International Journal of Medical Sciences and Education (IJMSE)
Vol. 4; Issue: 3 (July-Sept 2017) , Date of Publication: 01.10.2017
EFFECT OF BIRTH INTERVAL AND ABORTION STATUS ON ANEAMIA AMONG PREGNANT WOMEN: AN URBAN AND RURAL COMPARATIVE STUDY
Dr. Mohini Nainani
ABSTRACT
Background: Anaemia is one of the important factors which decide the outcome of pregnancy. Worldwide, it is estimated that anaemia contributes to 20% of maternal deaths. Among these; about half of the global maternal deaths occur in South Asian countries out of which 80% is contributed by India. This study is planned to study the relationship between anaemic status with abortion and birth interval. Material & Methods: Cross sectional study conducted during the period of July 2016 to December 2016. 200 Pregnant women were selected from by simple random sampling 100 from rural area and 100 from urban area.The data were collected by interview with each pregnant woman after taking the proper consent, in a predesigned, pretested, multiple response type questionnaire.Results: In present study the prevalence of severe anaemia was more among pregnant women who had birth interval of less than two years in rural areas i.e. 20% (p value < 0.001). Majority of pregnant women who had nil or one abortion before had no anaemia in both urban and rural areas (38.2%, 37.5%) and (21.5%, 33.3%) respectively and prevalence of severe anaemia was more among pregnant women who had two abortions before in rural areas i.e. 33.3% (p value < 0.001).Conclusions: This study reveals a highly significant association of anemic status with abortion status and birth interval among pregnant women. Public health education has to be a cornerstone for the successful national campaign to prevent, detect, evaluate, and treat anemia among pregnant women.
Key words: anaemia, pregnancy, abortion, birth interval.
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CLINICAL STUDY OF HYDATID CYST IN SOUTH RAJASTHAN
Dr. Vinod Kumar, Siddhartha Verma , Vandna Yadav
ABSTRACT
Background: Hydatidosis is a zoonotic disease of Mediterranean countries caused by larvae of Echinococcus, the exact burden of the which is either largely unknown or ignored. Our aims are to study the incidence, clinical presentations, pre and post operative complications and surgical interventions used for treatment of hydatidosis. Surgery is still the mainstay of treatment in developing countries like India. Methodology: This study was done in RNT Medical College, Udaipur from July 2012 to June 2016 over 100 patients. Children and pregnant females were not included. Results: A total of 100 patients were studies over a span of 48 months. Males were 57. Farmers were affected most followed by housewives. Liver (N=68) was most commonly affected organ followed by lung (N=26). Six cases presented at unusual sites. Most patients presented within 1 year of onset of symptoms but after 1 month. Wound infection was the most common pre and post operative complication. Various surgical modalities were used for treatment and partial pericystectomy with external drainage (N=43) was commonest followed by thoracotomy with enucleation and ICD (N=24). There were no mortality in this study. Conclusion: Hydatid cyst remains one of the fatal, preventable, ignored and under diagnosed disease. It affects people of both low and high socio-economic groups. Timely surgical interventions are most effective treatment with very few complications and recurrence.
Key words: zoonotic disease, Farmers, Wound infection.
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CORRELATION OF CLINICAL AND CYTO-HISTOPATHOLOGICAL DIAGNOSIS IN CNS TUMORS
Dr. Geeta Mukhiya, Dr. Manisha Baraiya , Dr. Gulshan Kumar Mukhiya
ABSTRACT
Background: Rapid and accurate intraoperative diagnosis of CNS tumors is essential for proper management. Though neuroimaging technique are available but they are only supportive. Intraoperative crush smear cytology is rapid and simple alternative to histopathological evaluation of CNS tumors. Material & methods: During operation of CNS tumors , small amount of tissue was sent to Department of Pathology for squash smear cytology. Subsequently more tissue was sent at the end of operation, which then was processed for Histopathology evaluation. All findings of Cytology and Histology were recorded on proforma. Evaluation of squash smears for diagnosis of CNS lesions was done and the morphological details as observed in the smears were correlated with Histopathology findings. Results: Age ,sex wise distribution shows Maximum number of cases (68 cases, 64.5%) was seen in males while the females comprised 37 cases (35.5%). Among males and females, again the highest number of cases was seen in the age group 41-50 years, 16 cases (15.2%) and 8 cases (7.6%) respectively. Distribution of CNS tumors shows The cerebral hemisphere including all regions had the largest number of cases (51 cases, 48.5%). Amongst lesions with more precise locations, the frontal lobe had the largest number of the cases (21 cases, 20%). Overall cytohistological correlation of 105 cases in present study was 71.4%. Where 18 cases in which cytological diagnosis was not given were taken out, the cytohistological correlation out of 87 cases was 86.2%. Conclusion: Study concludes that Intraoperative SQUASH smear cytology is a fairly rapid and reliable method of intra operative diagnosis for a wide spectrum of central nervous system tumors.
Key words: CNS tumors, Cytological, Histopathological evaluation.
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ASSESSMENT OF WOUND MANAGEMENT IN TERMS OF DELAYED PRIMARY CLOSURE VERSUS PRIMARY CLOSURE IN PERFORATED APPENDICITIS
Chandra Mauli Vyas, Mohd. Abbas Ali
ABSTRACT
Background: Appendectomy is the most common emergency surgical procedure and most common cause of acute abdomen pain in adults is acute appendicitis. Despite the use of broad spectrum antibiotics postoperative wound infection remains the most frequent complication. The method of wound closure has been implicated as an important factor influencing postoperative wound infection out of the many risk factors. Material & Methods: The present prospective comparative study carried out among 200 patients of perforated appendicitis. History and data were recorded on a pre-tested proforma. After the written informed consent was obtained all study patients were randomly allocated in to two groups A and B using lottery method. All patients were followed up to 8th post closure days to detect effectiveness of procedure and wound infection. Results: out of total 200 patients 94 (47%) patients in the range of 15–25 years, 70 (35%) patients in the range of 26–35 years and 36 (18%) patients in the range of 36–45 years. In Primary closure group 33% male and 67% females and in Delayed primary group 38% male and 62% females. 22.5% patients developed wound infection. In the primary closure group, wound infection was observed in 39% patients and in the Delayed primary closure group, wound infection was observed in 6% patients(P value < 0.001).Conclusion: we concluded that delayed primary closer is the better method for perforated appendicitis in terms of wound management because of it has lower incidence of wound infection and greater effectiveness when compared with primary closer.
Key words: Delayed primary closure, primary closure, perforated appendicitis.
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A STUDY OF CLINICAL PROFILE OF MALARIA
Dr Rajesh R Patel, Dr Samil Sajal, Dr Y K Boliya, Dr Anil Kumar Roy, Dr (Mrs) Hetal Pandya
ABSTRACT
Background: Malaria, the disease of the ancient past, has proved to be an alarming restraint to the cultural and socio-economic development of man in tropical, subtropical and monsoon prone zones of globe. As P. Falciparum malaria is associated with most serious complications, diagnosis of it constitutes a medical emergency. One of the most prominent problem in managing the morbidity and mortality caused by malaria is limited access to efficacious diagnosis and treatment in regions where malaria is endemic. Material & Methods: In present prspective study 50 patients of malaria of age above 12 years were included. Written informed consent and ethical approval was appropriately sought before the study. After taking detailed history, clinical examination and hematological investigation was done as mentioned in Performa.Results: Out of 50 cases of malaria, 41 cases (82%) had P. falciparum and 8 cases (16%) of P. vivax. In 1 case (2%) suggesting mixed infection. headache and body ache found in 49 patients (98%), followed by nausea and vomiting in 28 patients (56%). weakness was present in 24 patients (48%) and abdominal pain in 11 patients (22%), 41 cases (82%) were having hyperbilirubineamia, 40 (80%) cases having thrombocytopenia. Splenomegaly present in 14 (28%) cases; hepatomegaly was present in 13 (26%) cases and 10 (20%) cases had hepatosplenomegaly. Conclusion: Plasmodium falciparum infection was common than Plasmodium vivax infection. All had fever, majority had high grade, associated with rigors and nausea and vomiting. The patients also had anemia, thrombocytopenia, liver function derangement and impaired renal functions.
