Sumathi Publications (E-Journals)
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PLACENTAL MIGRATION AND ITS ROLE IN PREDICTION OF ROUTE OF DELIVERY
Get PDFIntroduction: The presence of a lowlying in the second trimester of pregnancy can be converted to an upper uterine segment placenta by the end of the third trimester. This phenomenon is important when a complete or marginal placenta previa is encountered in the second trimester of gestation because of the need to predict possible antepartum complications and mode of delivery. Aim: To examine the migration of placenta and the placental marginal sinus to predict the eventual route of delivery in low-lying placenta. Methodology: Women with a low-lying placenta with 30 weeks of gestation were included for study. The distance between the internal os and leading edge of the placenta was measured fortnightly using transvaginal ultrasonography until 36 weeks gestation. The relationship between the rate of placental migration, the presence of a placental marginal sinus and the eventual mode of delivery was investigated. Results: In the present study cesarean section rate was 60% (39/65) in the slow migration group (0 - 2.0 mm/week) group, six patients (6/35) in the fast (more than 2.0 mm/week) migration group underwent a cesarean section (p < 0.01) because of other problems. The cesarean section rate was 75.9% (22/29) in patients with a placental marginal sinus, significantly greater than the rate of 11.3% (8/71) in patients without a marginal sinus (p < 0.01). Conclusion: A decreased rate of placental migration until 36 weeks gestation and the presence of a placental marginal sinus were associated with subsequent cesarean delivery because of antepartum vaginal hemorrhage. These parameters may be useful for predicting the route of delivery in women with a lowlying placenta
STUDY OF LEVELS OF SERUM CREATINE PHOSPHOKINASE AND LIVER ENZYMES AS A PROGNOSTIC INDICATORS IN ACUTE ORGANOPHOSPHORUS POISONING
Get PDFBackground: Organophosphorus (OP) poisoning is one of the most common poisoning in rural and in developing country. Due to their easy availability and cost effective it is used frequently for homicidal and suicidal attempts. Routinely used biochemical markers like Erythrocyte cholinesterase (EChE) and Plasma cholinesterase (PChE) are used for the diagnosis of acute organophosphorus (OP) poisoning but estimation of these are very costly and not easily available. The mortality increases with increase in initial creatine phosphokinase level and can be used as alternative biomarker. Hence study was done to estimate levels of serum Creatine Phosphokinase (CPK) and liver enzymes in acute OP poisoning patients and its prognostic significance. Methodology: Patients (80) admitted in our hospital were included in this study. A brief history and detailed clinical examination was performed and patients were categorized on the basis Modified Dreisbach\u27s clinical criteria classification. Serum levels of Creatine kinase (CK) and Liver enzymes were analysed at the time of admission. The outcome of the patients were observed. Results: Out of 80 patients recruited for the study, 41 cases (51.3%) were females, and 39 cases (48.8%) were males. Majority of them were in the age group of 21-30 years. More cases of OP poisoning were among agriculturalists 28 (35%) and housewife 21 (28.8%) and among students 15 (18.8%). Malathion was the most common compound used followed by Monocrotphos. 60% had mild, 31.3% had moderate and 8.8% had severe poisoning. There is increase in Creatine Phosphokinase (CPK) levels in 6 patients who survived with ventilator support and also in 2 patients who died with ventilator support which was statistically highly significant (p<0.05). Serum liver enzymes were within normal limits. Conclusion: Elevated Creatine kinase is commonly seen in OPC poisoning. High initial serum Creatine Phosphokinase (CPK) levels are associated with severe degree of poisoning and are associated with complications and mortality. Serum liver enzymes (SGOT AND SGPT) are not elevated in OP poisoning
A RARE CASE OF SPACE OCCUPYING LESION OF BRAINSTEM IN AN ELDERLY MALE PATIENT
Get PDFAn elderly male patient aged 65 presented to us with history of swaying towards left side of the body since 1 month with normal higher mental functions and neurological examination suggestive of cerebellar ataxia. MRI Brain plus contrast was suggestive of an irregular, ill-defined heterogeneous enhancing lesion with few necrotic areas within and few foci of blooming on FFE (Fast Field Echo imaging technique) with significant perilesional oedema involving right thalamus and brainstem showing Choline peak on MR Spectroscopy.
