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Various Sources and Mode of Burns: Descriptive Study
Get PDFBackground: The World Health Organization estimates that the lifetime incidence of severe burns is 1% and that more than 300,000 people die annually from fire-related burns worldwide. Thermal injury is one of the major causes of morbidity & mortality in surgical patients & their successful management remains a challenge to modern medicine. Aim: Study of various sources and mode of burn. Method: Total of 764 patients admitted to the surgical ward and burn unit were included in the study. On admission, preliminary inquiries were made regarding the demographic profile, cause, mode of burn injury, surface area, and depth of burns were noted. Result: In most of the burn patient, the cause of burn was flame (75.9%), followed by moist heat (17.27%) and electricity (6.67%). Maximum no. of burn cases the source of heat was chimney (42.28%), followed by the stove (15.18%), as the next most common source. In most of the patient were accidentally burnt (96.20%) among which the majority were females. Conclusion: The most common cause of burn injury was flame. In most burn patients, the source of heat was a chimney, and most of the burn injuries were accidental.
Keywords: Burns; Source; Mode of injury
ELECTROPHYSIOLOGICAL CHANGES IN LATENCY IN DIABETIC RETINOPATHY: AN OBSERVATIONAL STUDY
Get PDFPurpose: Multifocal ERG is a useful indicator of diabetic retinopathy. The significant delay in local responses provides a chance for the detection and understanding of the various stages of diabetic retinopathy. Materials and Methods: This is a cross sectional study conducted in ERG clinic at M & J Western regional institute of ophthalmology, Ahmedabad from January 2013 to September 2015 who were more than 35yrs of age. Results: In our study, we studied 45 eyes of diabetic patients and 20 eyes of normal subjects. In our study the mean values of the various parameters was calculated in the control group with N1, P1 and N2 latency being 14.09ms. 29,76ms and 45.55ms respectively. The N1, P1 and N2 amplitude was found to be 31.52nV, 73.61nV and 90.38nV respectively. The maximum delay in N1, P1 and N2 latency was seen to be 3.24ms, 7.11ms and 8.40ms respectively from the normal value. We also found a decrease in amplitude of the ERG waveform with N1, P1 and N2 amplitude being 20.98nV, 61.48nV and 76.4nV respectively from the normal value. Also it is helpful in cases with clinically significant macular edema where responses are remarkably delayed suggesting local retinal dysfunction and macular pathology. It provides us information regarding the condition of the macula and some ideas about the extent of ischemia affecting this area. Conclusion: In conclusion, we can say that the delayed responses obtained indicate abnormal retinal function corresponding to local discrete retinal lesions. It provides a very sensitive and objective assessment of the local retinal condition in various stages of diabetic retinopathy.
KEYWORDS: Diabetes mellitus; Diabetic retinopathy; Multifocal electroretinogram
EFFECTS OF INTRATHECAL MIDAZOLAM IN SPINAL ANAESTHESIA: A PROSPECTIVE DOUBLE BLINDED CASE CONTROL STUDY
Get PDFBackground: Increasing the duration of action and maximizing postoperative analgesia has always been a domain of interest in spinal blocks. Many adjuvants have been tried along with local anaesthetic agent to achieve the same. The following study was conducted to compare sensory and motor characteristics with 2mg midazolam in subarachnoid block. Aim: To evaluate the efficacy and analgesic effect of the mixture of 2 mg midazolam and 15 mg (3 ml) hyperbaric bupivacaine as compared to bupivacaine alone in patients undergoing infra-umbilical surgery under spinal block. Material and Methods: In this observational prospective case control study 100 patients (ASA class I and II), aged 18 to 55 years, undergoing elective infra-umbilical surgeries under spinal block were randomly divided into Group I- patients were administered 0.5% hyperbaric Bupivacaine (3 ml) + 0.9% Normal saline (0.4 ml) intrathecally and Group 2- patients were administered 0.5% hyperbaric Bupivacaine (3 ml) + 2mg preservative free Midazolam (0.4 ml) intrathecally. The onset and duration of sensory and motor block, hemodynamic variables, and side effects during the surgery and recovery were compared among the groups. Results: 2mg of preservative free midazolam used as an adjuvant to bupivacaine intrathecally reduces onset time of sensory and motor blockade, also time taken to reach T-10. It also increases time taken for two segmental recession and mean duration of analgesia. Conclusion: It can be inferred that Inj. Midazolam 2 mg in combination with Inj. bupivacaine 0.5% hyperbaric can be safely administered intrathecally for better postoperative analgesia.
