International Journal of Medical Sciences and Education (IJMSE)
Vol. 3; Issue: 1 (Jan-March 2016) , Date of Publication: 01.04.2016
1. SERUM MAGNESIUM STATUS IN PREECLAMPSIA
Ankur Purohit, R. K. Vyas, Manju lata Sharma, Yogita Soni, Anita Verma
ABSTRACT:
Objective: To compare the level of total serum Magnesium (Mg) of pregnant women with preeclampsia with normal pregnant females.
Study design: This was a case control study which included 50 women with preeclampsia in their third trimester of pregnancy as Study group and 50 healthy pregnant women in the third trimester of pregnancy as control group, with similar maternal and gestational age. The concentration of total serum magnesium was measured by Atomic Absorption Spectroscopy. The data was analyzed using Students’ t-test wherever applicable.
Result: The total serum magnesium level in preeclamptic women was significantly lower (p<0.001) than in pregnant women of similar maternal and gestational age.
Conclusion: Hypomagnesemia related to preeclampsia supports the hypothesis that alteration in the total serum magnesium levels may be involved in possible etiologies of preeclampsia.
Keywords: - Preeclampsia, Magnesium, Hypomagnesemia, Hypertension, Atomic Absorption Spectrophotometry.
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2. MALARIA: RECENT TRENDS MANIFESTED AS THROMBOCYTOPENIA
Dr. Anil Rajani, Dr. Kishore Khatri, Dr. Kusum Vaishnav
ABSTRACT:
Objective: Malaria continues to be a cause of high mortality and morbidity in India and is commonly associated with mild hematological abnormalities. Yet the physicians, when evaluating patients for fever, frequently missed the diagnosis of malaria. We evaluated the role of platelet counts for predicting malaria infection. Materials &methods: It was a retrospective study. The study included patients came with complaint of fever and investigated at laboratory of M.G. hospital, Jodhpur and Army hospital, Jodhpur. Results: The mean platelet counts among non malarial patients were much higher than malaria positive group. On statistical analysis this difference was also found significant (p<0.001). Conclusion: Our study concluded that a finding of thrombocytopenia should increase the suspicion of malaria and lead to performance of more specific tests, including multiple peripheral smears and ELISA for parasite- specific antigen etc.
KEYWORDS: fever, malaria, thrombocytopenia.
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3. COMPARATIVE STUDY ON AWARENESS AND KNOWLEDGE OF BOYS AND GIRLS ABOUT HIV/AIDS AMONG STUDENTS OF SENIOR SECONDARY SCHOOL
Jyoti Jain, Hemlata Mittal
ABSTRACT
Objectives: In present scenario, HIV/AIDS is considered as one of the major non curable disease of developing countries like India. And young ones form a significant segment of those attending sexually transmitted infection (STI) clinics and those infected by HIV. In India HIV/AIDS is a one of the major contributory factor in mortality and morbidity of people. Material and Method: For the present study total of 360 students from class IX-XII (both science and commerce) were taken as sample from 10 senior secondary English medium co-ed school of Udaipur, Rajasthan were taken through convenience sampling method. 6 students (3 boys & 3 girls) from each class were taken which constituted 36(18 boys and 18 girls) students from each school. Thus total of 360 (180 boys and 180 girls) students were obtained. The pre tested interview schedule was given to all selected students aimed to measure their knowledge and awareness about HIV/AIDS. The entire questionnaire was retrieved and analyzed using simple descriptive statistical analysis.
Result: Among all the selected boys and girls it was found that majority were having awareness and knowledge about HIV/AIDS regarding general issues, mode of transmission, preventive measures and source of knowledge. Both boys and girls were having positive attitude towards infected person.
Conclusion: Thus it has overall observed that majority of our young ones who are the pillars of future are aware of knowledge about this incurable and killer disease as about its full form, its curability and its consequence.
Key words: HIV/AIDS, Awareness, knowledge, attitude, students.
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4. EVALUATION OF IMMUNIZATION COVERAGE IN THE RURAL AREA OF JAIPUR, RAJASTHAN, USING THE WHO THIRTY CLUSTER SAMPLING TECHNIQUE.
Laxmi Nidhi Pandey, Archana Paliwal, B. N. Sharma, R. C. Choudhary, S. L. Bhardwaj
Abstract
Background: Infectious diseases are a major cause of morbidity and mortality in children. One of the most cost-effective and easy methods for child survival is immunization. Objective- To assess the immunization coverage and it's determinants in 12-23 months old children in rural area of Jaipur. Materials and Methods: A cross-sectional study was conducted in the field practice area of the Rural Health Training Center (RHTC) using the WHO thirty clusters sampling method for evaluation of immunization coverage. Results: A total of 210 children aged 12‑23 months were included in the study. It was found that 76.19% of the children were fully immunized against all the six vaccine preventable diseases. While 22.86% & 0.95% are partially immunized & unimmunized respectively. Major reasons for non immunization are lack of awareness for immunization, no faith in immunization and OPV being considered the only vaccine, lack of motivation, lack of information, and various obstacles were the reasons for partial immunization.
Key words – WHO thirty cluster sampling technique, primary immunization, fully, partially & non immunized.
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5. IMAGING AND BIOCHEMICAL FINDINGS IN MAPLE SYRUP URINE DISEASE- A CASE REPORT
Gajera S., Bhanderi A., Mishra S. and Goyal M.M
Abstract
Maple syrup urine disease (MSUD) is a rare autosomal recessive disorder. It is caused by a deficiency of the branched chain α-ketoacid dehydrogenase enzyme complex, leading to accumulation of the branched chain amino acids (leucine, isoleucine, and valine) and their toxic byproducts (ketoacids) in the blood and urine. Imaging is characterestized by MSUD oedema affecting the myelinated white matter. We present a neonatal case with classic type of MSUD with radiological findings confirmed by biochemical investigations.
Keywords: maple syrup urine disease, radiological findings, Biochemical tests.
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6. ATTENDANCE, ATTITUDES AND ACADEMIC PERFORMANCE: A STUDY ON FIRST YEAR MBBS STUDENTS ATTENDING PHYSIOLOGY CLASSES
Maulik Varu, Anup Vegad, Chinmay Shah, Hemant Mehta, Yogesh Kacha
ABSTRACT:
Objective: Student attendance is declining day by day in medical colleges. In this context, the present study was undertaken to find out any impact of attendance on academic performance in exam as well as to find out students’ attitudes towards their absenteeism. Material and Methods: Based on percentage of attendance in Physiology department, students were divided into five groups, I (≤ 60%) to V ((≥ 91%). Academic performance was analyzed in terms of percentage of marks obtained in Physiology subject in final university exam including both theory and practical. Statistical analysis was carried out by obtaining p value with Kruskal Wallis test. Spearman Correlation was performed between attendance and academic performance. In predesigned pretested performa, students were asked reasons of their absenteeism at classes. Result: There was statistically significant difference between academic performance of five groups in both theory (P=0.0369) and practical. (P<0.0001) There was statistically significant positive correlation between attendance and academic performance in both theory (P=0.0010) and practical with more significant impact on practical. (P<0.0001) Most common reasons given by students for their absenteeism were either boring lecture or boring topic, which gives indication to do intervention and modification in teaching methods. Conclusion: The present study suggests a clear-cut impact of attendance on academic performance. Introspection need to be done and innovative method should be used to eliminate reasons of absenteeism.
