International Journal of Health and Clinical Research
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Frequency Estimate and Assessment Of Risk Factors For Postoperative Morbidity After Third Molar Removal
Get PDFAim: This study aims to determine the relationship of pre-operative clinic radiographic variables, difficulty index and the complications after extraction of impacted mandibular third molar. Material and Methods: During the period of study 110 number of patient reported to the investigator. There were total 70 subjects who underwent surgical removal of impacted mandibular third molar. A standard wards incision was given to expose the tooth. The bone removal was done by buccal guttering technique. All the patients were given antibiotic and analgesic for equal number of postoperative days.The clinical status of all third molars was recorded as unerupted (not at all visible), partially erupted (occlusal surface partially visible, erupted (occlusal surface completely visible) or missing. Orthopantomograms were taken for all the entire subjects in order to read the level of eruption, angulation, third molar space, mesio-distal length of the impacted third molar. Result & Conclusion: The most common postoperative complication were Trismus 92%, Pain 91% and swelling 86% followed by dry socket 8.96% and Paresthesia in 2.99
A Prospective Study of Efficacy And Safety of Standard Versus Tubeless Percutaneous Nephrolithotomy
Get PDFIntroduction: PCNL is considered to be the standard procedure in patients with large renal calculus. The essential step in standard percutaneous nephrolithotomy (PCNL) procedure is placement of a percutaneous nephrostomy tube for drainage. On the other hand, in recent years, the procedure has been reformed to one called as 'tubeless' PCNL in which a double-J stent without nephrostomy tube is placed for internal drainage.Materials and Methods: This was a prospective comparative study, conducted in the department of Urology, Arupadai Veedu Medical College, Puducherry a period of 12 months from March 2020 to February 2021. A total number of 108 cases of tubeless PCNL was studied data collected and results analysed. Sample size estimated based on prevalence of the operable renal calculi (using formula S =4pq/l2) Results of study group were compared with other group of traditional PCNL with 116 patients. Results: We evaluated the data of 224 cases undergoing PCNL in our hospital. We divided total cases in to 2 groups. There are 108 cases in group A who underwent totally tubeless PCNL and 116 patents in group B of traditional PCNL. Both groups has similar demographics according to age sex and comorbidities. Among these 108 cases (group A) 70 were male and 38 female patients. Male to female ratio is 1.66:1. The average age was 44.6 years with arrange of 20 to 65 years. Where as in group B male to female ratio is 2.3:1 and average age is 48.8 years. Out of 108 cases 12.9% (14) have hypertension, 9.25% (10) have diabetes mellitus, 4 patients have COPDs, 2 patients had hypothyroidism and 2 patients was known CKD. Conclusion: Our findings demonstrated that tubeless PCNLs can be safely and effectively performed by an experienced endourologic team without limiting the number of eligible candidates by preoperative patient selection. Tubeless PCNL has an obvious advantage of significantly reduced postoperative pain, less analgesic requirement and shorter hospital stays. Complications rate are less with tubeless PCNL and blood transfusion is less when compared with traditional PCNL. We believe that this study will contribute to the further popularization of the tubeless technique for the benefit of the patient, the medical team, and the health care system
Impaction of interventional study with intrastromal voriconazole in recalcitrant deep fungal keratitis
Get PDFAim: To evaluate the efficacy and outcome of intrastromal voriconazole, as treatment for management of recalcitrant fungal keratitis. Methods: Thirty patients with fungal keratitis, not responding to a topical antifungal medications, were treated with intrastromal voriconazole (50 μg/0.1 mL) injected around the circumference of the lesion. Results: The mean area of the infiltrate was 30.41±17.2 mm(2), hypopyon was present in 88% and all cases had infiltrates that extended beyond the mid-stromal level. Intrastromal voriconazole helped to resolve the infection in 30 patients. The improvement of BCVA in twenty seven patients from PL+,PR+ to CF-1mt group to 6/18 to 6/19 group another one patients from same group to CF-2mts to CF- 4mts and two patient to 6/60 to 6/24 group. This shows great significance of intrastromal voriconazole injection. In some patients there was a minimal improvement in BCVA atributtable to involvment of the abscesses and the resultant scar in the central cornea. Conclusions: Management of recalcitrant fungal keratitis with voriconazole by intrastromal injection (50 μg/0.1 mL) is a safe and effective way to treat deep recalcitrant fungal keratitis, though some may need repeated injections