KEYWORDS: Intrathecal Midazolam; Post-operative Analgesia; Bupivacaine; Spinal Anesthesia
HISTO-PATHOLOGICAL CORRELATION BETWEEN SENTINEL LYMPH NODE BIOPSY AND AXILLARY LYMPH NODE BIOPSY IN PATIENTS WITH CARCINOMA OF BREAST
Get PDFIntroduction: The present study was aimed at mapping of lymphatic passage of sentinel lymph node in patients of carcinoma of breast and to correlate pathology of Sentinel lymph node biopsy (SLNB) and Axillary Lymph node Dissection (ALND). Material and methods: Patients presenting with palpable breast carcinoma without clinically palpable or suspicious axillary lymph nodes, potentially curable breast carcinoma (T1, T2 tumours) who were undergoing ALND and willing to participate in the study were included in the study. Patients with prior axillary operations, large & locally advanced invasive breast cancers, ductal carcinoma in situ, prior breast surgery, prior chemotherapy, distant metastases and pregnant women were excluded from the study. The histopathology of SLNB and ALND were correlated in the patients and sensitivity and specificity of SLNB was calculated. Results: 50 patients were included in the study. The blue staining sentinel lymph node was identified in 30 of 50 (60%) procedures. Of the 30 patients in whom SLN was identified, 1(3.33%) had histologically negative nodes and 29(96.66%) had histologically positive nodes; of 20 patients who had negative sentinel nodes, 19(95%) had histologically negative evidence of axillary metastasis, while 1(5%) showed histologically positive evidence of axillary metastasis. The sensitivity of sentinel lymph node status with comparison to the gold standard i.e., histopathology report, was 96.6% while the specificity was 95%. The overall positive and negative predictive values were 96.67% and 95%, respectively. Conclusion: Although further studies are requires to confirm the findings of the present study, the SLN accurately reflects the status of axillary lymph nodes in most patients with breast cancer, and for those with early stage disease it is rapidly emerging as an alternative to conventional axillary dissection.
Key words: Carcinoma Breast, Histopathology, Mapping, Axillary Lymph node Dissection, Sentinel lymph node biops
HbA1C AS AN INDEX OF GLYCEMIC STATUS IN OBESE TYPE 2 DIABETICS
Get PDFIntroduction: Type 2 diabetes has become a worldwide issue with the dramatic increase in incidence and prevalence over the past two decades. As the epidemiological burden of diabetes increases, the economic burden on individuals and nation is expected to rise. Obesity being one of the major risk factor for development of T2DM and its complication, glycemic control is crucial for management of diabetes. HbA1c is an index of long term glycemic status of diabetic subjects and has become the gold standard test around the world for initiation of treatment in diabetics. Aims: The aim of this study was to determine the association of obesity with T2DM and to correlate dysglycemia with obesity. Material and Methods: A total of 100 type 2 diabetics were enrolled for the study. The subjects were categorized based on the revised consensus guidelines for India for generalized obesity and abdominal obesity. Results: The results of the study showed that gender wise there was no significant difference of the various clinical and biochemical characteristics except for the duration of diabetes. Subjects of this study were mostly overweight and obese having abdominal obesity. A significant correlation was seen between the glycemic and metabolic status of the diabetic study population. Conclusion: Overall an increasing trend of dysglycemia in diabetic subjects with normal BMI, overweight to obese was observed. The prevalence of both central and peripheral obesity was increased in the diabetic subjects.
KEY WORDS: HbA1c; Obesity; Type 2 diabetes mellitus
ACCURACY AND DIAGNOSTIC UTILITY OF FROZEN SECTION IN THYROID LESIONS: A COMPARATIVE STUDY
Get PDFIntroduction: Many surgeons perform intra operative frozen section to overcome the limitations of FNAC, to differentiate benign lesions from malignant lesions and to determine the extent of surgery. However, the use and cost effectiveness of FS is controversial in follicular lesions. Nevertheless FS is most useful in cases where FNA results are indeterminate or suspicious and it is a cost effective way to avoid second surgical procedure if a total thyroidectomy is indicated. Aim: To study the diagnostic utility of frozen section and fine needle aspiration cytology thyroid lesions utilizing final histopathology diagnosis as gold standard. Methods: The present study was conducted on 237 cases of thyroid tissue submitted for frozen section for a study period of 5 years. Among those, 95 cases had preoperative FNAC done. Results: The sensitivity, specificity and diagnostic accuracy of FNAC was 42.86%, 96.72% and 82.93%, whereas that of FS was comparatively superior (82%, 100% and 95.65% respectively). Conclusion: Thus, the overall sensitivity, specificity and diagnostic accuracy of FS was superior to that of FNAC in the present series. The main limitations of FS and FNAC in our study were- Capsular/ vascular invasion in follicular neoplasm was not detected in many cases and papillary microcarcinomas were missed.
