Sumathi Publications (E-Journals)
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DIABETES RISK SCORE OF STAFF OF AN URBAN MISSION HOSPITAL IN NIGERIA
Get PDFBackground: Diabetes mellitus is a major global health problem which in hospital staff poses a major stress and can lead to migration away from health related posts. Certain features of health work e.g. long hours, shifts and uncertain break times increase the risk for hospital staff. It is critical to predict chronic conditions like diabetes mellitus that have a definable onset in adults so that morbidity and mortality can be mitigated through early recognition and treatment. Aims: To determine the diabetes risk score of health workers in an urban hospital and the associated risk factors. Methods and Materials: A correlational cross sectional survey of staff was conducted and diabetes risk was determined using a modified form of the Finnish Diabetes Risk Score questionnaire. Results and Conclusions: A total of 220 staff representing a response rate of 69.8% completed the study. The mean age was 41.6±9.88, Median duration of employment was 7.2years with a range of (0-37). Majority (66.4%) were in the 25-44 years age group, and most were female (66.4%) and married (70.5%). Mean BMI was 26.62±4.85. The mean Diabetes Risk score for the entire study group was 7.43±4.46 with a median score of 7 and a range of 0-19. About 40.5% had slightly elevated risk, 14.5% had moderate risk, and 5% had high risk. Female gender (AOR 0.17, 95% CI 0.09-0.33), and duration of employment (AOR 2.27, 95% CI 1.18-4.37) were significant predictors of higher diabetic risk score category.
KEYWORDS: Type 2 Diabetes mellitus; Diabetes risk; Risk score; Health workforce
MICROALBUMINURIA IN SUBCLINICAL TARGET ORGAN DAMAGE AND ITS CORRELATION TO CREATININE CLEARANCE RATIO IN HYPERTENSION
Get PDFBackground: Target organ damage takes place early in course of hypertension. But, despite this, the disease remains inadequately controlled in majority of patients partly because of its asymptomatic nature. With incidence of hypertension on the rise, there have not been adequate studies in our country linking hypertensive target organ damage with microalbuminuria and creatinine clearance especially in asymptomatic patients. Aims: To find the relationship between microalbuminuria and reduced creatinine clearance with subclinical target organ damage in asymptomatic primary hypertensive patients. Material & Methods: 60 hypertensive patients were evaluated for mild renal dysfunction defined as 24 hour urine albumin (UA) > 30 mg/d and/or Creatinine Clearance (CCR) < 60 ml/min/1.73m2.Target organ damage evaluated were retinopathy (direct fundoscopy) and Left ventricular hypertrophy (2D ECHO). Results: There was significant association between microalbuminuria (30 %) and reduced creatinine clearance (38%) with target organ damage i.e. left ventricular hypertrophy [p < 0.001 & p 0.001 respectively] and hypertensive retinopathy [p 0.005 & p 0.03 respectively]. Patients with urine microalbumin had 30 times risk [95% CI: 3.6-253,p 0.001] and those with reduced creatinine clearance had 5.9 times the risk [95% CI: 1.7-19.4, p 0.0035] of developing target organ damage. But when present together the risk increased to 39.4 times [95% CI: 2.2-703, p 0.0124]. Conclusions: Results show that a reduction in creatinine clearance and/or presence of microalbuminuria is a marker of subclinical organ damage in patients with primary hypertension. Microalbuminuria showed better association with target organ damage than reduced creatinine clearance.
KEYWORDS: Microalbuminuria; Mild renal dysfunction; Primary hypertension; Subclinical; Retinopathy; Target organ damage
MULTIPLE CUTANEOUS PILOLEIOMYOMA WITH UTERINE FIBROIDS (REED\u27S SYNDROME): A RARE CASE REPORT
Get PDFCutaneous leiomyomas comprise approximately 5% of all leiomyomas. Solitary occurrence is more common than generalized. Multiple cutaneous piloleiomyomas are rare, painful and difficult-to-treat benign tumors originating in the arrectores pilorum muscles of the hair follicles. Multiple Cutaneous piloleiomyomas are associated with uterine fibroids in women (Reed\u27s syndrome) and it is a marker of a condition called hereditary leiomyomatosis and renal cell cancer (HLRCC). We report a case of multiple cutaneous piloleiomyoma with uterine fibroid in an adult female. Because of its rarity and association with renal cell cancer, it deserves a mention in literature.