Keywords: Attendance, Academic performance, Theory, Practical
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7. A COMPARATIVE STUDY OF LIGNOCAINE 0.5% AND ROPIVACAINE 0.2% FOR INTRAVENOUS REGIONAL ANESTHESIA FOR ELECTIVE UPPER LIMB SURGERY
S. Asrar , Devesh S , Vidushi S , Meenaxi S , Anumeha J
ABSTRACT:
Background: Day care surgeries and ambulatory surgeries have number of advantages for the patient as well as for health care providers also. Regional anesthesia has been very popular in day care surgery. Intravenous regional anesthesia is one such simple and reliable technique. Material And Methods: Patients included in the study were ASA grade I and II of ages 18 – 65 years, undergoing elective upper limb surgery. A total of 60 patients were randomly divided into 2 equal groups. We compared intravenous regional anesthesia by using lignocaine 0.5% with ropivacaine 0.2% for elective upper limb surgery. A detailed history and systemic examination was done to rule out presence of major illness. Routine investigations like haemogram and urine examination was done in all patients. Results: The difference in mean time of onset of sensory blockade between group L and group R was found to be in significant (p=0.3695 i.e. P>0.05). The difference in mean time of onset of motor blockade between group L and group R was found to be significant (p=0.0486 i.e. P<0.05). The difference in grade of sensory blockade was statistically insignificant (P>0.05). There was no evidence of side effects after the release of tourniquet in 0.2% ropvacaine group as compared to 0.5% lignocaine group. Difference in mean time of recovery from sensory blockade between group L and group R was highly significant (p=0.0001 i.e. P<0.05). CONCLUSION: 0.2% ropivacaine can be used as an alternative to 0.5% lignocaine for intravenous having just the similar onset and intensity of sensory block.
KEY WORDS: Day care surgery, Lignocaine, Ropivacaine, Intravenous regional Anaesthesia.
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8. Metabolic Syndrome: Can Serum Uric Acid Along With Hepatic Enzymes Serve As Potential Marker For Metabolic Syndrome?
Balveer Singh Gurjar, Vipul Garg, Manisha Verma, Suresh Meena, S.K. Vardey
ABSTRACT:
Background: With worldwide prevalence in cases of metabolic syndrome (MetS), is a cluster of clinical conditions characterized by high blood pressure, dyslipidemia, hyperglycemia and central abdominal obesity. Material and Methods: We have determined the level of liver enzymes along with serum uric acid (UA) to assess whether hyperuremia with dysfunctional liver enzyme are associated with MetS. Sixty four subjects at least showing one of the symptoms of MetS and sixty four age matched controls were selected from OPD/IPD of S.M.S. Medical College and Hospital, Jaipur for eleven months. Results: Participants with MetS had statistically significantly higher values of blood pressure, body mass index, waist circumference, fasting glucose and triglycerides while HDL-c levels are statistically significantly lower when compared with control group. The mean values of ALP, GGT and uric acid were 146.36 U/L, 53.39 U/L and 6.22 mg/dl respectively and were statistically significantly higher in MetS participants when compared with control group. Uric acid showed a statistically significant positive correlations with waist circumference (r = 0.4997), Triglycerides (r = 0.6696), and fasting glucose levels (r = 0.4573).Conclusion: GGT and uric acid may plays a role in early diagnosis of metabolic syndrome with a high predictive value for both metabolic syndrome and CVD. Regarding the availability and simplicity of these tests in routine clinical practice and their universal standardization, these findings indicate the potential of liver enzymes, especially GGT, to be considered in algorithms for metabolic syndrome.
Key words: Metabolic Syndrome, serum uric acid, aspartate aminotransferase, alanine aminotrasferase, alkaline phosphatase.
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9. RATIONALIZATION OF MYRINGOPLASTY IN CHILDREN: A COMPARISON WITH AN ADULT POPULATION
Meghal Chaudhary, Tarun Ojha, Natwar Singh Rathore, Amit singhal, Abhishek Sharma, Kanak Yadav, Vaishali Kataria
ABSTRACT:
Objective: Myringoplasty is the surgical repair of the perforation of the tympanic membrane. It is a simple and effective procedure that results in the successful closure of the perforation in most cases. This study is planned to find out reliability of myringoplasty in children by comparing its anatomical and functional results with adult myringoplasty.Study Design: A descriptive cross sectional study
Place and Duration of Study: Department of Otolaryngology at a tertiary care teaching hospital in Jaipur from January 2015 to June 2015.Materials and Methods: A total of 67 patients having dry central tympanic membrane perforation of various sizes secondary to chronic tubotympanic suppurative otitis media were included in the study. The patients were divided in two groups. First group comprised of children upto the age of 14 years whereas those above the age of 14 years were included in second group. Myringoplasty was performed in all patients with temporalis fascia utilizing underlay technique. The two groups were compared regarding graft success rate and hearing improvement at the end of 6 months of follow up.Results: Out of 67patients included in the study, 31 (46.2%) belonged to child group whereas 36 (53.73%) were included in adult group. Among 31 patients in child group, 28(90.32 %) had successful graft take at the end of 6 months of follow up whereas 32 (89.3 %) patients out of 52 in adult group had successful graft. Average air bone gap closure of 19 dB was noted in child group whereas in adult group it was 15.1 dB. The difference between graft success rate and average air bone gap closure was found to be statistically insignificant (P>0.05).Conclusion: Results of myringoplasty in paediatric and adult age group are comparable in terms of graft success rate and hearing improvement.
Key words: Myringoplasty, tympanic membrane, paediatric, middle ear.
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10. A COMPARATIVE SURVEY OF MEDICAL DISORDERS IN THE GERIATRIC POPULATION OF RURAL AND URBAN AREA
Dr. Kishore Moolrajani, Dr. Rashmi Modwal
ABSTRACT:
Objective: To compare and survey medical disorders in geriatric population who attended the medical outpatients department (OPD) in a tertiary care hospital from rural and urban area.Material and Methods: : This study was conducted in a total of 300 consecutive patients who were aged 60-years and above attended the Out-Patients Department (OPD) of Department of Medicine in JNU Medical College Hospital and Research Centre for a period of 2 months from November 2015 to January 2016. Detailed history of these patients was taken along with physical examination as per the pre-designed proforma and relevant investigations were done, wherever needed. Result: Among the 300 patients, male patients 164 (54.67%) predominated the female patients 136 (45.33%). Most of the patients belong to age of 60-70 years (82.33%). The no. of male patients (n=96) from the rural areas was higher than the number of females (n=63) and number of female patients (n=73) from the urban areas was slight higher than the number of males (n=68). The study showed the prevalence of medical disorders as follows: chronic obstructive pulmonary disease (COPD) – 20%, hypertension – 17%, diabetes mellitus – 12.67%, coronary artery disease – 12.33%, pulmonary tuberculosis – 11%, , respiratory infection (non-tubercular) – 9.33%, visual impairment / cataract – 5%, arthritis – 3.67%, cirrhosis of the liver – 3.33%, various types of cancers – 2%, urinary complaints / BPH – 2%, and stroke – 1.67%. Conclusion: The study showed a high prevalence of COPD, hypertension, diabetes mellitus, coronary artery disease and pulmonary tuberculosis in the geriatric population indicating the chances of non-communicable disease are more but communicable disease can also occur as the immunity is waning.
