International Journal of Health and Clinical Research
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Microbiological assessment of discharging ear – culture isolates, bacteriological isolates and their antimicrobial susceptibility patterns – A retrospective case study
Full text linkIn the present study, patients coming to ENT OPD with the complaint of discharge were examined and aural swabs were taken for study of bacteriological isolates and their antibiotic susceptibility, under all aseptic precautions and before starting any treatment. The samples were sent to Microbiology department. Empirical treatment was started before the reports arrived. After the reports were available, the treatment was revised according to the organism and their sensitivity report. The data regarding the same was studied and analysed.
In our study, we found that male patients were more commonly affected than female patients. Most common age group involved in our study was 26-35 years followed by 36-45 years. The number of children affected in our study was less as compared to other study which may be because of primary treatment received at primary or secondary care centre
Association of Autoimmune Thyroiditis with Thyroid Dysgenesis
Full text linkIntroduction: The thyroid gland is bilobed, with isthmus bridging the two lobes. The thyroid gland develops from the thyroglossal duct, which arises from the foramen caecum as an endodermal thickening during 3th week of intrauterine life, which reaches its definitive position by the seventh week. The high division of the thyroglossal duct can lead to the creation of two distinct lateral thyroid lobes and the absence of the thyroid isthmus. Hence, agenesis of the thyroid gland can be linked to its early embryonic development. Thyroid dysgenesis is also clinically associated with autoimmune thyroiditis (e.g. Hashimoto’s thyroiditis), dysorganogenesis, and ectopic thyroid tissue. Aim: To establish an association of Autoimmune thyroiditis with thyroid dysgenesis. Settings and Design: Descriptive observational study. Methods and Material: A study was conducted on 51 formalin fixed cadaveric thyroid glands over twenty months. After carefully dissecting the anterior aspect of the neck, the thyroid glands with absent isthmus were identified and subjected to histological examination. Statistical analysis used: Statistical analysis and sample size calculation was done using formula for prevalence as per previous studies. Results: Out of 51 thyroid glands, five glands (9.8%) were found to have absent isthmus and were subjected to haematoxylin and eosin (H&E) staining. All glands demonstrated the presence of diffuse lymphocytic infiltration and atretic thyroid follicles. Three glands showed the presence of hurthle cells, empty thyroid follicles along with diffuse lymphocytic infiltration which are typical histological features of autoimmune thyroiditis. Conclusions: The present study of thyroid dysgenesis can be histologically correlated with Autoimmune thyroiditis due to the presence of specific features, such as hurthle cells, diffuse lymphocytic infiltrate, atretic and empty thyroid follicles as seen in 10X and 40X magnification in all five glands. All of the above histological findings are typically seen in auto immune thyroiditis
Anaesthesia for thyroid surgeries using neural integrity monitoring endotracheal tube-our initial experience with more than 600 cases
Full text linkBackground and Aims: Recurrent laryngeal nerve (RLN) palsy is one of the most feared and common complication of thyroid surgeries. The neural integrity monitor electromyogram (NIM FLEX EMG) tracheal tube was introduced to identify RLN palsy. This retrospective study was conducted to record the incidence of nerve palsies during thyroid surgery while using a NIM FLEX EMG endotracheal tube as well as the anaesthesia technique employed without the use of muscle relaxants. Methods: This was a retrospective study of 628 patients who underwentthyroidectomy for benign and malignant goitres during a period fromOctober 2015 to September 2022 in a tertiary centre in Kerala, India. The case records of all the patients were thoroughly scrutinised and anaesthesia technique as well as a nerve palsy developing in the post operative period were noted.All patients were undergoing indirect laryngoscopy preoperatively inorder to know the status of vocal cords. After induction of anaesthesia,direct laryngoscopy was performed and all patients were intubated with aNIM FLEX EMG endotracheal tube. The crucial step is to ensureproper placement and prevent a malpositioning in the perioperative period. Since a continuous nerve monitoringwas in place, there was no need for a laryngoscopy at the end ofthe procedure. Results: Only in the case of two patients there was post operative RLN palsy. These two were due to the pre operative entrapment of the nerve within the malignant thyroid. None of them experienced bucking or coughing at any time during the procedure. Conclusion: Wefound that intraoperative nerve monitoring tube had greatly reduced the incidence of RLN/SLN (Superior laryngeal nerve) palsy.Adequate depth of anaesthesia could be achieved without the use of muscle relaxants. No incidence of increased length of hospital stay was noted. We have highlighted ourperioperative anaesthetic management strategies so that it will be useful for the future anaesthesiologists
