Volume 8 Issue 1

International Journal of Medical Sciences and Education (IJMSE)
Vol. 8 Issue: 1 (Jan.-March 2021), Date of Publication: 01.04.2021

1. MOTIVATIONAL FACTORS INFLUENCING THE DECISION OF SCHOOL GRADUATES TO APPLY FOR MEDICAL SCHOOL 1-5
Alsawi Y A Yusuf , Abdelsalam M H Elfaki PDF FULL TEXT

ABSTRACT

Background: To investigate the factors that influenced the choice for medical school, by first-year medical students in Kordofan University. Methods: A self-administered questionnaire was distributed to the first-year students. Demographic information, the grade achieved in the high school certificate examination and the number of times the student took that examination, the most important factor that influenced the decision and the relative importance of each factor on a scale of 1-5 were filled in. Results: Of the 200 first year students, 158 students participated and returned a filled questionaire. Most were females (63.3%). Mean age was 18.06 years. Most students came from families with educated parents. Only about 5% of fathers and 7.6% of mothers were illiterate. The majority came from middle income families (58.23%) and 42.4% had one physician or more in the family. The mean grade in examination was 88.26%. Most students took it more than once (mean 1.85 times).The main motivational factors were the desire to help people (n=144, 91.1%) and the personal preference (n= 110, 69.6%). Conclusion: Most medical students in this study were females, from middle income families with educated parents. Most students chose medical school to help people in need and to satisfy a personal desire. Family influence played a relatively important role. Only a minority considered the financial gains or social prestige.
Keywords: medical education, medical school, motivation theories.

2. SARS-COV2 ANTIVIRAL TESTING REPORT OF ACT 12 AND 13: SHORT COMMUNICATION 6-9
Dr. Shridhar Pandya, Mr. Chetan Savaliya PDF FULL TEXT

ABSTRACT

Background: In the current scenario of COVID-19 to take a step towards nutraceuticals and herbal medicines as a potential antiviral against COVID-19, and to encourage the use of nutraceuticals and herbal therapies as preventive steps towards SARS-CoV-2 virus till the other specific drugs and vaccines are discovered. By considering the current need for an effective medicine against the Coronavirus, GP Life Healthcare Pvt. Ltd. has proposed a product with renowned Phytoconstituents to evaluate its antiviral potential against SARS-CoV-2 and developed formulation ACT 12 & ACT 13 a potential candidate in the treatment of COVID-19 infection. Methods: The test substances were screened to determine the cytotoxic and Antiviral activities. The assay was done in a 96-well plate format in 3 wells for each sample. The results were compared with the positive control (Remdesivir). The results were recorded at definite time intervals i.e. after 24hrs and 48 hrs. Result: In the present study, it was evident that the test substance demonstrates no cytotoxicity. The ACT 12 demonstrating favorable results in % inhibition of viral replication assay. Conclusion: It was found from the study that there was no toxicity observed related to the test substance. Thus it depicts the safety of test substances, as well as its potential in inhibition of viral replication in cell culture, demonstrates its efficacy.
Keywords: SARS-CoV-2, Remdesivir, Antiviral, Cytotoxicity

3. DOES 2 ML BLOOD SAMPLE IN BACT/ALERT BLOOD CULTURE VERSUS 1 ML INCREASES YIELD OF ORGANISMS IN PREVIOUSLY ANTIBIOTIC-TREATED NEONATES OF MORE THAN 30 WEEKS GESTATION 10-13
Dr Sourabh Singh,Dr Siddharth Singh Rathore PDF FULL TEXT

ABSTRACT

Background: The problem in NICU is that outborn neonates referred to us usually come after receiving multiple antibiotics. Now we do not have neonatal blood culture (Bact /ALERT) bottles. We send blood culture in paediatric Bact /ALERT bottles. For proper blood to broth ratio, 2 ml blood sample should be taken in paediatric Bact /ALERT bottles. The previously antibiotic-treated neonates usually have low colony counts and due to the inhibitory effects of antibiotics, cultures usually come negative. If we use proper dilutions of the blood sample and culture media to reduce the antibacterial effect, it is expected to increase the yield of organisms in previously antibiotic-treated neonates. Method: All extramural neonates > 30 weeks gestation admitted in NICU having clinical features and signs of neonatal sepsis and with prior exposure to antibiotics were enrolled. With all sterile precautions, paired blood culture samples of 2 ml and 1 ml were taken. Result: The number of total blood culture positives were 40 out of 140 cultures. Blood culture positivity was 28.6%. 30 blood cultures were common in both 2 ml and 1 ml blood samples while 10 were positive in 1 ml blood samples and another 10 in 2 ml blood samples. The value of kappa is 0.65 which shows substantial agreement between the two samples. Conclusion: Our study suggests that in previously antibiotic-treated neonates, increasing volume of blood in the BacT/ALERT system neither lead to an increase in yield of organisms nor do any decrease in the isolation time
Keywords: previously antibiotic-treated neonates, BacT/ALERT blood culture