Key Words: Geriatric population, chronic disease, metabolic syndrome,
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11. INCIDENCE AND ETIO-PATHOGENESIS OF VOCAL CORD PARALYSIS IN A TERTIARY CARE HOSPITAL
Natwar Singh Rathore ,Tarun Ojha, Meghal Chaudhary,Amit singhal ,Abhishek Sharma,Saurabh Gakhar, Abhay Sharma
ABSTRACT:
Background: Vocal cord paralysis is an important issue in laryngeal diseases and considered to be a sign of underlying disease. The etiology of this problem is changing and varied. Aims and Objective: This study was a retrospective analysis of vocal cord paralysis in patients with some underlying disease. Material and Methods: Detailed history of patients diagnosed and treated for vocal cord paralysis were studied, the data regarding age, sex, etiology, and duration of symptoms were collected.Result:38.89% patients were classified as idiopathic as no pathology is found, 18.06% had neoplastic cause, 16.67% had mechanical trauma / radiation hazard as cause, and rest other had iatrogenic, infection, accidental trauma, neurological and congenital factors as etiology. Conclusion: Magnetic Resonance Imaging is crucial in the work-up of idiopathic vocal cord paralysis. Vocal cord paralysis has got a variable etiology which varies with the involvement of the vocal cord. Idiopathic causes predominated in our series, followed by malignant causes.
Key words: Vocal cord paralysis, Etiology, Idiopathic, Malignant.
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12. DIAGNOSTIC PROBLEMS IN CYTOLOGICAL DIAGNOSIS OF MUCOEPIDERMOID CARCINOMA: REPORT OF 6 CASES WITH HISTOPATHOLOGICAL CORRELATION
Dr Chandrika Gupta ,Dr Kamlesh Yadav
ABSTRACT:
Background: Mucoepidermoid carcinoma (MEC) is a malignant salivary gland neoplasm with extreme morphologic heterogeneity and hence rendering a definitive fine needle aspiration cytology (FNAC) diagnosis of this neoplasm is really challenging. The present study was undertaken to elucidate the cytological features of MEC and explore the diagnostic accuracy and pitfalls by comparing with subsequent histopathology. Material and Methods: The present study was conducted over a period of 1.5 years wherein we obtained six histopathologically confirmed cases of MEC. These patients were initially subjected to FNAC. The cytologic features studied included presence of mucous cells, intermediate cells, and squamous cells. Presence of background mucinous material was also noted. The cytological features were compared with the subsequent histopathology. Results: Of the 6 cases of MEC, a definite cytological diagnosis was possible only in 3 cases. Of the remaining 3 cases, 1 cases was broadly diagnosed in cytology as Chronic sialadenitis, 1 cases was underdiagnosed as pleomorphic adenoma and 1 case was diagnosed as nonspecific malignant epithelial neoplasm. Conclusion: A satisfactory aspirate with all three types of cells; mucous, intermediate and squamous cells may not be obtained in all cases of MEC for providing a definite diagnosis. Hence, a good clinicoradiological correlation, a high index of suspicion and repeated aspirations especially in cystic lesions may be particularly helpful in difficult cases. In addition, while dealing with mucinous cystic lesions with low cellularity, the importance of early excision should be communicated to the clinician since the possibility of low-grade MEC cannot be excluded.
Key words: Cystic lesions; diagnostic challenges; fine needle aspiration; histopathology.
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13. RECLASSIFICATION OF CARCINOMA CERVIX BASED ON MUCIN HISTOCHEMISTRY
Dr Sudha Gupta , Dr. Dinesh K.Gupta,Dr.Kunal Purohit
ABSTRACT:
Objectives: this study is planned to demonstrate mucin in cervical Carcinoma which were originally classified as squamous cell carcinoma and to reclassify and modify histological diagnosis after performing niucin histochemistry. Material and Methods: The present study was conducted by staining sections from cervical biopsies of 55 patients clinically suspected and/or diagnosed as carcinoma cervix of epithelial origin and subsequently confirmed histopathologically by Hematoxylin and Eosin staining, received at Histopathology section of Department of Pathology, Mahatma Gandhi Medical College, Jaipur. Results: Histologically these cases were diagnosed as squamous cell carcinoma 94.73%, adenocarcinoma -- 05.45% and adenosquamous carcinoma -01.83%. The classification proposed by Fox was followed in the study,according to which reclassification was necessary in 10.91% of cases. The distribution of cases was found to be as squamous cell carcinoima-81.82%, adenocarcinoma -05.45%,adenosquamous carcinoma - 12.72%.Conclusion: Thus after screening the results of the present study, it is concluded that mucin histochemistiy should be carried out routinely in all the cases of carcinoma cervix. This aids in the early detection of previously unrecognized mucin secreting adenocarcinoma and adenosquamous carcinoma which pursue a more aggressive clinical course and poorer prognosis than non mucin producing squamous cell carcinoma.
Key words: Cystic lesions; diagnostic challenges; fine needle aspiration; histopathology.
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14. A COMPARISON OF EPIDURAL AND GENERAL ANAESTHESIA TECHNIQUE FOR RENAL SURGERIES
Dr. Adhokshaj Joshi, Dr.Sidhrath Sharma, Dr.Rajesh Sharma
ABSTRACT:
Background: Mucoepidermoid Neuraxial anaesthesia has become popular for the renal surgeries during the last few years. This study was aimed at comparing general anaesthesia (GA) with epidural anaesthesia in patients undergoing renal surgeries. Methods: One hundred American Society of Anaesthesiologists (ASA) physical status‑I and II adult consenting patients of both gender in the age group of 25-55 years undergoing renal surgeries were randomly assigned to two groups of 50 patients each: Group G and Group E. Group G patients were administered conventional GA while Group E received epidural anaesthesia (EA) with 3 mg/kg of ropivacaine and 1 μg/kg of dexmedetomidine. Besides cardio‑respiratory parameters, surgeon’s satisfaction, patient’s satisfaction and side effects were observed. Parametric data were analysed by ANOVA while non‑parametric data were compared with Mann–Whitney U‑test and Wilcoxon test. Value of P < 0.05 was considered statistically significant. Results: The demographic profile, total anaesthesia time, surgical time and haemodynamic parameters and surgeon’s satisfaction scores were comparable in both groups. Patient’s satisfaction scores were better in Group E during the post‑operative period. Incidence of side‑effects such as nausea and vomiting and shivering were higher in Group G (P < 0.001) while the incidence of dry mouth was higher in Group E (P < 0.001). Conclusion: Epidural anaesthesia with ropivacaine and dexmedetomidine can be safely and effectively used in patients undergoing renal surgeries.
