International Journal of Medical Sciences and Education (IJMSE)
Vol. 1; Issue: 3 (July-Sept 2014) , Date of Publication: 01.10.2014
1. EFFICACY AND SAFETY OF INTRATYMPANIC STEROID TREATMENT FOR IDIOPATHIC SUDDEN SENSORINEURAL HEARING LOSS
Dr. Suresh Kumar1, Dr. Tarun Ojha2, Dr. Amit Singhal*3, Dr. Pratibha Vyas4, Dr. Indu Goel5, Dr. Natwar Singh Rathore6, Dr.Meghal Chaudhary7.
ABSTRACT: Objectives: This study is planned to evaluate the efficiency and safety of Intratympanic (IT) injection of methylprednisolone (IT-MP) on idiopathic sudden sensorineural hearing loss (ISSHL) patients as an initial therapy, by weighing against the outcome with intravenously administered dexamethasone (IV-DEX) treatment. Materials and Methods: A prospective, nonrandomized, comparative study was conducted for 50 patients presenting with ISSHL. Twenty-five patients were managed with intratympanic methylprednisolone as a single and initial treatment, and 25 with intravenous dexamethasone. The hearing level was described using the Pure Tone Average (PTA in dB) hearing level at four frequencies (0.5, 1, 2 and 4 kHz). Hearing gain was expressed as absolute hearing gain and relative hearing gain. Complete hearing recovery was defined as the final PTA within 10 dB of baseline. Partial recovery was defined as a final PTA with a ≥ 50% relative recovery. Results: Mean hearing improvement was significantly higher in IT MP group than in IV DEX group (50.7±22.11, versus 29.5±28.0, p<0.01). We found a high rate of relative recovery of hearing in IV DEX group, which was because of significant hearing level of the unaffected ear. Similar percent of patients in both group had complete recovery, but in the IV DEX group 42% patients had no recovery (versus 10% in IT MP group).Conclusion: Intratympanic treatment of ISSHL may be a first choice , since it can be delivered in outpatient settings, with no serious side effects and low complication rate.
Key words: Intratympanic (IT) injection, sensorineural hearing loss, dexamethasone.
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2. A STUDY ON PREVALANCE OF HYPOTHYROIDISM IN DIABETICS
Dr Asrar Ahmed1*
1.Assistant Professor ,Dept of Gen. Medicine, National Institute of Medical Sciences(NIMS),Jaipur
ABSTRACT
Objectives: Thyroid diseases and diabetes are two common endocrinopathies. The coexistence of diabetes mellitus with hypothyroidism is a known clinical observation. The association of these two diseases may lead to dyslipidaemia causing increased morbidity and mortality hence screening for hypothyroidism in diabetics may help in early detection and treatment to reduce this increased risk of morbidity and mortality. Material and methods: This study was designed to know the prevalence of hypothyroidism in diabetics at our institution, 100 known cases of diabetes attending outdoor of Nims Medical College Jaipur, were also screened for thyroid dysfunction by doing thyroid profile. Results: It was found that hypothyroidism was present in 13% patients of diabetes, which is a significant association. Conclusion: on the basis of observations of this study it is recommended to routinely screen patients of diabetes for presence of hypothyroidism to prevent long term morbidity and mortality.
Keywords: diabetes, hypothyroidism.