Key words: Complications, Malaria, P Falciparum, P Vivax.
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PREOPERATIVE PALONOSETRON AND DEXAMETHASONE IN PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING IN MIDDLE EAR SURGERY: A PROSPECTIVE RANDOMISED DOUBLE BLIND CONTROLLED STUDY
Dr.Nikita Baser, Dr.Sandeep Sharma, Dr. Indira Kumari, Dr.Pritam Yadav, Dr.Mohit Birla, Dr.Megha Arora
ABSTRACT
Background: Postoperative nausea and vomiting (PONV) is one of the most frequent and most unpleasant adverse outcomes of surgery and general anesthesia. PONV is defined as nausea or vomiting occurring within 24 hours of surgery. The present study was undertaken to compare the efficacy of palonosetron and dexamethasone for prevention of postoperative nausea and vomiting in middle ear surgeries. Materials and methods: After approval from institutional ethical committee and written, informed consent from the patients, this prospective randomized double blind controlled study was conducted on 150 ASA grade I and II patients, aged 18-60 years scheduled for middle ear surgery. The patients were divided into three groups (50 patients each). Group N, D and P received Normal saline 1.5 ml (control), Dexamethasone 1.5 ml (6 mg) and Palonosetron 1.5 ml (0.075 mg) respectively. The drug was administered according to allocated group along with preanesthetic medication. Standard general anesthesia technique was used in all patients. The incidence of nausea and vomiting was noted during the period of 0-8 hours, 8-16 hours and 16-24 hours postoperatively. Results: Incidence of post operative nausea was less in group P as compared to group D and group N in duration of 0-8 hours (P=0.001), 8-16 hours (P=0.008), 16-24 hours (P=0.016). Also post operative vomiting was less in group P in duration of 0-8 hours (P=0.001). Rescue anti emetic required was less in group P as compare to group D and group N (P=0.003).Conclusion: Preoperative administration of palonosetron was more effective than dexamethasone in prevention of postoperative nausea and vomiting in middle ear surgery without any apparent side effects.
KEYWORDS: Dexamethasone, Middle ear surgery, Palonosetron, Postoperative nausea vomiting.
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THE DIAGNOSIS OF ACUTE APPENDICITIS BY ULTRASONOGRAPHY IN PREGNANT AND NON-PREGNANT WOMEN: A COMPARATIVE STUDY
Dr.Paresh Kumar Sukhani, Dr.Nipun Gumber, Dr. Charul Vyas
ABSTRACT
Objective: To investigate whether the diagnosis of acute appendicitis by ultrasonography is affected by pregnancy or not. Material & Methods: In the present study a total of 50 pregnant and 150 non-pregnant women were included. After taking detailed history, clinical examination and hematological investigation was done as mentioned in Performa. The patients were divided into two groups according to whether they were pregnant or not during the surgery: group I, pregnant women, and group II, non-pregnant women. Results: The mean age of group I (pregnant women) and group II (non-pregnant women) was 28.29±5.63 and 29.09±6.47, respectively. In group I, 28 patients were diagnosed on USG as appendicitis and the histopathology showed 32 out of the 50 patients had confirmed inflammation either acute suppurative or complex form. The accuracy, sensitivity and specificity of USG in the diagnosis of appendicitis were found to be 92%, 100% and 81.8% respectively. In group II, 135 patients were diagnosed on USG as appendicitis and the histopathology showed 132 out of these 145 patients having an appendix with confirmed inflammation either acute suppurative or complex form. The accuracy, sensitivity and specificity of USG in group II were 98%, 97.7% and 100% respectively. Conclusion: Although the diagnosis of appendicitis in pregnant women is not delayed, but careful assessment of these patients suspected of having appendicitis should be encouraged when USG examination is normal or nondiagnostic.
KEYWORDS: appendicitis, pregnancy, ultrasonography, diagnosis.
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COMPARATIVE ANALYSIS OF PRIMARY CLOSURE AND LOOP ILEOSTOMY: THE SURGICAL MANAGEMENT OF ENTERIC PERFORATION
Dr.Saroj Chhabara Kapoor, Dr.Siddharth Jai Singh, Dr. Harshit Agarwal, Dr.S.C.Dutta
ABSTRACT
Background: In current scenario ileal perforation has a high incidence with a high mortality despite the availability of advanced diagnostic facilities and treatment regimes. Material & Methods: Fifty patients who were admitted to Surgical Emergency with acute abdomen had been selected for the study. These patients were taken up for emergency surgery after proper written consent. Patients were divided in two groups after randomization as group A (primary repair) and group B (loop ileostomy).Postoperative complications in each group was observed during follow up and duly recorded. Results: Typhoid remains the major cause of ileal perforation (36%) and tubercular perforation found in 28% of cases, nonspecific cause in 32% of patient and traumatic in 4% of patients. Among all patients wound infection was the most common complication (40%). Peristomal skin excoriation occurred in 8 patients (32%), weight loss in 3 (12%), retraction in 3 (12%), fluid and electrolyte imbalance in 2 (8%) and prolapse was seen in only 1 patient (4%). Complications related to Ileostomy closure occurred in 4 patients (16%), wound infection in 7 (28%), anastomotic leak in 2 (8%), intraabdominal collections in 2 (8%) and wound dehiscence in 3 patients (12%). Conclusion: We concluded that defunctioning loop ileostomy closure should be preferred over primary repair in cases of ileal perforations in present study. It should be concluded that loop ileostomy in these cases is only temporary and lifesaving advantages over longer hospital stay.
Key words: primary closure, loop ileostomy, ileal perforation. Nausea and vomiting.
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A STUDY CORRELATING THE CLINICAL PICTURE OF INFECTIVE ENDOCARDITIS WITH ECHOCARDIOGRAPHIC FINDINGS ESTABLISHING RELATIONSHIP WITH AGE
Dr. Mridul Bhushan, Dr.Prem Singh
ABSTRACT
Background: Infective endocarditis (IE) is the infection of a native or prosthetic heart valve, the endocardial surface of heart, or an indwelling cardiac device. Highly destructive staphylococci have now overtaken oral streptococci as the most common cause. The present study was conducted with the objective of establishing the relationship between the symptoms of diseases with the severity (echocardiographic findings), and establish the most common age group and the most common organism, causing severe disease (severe valvular infection) and associated complications. Methods: After taking clearance from the ethics committee of the institute, the patients coming to the department of cardiology, Government Medical College, Kannouj with suspected IE were thoroughly investigated after their consent. 2D echocardiography was done in all the subjects to confirm the diagnosis and the severity of valvular lesion. Several other investigations were done. Results: Majority of the patients in our study were found to be in the age group of 11 to 20 years. Fever was the most common symptom in all patients. Pallor and cardiac murmurs were the most common signs. Staph. aureus was the etiological agent in majority of the patients. The echocardiographic findings significantly correlated with the clinical picture and complications. Complications included severe anaemia, heart and renal failure and stroke. Staph organism was the most common etiological agent involved in our study. Conclusion: If the Echocardiography shows the involvement of cardiac valves, the clinical picture is usually severe. The change in pattern of the disease and the correlation of the clinical picture with the echocardiographic findings has been demonstrated without a doubt in our study.