Key words: Dexmedetomidine, epidural, general anaesthesia, renal surgery, ropivacaine
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15. EFFECT OF DEXAMETHASONE FOR IMPROVING ANALGESIA QUALITY IN AXILLARY BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES : A COMPARATIVE STUDY
Dr Gaurav sharma ,Vandana Mangal, Dr Surendra kumar Sharma,Dr.Pratibha Singh Rathore,Dr Rajani Mathur
ABSTRACT:
Background: Various adjuvants have been used to prolong the duration of local anaesthetic action after peripheral and regional block. We evaluated the effect of dexamethasone 8mg added to Fixed constant Mixture of Lignocaine and Bupivacaine on the duration and quality of pain relief in upper limb surgeries performed under axillary brachial plexus block using Dexamethasone .Methods: In this prospective randomized double-blind controlled study Total 50 patients [age 20-40 years] of ASA I and II undergoing elective upper Limb surgery under Axillary brachial Plexus Block were randomized into two groups.Patients in Group 1(n=25) received 12 ml bupivacaine 0.5% + 8ml lignocaine2% + 12ml Normal Saline And We Injected 12ml bupivacaine0.5% + 8ml lignocaine 2 % + 10 ml Normal Saline + 2ml Dexamethasone in Group 2(n=25) . Total 32 ml. volume of drug administered in both groups. Onset and recovery time of sensory and motor block, duration of analgesia and quality of block, hemodynamic variables, oxygen saturation were studied in both the groups. Results: The mean onset of motor block for Group I was 11.80±2.000 (min) for Group 2 was 11.08± 2.080 (min) and the difference was found to be statistically not significant between Group I and Group 2 (p >0. 05 ). Mean onset of sensory block for Group I was 9.12±1.394 (min) for Group 2 was 8.68±1.887(min) and this difference was not statistically significant between both groups (p >0.05). The mean duration of motor block (180.68±8.459 (min) ) was significantly lower in Group I as compared to Group 2 was 203.20±25.936 min. ( P value<0.001) The mean duration of analgesia in Group I was 222.52±9.713 (min) and it was significantly lower as compared to Group 2 which was 794.52±74.411 (min). (p value < 0.001)Conclusion : Addition of dexmethasone (2ml) to local anaesthetic mixture for axillary brachial plexus block was found highly effective in prolongation of duration of anaesthesia and analgesia. So, the patient remains comfortable in the postoperative period with considerable therapeutic benefit and without any potential side effects.
Keywords : axillary brachial plexus block, dexamethasone, Postoperative analgesia.
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16. A STUDY ON SURGICAL WOUND INFECTIONS CAUSED BY STAPHYLOCOCCUS SPECIES WITH SPECIAL REFERENCE TO METHICILLIN RESISTANT STAPHYLOCOCCI
Gaurav Dalela, Jitendra Ahuja, Nilofar Khayyam, Arvind Sharma
ABSTRACT
Background: To study the prevalence of Staphylococcus and Methicillin-Resistant Staphylococcus (MRS) in surgical site infections (SSIs) at Jhalawar. Aims and Objective: This study was conducted on 237 patients who underwent surgery in the obstetrics and gynaecology, orthopaedic and surgical departments of Jhalawar hospital and medical college, Jhalawar. Pus samples were collected with two sterile swabs and processed in the Microbiology department. Results: Of the 237 pus samples, 171 (72%) showed growth of aerobic bacteria were isolated. The most common organism which was isolated was Staphylococcus aureus, with 76 (32.2%) isolates. Of these, 8 (10.6%) were Methicillin Resistant Staphylococcus Aureus (MRSA).Conclusions: Indian clinicians and infectious disease specialists in the coastal areas are facing formidable challenges from Methicillin Resistant Staphylococcus aureus. Despite the best surgical practices, nearly a tenth of all the SSIs cases could be caused by MRSA. Routine screening for these multidrug resistant organisms in the hospital staff, especially in the surgical departments and pre-surgical screening of the patients could help in reducing the incidence of MRSA.
Key Words: Surgical Site Infections, Staphylococcus aureus, Methicillin resistant Staphylococcus aureus (MRSA)
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17. RADIO-PATHOLOGICAL CORRELATION OF THYROID MASSES
Dr. Dinesh K.Gupta, Dr.Sudha Gupta, Dr.Ashish kumar
ABSTRACT
Background: Thyroid gland is afflicted by various pathologies ranging from diffuse enlargement (goitre) to nodular lesions, thyroiditis, and malignancies. USG is the most common and the most useful way to image the thyroid gland and its pathology. The study was conducted with the objective of evaluating the applicability of Doppler-USG in diagnosing Thyroid pathologies, establish its superiority over Clinical palpation, and correlate histo pathologically using FNAC. Method: This was a prospective study done on 100 patients that came to the OPD of the department of radio diagnosis of Mahatma Gandhi medical college and hospital, Jaipur, from January 2010 to July 2011. All the patients with thyroid swelling/mass/ enlargement were studied under colour Doppler USG and then FNAC was performed. Results: Majority of the patients were females in the age group of 41-60 years. USG was found to be more sensitive than clinical palpation. Gross differences were found when the results of USG were correlated with FNAC. Conclusion: Ultrasound was found to be more reliable than palpation. The addition of colour flow imaging has added value to the prediction of thyroid, but definitive diagnosis can be reached only with FNAC/Biopsy.
Key words: USG, Colour Doppler, FNAC, Thyroid.
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18. ASSESSMENT OF CLINICAL AND HEMATOLOGIC PROFILE OF CHILDREN WITH MEGALOBLASTIC ANEMIA
Dr.Jaswant Mahawer
ABSTRACT
Background: Megaloblastic anemia is traditionally described as a macrocytic anemia distinguished by a characteristic megaloblastic bone marrow morphology, featuring metamyelocytes and megaloblasts, often accompanied by leukopenia and thrombocytopenia. The spectrum of diseases associated with vitamin B12 deficiency varies widely, ranging from asymptomatic cases to life-threatening conditions like pancytopenia or myelopathy. Material & Methods: The present cross sectional, prospective study was carried out at department of pediatrics, at our tertiary care hospital. The study duration was of six months from January 2015 to June 2015. In this prospective study we enrolled 100 children of age group of 6 months to 18 years presented at outpatient department with a diagnosis of Megaloblastic Anemia and enrolled by simple random sampling. Results: In the present study, out of total enrolled participants, on the basis of clinical presentation it was found that 100% children had pallor, 90% children had Anorexia and generalized weakness, 68% children had Hyperpigmentation and 36% children were diagnosed with Irritability/ tremors/ neurologic involvement. On the basis of hematological parameters it was found that 100% children had Macrocytic anemia ( MCV >100 μg/L), 100% children were diagnosed by VitaminB12 assay and 32% children had Severe Anemia (Hb <6 g/dl). There was no mortality reported in present study. Conclusion: We concluded from the present study that, most frequent presenting symptoms in megaloblastic anemia due to Vitamin B12 deficiency typically include anorexia, generalized weakness, and irritability, clinically manifested as pallor and hyperpigmentation.