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3.EXPLORATION OF EARLY AUDITORY EFFECTS OF HYPERBILIRUBINEMIA IN NEONATES USING BERA
Dr. Amit Singhal1*, Dr. Tarun Ojha2, Dr. Suresh Kumar3, Dr. Pratibha VyasVyas4, Dr. Indu Goel5, Dr. Meghal Chaudhary6, Dr. Natwar Singh Rathore7
ABSTRACT:
Objectives: This study was planned to assess the hearing of infants with Hyperbilirubinemia using brainstem evoked response audiometry (BERA) and to find a possible co-relation between the level of hyperbilirubinemia & the degree of hearing loss. Methods: The present study is conducted on 100 neonates to compare the BERA findings on cases presenting with hyperbilirubinemia born and admitted to the NICU of Mahatma Gandhi Medical College & Hospital, Jaipur. 60 control neonates also taken for comparison who were born in MGMCH with no medical and surgical ailment. A detailed history was taken and relevant investigations were done to rule out any other causes of hearing loss. Patients with coexisting causes for hearing loss were excluded from the study. The cases were subject to phototherapy or double volume exchange transfusion. BERA was carried out on the babies atleast 2 months after discharge from the hospital. Results: The Mean values for hyperbilirubinemia group were found to be more than the control group. It was found that the mean for the absolute latency of wave V & the interwave latency of I-V for the 0-12 months age group with bilirubin levels less than 15mg/dL was statistically significant when compared to the group with bilirubin level more than 15mg/dL with a p value of 0.01 & 0.05 respectively. Conclusion: Hyperbilirubinemia does have an adverse effect on neonatal hearing which is reflected on the BERA parameters.
Key words: Hyperbilirubinemia, BERA, Phototherapy, Exchange transfusion.
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4.RELATIONSHIP BETWEEN FOLIC ACID, ESR AND HAEMATOLOGICAL VARIABLES IN PATIENTS WITH CHRONIC PERIODONTAL DISEASE OF SMOKERS AND NON SMOKERS
Dr. Swati Agarwal 1*, Dr. Pulak Mishra 2, Dr. Devraj C.G. 3, Dr. Prathibha A. Nayak 4, Dr. Ashish Yadav 5, Dr. Swati Sharma 7
Abstract :Aim: Smoking is one of the important factors that can change the folic acid levels. The aim of the present study was to compare the serum folic acid levels, ESR and haematological variables in patients with chronic periodontal disease in relation to the patient’s smoking habits. Materials and methods: A total of 50 subjects in the age range of 25 to 65 years were included in the study with 25 subjects each in group A – patients of periodontitis and were smokers and group B - patients of periodontitis and were non-smokers. Clinical parameters like gingival index (GI),plaque index (PI), bleeding on probing (BOP), probing depth (PD) and clinical gingival attachment levels (CAL) were observed for all the patients. Folic acid,ESR and haematological variables were determined from peripheral blood samples. The results were statistically analysed. Results: Serum folic acid levels of non-smokers were significantly higher than that of smokers (p < 0.05). Plaque index , Probing Depth and Clinical Attachment Level means were significantly lower for Group B (Periodontitis and non-smokers) and higher for Group A (Periodontitis and smokers).ESR was higher whereas BOP was lower in smokers than non smokers (p < 0.05). Conclusion: This study suggests that among patients with chronic periodontal disease, the serum folic acid levels are lower in smokers as compared with non-smokers.
Key words: smoking; folic acid; nutrition; Periodontitis.
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5.DETERMINATION OF ERYTHROCYTE PARAMETERS IN CHRONIC PERIODONTITIS PATIENTS
Dr. Pulak Mishra1 , Dr. Swati Agarwal 2*, Dr. Devraj C.G. 3, Dr. Prathibha A. Nayak 4, Dr. Ashish Yadav 5, Dr. Swati Sharma
Abstract:Objective: Limited research has been reported on the relationship between periodontal status and erythrocyte parameters. Anemia of chronic diseases is one of the most common forms of anemia. It occurs due to chronic infections, inflammatory conditions or neoplastic disorders which are not due to marrow deficiencies or other diseases. Periodontitis is one of the most prevelant chronic inflammatory diseases in humans. This study is aimed at finding the relation between erythrocyte parameters and chronic periodontitis. Materials and methods: A total of 50 patients will be selected for the study. The patients chosen for study will have at least 30% or more of the teeth having greater than or equal to 4 mm probing death. Clinical parameters like gingival index (GI), plaque index (PI),probing pocket depth (PD) and clinical attachment levels (CAL) were recorded for all the patients and haematological variables were determined from peripheral blood samples. The statistical analysis of the results will be determined. Results: The mean values of haemoglobin (Hb) and red blood cell indices were significantly lower, while the value of ESR was significantly higher in test group as compared to control group,suggesting a mild anemia. Conclusion : A positive relationship was observed between the haematological parameters and the severity of the chronic periodontal disease, suggesting that like other chronic conditions, periodontitis, may tend towards anemia.
