International Journal of Medical Sciences and Education (IJMSE)
Vol. 3; Issue: 3 (July-Sept 2016) , Date of Publication: 01.10.2016
1. A COMPRATIVE STUDY OF POSTOPERATIVE COGNITIVE DYSFUNCTION IN ELDERLY PATIENTS AFTER GENERAL ANAESTHESIA AND COMBINED SPINAL EPIDURAL ANAESTHESIA
Dr. Lalita Jingar, Dr. Adhokshaj Joshi, Dr. S C Dulara
ABSTRACT
Aim: The aim of study was to compare the influence of either general anaesthesia(GA) or combined spinal epidural anaesthesia (CSEA) on post operative cognitive dysfunction (POCD) in elderly (60 to 70 years) subjects undergoing hip surgery and to note the impact of preoperative hospitalization on POCD. Methods: A total of 60 ASa physical status 1 & 2patients were recruited for a Prospective Randmoized Parallel-group study, comparable in age and sex. Subjects were enrolled and randomized to receive either GA ( Group A, n=30) or CSEA (Group B, n=30).All of them screened using Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT)preoperatively. The operated patients Re-Evaluated by same scale on 3rd postoperative day for POCD. The impact of preoperative hospitalization on POCD also noted. The data collected were analyzed to assess statistical significance. Results: We observed no statistical difference in cognitive behaviour in either group pre-operatively, which were comparable with respect age and sex. Postoperatively a significant difference was seen between the two groups in MMSE scores and CDT scores. No association of POCD and pre operative days of hospital stay seen. Conclusions: We observed a significant Postoperative Cognitive Dysfunction with GA in comparison to CSEA. Gender and preoperative hospitalization have no association with POCD.
KEYWORDS: General Anaesthesia combined spinal epidural anaesthesia, postoperative cognitive dysfunction.
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2. GENDER INFLUENCE ON LEARNING STYLES OF UNDERGRADUATE MEDICAL STUDENTS
Dr Shete Anjali1*, Dr KD Garkal, Dr Nidhi Yadav, Dr. Rahul Salwe, Dr. Beulah Rainer
ABSTRACT
Aim: Students differ in the types of instruction to which they respond best (learning style preferences), the ways they approach their studies and their attitudes about the nature of knowledge and their role in constructing it—that is, their levels of intellectual development.Many factors have been found to influence students’ learning styles, including gender, age, academic achievement.The aim of the study was to assess the gender influence on the learning styles of medical students.METHOD: VARK questionnaire was given to 381 undergraduate medical students .The distributions of VARK preferences were calculated, and the learning style of each student was determined.Descriptive statistics were used to describe the variables. The chi-square test was used to compare the gender influence on learning style preferences. RESULT: Of the 381 students 200 were females and 181 were males . More than half of the students exhibited a multiple learning preference (67%); of those, 20 percent, 33 percent, and 47 percent were bi-modal, tri-modal, and quad-modal, respectively. Remaining 33% students had a single learning preference. The unimodal preference showed statistically significant difference between male and female students whereas there was no statistically significant difference in multimodal learning style preferences.CONCLUSION: More than half of medical students who participated in this study were found to have multimodal learning preferences. The most common single learning preference was Kinesthetic (K) followed by Aural (A). The unimodal learning style showed statistically significant difference in male and female students whereas no such difference was seen in multimodal style.
KEY WORDS: Learning style, VARK Questionnaire, Medical students, Gender influence.
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3. CARDIOVASCULAR RESPONSE TO SUSTAINED ISOMETRIC CONTRACTION: AN INTERVENTIONAL STUDY
Ms Yogita Khandelwal, Dr. Anuradha Yadav, Dr. Manisha Sankhla, Dr. Kusum lata Gaur
ABSTRACT
Background: Cardiovascular diseases are the leading cause of death worldwide. Cardio- exercise is one of the preventive measures by which these cardiovascular diseases can be controlled. Exercise using a handgrip dynamometer is a type of isometric exercise where voluntary muscle activity is associated with parasympathetic withdrawal, an increase in sympathetic flow and activation of other central commands.
Method: This study included 300 healthy young adults (150 male and 150 female) of age group 18-25 years. Their height and weight were measured and body mass index (BMI) was calculated. Basal heart rate (HR) and blood pressure (BP) were recorded. They were subjected to hand grip at 30% maximum voluntary contraction for 3 minutes. Post-exercise HR and BP were also recorded. Pre and post exercise HR and BP were compared with paired ‘t’ test.
Result: All parameters of cardiovascular system increases with isometric contraction but it was found significant in the HR, diastolic blood pressure (DBP) and mean blood pressure (MAP). Another observation was revealed that although DBP was significantly increased with exercise but it was not increased upto normal range. DBP and MAP were significant positively correlated with BMI whereas no significant correlation was observed for systolic blood pressure (SBP) and HR with BMI.
Conclusion: Although there are significant changes in all studied cardiovascular parameters (except SBP) but they were found with sympathetic insufficiency.
KEYWORDS: Blood pressure, Body mass index, Heart Rate, Isometric Exercise
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4. BACTERIOLOGICAL PROFILE AND ANTIBIOGRAM OF AEROBIC WOUND INFECTION ISOLATES IN TERTIARY HEALTH CARE CENTRE
Shreeram G, Devesh S , Varsha S , Vidushi S
Abstract
Background: Health care associated infection possess major problem for both doctor as well as patients. Health care associated infection prolongs hospital stay which leads to financial burden to the patients. Among health care associated infections, surgical site infections are the second most common after Urinary tract infection. Material and Methods: The present study included a total of 102 cases of wound infection who attended surgery out patients in NIMS Hospital.All patients with clinical evidence of sepsis were included during the study period. The samples were collected from the depth of the wound with strict asepsis. Two sterile cotton swabs from each sample were obtained before the wound was cleaned with antiseptic solution. Samples were taken from the patients during the period of surgical wound dressing without contamination with skin commensals and transported to the laboratory immediately. Methods: A total of 204 wound swabs were collected from patients with wound infections and were processed according to the standard microbiological procedures. Results: In our study, we found 82 patients were infected by the single organism whereas, 20 patients were infected by multiple organisms. Among three most commonly bacterial isolates E. coli (29.5 %), Pseudomonas (25.5 %), S. aureus (19.7 %) gram negative organisms had a higher prevalence. Conclusion: Increasing resistance to antimicrobials increases the risk of morbidity and mortality; therefore there is urgent need of implementation of measures to restrict the health care associated infection. Rational use of antimicrobials, proper hygiene, and strict asepsis should be applied in all health care.
Keywords: Health care associated infection, wound swabs, ESBL, MRSA, Staphylococcus aureus, skin and soft tissue infections (SSTI`S).