Morphological variations in Common Facial Vein with variant venous drainage
Full text linkBackground: In depth anatomical knowledge of the facial vasculature is crucial not only for anatomists but also for Oto-rhino-laryngologists, reconstructive and oral and maxillofacial surgeons. The common facial vein (CFV) is a vital component of the facial venous system, which exhibits morphological variations that impact surgical and diagnostic procedures. The present study investigates the CFVs anatomical diversity, focusing on the divergent venous drainage patterns. Aim: To describe rare anatomical variations of the common facial vein. Material and Methods: The study was conducted in the Department of Anatomy, of a tertiary care establishment (Medical College) in Western Maharashtra, during the period 2023-24. Head and neck region of 20 cadavers (11 males and 9 females) i.e. 40 sides of embalmed cadavers of different age group were carefully dissected, and studied for variations in the formation and drainage pattern of Common facial vein. Results: In 34 sides (85 %), the common facial vein (CFV) terminated into the Internal jugular vein (IJV) as per standard anatomic description. On one side of the cadaver, the left common facial vein (2.5%) was found draining into the anterior jugular vein (AJV) as well as into the internal jugular vein (IJV). In three cadavers (7.5%), the CFV was found to be draining into the AJV. In two cadavers (5%), the facial vein (FV) was not receiving the anterior division of retromandibular vein and was directly draining into the IJV. Conclusion: A sound knowledge of variation in the course and termination of common facial vein is very useful for the clinicians and surgeons who perform procedures like cannulation and vein graft harvesting for endarterectomies of the head and neck region
Graphene Oxide Nanoparticles: A Genotoxic Risk for Patients with Lung Cancer, COPD and Asthma
Full text linkThe use of graphene oxide (GO) nanomaterials (NMs) has grown significantly over the last few decades because of theirbiomedical uses in anti-cancer medication delivery. Because of their distinct physicochemical characteristics and favorablesurface chemistry, which includes unbound surface functional groups that facilitate covalent bonding with organic molecules like DNA and RNA, GO NMs are great options for drug delivery nanocarriers. There are worries regarding their genotoxicity despite their growing use in biomedical applications. The impact of GO NMs on DNA has been the subject of relatively few published studies on humans, much less those with chronic lung diseases. The effects of commercial GO (15–20 sheets; 4–10% edge-oxidized; 1 mg/ml) in vitro are examined for the first time in this study. Specifically, DNA damage and other genotoxic endpoints are examined in whole blood and peripheral blood leucocytes (PBL) from both healthy individuals and patients with chronic pulmonary diseases, such as lung cancer, asthma, and chronic obstructive pulmonary disease (COPD). Following thorough characterization of commercial GO NMs, neutral red uptake (NRU) and dimethyl thiazolyl diphenyltetrazolium bromide (MTT) assays were used to perform cytotoxicity studies.. On the other hand, alkaline Comet and cytokinesis-blocked micronucleus (CBMN) assays were used to investigate genotoxicity (DNA damage and chromosome aberration parameters). According to our findings, cytotoxicity, genotoxicity, and chromosome abnormalities increased with concentration, and PBL from patients with lung cancer and COPD was more vulnerable to DNA damage than that of asthma patients and healthy controls. When designed to deliver drug payloads to cells for the treatment of cancer or COPD, GO NMs may play promising roles in drug delivery applications. However, the fact that exposed cells from healthy individuals had higher levels of cytotoxicity, genotoxicity, and chromosome instability parameters all biomarkers of cancer risk should raise concerns about public health, particularly when GO NMs are used as drug delivery nano-carriers in medical treatments and occupational exposures.
