect to preventive measures including accessibility of immunization particularly in the rustic territory. Better sterilization, arrangement of clean drinking water appropriate sewage removal, and government-funded instruction are the backbones for counteraction of HAV and HEV contamination.
Keywords: Clinical profile, Viral hepatitis, hepatitis.
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ENDOMETRIAL HISTOLOGY PATTERNS IN DYSFUNCTIONAL UTERINE HEMORRHAGE: A COMPREHENSIVE STUDY
Dr. Mohit Chaurasiya
Abstract: Background: Abnormal uterine bleeding (AUB) stands as one of the most prevalent concerns among women presenting at gynecology outpatient departments worldwide. The histology of the endometrium in patients presenting with DUB is essential for accurate diagnosis, effective management, and timely intervention to mitigate associated risks. Methods. A prospective study was conducted at our tertiary care hospital, focusing on analyzing the histopathological characteristics of the perimenopausal age group and associated histological findings. Our study included 150 cases of abnormal bleeding, ranging from 21 to 78 years of age. Results: The most prevalent age group was proliferative, accounting for 33.3% of the cases, followed by secretory and simple cystic hyperplasia at 13.3% and 16.7%, respectively. The prevalence of abnormal uterines was varying across different age cohorts. Conclusions. Our findings provide valuable insights into the age distribution and histomorphological patterns of endogenous lesions among women who present with AUB. These findings underscore the importance of age-related considerations in the evaluation and management of AUB, ultimately improving patient outcomes and quality of life.
Keywords: Abnormal Uterine Bleeding, Endometrial Histology, Perimenopausal Women, Proliferative Endometrium, Secretory Endometrium
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Patil Trilok*
Abstract
Objective: To study the prevalence of morbidity & mortality in ventilation associated pneumonia (VAP) patients of intensive care unit (ICU).Methods: The present study was conducted on 265 admitted patients of ICU during the period of July 2004 to June 2005 in Government Medical College & Hospital. A total of 100 patients on mechanical ventilation were followed-up prospectively. The microbiological test results were reported to the clinician immediately for appropriate antibiotic administration helping the betterment of the patient. Patients were followed-up twice a week on day 4 and day 7. The end-point was betterment with removal of patient from ventilation or death of the patient. Results: Out of the total 100 patients studied, 97 were colonized either with monomicrobial or polymicrobial pathogens. Out of these 97 colonized patients, 57 developed ventilation-associated pneumonia (VAP) with incidence of 58.76% among colonized patients. The overall mortality was 57% of the total studied patients. The mortality in patients colonizing trachea and developing VAP was 54.39%, whereas, the mortality in those only colonizing, but not developing VAP was 41.86%. Maximum 77.4% deaths were in the poisoning cases. Colonization rate among OPP cases was 97.44%, VAP rate was 64.10% and death rate was 43.59%. Conclusion: Knowledge about the colonization in mechanically ventilated patients, developing into VAP and their antimicrobial susceptibility pattern at the institute level by prospective study will definitely be useful in formulating its antibiotic policy and the optimal management of the patients by decreasing the incidence of morbidity and mortality amongst VAP.
Keywords: Ventilation-associated pneumonia, morbidity and mortality, colonization.
PDF Full Text
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2. DIAGNOSTIC YIELD OF FIBER-OPTIC BRONCHOSCOPY IN SPUTUM SMEAR NEGATIVE AND RADIOLOGICALLY SUSPECTED OLD CASES PULMONARY TUBERCULOSIS
Sharma Shubhkaran, Luhadia S.K., Gupta N.K.