Key Words :Anemia, Chronic Periodontitis, Erythrocyte Sedimentation Rate (ESR), Hemoglobin level (Hb),Red blood cells indices.
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6.ASSOCIATION BETWEEN DENTAL PROSTHESIS AND PERIODONTAL DISEASE IN A RURAL JAIPUR POPULATION.
Dr. Pulak Mishra 1, Dr. Swati Agarwal 2*,Dr. Shubham Jain ,Dr. Devaraj C.G. 4, Dr. Ashish Yadav 5, Dr. Swati Sharma
Abstract: Objective: The aim of this study was to describe the periodontal conditions and to analyze the association between the wearing of fixed or removable partial dentures and periodontal disease in a representative adult rural population in Jaipur. Materials and methods: Cross-sectional study of a representative sample comprising 200 individual aged 30-60 years. Data were collected by clinical examinations by the World Health Organization Basic Methods Criteria, which included the Community Periodontal Index and dental prosthesis exam. A descriptive analysis and the chi-square statistic were performed. Results: The wearing of dental prosthesis resulted in higher community Periodontal index. Conclusion: It was concluded that the wearing of dental prosthesis was detrimental to periodontal health in patients whose oral hygiene was less than adequate.
Keywords: periodontal diseases, dental prosthesis, oral health, periodontal index, epidemiology.
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7.ESTIMATION AND COMPARASION OF SERUM CORTISOL LEVEL AND ACADEMIC PSYCHOLOGICAL STRESS AND THEIR EFFECT ON CHRONIC PERIODONTITIS
Dr. Swati Agarwal 1*, Dr. Pulak Mishra2, Dr. Devraj C.G.3, Dr. Prathibha A. Nayak 4, Dr. Ashish Yadav 5, Dr. Swati Sharma 6
ABSTRACT:Objectives: Various risk factors are implicated in the pathogenesis of periodontal disease like uncontrolled diabetes, smoking, specific infections, age, and some Psychological conditions as psychosocial stress ,anxiety and depression. The aim of the present study was the association between psychological stress and chronic periodontitis. Materials and Methods: 60 patients were taken in this study and divided into two groups. Group I comprised of 30 chronic periodontitis subjects. Their stress level of patients was assessing using a social readjustment rating scale. Plaque index (PI), gingival index (GI), periodontal disease index (PDI) and serum cortisol level were also measured. Group II comprised of 30 stressed subjects and their clinical parameters PI, GI, PDI and cortisol level were recorded. Results: Chronic periodontitis showed a statistically significant correlation (P<0.05) was found between serum cortisol and clinical parameters. Conclusion: Stress may be a contributing factor in periodontal disease.
Keywords: Cortisol, periodontal disease, smoking and stress.
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8. ROLE OF WATER SOLUBLE CONTRAST RADIOLOGY IN SMALL INTESTINAL OBSTRUCTION
Dr Sanjay K.Gupta1*, Dr P.P. Sharma2
ABSTRACT:
Objectives: Evaluate the water soluble contrast radiography as diagnostic modality in small intestinal obstruction, where plain X-ray abdomen is inconclusive. Material and method: Study was conducted upon 20 patients admitted in the surgical department of Geetanjali Medical college and Hospital, with features of intestinal obstruction but no concrete evidence of the same and hence underwent contrast study with water soluble contrast agent. After admission a brief history, clinical assessment and plain abdominal radiograph were taken in the standing and supine position and in case of suspicion, there the water soluble contrast study was carried out. Results: Total 20 patients were taken for contrast study on the basis of X-ray findings. Out of these 6 Patients showed clear cut off in the contrast level in the small intestine and these Patients were taken fur surgery. Two patients in which findings were equivocal were also subjected to surgery and were found to have the intestinal obstruction. In twelve patients dye passed freely into large bowel, so these patients were managed conservatively. Out of these, 3 Patients didn't respond to conservative management and were subjected to surgery. Thus in 17 patients’ correct diagnosis could be made with the help of contrast studies. Conclusion: To Conclude water soluble contrast study is easy to perform, safe and gives useful information regarding presence or absence of complete obstruction and aids in the decision making regarding the mode management.