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5. A COMPARATIVE STUDY FOR DETECTION OF MYCOBACTERIA BY DIRECT AFB SMEAR EXAMINATION, CULTURE BY LOWENSTEIN JENSEN MEDIA, FLUORESCENT SENSOR TECHNOLOGY BASED BACTEC TM MICRO MGIT TM SYSTEM & PCR
Pratibha Mittal, Sweta Gupta
ABSTRACT
Background: Female Genital Tuberculosis is an important cause of infertility in developing countries about 5-16% of cases among women in India. Though the actual incidence may be underreported due to asymptomatic presentation of genital tuberculosis. This study was conducted for early detection of Mycobacteria by polymerase chain reaction and compare the results of direct AFB smear examination, conventional method Lowenstein Jensen media, Bactec Micro MGIT & Polymerase Chain Reaction.Materials & Methods: A total of 160 genital samples were recieved from suspected cases of female genital tuberculosis during the year 2013. These samples were processed by modified petroff"s method for detection of Mycobacteria was done by direct AFB smear examination, conventional method Lowenstein Jensen media, BACTEC Micro MGIT & Polymerase chain reaction.Results: Out of 160 genital samples, a total of 9.3% (15/160)were positive, 8/15 (53.3%) were detected by PCR, 5/15 (33.3%) isolates by BACTEC, 5/15 (33.3%) was isolated by LJ and 1/15(6.66%) only by Direct AFB smear examination. Mean time to detection of growth has seen earlier in BD BACTEC Micro MGIT for the detection of Mycobacteria.Conclusion:In our study PCR came out to be most sensitive method among all followed by MGIT & LJ both, then direct AFB smear examination.
Keywords:BACTEC Micro MGIT, Direct AFB smear, Genital tuberculosis, Lowenstein Jensen Media (LJ), Polymerase Chain Reaction(PCR), Tuberculosis.
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6. STUDENTS’ PERCEPTION ON EFFECTIVENESS OF PATHOLOGY TEACHING IN PHASE 1 MEDICAL PROGRAM AT UCSI UNIVERSITY
Naw May Emerald, Thu Zar Han, San San Oo
ABSTRACT
Objective: A sound knowledge of pathology is essential to clinical practice. This study explored the students’ perception on effectiveness of pathology teaching in Phase 1 medical program at UCSI University. Materials and methods: A cross sectional descriptive study was performed in 83 medical students from clinical phase by using pretested questionnaire which comprised 46 statements assessing the students’ perception on subject, teaching–learning methods, availability of facilities and resources, and effectiveness of pathology teaching. Results: Out of 83, 55.4% perceived that pathology is interesting and 81.9% responded as a challenging subject. More than half of the students were satisfied with general and systemic pathology teaching and agreed that they were made easy to understand the learning topics by lectures combined with museum and directed-self learning, and also by integrated with other basic science subjects. Students perceived that lectures are more effective than self-learning and knowledge obtained from lectures was more than that of problem-based learning. Over 60% agreed that phase 1 pathology teaching is helpful for better understanding of clinical teaching and they were given adequate foundation for clinical years. Conclusion: Although students were satisfied with the methods of teaching of pathology in Phase 1, teaching plan should be reviewed to create students’ centered, more active learning classroom persuading students to perceive more interest on the subject. Because of half of the students who did not agree and who gave neutral responses to the statement on adequacy of pathology knowledge, the contents in curriculum should be reviewed for further improvement.
Keywords: Effectiveness, Pathology, Phase 1, Students’ Perception
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7. TEACHING LEARNERS TO DO ASSESSMENT
Dr. Marius. T. George, Dr. VV. Unnikrishnan, Dr. Murali. CP
ABSTRACT
Background: It is a common occurrence that, many Assessors are being accused of being unfair to the students. Most often this is the perception of the students, which will continue until he or she becomes an Assessor. The best method to create awareness about the hardships of evaluation is to teach the students, how to do the assessment. Having this in mind, we started this community based project, where we trained the students to assess each other, using the simple lesson plan. Materials and methods: In this quantitative study 60 first year medical students of a Rural Medical School were selected at random, after obtaining their written informed consent. After taking students' opinion about routine assessments, on a five point Likert scale as pre test, the students were trained on performing assessment using a checklist. The students carried out reciprocal peer assessment using a simple lesson plan and upon completion, they sat together and evaluated the process. Post test done using the same five-point scale and Paired Sample T Test was run on the results. Result: Results showed a mean ± SD of (17.30± 2.20) before and (31.9 ± 3.94) after the training. The p value was 0.000, proving that the effectiveness of the training was statistically significant. Conclusion: By teaching the students how to conduct an assessment, we can help alleviate the age-old affectations of students, that the assessors are being unfair to them, so that they can learn confidently and more focused.
KEYWORDS: Assessor, OSCE, Medical Education, Nuances, Perception, Unfair.
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8. CLINICAL RELEVANCE OF LUMBAR –XRAY PRESCRIBED TO THE PATIENTS OF LOWER BACK PAIN: AN OBSERVATIONAL STUDY
Dr. Dwarka Prasad Agarwal, Dr. Shyam Mohan Dixit
ABSTRACT
Objective: To assess the relevance of lumbar X-Ray for the patients of lower back pain, and find out the age groups in which the X-Rays are least useful. Material and methods: A total of 128 patients visiting orthopaedics OPD of Pacific medical college and hospital, Udaipur, India from June 2015 to Nov 2015 were randomly selected and included in the study after their consent. Follow up was done with the consulting physician regarding the alteration of treatment, if any, after the X-Ray. Results: Out of 128 patients, only 32.03% of the patients had relevant findings on the X-Ray and the remaining 67.96% did not. Younger patients were found to be more likely to have a normal radiograph as compared to the older age groups. In the age group of 45-54 years, the most common diagnosis made by the X-Ray were infective causes of back pain (5 patients), sclerotic metastasis of lumbar spine (1 patient), osteoporosis (15 patients) and collapsed vertebral body due to osteoporosis (4 patients).Conclusion: Lumbar spine radiography only for lower back pain does not provide much clinical utility in terms of patient management and hence needs to be regulated. Appropriate guidelines should be issued to reduce unnecessary radiography referrals of routine practice.
Key words: lower back pain, lumbar spine radiography
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9. ANTIBIOTIC SUSCEPTIBILITY PATTERN OF COMMUNITY ACQUIRED UROPATHOGENS AT M. B. GOVT. HOSPITAL IN UDAIPUR, RAJASTHAN
Harsha Vijayvergiya, Anshu Sharma
ABSTRACT
Objectives: To determine prevalence of uropathogenic bacteria and their antibiotic susceptibility pattern along with detection of extended spectrum β-lactamase (ESBL) production in Escherichia coli and Klebsiella spp. and methicillin resistance in Staphylococcus aureus (MRSA). Materials and Methods: 250 urine specimens received in microbiology lab from suspected UTI patients attending to the outpatient department were processed by standard techniques. ESBL production was determined by double disc synergy test and phenotypic confirmatory method. Results: Of 250 samples 20.8% showed significant bacteriuria, higher in females (61.5%). Escherichia coli was the predominant uropathogen (35%), followed by coagulase negative Staphylococcus (10.6%), Klebsiella spp. (10.2%). Gram negative bacilli showed maximum sensitivity to nitrofurantoin (68.9%), amikacin (62.2%) and gram positive cocci showed maximum sensitivity for nitrofurantoin (83.5%) followed by vancomycin (79.7%), gentamicin (75.9%). High resistance was seen against ampicillin, nalidixic acid, co-trimoxazole, cephalexin and norfloxacin. Prevalence of ESBL in Escherichia coli and Klebsiella spp. and MRSA was found to be 45.3%, 40% and 70% respectively. Conclusions: Escherichia coli was the predominant uropathogen for community acquired UTIs in Udaipur, Rajasthan. Uropathogens showed resistance to commonly used antibiotics with increasing trend of ESBL production and methicillin resistance. Nitrofurantoin, vancomycin should be used as empirical therapy. The susceptibility and resistance patterns of uropathogens should be considered before starting empirical treatment.