KEYWORDS: Cutaneous leiomyoma; Uterine leiomyoma; Painful nodules
LIFESTYLE MODIFICATION - IMPACT OF WALKING ON FASTING BLOOD SUGAR
Get PDFBackground: An average person is interested in staying healthy and general well-being. The present study was conducted to know the effects of walking on Fasting blood sugar in healthy individuals who changed their lifestyle by motivating them. Aim: The primary objective of present study is to identify the changes in Fasting Blood Sugar in normal subjects before and after walking for 30 minutes. Materials & Methods: The present study was conducted in the department of Physiology, Siddhartha Medical College, at Vijayawada Andhra Pradesh. A total number of 25 male and female adult healthy individuals were selected. Fasting Blood Sugar levels were compared before and after walking. Results: in this study significant change with p value 0.001 in Fasting Blood Sugar in normal healthy individuals before walking and 30 minutes after walking is observed. Conclusion: our study demonstrated small changes in daily life help to prevent diseases of modern civilization.
KEYWORDS: Lifestyle; Fasting Blood Sugar; Walking
KEY FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT AT TERM IN NEPAL: A CASE CONTROL STUDY
Get PDFBackground:Low Birth Weight (LBW) is a major public health problem in developing countries including Nepal. Nepal has a prevalence of LBW of 21%. There are various factors associated to high prevalence of LBW. This study aimed to identify specific factors associated to LBW at term in hospital settings in Nepal. Methodology: This study used a hospital based case control design. Hospital nurses interviewed mothers aged 15-45 years who had delivered a full term, single and live baby. Results: A total of 1533 respondents (511 cases and 1022 controls) were taken which is slightly more than the estimated sample size. The mean weight of newborns among case group was 2215 gm (SD:203); and among control group was 3012gm (SD:367). This study revealed that factors such as mothers under 20 years old (OR=1.436, 95% CI:1.074-1.920); height below 145cm (OR=1.504, 95% CI:1.087 -2.083); primigravida (OR=1.423, 95% CI:1.132-1.788); illiterate (OR=1.407 95% CI:1.011-1.957); <4 ANC visits (OR=1.534, 95% CI:1.202-1.957); and iron supplement <180 tabs (OR=1.434, 95% CI:1.152-1.786) were associated with LBW. However, variables like <20 years at the first pregnancy (OR=1.139, 95% CI: 0.904-1.433), disadvantaged ethnicity (OR=1.077, 95% CI: 0.861-1.347) were not associated with LBW in this study.Conclusion: Maternal height, education, number of ANC visits, and iron consumption were strong predictors for LBW in Nepal. It would benefit the country to develop effective strategies on maternal nutrition, female education, and quality ANC to overcome LBW.KEYWORDS: Low Birth Weight; Socio-demographic and antenatal care, Case control design
ACCURACY OF FNAC IN FEMALE BREAST LESIONS
Get PDFBackground: Various breast lesions are common lesions in females with a wide range of variability from inflammatory lesions, benign and malignant breast lesions. FNAC is first diagnostic test, as it has high sensitivity and specificity. Lesions were categorized on FNA into inflammatory lesions, benign neoplastic lesions, malignant neoplastic lesions, and suspicious for malignancy. Methods: This was a retrospective study done in the Department of Pathology, P.D.U. Medical College, Rajkot, Gujarat State, India from Aug-2013 to July 2014. FNAC of 392 cases of breast lesions were done and reported by expert pathologist. The histopathological specimens when available were reported by other pathologist without prior knowledge of FNA diagnosis. Sensitivity, Specificity and Accuracy of FNA diagnosis were then analyzed. Results: A total of 392 cases of breast lesions were diagnosed on FNA, out of them histopathological correlation was available in 87 cases. Benign breast lesions are more common in younger patients in 21-30 yrs age group and malignant lesions are more common in old age group patients of 41-60 yrs with few exceptions. In our setup fibroadenoma is the most common benign breast lesion (26.53%) and ductal carcinoma (17.86%) is the most common malignant lesion. The sensitivity, specificity and accuracy of FNAC for malignant lesions were found to be 91.43%, 100% and 96.25% respectively. Conclusion: FNAC is an effective and valid tool as the first line diagnostic modality in the preoperative diagnosis of the malignant and benign breast lesions.KEYWORDS: FNAC; Breast lesions; Fibroadenoma; Ductal carcinoma