Key words: FNAC; Frozen section; Thyroid lesions
RISK FACTORS OF SURGICAL SITE INFECTION AT THE REGIONAL AND TEACHING HOSPITAL CENTER OF BORGOU (BENIN)
Get PDFIntroduction: The reduction of the SSI rate requires knowledge of its risk factors. Objective: To analyze the risk factors of SSI occurrence at CHD-B Methods: Prospective, descriptive and analytical study involving 603 patients undergoing general surgery (218) and obstetrics and gynecology (385) from 1st January to 31st July 2013. Results: 44 patients have developed SSI (7.3%). The SSI frequency was 12.8% in general surgery and 4.2% in gynecology-obstetrics (p significant). The mean age of patients developing SSI was 30.7 ± 15.8 years with a minimum and maximum 5 months and 70 years, respectively; and for general surgery patients, there were 23 men and 5 women (p not significant). The presence of preoperative infectious spot at admission (P = 0.003), the preoperative shaving of the site to be incised (p = 0.000), the ASA score (p = 0.000), the surgery contamination class (p = 0.000), and the NNIS score (p = 0.000) were all significantly related to SSI occurrence. Considering all these factors, the NNIS score ≥2 remained the predictive tool by multiplying by 3.4 the risk of SSI occurrence. Conclusion: NNIS score is the best SSI prediction tool at CHD-B.
KEYWORDS: Surgical site infection; Risk factor; NNIS score
CYBER PORNOGRAPHY ADDICTION AMONGST MEDICAL STUDENTS OF WESTERN RURAL MAHARASHTRA
Get PDFIntroduction: Cyberpornography is an act of using cyberspace to create, display, distribute, impart or publish pornography or obscene materials, especially materials depicting children engaged in sexual acts with adults. Cyberpornography on one hand, has opened up the new terrain of \u27safe sex\u27, and a positive space for sexual non-conformists. At the same time, it has negatively impacted many offline relations, and a new space for sexual predation and exploitation. Objective: To find out the prevalence, type and form of risk towards cyber pornography addiction amongst the students. Methods & Materials: A prospective cross sectional study was conducted after obtaining an ethical approval from the institute and an informed consent from volunteers fulfilling the eligibility criteria. The Internet sex screening test (ISST) questionnaire with score sheet was used and was collected by complete anonymity and confidentiality. 300 medical students were considered for the study and data collected was analysed by Microsoft-office excel. Results: 57.15% of the volunteer are in low-risk group whereas 30% are vulnerable and 12.85% are in highest-risk group. For boys, 65% are vulnerable whereas 21% in low-risk and the remaining 14% are in highest-risk group. For girls, 73% are in a low-risk, 19% are vulnerable and 8% are in highest-risk group. Conclusion: It is concluded that the majority of boys come under vulnerable category whereas the girls comes in low-risk group showing male preponderance towards addiction. The study reveals that, questions coming under the subgroup of online sexual behaviour-isolated have been answered the maximum number of times, by both the sexes. Whereas, the questions coming under the subgroup of online sexual spending has been answered the least by both the sexes.
KEYWORDS: Cyberpornography; Addiction; Sexual behaviour; ISST Questionnaire
STUDY OF MALONDIALDEHYDE, VITAMIN E AND VITAMIN C LEVELS IN DEPRESSIVE PYSCHAITRIC ILLNESS PATIENTS
Get PDFBackground: Incidence of psychomotor and psychiatric illness has promoted an awareness regarding the mental and emotional well-being as an important criterion of health. Research on depression is one of the important researches in psychiatric medicine. Negative reactions to life\u27s situations become repetitively intense and frequent leading to symptoms of depression. Aim: A study on changes between antioxidant levels in cases of depression. Method: It was a Case Control Observational Study. The patients newly diagnosed by psychiatrist & having depression were assessed with Hamilton\u27s depression scale are included in the study. The controls were free from depression. The blood sample was collected from each case and control at fasting. Serum Malondialdehyde (MDA), Serum Tocopherol (Vitamin-E) Serum Ascorbic acid (Vitamin-C) levels were estimated. Result: Category I: Group I, II, III MDA levels were 2.02±0.16, 2.02±0.16, 2.02±0.15 respectively. In Category II: Group I, II, III MDA levels were 6.28±0.77, 5.31±1.33, 5.74±1.13 respectively. Category I: Group I, II, III Vit E levels were 11.27 ± 1.21, 10.99 ± 1.03, 11.44 ± 1.20 respectively. In Category II: Group I, II, III Vit E levels were 9.92 ± 1.14, 10.44 ± 1.35, 10.21 ± 1.30respectively. Category I: Group I, II, III Vit C levels were 0.87 ± 0.06, 0.89 ± 0.14, 0.89 ± 0.06respectively. In Category II: Group I, II, III Vit C levels were 0.82±0.01, 0.82±0.01, 0.82±0.01 respectively. Conclusion: There is a significant difference between mean values of height & weight in Category I and Category II. Thus, the decreased antioxidant levels in depression cases show marked oxidant - antioxidant imbalance with evidence of increased oxidative stress.
KEYWORDS: Psychiatric illness; Serum Malondialdehyde; Serum Tocopherol; Serum ascorbic acid