4. EVALUATION OF FEBRILE SEIZURES AMONG CHILDREN TREATED AT DAY CARE FACILITY OF TERTIARY CARE HOSPITAL : A RETROSPECTIVE STUDY 14-17
Dr. Vidya Parshuram Paranjape, Dr Abender singh manju, Dr Jaswant Goyal,
Dr Ajay Kumar Arora PDF FULL TEXT

ABSTRACT

Background: Febrile seizures are the most frequent seizure type and reported among 2 to 5% of children aged less than 5 years with a pinnacle rate in the second year of life. Previous studies on febrile seizures were considered utilizing large epidemiologic surveys and researches. Febrile seizures are previously reported as benign as kind, however there is ongoing researches that recommends a little subset of children that present with seizures and fever may have recurrent febrile seizures or epilepsy. Material & Methods: The present retrospective study was conducted at department of Department of pediatrics of our tertiary care hospital. The study duration was September 2018 to September, 2019. A sample size of 100 was calculated at 95 % confidence interval at 5 % acceptable margin of error by epi info software version 7.2. Patients were enrolled from outdoor and from ward by simple random sampling. All children aged between 6 months to 5 years who were diagnosed as febrile seizures were enrolled in the present study. Results: In present study, out of the total study participants, family history of febrile seizure was present among 61% children and absent in 39% children. However, this difference was statistically non- significant ( p value >0.05). On the basis of type of febrile seizure, out of the total study participants 83% children had simple type of febrile seizure and 17% children had complex type of febrile seizure. However, this difference was statistically non- significant (p-value >0.05). On the basis of type of infection, upper respiratory tract infections were the most commonly present among 22% children, which was followed by lower respiratory tract infections among 21% children, followed by acute gastroenteritis among 18% children. 19% children had other infections irrespective to above three and 20% of children had no infection. Conclusion: We concluded from the present study that most common type of febrile seizure present in children was simple and predominant in male gender with positive family history. The most common infections associated with febrile seizures were upper and lower respiratory tract infections and acute gastroenteritis.
Keywords: Febrile seizure, Respiratory tract infection, Acute gastroenteritis.

5. ASSESSMENT OF PREVALENCE OF HYPERURICEMIA AMONG NEWLY DIAGNOSED PATIENTS OF TYPE 2 DIABETES MELLITUS 18-21
Dr. Amit Anand Patel, Dr. Jitesh Aggarwal PDF FULL TEXT

ABSTRACT

Background: Various studies have been reported that the association of serum uric acid levels with diabetes as a risk factor among prediabetes individuals to type 2 diabetes mellitus. It is well known that Serum uric acid is formed in the body by the breakdown of purines. Various studies have been reported that elevated serum uric acid is found to be associated with diabetes mellitus. Material & Methods: The present prospective study was conducted at the Department of General medicine of our tertiary care hospital. Patients were enrolled from the outdoor and the ward by simple random sampling. Clearance from Institutional Ethics Committee was taken before the start of the study. Written informed consent was taken from each study participant. All newly diagnosed patients (diagnosed within 3 months) with diabetic Mellitus were enrolled in the present study. Results. In the present study, based on HbA1c levels and hyperuricemia, out of the total majority of study participants 30% patients had HbA1C levels 6.5-8 out of these 10 patients had hyperuricemia which was followed by 29% patients had HbA1C levels >11 out of these 15 patients had hyperuricemia which was followed by 24% patients had HbA1C levels 8.1-9.5 out of these 11 patients had hyperuricemia which was followed by 17% patients had HbA1C levels 9.6-11 out of these 8 patients had hyperuricemia. This difference was statistically non-significant. Conclusion: We concluded from the present study that serum uric acid may be used as an independent diagnostic marker for the risk of the development of prediabetes to diabetes and its progression and complications. Patients with high HbA1C levels should be tested for serum uric acid levels.
Keywords: hyperuricemia, Diabetics Mellitus, HbA1C levels.