EVALUATION OF GLYCOSYLATED HEMOGLOBIN AND ELECTROLYTE STATUS IN DIABETIC KETOACIDOSIS
Get PDFBackground: The present study was conducted to evaluate glycosylated hemoglobin and electrolyte status in Diabetic ketoacidosis subjects compared with controlled type II diabetes mellitus. Methods: Totally 100 subjects were included in this study (75 known DKA subjects and 25 controlled type II Diabetes Mellitus subjects). 5ml of venous blood samples are collected from subjects, Biochemical parameters performed Fasting blood sugar, Post prandial blood sugar by Glucose oxidase and peroxidase method, Glycosylated hemoglobin by Ion exchange High performance liquid chromatography, serum electrolytes levels are estimated by Ion selective electrode method. Results: The serum levels of FBS, PPBS, HbA1c levels are high in DKA compared with controlled Type II DM. the serum levels of sodium are significantly decreased in DKA compared with controlled Type II DM. The serum levels of potassium and chloride are high in DKA compared with controlled Type II DM. Conclusion: We concluded that electrolyte imbalance is high in DKA due to hyperglycemic hyper-osmolality and insulin deficiency frequently leads to electrolyte imbalance. HbA1c, FBS, PPBS levels are elevated in DKA due to uncontrolled hyperglycemia.KEYWORDS: Peroxidase method; Fasting blood sugar; HbA1c; Glycosylated hemoglobin
RELAPSE OF GUILLAIN-BARRE SYNDROME AFTER SPINAL ANESTHESIA: A CASE REPORT
Get PDFGuillain-Barre Syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy characterized by progressive symmetric ascending muscle weakness, paralysis and hyporeflexia with or without sensory or autonomic symptoms. It is most commonly caused by an autoimmune response of the body to an infectious agent like Campylobacter jejuni. It is less common during pregnancy but it may relapse during postpartum period. Cases of GBS have been reported after Spinal, epidural and general anesthesia. Here we report a case of 28year old female patient who had relapse of GBS after undergoing emergency laparotomy for ruptured ectopic pregnancy. In this case report, we are presenting an unusual case of GBS relapsing 4 years after initial episode following spinal anesthesia.KEYWORDS: Guillain-Barre Syndrome; Campylobacter jejuni; Postpartum period
THE UNDERUSE OF SPIROMETERY IN ROUTINE MEDICAL PRACTICE FOR DIAGNOSIS AND MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS IN KARACHI, PAKISTAN
Get PDFIntroduction: Spirometry is important in the diagnosis and management of chronic obstructive pulmonary disease (COPD), yet it is a common clinical observation that it is underused though the extent is unclear. This survey aims to examine the use of spirometry in the diagnosis and management of COPD patients in districts of, Karachi. Material and Methods: It is a cross-sectional survey involving four clinic settings: hospital-based respiratory specialist clinic, hospital-based mixed medical specialist clinic, general outpatient clinic (primary care), and tuberculosis and chest clinic. Thirty physician-diagnosed COPD patients were randomly selected from each of the four clinic groups. All of them had a forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio less than 0.70 and had been followed up at the participating clinic for at least 6 months for COPD treatment. Results: Of the 120 COPD patients, there were 111 males and mean post-bronchodilator FEV1Â was 46.2% predicted. Only 22 patients (18.3%) had spirometry done during diagnostic workup, and 64 patients (53.3%) had spirometry done ever. Conclusion: We conclude that spirometry is underused in general but especially by non-respiratory physicians and family physicians in the management of COPD patients. More effort at educating the medical community is urgently needed.
KEYWORDS: Pulmonary function tests; Specialist; Forced expiratory volume in 1 second (FEV1); Forced vital capacity (FVC)
CASE REPORT ON UNILATERAL SEGMENTAL CALCIFICATION OF STYLOHYOID LIGAMENT
Get PDFAn unusual case of a unilaterally elongated styloid process with a length of 6.8 cm was found on orthopantomogram (OPG) of male patient. The patient reported with ipsilateralotalgia presumably due to nerve compression from the elongated styloid process. The symptomatology appeared by such an anatomical variant as well as relative literature is discussed in the present case.
KEYWORDS: Styloid process; Otalgia; Stylohyoid ligament; orthopantomogram