South East Asia Journal of Medical Sciences
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Differential diagnosis of benign ovarian cysts using tumor markers in serum and cyst fluid
Get PDFBackground: Differentiating the type of benign ovarian cyst can result in better care.
Aims: To measure CA-125, CA 19-9, Carcinoembryonic Antigen (CEA) and Alpha-fetoprotein (AFP) in serum and cyst fluid of patients with benign ovarian cysts and whether these biomarkers can be used to identify the type of the cyst.
Methods and materials: Patients with benign ovarian cysts undergoing laparoscopic cystectomy were included. Cyst types were determined histologically. Levels of CA 125, CA 19-9, CEA and AFP were measured in serum and cyst fluid.
Results: 98 cysts (25 functional, 12 endometrioma, 15 dermoid, 28 mucinous cystadenoma, 18 serous cystadenoma) were evaluated. There was a significant difference in levels of CA 125 and CA 19-9 in serum and CA-125, CA 19-9 and CEA in cyst fluid. For diagnostic purposes, a value of ≥35 IU/mL for serum CA 125 predicted endometriomas with a sensitivity of 91.7% and a specificity of 91.9%. A value of ≤22.5 IU/mL for cyst fluid CA 19-9, predicted functional cysts with a of sensitivity of 92% and specificity of 95.2%. A value of ≥100 ng/mL for cyst fluid CEA, predicted mucinous cysts with a sensitivity of 96.4% and specificity of 96.7%.
Conclusion: Levels of CA-125, CA 19-9 and CEA in serum and cyst fluid of patients with benign ovarian cysts can be used as a diagnostic tool in patient evaluation with acceptable sensitivity and specificity. This finding can be used in conjunction with other methods such as ultrasound, especially in cases that are harder to diagnose.
Keywords: Ovarian cyst, tumor marker, CA 125, CA 19-9, CEA, AF
Evaluation of Changes in Maternal Blood Sugar and Renal Function Tests during Gestational Period
Get PDFBackground and Objectives
The direct effects of altered maternal glucose metabolism and renal impairment from early pregnancy onwards with complications on mother as well as fetal growth and the risks of adverse birth outcomes. It is crucial to understand the biochemical changes to appropriately interpret common laboratory tests for evaluating renal disease and hyperglycemia in women during pregnancy. Thus, the study was focused to estimate the variability in blood glucose and renal functions as well as its association with BMI during pregnancy in Southern Terai of Province No. 2, Nepal.
Materials and Methods
Fasting blood glucose was determined by enzymatic (GOD/POD) method, Serum Urea by Urease-Bertholet’s Method, Serum creatinine by Jaffe’s Reaction Method, and Uric acid by Uricase method. All the biochemical parameters were analyzed using semi-automatic biochemical analyzer (Humalyzer 3500). Statistical analysis of the collected data was carried out using SPSS version 20. The p-value < 0.05 was considered statistically significant.
Results
The mean with standard deviation for fasting blood glucose (94.01+30.88; 99.71+23.97; 104.77+21.37) urea (23.22+7.89; 18.22+8.98; 20.64+9.09), creatinine (0.68+0.24; 0.65+0.20; 0.58+0.28), uric acid level with (3.14+0.93, 3.74+0.95, 3.95+0.85) was depicted in 1st, 2nd and 3rd trimester of pregnancy. Glucose and BMI were positively correlated and highly significant (r=0.191; p<0.01). BMI with urea was negatively correlated and was found to be highly significant(r= -0.196; p<0.01). Also, there was a negative correlation between BMI and Creatinine and was found to be significant (r=-0.132; p<0.01). But, the association of uric acid was positively correlated and statistically insignificant.
Conclusion
Blood glucose and uric acid gradually start increasing trimester-wise with the advancement of the gestational period. But, the mean urea level was decreased in the 2nd trimester as compared to the 1st and 3rd trimester. Also, small variation for creatinine level was found in different trimesters of pregnancy.
The association of Glucose, uric acid, and BMI were positively correlated and statistically insignificant whereas Urea and BMI was negatively correlated and highly significant. Also, there was a negative correlation between BMI and Creatinine and was found to be significant.