6. AUDITORY DISTURBANCES ACCOMPANYING THE USE OF MOBILE PHONES AMONG MEDICAL STUDENTS- A CROSS-SECTIONAL STUDY 22-30
Dr. Almas J. Vakil, Dr. Pratibha Vyas, Dr. Nikhil Soni PDF FULL TEXT

ABSTRACT

Background: Mobile telephony has emerged as one of the greatest technological accomplishments of the present century. Their inadvertent use puts millions, especially youngsters at a risk of developing noise-induced hearing loss (NIHL). This study was aimed to assess the auditory disturbances accompanying the use of mobile phones among medical students. Methods: The study was conducted in the Department of Otorhinolaryngology and Head & Neck Surgery at Mahatma Gandhi Medical College and Hospital, Jaipur, on a total of 290 medical students. A detailed history of all participants was taken, followed by a meticulous clinical examination. A detailed questionnaire enquiring about the pattern of use of mobile phones was distributed to all the students. Assessment of hearing was done by pure tone audiometry (PTA). Results: The study included 144 (49.7%) students who were males and 146 (50.3%) who were females. The mean age of the students was 21.47±1.72 years. The mean hearing thresholds in both ears, at all frequencies, were correlated with daily usage hours and years of use. They were found to be significantly correlating at 4000 Hz (P<0.05). This correlation was not found to be significant at other frequencies (p >0.05). The mean hearing thresholds in both ears at all frequencies were also correlated between males and females. A significant correlation was found at 4000 Hz (P=0.001). This correlation was not found to be significant at other frequencies (p>0.05). Conclusions: The permanence of noise-induced hearing loss underlines the importance of noise damage prevention caused by the use of mobile phones, by making small changes in daily routine right from early days before irreversible changes start.
Keywords: Hearing thresholds; Mobile phones; Noise-induced hearing loss (NIHL); Pure Tone Audiometry (PTA).

7. IMPACT OF DIABETES ON INFLAMMATORY, COAGULATION AND RADIOLOGICAL MARKERS IN
HOSPITALISED COVID-19 PNEUMONIA PATIENTS 31-38
Dr. Srishti Jain, Dr. Rajeev Kasaliwal, Dr. Naveen Gupta, Dr. Nimish Mathur,
Dr.Ashish Jain, Dr. Puneet Rijwani, Dr. Rajat Bohra PDF FULL TEXT

ABSTRACT

Background: Diabetes has been suggested as a risk factor for increased severity in COVID-19 pneumonia patients. Accumulating evidence has suggested that inflammatory responses play a critical role in the progression of COVID-19. Objective: This study intends to evaluate the impact of diabetes on various inflammatory and coagulataory markers in COVID-19 pneumonia. Methods: This is a single centre retrospective observational study. Seven hundred thirty-one patients diagnosed with COVID-19 with or without diabetes were included in this study. Data was collected on admission or during hospitalization by attending physicians and documented in the form of electronic medical records. Results: Of the 731 hospitalized patients with COVID-19, the median age was 60 years and 528 (72%) were male and 331(45 %) were diabetic. Hospitalised COVID-19 patients with diabetes had significantly higher N:L ratio, LDH, Ferritin, CRP and D-dimer compared with those without diabetes. Conclusion: We concluded that hospitalised Covid-19 pneumonia with diabetes mellitus are associated with increased inflammatory activity and greater coagulation abnormality compared to nondiabetic patients.
Keywords: Diabetes, COVID-19.