Attitude and perception of adults toward cosmetic products amid Covid-19 pandemic in India
Get PDFBackground: Because of the variety of brands available, the dependency of cosmetics is escalating among male and female consumers equally. Whilst there is a upsurge in cosmetic product usage, it is unclear whether end users are cognizant of the items' safety. Aims: The goal of this trial was to learn maximum conceivable about consumers' opinions and attitudes regarding cosmetics in the milieu of the COVID-19 pandemic. Methods: In Madhya Pradesh, India, a cross-sectional survey was conducted amid adults. Thirty-three questions were designed and validated to be responded by cosmetics customers, and they were grouped into 3 aspects (socio-demographic factors, valuation of both perception and attitude). The descriptive in addition inferential statistical analysis were carried out using SPSS. Results: The average age of the participants was 33.2 percent, and the response rate was 87 percent. Cosmetic product perceptions demonstrate a low level of acuity and a moderate attitude toward them among consumers. Participants' perception and attitude had a strong positive association (p = 0.001, r = 0.72) and a high link (p = 0.001, r = 0.72). There was a considerable correlation between demographic data and attitudes and views of cosmetic items among respondents. Participants were ignorant that sharing cosmetics could result in bacterial infection, potentially increasing their risk of getting COVID-19. Conclusion: According to the findings, Indian adults have a casual attitude toward cosmetics, focused on aesthetics rather than health safety. To prevent COVID-19 transmissions, it is recommended that people become more aware of the content and effects of cosmetic goods, practise better hygiene, and refrain from sharing cosmetics
A prospective study of study to assess awareness amongst pregnant women about the effects of drugs on the fetus and self-medication
Get PDFIntroduction: Self-medication as defined by World Health Organization is the “use of medicinal products by the consumer to treat self-recognized disorders or symptoms, or the intermittent or continued use of a medication prescribed by a physician for chronic or recurring diseases or symptoms.” Materials and Methods: This was a prospective study conducted on randomly selected 100 pregnant women attending tertiary care hospital. The study was conducted in department of Obstetrics and Gynecology, Sri Venkateswaraa Medical College and Research Center, Ariyur, Puducherry. Data was collected by means of a pre-designed semi structured questionnaire composed of 26 questions. The questionnaire used was a modified form of a previously validated survey carried out by Nordeng et al, the modifications made in the questionnaire were discussed in the Obstetrics and Gynecology and Pharmacology department of Sri Venkateswaraa Medical College and Research Center, Ariyur, Puducherry before administering the same to the participants. Results: There were total 100 participants selected in the study. The average age of the participants was 23.7±3.68 years. Not a single participant was below 18 years of age. It was evident from the Table 1 that more than 90% of the participants were in the age group of 18-29 yrs. Only one participant was of the age group 40 and above. Educational status of the participants was as shown in Table 2. It was found that 74% of participants were taking iron and folic acid supplements but only 38.5% participants were aware about the purpose of taking iron and folic acid supplement and only 16% were aware about the duration to which this supplement is to be taken (Table 6). There were only 51% of the participants who were taking these supplements on regular basis. Conclusion: There is a lack of awareness amongst the pregnant women regarding the effect of the drugs on the health of foetus. More than half of the women take medication on regular basis. However, low proportion of self-medication during pregnancy suggests that during pregnancy women preferred to take advice of physician for medication rather than taking self-medication
Reliability of S-100 and Tuj-1 immunofluorescence markers in the diagnosis of Hirschsprung’s disease