KEYWORDS: Antibiotic Susceptibility, Escherichia coli, ESBL, MRSA, Staphylococcus aureus Urinary Ttract Infections (UTIs)
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10. THE ALTERATIONS IN GROUND SUBSTANCES AND COLLAGEN METABOLISM IN CASES OF CHRONIC FLUORIDE INTOXICATION BEFORE AND AFTER SUPPLEMENTATION WITH CALCIUM, VITAMIN C(ASCORBIC ACID) AND VITAMIN D
Ailani Vinita, Gupta RC , Dadheech Gora
ABSTRACT
Background: The aim of present study was to find out the effects of excess of fluoride on ground substance and collagen metabolism and to assess the effects of supplementation of vitamin C, D and calcium on fluoride intoxication. Material and Method: The study was conducted on 100 children of age group 5 to 12 years selected from three fluoride belts of Jaipur district (25 children from each area consuming water with 2.4, 5.6, & 13.6 mg/l of fluoride) compared with 25 controls, consuming water with normal fluoride levels. Drinking water fluoride, serum and urinary fluoride levels were measured by ion selective electrode method. Urinary hydoxyproline, Serum ascorbic acid, Serum calcium, Urinary calcium, Serum sialic acid, Serum hexosamine, Serum inorganic phosphate were estimated by spectrophotometic method. Result: The study indicated an increase in levels of urinary hydoxyproline and decrease in ascorbic acid levels with increase in drinking water fluoride, similarly levels of serum sialic acid and serum hexosamine decreased with increase in fluoride concentration and an increase in urinary calcium was also observed but serum calcium levels and inorganic phosphate levels were found to be normal. Treatment with calcium, Vitamin C and Vitamin D showed reduction in serum fluoride, increase in urinary fluoride concentration and decease in urinary calcium levels and decrease in urinary hydroxyproline levels. Conclusion: Fluoride intoxication due to drinking water can result in abnormalities in ground substance metabolism which can be resolved by proper supplementation with calcium, vitamin C and D.
Key words: Chronic fluoride intoxication, hydroxyproline, collagen, ground substance, ascorbic acid, vitamin D
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11. SONOGRAPHIC MEASUREMENTS OF UTERUS AND ITS CORRELATION WITH DIFFERENT PARAMETERS IN PAROUS AND NULLIPAROUS WOMEN
Dr. Ajay M. Parmar ,Dr. D P.Agarwal, Dr. Nipa Hathila, Dr. T. C. Singel
ABSTRACT
Aim: To determine normal standards of uterine dimensions by using ultrasonography and to find out correlation between size of uterus with age, height, weight and body surface area of parous and nulliparous women. Material and methods: This study consists 80 women (40 parous&40 nulliparous) had sonography because of abdominal and /or pelvic problem unrelated to uterus. The uterine dimensions are measured and correlated with age, height, weight, body surface area in parous and nulliparous women. Results: The result shows that the uterine length increases in 21to40 age group and decrease in 41to 60 age group women. The uterine length increase with increase in the body weight, height, and body surface area in both parous and nulliparous women. The size of uterus are more in parous than nulliparous women. Conclusion: on the basis of the present study, it was concluded that the uterine length increase in 21to40 age group and decrease in 41to 60 age group women. Positive correlation between uterine length and age, body weight, height, surface area is seen in parous but not in nulliparous women. The uterine length was less in nulliparous than that in parous women with corresponding age, body weight, body height, and body surface area.
Key words: Uterus, ultra sonography, uterine length, height, weight, body surface area.
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12. COMPARISON OF INCIDENCE, INDICATION AND COMPLICATION OF PRIMARY CESAREAN SECTION IN PRIMIGRAVIDA AND MULTIGRAVIDA
Dr. Shrutee Birla ,Dr. Manisha Gupta ,Dr. Pankaj Birla, Dr. Jaishree Sharma
ABSTRACT
Background: To compare the indications, incidence and complication of primary cesarean section performed in primigravida to that in multigravida Methods :This was a prospective study carried out in Umaid Hospital, Department of obstetrics and gynecology, attached to Dr.S.N. Medical College, Jodhpur from 1st march 2013 to 31st May 2013. All patients who delivered vaginally or abdominally during this period were calculated. Those who had a primary cesarean section were considered as cases. Indication for cesarean section was noted before operation. All complications were observed and noted till the discharge of the patient. Calculations were made separately for primigravida and a multigravida and the results were compared. Statistical analysis was done by chi square test of significance. Result: During this period 2179 primigravida and 2802 multigravida were delivered of which 475 primigravida had a cesarean section and 275 multigravida had a primary cesarean section. Incidence of primary cesarean section was higher in primigravida. Fetal distress and CPD were the most common indications in both primigravida and multigravida. Incidence of APE was higher in primigravida whereas the incidence of APH was higher in multigravida. Incidence of blood transfusion was higher in multigravida. Incidence of wound gape was statistically higher in multigravida. Conclusion :First labor of women needs to be well managed to reduce cesarean section rates. Incidence of APE can be reduced by good antenatal checkups. Multigravida runs a higher risk of morbidity which emphasizes the need of improving the health status of women in reproductive age group and better implementation of family planning services.
Keywords Cephalopelvic disproportion (CPD), Antepartum eclampsia (APE), Antepartum hemorrhage (APH), Postpartum hemorrhage (PPH)
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13. PERCEPTION OF INTERNS REGARDING TYPES OF THEORY QUESTIONS AND TYPES OF PRACTICAL EXAMINATIONS DONE IN DEPARTMENT OF PATHOLOGY FOR FORMATIVE AND SUMMATIVE ASSESSMENT IN MEDICAL COLLEGES
Vijai Singh, Pratap Shankar, Amod Kumar Sachan, Rakesh Kumar Dixit
ABSTRACT
Background: Present time there are many diseases flourishing and it can be prohibit by the drugs and these drugs are designed, developed and prescribed by the doctors and these doctors are product of medical colleges after internship training. For development of medical skills as well as knowledge, perception of medical intern is very important. In this study we focused on the medical interns about perception regarding the type of theory questions and types of practical examinations done for formative and summative assessment in medical colleges of northern India. Material and Methods: Total 200 medical interns were enrolled with the written consent. Inclusion criteria was the intern should be MBBS intern and exclusion criteria was MBBS intern with supplementary exams. A questionnaire was designed after literature review. The questionnaire covered perception about types of theory questions and practical examinations. Results: Out of 200 interns 80(40%) interns liked assay type questions, 30 (15%) liked short answer, 30(15%) liked objective type questions, 20(10%) liked true/false while the 40(20%) interns were in favour of all types of questions in examination. While out of 200 interns 60(30%) were Satisfied, 100 (50%) were unsatisfied while remaining 40(20%) were neutral. Out 200 interns 170(85%) answered about change required while 30(15%) supported the present pattern. Conclusions: Medical interns and their suggestions should be included during decision making about the types of theory questions and types of practical examinations with possible execution is highly recommended.