Abstract
Objectives: - To study the diagnostic yield of fiber-optic bronchoscopy in sputum smear negative under RNTCP and radiologically suspected old cases of pulmonary tuberculosis. Material and Methods: - The present study was carried out on 57 patients, who has come with previous history and three tuberculosis sputum smears for Acid Fast Bacilli was negative under RNTCP and chest X-ray suggestive of pulmonary tuberculosis at Department of Tuberculosis and Chest Diseases, RNT Medical College, Udaipur from 1st July, 2005 to 7th July, 2006 (one year). After assessment, Fiber optic bronchoscopy was performed in every case per nasal or oral, to observe the changes in tracheobronchial tree and to obtain specimens. Obtained specimens were subjected to AFB smear examinations, AFB culture, Cytology examinations. Reports were obtained and analyzed accordingly. Results: - Diagnostic yield of fiber optic bronchoscopy for tuberculosis in patients who had history of ATT (n=57). Early positive yield for tuberculosis was 8.8% whereas overall positive diagnostic yield after culture results was 12.3%. Bronchial biopsy histopathology showed fibroid granuloma in one out of 6 patients (16.7%). Conclusion: - In conclusion, bronchoscopic procedures was found to be relatively safe and provided a better choice for the diagnostic of pulmonary tuberculosis in the sputum smear negative under RNTCP and radiologically suspected old cases of pulmonary tuberculosis.
Key words: Sputum smear-negative pulmonary tuberculosis (SSN-PTB), Radiologically suspected pulmonary tuberculosis, fiber- optic bronchoscopy.
PDF Full text
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3.ASSESSMENT OF CORRELATION BETWEEN OBESITY AND BARRETT’S ESOPHAGUS IN A POPULATION OF URBAN AREAS OF UDAIPUR
Tambi Shyam Sharan, Khoiwal Rajesh
Abstract
Objectives: - The main risk for Barrett’s esophagus (BE) is considered to be gastro esophageal reflux disease (GERD) . The correlation between obesity and Barrett’s esophagus (BE) in urban areas of Udaipur {Rajasthan} is studied in present study in patient visiting Getanjali medical college, udaipur. Material & method:- A cross-sectional study had been carried out from January 2013 to September 2013 at Getanjali medical college hospital, Udaipur in which 1080 subjects who underwent upper gastrointestinal endoscopy and the prevalence of endoscopically suspected BE (ESBE) was evaluated. Obesity was evaluated by body mass index (BMI, ≥ 25 kg/m2) and waist circumference (WC) (males, ≥ 85 cm; females, ≥ 90 cm). Since the endoscopic diagnosis of short ESBE (<1 cm in extent) is difficult therefore it was excluded from the study.Result:- In present study by generating data and by analyzing it was came out that obesity (BMI, WC) is not independently a risk factor for barrett’s oesophagus result is non significant means (p value >0.05). In contrast the reflex eosophagitis significantly found as a risk factor (p value= 0.00)Conclusion:- RE, but not obesity, may have an independent association with the risk of endoscopically suspected BE (ESBE). Furthermore, obesity measures were not independent risks for RE.
Keywords:- Barrett’s esophagus, Body mass index, obesity, Reflux esophagitis
PDF Full Text
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4.COMPARISON OF LIGNOCAINE 1.5% ALONE AND LIGNOCAINE 1.5% WITH TRAMADOL FOR POST OPERATIVE EPIDURAL ANALGESIA
Dr Kumar Asnani , Dr Sonu
ABSTRACT
Objective: Aim of this study was to establish new synthetic opioid analgesic Tramadol as better agent for post operative pain relief. Material and Methods: Study consists of 25 patients undergoing lower abdominal surgeries with the epidural anaesthesia supplemented inj. Tramadol for post operative pain relief. Effect of drug on vital parameters, onset and level of block, muscle relaxation were taken as indicators of study. Result: Tramadol when mixed with lignocaine was better tolerated without interfering each other. Duration and quality of anaesthesia was not affected. The age, gender and type of surgery had well correlation in both groups. The vitals as pulse, BP (systolic and diastolic), respiratory rate were raised in-group 2 (lignocaine alone) and significant prolongation of duration of analgesia 544.48±182.94 min in group 1 than 62.44 ± 13.82 min in group 2 was noted. Conclusion: The newer synthetic opioid analgesic tramadol with atypical clinical profile can be used epidural safely with rapid onset, effective and prolonged post operative analgesia allowing cardiovascular, respiratory stability and minimum side effects as well high acceptability.