8. EVALUATION OF COLOR VISION DISCRIMINATION ABILITY IN DOMINANT AND NON DOMINANT EYE AMONG YOUNG ADULTS WITH NORMAL COLOR VISION 39-45

Dr. Chhaya Gupta, Dr. Pradeep Kumar Gupta, Dr Jyotsana Shukla,
Dr. Manoj Kumar Gupta PDF FULL TEXT

ABSTRACT

Backgrund: The phenomenon of dominance in the domain of sensorial neurophysiology is an accepted and acknowledged framework of physiological functioning of varied precepts of sensoria. Dominance in and of vision is a function that elaborates from periphery of eye extending all along visual pathway involving both bottom-up and top-down influences. Methods: The present study attempts to investigate the relationship between color vision discrimination ability and eye dominance in young adults using Farnsworth Munsell 100 (FM 100) hue test. It is a cross sectional comparative type of study including 170 young adults with normal color vision. The tests used were Ishihara Pseudo-Isochromatic Plate Test (IPPT) for screening of CCVD (Congenital Color Vision Deficiency), FM100 hue test for color discrimination ability and Gundogan Test for detection of dominant eye. Color discrimination ability was assessed in terms of Total Error Scores, evaluated for two eyes used together, dominant eye and non dominant eye. P values below 0.05 were considered to be statistically significant. Results:The study revealed a mean Total Error Score of FM 100 Hue test for dominant eye (DE) as being 72.14±21.46 and 87.89±25.15 for the non dominant eye (NDE) indicating superior color discrimination ability in dominant eye (DE) in comparison to non dominant eye (NDE). Conclusion: The finding of superiority of the dominant eye with regard to color discrimination ability is hypothesised as taking place along the lines of a generalized precept wherein maximum resource economy and functional laterality of cerebral hemispheres is achieved without producing extrusive compromises in overt sensory experiences.
Keywords: Eye Dominance, Color discrimination ability,Farnsworth Munsell 100 hue test, Ishihara Pseudo-Isochromatic Plate Test,Gundogan Test.

9. OBSERVATIONAL STUDY OF CUTANEOUS MANIFESTATIONS AMONG PATIENTS OF
DIABETES MELLITUS 46-49

Dr. Mohit Saxena , Dr Simran Singh Ajula PDF FULL TEXT

ABSTRACT

Background: Cutaneous manifestations sometimes may be the first presenting clinical sign of diabetes mellitus but more commonly manifest in known diabetic Mellitus patients during the time period of the disease as reported in previous studies among 45-65% of diabetic Mellitus patients. Abnormalities in carbohydrate metabolism along with atherosclerosis, neuropathy, impaired host immunity, and microangiopathy all together act in the etiopathogenesis of cutaneous manifestations in known diabetic Mellitus patients. Material & Methods: The present prospective study was conducted at the Department of Dermatology of our tertiary care hospital. Patients were enrolled from the outdoor and the ward by simple random sampling. Clearance from Institutional Ethics Committee was taken before the start of the study. Written informed consent was taken from each study participant. All known diabetic Mellitus patients irrespective of age, gender, duration of illness, and associated complications were enrolled in the present study.: Results. In the present study, based on cutaneous manifestations, out of the total majority of study participants, 61% had cutaneous infections which were followed by 40 % patients had dermatosis more commonly associated with diabetes which was followed by 26 % of patients who had Nonspecific cutaneous manifestations which were followed by 6 % patients had Dermatosis associated with microangiopathy which was followed by 4 % patients had Neuropathic and ischemic diabetic skin disease which was followed by 4 % patients had Metabolic disease manifestations. Conclusion: We concluded from the present study that cutaneous infections were the most common cutaneous manifestations in diabetics Mellitus patients which were followed by dermatoses most commonly reported with diabetes mellitus patients.
Keywords: cutaneous manifestations, skin disease, diabetes.

10. IMPACT OF CORONA VIRUS DISEASE (COVID-19) ON MENTAL HEALTH:
A COMPARATIVE STUDY 50-54

Dr. Dinesh Kumar Jain, Dr. Monika Gupta, Dr. Jaishree Jain, Dr.Gaurav Rajender,
Dr. Sandeep Gupta, Dr. Shanoo Sharma PDF FULL TEXT

