Sumathi Publications (E-Journals)
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PREVALENCE AND RISK FACTORS OF INCISIONAL HERNIA: AN OBSERVATIONAL STUDY
Get PDFInfection at the surgical site, which leads to the development of excessive tension causing inadequate healing is the most common cause of incisional hernia. Objective: To find out risk factors associated with incisional hernia and its prevalence. Method: A general proforma was prepared for studying each case in detail and underwent routine blood, radiology investigations. A detailed enquiry was made regarding the demographic profile, history of previous operations, its nature and postoperative period. Onset and progress of the hernia were noted. Result: During the study period total operated cases were 921. From that 50 cases of incisional were reported during the follow-up. Out of fifty cases 12 (24%) were male, and 38 (76%) were female. Ratio of male to female is 1:3.2. The difference was found to be significantly significant (p<0.05). Maximum cases were distributed between the age group of 41-50 (32%). Overall highest prevalence of incisional hernia was noted with perforation peritonitis operation, and female it was noted with LSCS operation commonest incision was midline (76 %) which lead to incisional hernia. Conclusion: The prevalence rate of incisional hernia was 5.42%. Overall highest prevalence of incisional hernia was noted with perforation peritonitis operation, and female it was noted with LSCS operation. 76% cases of incisional hernia associated with midline incision
ETIOLOGICAL FACTORS, CLINICAL PRESENTATIONS AND TREATMENT OUTCOME OF CERVICAL LYMPHADENOPATHY: AN OBSERVATIONAL DESCRIPTIVE STUDY
Get PDFAim: To study various etiological factors, clinical presentations of cervical lymphadenopathy. To study the management and outcome of cervical lymphadenopathy Method: Proper clinical history was first noted, local and systemic examination was performed and a clinical diagnosis was made. Gender wise distribution, presenting symptoms, site distribution, and treatment outcome were noted. Result: Gender wise distribution of male and female was 52%, and 48%, commonest site of primary in cases of metastatic Secondaries was tongue followed by oesophagus and thyroid. After proper diagnosis confirmed by Histopathology (biopsy), treatment constituted properly- Cases of Tubercular Lymphadenitis (49 cases) were Started on Anti-tubercular treatment, all were showed improvement in symptoms. Cases of Reactive lymphadenitis (26 cases) started on antibiotics, all recovered well. Among 14 Cases of Metastatic secondaries, 5 cases were given Chemotherapy/Radiotherapy after expert oncologist opinion out of which 3 showed improved symptoms and 2 were expired, 6 cases were operated out of which 5 showed improved symptoms and 1 expired post operatively, 3 cases were referred to specialized oncological and oncosurgical center for further management. All 6 Lymphoma cases were started on chemotherapy after expert oncologist opinion showed improvement in symptoms. Conclusion: Commonest site of primary in cases of metastatic Secondaries was tongue followed by oesophagus and thyroid. Anti-tubercular treatment for tubercular lymphadenitis was highly satisfactory with improvement in almost all patients. Surgery was restricted as an adjuvant to chemotherapy, as diagnostic biopsy, for treatment of abscess/sinuses and for a lymph nodes that do not resolve with chemotherapy. Non-tuberculous non-neoplastic lesions can be best managed by conservatively.
