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Cytogenetic Analysis of Down Syndrome
Get PDFObjective: Down syndrome is a common genetic disease, diagnosed with congenital malformation/mental retardation. Down syndrome occurs in all races & economic levels. It is caused by third copy of chromosome 21, there are there forms of DS. Simple Trisomy 21, Translocation Trisomy and Mosaic Trisomy. The aim of the study is to know cause of Down syndrome. Chromosomal analysis was carried out by G banding technique. Materials and Methods: 1 ml of peripheral blood samples were collected in Out Patient Department of pediatrics and Cytogenetic analysis was performed. Results: out of 28, 3 female cases, 2 male cases were Down syndrome, All the 5 cases were free trisomy 21, which is common type of Down syndrome; we have not identified Robertsonian translocation and mosaic type of DS. Conclusion: The present analysis shows that genetic risk factors are responsible for the incidence of Down syndrome
Effect of Various Concentrations of Lignocaine & Adrenaline Combination as Local Anesthetic on ECG Parameters of Patients Undergoing Dental Procedures
Get PDFBackground: Systemic absorption of local anesthetics occurs due to its local vasodilator effects. This leads to inhibitory action on the heart which is represented in the form of a decrease in conduction rate, the excitability of myocardium and force of contraction. The aim of the present study was to evaluate the effects of Lignocaine and adrenaline combinations on electrocardiogram undergoing dental procedures. Methods: This was a prospective, observational clinical study done in collaboration with the Department of Oral & Maxillofacial Surgery. All patients scheduled for oral surgeries under local anesthesia with Lignocaine 2% and adrenaline (1:80000 or 1:200000) combination of age 18 years or above 150 patients were included in the study. Patients with a history of hepatic, renal, cardiovascular and thyroid disorders were excluded from the study. A standard 12-lead ECG (25 mm/s) was recorded for each patient before administration of drugs (Basal), during the dental procedure (Intraoperative) and immediately after completion of surgical procedure. Results: There was no statistically significant difference seen between the Group A (Lignocaine 2% with 1:80000 adrenaline) and B (Lignocaine 2% with 1:200000 adrenaline) when the age, gender, PR interval, RR interval, mean QT & QTc dispersion, and heart rate were compared. Statistically significant difference was seen in comparing the mean QT & QTc interval, which was higher in Group A. ECG parameters in Group A and B showed a statistically significant decrease in PR interval, RR interval, QT interval, QTc interval, QT dispersion and QTc dispersion, with the basal, was compared with intraoperative and postoperative findings. The increase in heart rate although was statistically significant in both the groups, it was always within normal limits suggestive of no clinical significance. There was a statistically significant decrease in QT and QTc interval, QT and QTc dispersion. The change in all these parameters was within the physiologic range. All these relevant parameters for cardiac arrhythmias did not show any arrhythmogenic potential of lignocaine-adrenaline combination in both the groups. Both the combinations are comparable with each other in terms of ECG parameters with changes more with group A suggesting the effect of increased concentration of adrenaline. The change in the heart rate and ECG parameters in both the study group might be attributed to the presence of adrenaline in the combination. No cardiovascular morbidities were observed except palpitation. Conclusion: Thus it can be very well concluded that the effects of lignocaine-adrenaline combinations on electrocardiographic parameters are minimal and clinically irrelevant. Both the combination appears to be safe to use in healthy individuals.
Keywords: Adrenaline; Lignocaine; ECG parameters; Dental procedures
Number of Hours of Sleep with Changes in Blood Pressure Amongst Medical Students in Western Maharashtra
Get PDFIntroduction: Sleep has become one of the most ignored factors today. More sleep or less sleep does not matter it is just compensated the next day. Importance of regular and timely sleep amongst the students and their correlation with blood pressure is necessary to be found out so that the students can be made aware of and can be provided treatment to prevent further complications. Method: Demographic profile was noted it includes name, age, gender, professional year of MBBS and residence. History of sleeping was noted and other factors which influences sleeping pattern (i.e, alcohol, smoking, an association of dreams with sleep, midnight awakenings with sleep, caffeine intake before bed and average stress levels) through a well-structured questionnaire. Blood pressures of all eligible students were recorded 3 times in a week at the same time by the principal investigator with the same instrument according to the JNC 7 classification for hypertension. Results: Amongst all the medical students, 6% had systolic hypertension and 22.50% had diastolic hypertension. Comparing blood pressures according to sleeping patterns, amongst cases (less than 5 hours of sleep) 20.8% had systolic hypertension and 56.30% had diastolic hypertension. Whereas in controls (more than 5 hours of sleep) 1.40% had systolic hypertension and 11.90% had diastolic hypertension. Factors such as alcohol consumption, smoking, caffeine consumption before sleep, dreams, midnight awakenings and stress were found to be associated with sleeping patterns and the results were found to be extremely significant (p<0.0001) statistically. Conclusion: Sleep duration of less than 5 hours was noted in 24% of the total population. The subjects with lesser number of sleeping hours had increased levels of blood pressure and a higher prevalence of hypertension. The average systolic blood pressure in subjects with less than 5 hours of sleep (cases) showed 48.50% pre-hypertensives and 20.80% hypertensives whereas in case of average diastolic blood pressure 18.50% were prehypertensive and 56.30% were hypertensive.
