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To Identify the Risk Factors Associated with Axillary Lymph Node Metastasis and to Determine the Accuracy of Sentinel Lymph Node Biopsy in Predicting Axillary Lymph Node Metastasis in Early Breast Cancer in a Tertiary Care Centre: A Cross Sectional Analytical study
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Development and Validation of a Pancreatic Injury Mortality Score at a Tertiary Care Centre in Chennai
No full textA Study Comparing Postoperative Hypocalcemia in Truncal Versus Branch Ligation of Inferior Thyroid Artery in Patients Undergoing Total Thyroidectomy
No full textA Comparative study on Port Site Infection following Gall Bladder Retrieval using Endobag and Conventional Method in Laparoscopic Cholecystectomy
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To Study the Incidence of Contrast Induced Nephropathy in Patients Undergoing Coronary Angiogram with Normal Renal Parameters in Chengalpattu Medical College Hospital
No full textBACKGROUND: CIN is the third most common cause of hospital related acute renal failure after decreased renal perfusion and post-operative acute renal failure. Contrast-induced nephropathy (CIN) is a well-recognized complication of radiological interventions, cardiac catheterization, or invasive procedures that require iodinated contrast administration, where there is a decrease in glomerular filtration rate (GFR) following the injection of these contrast media (CM). They might need short-term hemodialysis, which would lengthen their hospital stay and raise the possibility of chronic kidney damage.
AIM OF THE STUDY: To study the incidence of contrast induced nephropathy in patients undergoing coronary angiogram with normal renal function.
MATERIALS AND METHODS: After getting approval of institutional Ethical committee, 100 patients who had coronary angiogram in the Cardiology Department in the Government Chengalpattu Medical College who fulfilled the inclusion and exclusion criteria were studied. No emergency procedure was included in the study; all procedures were elective. Age, gender, smoking history, hypertension, diabetes mellitus, usage of ACE inhibitors, diuretics, Non-steroidal anti-inflammatory medicines, the amount of contrast material utilized, the patient's level of hydration, and hemoglobin were the information gathered from the patients and filled in the proforma. In the current study, Analysis was performed in SPSS 24 software. All continuous variables were presented as mean ±standard deviation if they were normally distributed.
RESULTS: Age, gender, smoking, diabetes, hypertension, dehydration use of ACE I and diuretics, use of NSAIDS are the variables that increase the chance of developing contrast-induced nephropathy. The significant risk factors in our study was age, anaemia and usage of diuretics. The yield of the result may be improved when the number of patients is large. Long-term patient monitoring is also necessary.
CONCLUSION: The incidence of CIN is 18% in our study. Age, gender, smoking, diabetes, hypertension, use of ACE I and diuretics, use of NSAIDS and dehydration are the variables that increase the chance of developing contrast-induced nephropathy. The significant risk factors in our study was age, anaemia and usage of diuretics
A Clinical study about Cerebral Venous Thrombosis in Tertiary Care Centre
No full textBACKGROUND:
Cerebral venous sinus thrombosis (CVT) has been recognized since the early part of the nineteenth century but still remains a diagnostic and therapeutic challenge for the clinician given the varying and often misleading clinical presentation of this condition. It forms a distinct
subgroup of cerebrovascular disease and is one of the commonest causes of stroke in India.
AIMS AND OBJECTIVES:
To analyse the commonest clinical modes of presentation and to find out the possible etiology.
MATERIALS AND METHODS:
Fifty (50) patients admitted to the Medical Emergency Ward, clinically suspected of CVT, during the period of 2021 to 2022 are subjected to neuro imaging techniques, fulfilling the study criteria are recruited by simple random sampling and data collected was analyzed by correlation studies. The data will be entered in Microsoft excel and will be analysed by using SPSS software. Appropriate tests of significance will be done.
RESULTS:
The age groups 21–30 years had 38/70 [54.3%] while the years 31–40 years had 22 [31.4%]. As a result, the majority of patients [23/70 or 57.5%] were between the ages of 21 and 40. In this study, the oldest patient was 60 years old. The youngest patient was a male 19 year-old, while the other was a 21-year female. Most of these may be non-specific like headache, seizures, focal neurological deficit, hemiparesis,
paraparesis, diminished vision, nausea, vomiting and even decreased the level of consciousness.