Key words: Triglycerides, Total Cholesterol, Basal Metabolic Index, Chronic Obstructive Pulmonary Disease, Low Density Lipoprotein.
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14.HEMATOLOGICAL CHANGES IN P.FALCIPARUM & P.VIVAX MALARIA
Bhavin D. Patel1*,
ABSTRACT
Background: Malaria continues to be a great health problem in some of the most populated areas of the world & continues to cause significant morbidity and mortality worldwide. The hematological abnormalities that have been reported to consistently with malaria are anemia, thrombocytopenia, atypical lymphocytosis and infrequently disseminated intravascular coagulation.Methodology: This cross sectional study was conducted in central hospital laboratory of a tertiary care hospital of Surat, Gujarat. The laboratory confirmed cases of malaria from August to October, 2012 were included in the study. Hematological profile of different spices of malaria was compared. Results: The difference in mean platelet count according to severity of infection was highly statistically significant according to ANOVA test both for P.Vivax and P.Falciparum. Platelet counts show decreasing trend according to severity of infection. Difference in the mean haemoglobin level and mean platelet counts of P.Vivax cases and P.Falciparum cases was also statistically significant. Conclusion: The low level of platelet can be used as predictor of severity of the infection. And thus, prediction of the hematological changes enables the clinician to establish an effective and early therapeutic intervention in order to prevent the occurrence of major complications.
Keywords: Plasmodium Falciparum, Plasmodium Vivax, Haematological Profile, Malaria
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15.EVALUATION OF TERIPARATIDE THERAPY IN JOINT REPLACEMENT SURGERY
Dr. Nitin Gupta
ABSTRACT:
Background: Teriparatide acts by increasing the number and activity of osteoblasts, responsible for bone formation, and by modulating the activity of osteoclasts, involved in bone resorption. The success of joint replacement surgery relies heavily on integrating the implant with the surrounding bone tissue—a process known as osseointegration. Material & Methods: The present cross-sectional, prospective study was carried out at the Department of Orthopedics, at our tertiary care hospital. The study duration was of one year from January 2012 to December 2012. A sample size of 50 was calculated at a 90% confidence interval at 10% acceptable margin of error by Epi info software version 7.3. Only those patients who matched the inclusion and exclusion criteria were enrolled in the present study. Results: In the present study, out of the total study participants, based on the complications and adverse event profile, during the treatment period, all patients were administered a consistent dose of teriparatide (20 μg subcutaneously daily) for a duration of 90 days. No adverse events related to the teriparatide treatment were reported, indicating a well-tolerated intervention. There were no documented complications, such as infections or blood clots, during the course of teriparatide treatment. Importantly, none of the patients experienced complications related to periprosthetic fractures potentially induced by osteoporosis. These findings suggest a favorable safety profile and absence of treatment-related issues in the study group during the specified treatment duration. Conclusion: We concluded from the present study that Teriparatide therapy enhances osseointegration by stimulating bone formation around the implant site and increasing bone strength around the prosthesis. It improves the stability and durability of the implant and prevents post-surgical complications and poor outcomes.
Keywords: Teriparatide, Joint replacement surgery, Post-surgical complications.
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15.GLYCEMIC CONTROL AND SERUM MICRONUTRIENTS LEVELS IN TYPE 2 DIABETES MELLITUS- A CASE CONTROL STUDY
Dr.Ashok Tukaram Pardeshi
ABSTRACT:
Background: Altered metabolism of some essential micronutrients has been reported in type 2 diabetes mellitus. Hyperglycemia, hyperinsulinemia & increased protein glycosylation observed in diabetics become more pronounced in conditions of poor glycemic states aggravating the serum micronutrients levels. Aims & objectives- To assess the serum levels of calcium, Iron and phosphorus in relation to glycemic control in type 2 diabetes mellitus. Material & Methods - This case-control study recruited patients suffering from type 2 diabetes mellitus who came to the department of medicine, of our tertiary care hospital from February 2015 to April 2015.50 patients with type 2 DM, aged 30-65 yrs was recruited as test group. Sociodemographic parameters, age, family history, social history, history of smoking & alcohol, height, weight, BMI, blood pressure were recorded. 5 ml of venous blood was collected by venipuncture and serum levels of calcium, iron and phosphorus were estimated. Results- Fasting plasma glucose, HbA1c levels, serum calcium & serum iron levels were statistically significantly higher while serum phosphorus levels were lower in the test group as compared to the control group. Male subjects were observed to have higher phosphorus levels as compared to the female subjects (p<0.05). Increased serum Calcium levels and decreased phosphorus levels were observed as age increased in all the study subjects (p<0.05). On comparing glycemic control with the various parameters, a statistical difference was observed with higher calcium levels in patients with poor glycemic control (p<0.05). Conclusion- Diabetes has a significant effect on the metabolism of micronutrients. Serum calcium levels & serum iron levels show an increase while serum phosphate levels decrease. These changes increase with increasing age & variable glycemic control.
Keywords: Hyperglycaemia, Hyperinsulinemia, Protein glycosylation, Micronutrients, Calcium.
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16.ASSESSMENT AND OUTCOME OF CHILDREN WITH SEVERE ACUTE MALNUTRITION A PROSPECTIVE CROSS SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL
Dr.Satish Kumar Srivastav
ABSTRACT:
Background: In India, data from the National Family Health Survey 3 (NFHS-3) reveals a gradual decline in childhood malnutrition over the past fifteen years. Approximately 46% of children under 5 years of age in India are reported to be moderately to severely underweight, 38% are moderately to severely stunted, and around 19% suffer from moderate to severe wasting. Material & Methods: The present cross sectional, prospective study was carried out at department of paediatrics, at our tertiary care hospital. In this prospective study we enrolled 100 children aged less than 5 years with severe acute malnutrition diagnosed using WHO protocol were enrolled and their management, complications and outcome were recorded. Strict confidentiality was maintained with patient identity and data and not revealed, at any point of time. Results: Out of the total enrolled children 28% were males and 72% were females. Mean age of study participants was 1.3 ± 0.5 years. Out of total, PEM grade II was seen in 11% children, PEM grade III was seen in 49% children, PEM grade IV was seen in 32% children and kwashiorkor was seen in 8% children. Mean duration of hospital stay in present study was 16.5 ± 3.4 days. 42% of children were received vaccines according to national immunization schedule. 38% children shown good weight gain, 54% children shown moderate weight gain and 8% of children reported to shown poor weight gain. There was no mortality reported in present study. Conclusion: We concluded from the present study that children aged less than 5 years with severe acute malnutrition managed using WHO protocol and showed good outcome. 38% children shown >10gm/kg/day weight gain, 54% children shown 5-10gm/kg/day weight gain. There was no mortality reported in present study.
