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COMPARATIVE STUDY OF PULMONARY FUNCTION TESTS WITH MICROVASCULAR COMPLICATIONS, RETINOPATHY AND NEPHROPATHY IN TYPE 2 DIABETES MELLITUS AND CORRELATION WITH DURATION OF DIABETES
Get PDFBackground: The major morbidity in type 2 diabetes mellitus is due to microangiopathic and macroangiopathic complications. Though lung has been widely acknowledged to be a target organ in diabetes mellitus, its correlation and severity of involvement to other microvascular complications has not been studied. Aim: To study pulmonary function tests in type 2 diabetes mellitus and evaluate association of PFTs with microvascular complications, retinopathy and nephropathy and further assess the relationship of retinopathy, nephropathy and lungs with duration of diabetes. Methods: A cross sectional study was carried out in 100 male type 2 diabetic patients attending diabetic clinic in tertiary hospital. 100 non- diabetic subjects were selected as control from general population. PFTs tests were performed. Results were interpreted by one way ANOVA test. Association of PFT parameters FVC, FEV1, FEV1% in type 2 diabetic patients with nephropathy and retinopathy was analysed by Pearson\u27s correlation coefficient. The patient population was subdivided according to the duration of diabetes into 2 groups; less than 10 years of illness and more than 10 years. Relationship of each microvascular complications, retinopathy, nephropathy and pulmonary function tests with duration of diabetes was assessed by one- way ANOVA test. Results: There was a significant decrease in PFT parameters as compared to non-diabetic controls. The PFTs in type 2 diabetic subjects with nephropathy showed decline in FVC, FEV1, FEV1%, however association of these parameters with GFR and microalbuminuria was not significant. Also, a similar decline of PFT parameters was observed with increasing grades of retinopathy, though not significant. There was a significant positive correlation of retinopathy with microalbuminuria and GFR (nephropathy) in type 2 diabetic subjects. Also, there was significant association of microalbuminuria, GFR and retinopathy with increase in duration of diabetes. On the contrary the decline in FVC, FEV1, FEV1% with duration of diabetes was not statistically significant. Conclusion: Type 2 diabetic patients with poor glycaemic control and longer duration of diabetes history had significant correlation with microvascular complications, nephropathy and retinopathy as compared to pulmonary complications (PFT parameters). It is highly suggestive that diabetic patients with retinopathy must be screened for nephropathy
MYASTHENIA GRAVIS, THYMOMA, AND THYMOMECTOMY: THE CLINICAL INTERPLAY.
Get PDFMyasthenia gravis is an autoimmune disorder that places patients in debilitating condition. It currently affects 14 to 20 per 100,000 population. Its pathogenesis involves the destruction of acetylcholine receptor by antibodies produced by lymphocytes in the thymus gland. Symptoms could vary from impair extraocular muscles to generalized weakness. The antibodies have also been reported to affect other muscle structure within the body such as cardiomyocytes, leading to arrhythmia episodes which could be fatal. This review is a student project and involves the assessment of myasthenia gravis and the interplay between thymoma and thymomectomy
Comparison of Racemic Bupivacaine and Levobupivacaine; combined with low dose Fentanyl, through Intrathecal Route for Transurethral Resection of Prostate
No full textBackground and Objectives: Bupivacaine is available as a racemic mixture of dextro and levobupivacaine. Many studies show that dextrobupivacaine has greater cardiovascular and central nervous system toxicity than levobupivacaine. The objectives of the present study were to compare the effects of racemic Bupivacaine + Fentanyl and Levobupivacaine + Fentanyl on the complete regression of motor block, onset time to reach T10 level sensory block, duration of T10 level sensory block, onset time of motor block, duration of sensory block.
Materials and Method: The study was conducted in 100 patients undergoing transurethral resection of prostate operation, who received either 1.75 ml Bupivacaine (0.5%) + 25µg Fentanyl (Gr A) or 1.75 ml Levobupivacaine (0.5%) + 25µg Fentanyl (Gr B) intrathecally.