Keywords: water soluble contrast radiography, intestinal obstruction, plain X-ray abdomen
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9.CLINICAL PRESENTATIONS, FACTORS RELATED WITH COMPLICATIONS AND MORTALITY IN PEPTIC ULCER PERFORATION IN YOUNG ADULTS: A TERTIARY LEVEL HOSPITAL STUDY
Dr.Vineet Chaudhary1, Dr. Ravi Mathur 2
ABSTRACT:Objectives: Peptic ulcer perforation is the commonest perforation of the gastrointestinal tract affecting 2-10% population showing a shift from older to the younger population. With this statistics a study for Clinical presentations, complications and incidence of peptic ulcer perforation in young adults 18-30 years was carried out. Methods: Prospective study of patients admitted on emergency basis and diagnosed as peptic ulcer perforation either gastric or duodenal perforation intraoperatively in patients 18-30 years were studied from June 2010 to October 2012. Results: Of 270 patients, 96(35.5 %) patients were between 18 and 30 years age. 78 (81.2%) were males and 18 (18.7%) were females. Twenty (20.8 %) patients had history suggestive of acute peptic disease/ulcer and had taken some treatment in the form of antacid H -2 blocker or proton pump inhibitor while 76 (79.1%) patients had no history. Pain was the consistent symptom while tachycardia, tenderness, and guarding were the signs present in all 96 (35.5%) patients. Gas under diaphragm (pneumoperitoneum) was found in 89 (92.7%). Ultrasonography abdomen S/O pyoperitoneum was found that all 96(100%). 67 (69.7%) patients had an anterior duodenal perforation, 29 (30.2 %) patients had a gastric perforation with a ratio of 2.3:1, and 2 patient had a combined gastric and duodenal perforation. 2 (2.08%) patient expired in the post-operative period, 65 (67.7%) patients come for regular follow and 31 (32%) patients were lost to follow -up. Only 6 (6.25%) patients had mild to moderate symptoms of peptic ulcer disease which were controlled by anti-ulcer drugs. Conclusion: Peptic ulcer perforation is a disease more common in the young population with a male preponderance.
Keywords: Incidence, Young adults, Peptic ulcer perforation, Pneumoperitoneum.
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10.ASSESSMENT OF CLINICAL PROFILE OF PITYRIASIS ROSEA AT TERTIARY CARE CENTER
Dr. Jayesh Rashik Lal Shah
Abstract:
Background: Pityriasis rosea (PR) is common, self-limited papulo-squamous dermatosis of unknown origin, which mainly appears in adolescents and young adults (10-35 years). Slightly more common in females. It has a sudden onset, and in its typical presentation, the eruption is preceeded by a solitary patch termed “herald patch”, mainly located on the trunk. Material & Methods: The present prospective study was conducted at department of dermatology of our tertiary care hospital. It is a descriptive observational study. A total 79 patients suffering from PR who attended the outpatient department were included in the present study during the period from 2016 to 2017. Written consent was taken from patients who were included in the study. Results: In present study, majority were from 11-20 years age group 33 (41.8%) followed by 27.8% from 21-30 years age group. The mean age of study population was found to be 21.3±6.4 years. 11% gave history of acne vulgaris, 8% each had history of atopy and drugs. Commonly observed prodromal symptoms were URTI (25.3%) and fever (17.7%). Herald patch was seen on trunk in majority of patients i.e. 36 (61%) followed by 18.6% cases on upper extremity and on neck (8.5%). Conclusion: We concluded from the present study that pityriasis is common in 11-20 years age group with male predominance having URTI as common prodromal symptom and typical rash with trunk as predominant site of herald patch.
Keywords: Pityriasis rosea, Rash, Clinical profile.