Keywords: Severe acute malnutrition, WHO protocol, Facility based treatment.
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Dr. Lalita Jingar, Dr. Adhokshaj Joshi, Dr. S C Dulara
ABSTRACT
Aim: The aim of study was to compare the influence of either general anaesthesia(GA) or combined spinal epidural anaesthesia (CSEA) on post operative cognitive dysfunction (POCD) in elderly (60 to 70 years) subjects undergoing hip surgery and to note the impact of preoperative hospitalization on POCD. Methods: A total of 60 ASa physical status 1 & 2patients were recruited for a Prospective Randmoized Parallel-group study, comparable in age and sex. Subjects were enrolled and randomized to receive either GA ( Group A, n=30) or CSEA (Group B, n=30).All of them screened using Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT)preoperatively. The operated patients Re-Evaluated by same scale on 3rd postoperative day for POCD. The impact of preoperative hospitalization on POCD also noted. The data collected were analyzed to assess statistical significance. Results: We observed no statistical difference in cognitive behaviour in either group pre-operatively, which were comparable with respect age and sex. Postoperatively a significant difference was seen between the two groups in MMSE scores and CDT scores. No association of POCD and pre operative days of hospital stay seen. Conclusions: We observed a significant Postoperative Cognitive Dysfunction with GA in comparison to CSEA. Gender and preoperative hospitalization have no association with POCD.
KEYWORDS: General Anaesthesia combined spinal epidural anaesthesia, postoperative cognitive dysfunction.
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2. GENDER INFLUENCE ON LEARNING STYLES OF UNDERGRADUATE MEDICAL STUDENTS
Dr Shete Anjali1*, Dr KD Garkal, Dr Nidhi Yadav, Dr. Rahul Salwe, Dr. Beulah Rainer
ABSTRACT
Aim: Students differ in the types of instruction to which they respond best (learning style preferences), the ways they approach their studies and their attitudes about the nature of knowledge and their role in constructing it—that is, their levels of intellectual development.Many factors have been found to influence students’ learning styles, including gender, age, academic achievement.The aim of the study was to assess the gender influence on the learning styles of medical students.METHOD: VARK questionnaire was given to 381 undergraduate medical students .The distributions of VARK preferences were calculated, and the learning style of each student was determined.Descriptive statistics were used to describe the variables. The chi-square test was used to compare the gender influence on learning style preferences. RESULT: Of the 381 students 200 were females and 181 were males . More than half of the students exhibited a multiple learning preference (67%); of those, 20 percent, 33 percent, and 47 percent were bi-modal, tri-modal, and quad-modal, respectively. Remaining 33% students had a single learning preference. The unimodal preference showed statistically significant difference between male and female students whereas there was no statistically significant difference in multimodal learning style preferences.CONCLUSION: More than half of medical students who participated in this study were found to have multimodal learning preferences. The most common single learning preference was Kinesthetic (K) followed by Aural (A). The unimodal learning style showed statistically significant difference in male and female students whereas no such difference was seen in multimodal style.
KEY WORDS: Learning style, VARK Questionnaire, Medical students, Gender influence.
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3. CARDIOVASCULAR RESPONSE TO SUSTAINED ISOMETRIC CONTRACTION: AN INTERVENTIONAL STUDY
Ms Yogita Khandelwal, Dr. Anuradha Yadav, Dr. Manisha Sankhla, Dr. Kusum lata Gaur
ABSTRACT
Background: Cardiovascular diseases are the leading cause of death worldwide. Cardio- exercise is one of the preventive measures by which these cardiovascular diseases can be controlled. Exercise using a handgrip dynamometer is a type of isometric exercise where voluntary muscle activity is associated with parasympathetic withdrawal, an increase in sympathetic flow and activation of other central commands.
Method: This study included 300 healthy young adults (150 male and 150 female) of age group 18-25 years. Their height and weight were measured and body mass index (BMI) was calculated. Basal heart rate (HR) and blood pressure (BP) were recorded. They were subjected to hand grip at 30% maximum voluntary contraction for 3 minutes. Post-exercise HR and BP were also recorded. Pre and post exercise HR and BP were compared with paired ‘t’ test.
Result: All parameters of cardiovascular system increases with isometric contraction but it was found significant in the HR, diastolic blood pressure (DBP) and mean blood pressure (MAP). Another observation was revealed that although DBP was significantly increased with exercise but it was not increased upto normal range. DBP and MAP were significant positively correlated with BMI whereas no significant correlation was observed for systolic blood pressure (SBP) and HR with BMI.
Conclusion: Although there are significant changes in all studied cardiovascular parameters (except SBP) but they were found with sympathetic insufficiency.
KEYWORDS: Blood pressure, Body mass index, Heart Rate, Isometric Exercise
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4. BACTERIOLOGICAL PROFILE AND ANTIBIOGRAM OF AEROBIC WOUND INFECTION ISOLATES IN TERTIARY HEALTH CARE CENTRE
Shreeram G, Devesh S , Varsha S , Vidushi S
Abstract
Background: Health care associated infection possess major problem for both doctor as well as patients. Health care associated infection prolongs hospital stay which leads to financial burden to the patients. Among health care associated infections, surgical site infections are the second most common after Urinary tract infection. Material and Methods: The present study included a total of 102 cases of wound infection who attended surgery out patients in NIMS Hospital.All patients with clinical evidence of sepsis were included during the study period. The samples were collected from the depth of the wound with strict asepsis. Two sterile cotton swabs from each sample were obtained before the wound was cleaned with antiseptic solution. Samples were taken from the patients during the period of surgical wound dressing without contamination with skin commensals and transported to the laboratory immediately. Methods: A total of 204 wound swabs were collected from patients with wound infections and were processed according to the standard microbiological procedures. Results: In our study, we found 82 patients were infected by the single organism whereas, 20 patients were infected by multiple organisms. Among three most commonly bacterial isolates E. coli (29.5 %), Pseudomonas (25.5 %), S. aureus (19.7 %) gram negative organisms had a higher prevalence. Conclusion: Increasing resistance to antimicrobials increases the risk of morbidity and mortality; therefore there is urgent need of implementation of measures to restrict the health care associated infection. Rational use of antimicrobials, proper hygiene, and strict asepsis should be applied in all health care.
Keywords: Health care associated infection, wound swabs, ESBL, MRSA, Staphylococcus aureus, skin and soft tissue infections (SSTI`S).