KEY WORDS: Infective endocarditis, 2D Echocardiography, Staph aureus, valvular lesions.
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MORBIDITY ASSESSMENT OF CONSTRUCTION SITE WORKERS
Dr. Mohammed Shadab Gouri, Dr. Shikha Sharma, Dr. Shiv Prakash Sharma
ABSTRACT
Background: occupation plays a central role in people’s health since most workers spend not less than 8 hours of day at their workplace, whether it is an office, construction site, or a factory. In India construction site workers are mostly inter-state migrants, less educated and not aware about preventive health measures. Present study addresses the health problems among construction site workers and to educate them about preventive health measures. Material & Methods: Cross sectional study conducted during the period of January 2017 to June 2017. 300 construction site workers were selected by purposive sampling method. Data were collected after undertaking proper written consent of each worker for their voluntary participation. Results: In present study the out of total 300 workers 54% were anaemic. The morbidity pattern shows that 26.3% were had skin diseases,19% workers had musculoskeletal problems, 8.6% workers had hypertension, Urinary tract infections found in 7 % workers, 7.6% had ophthalmic problems, 5.6% reported respiratory problems, Gastrointestinal problems were found in 5% respondents. Out of total 300 workers 08 (2.6%) were suffering from occupational injuries. Conclusions: The study concluded that poor working conditions along with illiteracy, lack of infrastructure and security most important the inadequate health service utilization make these workers a vulnerable population to morbid health conditions.
Key words: construction site workers, health, morbidity.
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LUMINAL SILICONE CASTS OF HUMAN AND SHEEP BRAIN VENTRICULAR SYSTEM AS TEACHING
TOOLS IN ANATOMY
Dr. K.A.Ashma, Dr. S.Sundarapandian, Dr. S.Manisha Raaj
ABSTRACT
Background: Medical students studying human gross anatomy have difficulty in conceptualizing the internal three dimensional structure of the brain ventricular system. The students are further challenged with comprehending the orientation and spatial relationship between the different parts of the brain and the ventricles. Objectives: To overcome these difficulties and to visualize better the three dimensional structure of ventricles, using silicone casts of human brain ventricular system. To use these casts to teach the anatomy of ventricles and to compare the ventricle system of human and sheep brain to help student understand comparative anatomy. Methodology: All purpose silicone sealant was injected into the ventricles of embalmed human and sheep brains. It was then cured, macerated and mounted. Results: Complete silicone casts were obtained which were durable and life like replica of the human and sheep brain ventricular system. These casts were used effectively to teach the gross Anatomy of Human ventricles and to teach comparative Anatomy.
Key words: Brain ventricular system, Human and sheep brain, Silicone casts
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ASSESSMENT OF THE SERUM ALUMINIUM AND ZINC LEVEL AMONG CHRONIC KIDNEY DISEASE PATIENTS ON CONSERVATIVE MANAGEMENT VS CONTINUOUS AMBULATORY PERITONEAL DIALYSIS
Dr. Sunil Kumar Bairwa, Dr. Savita Kumri , Dr. Sunil Gupta, Dr. Vijay Laxmi Gupta
ABSTRACT
Background: Chronic kidney disease (CKD) is one of the major global health problem, not only contributing to increased mortality and morbidity but also responsible for immense economic strain on the health care system.Material & Methods: In present prspective study76 patients of either sex ranging in age from 18 to 70 years. The study was planned to evaluate serum zinc and serum aluminium in CKD patients who are on conservative management and also who are on peritoneal dialysis.. After taking detailed history, clinical examination and hematological investigation was done as mentioned in Performa. Results: CRF patients on conservative treatment as Group 2 and CRF patients on CAPD as Group 3 , in that order, a significantly higher aluminum levels in Group 2 and Group 3 relative to healthy controls (group 1) were found (20.2 + 6.60 Vs 89.8 ± 14.49, p<0.05; 20.2 ± 6.60 Vs 73.6 ± 10.18, p<0.05) but in both group of CRF patients aluminum level were not significant (89.8 ± 14.49 Vs. 73.6 ± 10.18, p>0.05).Serum Zinc levels in Group 2 and Group 3 comparative to healthy controls (group 1) were found significantly lower (94.4 ± 24.72 Vs. 40.9 ± 10.92, p<0.05, 94.4 ± 24.72 Vs. 39.3 ± 11.76, p<0.05) however in both group of CRF patients Zinc level were not significant (40.9 ± 10.92 Vs. 39.3 ± 11.76, p>0.05). Conclusion: Patients on CAPD showed markedly reduced concentrations of serum zinc, although a slight reduction was also present in CRF patients. Plasma aluminium concentrations were increased in patients on CAPD and CRF patients.
Key words: Chronic kidney disease, Chronic renal failure, continuous ambulatory peritoneal dialysis.
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EFFECTIVENESS OF DIDACTIC LECTURE IN IMPARTING KNOWLEDGE IN MEDICAL EDUCATION
Dr Manjusha Viswanathan, Dr Viswanathan K V
ABSTRACT
Objectives: To find out the opinion of students on the effectiveness of lectures and to assess the knowledge of students after didactic lecture. Background: Lectures are the time tested and the oldest teaching method in a teacher’s repertoire. There is a general view that lectures are not effective teaching learning method. My study was an endeavor to find answers to this. Methodology: This was a quasi- experimental study of 6 months duration conducted at Sree Gokulam Medical College and research Foundation after obtaining consent from the institutional review board. The ninth semester students of 2011 batch were included in the study after obtaining consent. A pretest was conducted and a lecture of 40 minutes duration was taken followed by post- test. Both the marks were tabulated. This was repeated with seven topics and seven faculty members. A questionnaire was circulated among the students and the findings also tabulated. These were subjected to qualitative and quantitative analysis. Results: 98% of students agreed that there was definite improvement of knowledge after the lectures. There were gaps to be filled after lectures. The faculty involved also influenced the student satisfaction even though there was no difference in the knowledge gained. Conclusion: Lectures are effective method of teaching to impart knowledge and there is definite increase in knowledge after didactic lecture. But the effectiveness of lectures depends on the teacher. There are definitely gaps to be filled after a lecture
Key words: Didactic lectures, learning tool, Knowledge teaching tool
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ANTIBODY DETECTION OF DENGUE INFECTION IN CLINICALLY SYMPTOMATIC PATIENTS BY MAC-ELISA DURING POST MONSOON SEASON AT A TERTIARY CARE HOSPITAL AT JAIPUR, RAJASTHAN
Dr Nilofar Khayyam, Manuja Agarwal, Gaurav Dalela, Bhagwati Chundawat, Jitendra Panda, Vijeta Sharma
ABSTRACT
Objectives: Cyclic epidemics of dengue infection are increasing with time in India. The disease shows a wide spectrum of clinical manifestations ranging from mild self-limiting illness to severe fatal haemorrhagic condition. The present study was conducted to detect dengue infection in its peak season in Jaipur, Rajasthan using Dengue MAC-ELISA. Materials and Methods: Serum samples from 3730 patients clinically suspected of having dengue infection visiting a tertiary care hospital during the period of two months from October to November 2015 were screened for the presence of Dengue IgM and IgG antibodies using one-step immuno-chromatographic assay (Dengue Rapid IgG/IgM Test by SD BIOLINE. Positive samples were subjected to Dengue IgM ELISA. Results: Out of to 3730 samples 413(11.07%) were found positive by rapid test. Of these positive samples 318/413 (76.99%) were found positive, 56/413 (13.55%) were equivocal and 39/413 (9.4%) were negative by Dengue MAC-ELISA.