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Dr. Suresh Kumar1, Dr. Tarun Ojha2, Dr. Amit Singhal*3, Dr. Pratibha Vyas4, Dr. Indu Goel5, Dr. Natwar Singh Rathore6, Dr.Meghal Chaudhary7.
ABSTRACT: Objectives: This study is planned to evaluate the efficiency and safety of Intratympanic (IT) injection of methylprednisolone (IT-MP) on idiopathic sudden sensorineural hearing loss (ISSHL) patients as an initial therapy, by weighing against the outcome with intravenously administered dexamethasone (IV-DEX) treatment. Materials and Methods: A prospective, nonrandomized, comparative study was conducted for 50 patients presenting with ISSHL. Twenty-five patients were managed with intratympanic methylprednisolone as a single and initial treatment, and 25 with intravenous dexamethasone. The hearing level was described using the Pure Tone Average (PTA in dB) hearing level at four frequencies (0.5, 1, 2 and 4 kHz). Hearing gain was expressed as absolute hearing gain and relative hearing gain. Complete hearing recovery was defined as the final PTA within 10 dB of baseline. Partial recovery was defined as a final PTA with a ≥ 50% relative recovery. Results: Mean hearing improvement was significantly higher in IT MP group than in IV DEX group (50.7±22.11, versus 29.5±28.0, p<0.01). We found a high rate of relative recovery of hearing in IV DEX group, which was because of significant hearing level of the unaffected ear. Similar percent of patients in both group had complete recovery, but in the IV DEX group 42% patients had no recovery (versus 10% in IT MP group).Conclusion: Intratympanic treatment of ISSHL may be a first choice , since it can be delivered in outpatient settings, with no serious side effects and low complication rate.
Key words: Intratympanic (IT) injection, sensorineural hearing loss, dexamethasone.
PDF FULL TEXT
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2. A STUDY ON PREVALANCE OF HYPOTHYROIDISM IN DIABETICS
Dr Asrar Ahmed1*
1.Assistant Professor ,Dept of Gen. Medicine, National Institute of Medical Sciences(NIMS),Jaipur
ABSTRACT
Objectives: Thyroid diseases and diabetes are two common endocrinopathies. The coexistence of diabetes mellitus with hypothyroidism is a known clinical observation. The association of these two diseases may lead to dyslipidaemia causing increased morbidity and mortality hence screening for hypothyroidism in diabetics may help in early detection and treatment to reduce this increased risk of morbidity and mortality. Material and methods: This study was designed to know the prevalence of hypothyroidism in diabetics at our institution, 100 known cases of diabetes attending outdoor of Nims Medical College Jaipur, were also screened for thyroid dysfunction by doing thyroid profile. Results: It was found that hypothyroidism was present in 13% patients of diabetes, which is a significant association. Conclusion: on the basis of observations of this study it is recommended to routinely screen patients of diabetes for presence of hypothyroidism to prevent long term morbidity and mortality.
Keywords: diabetes, hypothyroidism.
PDF FULL TEXT
_________________________________________________________________________________________________
3.EXPLORATION OF EARLY AUDITORY EFFECTS OF HYPERBILIRUBINEMIA IN NEONATES USING BERA
Dr. Amit Singhal1*, Dr. Tarun Ojha2, Dr. Suresh Kumar3, Dr. Pratibha VyasVyas4, Dr. Indu Goel5, Dr. Meghal Chaudhary6, Dr. Natwar Singh Rathore7
ABSTRACT:
Objectives: This study was planned to assess the hearing of infants with Hyperbilirubinemia using brainstem evoked response audiometry (BERA) and to find a possible co-relation between the level of hyperbilirubinemia & the degree of hearing loss. Methods: The present study is conducted on 100 neonates to compare the BERA findings on cases presenting with hyperbilirubinemia born and admitted to the NICU of Mahatma Gandhi Medical College & Hospital, Jaipur. 60 control neonates also taken for comparison who were born in MGMCH with no medical and surgical ailment. A detailed history was taken and relevant investigations were done to rule out any other causes of hearing loss. Patients with coexisting causes for hearing loss were excluded from the study. The cases were subject to phototherapy or double volume exchange transfusion. BERA was carried out on the babies atleast 2 months after discharge from the hospital. Results: The Mean values for hyperbilirubinemia group were found to be more than the control group. It was found that the mean for the absolute latency of wave V & the interwave latency of I-V for the 0-12 months age group with bilirubin levels less than 15mg/dL was statistically significant when compared to the group with bilirubin level more than 15mg/dL with a p value of 0.01 & 0.05 respectively. Conclusion: Hyperbilirubinemia does have an adverse effect on neonatal hearing which is reflected on the BERA parameters.