Keywords: Macrocytic anemia, VitaminB12 deficiency, Pallor.
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Ankur Purohit, R. K. Vyas, Manju lata Sharma, Yogita Soni, Anita Verma
ABSTRACT:
Objective: To compare the level of total serum Magnesium (Mg) of pregnant women with preeclampsia with normal pregnant females.
Study design: This was a case control study which included 50 women with preeclampsia in their third trimester of pregnancy as Study group and 50 healthy pregnant women in the third trimester of pregnancy as control group, with similar maternal and gestational age. The concentration of total serum magnesium was measured by Atomic Absorption Spectroscopy. The data was analyzed using Students’ t-test wherever applicable.
Result: The total serum magnesium level in preeclamptic women was significantly lower (p<0.001) than in pregnant women of similar maternal and gestational age.
Conclusion: Hypomagnesemia related to preeclampsia supports the hypothesis that alteration in the total serum magnesium levels may be involved in possible etiologies of preeclampsia.
Keywords: - Preeclampsia, Magnesium, Hypomagnesemia, Hypertension, Atomic Absorption Spectrophotometry.
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2. MALARIA: RECENT TRENDS MANIFESTED AS THROMBOCYTOPENIA
Dr. Anil Rajani, Dr. Kishore Khatri, Dr. Kusum Vaishnav
ABSTRACT:
Objective: Malaria continues to be a cause of high mortality and morbidity in India and is commonly associated with mild hematological abnormalities. Yet the physicians, when evaluating patients for fever, frequently missed the diagnosis of malaria. We evaluated the role of platelet counts for predicting malaria infection. Materials &methods: It was a retrospective study. The study included patients came with complaint of fever and investigated at laboratory of M.G. hospital, Jodhpur and Army hospital, Jodhpur. Results: The mean platelet counts among non malarial patients were much higher than malaria positive group. On statistical analysis this difference was also found significant (p<0.001). Conclusion: Our study concluded that a finding of thrombocytopenia should increase the suspicion of malaria and lead to performance of more specific tests, including multiple peripheral smears and ELISA for parasite- specific antigen etc.
KEYWORDS: fever, malaria, thrombocytopenia.
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3. COMPARATIVE STUDY ON AWARENESS AND KNOWLEDGE OF BOYS AND GIRLS ABOUT HIV/AIDS AMONG STUDENTS OF SENIOR SECONDARY SCHOOL
Jyoti Jain, Hemlata Mittal
ABSTRACT
Objectives: In present scenario, HIV/AIDS is considered as one of the major non curable disease of developing countries like India. And young ones form a significant segment of those attending sexually transmitted infection (STI) clinics and those infected by HIV. In India HIV/AIDS is a one of the major contributory factor in mortality and morbidity of people. Material and Method: For the present study total of 360 students from class IX-XII (both science and commerce) were taken as sample from 10 senior secondary English medium co-ed school of Udaipur, Rajasthan were taken through convenience sampling method. 6 students (3 boys & 3 girls) from each class were taken which constituted 36(18 boys and 18 girls) students from each school. Thus total of 360 (180 boys and 180 girls) students were obtained. The pre tested interview schedule was given to all selected students aimed to measure their knowledge and awareness about HIV/AIDS. The entire questionnaire was retrieved and analyzed using simple descriptive statistical analysis.
Result: Among all the selected boys and girls it was found that majority were having awareness and knowledge about HIV/AIDS regarding general issues, mode of transmission, preventive measures and source of knowledge. Both boys and girls were having positive attitude towards infected person.
Conclusion: Thus it has overall observed that majority of our young ones who are the pillars of future are aware of knowledge about this incurable and killer disease as about its full form, its curability and its consequence.
Key words: HIV/AIDS, Awareness, knowledge, attitude, students.
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4. EVALUATION OF IMMUNIZATION COVERAGE IN THE RURAL AREA OF JAIPUR, RAJASTHAN, USING THE WHO THIRTY CLUSTER SAMPLING TECHNIQUE.
Laxmi Nidhi Pandey, Archana Paliwal, B. N. Sharma, R. C. Choudhary, S. L. Bhardwaj
Abstract
Background: Infectious diseases are a major cause of morbidity and mortality in children. One of the most cost-effective and easy methods for child survival is immunization. Objective- To assess the immunization coverage and it's determinants in 12-23 months old children in rural area of Jaipur. Materials and Methods: A cross-sectional study was conducted in the field practice area of the Rural Health Training Center (RHTC) using the WHO thirty clusters sampling method for evaluation of immunization coverage. Results: A total of 210 children aged 12‑23 months were included in the study. It was found that 76.19% of the children were fully immunized against all the six vaccine preventable diseases. While 22.86% & 0.95% are partially immunized & unimmunized respectively. Major reasons for non immunization are lack of awareness for immunization, no faith in immunization and OPV being considered the only vaccine, lack of motivation, lack of information, and various obstacles were the reasons for partial immunization.
Key words – WHO thirty cluster sampling technique, primary immunization, fully, partially & non immunized.
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5. IMAGING AND BIOCHEMICAL FINDINGS IN MAPLE SYRUP URINE DISEASE- A CASE REPORT
Gajera S., Bhanderi A., Mishra S. and Goyal M.M
Abstract
Maple syrup urine disease (MSUD) is a rare autosomal recessive disorder. It is caused by a deficiency of the branched chain α-ketoacid dehydrogenase enzyme complex, leading to accumulation of the branched chain amino acids (leucine, isoleucine, and valine) and their toxic byproducts (ketoacids) in the blood and urine. Imaging is characterestized by MSUD oedema affecting the myelinated white matter. We present a neonatal case with classic type of MSUD with radiological findings confirmed by biochemical investigations.
Keywords: maple syrup urine disease, radiological findings, Biochemical tests.
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6. ATTENDANCE, ATTITUDES AND ACADEMIC PERFORMANCE: A STUDY ON FIRST YEAR MBBS STUDENTS ATTENDING PHYSIOLOGY CLASSES
Maulik Varu, Anup Vegad, Chinmay Shah, Hemant Mehta, Yogesh Kacha
ABSTRACT:
Objective: Student attendance is declining day by day in medical colleges. In this context, the present study was undertaken to find out any impact of attendance on academic performance in exam as well as to find out students’ attitudes towards their absenteeism. Material and Methods: Based on percentage of attendance in Physiology department, students were divided into five groups, I (≤ 60%) to V ((≥ 91%). Academic performance was analyzed in terms of percentage of marks obtained in Physiology subject in final university exam including both theory and practical. Statistical analysis was carried out by obtaining p value with Kruskal Wallis test. Spearman Correlation was performed between attendance and academic performance. In predesigned pretested performa, students were asked reasons of their absenteeism at classes. Result: There was statistically significant difference between academic performance of five groups in both theory (P=0.0369) and practical. (P<0.0001) There was statistically significant positive correlation between attendance and academic performance in both theory (P=0.0010) and practical with more significant impact on practical. (P<0.0001) Most common reasons given by students for their absenteeism were either boring lecture or boring topic, which gives indication to do intervention and modification in teaching methods. Conclusion: The present study suggests a clear-cut impact of attendance on academic performance. Introspection need to be done and innovative method should be used to eliminate reasons of absenteeism.