Conclusion: Rapid immuno-chromatographic tests may offer a convenient method to screen samples for dengue infection in field during epidemic threats but confirmatory tests should be performed for the confirmation of Dengue infection as accuracy of available rapid tests has yet to be verified.
Key words: Dengue MAC-ELISA, Immuno-chromatographic, IgM, Dengue virus
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ASSOCIATION BETWEEN QUALITY OF LIFE AND ANXIETY, DEPRESSION, AND PHYSICAL PERFORMANCE IN CONGESTIVE HEART FAILURE PATIENTS
Dr. Ashok Goyal, Dr. Fiza Hasny
ABSTRACT
Background: Quality of life is a comparatively new scientific measure to assess the effectiveness of treatment approaches and the progress of a disease. Depression and anxiety are two important psychological disorders and are very common in patients with heart failure. In the present study, to assess physical performance in CHF patients, we conducted a cross-sectional study of the frequency and severity of impaired QOL scores and their relationship with physical performance. Method: This was a cross-sectional, non-interventional study. All 72 CHF patients were recruited during June 2005 to March 2006 from the department of cardiology and Department of Psychiatry, Mahatma Gandhi Medical College & Hospital, Jaipur, Rajasthan. NYHA classification was used to assess the CHF severity by a cardiologist. SF-36, Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI)-II and 6-MWT study tools were used for quality of life, depression, anxiety and physical performance in CHF patients respectably. Results: Most of the patients were male (91.67%) and unemployed or retired (80.83%). The majority of the patients (83.3%) were in NYHA functional class II or III, and, 32% a six-minute walk test of < 450 m. There were significantly reduced NYHA scores in all aspects of quality of life and SF-36 scores from NYHA class I to class III was a gradually drop. CHF patients who had neither anxiety nor depression had significantly more impaired 6-MWT. Conclusion: The findings of this study suggest important directions for planning effective care to enhance QoL in CHF patients. We have identified the detrimental impact of psychological distress on QoL in these patients. Psychological interventions that are effective in reducing depression should be identified.
Keywords: congested heart failure,cardiomyopathy-targeted areas, Beck Depression Inventory, psychological distress.
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EVALUATION OF THE NEONATAL OUTCOMES AMONG BABIES OF ELDERLY AND YOUNG MOTHERS
Dr. Ashok Kumar, Dr. Bajrang Lal Rar, Dr. Mahendra Fenin, Dr. Ritu Sharma
ABSTRACT
Background: This study is planned to study the relationship between advanced maternal age and neonatal outcomes. Materials and method: The present study was an observational cross-sectional study. Total sample size calculated was 400, out of the cases and controls were selected in the ratio of 1:1 after undertaking written informed consent. Cases include babies born to mothers more than 35 years and controls includes babies were born to mothers between the age of 19 to 35 years. Results In the present study the number of premature babies in the case group were 44 (22%) and in controls 20 (10%) (P value=0.001). Out of 200 cases, 20 babies (10%) had APGAR <7 at 1 minute and 6 (3%) babies had APGAR <7 at 5 minutes.56 cases (28%) had low birth weight and only 12 babies (6%) had low birth weight( P-value < 0.001). 22 cases (11%) were SGA and among controls only 02 (1%) babies were born SGA( P-value < 0.001).68 babies (34%) had SNCU (Special Neonatal Care Unit)admission and 36 babies (18 %) had SNCU admission in the control group( P value < 0.001). Conclusion: Incidence of Prematurity, low birth weight, Small for gestational age and SNCU admissions was found more in babies born to elderly pregnant women than babies born to pregnant women less than 35 years of age.
Keywords: outcome Advanced maternal age, Low birth weight, APGAR.
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PROSPECTIVE RANDOMIZED CONTROL STUDY COMPARING GLYCOPYRRONIUM VERSUS TIOTROPIUM ANALYZING TROUGH FEV1, BREATHLESSNESS AND HEALTH STATUS
Dr. Gaurav Chhabra, Dr. Shubhakaran Sharma
ABSTRACT
Background: Presently two long acting muscarinic antagonists (LAMAs) glycopyrornium and tiotropium are widely used for treatment of chronic obstructive pulmonary disease (COPD). This study is plan to compare therapeutic efficacy of these currently available drugs Methods : This study include COPD patients subjected to either 50 μg glycopyrronium or 18 μg tiotropium once daily, having an objective to compare patient compliance and health indices between these two groups over a period of 12 week treatment. Results: 57 patients were randomized (glycopyrronium: 27; tiotropium: 30) completed the study. Glycopyrronium demonstrated rapid bronchodilation following first dose on Day 1as well as after 12 weels treatment, with significantly higher FEV1.Glycopyrronium shows comparable improvement in Transition Dyspnea Index (TDI) and the frequency as well as rate of COPD exacerbations. Patients shows markedly low symptom compare to the patients on tiotropium after 12 weeks Adverse events were somewhat similar in incidence with both the drugs glycopyrronium (40.4%) and tiotropium (40.6%).Conclusion: glycopyrronium having a faster onset of action as well as shows statistically significant difference in FEV1, breathlessness and patient compliance After 12 weeks of treatment in comparison with tiotropium.
Keywords: acting muscarinic antagonists , Transition Dyspnea Index, chronic obstructive pulmonary disease (COPD).
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ASSESSMENT OF BURDEN OF VITILIGO AMONG PATIENTS AT TERTIARY CARE CENTER
Dr. Gajanand Ojha, Dr. Kishor Singh
ABSTRACT
Background: Vitiligo refers to an acquired, idiopathic, and common de-pigmentation disorder of the skin. The clinically characteristic symptoms of the vitiligo are pale or milk-white macules or patches due to the selective destruction of melanocytes. Material & Methods: The present cross-sectional prospective study was conducted at department of dermatology of our tertiary care hospital. The study duration was of one year from November 2015 to October 2016. A sample size of 100 was calculated at 95% confidence interval at 10% acceptable margin of error. Results: In non-segmental (44%) type of vitiligo, acro-facial (20%) was the most common type, followed by mixed (8%) and mucosal (8%), universal (5%) and vulgaris (3%). Segmental vitiligo was found in 22% of patients. In unclassified vitiligo (39%), the focal and mucosal type was found in 33% and 6% respectively. Lesions were mostly seen on lower limbs (32%) followed by head and neck (24%), upper limbs (23%), trunk (11%) and oral and genital mucosa (9%). Conclusion: local epidemiological behavior of vitiligo need not be the same across different regions. Variations do exist and may be due to certain clinico-epidemiological parameters.
Key words: Vitiligo, Acro-facial, Clinical epidemiology.
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Nutritional Anemia in Pediatrics: Unveiling Patterns and Profiles through Hospital-based Investigation
Dr. Atul Kumar Heda , Dr. Krishna Heda
ABSTRACT
Background: Nutritional anemia remains a significant public health concern globally, particularly among pediatric populations, as it reflects an intricate interplay of nutritional, socioeconomic, and demographic factors. This scientific article delves into the depths of pediatric nutritional anemia, aiming to unravel the intricate patterns and profiles through a meticulous hospital-based investigation. Methods : This cross-sectional study was conducted over a period of one year at the Department of pediatrics, Geetanjali Medical College and Hospital, Udaipur, India. The study design aimed to capture a snapshot of the prevalence and characteristics of pediatric anemia. Results: A total of 300 cases were enrolled in the study. The prevalence of anemia (51.33%) uncovered by this study reinforces its status as a severe public health problem in the studied population. Conclusion : tailored interventions addressing socioeconomic, dietary, and clinical factors are essential to reduce pediatric nutritional anemia. Collaboration among healthcare, research, and policy is crucial for effective public health responses. Identified patterns inform targeted screening and personalized interventions for affected children.