Key words: Hyperbilirubinemia, BERA, Phototherapy, Exchange transfusion.
PDF FULL TEXT
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4.RELATIONSHIP BETWEEN FOLIC ACID, ESR AND HAEMATOLOGICAL VARIABLES IN PATIENTS WITH CHRONIC PERIODONTAL DISEASE OF SMOKERS AND NON SMOKERS
Dr. Swati Agarwal 1*, Dr. Pulak Mishra 2, Dr. Devraj C.G. 3, Dr. Prathibha A. Nayak 4, Dr. Ashish Yadav 5, Dr. Swati Sharma 7
Abstract :Aim: Smoking is one of the important factors that can change the folic acid levels. The aim of the present study was to compare the serum folic acid levels, ESR and haematological variables in patients with chronic periodontal disease in relation to the patient’s smoking habits. Materials and methods: A total of 50 subjects in the age range of 25 to 65 years were included in the study with 25 subjects each in group A – patients of periodontitis and were smokers and group B - patients of periodontitis and were non-smokers. Clinical parameters like gingival index (GI),plaque index (PI), bleeding on probing (BOP), probing depth (PD) and clinical gingival attachment levels (CAL) were observed for all the patients. Folic acid,ESR and haematological variables were determined from peripheral blood samples. The results were statistically analysed. Results: Serum folic acid levels of non-smokers were significantly higher than that of smokers (p < 0.05). Plaque index , Probing Depth and Clinical Attachment Level means were significantly lower for Group B (Periodontitis and non-smokers) and higher for Group A (Periodontitis and smokers).ESR was higher whereas BOP was lower in smokers than non smokers (p < 0.05). Conclusion: This study suggests that among patients with chronic periodontal disease, the serum folic acid levels are lower in smokers as compared with non-smokers.
Key words: smoking; folic acid; nutrition; Periodontitis.
PDF FULL TEXT
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5.DETERMINATION OF ERYTHROCYTE PARAMETERS IN CHRONIC PERIODONTITIS PATIENTS
Dr. Pulak Mishra1 , Dr. Swati Agarwal 2*, Dr. Devraj C.G. 3, Dr. Prathibha A. Nayak 4, Dr. Ashish Yadav 5, Dr. Swati Sharma
Abstract:Objective: Limited research has been reported on the relationship between periodontal status and erythrocyte parameters. Anemia of chronic diseases is one of the most common forms of anemia. It occurs due to chronic infections, inflammatory conditions or neoplastic disorders which are not due to marrow deficiencies or other diseases. Periodontitis is one of the most prevelant chronic inflammatory diseases in humans. This study is aimed at finding the relation between erythrocyte parameters and chronic periodontitis. Materials and methods: A total of 50 patients will be selected for the study. The patients chosen for study will have at least 30% or more of the teeth having greater than or equal to 4 mm probing death. Clinical parameters like gingival index (GI), plaque index (PI),probing pocket depth (PD) and clinical attachment levels (CAL) were recorded for all the patients and haematological variables were determined from peripheral blood samples. The statistical analysis of the results will be determined. Results: The mean values of haemoglobin (Hb) and red blood cell indices were significantly lower, while the value of ESR was significantly higher in test group as compared to control group,suggesting a mild anemia. Conclusion : A positive relationship was observed between the haematological parameters and the severity of the chronic periodontal disease, suggesting that like other chronic conditions, periodontitis, may tend towards anemia.