Keywords: post operative epidural analgesia ,opioid analgesic, postoperative pain relief
PDF Full Text
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5.A NEW BIOCHEMICAL MARKER : SERUM ADENOSINE DEAMINASE ACTIVITY FOR ASSESSMENT OF SEVERITY IN ULCERATIVE COLITIS PATIENTS
Tambi Shyam Sharan , Khoiwal Rajesh
Abstract
Background: Ulcerative colitis (UC) is a chronic inflammatory disease characterized by recurrent inflammation and ulcerations of colonic mucosa and an inappropriate and delayed healing. It is known as a key enzyme in purine metabolisim and DNA turnover Although ADA has been shown to increase in several inflammatory conditions, there are less studies signifying a change in UC. Material and Methods: This study evaluated the activity of total ADA in serum of 50 patients with UC and 25 healthy controls. Patients’ age, disease duration, drug intake, and other medical history were all noted for each subject. Complete blood count, and ADA were determined for both patients and controls. Results: Serum mean ADA levels were 16.22 + 5.91and 9.24 ± 2.19 U/l for patients with UC in active state and in remission and 9.64 ±3.37 U/l in the healthy control group. Mean serum ADA levels were significantly elevated in active UC patients compared with patients with UC in remission and control groups. Conclusions: Serum ADA levels were found to be elevated in UC patients in active state suggesting a partial role of activated T-cell response in the disease pathophysiology. Further randomized controlled studies are warranted to demonstrate the role of the ADA in UC patients, with a special interest in specifically targeted therapies against ADA for achieving disease remission.
Keywords: Adenosine deaminase, Ulcerative colitis, Disease activity
PDF Full Text
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6.CLINICAL EVALUATION OF FLEXIBLE FIBEROPTIC BRONCHOSCOPE IN DIAGNOSIS OF NEW CASES OF SPUTUM SMEAR-NEGATIVE PULMONARY TUBERCULOSIS (SSN-PTB)
Sharma Shubhkaran , Luhadia S.K., Gupta N.K.
ABSTRACT
Background: A bronchoscopy are very useful for diagnosing of Sputum smear-negative pulmonary tuberculosis (SSN-PTB). Our aim is to find out the diagnostic yield of fiberoptic bronchoscopy in sputum smear negative under RNTCP and radiologically suspected new cases of pulmonary tuberculosis and the complications of fiberoptic bronchoscopy. Material and Methods: It is a cross-sectional prospective study in which consecutive 43 patients were enrolled in the present study, at Department of Tuberculosis and Chest Diseases, RNT Medical College, Udaipur from 1st July, 2005 to 7th July, 2006. The patients whose three-sputum smear for Acid Fast Bacilli was negative and chest X-ray suggestive of pulmonary tuberculosis were included into the study. Patient’s history, observations on physical examination and relevant investigations were noted. Fiberoptic bronchoscopy was carried out. Results: The diagnostic yield of fiber optic bronchoscopy for tuberculosis in new cases. Positive early diagnosis was done in 5 cases (11.6%) whereas, overall yield for AFB after bronchial aspirate culture was 8 out of 43 patients (18.6%). Conclusions: Our study suggests that fibre-optic bronchoscopy can provide excellent material for diagnosis of suspected cases of pulmonary tuberculosis when smears of expectorated sputum do not reveal mycobacteria. Fibre-optic bronchoscopy combined with transbronchial lung biopsy helps in early diagnosis of smear negative pulmonary tuberculosis and can differentiation of other disorders which clinical picture mimics tuberculosis.