Keywords: Pediatric anemia, Nutritional deficiencies, Hematological disorders in children, Socioeconomic factors
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Dr. Mohini Nainani
ABSTRACT
Background: Anaemia is one of the important factors which decide the outcome of pregnancy. Worldwide, it is estimated that anaemia contributes to 20% of maternal deaths. Among these; about half of the global maternal deaths occur in South Asian countries out of which 80% is contributed by India. This study is planned to study the relationship between anaemic status with abortion and birth interval. Material & Methods: Cross sectional study conducted during the period of July 2016 to December 2016. 200 Pregnant women were selected from by simple random sampling 100 from rural area and 100 from urban area.The data were collected by interview with each pregnant woman after taking the proper consent, in a predesigned, pretested, multiple response type questionnaire.Results: In present study the prevalence of severe anaemia was more among pregnant women who had birth interval of less than two years in rural areas i.e. 20% (p value < 0.001). Majority of pregnant women who had nil or one abortion before had no anaemia in both urban and rural areas (38.2%, 37.5%) and (21.5%, 33.3%) respectively and prevalence of severe anaemia was more among pregnant women who had two abortions before in rural areas i.e. 33.3% (p value < 0.001).Conclusions: This study reveals a highly significant association of anemic status with abortion status and birth interval among pregnant women. Public health education has to be a cornerstone for the successful national campaign to prevent, detect, evaluate, and treat anemia among pregnant women.
Key words: anaemia, pregnancy, abortion, birth interval.
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CLINICAL STUDY OF HYDATID CYST IN SOUTH RAJASTHAN
Dr. Vinod Kumar, Siddhartha Verma , Vandna Yadav
ABSTRACT
Background: Hydatidosis is a zoonotic disease of Mediterranean countries caused by larvae of Echinococcus, the exact burden of the which is either largely unknown or ignored. Our aims are to study the incidence, clinical presentations, pre and post operative complications and surgical interventions used for treatment of hydatidosis. Surgery is still the mainstay of treatment in developing countries like India. Methodology: This study was done in RNT Medical College, Udaipur from July 2012 to June 2016 over 100 patients. Children and pregnant females were not included. Results: A total of 100 patients were studies over a span of 48 months. Males were 57. Farmers were affected most followed by housewives. Liver (N=68) was most commonly affected organ followed by lung (N=26). Six cases presented at unusual sites. Most patients presented within 1 year of onset of symptoms but after 1 month. Wound infection was the most common pre and post operative complication. Various surgical modalities were used for treatment and partial pericystectomy with external drainage (N=43) was commonest followed by thoracotomy with enucleation and ICD (N=24). There were no mortality in this study. Conclusion: Hydatid cyst remains one of the fatal, preventable, ignored and under diagnosed disease. It affects people of both low and high socio-economic groups. Timely surgical interventions are most effective treatment with very few complications and recurrence.
Key words: zoonotic disease, Farmers, Wound infection.
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CORRELATION OF CLINICAL AND CYTO-HISTOPATHOLOGICAL DIAGNOSIS IN CNS TUMORS
Dr. Geeta Mukhiya, Dr. Manisha Baraiya , Dr. Gulshan Kumar Mukhiya
ABSTRACT
Background: Rapid and accurate intraoperative diagnosis of CNS tumors is essential for proper management. Though neuroimaging technique are available but they are only supportive. Intraoperative crush smear cytology is rapid and simple alternative to histopathological evaluation of CNS tumors. Material & methods: During operation of CNS tumors , small amount of tissue was sent to Department of Pathology for squash smear cytology. Subsequently more tissue was sent at the end of operation, which then was processed for Histopathology evaluation. All findings of Cytology and Histology were recorded on proforma. Evaluation of squash smears for diagnosis of CNS lesions was done and the morphological details as observed in the smears were correlated with Histopathology findings. Results: Age ,sex wise distribution shows Maximum number of cases (68 cases, 64.5%) was seen in males while the females comprised 37 cases (35.5%). Among males and females, again the highest number of cases was seen in the age group 41-50 years, 16 cases (15.2%) and 8 cases (7.6%) respectively. Distribution of CNS tumors shows The cerebral hemisphere including all regions had the largest number of cases (51 cases, 48.5%). Amongst lesions with more precise locations, the frontal lobe had the largest number of the cases (21 cases, 20%). Overall cytohistological correlation of 105 cases in present study was 71.4%. Where 18 cases in which cytological diagnosis was not given were taken out, the cytohistological correlation out of 87 cases was 86.2%. Conclusion: Study concludes that Intraoperative SQUASH smear cytology is a fairly rapid and reliable method of intra operative diagnosis for a wide spectrum of central nervous system tumors.
Key words: CNS tumors, Cytological, Histopathological evaluation.
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ASSESSMENT OF WOUND MANAGEMENT IN TERMS OF DELAYED PRIMARY CLOSURE VERSUS PRIMARY CLOSURE IN PERFORATED APPENDICITIS
Chandra Mauli Vyas, Mohd. Abbas Ali
ABSTRACT
Background: Appendectomy is the most common emergency surgical procedure and most common cause of acute abdomen pain in adults is acute appendicitis. Despite the use of broad spectrum antibiotics postoperative wound infection remains the most frequent complication. The method of wound closure has been implicated as an important factor influencing postoperative wound infection out of the many risk factors. Material & Methods: The present prospective comparative study carried out among 200 patients of perforated appendicitis. History and data were recorded on a pre-tested proforma. After the written informed consent was obtained all study patients were randomly allocated in to two groups A and B using lottery method. All patients were followed up to 8th post closure days to detect effectiveness of procedure and wound infection. Results: out of total 200 patients 94 (47%) patients in the range of 15–25 years, 70 (35%) patients in the range of 26–35 years and 36 (18%) patients in the range of 36–45 years. In Primary closure group 33% male and 67% females and in Delayed primary group 38% male and 62% females. 22.5% patients developed wound infection. In the primary closure group, wound infection was observed in 39% patients and in the Delayed primary closure group, wound infection was observed in 6% patients(P value < 0.001).Conclusion: we concluded that delayed primary closer is the better method for perforated appendicitis in terms of wound management because of it has lower incidence of wound infection and greater effectiveness when compared with primary closer.
Key words: Delayed primary closure, primary closure, perforated appendicitis.
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A STUDY OF CLINICAL PROFILE OF MALARIA
Dr Rajesh R Patel, Dr Samil Sajal, Dr Y K Boliya, Dr Anil Kumar Roy, Dr (Mrs) Hetal Pandya
ABSTRACT
Background: Malaria, the disease of the ancient past, has proved to be an alarming restraint to the cultural and socio-economic development of man in tropical, subtropical and monsoon prone zones of globe. As P. Falciparum malaria is associated with most serious complications, diagnosis of it constitutes a medical emergency. One of the most prominent problem in managing the morbidity and mortality caused by malaria is limited access to efficacious diagnosis and treatment in regions where malaria is endemic. Material & Methods: In present prspective study 50 patients of malaria of age above 12 years were included. Written informed consent and ethical approval was appropriately sought before the study. After taking detailed history, clinical examination and hematological investigation was done as mentioned in Performa.Results: Out of 50 cases of malaria, 41 cases (82%) had P. falciparum and 8 cases (16%) of P. vivax. In 1 case (2%) suggesting mixed infection. headache and body ache found in 49 patients (98%), followed by nausea and vomiting in 28 patients (56%). weakness was present in 24 patients (48%) and abdominal pain in 11 patients (22%), 41 cases (82%) were having hyperbilirubineamia, 40 (80%) cases having thrombocytopenia. Splenomegaly present in 14 (28%) cases; hepatomegaly was present in 13 (26%) cases and 10 (20%) cases had hepatosplenomegaly. Conclusion: Plasmodium falciparum infection was common than Plasmodium vivax infection. All had fever, majority had high grade, associated with rigors and nausea and vomiting. The patients also had anemia, thrombocytopenia, liver function derangement and impaired renal functions.