Key Words :Anemia, Chronic Periodontitis, Erythrocyte Sedimentation Rate (ESR), Hemoglobin level (Hb),Red blood cells indices.
PDF FULL TEXT
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6.ASSOCIATION BETWEEN DENTAL PROSTHESIS AND PERIODONTAL DISEASE IN A RURAL JAIPUR POPULATION.
Dr. Pulak Mishra 1, Dr. Swati Agarwal 2*,Dr. Shubham Jain ,Dr. Devaraj C.G. 4, Dr. Ashish Yadav 5, Dr. Swati Sharma
Abstract: Objective: The aim of this study was to describe the periodontal conditions and to analyze the association between the wearing of fixed or removable partial dentures and periodontal disease in a representative adult rural population in Jaipur. Materials and methods: Cross-sectional study of a representative sample comprising 200 individual aged 30-60 years. Data were collected by clinical examinations by the World Health Organization Basic Methods Criteria, which included the Community Periodontal Index and dental prosthesis exam. A descriptive analysis and the chi-square statistic were performed. Results: The wearing of dental prosthesis resulted in higher community Periodontal index. Conclusion: It was concluded that the wearing of dental prosthesis was detrimental to periodontal health in patients whose oral hygiene was less than adequate.
Keywords: periodontal diseases, dental prosthesis, oral health, periodontal index, epidemiology.
PDF FULL TEXT
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7.ESTIMATION AND COMPARASION OF SERUM CORTISOL LEVEL AND ACADEMIC PSYCHOLOGICAL STRESS AND THEIR EFFECT ON CHRONIC PERIODONTITIS
Dr. Swati Agarwal 1*, Dr. Pulak Mishra2, Dr. Devraj C.G.3, Dr. Prathibha A. Nayak 4, Dr. Ashish Yadav 5, Dr. Swati Sharma 6
ABSTRACT:Objectives: Various risk factors are implicated in the pathogenesis of periodontal disease like uncontrolled diabetes, smoking, specific infections, age, and some Psychological conditions as psychosocial stress ,anxiety and depression. The aim of the present study was the association between psychological stress and chronic periodontitis. Materials and Methods: 60 patients were taken in this study and divided into two groups. Group I comprised of 30 chronic periodontitis subjects. Their stress level of patients was assessing using a social readjustment rating scale. Plaque index (PI), gingival index (GI), periodontal disease index (PDI) and serum cortisol level were also measured. Group II comprised of 30 stressed subjects and their clinical parameters PI, GI, PDI and cortisol level were recorded. Results: Chronic periodontitis showed a statistically significant correlation (P<0.05) was found between serum cortisol and clinical parameters. Conclusion: Stress may be a contributing factor in periodontal disease.
Keywords: Cortisol, periodontal disease, smoking and stress.
PDF FULL TEXT
_________________________________________________________________________________________________
8. ROLE OF WATER SOLUBLE CONTRAST RADIOLOGY IN SMALL INTESTINAL OBSTRUCTION
Dr Sanjay K.Gupta1*, Dr P.P. Sharma2
ABSTRACT:
Objectives: Evaluate the water soluble contrast radiography as diagnostic modality in small intestinal obstruction, where plain X-ray abdomen is inconclusive. Material and method: Study was conducted upon 20 patients admitted in the surgical department of Geetanjali Medical college and Hospital, with features of intestinal obstruction but no concrete evidence of the same and hence underwent contrast study with water soluble contrast agent. After admission a brief history, clinical assessment and plain abdominal radiograph were taken in the standing and supine position and in case of suspicion, there the water soluble contrast study was carried out. Results: Total 20 patients were taken for contrast study on the basis of X-ray findings. Out of these 6 Patients showed clear cut off in the contrast level in the small intestine and these Patients were taken fur surgery. Two patients in which findings were equivocal were also subjected to surgery and were found to have the intestinal obstruction. In twelve patients dye passed freely into large bowel, so these patients were managed conservatively. Out of these, 3 Patients didn't respond to conservative management and were subjected to surgery. Thus in 17 patients’ correct diagnosis could be made with the help of contrast studies. Conclusion: To Conclude water soluble contrast study is easy to perform, safe and gives useful information regarding presence or absence of complete obstruction and aids in the decision making regarding the mode management.
