ePrints@TNMGRM (Tamil Nadu Dr. M.G.R. Medical University)
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A Comparative study of Conventional Saline and Topical Heparin Saline Dressing in Lower Limb Diabetic Ulcers
No full textA Study of Effectiveness of Topical Insulin on the Healing of Diabetic Foot Ulcers in General Surgery Department at Kilpauk Medical College
No full textA Study on Etiology, Grading and Various Surgical Management of Fistula in Ano in a Tertiary Care Hospital
No full textA Comprehensive study on Various Surgical Presentations in Patients with Alcohol use Disorder
No full textProspective study on Various Decisive Factors for Non Operative Management of Blunt Trauma Abdomen with Solid Organ Injury
No full textA Clinical study on Effect of Platelet Rich Plasma on Wound Healing in Patients Undergoing Modified Radical Mastectomy
No full textBACKGROUND AND OBJECTIVES:
Breast cancer forms more than thirty three percent of all malignancy affecting women and for twenty percent of cancer related deaths in women. The standard of therapy for the majority of patients with invasive breast cancer is still complete breast excision along with axillary lymph node dissection. Seroma development might occur anywhere from 5% to 85% of the time. Seroma can increase morbidity, lengthen hospital stays, necessitate multiple aspirations, cause wound gaping and erythema, and delay chemotherapy and radiotherapy cycles, among other things.
To evaluate using platelet rich plasma in a prospective randomised controlled manner, the decrease in the incidence of seroma formation among patients subjected to modified
radical mastectomy.
METHOD:
A total of 90 Carcinoma Breast who underwent Modified Radical Mastectomy in the Institute of General Surgery, Madras Medical College, Chennai, were in included in this prospective study and randomised into two groups based on in-patient number. 45 patients with odd IP no in Group A received Platelet Rich Plasma injections and 45 patients with even IP no in Group B did not receive any topical treatment. Patients were evaluated for day 1 drain volume, total drain volume, drain removal day, seroma, and wound complications using REEDA score Vancouver Scar Scale.
RESULTS:
The mean seroma formation on post-operative day one was 141.11 ml in PRP group and 162.33 ml in control group and there is a statistically significant association between PRP
injection and seroma formation.
There was also statistically significant association between PRP injection and total seroma formation and day of drain removal. In our study wound healing was also observed using two parameters REEDA score and VSS.
CONCLUSION:
The most common complication following modified radical mastectomy is seroma formation and the present prospective study demonstrated that local injection of Platelet Rich
Plasma significantly decreased the seroma formation and favours wound healing
The Effect of Intradialytic Aerobic Exercise on Dialysis Efficacy in Hemodialysis Patients at Selected Hospitals
No full textDesign, Synthesis and Pharmacological Evaluation of Novel Acridine Derivatives as Multi-Target Mao and Cholinesterase Inhibitor
No full textPrevalence of Post-Intensive Care Syndrome in Critically-ill COVID Positive Patients
No full textINTRODUCTION:
Survivors of critical illness sustain many problems such as post-traumatic stress disorder, depression, anxiety, fatigue, weight loss, sleep disturbance, anxiety, depression because of which they have a poor quality of life, unemployment, and impaired social integration. The Society of Critical Care Medicine has termed these issues as post-intensive care syndrome (PICS).
Post-intensive care syndrome (PICS) is a new term which defines any “new or worsening impairments in physical, cognitive, or mental health status arising after critical illness and persisting beyond acute care hospitalization”.