Key words: Complications, Malaria, P Falciparum, P Vivax.
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PREOPERATIVE PALONOSETRON AND DEXAMETHASONE IN PREVENTION OF POST-OPERATIVE NAUSEA AND VOMITING IN MIDDLE EAR SURGERY: A PROSPECTIVE RANDOMISED DOUBLE BLIND CONTROLLED STUDY
Dr.Nikita Baser, Dr.Sandeep Sharma, Dr. Indira Kumari, Dr.Pritam Yadav, Dr.Mohit Birla, Dr.Megha Arora
ABSTRACT
Background: Postoperative nausea and vomiting (PONV) is one of the most frequent and most unpleasant adverse outcomes of surgery and general anesthesia. PONV is defined as nausea or vomiting occurring within 24 hours of surgery. The present study was undertaken to compare the efficacy of palonosetron and dexamethasone for prevention of postoperative nausea and vomiting in middle ear surgeries. Materials and methods: After approval from institutional ethical committee and written, informed consent from the patients, this prospective randomized double blind controlled study was conducted on 150 ASA grade I and II patients, aged 18-60 years scheduled for middle ear surgery. The patients were divided into three groups (50 patients each). Group N, D and P received Normal saline 1.5 ml (control), Dexamethasone 1.5 ml (6 mg) and Palonosetron 1.5 ml (0.075 mg) respectively. The drug was administered according to allocated group along with preanesthetic medication. Standard general anesthesia technique was used in all patients. The incidence of nausea and vomiting was noted during the period of 0-8 hours, 8-16 hours and 16-24 hours postoperatively. Results: Incidence of post operative nausea was less in group P as compared to group D and group N in duration of 0-8 hours (P=0.001), 8-16 hours (P=0.008), 16-24 hours (P=0.016). Also post operative vomiting was less in group P in duration of 0-8 hours (P=0.001). Rescue anti emetic required was less in group P as compare to group D and group N (P=0.003).Conclusion: Preoperative administration of palonosetron was more effective than dexamethasone in prevention of postoperative nausea and vomiting in middle ear surgery without any apparent side effects.
KEYWORDS: Dexamethasone, Middle ear surgery, Palonosetron, Postoperative nausea vomiting.
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THE DIAGNOSIS OF ACUTE APPENDICITIS BY ULTRASONOGRAPHY IN PREGNANT AND NON-PREGNANT WOMEN: A COMPARATIVE STUDY
Dr.Paresh Kumar Sukhani, Dr.Nipun Gumber, Dr. Charul Vyas
ABSTRACT
Objective: To investigate whether the diagnosis of acute appendicitis by ultrasonography is affected by pregnancy or not. Material & Methods: In the present study a total of 50 pregnant and 150 non-pregnant women were included. After taking detailed history, clinical examination and hematological investigation was done as mentioned in Performa. The patients were divided into two groups according to whether they were pregnant or not during the surgery: group I, pregnant women, and group II, non-pregnant women. Results: The mean age of group I (pregnant women) and group II (non-pregnant women) was 28.29±5.63 and 29.09±6.47, respectively. In group I, 28 patients were diagnosed on USG as appendicitis and the histopathology showed 32 out of the 50 patients had confirmed inflammation either acute suppurative or complex form. The accuracy, sensitivity and specificity of USG in the diagnosis of appendicitis were found to be 92%, 100% and 81.8% respectively. In group II, 135 patients were diagnosed on USG as appendicitis and the histopathology showed 132 out of these 145 patients having an appendix with confirmed inflammation either acute suppurative or complex form. The accuracy, sensitivity and specificity of USG in group II were 98%, 97.7% and 100% respectively. Conclusion: Although the diagnosis of appendicitis in pregnant women is not delayed, but careful assessment of these patients suspected of having appendicitis should be encouraged when USG examination is normal or nondiagnostic.
KEYWORDS: appendicitis, pregnancy, ultrasonography, diagnosis.
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COMPARATIVE ANALYSIS OF PRIMARY CLOSURE AND LOOP ILEOSTOMY: THE SURGICAL MANAGEMENT OF ENTERIC PERFORATION
Dr.Saroj Chhabara Kapoor, Dr.Siddharth Jai Singh, Dr. Harshit Agarwal, Dr.S.C.Dutta
ABSTRACT
Background: In current scenario ileal perforation has a high incidence with a high mortality despite the availability of advanced diagnostic facilities and treatment regimes. Material & Methods: Fifty patients who were admitted to Surgical Emergency with acute abdomen had been selected for the study. These patients were taken up for emergency surgery after proper written consent. Patients were divided in two groups after randomization as group A (primary repair) and group B (loop ileostomy).Postoperative complications in each group was observed during follow up and duly recorded. Results: Typhoid remains the major cause of ileal perforation (36%) and tubercular perforation found in 28% of cases, nonspecific cause in 32% of patient and traumatic in 4% of patients. Among all patients wound infection was the most common complication (40%). Peristomal skin excoriation occurred in 8 patients (32%), weight loss in 3 (12%), retraction in 3 (12%), fluid and electrolyte imbalance in 2 (8%) and prolapse was seen in only 1 patient (4%). Complications related to Ileostomy closure occurred in 4 patients (16%), wound infection in 7 (28%), anastomotic leak in 2 (8%), intraabdominal collections in 2 (8%) and wound dehiscence in 3 patients (12%). Conclusion: We concluded that defunctioning loop ileostomy closure should be preferred over primary repair in cases of ileal perforations in present study. It should be concluded that loop ileostomy in these cases is only temporary and lifesaving advantages over longer hospital stay.
Key words: primary closure, loop ileostomy, ileal perforation. Nausea and vomiting.
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A STUDY CORRELATING THE CLINICAL PICTURE OF INFECTIVE ENDOCARDITIS WITH ECHOCARDIOGRAPHIC FINDINGS ESTABLISHING RELATIONSHIP WITH AGE
Dr. Mridul Bhushan, Dr.Prem Singh
ABSTRACT
Background: Infective endocarditis (IE) is the infection of a native or prosthetic heart valve, the endocardial surface of heart, or an indwelling cardiac device. Highly destructive staphylococci have now overtaken oral streptococci as the most common cause. The present study was conducted with the objective of establishing the relationship between the symptoms of diseases with the severity (echocardiographic findings), and establish the most common age group and the most common organism, causing severe disease (severe valvular infection) and associated complications. Methods: After taking clearance from the ethics committee of the institute, the patients coming to the department of cardiology, Government Medical College, Kannouj with suspected IE were thoroughly investigated after their consent. 2D echocardiography was done in all the subjects to confirm the diagnosis and the severity of valvular lesion. Several other investigations were done. Results: Majority of the patients in our study were found to be in the age group of 11 to 20 years. Fever was the most common symptom in all patients. Pallor and cardiac murmurs were the most common signs. Staph. aureus was the etiological agent in majority of the patients. The echocardiographic findings significantly correlated with the clinical picture and complications. Complications included severe anaemia, heart and renal failure and stroke. Staph organism was the most common etiological agent involved in our study. Conclusion: If the Echocardiography shows the involvement of cardiac valves, the clinical picture is usually severe. The change in pattern of the disease and the correlation of the clinical picture with the echocardiographic findings has been demonstrated without a doubt in our study.
KEY WORDS: Infective endocarditis, 2D Echocardiography, Staph aureus, valvular lesions.