Results: Time to complete regression of motor block, onset time toT10 level sensory block were significantly prolonged in Gr A compared to Gr B. The onset time of motor block was significantly shorter in Gr A compared to Gr B. There was no statistically significant difference between the two groups in respect to the duration of T10 level sensory block, duration of sensory block.
Conclusion: Intrathecal Levobupivacaine + Fentanyl used in the present study can be considered as a suitable alternative to Bupivacaine + Fentanyl for spinal anaesthesia in elective TURP surgery
INFLUENCE OF DIFFERENT BLEACHING SYSTEMS ON THE BOND STRENGTH OF LAMINATE VENEER TO ENAMEL
Get PDFPurpose: The objective of this in-vitro study was to examine the microtensile bond strength of a porcelain laminate veneer (PLV) to tooth surface bleached with photoactivation by blue light-emitting diode (LED) or diode laser. Methods: Eigthteen extracted human central incisors were randomly divided into three groups. Two sticks were obtained from each tooth (n=12). Before surface treatments; teeth were prepared to provide space for PLVs. The first group teeth were bleached with Whiteness HP which is contain 35% hydrogen peroxide (HP) and then photoactivated with a LED for 20 seconds. The second group were bleached with Laserwhite 20 which is contain 46% HP and photoactivated with a diode laser for 30 seconds. The third group received no surface treatment and served as the control group. IPS Esthetic ceramic veneers were luted with Variolink II veneer cement . The teeth were sectioned to obtain porcelain-resin-enamel/dentin sticks and submitted to a MTB testing device. The maximum load at fracture was recorded. Data were analyzed using one-way ANOVA followed by the Tukey HSD post-hoc test at a preset α of 0.05. Results: One-way ANOVA revealed that there was significant difference between LED unit group and control group (p<.05) but no statistical differences were observed with diode laser group (p>.05) The LED unit group presented significantly lower bond strength value (6.49±2.3 MPa) than diode laser (8.49 ±3.1 MPa) and control groups (9.53±2.7 MPa). Conclusion: The results suggested that bleaching therapy with activation by LED or diode laser reduced the bond strength of IPS Esthetic ceramic veneers to tooth surfaces.
Keywords: Teeth Bleaching; Photoactivation; Semiconductor lasers; Diode laser; Microtensile
CORRELATION OF PROLACTIN LEVELS WITH THYROID HORMONE LEVELS IN THYROID DISORDERS, INFERTILITY AND MENSTRUAL DISORDERS
Get PDFIntroduction: Prolactin and Thyroid hormones are regulated through an interrelated pathway. The increased level of TRH in hypothyroidism stimulates the release of prolactin. Prolactin and thyroid disorders are associated in a variety of conditions. Aims: To find if any correlation exists between Prolactin and Thyroid hormone levels in thyroid disorders. Methods: It was an observational, retrospective study. Serum levels of T3, T4, TSH and Prolactin were estimated by ELISA kits. The data was collected from registers and analyzed for correlation. Results: A significant proportion of hyperprolactinemia cases are Euthyroid. Hyperprolactinemia is associated with both hypothyroidism as well as hyperthyroidism. It is more prevalent in hypothyroid cases. Prolactin has a positive correlation with TSH in both hyperthyroidism and hypothyroidism. Conclusion: Prolactin has a positive correlation with TSH in both hyperthyroidism and hypothyroidism. Both prolactin and thyroid hormone levels should be estimated in cases of infertility, menstrual disturbances and thyroid disorders.