Keywords: Cervical lymphadenopathy; Clinical presentations; Treatment outcome
ASSESSMENT OF SERUM PARAOXONASE-1 ENZYME ACTIVITY, MALONDIALDEHYDE AND VITAMIN-C IN ORAL PREMALIGNANCIES
Get PDFBackground: Oral premalignancies are a group of disease or syndromes which if left untreated can lead to cancer. It carries a great significance in Indian perspective. The actual figure of oral cancers arising from oral premalignancies is not known and to predict accurately the malignant transformations of them is still not possible. Oxidative stress is a known player behind cancerogenesis. Recently decreased Paraoxonase-1 activity and increased oxidative stress markers ware found to be associated with Oral Squamous Cell Carcinoma. So, there is a strong possibility of a similar finding in Oral Premalignancies too. Aim: This study aims to investigate the correlation between serum PON-1 activity and oxidative stress markers (MDA & Vitamin C) in patients with Oral Premalignancies. Material and Methods: A total of 62 patients with clinically diagnosed oral premalignant lesions and diseased controls were chosen for the study. Venous blood samples were collected and PON-1, MDA (in serum) & Vitamin c (in plasma) were analysed spectro-photometrically. Results: significant decreased serum PON-1 activity (P<0.05) and concomitant significantly increased serum MDA (P <0.05) and decreased Vitamin C levels (P<0.05) were observed in premalignancies compared to the controls. These finding were more pronounced in Oral Leukoplakia (OL) than in Oral Submucous Fibrosis (OSMF) with a significant difference. Mean levels of the analysed parameters differed accordingly in the clinical grades of oral premalignancies. Conclusion: It can be envisaged that serum PON-1 activity and increased oxidative stress might be a contributing factor behind pathogenesis and progression of Oral Premalignant Diseases
IDENTIFICATION OF MEGALOBLASTIC ANEMIA CELLS THROUGH THE USE OF IMAGE PROCESSING TECHNIQUES
Get PDFObjective: Our aim is to show the possibility of using different image processing techniques for blood smear analysis. Also our aim is to determine the sequence of image processing techniques to identify megaloblastic anemia cells. Methods: We consider blood smear image. We use a variety of image processing techniques to identify megaloblastic anemia cells. Among these methods, we distinguish the modification of the color space and the use of wavelets. Results: We developed a sequence of image processing techniques for blood smear image analysis and megaloblastic anemia cells identification. As a characteristic feature for megaloblastic anemia cells identification, we consider neutrophil image structure. We also use the morphological methods of image analysis in order to reveal the nuclear lobes in neutrophil structure. Conclusion: We can identify the megaloblastic anemia cells. To do this, we use the following sequence of blood smear image processing: color image modification, change of the image contrast, use of wavelets and morphological analysis of the cell structure
COMPARATIVE STUDY OF LITHOTRIPSY AND MINIPERC IN 11 TO 18 MM IMPACTED PUJ CALCULI
Get PDFBackground: Impacted PUJ calculi are well known entity. Nephrolithiasis is a common disorder that accounts for significant cost, morbidity, and loss of work. Over last 3 decades considerable advances have been made in the management of kidney stone disease, still there is no single universally accepted and uniformly effective modality of treatment in medium size of impacted PUJ calculi. Aim: To study the efficacy of lithotripsy and MINIPERC in 11mm to 18mm impacted PUJ calculi. Methodology: The patients with impacted PUJ calculi of size 11 to 18mm of both sexes of all age group varying form 18-60 years, on consecutive sampling method total 84 patients were included. All patients underwent basic lab investigations, USG, IVU and investigations for fitness purpose. Group 1: All procedures were tubeless. We used 15 Fr Richard Wolf nephroscope for the procedure. 