International Journal of Health and Clinical Research
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A study of the results of myringoplasty with and without cortical mastoidectomy in chronic suppurative otitis media safe type dry ears
Get PDFThis prospective study of the results of myringoplasty with and without cortical mastoidectomy in chronic suppurative otitis media safe type dry ears revealed that success rate was higher in terms of graft uptake, hearing improvement and subjective sense of well-being in patients in whom myringoplasty was accompanied with mastoidectomy as compared to those with myringoplasty alone
Clinical characteristics and laboratory findings of mild to moderate covid 19 cases admitted to tertiary care hospitals and their association with adverse outcomes
Get PDFIntroduction:The symptoms of COVID 19 are highly variable, classifying cases diagnosed with coronavirus disease (COVID 19) according totheir clinical characteristics and associated outcomes is important for management of this disease. Methods: Clinical characteristics of mildmoderate COVID 19 was studied at tertiary care f acilities in India. A total of 668 patients were analysed, their demographics, disease, clinicalcharacteristics and laborator y parameters were recorded and the association of these factors with adverse outcomes was analysed. Results: A totalof 668 patien ts were included in this study, of those 69 % were males and the overall mean age was 50.7 13.2 years . Comorbidities werepresent in 530 patients and 32 patients were smokers, except 2 patients all were symptomatic at the time of admission. During hospit al stay,eventually 124 (18.5%) required high flow nasal cannula , 71 (10.6%) required ventilator support and 5 (0.7%) succumbed to de ath. Majority ofpatients i.e., 70% were discharged without any adverse outcomes. The factors significantly associated wit h adverse outcomes were age,comorbidity, duration of stay, elevated CRP, SGPT, SGOT, INR, NT proBNP, IL 6, ferritin, D Dimer, and LDH; low platelet count andhemoglobin. Conclusion: Clinical characteristics, hematological, inflammatory markers and biochem ical parameters can predict diseaseprogression and adverse outcomes
Knowledge, attitude and perception of Phase One MBBS students about immunization in children
Get PDFBackground: Immunization is a very important strategy for improving the health in the community. During the pre-clinical years, MBBS students receive knowledge about immunization. Besides increasing awareness, inculcating positive attitudes in medical students toward immunization would lead to their increased participation in immunization promotion programs and their implementation. We planned this study with the aim of understanding the knowledge, attitude and perception of these new medical students about immunization in children and incorporation of immunization class in foundation course. Materials and methods: The study was conducted in a Medical college in North India. Phase One MBBS students who were undergoing the Foundation course were included in the study after taking informed consent. They were asked to fill a pre validated questionnaire containing questions about their knowledge, attitude and perception about immunization in children. The data was analyzed by Excel 2013. The study was approved by the institutional ethical committee. Results: Ninety eight out of 100 students filled the questionnaire, 54% of them were females. Sixty two (63.2%) students knew about the immunizations prior to the class. The knowledge scores ranged from 0-4 with 7 (7.3%) having full score of four while only 2 (2.1%) achieved score of zero. All of them (100%) agreed that doctors have very important role in educating the parents about importance of immunization and most of them (98%) believed that educating parents will improve the vaccine coverage. Most of them also believed that it is necessary to vaccination the children. Regarding the perception about the immunization and the inclusion of immunization class in the foundation course, all of them (100%) believed that it is important for the first year MBBS students to know the basics of immunization. Most of them believed that the immunization class in foundation course will help them understand immunization better in future classes and also felt motivated to promote immunization in the community. Conclusion: Newly joined Phase one MBBS students showed positive attitude and perceptions about immunization in children and inclusion of immunization class in foundation course. They had gaps in knowledge about immunization which needs to be filled during the medical curriculum
Susceptibility of males in second wave of Covid and infection in young: A comparison of two waves
Get PDFMany countries have seen a two-wave pattern in reported cases of coronavirus disease-19 during the 2020 pandemic, with a first wave during spring followed by the current second wave in late summer and autumn. Empirical data show that the characteristics of the effects of the virus do vary between the two periods. Differences in age range and severity of the disease have been reported, although the comparative characteristics of the two waves still remain largely unknown. This was a challenging time, but we should faith on science to help us get through these pandemic and future ones. Differences in age range and severity of the disease will reported, although the comparative characteristics of the two waves still remain largely unknown. Those characteristics will be compared in this study using data from two equal periods of 3 and a half months. The first period, between 15th March and 30th June, corresponding to the entire first wave, and the second, between 1st July and 15th October, corresponding to part of the second wave. The most frequent signs and symptoms has been be noted. Several differences in mortality risk factors have also been observed. These results might help to understand the characteristics of the second wave and the behaviour and danger of SARS-CoV-2 in India. Further studies are needed to confirm our findings