Keywords: water soluble contrast radiography, intestinal obstruction, plain X-ray abdomen
PDF FULL TEXT
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9.CLINICAL PRESENTATIONS, FACTORS RELATED WITH COMPLICATIONS AND MORTALITY IN PEPTIC ULCER PERFORATION IN YOUNG ADULTS: A TERTIARY LEVEL HOSPITAL STUDY
Dr.Vineet Chaudhary1, Dr. Ravi Mathur 2
ABSTRACT:Objectives: Peptic ulcer perforation is the commonest perforation of the gastrointestinal tract affecting 2-10% population showing a shift from older to the younger population. With this statistics a study for Clinical presentations, complications and incidence of peptic ulcer perforation in young adults 18-30 years was carried out. Methods: Prospective study of patients admitted on emergency basis and diagnosed as peptic ulcer perforation either gastric or duodenal perforation intraoperatively in patients 18-30 years were studied from June 2010 to October 2012. Results: Of 270 patients, 96(35.5 %) patients were between 18 and 30 years age. 78 (81.2%) were males and 18 (18.7%) were females. Twenty (20.8 %) patients had history suggestive of acute peptic disease/ulcer and had taken some treatment in the form of antacid H -2 blocker or proton pump inhibitor while 76 (79.1%) patients had no history. Pain was the consistent symptom while tachycardia, tenderness, and guarding were the signs present in all 96 (35.5%) patients. Gas under diaphragm (pneumoperitoneum) was found in 89 (92.7%). Ultrasonography abdomen S/O pyoperitoneum was found that all 96(100%). 67 (69.7%) patients had an anterior duodenal perforation, 29 (30.2 %) patients had a gastric perforation with a ratio of 2.3:1, and 2 patient had a combined gastric and duodenal perforation. 2 (2.08%) patient expired in the post-operative period, 65 (67.7%) patients come for regular follow and 31 (32%) patients were lost to follow -up. Only 6 (6.25%) patients had mild to moderate symptoms of peptic ulcer disease which were controlled by anti-ulcer drugs. Conclusion: Peptic ulcer perforation is a disease more common in the young population with a male preponderance.
Keywords: Incidence, Young adults, Peptic ulcer perforation, Pneumoperitoneum.
PDF FULL TEXT
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10.ASSESSMENT OF CLINICAL PROFILE OF PITYRIASIS ROSEA AT TERTIARY CARE CENTER
Dr. Jayesh Rashik Lal Shah
Abstract:
Background: Pityriasis rosea (PR) is common, self-limited papulo-squamous dermatosis of unknown origin, which mainly appears in adolescents and young adults (10-35 years). Slightly more common in females. It has a sudden onset, and in its typical presentation, the eruption is preceeded by a solitary patch termed “herald patch”, mainly located on the trunk. Material & Methods: The present prospective study was conducted at department of dermatology of our tertiary care hospital. It is a descriptive observational study. A total 79 patients suffering from PR who attended the outpatient department were included in the present study during the period from 2016 to 2017. Written consent was taken from patients who were included in the study. Results: In present study, majority were from 11-20 years age group 33 (41.8%) followed by 27.8% from 21-30 years age group. The mean age of study population was found to be 21.3±6.4 years. 11% gave history of acne vulgaris, 8% each had history of atopy and drugs. Commonly observed prodromal symptoms were URTI (25.3%) and fever (17.7%). Herald patch was seen on trunk in majority of patients i.e. 36 (61%) followed by 18.6% cases on upper extremity and on neck (8.5%). Conclusion: We concluded from the present study that pityriasis is common in 11-20 years age group with male predominance having URTI as common prodromal symptom and typical rash with trunk as predominant site of herald patch.
Keywords: Pityriasis rosea, Rash, Clinical profile.
PDF FULL TEXT
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