ABSTRACT

Background: Corona Virus disease (Covid-19) has been declared a notified disease and public health emergency of global concern. The fast-emerging mental health problems can disturb people’s general well-being and have enormous potential to influence the health system; therefore, they need immediate and urgent action and attention leading to this study. Aims & objectives: To compare mental health issues among the normal and Covid-19 infected individuals on the sub-scales somatic complaints, obsessive-compulsive, phobias, traumatic stress, anxiety, and anxiety-related disorders. Materials & Methods: The participants in this study were a total n= 500 out of which n=250 were noninfected and 250 were covid-19 infected patients, age range from 18 years to 50 years. Data were collected randomly from various Covid-19 hospitals of Jaipur. For non-infected samples data were collected from different parts of Jaipur. Both the participants were administered a personality assessment scale and assessed on the subscales i.e. conversion, somatization, health concerns, cognitive, affective, physiological, obsessive-compulsive, phobias, and Post-trauma stress disorder. Each Subscale consists of eight items (Total Items are seventy-two) Results: The present study indicates all scales except conversion, i.e. somatization, health concerns, cognitive, affective, physiological, obsessive-compulsive, phobias, and post-trauma stress disorders have significant differences among the normal and covid-19 infected patients while conversion has a non-significant difference. Conclusion: Based on research findings associated with mental health issues of covid-19 infected patients, the further attempt must be encouraged to understand various facets of mental health and appropriate interventions should be introduced by mental health professionals and policymakers at a world level so that a large section of our society can be benefited.
Keyword:- covid-19, anxiety, conversion, phobias, obsessive-compulsive, traumatic stress.

11. Comparative Assessment of Right Anterolateral Thoracotomy with Standard Median Sternotomy for Mitral Valve Replacement- A Prospective Single Center Study 55-60

Dr. Krishna Kumar Mawar, Dr. Pramod Chandolia, Dr. Vaibhav Gupta PDF FULL TEXT

ABSTRACT

Background: In current decade rapid advancement of surgical techniques and the assistance of developed instrumentation has been improved the outcome of cardiac surgeries. Minimally invasive cardiac valve surgeries are reported to conduct with improved outcome. Mitral valve surgeries have been conducted through Median Sternotomy as reported as the early era of cardiopulmonary bypass. Material & Methods: The present Hospital based prospective study was conducted at department of Cardiothoracic Vascular Surgery of S.M.S. Medical college Hospital from December 2017 to December 2020. Total 200 patients were included in our study with moderate to severe mitral valve disease who were scheduled for elective mitral valve surgery were prospectively randomized according to the ACC/AHA guidelines to undergo either right anterolateral thoracotomy (Group I, n:100) or through standard Median Sternotomy for mitral valve replacement (Group II, n:100). Results: Mean operation duration (min) was 178.1 ± 24.7 among group I and 138.3 ± 31.5 among group II (p value > 0.05). Cardiopulmonary bypass time was 81.5 ± 13.1 among group I and 71.7 ± 15.2 among group II (p value < 0.05). Aortic clamp time (min) was 32.1 ± 7.2 among group I and 30.1 ± 8.4 among group II (p value > 0.05). Chest tube drainage (ml) was 167 ± 22 among group I and 319 ± 46 among group II (p value < 0.05). Score of visual analogue scale was 42.0 ± 14.2 among group I and 45.4 ± 12.8 among group II (p value > 0.05). Mechanical ventilation time was 4.3 ± 1.1 among group I and 6.1 ± 2.4 among group II (p value > 0.05). Blood transfusion (unit) was 1.4 ± 1.1 among group I and 2.2 ± 3.2 among group II (p value > 0.05). Wound infection in no. of cases (%) was 4% among group I and 9% among group II (p value > 0.05). Hospital stay (days) was 8.2 ± 0.9 among group I and 10.5 ± 2.8 among group II (p value < 0.05). ICU stay (days) was 1.9 ± 0.7 among group I and 1.6 ± 1.4 among group II (p value < 0.05). Time to normal activity (weeks) was 8.2 ± 4.8 among group I and 11.8 ± 3.6 among group II (p value < 0.05). Conclusion: We concluded that minimal invasive right anterolateral thoracotomy has less bleeding, shorter hospital and ICU stay, less pain score and faster recovery than standard Median Sternotomy for mitral valve replacement.
Keywords: Right anterolateral thoracotomy, standard Median Sternotomy, mitral valve disease.