OBJECTIVE:
To determine the prevalence of post-intensive care syndrome in critically ill COVID patients through assessment of impairment in three domains-
1. Cognition,
2. Mental health,
3. Physical function.
METHODS: This is a prospective cohort study wherein patients were assessed at 6 and 12 months since testing positive. Patients were contacted via telephone and telephonic consent was obtained. Patients were then assessed based on three domains – cognition, mental health and physical function using validated questionnaires – MoCA 5-min protocol for cognition, Hospital anxiety and depression scale for mental health and Barthel index for physical function. We also assessed for risk factors for occurrence of post-intensive care syndrome inclusive of demographic details, disease severity through the APACHE II score at admission, treatment data (duration of noninvasive and invasive ventilation, duration of hospital/ ICU stay, presence of organ dysfunction during ICU stay such as acute kidney injury requiring dialysis, and presence of hospital acquired infections such as Ventilator associated pneumonia, catheter-related blood stream infection and Urosepsis.
RESULTS:
In our study, we found that following a severe or critical COVID 19 infection, the prevalence of PICS was found to be 23.8% at 6-month follow-up and 57.3% in 12-month follow-up.
The prevalence in our study was 13.6% at 6 month follow up and 40% at 12 month follow up.
At the 6 month follow up, the risk factors identified to be statistically significant between the 2 groups were Age [OR] of 1.058, ( 95% CI 1.022-1.095, and p = 0.001), Charleson co-morbidity index ( [OR] of 1.532, 95% CI 1.165-2.015, and p = 0.002), Duration of hospital stay [ OR of 1.043, 95% CI 1.011–1.176, and p = 0.023), Need for tracheostomy during ICU stay [OR of 6.341, (95% CI 1.920-20.935) p= 0.003], Presence of ventilator associated pneumonia during hospital stay [OR of 2.750 95% CI 1.13-6.68) p= 0.022 ].
However, at 12-month follow-up, no statistically significant risk factors were identified in both the studies.
CONCLUSION:
Our study demonstrates the high prevalence of post-intensive care syndrome in COVID-19 patients and highlights the risk factors for the occurrence of the same.
Hence, it is evident that there is a major need for interventions that reduce the incidence of PICS and for follow-up of these patients after discharge to provide appropriate rehabilitation interventions through multi-disciplinary approach
Impact of COVID 19 Pandemic on Patients with Diabetes Mellitus followed up in the General Medicine OPD and in patients in a Tertiary Care Centre in South India
No full textINTRODUCTION:
The COVID pandemic has had an impact on the management of the ongoing treatment of various chronic diseases, Diabetes Mellitus being one of them. Insights from recent experience will help to guide future management during pandemics.
OBJECTIVES:
The primary objective of the study was to determine the effect of the COVID 19 pandemic on glycemic control among diabetic patients being followed up in the General medicine OPD and the factors affecting the same.
METHODS:
This cross-sectional study included diabetic patients who were on regular follow up under the general medicine department since January 2020 or earlier. The patients were recruited after informed consent and data collected by the principal investigator using the clinical research form. Data was entered into epidata and analysed using SPSS 20. The Paired sample t-test or Wilcoxon signed rank test was used to compare the HbA1c of diabetic patients before and during the pandemic. The Chi-square test was used to find the association between categorical variables. Univariate, followed by multivariate linear regression, was used to check for factors that predisposed to poor glycaemic control.
RESULTS:
There was no significant difference in HbA1c (7.22 ± 1.36% vs 7.41 ± 1.43%; p-value = 0.19) before and during the pandemic. The mean change in HbA1c was 0.198 ± 1.52 (CI -0.5 – 0.1) p-value 0.19. There was no statistically significant effect of the pandemic on the determinants of glycemic control and its determinants such as nutrition, physical activity, adherence to medications and regularity of follow-up. 16% of our patients were found to have macrovascular complications of diabetes, the most common being coronary artery disease. Dyslipidaemia had significant association with a poor glycemic control during the COVID pandemic (Odds ratio 6.93 (CI 1.91-25.2, p–value = 0.03).
CONCLUSION:
There was no demonstrable statistically significant effect of the COVID-19 pandemic on the glycaemic control among the diabetic patients in our study. Patients with dyslipidaemia were also found to have a poor glycaemic control during the pandemic