Keywords: Blood Sugar, Creatinine, Pregnancy, Province 2, Terai, Ure
Emergence of Methicillin Resistant Staphylococcus aureus Strains in Mahajanga
Get PDFMethicillin-resistant Staphylococcus aureus (MRSA) becomes along decades one of the main organisms affecting the health cares area. Thus, the present study was conducted with aims of determining the resistance phenotype of the methicillin-resistant germ, to identify the type of sampling, and to locate hospital departments that are mostly exposed to risks. A retrospective, a descriptional study was conducted at the laboratory of the microbiology of the UHC Professeur Zafisaona Gabriel (PZaGa) for five years from January 2013 to December 2017. In whole, 97 samples with Staphylococcus aureus were included, and 47% (n=46) of which were resistant to methicillin. Patients aged from 28 to 38 years were severely hit by methicillin-resistant Staphylococcus aureus, which was 28,26% (n=13). No significant predominance was related to gender. The sex-ratio was of 1,08 (p>0.05). Hospitalized patients and those from outward care were respectively 59% and 41%. The Surgery Department and Reanimation Unit were mostly affected, with respectively 63% and 15%. Suppuration sampling was the most exposed, which was 30% (n=29) among which wounds from chronic suppurative sores and diabetic patients were common, respectively, with 11% and 10%. This study showed results with a high rate of MRSA. It represents half of the strains
Comparison of the Toxogen® rapid test with ELISA immunoenzymatic technique for toxoplasmosis serology in pregnant women
Get PDFThe aim of this study was to compare the technical performance of the Toxogen® rapid test against the ELISA technique for serological screening and/or serological monitoring of toxoplasmosis in pregnant women.
Methods and material: A prospective, descriptive and analytical study was conducted over a period of 7 months from January to July 2018. One hundred and eighty-two toxoplasmosis serologies were carried out on 144 pregnant women followed in two hospitals in Mahajanga and in a private laboratory in Antananarivo. Two serologies were performed for each case, the first by the rapid test Toxogen®, a latex agglutination test, and the second by the IgG-ELISA and IgM-ELISA technique.
Results: The Toxogen® rapid test had a sensitivity of 62.5%, a specificity of 97.1%, a Positive Predictive Value of 94.3%, a Negative Predictive Value of 76.7% compared to the IgG-ELISA technique. The correlation between the dilution titer by the Toxogen® rapid test and the optical density (OD) of anti-toxoplasmics IgG by the ELISA technique was very low (r² = 0.17, p <0.001). The crude prevalence of toxoplasmosis was 30,6% (n=44) by the Toxogen® rapid test and 46.5% (n=67) by the IgG-ELISA technique, the difference was significant (p <0.001). We had 2 cases (0.01%) positives by the IgM-ELISA which were not detected by the Toxogen® rapid test.
Conclusion: The Toxogen® rapid test cannot substitute the ELISA technique for the serological screening and/or serological monitoring of toxoplasmosis in pregnant women.
Keywords: ELISA; pregnant women; latex agglutination test; serology; toxoplasmosis
Detection of Metallo beta - lactamases among Enterobacteriaceae isolates at a tertiary care hospital, south India
Get PDFBackground:
The spread of carbapenem resistant bacteria has caused grave concern due to the limited choice in antibiotics for treating infections caused by them. The emergence of metallo beta-lactamse (MBL) producing gram negative bacilli poses a therapeutic challenge and is of serious concern for infection control in hospital environment.
Materials & Methods:
A total of 475 non repeat clinical isolates of family Enterobacteriaceae were included in the study. Resistance to imipenem was determined in isolates by disc diffusion & minimum inhibitory concentration (MIC) method. Imipenem resistant isolates were tested for MBL production by combined disc diffusion test and modified Hodge test.
Results:
Out of the 475 Enterobacteriaceae strains, 20 showed resistance to imipenem. MBL activity was detected in all 20 (4.2%) isolates by combined disc diffusion test, in 18 isolates by modified Hodge test. The MBL producing isolates included clinical strains of Klebsiella spp (45%), E. coli (40%), Citrobacter spp (15%). Majority of the MBL isolates were from Intensive care unit (65%), from patients with comorbid conditions and with invasive devices. MBL producing isolates showed high level of resistance to aminoglycosides and fluoroquinolones but all were susceptible to colistin.