12. OUTCOMES OF ACUTE MYELOID LEUKEMIA FROM A TERTIARY CENTRE IN NORTH INDIA 61-64

Dr. Naveen Gupta, Dr. Ajay Yadav PDF FULL TEXT

ABSTRACT

Background: The outcomes of Acute Myeloid Leukemia (AML) remain inferior in developing countries owing to poor accessibility of treatment and supportive care. Methodology: This study is a single centre retrospective observational study of patients diagnosed with AML in the preceding 2 years. Results: Forty two patients were diagnosed with AML during the study duration. The median age was 38 years with a male preponderance. Majority patients had intermediate risk genetic profile. 23.8% patients presented with infection at the time of presentation. Patients received the following treatment regimens- 3+7 induction (36%), ATRA based induction for APML (12%), metronomic therapy (19%), Hypomethylating agents (HMA) (7%), HMA+venetoclax (5%) and best supportive care only in 21%. Amongst patients receiving 3+7 induction- all developed febrile neutropenia, 80% developed CR, 33.3% had relapse after CR. 45.2% of the total patients are currently alive. Conclusions: Treatment with curative intent was given to less than half of AML patients. There was a high prevalence of infections both at presentation and during chemotherapy. Induction mortality was 13.3%.
Keywords: Acute myeloid leukemia, 3+7 induction, metronomic chemotherapy, Azacitidine
.

13.  ASSESSMENT OF FREQUENCY OF CATHETER RELATED BLOOD STREAM INFECTIONS
AT CARDIAC SURGERY INTENSIVE CARE UNIT OF TERTIARY CARE CENTER 65-68

Dr. Krishna Kumar Mawar, Dr. Vaibhav Gupta, Dr.Kiran Dawla      PDF FULL TEXT

ABSTRACT

Background: The central venous catheters are commonly used among critically ill patients and their application sometimes lead to various complications such a catheter-related bloodstream infections. Catheter-related blood stream infections are described as a infections of blood stream caused by an indwelling intravenous catheter which acts as a portal of infection. Material & Methods: The Hospital based observational study was conducted at department of Cardiothoracic Vascular Surgery of S.M.S. Medical college Hospital from Oct. 2018 to Jan 2021. Total 300 patients having clinical signs and symptoms of bacteremia and septicemia and were suspected forthe catheter related blood stream infection due to indwelling central venous catheters were included in our study. Clearance from hospital ethics committee was taken before start of study. Written informed consent was taken from each study participant. Results: Out of 300 study participants it was found that, 162 (54%) study participants had CVC tip colonization which was followed by Central line associated bloodstream infections which was present in 35 (11.6%) patients. A catheter-related bloodstream infection was positive among 13 (4.3%) patients and catheter related candidemia was present among 9 (3%) study participants respectively. Conclusion: We concluded from the present study that that Candida species were the most common important cause of catheter related blood stream infection among patients from Cardiac surgery intensive care units.
Keywords: Catheter related blood stream infection, bacteremia, septicemia.

14. EVALUATION OF STABILITY OF RNA IN VIRAL TRANSPORT MEDIA FOR THE DETECTION
OF SARS-COV-2 BY RT-PCR UNDER DIFFERENT TEMPERATURE CONDITIONS 69-74

Dr.Sandeep Gupta ,Dr. Dinesh Kumar Jain, Dr. Parul Sinha, Dr..Monika Gupta,
Dr.Malvika Sharma,Dr. Nitya Vyas PDF FULL TEXT

ABSTRACT

15.A STUDY OF VARIABILITY OF QUADRICEPS ANGLE (Q-ANGLE) IN A GROUP OF ASYMPTOMATIC
  YOUNG ADULTS 75-82

Tuhin Ghulyani, Sumit Babuta, Virendra Kumar, Meenakshi Singhal   PDF FULL TEXT

ABSTRACT

Background: The knee is a complex joint posing a challenge to biomechanics and has an immense clinical applied aspect. One of the ways to study force vectors acting on the knee joint is the Quadriceps angle (Q angle). The purpose of this study was to establish the normal values and ranges of Q angle in a cohort of asymptomatic college-going adults of the Rajasthan region.Methods: The Q angle was analyzed in one hundred and twenty healthy adult volunteers divided into two equal groups of male students (MS) and female students (FS). The Q angle was measured using a flexible plastic goniometer with the subject in a supine position, knees extended, quadriceps relaxed and feet in a neutral position. Results: The mean Q angles were higher in females and it was statistically significant (p<0.05). The mean Q angle of both limbs in MS and FS was 12.84° and 14.48°, respectively. The means of right and left Q angle in males was 12.62° & 13.07° and in females was 14.37° & 14.58°. The majority of subjects (n=84, 70 %) showed a bilateral difference and the difference was mostly small (1°) in 50 (41.67%). The mean Q angle was higher on the left side, in both groups, but the difference was not statistically significant (p>0.05).Conclusion: The results corroborate Q angle disparity in gender and it is higher in females than males. However, the mean Q angle obtained differs from most other foreign population studies. Though the Q angle was found to vary bilaterally in most individuals, the difference was insignificant. A large-scale study of Q angle gender-related difference is recommended, between individuals of similar height & age, of both sexes. This will give more reliable results to treating surgeons.
Keywords: Quadriceps angle, Q angle, gender differences, center of patella, tibial tuberosity