Prevalence and spectrum of refractive errors in children attending out-patient department of Ophthalmology, Government Medical College, Doda, Jammu and Kashmir
Get PDFIntroduction: Uncorrected refractive errors are a common problem in school aged children. The presence of refractive error in school going children affects their physical, mental and behavioral development as well. Inability to detect them at an early stage can adversely impact their learning and academic performancepurpose. Objective: To study prevalence and spectrum of refractive errors in children aged between 10 and 16 years in the rural population of the Doda district of Union territory of Jammu and Kashmir who attended the outpatient department of ophthalmology GMC Doda between July 2019 and July 2021. Materials and Methods: All children aged between 10 to 16 years coming to Outpatient Eye Department of GMC Doda from July 2019 to July 2021 were included in this repetitive study. Detailed ocular examination was performed on each patient. It consisted of visual acuity testing, pupillary reaction, ocular motility examination,cover-uncover test, anterior segment examination and direct ophthalmoscopy. Depending on type of eye disease, they were categorized. Children with defective vision were further examined employing objective refraction using autorefractometer followed by streak retinoscopy after instilling 1% cyclopentolate eye drops. Children with any kind of refractive errors were evaluated and categorized according to the type of refractive error on post-mydriatic examination. Children with prior ocular surgery or any ocular disease contributing to diminished VA, manifest strabismus, and pathological myopia were excluded from the study. Results: The prevalence of refractive error in this study is 13.4%. Total of 500 children were examined which included 187 male and 313 female children aged between 10 to 16 years. Out of 500 children, 433 (167 males and 266 females) had no refractive error and in 67 (20males and 47 females) had varying degree of refractive errors. Myopia was most common type of refractive error seen in 35 (11 males and 24 females), hypermetropia in 3 (1 males and 2 females), Astigmatism in 24 (7 males and 17 female) and mixed refractive error (spherical and cylindrical) in 5 (1 males and 4 females). Among children having refractive error visual acuity of 6/9 was seen in 23 (9 males &14 females), 6/18 in 16 (4 males and 12females), 6/24 in 14 (3 males and 11 females), 6/36 in 11 (2 males and 9 females) and 6/60 in 3 (2 males and 1 female). Conclusion: Refractive error is important cause of treatable blindness in children in the age group of 10-16 years.A larger study needs to be conducted in all the schools of the district to get a clearer picture of refractive errors and other eye-related diseases to detect vision problems as early as possible
Analysis of lipid profile in various phenotypes of Polycystic ovary syndrome at Tertiary Care facility: An observational study
Get PDFObjective- To assess the sociodemographic and lipid profile (Total cholesterol, Triglycerides and HDL) of various phenotypes of woman with PCOS. Methodology- This observational study was conducted at Tertiary care facility, Jaipur from July 2020 to December 2021 on cases of PCOS aged between 18-35 years attending Gynaecology OPD clinic. 90 women with PCOS, fulfilling the inclusion and exclusion criteria, were enrolled in the study. They were divided into four subgroups- A, B, C and D phenotype. Demographic characteristics, Anthropometric measurementwere done and lipid profile was noted and analysed using SPSS software. Result- Most of cases 38(42.2%) showed D phenotype, followed by A phenotype in 32(35.6%) cases, C phenotype in 12(13.3%) and B phenotype in 8(8.9%) cases. BMI was higher in phenotype A as compared to phenotype D.Mean levels of cholesterol and Triglycerides were significantly higher and mean HDL level was significantly lower in cases with phenotype B as compared to other phenotypes (p value<0.05). Conclusion- It can be concluded that there are raised levels of triglycerides and decreased levels of HDL in androgenic phenotype of PCOS (A, B & C).Women with PCOS should be counselled regarding life style modification including exercise and weight reduction for prevention of cardiovascular events due to dyslipidaemia
Comparison of diagnostic modalities for diagnosis of hepatitis-C virus infection using Rapid Antigen Diagnostic Kit and ELISA
Get PDFIntroduction: Hepatitis-C virus (HCV) causes liver disease which can cause acute & chronic hepatitis, Illness may range from asymptomatic cases to serious life long illness which may result in chronic hepatitis & hepato-cellular carcinoma. HCV is blood borne virus transmission of which is mainly parental, infection also spread by sexual contact & from vertical transmission from mother to baby. Material & Method: Study was conducted for a period of six month. Sample send for routine anti HCV antibodies were subjected to ELISA & rapid card test. Considering ELISA as gold standard, rapid card test was compared with it. Result: Out of 2295 blood samples tested on rapid card 56 samples were reactive while 2239 sample were non reactive. On further testing with ELISA 2 samples were false positive and 8 samples were detected false negative using ELISA as gold standard test. Sensitivity of rapid test was 85.7% while specificity of rapid test was found to be 99.91%. Positive predictive value (PPV) was 96% while negative predictive value (NPV) was 99.64% . P value was <0.001 which is statistically significant and in favor of ELISA. Conclusion: Present study shows that rapid tests are inferior as compared to ELISA and hence they should not be recommended in screening of blood donor and for treatment initiation