Conclusion:
The need of the hour is to detect MBL producing isolates for better patient outcomes, to execute prompt infection control measures and decrease the escalation of resistance.
Keywords: Imipenem resistance, Phenotypic methods, Colistin sensitivit
Conventional radiograph V/S CT for evaluation of sagittal fracture of mandibular condyle: A Case report
Get PDFCondylar fractures of mandible are not very easy to diagnose radiographicaly. If fracture is vertical, it would be much more difficult to diagnose. Since treatment depends on type of fracture, CT scan is advised rather than conventional radiographs to diagnose condylar fractures.The cases reporting to the hospital during the period of July 2019 to April 2020 were enrolled, of which 2 cases have been reported here. It was observed that there are chances of missing the diagnosis of the condylar fracture if only the conventional radiographs are used. CT along with conventional radiographs should be considered for better treatment and management of the patients with maxillofacial injuries.
Keywords: Sagittal fracture; Mandibular condyle; Conventional radiographs; Axial & Coronal CT
Adverse skin reactions of personal protective equipment on health care workers against COVID -19
Get PDFThe coronavirus outbreak, which was first detected in China, has infected people in 185 countries. COVID-19 is a pneumonia-like disease caused by a new coronavirus, named SARS-CoV-2, that is similar to the virus that causes Severe Acute Respiratory Syndrome (SARS Coronavirus disease 2019 (COVID-19). To study the prevalence of adverse reactions of wearing PPE among healthcare workers in Karnataka India during the Covid -19 outbreak. Twenty-one-day observation were made on twenty laboratory health workers and observed hazardous skin effect on health workers wearing PPE long hours during working period. long hour wearing of PPE in our study found respiratory complications, sweating and skin damage. Adequate dermatological knowledge of PPE use and design and extensive comprehensive training is important in risk of pandemic outbreak.
Keywords: Corona Virus, Covid -19, Personal Protective Equipment, Transmissio
Awareness of oral health among undergraduate Medical Students of Vijayapura city: A cross-sectional survey
Get PDFBackground: Oral health is integral to general health. Certain systemic diseases can manifest in the oral cavity. Many times an oral examination may lead to the diagnosis of systemic illness. Primary health centers are approached by the majority of the population for their health problems including oral health problems. Hence, general practitioners should have adequate knowledge about oral health which helps in early diagnosis of systemic diseases. Awareness of oral health among general practitioners may help promote oral health among the population. Aim: The present study was aimed to assess oral health awareness among undergraduate medical students in Vijayapura city. Materials and Methods: It was a cross-sectional questionnaire survey. The questionnaire consisted of pre-tested, closed-ended 21 questions. All the undergraduate students of BLDE (DU) Shri B M Patil Medical college hospital and research center were included in the study. Questions were related to oral health problems and their relation with general health. The data collected were tabulated, analyzed, and subjected to statistical analysis using the Chi-square test. Results: 57.33% of the participating students had good oral health awareness, 24.43% were found to have fair and 18.24% were found to have poor awareness of oral health. Conclusions: Overall the undergraduate medical students had good oral health awareness. Awareness of oral health was better among the final year undergraduate students.
Keywords: Medical students, oral health, knowledge, practices, awareness
COVID-19 pandemic and changes in the plastic surgery activity in a tertiary care centre in pondicherry
Get PDFThe COVID-19 pandemic has changed the way plastic surgeons treat their patients. Lockdown was introduced and all elective surgeries were cancelled and only emergency procedures were done during the time of corona pandemic. Patients were followed up through telemedicine consultations using various mobile devices and web-based tools. Teaching programmes were also channelled through web-based tools in the form of webinars. Various measures were taken to uphold the norms of social distancing. Here we describe our experience regarding the way our department functioned at the time of corona pandemic.
KEYWORDS: COVID-19, Plastic Surger