Keywords: Blood pressures; Sleeping hours; Medical Students
Lessons learned from performance of students of Pharmacology in self coded surprise test with negative marking.
Get PDFIntroduction: The present study aims to find the effect of instruction of negative marking in a self-coded MCQ examination on the performance of students in the subject of Pharmacology with respect to the raw score, correct score and negative score.
Material and methods: This longitudinal study was conducted in the Department of Pharmacology, Rural Medical College, Loni. The Second MBBS students were exposed to a self-coded MCQ test twice by surprise. The first test (T1) was given without instructions of negative marking, while during the second test (T2) instructions for negative marking were given. The parameters of the raw score, negative score, corrected score and number of students who did not attempt respective MCQs were calculated. The number of students passing with modified Minimum Passing Level was calculated was compared with conventional Minimum Passing Level.
Results: Sixty-seven students participated in the study. There was a statistically significant decrease in the raw score in the T2, while the increase in the negative score when compared with T1. The number of non-attempted questions was increased in T2. There was a statistically significant difference in the number of students passed with respect to raw score in T1 and T2, while no such difference was seen with respect to Negative score and Corrected score.
Conclusion: The Corrected score and Negative score are not affected by the minimum passing level, indicating a better parameter of scoring than the raw score. Hence, the use of Negative score or Corrected score should be encouraged than the use of conventional Raw score.
Keywords: Minimum Passing Level, Negative Marking, MCQ, Corrected score, Pharmacology, Formative assessment, surprise test, self-coded test
Evaluating serum C-reactive protein level in patients with chronic obstructive pulmonary disease – A cross-sectional study
Get PDFAbstract
Patients with the chronic obstructive pulmonary disease have ongoing systemic inflammation, which can be assessed by measuring serum C- reactive protein.
Objective: To explore whether CRP could be used as an independent predictor of disease outcome in COPD.
Methods: A cross-sectional study was conducted among 50 COPD patients attending Respiratory Medicine outpatient services in the Regional Institute of Medical Sciences (RIMS), Imphal from January 2015 to September 2016. Patients aged 18-67 were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. Computerized Spirometer Helios 401 was the instrument used to measure lung volumes and capacities. BeneSpheraTM CRP Latex Slide test kit was used to estimate serum c-reactive protein.
Results and observation: The present study was conducted on fifty COPD patients in which serum CRP level showed positive correlation with COPD (p=0.002) but serum CRP level with spirometric parameters showed significant negative correlation;FEV1 (r=-0.451, p=0.001), FEV1/FVC (r=-0.617, p<0.001) and PEFR (r=-0.398, p=0.004).
Conclusion: In our study, we found an association between serum CRP level and severity of COPD and Plasma CRP may be used as a marker of prognosis in COPD as the small increase is associated with poorer prognosis in COPD.
Keywords: CRP; Chronic obstructive pulmonary disease (COPD); Imphal
Clinico-Microbiological Profile of Infective Keratitis in a Tertiary Care Hospital, Eastern India
Get PDFBackground: Infective Keratitis (Microbial Keratitis) is an infection of the cornea caused by a wide spectrum of microbial agents. Its main clinical presentation is a Corneal ulcer that is defined as a Loss of corneal epithelium with infiltration and suppuration of the underlying stroma. According to the World health organization (WHO), corneal diseases are among the major causes of vision loss and blindness in the world today, second only to cataract in overall importance. Aim: To isolate and identify the pathogenic organism Method: The study was conducted in 45 patients diagnosed with corneal ulcer attending Ophthalmology OPD, MKCG Medical College and Hospital, Berhampur over a period of 2 months. The material was scraped from the leading edge and base of the ulcer and was inoculated onto Blood agar, Mac Conkey agar and Sabouraud Dextrose agar for culture and onto 2 slides for Gram’s stain and 10% KOH wet mount. The antibiotic susceptibility testing was done by Kirby Bauer’s disc diffusion method. Results: Out of a total of 45 patients, 35were males. The majority of the patients belonged to the age group of 50-60 years. Pain, Redness, Hypopyon was most commonly seen in Bacterial keratitis. In Fungal Keratitis, Redness (80%), Blurred vision (80%) was seen. The most common occupation was Farmers (66.6%). Trauma was the most common risk factor (23 isolates). The majority were bacterial isolates (29 isolates, 64.4%) followed by fungal (5 isolates, 11.1%). The predominant isolate was Staphylococcus aureus (68.9%). Staphylococcus aureus showed 70% sensitivity to Moxifloxacin and 65% sensitivity to Gentamycin. Conclusion: Knowledge of the local prevalence of etiological agents of IK and their susceptibility patterns helps in guiding ophthalmologists to select appropriate antibiotic for empirical therapy
Public Health concern for a Nipah Virus disease
Get PDFNipah virus (NiV) is a pathogenic paramyxovirus that has been responsible for sporadic outbreaks of respiratory and encephalitic disease in tropical countries. Elevated case mortality rate has also been connected with recent outbreaks in India (Kerala), Malaysia and Bangladesh. The virus generally infects animals like pigs and bats, but they do not show any symptoms of NiV. The mortality rate in NiV infected humans is more as compared to other mammals. The patient usually shows no symptoms to headache fever, cough, dyspnea, confusion and more consequences lead to a coma. Although there are no drugs or vaccines available against this severe disease, precaution and awareness reduce the risk of NiV-infection. This review will be helpful to save the life of people and decrease death by the NiV-infection outbreak.