16 to 20 Fr Amplatz sheath was used depending upon situation. Fragmentation was performed using pneumatic lithoclast or holmium Laser depending upon stone size and characteristics. Group 2: Underwent DJ stenting under subarachnoid block or short GA depending upon situation. On the next day they were subjected for lithotripsy on Dorniel alpha machine under USG guidance, 3000 shocks were given in each sitting. One to three such sittings were given. Post operatively ultrasonography and X-ray KUB was done in all the patients and stents were removed after assuring complete clearance. Patients with absence of stone or presence of stone less than 4 mm on USG or x-ray KUB were declared as completely cleared. Results: Average hospital stay was 48 hours in miniperc group and it was 30 hours in DJ with ESWL group. Clearance rate was 100 % in Miniperc group and it was 85.71 % in DJ with ESWL group. Five patients (11.9%) in DJ lithotripsy group required another procedure. (Two needed miniperc and three needed URS). Two(4.76 %) patients in miniperc group had fever in post op period but nobody suffered major sepsis. Conclusion: Miniperc fulfils many criteria if we see results and complications. Although bigger sized multicentric study and long term follow up is needed
ROLE OF METFORMIN ON CLOZAPINE INDUCED DYSLIPIDAEMIA IN WISTAR RATS
Get PDFBackground: The clinical research in past decade has reported that most second-generation antipsychotics (SGAs) can cause serious metabolic derangement, which substantially increases the risk for type II diabetes mellitus. Several retrospective studies have shown increased in serum triglyceride in patients treated with Clozapine. SGAs induced metabolic syndrome is characterized by weight gain, hyperglycaemia, hypertension, hyperlipidaemia, glucose intolerance and insulin resistance. Metformin is currently used to treat metabolic syndrome and type II diabetes mellitus. It is therefore important to determine whether Metformin is efficacious in treating Clozapine-induced metabolic derangement like dyslipidaemia. Objectives: To evaluate the effect of Metformin in minimizing Clozapine induced metabolic derangement like dyslipidaemia. Methodology: Wistar rats weighing 180-240g either sex were divided into 3 groups of 6 rats each. Group 1 served as control, Group 2 Treated with Clozapine 25mg/kg body weight and Group 3 Treated with Clozapine 25mg + Metformin 100mg/kg body weight for 28 days P.O. Group 2 and group 3 were treated for 28 days. Biochemical investigations: Retro-orbital blood was collected for Lipid profile. Result: Lipid profile of group 2 rats treated with Clozapine showed dyslipidaemia (TG 103.3 ±1.7mg/dl, Tc 113.7 ±1.6mg/dl). Whereas group 3 rats treated with Clozapine 25mg + Metformin showed normal lipid levels (TG 94.7±1.7mg/dl, TC 102.8 ±0.8 mg/dl) comparable to group 1(TG 93.0 ±2.6mg/dl, TC 103.7 ±1.5mg/dl). Conclusion: This study exploring the use of Metformin to prevent metabolic derangement like dyslipidaemias in patients of schizophrenia treated with Clozapine.
KEYWORDS: Clozapine; Metformin; Dyslipidaemia
AN EVALUATION OF FIXED DOSE COMBINATIONS (FDCs) USED FOR TREATMENT OF DIABETES IN INDIAN MARKET
Get PDFObjective: To analyse the rationality of various FDCs used in the treatment Diabetes Mellitus and to find out the irrational FDCs existing in Indian market. Material and Methods: Study Design: Analytical study. Data on FDC\u27s available in the Indian market was collected from Current Index of Medical Specialities (CIMS) and Monthly Index of Medical Specialities (MIMS) and their rationality was analysed using a pretested tool based on FDCs listed in WHO essential list of medicines and National List of Essential Medicines (NLEM), others based on their pharmacodynamic activity, Pharmacokinetic parameters and significant drug interactions occurring due to API (Active pharmaceutical ingredients) contained within the product Result: A total of 18 combinations were analysed, among those 11 combinations were irrational. Conclusion: Predominantly irrational FDCs are being circulated in the Indian market hence through analyses by prescribers is needed before prescribing to patients in order to avoid ADR. This calls for a close scrutiny of marketed FDC\u27s and educating prescribers to use them with great care and caution also indicates a serious review of regulatory framework for drug manufacturing and marketing.