Keywords: Hyperprolactinemia; Hyperthyroidism; Hypothyroidism
PREVALENCE OF VULVOVAGINAL CANDIDIASIS IN SEXUALLY ACTIVE FEMALES WITH ANTIFUNGAL SUSCEPTIBILITY PATTERNS OF THE ISOLATES
Get PDFIntroduction: Vulvovaginal candidiasis (VVC) is the most common fungal infection of lower genital tract of females. It is an important cause of morbidity in young women due to its increasing incidence and is considered as an important public health problem worldwide. In recent years there has been a change in the trend of infections caused by non-albicans Candida species and anti-fungal susceptibility patterns. This study was carried out to assess the prevalence, potential risk factors and detect the antifungal susceptibilities of the isolates. Methods: A prospective study was conducted in a tertiary health centre of southern Odisha from January 2016 to December 2017and included 240 clinically diagnosed cases of VVC in the reproductive age group presenting with curdy white discharge with or without pruritus, burning, or dysuria. After getting an informed consent and brief history, vaginal swabs were collected and microscopic examination, culture and antifungal susceptibility were done. Results: Most common age group affected by VVC belonged to 26-35 years and majority of the cases were from rural areas. A total of 87 Candida species (36.3%) and, 4 Trichosporon asahii were isolated. Candida albicans was the most common isolate (52), followed by Candida glabrata. Most of the isolates were sensitive to clotrimazole (90.1%) followed by fluconazole (83.5%). Conclusion: The prevalence of VVC in our study was found to be 36.3%. Low socioeconomic status, low education, oral contraceptive pill users and Diabetes were the common predisposing factors. The most common agent causing VVC was Candidia albicans followed by Candida glabrata. Most of the yeasts isolated were sensitive to Clotrimazole followed by fluconazole.
Keywords: Candida; Vulvovaginal candidiasis; Antifungal susceptibility
ENDO-PERIO LESION: A CASE REPORT
Get PDFThe pulp and periodontium have embryonic, anatomic and functional interrelationships. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. This case report evaluates the efficacy of G-Bone graft in the management of vertical bone loss associated with an endo-perio lesion in a left mandibular first molar and second molar. A 40 year-old male patient with an endo-perio lesion in the left mandibular first and second molars was initially treated with endodontic therapy. Following the endodontic treatment, the defect was treated using G-Bone graft. At the end of 6 months, there was a gain in the clinical attachment level and reduction in probing depth. Radiographic evidence showed that there was a significant bony fill.
Keywords: Endo - perio lesion; Vertical bone loss; G - Bone graft
ELECTROMYOGRAPHIC ACTIVITY OF VARIOUS MUSCLES DURING SIT-TO-STAND IN PATIENTS WITH STROKE: A META-ANALYSIS
Get PDFAims: To provide a comprehensive information about analysis of activation of various muscles during Sit-to-Stand in patients with stroke. To determine if there exists any common pattern of muscle activation. To give direction to future studies regarding the muscles to be investigated during Sit-to-Stand. Methods: literature search was performed with help of the most commonly used database i.e. PubMed to select the studies related to electromyographic activities of various lower extremity, trunk and upper extremity muscles during Sit-to-Stand activity, published till 2016. The Inclusion criteria for the study were Prospective or retrospective cohort studies, studies that included only participants with stroke leading to hemiparesis and/or along with healthy participants as control group and studies that measured the EMG activity in either trunk muscles and/or limb muscles during sit to stand. The exclusion criteria were if their population of interest also included patients with other neurological conditions and studies in any language other than English. Two independent investigators assessed the studies based on inclusion and exclusion criteria. Â Keywords used during the search were Electromyography, Stroke, Sit-to-Stand. The studies were thoroughly evaluated with respect to the Sit-to-Stand procedure and variety of muscles that were investigated through EMG analysis. Results: With the help of given keywords, abstracts/articles of 21 studies were retrieved from the database. After initial screening of the abstracts 12 studies were selected for in depth analysis. Various lower extremity muscles including Tibialis Anterior, Soleus, Quadriceps, Vastusmedialis, Gluteus Maximus were investigated in the studies. In 2 studies, Trunk muscles were investigated whereas in one study Triceps muscle activity was analyzed during Sit-to Stand activity in patients with stroke. Conclusion: From this study it can be concluded that the activity of Tibialis Anterior muscle was investigated more frequently by various researchers followed by the activity of Soleus and Quadriceps muscle