Get PDFBackground: Hirschsprung’s disease (HSD) is a congenital malformation of the hindgut characterised by absence of intrinsic ganglion cells. Acetyl cholinesterase (AChE) staining is used as a gold standard test in HSD. Intramucosal neuroglial cells (INCs) are present in aganglionic colonic mucosa of HSD patients, challenging our current understanding.Objectives: To evaluate for the presence of INCs using S100 and Tuj 1 and to evaluate for the presence of ganglion cells (GCs) using Tuj1 immunofluorescence in clinically suspected cases of HSD.Materials and Methods: This study was carried out in the Department of Pathology, Bangalore Medical College and Research Institute, Bangalore on 35 colorectal biopsies of patients suspicious of HSD. Direct immunofluorescence (DIF) was done on rectal biopsies using Tuj1 and S100 markers.Results: Out of 35 biopsies, 24 showed absence of Tuj 1 and S 100 expressing cells in the biopsy and were diagnosed as HSD and 8 cases showed presence of Tuj 1 and S 100 expressing cells in the biopsy and were diagnosed as not suggestive of HSD. 3 were excluded as they were low rectal biopsies. Tuj 1 and S 100 DIF showed sensitivity of 100% and specificity of 72.7%.Conclusion: DIF markers Tuj 1 and S 100 were found to be more sensitive than AChE stain and these markers are helpful in detecting false negative cases missed by AChE. A larger cohort is necessary to consider these DIF markers as an additional tool in evaluatingand ruling out HSD in cases where AChE stain is equivocal
A cadaveric study on anatomy of axillary nerve and its clinical importance
Get PDFBackground & objectives: The axillary nerve is one of the terminal branches of the posterior cord of the brachial plexus, and it is frequently injured during orthopaedic procedures, shoulder dislocations, and rotator cuff tears. All of these possible iatrogenic injuries are the result of a lack of understanding of the nerve's anatomical differences. As a result, it is critical to investigate its possible variations and provide guidance to surgeons in order to improve clinical outcomes by lowering risk and complications. Materials and methods: 72 cadavers adult embalmed (55 males and 16 females), both right and left sides were dissected as per standard dissection methods. Results: The division of axillary nerve into anterior and posterior branches occur in quadrangular space and within deltoid muscle in 84.5% and 12% respectively.Posterior cord was formed by union of posterior division of C5 and C6 roots with posterior division of middle and lower trunk (there was no upper trunk) in 15.2% (11/72) of upper extremities . Posterior cord of brachial plexus was present lateral to the second part of axillary artery in 18% (13/72) of upper extremities. Axillary nerve was taking origin from posterior division of upper trunk in 9.7 % (7/72) upper extremities and thoracodorsal nerve arising from axillary nerve in 22.2% (16/72) upper extremities. Conclusion: It is important to be aware of such variations while planning a surgery in the region of axilla as these nerves are more liable to be injured during surgical procedures
A retrospective study assessing the effect of maternal factors on birth weight of Newborn in a tertiary care teaching hospital at Eastern India
Get PDFBackground: Although neonatology has advanced a lot in last few years, low birth weight babies still put a challenge in terms of mortality and morbidity. Maternal parameters during antenatal period are directly or indirectly linked to the birth weight of a newborn. We intended to study the effect of maternal factors on birth weight from eastern part of India. Objective: To assess the effect of maternal factors on birth weight. Materials and Methods: A retrospective cross-sectional study was conducted in Gouri Devi Institute of Medical Sciences and Hospital, Durgapur, West Bengal, from 1st July 2019 to 30th June 2020. Data were collected from the mothers who visited the pediatrics OPD with their child during the study period. Results: Out of 225 mothers, 76 mothers had babies with low birthweight which accounted for 33.78% of total babies in our study. Seventeen (22.37%) no. of LBW babies were born to young mothers (<20yrs of age). Proportion of LBW babies born to young mothers was higher than those born to normal age mothers (20-34yrs) which was found to be significant. Lower SES of families had more chances of LBW babies as compared to middle SES groups. Anemia was found in 191(84.89%) mothers which was significantly associated with higher risks of LBW. Only 4.76% of mothers (BMI 18.5-24.9) with adequate wt. gain had delivered LBW babies as compared to 37.42% of mothers with poor wt. gain which was significant. Antenatal checkup, BMI of mother in pre pregnancy period and sex of the baby was not found to influence birth weight. Conclusion: Young maternal age, poor socioeconomic status, anemia and poor weight gain during pregnancy were important predictors of low birth weight
A study of prevalence of pre-diabetes and cardio-metabolic risk factors in first degree relatives of patients with type-II diabetes mellitus