KEYWORDS: Fixed Dose Combinations; Antidiabetics; Irrational
VARIATIONS OF ORIGIN AND DISTANCE OF AXILLARY NERVE: A DESCRIPTIVE STUDY
Get PDFBackground: Axillary nerve, one of the terminal branches of posterior cord of brachial plexus is more prone for injuries. Lack of proper anatomical knowledge and variations of axillary nerve leads to risk of nerve injuries. The present study describes the origin of axillary nerve, its distance of origin from tip of coracoids process. Method: Thirty brachial plexuses from fifteen formalin fixed human cadavers of both the sexes were studied by dissection method. Origin and branching pattern of axillary nerve and its distance of origin from the anteromedial aspect of tip of coracoid process & posterolateral aspect of acromion process was recorded. Results: Out of the 30 specimens studied, axillary nerve was originating from the posterior cord of brachial plexus in 90% of specimens, remaining 10% specimens showed a common trunk of origin of axillary nerve from posterior cord of brachial plexus. The mean distance of origin of axillary nerve from the anteromedial aspect of tip of coracoid process and posterolateral aspect of acromion process is 3.98cm & 6.30cm respectively. The axillary nerve terminated into anterior and posterior branch within quadrangular space in 29 specimens. In one specimen articular branch for shoulder joint was not directly arising from axillary nerve instead it is arising from anterior branch of axillary nerve. Conclusion: In studied population Axillary nerves display variations in the origin and distance of origin. Knowledge of this variation in axillary nerve is very important to clinicians, anaesthetists and orthopaedic surgeons during surgical exploration of neck, axilla and upper arm, shoulder dislocation, infraclavicular brachial plexus block and fracture of surgical neck of humerus.
Keywords: Axillary nerve; Posterior cord; Coracoid process; Acromion process
ROAD TRAFFIC ACCIDENTS IN INDIA: AN OVERVIEW
Get PDFRoad traffic accidents claim over a million lives every year in the world. As per World Health Organization (WHO) it is one of the leading cause of death. India, being a rapidly developing country with expanding economy has its own issues as regarding road traffic accidents due to rapid proliferation of motorization. Road traffic accidents causes enormous morbidity and mortality and at the same time, the toll on the economy of the country as a result of it is quite heavy. Road traffic accident is a result of an interaction among different factors which include the environment, vehicle and the human being. Traditionally it is considered that road traffic accidents are accidents which are unpredictable, inevitable and not preventable. But road traffic accidents are indeed predictable and preventable in majority of the cases. This require the knowledge of factors contributing and leading to road traffic accidents. There are certain preventive measures which if adopted can lead to decrease in morbidity and mortality resulting from RTA. Hence, it is the responsibility of all to contribute in reducing road traffic accidents.
Keywords: Road traffic accidents; Road traffic injuries; Roads in India; Road safety; Vehicular registration
ASSESSMENT OF KNOWLEDGE AND AWARENESS ABOUT LEPROSY AMONG MEDICAL COLLEGE STUDENTS IN MEWAT REGION OF HARYANA
Get PDFIntroduction -Leprosy is a chronic infectious disease which still remains a serious public health problem due to its ability to cause disability. The prevention of leprosy ultimately lies in the early diagnosis and treatment of the individuals having leprosy. Changing leprosy scenario has led to requirement of leprosy education. However the knowledge of medical college students on leprosy remains unknown. Aim: To assess the post-sensitization knowledge and awareness of medical students after state leprosy sensitization program. Materials and methods: A questionnaire based, cross sectional study was conducted among 107 medical students of different years starting from 2nd year and onwards in the month of July 2017 after state leprosy sensitization program. Results: Among the medical students 70 (75%) were male students and 37(25%) were female students coming from different years of their admission in medical college .Regarding the basic knowledge of leprosy 100 % of 3nd year and final year students were having knowledge about the cause of leprosy and 100% of final year and 3rd year medical students know about other name of Leprosy (Hansen,s disease) respectively.100% of final year, 3rd year and 2nd year medical students had knowledge about multidrug therapy (MDT) in in-depth knowledge of leprosy respectively. Regarding the virulence of bacilli 87%, 60% and 63% of final, 3rd and 2nd year medical students had apt knowledge respectively. Conclusion-These observations suggest that the basic and in-depth knowledge of medical students about cause, types, prevention and treatment etc. of leprosy shows increasing trend owing to the part of their curriculum. However there is still a need to organize sensitization programs at regular intervals to impart basic and in-depth knowledge to new medical students, as well as to update the knowledge of those who already had such sensitization programs.Keywords: Awareness; Knowledge; Leprosy; Sensitization