PELVIC INFLAMMATORY DISEASE (PID): A CROSS SECTIONAL PROSPECTIVE STUDY AT A TERTIARY CARE CENTRE
Get PDFIntroduction : Pelvic inflammatory disease (PID) is an infection of the upper part of the female reproductive system namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. Objective: to find out the clinical profile of PID in a tertiary care centre. Methods: This was a cross sectional, descriptive study conducted at the Department of Obstetrics and Gynaecology, during period from January to December2016. Total 200 patients complaining of lower abdominal pain, vaginal discharge & having adnexal as well as cervical motion tenderness on bimanual examination between the age group of 18 -45 years were randomly selected for study. Parameters like age, parity, socio-economic status, age of marriage, sexual behavior, Presenting complaints and use of contraceptive were recorded. Results: Most common age group was 20-24 years (29.5%). Maximum number of cases was seen in parity between 2-5 (58%). PID was commonest amongst illiterate women (36%). Maximum number of cases was seen in women from lower socioeconomic class (74%). Out of 200 cases, 79% patients were married, 14% were remarried. Presenting complaints were pain in abdomen (93.5%), per vaginal discharge (66%), fever (51%). Abdominal tenderness was seen in 95% of cases. Palpable mass was present in 11% of cases. Forniceal & cervical motion tenderness were the commonest Per Vaginal examination findings seen in 89% & 84% cases respectively. Conclusion: Incidence of PID was higher in age group between 20-29 years, multipara, women from lower socioeconomic class & illiterate women. Pain in lower abdomen, per vaginal discharge & fever were the commonest complaints. Most of the patients on examination had forniceal & cervical motion tenderness
ANTIBIOTIC USE IN PEDIATRIC INFECTIONS; A STUDY IN TERTIARY CARE HOSPITAL
Get PDFObjectives: Antibiotics are frequently used in tertiary care hospitals. We conducted an observational study on children admitted to a teaching hospital in south India, to make a profile of antibiotics use and suspected adverse drug reactions (ADRs) owing to them. Methods: Hospitalized children of either sex, aged between 1 month and 12 years, were inspected. Baseline demographic and clinical features, duration of hospital stay, antibiotics received in hospital along with dosing and indications and interest of suspected ADRs attributable to their use were recorded. Every patient was followed up till discharge, admission to the Pediatric Intensive Care Unit, or passing. Results: Over the year and a half report period 364 confirmations were screened. The prevalence of Antibiotics use was 80.22%. The majority of the 292 children who received Antibiotics were males (63.35%). Median age was 35 months, five children died. In most instances, either two (41%) or a single antibiotic (37.32%) was used. Ceftriaxone, co-amoxiclav, amikacin, vancomycin, and ampicillin were predominantly used. Antimalarials, antivirals and antiprotozoals were used occasionally. Average number of Antibiotics per patient was 2.2 ± 1.1 the majority (81.15%) were by parenteral route and initial choice was usually empirical. Prescriptions were usually in generic name. The antibiotic treatment went somewhere in the range of 1 and 32 days, with a middle of 8 days. Five ADRs were noted of which half were skin rash and the rest loose stools. Conclusions: The profile of Antibiotic utilize is comprehensively like prior Indian investigations. Apparent overuse of multiple Antibiotics per prescription and the parenteral route requires exploration. Antibiotics are being used empirically in the absence of policy. ADRs to Antibiotics are occasional and usually mild. The benchmark information can serve in situation analysis for antibiotic prescribing guidelines.
Keywords: Antibiotic; Pediatric infections; Adverse drug reactions; Tertiary care hospital