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A Study on Morbidity, Functional Disability and Health Care Utilisation among the Elderly in a Rural Coimbatore
No full textThe Spectrum of Heart Disease in Pregnancy and Its Outcome in Patients Visiting a Tertiary Care Centre: A Prospective Observational study
No full textTotal 100 women were enrolled for the present study and maximum women were found in the age group of 26 to 30 years and 21 to 25 years each with 35 (35%).
• The obstetric score of all 100 women was carried out and it was observed that 65 (65%) women were multi-gravida whereas only 35 (35%) were reported to be primi.
• NYHA class, it was observed that maximum women were in class I category 52(52%), followed by class II 41 (41%) and minimum patients were reported in class III 3 (3%).
• The maximum patients were observed with Rheumatic heart disease 55 (55%), followed by congenital heart disease 26 (26%) and least subjects2 (2%) were observed with a complete heart attack.
• RHD lesion, it was found that maximum patients 21 (38.2%) were reported with MS/MR RHD lesion.
• CHD, 69 (69%) patients were observed with ASD, followed by pulmonary valve stenosis and Bicuspid Aortic Valve Disease each with 4 (15.4%) patients.
• In the present study 73 (73%) women were observed with normal vaginal delivery whereas 27 (17%) women were reported with caesarean delivery.
• Of all 100 subjects, 49 (49%) were observed with Outlet forceps delivery, followed by emergency delivery with 20 (20%) subjects and natural delivery in 18 (18%) participants.
• Maximum neonates 53 (53%) were observed in the range of 2.6 to 3 kg, followed by 2.1 to 2.5 kg in 40 (40%).
• A good foetal outcome was observed in 74 (74%) followed by birth asphyxia was observed in 9 (9%) patients and Preterm in 7 (7%) patients.
• 4(4%) neonates were observed with congenital heart disease.
• 76 (76%) subjects with safe delivery followed by accidentally diagnosed heart disease during pregnancy in 14 (14%) patients and PPCM recovered in 12 (12%) patients.
CONCLUSION:
Rheumatic heart disease is the predominant lesion followed by congenital heart disease. The incidence of RHD for years has continued to be higher, as most of the patients belonged to low socioeconomic class where poverty, poor nutrition, low level of sanitation and hygiene and inaccessibility to health services are common. In pregnancies complicated with cardiac disorders, maternal and perinatal mortality and morbidity depends on the type of disorder, the functional status of the patient and the complications associated with the pregnancy. Hence multidisciplinary approach has been done with the obstetricians, cardiologists, anaesthetist and neonatologists and early diagnosis, treatment and proper follow up is done and mortality has been reduced
Elucidating the Role of Heart Type Fatty Acid Binding Protein in Cardiovascular Diseases
No full textRole of Adiponectin as an Inflammatory Marker in the Assessment of Disease Activity in Rheumatoid Arthritis
No full textClinico-Radiological Profile and Outcome of the Patient with Pleural Pathology Undergone Pigtail Catheter in Thanjavur Medical College,Thanjavur
No full textThe Study of Efficacy of Rectus Sheath Block in Patient Undergoing Emergency Laparotomy Surgeries for Post Operative Analgesia
No full textClinical factors and urinary Vitamin D binding protein levels in predicting steroid resistance in Nephrotic syndrome
No full textEvaluating efficacy of early nasal CPAP in preterm babies with respiratory distress syndrome
No full textStudy of significance of nucleated RBC count in cord blood of babies born with meconium stained amniotic fluid
No full textA Study about Pre and Post Operative Evaluation of Apnea Hypopnea Index in Polysomnography in Adult Obstructive Sleep Apnea-Hypopnea Syndrome Patients
No full textINTRODUCTION:
Obstructive sleep apnoea (OSA) can be regarded as a condition characterized by repetitive upper airway obstruction leading to sleep fragmentation, cardiovascular stimulation and oxygen desaturation during sleep. These together lead to symptoms such as snoring, unrefreshing sleep, excessive daytime sleepiness (EDS) and the increased risk of cardiovascular disease, hypertension, insulin resistance and road traffic accidents. Any individual with time may oscillate within a spectrum of sleep disordered breathing, from intermittent simple snoring, to chronic heavy snoring, to upper airway resistance syndrome (UARS), to mild OSA, to moderate OSA, to severe OSA or to obesity hypoventilation syndrome (OHS).
❖ OSA is characterized by complete breath-holds (apnoeas) and partial breath-holds (hypopnoeas) – With the present obesity epidemic, ear, nose and throat (ENT), hypertension, obesity, diabetes and sleep specialists are witnessing a large increase in the prevalence of OSA in their practice. The medical management of OSA, especially associated comorbidities, diagnosis and continuous positive airway pressure (CPAP), all relevant to the work environment of ENT specialists. Eventhough the OSA patients are classically treated with lifestyle modifications and medical management, poor compliance in these patients warranting surgical management.
❖ In our study after vigorous investigations in OSA patients, various surgeries has been done addressing the level of obstruction and improvement after surgery both in terms of subjective and objective results were analysed.
AIM AND OBJECTIVES:
1. To study about the pre and post operative apnea hypopnea index in polysomnography in adult obstructive apnea hypoapnea syndrome patients
2. To study the effectiveness of various surgeries for obstructive sleep apnea.
MATERIALS AND METHODS:
STUDY PLACE: Government Rajaji Hospital, Madurai – 625020. Department of Otorhinolaryngology.
STUDY DESIGN: Prospective study.
STUDY PERIOD: One year.
STUDY POPULATION:
All patients with snoring and OSA who reported to the
department of otorhinolaryngology of Madurai Medical College during the study period with the fulfillment of inclusion criteria.
INCLUSION CRITERIA:
1) Age > 18 years.
2) Both sexes (male and female).
3) BMI < 40.
4) Patient with excessive daytime sleepiness.
5) Wittnesed apnea snoring.
EXCLUSION CRITERIA:
1) Age below 18 yrs and above 55 yrs.
2) Hypothyroidism and other metabolic disorders.
3) BMI > 40.
4) Associated craniofacial abnormalities.
METHODOLOGY:
This is a prospective study conducted Department of
Otorhinolaryngology, Madurai Medical College from June 2020to December 2021. All patients who attend our op with the complaints of snoring, frequent awakening at night, excessive day time sleepiness, choking in sleep are further evaluated. All the patients underwent clinical examination followed by blood investigations especially thyroid function test and BMI evaluation. Then polysomnography level1is done.
CONCLUSION:
❖ Obstructive sleep apnea which is an entity of sleep disordered breathing leads on to various systemic consequences, if left untreated. Thus in the study conducted in our institution patients of OSA were clinically
evaluated and admitted in ward and perform pre op AHI in polysomnography. After identifying the site of obstruction, patients were channelized to different surgeries addressing velum, tonsil and uvula, turbinate, septum, sinuses. Significant proportion of patients improved both subjectively and objectively as determined by reduction in AHI from 37.42 to 12.72, reduction in ESS from 12.41+ 3.09 to 5.14±3.41 and reduction in snoring. Since the complications of surgeries were anticipated preoperatively and managed accordingly.
❖ Thus nasal pathologies were produce significant O2 desaturation and significant AHI so addressing the nasal pathology by surgery in selected single level obstruction patient it may improve nasal patency and help to improve nasal resistance.
❖ Level 2 obstruction produce more obstruction so effective with proper preoperative investigations, appropriate surgery, anticipation and management of complications was needed. Lifestyle modifications should be consider to achieve better results