CONCLUSION:
It can be inferred from our research on cerebral venous thrombosis that MRI is helpful in assessing prognosis. The prognostic tools asseesed by diffusion weighted images are effective. Diffusion restriction is a bad prognostic sign. MRI features of deep T2 hyperintense lesions,
intraparenchymal hemorrhage, and straight sinus thrombosis are poor prognostic factors
A Study on Epidemiological Profile, Clinical, Immunological and Functional Status Outcome after Initiation of HAART in Adults with Newly Diagnosed HIV Infection in a Tertiary Care Hospital in Chengalpattu
No full textINTRODUCTION:
The Discovery of HIV in 1981 was a milestone in the history of AIDS. Later on, elaborate research and studies were conducted and the impacts of HIV on human immune system were revealed. One of the vastly studied materials is the destruction of CD4+ T Lymphocytes by HIV, a key factor in the pathogenesis of the disease. The CD4+ T helper cells play a major role in the body’s immune system. The CD4 cells are undoubtedly much reduced in number with advanced disease and this correlation of CD4 cells and AIDS progression have been studied elaborately by researchers. Nowadays the disease progression and emergence of opportunistic infections are predicted by CD4+ T helper cell counts. The CD4 cells help to recognize the foreign agents and with the help of other T cell lineages tend to contain the infection and eliminate the infective agents.
By destroying the CD4 cells, the HIV gain access to the body without any resistance if at all and cause a varied syndrome. Many of the studies have shown an inverse relationship with CD4 cells and viral load. The CD4 counts are the predictors of disease progression and to plan the necessary treatment even though there are other parameters available. The antiretroviral drugs by eliminating the virions tend to increase the CD4+ cells indirectly The present study aims at evaluating the treatment outcome to the highly active retroviral therapy (HAART) among the study population in terms of functional status, immunological and clinical profile.
OBJECTIVES:
1. To assess the immune response of HIV-positive adults initiated on HAART.
2. To assess the clinical response of HAART therapy.
3. To assess the functional status improvement after initiation of HAART therapy.
STUDY DESIGN: Retrospective non interventional observational study.
STUDY POPULATION: This study to be conducted at the ART Centre in Chengalpattu Medical College Hospital, Chengalpattu.
SAMPLE SIZE: 200.
STUDY DURATION: One year (November 2021 to October 2022).
INCLUSION CRITERIA:
The following criteria are used for selection of HIV infected patients,
1. The diagnosis of HIV confirmed as per WHO criteria.
2. Initiation of Treatment for HIV infected patients according to WHO criteria.
3. Patients should be more than 12 years of age, from Kanchipuram and Chengalpattu attending ART clinic in Chengalpattu Medical College, in the last one year.
EXCLUSION CRITERIA:
1. Patients less than 12 years of age.
2. The patients who have already received treatment with antiretroviral drugs outside.
3. Patients who died within 6 months after initiation of antiretroviral therapy.
4. Patients who lost to follow-up after initiation of anti-retroviral therapy.
5. Patients not willing to participate in the study.
MATERIAL AND METHODS:
The study to be conducted on 200 HIV infected adults who attend the ART Centre, in Chengalpattu Medical College Hospital for 1 year.
Various pre and post treatment investigation included the following
Total and Differential Count,
Hemoglobin,
Blood Urea,
Blood Sugar,
Serum creatinine,
Liver Functions tests,
X ray chest.
Sputum AFB, if necessary,
Body weight,
CD4 Count,
Viral load,
Clinical profile,
Immunological profile will be assessed after 6 months of initiation of HAART and assessed more frequently if patient develops any opportunistic infections during the course of treatment.
DATA ANALYSIS:
The data will be entered in Microsoft excel and will be analysed by using SPSS software version 21. Appropriate tests of significance will be done.
RESULTS AND CONCLUSION:
1. Majority of HIV Patients belonged to the economically productive age group of 20-40 years.
2. A High rate of Immunological response was observed after 6 months of HAART.
3. Initiation of HAART was associated with a favorable clinical response.
4. Improvement in functional status level was observed among the HIV patients after 6 months of HAART.
5. The Immunological and clinical response to HAART in HIV infected TB patients were similar to those of non – TB patients