Assessment of knowledge, awarness, and covid appropriate behaviour of MBBS students regarding covid-19 pandemic
Get PDFBackground: The present study was conducted to assess knowledge, awareness and practice of MBBS students regarding COVID-19 pandemic. Materials & Methods: 170 Medical students of both genders were given a questionnaire regarding clinical symptoms, transmission routes, prevention, and control of COVID-19. Results77% showed that SARS-CoV-2 is the cause of COVID- 19. Main symptoms are fever, fatigue, dry cough and myalgia was replied true by 90%, 90% replied that 2- 14 days is the incubation period of Covid- 19, the overall mortality was correctly answered by 80% and 83% correctly showed that rRT-PCR is the laboratory test available for detection of COVID- 19. The difference was significant (P< 0.05). 75% replied that COVID- 19 increased the frequency of washing hands, 70% replied that COVID- 19 increased the frequency of using hand sanitizers, use of handkerchief while coughing is by 75%, unnecessary travel is avoided by 81%, 78% maintain social distance. The difference was significant (P< 0.05). Conclusion: Most of the students had sufficient knowledge, awareness and practice of regarding COVID-19 pandemic
Evaluation of prognostic factors for acute pancreatitis—A retrospective study
Get PDFBackground: Acute pancreatitis is a common disease frequently caused by choledocholithiasis or excess alcohol ingestion. A three category classification of severity of acute pancreatitis was recently designed. The management of acute pancreatitis is frequently challenging, and multidisciplinary approach should be used for the management of the patient with acute pancreatitis. In this study we aim to evaluate early indicators that predict the mortality of Acute Pancreatitis. Materials & Methods: Total number of subjects in this study was 100 patients with clinical diagnosis of acute pancreatitis were treated at M.G.M. Medical College& L.S.K. Hospital and analyzed retrospectively during the period from October 2018 to August 2020. Results: 69.7% of patients who developed acute pancreatitis had a mild clinical disease without complication. The remainder had a moderate to severe illness with complications, prolonged hospital stay and this group as a whole had a mortality of (52.0%).The overall morality was15.0%. In this study 42.0% had addiction to alcohol. Biliary tract disease was present in 26.9% of cases. 30%had neither history of alcoholism nor biliary tract disease i.e. idiopathic group. Post ERCP acute pancreatitis was found in 2.0% of patients and 1% had a history of blunt trauma. The mortality rate for the idiopathic group (24.1%) was higher than that of alcoholic group (14.3%) or that of biliary tract disease (7.7%). Conclusion: Despite earlier recognition of severe attack of acute pancreatitis by reliable and sophisticated diagnostic techniques, appropriate care and supportive measures the morbidity and mortality rates have remained unacceptably high. To reduce this high mortality the major aim of management should be to anticipate and treat complications and systemic failure, which may develop
A Hospital Based Prospective Study to Assess the Clinical and Laboratory Parameters in Diagnosing Patients with Acute Appendicitis Admitted in Surgical Ward
Get PDFBackground: Acute appendicitis is one of the most common general surgical emergency that has a lifetime risk of about 7%. The laboratory investigations namely white blood cell count (WBC), C-reactive protein (CRP) and erythrocyte blood sedimentation rate (ESR) are useful in diagnosing acute appendicitis. This study proposes to compare the various scoring systems in diagnosing a case of acute appendicitis and to suggest a scoring system which is suitable for our population. Materials & Methods: A hospital based prospective study is to be conducted on 50 patients admitted in department of general surgery at district hospital for appendicectomy during one year period. Informed consent will be taken from each respondent. The per-operative macroscopic appearance of the appendix specimen and subsequent histo-pathological study of the specimen is to be performed. Chi-square tests, Student's t tests, significance testing, and 95% Confidence Interval formulation are to be carried out wherever appropriate.Results: Acute appendicitis was more common in age group less than with more than 90.62% of patients with appendicitis being less than 40 years of age and is statistically significant (p value < 0.05*). The occurrence of acute appendicitis was significantly higher when the duration of symptoms was less than 2 days. This p value is statistically significant (p value < 0.05*). When the C reactive protein levels were higher than 10 mg/dl, the occurrence of acute appendicitis was significantly higher than in the patients with levels less than 10 mg /dl. The occurrence of acute appendicitis did not have any significant correlation with the serum bilirubin levels when the cut off was placed at 2 mg/dl in this study (p value = 0.243). When the ESR levels were higher than 15 mm/hr, the occurrence of acute appendicitis was significantly higher than in the patients with levels less than 10 mg /dl. The p value is < 0.05*.The various scoring systems analyzed were compared among themselves and along with the combined predictor score formulated. Conclusion: We concluded that there must be early and prompt diagnosis, adequate resuscitation as well as early surgery in patients with acute appendicitis to keep the morbidity and mortality low. In patients with equivocal findings, imaging studies and laboratory tests should be ordered to help confirm the diagnosis