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5. A COMPARATIVE STUDY FOR DETECTION OF MYCOBACTERIA BY DIRECT AFB SMEAR EXAMINATION, CULTURE BY LOWENSTEIN JENSEN MEDIA, FLUORESCENT SENSOR TECHNOLOGY BASED BACTEC TM MICRO MGIT TM SYSTEM & PCR
Pratibha Mittal, Sweta Gupta
ABSTRACT
Background: Female Genital Tuberculosis is an important cause of infertility in developing countries about 5-16% of cases among women in India. Though the actual incidence may be underreported due to asymptomatic presentation of genital tuberculosis. This study was conducted for early detection of Mycobacteria by polymerase chain reaction and compare the results of direct AFB smear examination, conventional method Lowenstein Jensen media, Bactec Micro MGIT & Polymerase Chain Reaction.Materials & Methods: A total of 160 genital samples were recieved from suspected cases of female genital tuberculosis during the year 2013. These samples were processed by modified petroff"s method for detection of Mycobacteria was done by direct AFB smear examination, conventional method Lowenstein Jensen media, BACTEC Micro MGIT & Polymerase chain reaction.Results: Out of 160 genital samples, a total of 9.3% (15/160)were positive, 8/15 (53.3%) were detected by PCR, 5/15 (33.3%) isolates by BACTEC, 5/15 (33.3%) was isolated by LJ and 1/15(6.66%) only by Direct AFB smear examination. Mean time to detection of growth has seen earlier in BD BACTEC Micro MGIT for the detection of Mycobacteria.Conclusion:In our study PCR came out to be most sensitive method among all followed by MGIT & LJ both, then direct AFB smear examination.
Keywords:BACTEC Micro MGIT, Direct AFB smear, Genital tuberculosis, Lowenstein Jensen Media (LJ), Polymerase Chain Reaction(PCR), Tuberculosis.
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6. STUDENTS’ PERCEPTION ON EFFECTIVENESS OF PATHOLOGY TEACHING IN PHASE 1 MEDICAL PROGRAM AT UCSI UNIVERSITY
Naw May Emerald, Thu Zar Han, San San Oo
ABSTRACT
Objective: A sound knowledge of pathology is essential to clinical practice. This study explored the students’ perception on effectiveness of pathology teaching in Phase 1 medical program at UCSI University. Materials and methods: A cross sectional descriptive study was performed in 83 medical students from clinical phase by using pretested questionnaire which comprised 46 statements assessing the students’ perception on subject, teaching–learning methods, availability of facilities and resources, and effectiveness of pathology teaching. Results: Out of 83, 55.4% perceived that pathology is interesting and 81.9% responded as a challenging subject. More than half of the students were satisfied with general and systemic pathology teaching and agreed that they were made easy to understand the learning topics by lectures combined with museum and directed-self learning, and also by integrated with other basic science subjects. Students perceived that lectures are more effective than self-learning and knowledge obtained from lectures was more than that of problem-based learning. Over 60% agreed that phase 1 pathology teaching is helpful for better understanding of clinical teaching and they were given adequate foundation for clinical years. Conclusion: Although students were satisfied with the methods of teaching of pathology in Phase 1, teaching plan should be reviewed to create students’ centered, more active learning classroom persuading students to perceive more interest on the subject. Because of half of the students who did not agree and who gave neutral responses to the statement on adequacy of pathology knowledge, the contents in curriculum should be reviewed for further improvement.
Keywords: Effectiveness, Pathology, Phase 1, Students’ Perception
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7. TEACHING LEARNERS TO DO ASSESSMENT
Dr. Marius. T. George, Dr. VV. Unnikrishnan, Dr. Murali. CP
ABSTRACT
Background: It is a common occurrence that, many Assessors are being accused of being unfair to the students. Most often this is the perception of the students, which will continue until he or she becomes an Assessor. The best method to create awareness about the hardships of evaluation is to teach the students, how to do the assessment. Having this in mind, we started this community based project, where we trained the students to assess each other, using the simple lesson plan. Materials and methods: In this quantitative study 60 first year medical students of a Rural Medical School were selected at random, after obtaining their written informed consent. After taking students' opinion about routine assessments, on a five point Likert scale as pre test, the students were trained on performing assessment using a checklist. The students carried out reciprocal peer assessment using a simple lesson plan and upon completion, they sat together and evaluated the process. Post test done using the same five-point scale and Paired Sample T Test was run on the results. Result: Results showed a mean ± SD of (17.30± 2.20) before and (31.9 ± 3.94) after the training. The p value was 0.000, proving that the effectiveness of the training was statistically significant. Conclusion: By teaching the students how to conduct an assessment, we can help alleviate the age-old affectations of students, that the assessors are being unfair to them, so that they can learn confidently and more focused.
KEYWORDS: Assessor, OSCE, Medical Education, Nuances, Perception, Unfair.
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8. CLINICAL RELEVANCE OF LUMBAR –XRAY PRESCRIBED TO THE PATIENTS OF LOWER BACK PAIN: AN OBSERVATIONAL STUDY
Dr. Dwarka Prasad Agarwal, Dr. Shyam Mohan Dixit
ABSTRACT
Objective: To assess the relevance of lumbar X-Ray for the patients of lower back pain, and find out the age groups in which the X-Rays are least useful. Material and methods: A total of 128 patients visiting orthopaedics OPD of Pacific medical college and hospital, Udaipur, India from June 2015 to Nov 2015 were randomly selected and included in the study after their consent. Follow up was done with the consulting physician regarding the alteration of treatment, if any, after the X-Ray. Results: Out of 128 patients, only 32.03% of the patients had relevant findings on the X-Ray and the remaining 67.96% did not. Younger patients were found to be more likely to have a normal radiograph as compared to the older age groups. In the age group of 45-54 years, the most common diagnosis made by the X-Ray were infective causes of back pain (5 patients), sclerotic metastasis of lumbar spine (1 patient), osteoporosis (15 patients) and collapsed vertebral body due to osteoporosis (4 patients).Conclusion: Lumbar spine radiography only for lower back pain does not provide much clinical utility in terms of patient management and hence needs to be regulated. Appropriate guidelines should be issued to reduce unnecessary radiography referrals of routine practice.
Key words: lower back pain, lumbar spine radiography
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9. ANTIBIOTIC SUSCEPTIBILITY PATTERN OF COMMUNITY ACQUIRED UROPATHOGENS AT M. B. GOVT. HOSPITAL IN UDAIPUR, RAJASTHAN
Harsha Vijayvergiya, Anshu Sharma
ABSTRACT
Objectives: To determine prevalence of uropathogenic bacteria and their antibiotic susceptibility pattern along with detection of extended spectrum β-lactamase (ESBL) production in Escherichia coli and Klebsiella spp. and methicillin resistance in Staphylococcus aureus (MRSA). Materials and Methods: 250 urine specimens received in microbiology lab from suspected UTI patients attending to the outpatient department were processed by standard techniques. ESBL production was determined by double disc synergy test and phenotypic confirmatory method. Results: Of 250 samples 20.8% showed significant bacteriuria, higher in females (61.5%). Escherichia coli was the predominant uropathogen (35%), followed by coagulase negative Staphylococcus (10.6%), Klebsiella spp. (10.2%). Gram negative bacilli showed maximum sensitivity to nitrofurantoin (68.9%), amikacin (62.2%) and gram positive cocci showed maximum sensitivity for nitrofurantoin (83.5%) followed by vancomycin (79.7%), gentamicin (75.9%). High resistance was seen against ampicillin, nalidixic acid, co-trimoxazole, cephalexin and norfloxacin. Prevalence of ESBL in Escherichia coli and Klebsiella spp. and MRSA was found to be 45.3%, 40% and 70% respectively. Conclusions: Escherichia coli was the predominant uropathogen for community acquired UTIs in Udaipur, Rajasthan. Uropathogens showed resistance to commonly used antibiotics with increasing trend of ESBL production and methicillin resistance. Nitrofurantoin, vancomycin should be used as empirical therapy. The susceptibility and resistance patterns of uropathogens should be considered before starting empirical treatment.