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MORBIDITY ASSESSMENT OF CONSTRUCTION SITE WORKERS
Dr. Mohammed Shadab Gouri, Dr. Shikha Sharma, Dr. Shiv Prakash Sharma
ABSTRACT
Background: occupation plays a central role in people’s health since most workers spend not less than 8 hours of day at their workplace, whether it is an office, construction site, or a factory. In India construction site workers are mostly inter-state migrants, less educated and not aware about preventive health measures. Present study addresses the health problems among construction site workers and to educate them about preventive health measures. Material & Methods: Cross sectional study conducted during the period of January 2017 to June 2017. 300 construction site workers were selected by purposive sampling method. Data were collected after undertaking proper written consent of each worker for their voluntary participation. Results: In present study the out of total 300 workers 54% were anaemic. The morbidity pattern shows that 26.3% were had skin diseases,19% workers had musculoskeletal problems, 8.6% workers had hypertension, Urinary tract infections found in 7 % workers, 7.6% had ophthalmic problems, 5.6% reported respiratory problems, Gastrointestinal problems were found in 5% respondents. Out of total 300 workers 08 (2.6%) were suffering from occupational injuries. Conclusions: The study concluded that poor working conditions along with illiteracy, lack of infrastructure and security most important the inadequate health service utilization make these workers a vulnerable population to morbid health conditions.
Key words: construction site workers, health, morbidity.
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LUMINAL SILICONE CASTS OF HUMAN AND SHEEP BRAIN VENTRICULAR SYSTEM AS TEACHING
TOOLS IN ANATOMY
Dr. K.A.Ashma, Dr. S.Sundarapandian, Dr. S.Manisha Raaj
ABSTRACT
Background: Medical students studying human gross anatomy have difficulty in conceptualizing the internal three dimensional structure of the brain ventricular system. The students are further challenged with comprehending the orientation and spatial relationship between the different parts of the brain and the ventricles. Objectives: To overcome these difficulties and to visualize better the three dimensional structure of ventricles, using silicone casts of human brain ventricular system. To use these casts to teach the anatomy of ventricles and to compare the ventricle system of human and sheep brain to help student understand comparative anatomy. Methodology: All purpose silicone sealant was injected into the ventricles of embalmed human and sheep brains. It was then cured, macerated and mounted. Results: Complete silicone casts were obtained which were durable and life like replica of the human and sheep brain ventricular system. These casts were used effectively to teach the gross Anatomy of Human ventricles and to teach comparative Anatomy.
Key words: Brain ventricular system, Human and sheep brain, Silicone casts
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ASSESSMENT OF THE SERUM ALUMINIUM AND ZINC LEVEL AMONG CHRONIC KIDNEY DISEASE PATIENTS ON CONSERVATIVE MANAGEMENT VS CONTINUOUS AMBULATORY PERITONEAL DIALYSIS
Dr. Sunil Kumar Bairwa, Dr. Savita Kumri , Dr. Sunil Gupta, Dr. Vijay Laxmi Gupta
ABSTRACT
Background: Chronic kidney disease (CKD) is one of the major global health problem, not only contributing to increased mortality and morbidity but also responsible for immense economic strain on the health care system.Material & Methods: In present prspective study76 patients of either sex ranging in age from 18 to 70 years. The study was planned to evaluate serum zinc and serum aluminium in CKD patients who are on conservative management and also who are on peritoneal dialysis.. After taking detailed history, clinical examination and hematological investigation was done as mentioned in Performa. Results: CRF patients on conservative treatment as Group 2 and CRF patients on CAPD as Group 3 , in that order, a significantly higher aluminum levels in Group 2 and Group 3 relative to healthy controls (group 1) were found (20.2 + 6.60 Vs 89.8 ± 14.49, p<0.05; 20.2 ± 6.60 Vs 73.6 ± 10.18, p<0.05) but in both group of CRF patients aluminum level were not significant (89.8 ± 14.49 Vs. 73.6 ± 10.18, p>0.05).Serum Zinc levels in Group 2 and Group 3 comparative to healthy controls (group 1) were found significantly lower (94.4 ± 24.72 Vs. 40.9 ± 10.92, p<0.05, 94.4 ± 24.72 Vs. 39.3 ± 11.76, p<0.05) however in both group of CRF patients Zinc level were not significant (40.9 ± 10.92 Vs. 39.3 ± 11.76, p>0.05). Conclusion: Patients on CAPD showed markedly reduced concentrations of serum zinc, although a slight reduction was also present in CRF patients. Plasma aluminium concentrations were increased in patients on CAPD and CRF patients.
Key words: Chronic kidney disease, Chronic renal failure, continuous ambulatory peritoneal dialysis.
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EFFECTIVENESS OF DIDACTIC LECTURE IN IMPARTING KNOWLEDGE IN MEDICAL EDUCATION
Dr Manjusha Viswanathan, Dr Viswanathan K V
ABSTRACT
Objectives: To find out the opinion of students on the effectiveness of lectures and to assess the knowledge of students after didactic lecture. Background: Lectures are the time tested and the oldest teaching method in a teacher’s repertoire. There is a general view that lectures are not effective teaching learning method. My study was an endeavor to find answers to this. Methodology: This was a quasi- experimental study of 6 months duration conducted at Sree Gokulam Medical College and research Foundation after obtaining consent from the institutional review board. The ninth semester students of 2011 batch were included in the study after obtaining consent. A pretest was conducted and a lecture of 40 minutes duration was taken followed by post- test. Both the marks were tabulated. This was repeated with seven topics and seven faculty members. A questionnaire was circulated among the students and the findings also tabulated. These were subjected to qualitative and quantitative analysis. Results: 98% of students agreed that there was definite improvement of knowledge after the lectures. There were gaps to be filled after lectures. The faculty involved also influenced the student satisfaction even though there was no difference in the knowledge gained. Conclusion: Lectures are effective method of teaching to impart knowledge and there is definite increase in knowledge after didactic lecture. But the effectiveness of lectures depends on the teacher. There are definitely gaps to be filled after a lecture
Key words: Didactic lectures, learning tool, Knowledge teaching tool
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ANTIBODY DETECTION OF DENGUE INFECTION IN CLINICALLY SYMPTOMATIC PATIENTS BY MAC-ELISA DURING POST MONSOON SEASON AT A TERTIARY CARE HOSPITAL AT JAIPUR, RAJASTHAN
Dr Nilofar Khayyam, Manuja Agarwal, Gaurav Dalela, Bhagwati Chundawat, Jitendra Panda, Vijeta Sharma
ABSTRACT
Objectives: Cyclic epidemics of dengue infection are increasing with time in India. The disease shows a wide spectrum of clinical manifestations ranging from mild self-limiting illness to severe fatal haemorrhagic condition. The present study was conducted to detect dengue infection in its peak season in Jaipur, Rajasthan using Dengue MAC-ELISA. Materials and Methods: Serum samples from 3730 patients clinically suspected of having dengue infection visiting a tertiary care hospital during the period of two months from October to November 2015 were screened for the presence of Dengue IgM and IgG antibodies using one-step immuno-chromatographic assay (Dengue Rapid IgG/IgM Test by SD BIOLINE. Positive samples were subjected to Dengue IgM ELISA. Results: Out of to 3730 samples 413(11.07%) were found positive by rapid test. Of these positive samples 318/413 (76.99%) were found positive, 56/413 (13.55%) were equivocal and 39/413 (9.4%) were negative by Dengue MAC-ELISA.
Conclusion: Rapid immuno-chromatographic tests may offer a convenient method to screen samples for dengue infection in field during epidemic threats but confirmatory tests should be performed for the confirmation of Dengue infection as accuracy of available rapid tests has yet to be verified.