Key words: Sputum smear-negative pulmonary tuberculosis (SSN-PTB), Fiberoptic bronchoscopy,
PDF Full Text
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7.PREVALENCE OF ERUPTION STATUS OF THIRD MOLARS IN COLLEGE STUDENTS OF BIKANER (INDIA)
Saini Pankaj, Pankaj Jai Prakash, Sharma Vijay Kumar , Katara Priyanka
ABSTRACT
Background: Generally, eruption of third molars occurs between the age of 18 and 24 years with a wide variation. The prevalence rate of non-erupted third molars widely varies and it is influenced by age, sex and ethnic origin. The failure of third molar eruption is a quite common condition and the extraction of impacted third molar teeth is carried out as routine surgical procedure in dental departments. The present study was aimed to determine the number of third molars per person with their eruption status. Material and Methods: A sample size of 180 students between the age group 17-25 years was selected by multistage random sampling. All the participants were interviewed, examined and intra-oral X-rays of lower third molar tooth were taken. Results: The results showed that 3.33% of third molars are congenitally missing. Approximately 94% of the subjects had all four third molars, 2.78% had three molars, 1.11% had two third molars and 0.5% had one third molar with 1.67% having agenesis of all third molars. The third molar agenesis showed predilection for maxilla (4.72%) than mandible (1.94%). Sex, religion and socio-economic status had no effect on the eruption of third molar teeth. Conclusion: The present study showed that 33.62% of third molars were fully erupted, 40.09% partially erupted and 26.29% were remained unerupted. About 3.33% third molars were congenitally missing.
Key words: Third molar, tooth eruption, prevalence.
PDF Full Text
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8.COMPARATIVE STUDY OF EVACUATION OF CHRONIC SUBDURAL HAEMATOMA BY TWO BURR HOLE TECHNIQUE VERSUS SINGLE BURR HOLE WITH PRACTICAL EXCISION OF MEMBRANE TECHNIQUE
Gupta Sanjay K. , Jhanwar Atul
ABSTRACT:
OBJECTIVES: Present study was planned to compare the postoperative outcome of surgical evacuation of chronic subdural haematoma through two burr hole technique versus single burr hole with partial excision of membrane technique. METHODS: All patients admitted in neurosurgery ward Geetanjali Medical college and hospital Udaipur were evaluated by taking detailed history, clinical examination and investigations. After confirmation of Ch. SDH by CT/MRI scan patients were operated. Initial 50 patient were operated by two burr hole technique and last 50 patient were operated by using single burr hole with parted excision of membrane technique. RESULTS: 50 patients were operated by Two Burr Hole technique the duration of operation ranged from 15 to 40 min. Most of the symptoms relieved postoperatively within 6 hours to 6 days. Hospital stay found with average of 6.5 days. During follow-up 3 patients showed recurrence. The results after 3 months follow up was excellent 86 % .50 patients were treated with Single burr hole with partial excision of membrane technique techniques. The duration of operation ranged from 10-30 minutes. Most of the symptoms relieved within 6 hours to 6 days. Hospital stay of patients was with average of 5 days. Two patients, showed re-accumulation of Ch. SDH During follow up. The result after 3 months follow up was excellent in 90 %.CONCLUSIONS: With this study, we have reached to the conclusion that single burr hole evacuation of Ch. SDH with partial excision of membrane technique is simple, safe, less time consuming and effective treatment of Ch. SDH.
Keywords: Chronic Subdural Haematoma, two burr hole technique , single burr hole technique.
PDF Full Text
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9 ASSESSMENT OF CUTANEOUS MANIFESTATIONS AMONG PATIENTS OF DIABETES MELLITUS
Dr. Jayesh Rashik Lal Shah
ABSTRACT:
Background: Present Background: Diabetes mellitus affects individuals of all ages and in all socio-economic segments of the population. The International Diabetes Federation (IDF) estimates the total number of diabetic subjects to be around 40.9 million in India and this is further set to raise to 69.9 million by the year 2025.Material & Methods: The present prospective study was conducted at department of dermatology of our tertiary care hospital. A convenient (non random) sample of 100 cases of type 1 and type 2 diabetes mellitus with cutaneous manifestations attending skin outpatient and inpatient department and other patients admitted for period of 6 months from September 2018 to February 2019. Results: In present study, The common skin disorders were cutaneous manifestations (67%), dermatosis more commonly associated with diabetes (36%), neuropathic and ischemic diabetic skin disease (11%).Conclusion: Most common cutaneous manifestation was cutaneous infections followed by dermatosis more commonly associated with diabetes. Among cutaneous infections fungal infections were more common followed by bacterial infections. Cutaneous infections were more common in patients with poor glycaemic control and the association was found to be statistically significant.