KEYWORDS: Antibiotic Susceptibility, Escherichia coli, ESBL, MRSA, Staphylococcus aureus Urinary Ttract Infections (UTIs)
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10. THE ALTERATIONS IN GROUND SUBSTANCES AND COLLAGEN METABOLISM IN CASES OF CHRONIC FLUORIDE INTOXICATION BEFORE AND AFTER SUPPLEMENTATION WITH CALCIUM, VITAMIN C(ASCORBIC ACID) AND VITAMIN D
Ailani Vinita, Gupta RC , Dadheech Gora
ABSTRACT
Background: The aim of present study was to find out the effects of excess of fluoride on ground substance and collagen metabolism and to assess the effects of supplementation of vitamin C, D and calcium on fluoride intoxication. Material and Method: The study was conducted on 100 children of age group 5 to 12 years selected from three fluoride belts of Jaipur district (25 children from each area consuming water with 2.4, 5.6, & 13.6 mg/l of fluoride) compared with 25 controls, consuming water with normal fluoride levels. Drinking water fluoride, serum and urinary fluoride levels were measured by ion selective electrode method. Urinary hydoxyproline, Serum ascorbic acid, Serum calcium, Urinary calcium, Serum sialic acid, Serum hexosamine, Serum inorganic phosphate were estimated by spectrophotometic method. Result: The study indicated an increase in levels of urinary hydoxyproline and decrease in ascorbic acid levels with increase in drinking water fluoride, similarly levels of serum sialic acid and serum hexosamine decreased with increase in fluoride concentration and an increase in urinary calcium was also observed but serum calcium levels and inorganic phosphate levels were found to be normal. Treatment with calcium, Vitamin C and Vitamin D showed reduction in serum fluoride, increase in urinary fluoride concentration and decease in urinary calcium levels and decrease in urinary hydroxyproline levels. Conclusion: Fluoride intoxication due to drinking water can result in abnormalities in ground substance metabolism which can be resolved by proper supplementation with calcium, vitamin C and D.
Key words: Chronic fluoride intoxication, hydroxyproline, collagen, ground substance, ascorbic acid, vitamin D
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11. SONOGRAPHIC MEASUREMENTS OF UTERUS AND ITS CORRELATION WITH DIFFERENT PARAMETERS IN PAROUS AND NULLIPAROUS WOMEN
Dr. Ajay M. Parmar ,Dr. D P.Agarwal, Dr. Nipa Hathila, Dr. T. C. Singel
ABSTRACT
Aim: To determine normal standards of uterine dimensions by using ultrasonography and to find out correlation between size of uterus with age, height, weight and body surface area of parous and nulliparous women. Material and methods: This study consists 80 women (40 parous&40 nulliparous) had sonography because of abdominal and /or pelvic problem unrelated to uterus. The uterine dimensions are measured and correlated with age, height, weight, body surface area in parous and nulliparous women. Results: The result shows that the uterine length increases in 21to40 age group and decrease in 41to 60 age group women. The uterine length increase with increase in the body weight, height, and body surface area in both parous and nulliparous women. The size of uterus are more in parous than nulliparous women. Conclusion: on the basis of the present study, it was concluded that the uterine length increase in 21to40 age group and decrease in 41to 60 age group women. Positive correlation between uterine length and age, body weight, height, surface area is seen in parous but not in nulliparous women. The uterine length was less in nulliparous than that in parous women with corresponding age, body weight, body height, and body surface area.
Key words: Uterus, ultra sonography, uterine length, height, weight, body surface area.
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12. COMPARISON OF INCIDENCE, INDICATION AND COMPLICATION OF PRIMARY CESAREAN SECTION IN PRIMIGRAVIDA AND MULTIGRAVIDA
Dr. Shrutee Birla ,Dr. Manisha Gupta ,Dr. Pankaj Birla, Dr. Jaishree Sharma
ABSTRACT
Background: To compare the indications, incidence and complication of primary cesarean section performed in primigravida to that in multigravida Methods :This was a prospective study carried out in Umaid Hospital, Department of obstetrics and gynecology, attached to Dr.S.N. Medical College, Jodhpur from 1st march 2013 to 31st May 2013. All patients who delivered vaginally or abdominally during this period were calculated. Those who had a primary cesarean section were considered as cases. Indication for cesarean section was noted before operation. All complications were observed and noted till the discharge of the patient. Calculations were made separately for primigravida and a multigravida and the results were compared. Statistical analysis was done by chi square test of significance. Result: During this period 2179 primigravida and 2802 multigravida were delivered of which 475 primigravida had a cesarean section and 275 multigravida had a primary cesarean section. Incidence of primary cesarean section was higher in primigravida. Fetal distress and CPD were the most common indications in both primigravida and multigravida. Incidence of APE was higher in primigravida whereas the incidence of APH was higher in multigravida. Incidence of blood transfusion was higher in multigravida. Incidence of wound gape was statistically higher in multigravida. Conclusion :First labor of women needs to be well managed to reduce cesarean section rates. Incidence of APE can be reduced by good antenatal checkups. Multigravida runs a higher risk of morbidity which emphasizes the need of improving the health status of women in reproductive age group and better implementation of family planning services.
Keywords Cephalopelvic disproportion (CPD), Antepartum eclampsia (APE), Antepartum hemorrhage (APH), Postpartum hemorrhage (PPH)
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13. PERCEPTION OF INTERNS REGARDING TYPES OF THEORY QUESTIONS AND TYPES OF PRACTICAL EXAMINATIONS DONE IN DEPARTMENT OF PATHOLOGY FOR FORMATIVE AND SUMMATIVE ASSESSMENT IN MEDICAL COLLEGES
Vijai Singh, Pratap Shankar, Amod Kumar Sachan, Rakesh Kumar Dixit
ABSTRACT
Background: Present time there are many diseases flourishing and it can be prohibit by the drugs and these drugs are designed, developed and prescribed by the doctors and these doctors are product of medical colleges after internship training. For development of medical skills as well as knowledge, perception of medical intern is very important. In this study we focused on the medical interns about perception regarding the type of theory questions and types of practical examinations done for formative and summative assessment in medical colleges of northern India. Material and Methods: Total 200 medical interns were enrolled with the written consent. Inclusion criteria was the intern should be MBBS intern and exclusion criteria was MBBS intern with supplementary exams. A questionnaire was designed after literature review. The questionnaire covered perception about types of theory questions and practical examinations. Results: Out of 200 interns 80(40%) interns liked assay type questions, 30 (15%) liked short answer, 30(15%) liked objective type questions, 20(10%) liked true/false while the 40(20%) interns were in favour of all types of questions in examination. While out of 200 interns 60(30%) were Satisfied, 100 (50%) were unsatisfied while remaining 40(20%) were neutral. Out 200 interns 170(85%) answered about change required while 30(15%) supported the present pattern. Conclusions: Medical interns and their suggestions should be included during decision making about the types of theory questions and types of practical examinations with possible execution is highly recommended.