Keywords: Neurological examination; Cerebellar ataxia; MRI brain; FFE
STUDY OF SERUM HOMOCYSTEINE LEVELS IN CEREBROVASCULAR ACCIDENT
Get PDFBackground: Stroke is the second most common cause of death and major cause of disability worldwide. Plasma homocysteine concentration is one of the emerging modifiable risk factor for stroke. The objective of this study was to evaluate the fasting homocysteine level in different type of stroke (Ischemia & Hemorrhage). MATERIAL & METHOD: The present study is case control study in which 90 patients with diagnosis of stroke (intracerebral infarct & hemorrhage) were enrolled and fasting serum homocysteine were measured in all and its comparison was done with matched healthy controls. Result: In study group the mean serum homocysteine level is 31.47±39.89µmol/L and in control group 16.62±22.08µmol/L, it indicates that serum homocysteine level is highly significantly raised (P value < 0.0001) in cases of stroke compared with control patients. However there is no significant difference in homocysteine level between intracerebral infarct and intracerebral hemorrhage (P= 0.5817). There is significant relationship of raised serum homocysteine level with hypertension & smoking. Conclusion: The present study revealed that hyperhomocysteinemia appears to be an important risk factor for cerebrovascular accidents. It is therefore important to use serum homocysteine level as an important tool to investigate all cases of cerebrovascular accidents and also in those who are at risk of developing stroke
FUNCTIONAL OUTCOME AND ASSOCIATED COMPLICATIONS OF INTERTROCHANTERIC FRACTURE TREATED WITH TROCHANTERIC FEMORAL NAIL: A PROSPECTIVE OBSERVATIONAL STUDY
Get PDFIntroduction: As age increases, fall becomes more often so as intertrochanteric fracture of femur. Because of early mobilization, The Trochanteric Femoral Nail (TFN) is found effective and suitable in Indian population as it is smaller in size than Proximal Femoral Nail (PFN). AIM: To clinically evaluate the functional outcome and associated complications of intertrochanteric fracture treated with trochanteric femoral nail. Methodology: Study was done in 30 patients with intertrochanteric fractures treated with trochanteric femoral nail. Patients were followed up at 6 wks, 3months, and 6 months. The intraoperative blood loss, duration of surgery, intra operative complications, post-operative complication, duration of hospital stay were studied. Functional outcome was assessed based on Kyle criteria. Results: In our series of 30 cases there were 22 male and 8 female, maximum age of 90 yrs and minimum age of 20 yrs, most of the patients were between 60 to 70 yrs. Mean age of 58 yrs. 63.3% of cases were admitted due to Domestic fall and 36.7% due to road traffic accidents with common predominance of both sides.AO Type 31A2 fracture accounted for 40 % of cases. Mean duration of hospital stay is 14 days and mean time of full weight bearing is 6 wks. Good to excellent results are seen in 81% cases, Fair in 16%, 3% case with poor results according to kyle\u27s criteria. Conclusion: Trochanteric femoral nail can be considered the most judicious and rational method of treating intertrochanteric fractures, especially the unstable and reverse oblique type
EVALUATION OF RENAL STONES BY COMPUTED TOMOGRAPHY AND ITS CORRELATION WITH URINE pH AND BIOCHEMICAL ANALYSIS
Get PDFIntroduction: The aim of the study is to assess the composition of renal stones by non chemical analysis that is by use of computed tomography (CT) values in Hounsfield Units (HU) and to compare the results of biochemical stone analysis collected post surgically done in biochemistry lab. Methodology: This is a prospective study, included patients in age group of 25 - 60yrs. Patients who were referred to radiology department from Urology and also patients referred from surgery with complaints of loin pain, groin pain, hematuria, crystalluria were recruited for the study. About 100 patients were screened with first line modality of ultrasound evaluation for identifying the presence of stone in kidney, later on positive confirmation from ultrasound evaluation they were further subjected to CT scan evaluation. Urine was collected from all the patients with renal stones and urine pH was measured. Stones collected post surgically were used for the biochemical analysis to know the chemical composition of the stones RESULTS: The stone removed from the patients of this group contain high calcium content. Most of the stones removed from bladder comprises two categories 1.uric acid (mainly) 2.large stones more than 20 mm size were proved to be calcium stones possibly related to greater sunlight exposure, resulting in increase in insensible fluid losses and increase in vitamin D production. We obtained a reference from hounsfield units value from stones collected post surgically from the urological department. The stones are categorized into three types - Pure highly reflective crystalline white stones, Stones which appears most mostly black, Complex mild yellow stones. Conclusion: CT may enable accurate in vivo characterization of kidney stone composition
PREVALENCE AND SEVERITY OF HAMSTRING TIGHTNESS AMONG COLLEGE STUDENT: A CROSS SECTIONAL STUDY
Get PDFBackground: Flexibility is important for normal biomechanical function. Muscle tightness is caused by a decrease in the ability of the muscle to deform. Hamstring tightness leads to high risk of recurrent injury, decreases the performance in athletes, lead to post-exercise soreness and decreases coordination among athletes. Hence, the objectives of this study was to find out the prevalence and severity of the hamstring tightness among college going student. Method: In this cross sectional study 50 participants with hamstring tightness were included using purposive sampling. The tightness was measured by AKE test. Three measurement were taken and average of their reading was noted. Result: Analysis showed higher prevalence of hamstring tightness among college students. More students were affected with AKE angle between 30o-45o. Conclusion: Prevalence of hamstring tightness is very high in college going student of age group 18-25 years.