Get PDFBackground: Diabetes mellitus encompasses a range of heterogeneous metabolic disorders characterized bythe inability of the body to assimilate glucose and maintain glucose homeostasis. Aims and Objectives: To find out the prevalence of Prediabetes and Cardio metabolic risk factors in first degree relatives of patients with Type2DM. Material and Methods: This cross-sectional, observational study was conducted in the Department of Medicine and Department of Biochemistry, MGM Medical College and Hospital, Navi Mumbai. A total of 100 first degree relatives of patients suffering from Type 2 DM included in the study. Results: The prevalence of Prediabetes amongst the first degree relatives of Type 2DM was found to be 26%. The prevalence of cardio metabolic risk factors observed amongst the first degree relatives of patients of Type 2 DM were: history of CVD in 12%, Over weight by BMI in 73%, Overweight by WHR in 54%, Hypertension in32%, Dyslipidemiain 47%. The prevalence of Prediabetes was found to be more in the first degree relatives of diabetes patients who were overweight (by BMI) (32.88%) than those first degree relatives with the normal weight(by BMI) (7.41%). The prevalence of Prediabetes was more in the first degree relatives of Type 2diabetes patients who were Overweight (by WHR) (37.04%) than the first degree relatives with the normal weight (byWHR) (13.04%). The mean BMI and WHR was higher in the first degree relatives of Type2 diabetes patients with Prediabetes. The mean levels of LDL and TG were higher and mean HDL was lower in the first degree relatives of Type2 diabetes patients with Prediabetes. The mean levels of FBS and PLBS was higher in the study population with Prediabetes amongst the first degree relatives of Type2 DM. Conclusion: In the present scenario of rising worldwide incidence of Diabetes, identifying the risk factors which can be amenable to prevention is important, as Diabetes increases the risk of both microvascular and macrovascular complications contributing to increased morbidity and mortality in diabetic patients. Besides increasingly prevalent sedentary lifestyle in our general population, rampant adoption of western culture including increasing intake of fast food added with the underlying genetic predisposition is alsomaking the people in general more obese and insulin resistant thus contributing to rapidly increasing incidence of diabetes in our country. It was concluded from the present study that first degree relatives of patients withType2DM patients have high prevalence of prediabetes and other cardio metabolic risk factors
Comparison of minimally invasive procedure with the standard open approach for lumbar sympathectomy
Get PDFAim: To compare minimally invasive procedure with the standard open approach for lumbar sympathectomy and to assess the morbidity and evaluate the outcome in terms of operative time, blood loss, complications and recovery time. Method: The present study was carried out as a prospective cross-sectional observational study. A total of 60 patients were enrolled in the study who were divided into two groups A and B of 30 each who were operated by open method and laparoscopic method respectively.Patients between age 17 to 80 years with ischemic rest pain that requires continuous analgesia for > 2 weeks, ischemic foot ulcers that failed to heal for > 6 weeks and distal gangrene which is limited to the fore foot were included in the study. Result. In group A total 18 out of 30 patients(60%) and in group B total 21 out of 30 patients(70%)were taking analgesics for pain from more than 4 weeks. In group A operative time in 6 patients was ½-1hr, in 20 patients 1-1½ hrs and in 4 patients operative time was more than 1½ hrs while in group B in 22 patients operative time was ½-1 hr, in 6 patients 1-1½ hr and in 2 patients it was more than 1½ hrs.P value was 0.0002 which was significant. In group A there were ureteric injury in 2 patients, venacaval injury in 1 patient, peritoneal perforation in 1 patient, wound haematoma in 7 patients, wound infection in 6 patients and incisional hernia in 2 patients as intra operative and post operative complications while in group B there was ureteric injury in 1 patient, peritoneal perforation in 1 patient, wound haematoma in 1 patient, wound infection in 2 patient and there was no vena caval injury and incisional hernia as intra operative and post operative complications. P value was 0.02 which was significant. In group A 4 patients recovered in 5-7 days and 26 patient took more than 7 days to recover while in group B 5 patients recovered in 3-5 days,20 patients recovered in 5-7 days and 5 patients took more than 7 days to recover.P value was 0.006 which was significant. Conclusion: In minimally invasive technique of lumbar sympathectomy operative time,intraoperative complications were much less and recovery was significantly faster as compared to classical open method