Key words: Triglycerides, Total Cholesterol, Basal Metabolic Index, Chronic Obstructive Pulmonary Disease, Low Density Lipoprotein.
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14.HEMATOLOGICAL CHANGES IN P.FALCIPARUM & P.VIVAX MALARIA
Bhavin D. Patel1*,
ABSTRACT
Background: Malaria continues to be a great health problem in some of the most populated areas of the world & continues to cause significant morbidity and mortality worldwide. The hematological abnormalities that have been reported to consistently with malaria are anemia, thrombocytopenia, atypical lymphocytosis and infrequently disseminated intravascular coagulation.Methodology: This cross sectional study was conducted in central hospital laboratory of a tertiary care hospital of Surat, Gujarat. The laboratory confirmed cases of malaria from August to October, 2012 were included in the study. Hematological profile of different spices of malaria was compared. Results: The difference in mean platelet count according to severity of infection was highly statistically significant according to ANOVA test both for P.Vivax and P.Falciparum. Platelet counts show decreasing trend according to severity of infection. Difference in the mean haemoglobin level and mean platelet counts of P.Vivax cases and P.Falciparum cases was also statistically significant. Conclusion: The low level of platelet can be used as predictor of severity of the infection. And thus, prediction of the hematological changes enables the clinician to establish an effective and early therapeutic intervention in order to prevent the occurrence of major complications.
Keywords: Plasmodium Falciparum, Plasmodium Vivax, Haematological Profile, Malaria
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15.EVALUATION OF TERIPARATIDE THERAPY IN JOINT REPLACEMENT SURGERY
Dr. Nitin Gupta
ABSTRACT:
Background: Teriparatide acts by increasing the number and activity of osteoblasts, responsible for bone formation, and by modulating the activity of osteoclasts, involved in bone resorption. The success of joint replacement surgery relies heavily on integrating the implant with the surrounding bone tissue—a process known as osseointegration. Material & Methods: The present cross-sectional, prospective study was carried out at the Department of Orthopedics, at our tertiary care hospital. The study duration was of one year from January 2012 to December 2012. A sample size of 50 was calculated at a 90% confidence interval at 10% acceptable margin of error by Epi info software version 7.3. Only those patients who matched the inclusion and exclusion criteria were enrolled in the present study. Results: In the present study, out of the total study participants, based on the complications and adverse event profile, during the treatment period, all patients were administered a consistent dose of teriparatide (20 μg subcutaneously daily) for a duration of 90 days. No adverse events related to the teriparatide treatment were reported, indicating a well-tolerated intervention. There were no documented complications, such as infections or blood clots, during the course of teriparatide treatment. Importantly, none of the patients experienced complications related to periprosthetic fractures potentially induced by osteoporosis. These findings suggest a favorable safety profile and absence of treatment-related issues in the study group during the specified treatment duration. Conclusion: We concluded from the present study that Teriparatide therapy enhances osseointegration by stimulating bone formation around the implant site and increasing bone strength around the prosthesis. It improves the stability and durability of the implant and prevents post-surgical complications and poor outcomes.
Keywords: Teriparatide, Joint replacement surgery, Post-surgical complications.
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15.GLYCEMIC CONTROL AND SERUM MICRONUTRIENTS LEVELS IN TYPE 2 DIABETES MELLITUS- A CASE CONTROL STUDY
Dr.Ashok Tukaram Pardeshi
ABSTRACT:
Background: Altered metabolism of some essential micronutrients has been reported in type 2 diabetes mellitus. Hyperglycemia, hyperinsulinemia & increased protein glycosylation observed in diabetics become more pronounced in conditions of poor glycemic states aggravating the serum micronutrients levels. Aims & objectives- To assess the serum levels of calcium, Iron and phosphorus in relation to glycemic control in type 2 diabetes mellitus. Material & Methods - This case-control study recruited patients suffering from type 2 diabetes mellitus who came to the department of medicine, of our tertiary care hospital from February 2015 to April 2015.50 patients with type 2 DM, aged 30-65 yrs was recruited as test group. Sociodemographic parameters, age, family history, social history, history of smoking & alcohol, height, weight, BMI, blood pressure were recorded. 5 ml of venous blood was collected by venipuncture and serum levels of calcium, iron and phosphorus were estimated. Results- Fasting plasma glucose, HbA1c levels, serum calcium & serum iron levels were statistically significantly higher while serum phosphorus levels were lower in the test group as compared to the control group. Male subjects were observed to have higher phosphorus levels as compared to the female subjects (p<0.05). Increased serum Calcium levels and decreased phosphorus levels were observed as age increased in all the study subjects (p<0.05). On comparing glycemic control with the various parameters, a statistical difference was observed with higher calcium levels in patients with poor glycemic control (p<0.05). Conclusion- Diabetes has a significant effect on the metabolism of micronutrients. Serum calcium levels & serum iron levels show an increase while serum phosphate levels decrease. These changes increase with increasing age & variable glycemic control.
Keywords: Hyperglycaemia, Hyperinsulinemia, Protein glycosylation, Micronutrients, Calcium.
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16.ASSESSMENT AND OUTCOME OF CHILDREN WITH SEVERE ACUTE MALNUTRITION A PROSPECTIVE CROSS SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL
Dr.Satish Kumar Srivastav
ABSTRACT:
Background: In India, data from the National Family Health Survey 3 (NFHS-3) reveals a gradual decline in childhood malnutrition over the past fifteen years. Approximately 46% of children under 5 years of age in India are reported to be moderately to severely underweight, 38% are moderately to severely stunted, and around 19% suffer from moderate to severe wasting. Material & Methods: The present cross sectional, prospective study was carried out at department of paediatrics, at our tertiary care hospital. In this prospective study we enrolled 100 children aged less than 5 years with severe acute malnutrition diagnosed using WHO protocol were enrolled and their management, complications and outcome were recorded. Strict confidentiality was maintained with patient identity and data and not revealed, at any point of time. Results: Out of the total enrolled children 28% were males and 72% were females. Mean age of study participants was 1.3 ± 0.5 years. Out of total, PEM grade II was seen in 11% children, PEM grade III was seen in 49% children, PEM grade IV was seen in 32% children and kwashiorkor was seen in 8% children. Mean duration of hospital stay in present study was 16.5 ± 3.4 days. 42% of children were received vaccines according to national immunization schedule. 38% children shown good weight gain, 54% children shown moderate weight gain and 8% of children reported to shown poor weight gain. There was no mortality reported in present study. Conclusion: We concluded from the present study that children aged less than 5 years with severe acute malnutrition managed using WHO protocol and showed good outcome. 38% children shown >10gm/kg/day weight gain, 54% children shown 5-10gm/kg/day weight gain. There was no mortality reported in present study.
Keywords: Severe acute malnutrition, WHO protocol, Facility based treatment.
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