16. ASSESSMENT OF THE OUTCOME OF EARLY APPENDECTOMY AMONG CASES OF THE APPENDICULAR LUMP AT A TERTIARY CARE CENTER 83-86

Dr. Praveen Jhanwar, Dr. Hanuwant Singh PDF FULL TEXT

ABSTRACT

Background: An appendicular lump presents in the right iliac fossa usually after 48-72 hours of first sign and symptoms of acute appendicitis. The lump usually develops when appendicitis is followed by an obstruction in the lumen of the appendix. The decision for surgical intervention on a patient with an appendicular lump can therefore be published as a research study that how various factors are associated with surgical decision-making. Material & Methods: A total of 40 patients had developed an appendicular lump within 3 to 8 days after acute appendicitis. Patients of 11 to 18 years of age who had been admitted to the pediatric surgery department were enrolled by simple random sampling. Clearance from Institutional Ethics Committee was taken before the start of the study. Initially Informed and written individual consent was taken from each and every patient/parent included in the study. Results: In the present study among group I, out of 20 patients, 18 patients were discharged from the hospital without any complications, only 01 patient have developed wound infections and only 01 patient had developed fecal fistula in the post-operative period. In group II, out of 20 patients, 12 patients were needed exploration who was progressed to complications and 08 patients were continued the conservative treatment those were progressed to resolving the lump. In group II, 06 patients were developed wound infections, 04 patients were developed paralytic ileus and 02 patients were developed fecal fistula in the post-operative period. This difference between the two groups was statistically significant (P-value < 0.05). The duration of stay is shorter among group I patients and the difference between the two groups was statistically significant (P-value < 0.05).Conclusion: We concluded from the present study that early surgical exploration of appendicular lump cures the problem, reduces the cost of management and shortens the period of hospital stays with a reasonably satisfactory outcome.
Keywords: Abdominal lump, Appendicitis, Appendicectomy.

17. AN OBSERVATIONAL STUDY ON CLINICAL PROFILE OF PATIENTS WITH RENAL TRAUMA 87-90

Dr. Kshitiz Ranka, Dr. Hanuwant Singh PDF FULL TEXT

ABSTRACT

Background: the kidney is among the most common organ involved during abdominal trauma. Both conservative and surgical management are employed depending upon the grading of the injury clinical profile of the patient. Methodology: All the cases of renal trauma coming to the emergency room, aged more than 18 years during the period of January 2019 to December 2020 are included in the study. Detailed history & examination was done & the patient underwent CT for grading the injury. Result: The mean age of the patients was 40.36±15.85 years. 31(62%) had an injury on the left side. The most common associated injury was Rib fracture seen in 5 (10%) cases. On grading the renal injury according to the American Association for the surgery of trauma (AAST), it was found that 20 (40%) patients belonged to Grade II followed by 12 (24%) in Grade I, 8 (16%) in Grade III, 6 (12) patients in Grade IV & 4 (8%) patients belonged to Grade V. 41 (82%) patients were managed conservatively & in 9 (18%) patients surgical inventions were done. Double J stenting was done in 4 (44.44%) patients, Percutaneous drainage of the perinephric collection was done in 3 (33.33%) patients & in 2 (22.22%) patients Nephrectomy was done. The mean duration of stay in the hospital was 11±5.65 days. Conclusion: Conservative management is the treatment of choice for renal trauma & it is associated with less complication & decreased duration of stay.
Keywords: kidney, renal injury, Double J stenting, perinephric collection.

International Journal of Medical Sciences and Education (IJMSE)Vol. 8 Issue: 1 (Jan.-March 2021), Date of Publication: 01.04.2021

International Journal of Medical Sciences and Education (IJMSE)
Vol. 8 Issue: 1 (Jan.-March 2021), Date of Publication: 01.04.2021