Keywords: Prevalence; Active knee extension test; Hamstring Tightness severity
Awareness about the concept of Green Corridor among medical student and doctors in a Rural Medical College of Maharashtra, India
Get PDFBackground: India\u27s traffic problem over the years has been the root cause of many deaths. During an medical emergency like organ transplantation over long distances, the unsuitability of roads and highways hamper in the worst way possible. In a developing unplanned country like India, where lane discipline is an alien concept, emergency lanes won\u27t sustain as of now. Thus, for provision of better health services, a temporary emergency lane has been implemented in organ transplantation cases known as a Green Corridor. It is a special route with manual operation of street signals and traffic to avoid any hindrances that could come in the way of an ambulance. Aims and Objectives: To learn about the awareness, strategies and possibilities of Green Corridor in India. Material and Method: This was an interventional study by the undergraduate students of Rural Medical College, Pravara Institute of Medical Sciences, Loni, Maharashtra. The study also included 350 Students and 150 Faculty members of Pravara Institute of Medical Sciences (Deemed University) and Practicing Doctors of Central Maharashtra were included in the survey. The survey conducted was in a pre and post-test format. Results: The study involved 500 participants out of which 135 were medical faculty and practicing doctor and 350 were students of Rural Medical College. The awareness among medical students about green corridor increased from 14% to 61%, while it went up to 71% from 26% in medical faculty after intervention. Willingness to donate organs increased from 57% to 66% and 78% to 85% among medical students and medical faculty, respectively. The participants gave suggestions to make available air ambulance & emergency roads and increase awareness regarding green corridor. Conclusion: From the survey conducted, it can be perceived that there is a massive lack of awareness about Green Corridor as well as reluctance for organ donation. Therefore, awareness should be created on a large scale so that no person is left oblivious. Even on a smaller scale, an implementation of the suggested strategies could make a massive difference in the present scenario regarding medical emergencies
PROTECTIVE EFFECT OF DIOSGENIN AGAINST CARBON TETRACHLORIDE AND CISPLATIN INDUCED HEPATOTOXICITY IN RATS
Get PDFBackground: Activation of hepatic stellate cells (HSC) plays central role in the development of liver fibrosis. In HSC activation, the transforming growth factor-1 (TGF-1) is considered to be the main stimuli factor. Diosgenin are the steroidal saponin and found in Trigonella foenum graecum Linn (Fenugreek) and some other species of Dioscorea. Diosgenin attenuates HSC activation by inhibiting transforming growth factor. Aim: In present study an attempt was made to explore the effect of diosgenin on liver fibrosis. Methods: Liver fibrosis was induced in rats by carbon tetrachloride (CCl4) 1 ml/kg intraperitoneally twice a week for 28 days and cisplatin 3mg/kg intraperitoneally at 0, 1, 3 week for 4 weeks. The extent of liver fibrosis was assessed by measuring the weight of liver and levels of total bilirubin (TBL), hydroxyproline (HP) and serum enzymes due to deposition of extracellular matrix (ECM). Results: The administration of diosgenin reduced the liver weight of CCl4 and cisplatin treated animals and reduced the TBL, HP level and serum enzymes significantly and inhibited liver fibrosis induced by CCl4 and cisplatin. Conclusion: The result obtained in the present investigation, Diosgenin treatment exerted significant hepatoprotective effect in animals by inhibiting ECM deposition and HSCs activation
COMPARISON OF CERVICAL BIOPSY USING PUNCH BIOPSY FORCEPS VERSUS LOOP ELECTRODE
Get PDFContext: The biopsy of cervix can be obtained by various methods with availability of newer modalities like loop electrode. Objectives: To compare the histo-pathological parameters and clinical outcome of cervical biopsy obtained using punch biopsy forceps versus loop electrode. Methods: Women attending OPD were screened for cervical pathology, and colposcopy was done for those who screened positive. Patients who required cervical biopsy after colposcopy were allocated into 2 group; one undergoing LEEP biopsy and other half biopsied with Punch forceps. During procedure patients were evaluated for the intra-op pain and bleeding and their severity. The histo- pathological diagnosis was carried out and the sample was studied for its size, adequacy, and presence of any thermal or crush artefacts. Result: The two methods of biopsy were comparable in intra-op parameters, except for the increased requirement for additional haemostasis in LEEP biopsy. There was no case of bleeding from biopsy site at the follow-up visit. LEEP biopsy was associated with continued vaginal discharge more often than punch biopsy. An adequate sample for histopathological diagnosis was obtained in 91.25% of all cases. The comparative findings were reflective of comparable efficacy of both methods in providing an acceptable tissue sample for diagnosis. Conclusion: After analysing and comparing the aforementioned parameters, we opined that neither method can be deemed clearly superior to the other as a cervical biopsy procedure.
Keywords: Punch biopsy forceps; Loop electrode; Cervical biopsy