Keywords: Diagnosis, Henipavirus, Nipah virus, Prevention and treatmen
Evaluation of Effect of Melatonin on Hematological Parameters in Patients of Periodontitis
Get PDFIntroduction: Considering the immunity enhancing property of melatonin, a study on the evaluation of the effect of melatonin on the hematological parameters in patients suffering from Periodontitis. Methods: This study was conducted in the Department of Periodontics, Rural Dental College, Loni. Patients of chronic Periodontitis, of age between 18 to 65 years of either gender ready to give informed consent to participate in the study were included. Postoperative patients, patients having night duties, drivers and those using heavy machinery, pregnant women, lactating mothers, patients with any clinically significant systemic disease and patients on any other drugs were excluded from the study. Patients were divided into two Groups. Group B received scaling and root planning (SRP) and melatonin 3 mg per day were compared to Group A which received SRP only. The Total Leukocyte count, Differential Leukocyte count and Erythrocyte sedimentation rate of each patient was studied at a baseline, 1st (30 days) visit, 2nd (60 days) visit and 3rd (90 days) visit. Results: Both the groups consisted of 80 subjects each. Group A consisted of 71.25% male and 28.75% female patients. There were 56.25% male and 43.75% female patients in Group B. With respect to visit 3, the TLC was statistically lower in Group B. The neutrophil count of Group B was significantly lower during visit 3 as compared to Group A. The lymphocyte count of Group B was significantly lower than that of Group A during the visit 1, and also significantly higher during visit 3 on comparison with Group A. There was no statistically significant difference in the groups with respect to eosinophil and basophil count. The Monocyte count of Group B was statistically lower when compared to that of Group A. There was no statistically significant difference between ESR of Group A & Group B. Conclusions: It can be concluded that melatonin has a positive effect on TLC and differential count of patients of periodontitis, conferring a new facet to the management of periodontitis and an attempt to impede the disease progression.
Keywords: Melatonin; Hematological parameters; Periodontitis; Total Leukocyte count; Differential Leukocyte count; Erythrocyte sedimentation rate; Scaling and Root Planning
Effectiveness of Balance Exercise Program in Total Knee Arthroplasty: Meta-Analysis
Get PDFBackground: Balance is essential for maintaining postural stability while performing functional activities and for falls avoidance in patients with TKA. There are very few RCTs done to assess functional improvement after TKA. Hence, this study was undertaken to find out evidence on physiotherapy treatment in TKA and analyze it. Methods: We searched Medline, CINAHL, PEDro from the year 2001 to 2015 for RCT involving evaluations of physiotherapy exercise in adults with a knee replacement. Search criteria’s were pain, stiffness, adherence and attrition. The inclusion criteria were studies which included physiotherapy exercise for balance specific exercises which compared various functional training and functional training with balance exercise in TKA. Result: Searches identified 20 randomized trials related to TKA and physiotherapy. Only three were fulfilled the inclusion criteria. Functional training with balance exercises found to be effective in patients with total knee arthroplasty. Conclusion: After total knee replacement, interventions including physiotherapy along with balance exercises showed improvement in pain, stiffness and functional performance in mobility.
Keywords: Osteoarthritis; Balance; Total knee arthroplasty physiotherapy
Cutaneous Complications in Macrolide Prescribing in Pediatrics
Get PDFCutaneous adverse reactions are very common adverse effect of post antibiotic therapy. Cutaneous adverse reactions include skin lesions in the form of rashes urticaria, maculopapular rashes, eythema multiforme, stevens-johnson syndrome and toxic epidermal necrolysis. However macrolides, generally considered safer in this regard, are frequently used to treat both adult and childhood infections, with favorable outcomes. Cutaneous manifestations of this class of antibiotic are scarce. The present case series focuses on conglomeration of few cases of cutaneous reactions due to macrolide therapy in both children and adult population