Keywords: Attendance, Academic performance, Theory, Practical
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7. A COMPARATIVE STUDY OF LIGNOCAINE 0.5% AND ROPIVACAINE 0.2% FOR INTRAVENOUS REGIONAL ANESTHESIA FOR ELECTIVE UPPER LIMB SURGERY
S. Asrar , Devesh S , Vidushi S , Meenaxi S , Anumeha J
ABSTRACT:
Background: Day care surgeries and ambulatory surgeries have number of advantages for the patient as well as for health care providers also. Regional anesthesia has been very popular in day care surgery. Intravenous regional anesthesia is one such simple and reliable technique. Material And Methods: Patients included in the study were ASA grade I and II of ages 18 – 65 years, undergoing elective upper limb surgery. A total of 60 patients were randomly divided into 2 equal groups. We compared intravenous regional anesthesia by using lignocaine 0.5% with ropivacaine 0.2% for elective upper limb surgery. A detailed history and systemic examination was done to rule out presence of major illness. Routine investigations like haemogram and urine examination was done in all patients. Results: The difference in mean time of onset of sensory blockade between group L and group R was found to be in significant (p=0.3695 i.e. P>0.05). The difference in mean time of onset of motor blockade between group L and group R was found to be significant (p=0.0486 i.e. P<0.05). The difference in grade of sensory blockade was statistically insignificant (P>0.05). There was no evidence of side effects after the release of tourniquet in 0.2% ropvacaine group as compared to 0.5% lignocaine group. Difference in mean time of recovery from sensory blockade between group L and group R was highly significant (p=0.0001 i.e. P<0.05). CONCLUSION: 0.2% ropivacaine can be used as an alternative to 0.5% lignocaine for intravenous having just the similar onset and intensity of sensory block.
KEY WORDS: Day care surgery, Lignocaine, Ropivacaine, Intravenous regional Anaesthesia.
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8. Metabolic Syndrome: Can Serum Uric Acid Along With Hepatic Enzymes Serve As Potential Marker For Metabolic Syndrome?
Balveer Singh Gurjar, Vipul Garg, Manisha Verma, Suresh Meena, S.K. Vardey
ABSTRACT:
Background: With worldwide prevalence in cases of metabolic syndrome (MetS), is a cluster of clinical conditions characterized by high blood pressure, dyslipidemia, hyperglycemia and central abdominal obesity. Material and Methods: We have determined the level of liver enzymes along with serum uric acid (UA) to assess whether hyperuremia with dysfunctional liver enzyme are associated with MetS. Sixty four subjects at least showing one of the symptoms of MetS and sixty four age matched controls were selected from OPD/IPD of S.M.S. Medical College and Hospital, Jaipur for eleven months. Results: Participants with MetS had statistically significantly higher values of blood pressure, body mass index, waist circumference, fasting glucose and triglycerides while HDL-c levels are statistically significantly lower when compared with control group. The mean values of ALP, GGT and uric acid were 146.36 U/L, 53.39 U/L and 6.22 mg/dl respectively and were statistically significantly higher in MetS participants when compared with control group. Uric acid showed a statistically significant positive correlations with waist circumference (r = 0.4997), Triglycerides (r = 0.6696), and fasting glucose levels (r = 0.4573).Conclusion: GGT and uric acid may plays a role in early diagnosis of metabolic syndrome with a high predictive value for both metabolic syndrome and CVD. Regarding the availability and simplicity of these tests in routine clinical practice and their universal standardization, these findings indicate the potential of liver enzymes, especially GGT, to be considered in algorithms for metabolic syndrome.
Key words: Metabolic Syndrome, serum uric acid, aspartate aminotransferase, alanine aminotrasferase, alkaline phosphatase.
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9. RATIONALIZATION OF MYRINGOPLASTY IN CHILDREN: A COMPARISON WITH AN ADULT POPULATION
Meghal Chaudhary, Tarun Ojha, Natwar Singh Rathore, Amit singhal, Abhishek Sharma, Kanak Yadav, Vaishali Kataria
ABSTRACT:
Objective: Myringoplasty is the surgical repair of the perforation of the tympanic membrane. It is a simple and effective procedure that results in the successful closure of the perforation in most cases. This study is planned to find out reliability of myringoplasty in children by comparing its anatomical and functional results with adult myringoplasty.Study Design: A descriptive cross sectional study
Place and Duration of Study: Department of Otolaryngology at a tertiary care teaching hospital in Jaipur from January 2015 to June 2015.Materials and Methods: A total of 67 patients having dry central tympanic membrane perforation of various sizes secondary to chronic tubotympanic suppurative otitis media were included in the study. The patients were divided in two groups. First group comprised of children upto the age of 14 years whereas those above the age of 14 years were included in second group. Myringoplasty was performed in all patients with temporalis fascia utilizing underlay technique. The two groups were compared regarding graft success rate and hearing improvement at the end of 6 months of follow up.Results: Out of 67patients included in the study, 31 (46.2%) belonged to child group whereas 36 (53.73%) were included in adult group. Among 31 patients in child group, 28(90.32 %) had successful graft take at the end of 6 months of follow up whereas 32 (89.3 %) patients out of 52 in adult group had successful graft. Average air bone gap closure of 19 dB was noted in child group whereas in adult group it was 15.1 dB. The difference between graft success rate and average air bone gap closure was found to be statistically insignificant (P>0.05).Conclusion: Results of myringoplasty in paediatric and adult age group are comparable in terms of graft success rate and hearing improvement.
Key words: Myringoplasty, tympanic membrane, paediatric, middle ear.
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10. A COMPARATIVE SURVEY OF MEDICAL DISORDERS IN THE GERIATRIC POPULATION OF RURAL AND URBAN AREA
Dr. Kishore Moolrajani, Dr. Rashmi Modwal
ABSTRACT:
Objective: To compare and survey medical disorders in geriatric population who attended the medical outpatients department (OPD) in a tertiary care hospital from rural and urban area.Material and Methods: : This study was conducted in a total of 300 consecutive patients who were aged 60-years and above attended the Out-Patients Department (OPD) of Department of Medicine in JNU Medical College Hospital and Research Centre for a period of 2 months from November 2015 to January 2016. Detailed history of these patients was taken along with physical examination as per the pre-designed proforma and relevant investigations were done, wherever needed. Result: Among the 300 patients, male patients 164 (54.67%) predominated the female patients 136 (45.33%). Most of the patients belong to age of 60-70 years (82.33%). The no. of male patients (n=96) from the rural areas was higher than the number of females (n=63) and number of female patients (n=73) from the urban areas was slight higher than the number of males (n=68). The study showed the prevalence of medical disorders as follows: chronic obstructive pulmonary disease (COPD) – 20%, hypertension – 17%, diabetes mellitus – 12.67%, coronary artery disease – 12.33%, pulmonary tuberculosis – 11%, , respiratory infection (non-tubercular) – 9.33%, visual impairment / cataract – 5%, arthritis – 3.67%, cirrhosis of the liver – 3.33%, various types of cancers – 2%, urinary complaints / BPH – 2%, and stroke – 1.67%. Conclusion: The study showed a high prevalence of COPD, hypertension, diabetes mellitus, coronary artery disease and pulmonary tuberculosis in the geriatric population indicating the chances of non-communicable disease are more but communicable disease can also occur as the immunity is waning.