Keywords: Diabetes, Cutaneous infections, Dermatosis.
PDF Full Text
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EVALUATION OF CLINICO-EPIDEMIOLOGICAL PROFILE OF ACUTE VIRAL HEPATITIS AMONG PAEDIATRIC AGE GROUP PATIENTS AT TERTIARY CARE CENTRE
Dr. Jayant R. Deore
ABSTRACT:
Background: Viral hepatitis keeps on being a significant medical issue worldwide and in India. This issue is brought about by the 5 pathogenic hepatotropic infections perceived to date: hepatitis A (HAV), E(HEV), C(HCV), B(HBV), and D(HDV) infections. Be that as it may, the most successive viral operators of acute viral hepatitis with significant wellbeing trouble in India are hepatitis A infection and hepatitis E infections. Material & Methods: The present prospective study was conducted at the department of pediatrics of our tertiary care hospital. The study was an observational study conducted for a period of one year. A total of 100 children who were of aged 1 to 16 years and who were diagnosed with two or more symptoms of loss of appetite, nausea, vomiting, pain abdomen, itching, and jaundice enrolled for study. along with patients who had positive serum levels of IgM HAV, IgM HEV and IgM HCV and hepatitis B surface antigen [HBsAg) were enrolled for the study. Results: In the present study, out of total study participants, based on the signs and symptoms, the most common presenting symptom was jaundice present in92% patients which were followed by hepatomegaly present in83% patients, which was followed by dark urine present in 82% patients which was followed by loss of appetite present in 82% patients. Out of the total study participants, nausea was present among 76% patients which was followed by vomiting present in73% patients, which was followed by fever present in 70% patients which were followed pain abdomen present in 82% patients. Out of total study participants, loose stools were present among 54% patients which were followed by itching present in38% patients, which was followed by Splenomegaly present in 21% patients which was followed by ascites present in 14% patients. Conclusion: It's critical to make mindfulness in the general public with respect to preventive measures including accessibility of immunization particularly in the rustic territory. Better sterilization, arrangement of clean drinking water appropriate sewage removal, and government-funded instruction are the backbones for counteraction of HAV and HEV contamination.
Keywords: Clinical profile, Viral hepatitis, hepatitis.
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ENDOMETRIAL HISTOLOGY PATTERNS IN DYSFUNCTIONAL UTERINE HEMORRHAGE: A COMPREHENSIVE STUDY
Dr. Mohit Chaurasiya
Abstract: Background: Abnormal uterine bleeding (AUB) stands as one of the most prevalent concerns among women presenting at gynecology outpatient departments worldwide. The histology of the endometrium in patients presenting with DUB is essential for accurate diagnosis, effective management, and timely intervention to mitigate associated risks. Methods. A prospective study was conducted at our tertiary care hospital, focusing on analyzing the histopathological characteristics of the perimenopausal age group and associated histological findings. Our study included 150 cases of abnormal bleeding, ranging from 21 to 78 years of age. Results: The most prevalent age group was proliferative, accounting for 33.3% of the cases, followed by secretory and simple cystic hyperplasia at 13.3% and 16.7%, respectively. The prevalence of abnormal uterines was varying across different age cohorts. Conclusions. Our findings provide valuable insights into the age distribution and histomorphological patterns of endogenous lesions among women who present with AUB. These findings underscore the importance of age-related considerations in the evaluation and management of AUB, ultimately improving patient outcomes and quality of life.
Keywords: Abnormal Uterine Bleeding, Endometrial Histology, Perimenopausal Women, Proliferative Endometrium, Secretory Endometrium
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