Key words: Dengue MAC-ELISA, Immuno-chromatographic, IgM, Dengue virus
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ASSOCIATION BETWEEN QUALITY OF LIFE AND ANXIETY, DEPRESSION, AND PHYSICAL PERFORMANCE IN CONGESTIVE HEART FAILURE PATIENTS
Dr. Ashok Goyal, Dr. Fiza Hasny
ABSTRACT
Background: Quality of life is a comparatively new scientific measure to assess the effectiveness of treatment approaches and the progress of a disease. Depression and anxiety are two important psychological disorders and are very common in patients with heart failure. In the present study, to assess physical performance in CHF patients, we conducted a cross-sectional study of the frequency and severity of impaired QOL scores and their relationship with physical performance. Method: This was a cross-sectional, non-interventional study. All 72 CHF patients were recruited during June 2005 to March 2006 from the department of cardiology and Department of Psychiatry, Mahatma Gandhi Medical College & Hospital, Jaipur, Rajasthan. NYHA classification was used to assess the CHF severity by a cardiologist. SF-36, Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI)-II and 6-MWT study tools were used for quality of life, depression, anxiety and physical performance in CHF patients respectably. Results: Most of the patients were male (91.67%) and unemployed or retired (80.83%). The majority of the patients (83.3%) were in NYHA functional class II or III, and, 32% a six-minute walk test of < 450 m. There were significantly reduced NYHA scores in all aspects of quality of life and SF-36 scores from NYHA class I to class III was a gradually drop. CHF patients who had neither anxiety nor depression had significantly more impaired 6-MWT. Conclusion: The findings of this study suggest important directions for planning effective care to enhance QoL in CHF patients. We have identified the detrimental impact of psychological distress on QoL in these patients. Psychological interventions that are effective in reducing depression should be identified.
Keywords: congested heart failure,cardiomyopathy-targeted areas, Beck Depression Inventory, psychological distress.
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EVALUATION OF THE NEONATAL OUTCOMES AMONG BABIES OF ELDERLY AND YOUNG MOTHERS
Dr. Ashok Kumar, Dr. Bajrang Lal Rar, Dr. Mahendra Fenin, Dr. Ritu Sharma
ABSTRACT
Background: This study is planned to study the relationship between advanced maternal age and neonatal outcomes. Materials and method: The present study was an observational cross-sectional study. Total sample size calculated was 400, out of the cases and controls were selected in the ratio of 1:1 after undertaking written informed consent. Cases include babies born to mothers more than 35 years and controls includes babies were born to mothers between the age of 19 to 35 years. Results In the present study the number of premature babies in the case group were 44 (22%) and in controls 20 (10%) (P value=0.001). Out of 200 cases, 20 babies (10%) had APGAR <7 at 1 minute and 6 (3%) babies had APGAR <7 at 5 minutes.56 cases (28%) had low birth weight and only 12 babies (6%) had low birth weight( P-value < 0.001). 22 cases (11%) were SGA and among controls only 02 (1%) babies were born SGA( P-value < 0.001).68 babies (34%) had SNCU (Special Neonatal Care Unit)admission and 36 babies (18 %) had SNCU admission in the control group( P value < 0.001). Conclusion: Incidence of Prematurity, low birth weight, Small for gestational age and SNCU admissions was found more in babies born to elderly pregnant women than babies born to pregnant women less than 35 years of age.
Keywords: outcome Advanced maternal age, Low birth weight, APGAR.
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PROSPECTIVE RANDOMIZED CONTROL STUDY COMPARING GLYCOPYRRONIUM VERSUS TIOTROPIUM ANALYZING TROUGH FEV1, BREATHLESSNESS AND HEALTH STATUS
Dr. Gaurav Chhabra, Dr. Shubhakaran Sharma
ABSTRACT
Background: Presently two long acting muscarinic antagonists (LAMAs) glycopyrornium and tiotropium are widely used for treatment of chronic obstructive pulmonary disease (COPD). This study is plan to compare therapeutic efficacy of these currently available drugs Methods : This study include COPD patients subjected to either 50 μg glycopyrronium or 18 μg tiotropium once daily, having an objective to compare patient compliance and health indices between these two groups over a period of 12 week treatment. Results: 57 patients were randomized (glycopyrronium: 27; tiotropium: 30) completed the study. Glycopyrronium demonstrated rapid bronchodilation following first dose on Day 1as well as after 12 weels treatment, with significantly higher FEV1.Glycopyrronium shows comparable improvement in Transition Dyspnea Index (TDI) and the frequency as well as rate of COPD exacerbations. Patients shows markedly low symptom compare to the patients on tiotropium after 12 weeks Adverse events were somewhat similar in incidence with both the drugs glycopyrronium (40.4%) and tiotropium (40.6%).Conclusion: glycopyrronium having a faster onset of action as well as shows statistically significant difference in FEV1, breathlessness and patient compliance After 12 weeks of treatment in comparison with tiotropium.
Keywords: acting muscarinic antagonists , Transition Dyspnea Index, chronic obstructive pulmonary disease (COPD).
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ASSESSMENT OF BURDEN OF VITILIGO AMONG PATIENTS AT TERTIARY CARE CENTER
Dr. Gajanand Ojha, Dr. Kishor Singh
ABSTRACT
Background: Vitiligo refers to an acquired, idiopathic, and common de-pigmentation disorder of the skin. The clinically characteristic symptoms of the vitiligo are pale or milk-white macules or patches due to the selective destruction of melanocytes. Material & Methods: The present cross-sectional prospective study was conducted at department of dermatology of our tertiary care hospital. The study duration was of one year from November 2015 to October 2016. A sample size of 100 was calculated at 95% confidence interval at 10% acceptable margin of error. Results: In non-segmental (44%) type of vitiligo, acro-facial (20%) was the most common type, followed by mixed (8%) and mucosal (8%), universal (5%) and vulgaris (3%). Segmental vitiligo was found in 22% of patients. In unclassified vitiligo (39%), the focal and mucosal type was found in 33% and 6% respectively. Lesions were mostly seen on lower limbs (32%) followed by head and neck (24%), upper limbs (23%), trunk (11%) and oral and genital mucosa (9%). Conclusion: local epidemiological behavior of vitiligo need not be the same across different regions. Variations do exist and may be due to certain clinico-epidemiological parameters.
Key words: Vitiligo, Acro-facial, Clinical epidemiology.
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Nutritional Anemia in Pediatrics: Unveiling Patterns and Profiles through Hospital-based Investigation
Dr. Atul Kumar Heda , Dr. Krishna Heda
ABSTRACT
Background: Nutritional anemia remains a significant public health concern globally, particularly among pediatric populations, as it reflects an intricate interplay of nutritional, socioeconomic, and demographic factors. This scientific article delves into the depths of pediatric nutritional anemia, aiming to unravel the intricate patterns and profiles through a meticulous hospital-based investigation. Methods : This cross-sectional study was conducted over a period of one year at the Department of pediatrics, Geetanjali Medical College and Hospital, Udaipur, India. The study design aimed to capture a snapshot of the prevalence and characteristics of pediatric anemia. Results: A total of 300 cases were enrolled in the study. The prevalence of anemia (51.33%) uncovered by this study reinforces its status as a severe public health problem in the studied population. Conclusion : tailored interventions addressing socioeconomic, dietary, and clinical factors are essential to reduce pediatric nutritional anemia. Collaboration among healthcare, research, and policy is crucial for effective public health responses. Identified patterns inform targeted screening and personalized interventions for affected children.
Keywords: Pediatric anemia, Nutritional deficiencies, Hematological disorders in children, Socioeconomic factors
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