Key Words: Geriatric population, chronic disease, metabolic syndrome,
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11. INCIDENCE AND ETIO-PATHOGENESIS OF VOCAL CORD PARALYSIS IN A TERTIARY CARE HOSPITAL
Natwar Singh Rathore ,Tarun Ojha, Meghal Chaudhary,Amit singhal ,Abhishek Sharma,Saurabh Gakhar, Abhay Sharma
ABSTRACT:
Background: Vocal cord paralysis is an important issue in laryngeal diseases and considered to be a sign of underlying disease. The etiology of this problem is changing and varied. Aims and Objective: This study was a retrospective analysis of vocal cord paralysis in patients with some underlying disease. Material and Methods: Detailed history of patients diagnosed and treated for vocal cord paralysis were studied, the data regarding age, sex, etiology, and duration of symptoms were collected.Result:38.89% patients were classified as idiopathic as no pathology is found, 18.06% had neoplastic cause, 16.67% had mechanical trauma / radiation hazard as cause, and rest other had iatrogenic, infection, accidental trauma, neurological and congenital factors as etiology. Conclusion: Magnetic Resonance Imaging is crucial in the work-up of idiopathic vocal cord paralysis. Vocal cord paralysis has got a variable etiology which varies with the involvement of the vocal cord. Idiopathic causes predominated in our series, followed by malignant causes.
Key words: Vocal cord paralysis, Etiology, Idiopathic, Malignant.
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12. DIAGNOSTIC PROBLEMS IN CYTOLOGICAL DIAGNOSIS OF MUCOEPIDERMOID CARCINOMA: REPORT OF 6 CASES WITH HISTOPATHOLOGICAL CORRELATION
Dr Chandrika Gupta ,Dr Kamlesh Yadav
ABSTRACT:
Background: Mucoepidermoid carcinoma (MEC) is a malignant salivary gland neoplasm with extreme morphologic heterogeneity and hence rendering a definitive fine needle aspiration cytology (FNAC) diagnosis of this neoplasm is really challenging. The present study was undertaken to elucidate the cytological features of MEC and explore the diagnostic accuracy and pitfalls by comparing with subsequent histopathology. Material and Methods: The present study was conducted over a period of 1.5 years wherein we obtained six histopathologically confirmed cases of MEC. These patients were initially subjected to FNAC. The cytologic features studied included presence of mucous cells, intermediate cells, and squamous cells. Presence of background mucinous material was also noted. The cytological features were compared with the subsequent histopathology. Results: Of the 6 cases of MEC, a definite cytological diagnosis was possible only in 3 cases. Of the remaining 3 cases, 1 cases was broadly diagnosed in cytology as Chronic sialadenitis, 1 cases was underdiagnosed as pleomorphic adenoma and 1 case was diagnosed as nonspecific malignant epithelial neoplasm. Conclusion: A satisfactory aspirate with all three types of cells; mucous, intermediate and squamous cells may not be obtained in all cases of MEC for providing a definite diagnosis. Hence, a good clinicoradiological correlation, a high index of suspicion and repeated aspirations especially in cystic lesions may be particularly helpful in difficult cases. In addition, while dealing with mucinous cystic lesions with low cellularity, the importance of early excision should be communicated to the clinician since the possibility of low-grade MEC cannot be excluded.
Key words: Cystic lesions; diagnostic challenges; fine needle aspiration; histopathology.
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13. RECLASSIFICATION OF CARCINOMA CERVIX BASED ON MUCIN HISTOCHEMISTRY
Dr Sudha Gupta , Dr. Dinesh K.Gupta,Dr.Kunal Purohit
ABSTRACT:
Objectives: this study is planned to demonstrate mucin in cervical Carcinoma which were originally classified as squamous cell carcinoma and to reclassify and modify histological diagnosis after performing niucin histochemistry. Material and Methods: The present study was conducted by staining sections from cervical biopsies of 55 patients clinically suspected and/or diagnosed as carcinoma cervix of epithelial origin and subsequently confirmed histopathologically by Hematoxylin and Eosin staining, received at Histopathology section of Department of Pathology, Mahatma Gandhi Medical College, Jaipur. Results: Histologically these cases were diagnosed as squamous cell carcinoma 94.73%, adenocarcinoma -- 05.45% and adenosquamous carcinoma -01.83%. The classification proposed by Fox was followed in the study,according to which reclassification was necessary in 10.91% of cases. The distribution of cases was found to be as squamous cell carcinoima-81.82%, adenocarcinoma -05.45%,adenosquamous carcinoma - 12.72%.Conclusion: Thus after screening the results of the present study, it is concluded that mucin histochemistiy should be carried out routinely in all the cases of carcinoma cervix. This aids in the early detection of previously unrecognized mucin secreting adenocarcinoma and adenosquamous carcinoma which pursue a more aggressive clinical course and poorer prognosis than non mucin producing squamous cell carcinoma.
Key words: Cystic lesions; diagnostic challenges; fine needle aspiration; histopathology.
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14. A COMPARISON OF EPIDURAL AND GENERAL ANAESTHESIA TECHNIQUE FOR RENAL SURGERIES
Dr. Adhokshaj Joshi, Dr.Sidhrath Sharma, Dr.Rajesh Sharma
ABSTRACT:
Background: Mucoepidermoid Neuraxial anaesthesia has become popular for the renal surgeries during the last few years. This study was aimed at comparing general anaesthesia (GA) with epidural anaesthesia in patients undergoing renal surgeries. Methods: One hundred American Society of Anaesthesiologists (ASA) physical status‑I and II adult consenting patients of both gender in the age group of 25-55 years undergoing renal surgeries were randomly assigned to two groups of 50 patients each: Group G and Group E. Group G patients were administered conventional GA while Group E received epidural anaesthesia (EA) with 3 mg/kg of ropivacaine and 1 μg/kg of dexmedetomidine. Besides cardio‑respiratory parameters, surgeon’s satisfaction, patient’s satisfaction and side effects were observed. Parametric data were analysed by ANOVA while non‑parametric data were compared with Mann–Whitney U‑test and Wilcoxon test. Value of P < 0.05 was considered statistically significant. Results: The demographic profile, total anaesthesia time, surgical time and haemodynamic parameters and surgeon’s satisfaction scores were comparable in both groups. Patient’s satisfaction scores were better in Group E during the post‑operative period. Incidence of side‑effects such as nausea and vomiting and shivering were higher in Group G (P < 0.001) while the incidence of dry mouth was higher in Group E (P < 0.001). Conclusion: Epidural anaesthesia with ropivacaine and dexmedetomidine can be safely and effectively used in patients undergoing renal surgeries.
Key words: Dexmedetomidine, epidural, general anaesthesia, renal surgery, ropivacaine
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15. EFFECT OF DEXAMETHASONE FOR IMPROVING ANALGESIA QUALITY IN AXILLARY BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES : A COMPARATIVE STUDY
Dr Gaurav sharma ,Vandana Mangal, Dr Surendra kumar Sharma,Dr.Pratibha Singh Rathore,Dr Rajani Mathur
ABSTRACT:
Background: Various adjuvants have been used to prolong the duration of local anaesthetic action after peripheral and regional block. We evaluated the effect of dexamethasone 8mg added to Fixed constant Mixture of Lignocaine and Bupivacaine on the duration and quality of pain relief in upper limb surgeries performed under axillary brachial plexus block using Dexamethasone .Methods: In this prospective randomized double-blind controlled study Total 50 patients [age 20-40 years] of ASA I and II undergoing elective upper Limb surgery under Axillary brachial Plexus Block were randomized into two groups.Patients in Group 1(n=25) received 12 ml bupivacaine 0.5% + 8ml lignocaine2% + 12ml Normal Saline And We Injected 12ml bupivacaine0.5% + 8ml lignocaine 2 % + 10 ml Normal Saline + 2ml Dexamethasone in Group 2(n=25) . Total 32 ml. volume of drug administered in both groups. Onset and recovery time of sensory and motor block, duration of analgesia and quality of block, hemodynamic variables, oxygen saturation were studied in both the groups. Results: The mean onset of motor block for Group I was 11.80±2.000 (min) for Group 2 was 11.08± 2.080 (min) and the difference was found to be statistically not significant between Group I and Group 2 (p >0. 05 ). Mean onset of sensory block for Group I was 9.12±1.394 (min) for Group 2 was 8.68±1.887(min) and this difference was not statistically significant between both groups (p >0.05). The mean duration of motor block (180.68±8.459 (min) ) was significantly lower in Group I as compared to Group 2 was 203.20±25.936 min. ( P value<0.001) The mean duration of analgesia in Group I was 222.52±9.713 (min) and it was significantly lower as compared to Group 2 which was 794.52±74.411 (min). (p value < 0.001)Conclusion : Addition of dexmethasone (2ml) to local anaesthetic mixture for axillary brachial plexus block was found highly effective in prolongation of duration of anaesthesia and analgesia. So, the patient remains comfortable in the postoperative period with considerable therapeutic benefit and without any potential side effects.
Keywords : axillary brachial plexus block, dexamethasone, Postoperative analgesia.
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16. A STUDY ON SURGICAL WOUND INFECTIONS CAUSED BY STAPHYLOCOCCUS SPECIES WITH SPECIAL REFERENCE TO METHICILLIN RESISTANT STAPHYLOCOCCI
Gaurav Dalela, Jitendra Ahuja, Nilofar Khayyam, Arvind Sharma
ABSTRACT
Background: To study the prevalence of Staphylococcus and Methicillin-Resistant Staphylococcus (MRS) in surgical site infections (SSIs) at Jhalawar. Aims and Objective: This study was conducted on 237 patients who underwent surgery in the obstetrics and gynaecology, orthopaedic and surgical departments of Jhalawar hospital and medical college, Jhalawar. Pus samples were collected with two sterile swabs and processed in the Microbiology department. Results: Of the 237 pus samples, 171 (72%) showed growth of aerobic bacteria were isolated. The most common organism which was isolated was Staphylococcus aureus, with 76 (32.2%) isolates. Of these, 8 (10.6%) were Methicillin Resistant Staphylococcus Aureus (MRSA).Conclusions: Indian clinicians and infectious disease specialists in the coastal areas are facing formidable challenges from Methicillin Resistant Staphylococcus aureus. Despite the best surgical practices, nearly a tenth of all the SSIs cases could be caused by MRSA. Routine screening for these multidrug resistant organisms in the hospital staff, especially in the surgical departments and pre-surgical screening of the patients could help in reducing the incidence of MRSA.
Key Words: Surgical Site Infections, Staphylococcus aureus, Methicillin resistant Staphylococcus aureus (MRSA)
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17. RADIO-PATHOLOGICAL CORRELATION OF THYROID MASSES
Dr. Dinesh K.Gupta, Dr.Sudha Gupta, Dr.Ashish kumar
ABSTRACT
Background: Thyroid gland is afflicted by various pathologies ranging from diffuse enlargement (goitre) to nodular lesions, thyroiditis, and malignancies. USG is the most common and the most useful way to image the thyroid gland and its pathology. The study was conducted with the objective of evaluating the applicability of Doppler-USG in diagnosing Thyroid pathologies, establish its superiority over Clinical palpation, and correlate histo pathologically using FNAC. Method: This was a prospective study done on 100 patients that came to the OPD of the department of radio diagnosis of Mahatma Gandhi medical college and hospital, Jaipur, from January 2010 to July 2011. All the patients with thyroid swelling/mass/ enlargement were studied under colour Doppler USG and then FNAC was performed. Results: Majority of the patients were females in the age group of 41-60 years. USG was found to be more sensitive than clinical palpation. Gross differences were found when the results of USG were correlated with FNAC. Conclusion: Ultrasound was found to be more reliable than palpation. The addition of colour flow imaging has added value to the prediction of thyroid, but definitive diagnosis can be reached only with FNAC/Biopsy.
Key words: USG, Colour Doppler, FNAC, Thyroid.
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18. ASSESSMENT OF CLINICAL AND HEMATOLOGIC PROFILE OF CHILDREN WITH MEGALOBLASTIC ANEMIA
Dr.Jaswant Mahawer
ABSTRACT
Background: Megaloblastic anemia is traditionally described as a macrocytic anemia distinguished by a characteristic megaloblastic bone marrow morphology, featuring metamyelocytes and megaloblasts, often accompanied by leukopenia and thrombocytopenia. The spectrum of diseases associated with vitamin B12 deficiency varies widely, ranging from asymptomatic cases to life-threatening conditions like pancytopenia or myelopathy. Material & Methods: The present cross sectional, prospective study was carried out at department of pediatrics, at our tertiary care hospital. The study duration was of six months from January 2015 to June 2015. In this prospective study we enrolled 100 children of age group of 6 months to 18 years presented at outpatient department with a diagnosis of Megaloblastic Anemia and enrolled by simple random sampling. Results: In the present study, out of total enrolled participants, on the basis of clinical presentation it was found that 100% children had pallor, 90% children had Anorexia and generalized weakness, 68% children had Hyperpigmentation and 36% children were diagnosed with Irritability/ tremors/ neurologic involvement. On the basis of hematological parameters it was found that 100% children had Macrocytic anemia ( MCV >100 μg/L), 100% children were diagnosed by VitaminB12 assay and 32% children had Severe Anemia (Hb <6 g/dl). There was no mortality reported in present study. Conclusion: We concluded from the present study that, most frequent presenting symptoms in megaloblastic anemia due to Vitamin B12 deficiency typically include anorexia, generalized weakness, and irritability, clinically manifested as pallor and hyperpigmentation.
Keywords: Macrocytic anemia, VitaminB12 deficiency, Pallor.
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