Clinical Profile and Outcome of Patients Admitted with Rodenticide Poisoning – A Single Centre Experience from Andhra Pradesh
Full text linkIntroduction: Rodenticides are easily available and inexpensive poisons found in almost every house in India to prevent rodent infestation. Rodenticide poisoning is the second most common type of poisoning in the Indian Subcontinent, and there is a limited amount of research on it. The aim of our study is to evaluate the clinical profile of patients admitted with rodenticide poisoning and to correlate various parameters like serum bilirubin, and serum creatinine with mortality. Methodology: A prospective hospital-based study of 100 consecutive cases diagnosed as Spontaneous Pneumothorax from January 2019 to September 2020. Every patient underwent comprehensive history taking, in-depth clinical examination, and investigations. Data were entered into Excel spreadsheets in 2019. Data was presented by using frequency and percentage and descriptive statistics were used. Results: A total of 100 patients were included in the study. The most commonly consumed poison was a phosphorus-based paste. The most common symptom reported was abdominal pain (90%). Warfarin-based baits were associated with a high incidence of bleeding manifestations. The mortality rate was 20%. Additionally, a delay in hospitalization was found to be a significant risk factor for mortality. Higher mortality rates and was accompanied by elevated bilirubin and SGPT levels. Conclusion: In this study, mortality was 20%, all due to phosphorus compound. Mortality was common in phosphorus compound, particularly in those who developed jaundice on day 4 of admission which is reflected by elevated bilirubin and serum creatine level
Pattern of ocular comorbidities in patients presenting with cataract in a tertiary eye care hospital
Full text linkIntroduction: Cataract is a slowly progressing eye condition marked by clouding of the normally clear lens of the eye or its capsule that prevents light from entering the eye. Ocular comorbidities are collections of eye conditions that exist simultaneously, regardless of their etiopathogenic relationship. Ocular comorbidities are frequently associated with reduced quality of life and disabilities caused by visual impairment. Aim: To determine the pattern of ocular comorbidities in patients presenting with cataract in a tertiary eye care hospital. Material and methods: This hospital based observational study was conducted in the OPD of the Department of Ophthalmology, Government Medical College Jammu over a period of 1 year from November 2021 to October 2022. A total of 500 patients were included in this study. Data was collected using a clinical proforma and analysed using SPSS inc., v.16. Results: The present study found majority of the participants 195(39.0%) in the age group of 61-70 years with female to male ratio of 1.15:1. Diabetic retinopathy was the most commonly associated ocular comorbidity seen in 5.5% of cataract patients. (5.4% R/E and 5.6% L/E). Conclusion: Adequate control of coexisting ocular diseases is of utmost importance in order to avoid any intraoperative or postoperative problems, anticipating visual outcomes and improving visual results postoperatively by taking necessary steps wherever possible
Hematological profile in geriatric patients with special emphasis on morphological and etiological classification of anemia in patients presenting at a tertiary care hospital
Full text linkBackground& Objective: Anemia is prevalent among geriatric populations and can have significant implications for health outcomes. Understanding the hematological profile of geriatric patients, particularly the morphological and etiological classification of anemia, is crucial for effective management and intervention.This study aimed to investigate the demographic characteristics, etiology, and correlation of red blood cell indices with anemia in geriatric patients presenting at a tertiary care hospital. Methods: A prospective analysis was conducted on data from geriatric patients with anemia, focusing on age, gender distribution and etiology. Hemoglobin levels and hematological indices were correlated with underlying causes of anemia. Results: The majority of participants (83.6%) fell within the 65-75 age range, with a slightly higher representation of females (56.2%). Iron deficiency (35.2%) was the most common cause of anemia, followed by anemia of unknown etiology (34.2%), anemia of chronic diseases (19.6%), megaloblastic anemia (8.5%), and dimorphic anemia (2.5%). Correlation analysis revealed distinct patterns in red blood cell indices across different etiological subtypes, with significant differences in hemoglobin levels, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width. Conclusion: The study provides valuable insights into the hematological profile of geriatric patients with anemia, highlighting the prevalence, causes, and correlations associated with this condition. These findings underscore the importance of comprehensive assessment and tailored management strategies for older adults with anemia. Prospective, multicenter studies are needed to validate these findings and improve outcomes for geriatric patients with anemia
Formulation and evaluation of fast dissolving tablet-bilastine
Full text linkIn the present, study to establish Fast dissolving tablets of Bilastine by using different ratio of superdisintegrants. The tablets were prepared by using two superdisintegrants( croscarmellose sodium, sodium starch glycolate) in different composition. Development of Fast dissolving tablets of Bilastine were designed to give rapid onset of action and help those patients who have difficulty in swallowing the drug . The present study aims to improve patient compliance, reduce the condition of dysphagia and also reduces the multiple dosing. Tablets were evaluated by different parameters such as Weight variation, Tablet hardness, Friability ,Mouth feel ,Wetting time, Water absorption ratio, In vitro drug release study, In vitro disintegration time, Drug content uniformity, Accelerated stability testing. The present study concludes that fast dissolving tablets of Bilastine with different composition of superdisintrgants shows rapid disintregation time as well as dissolution profile which represents rapid onset of action of the formulation
Formulation and evaluation of sustained release floating microspheres of ketorolac using chitosan as a natural polymer
Full text linkSustained release medication conveyance Systems is a way to deal with broaden the gastric duration of medication in stomach. This technique is intended for site-explicit oral medications with low mass thickness than gastric liquid so on light the measurement structures in stomach to expand the span of the medication and consequently improve the bioavailability of medication. As a response to the issue, gastroretentive medication conveyance frameworks (SRDDS), which highlight an improved gastric length (GRT), were created.The in vitro data indicated that pure drug showed 100% release within 2 hr. The drug release from the microspheres prepared in formulation F6 achieved 92.40±0.2% in 24 hr. per model fitting methods the very best parametric statistic (R2) value was 0.978 through Higuchi order model. Hence from all aspects; we concluded that the discharge of drug Ketorolac will be controlled by proper designing of the formulation and selection of an acceptable method of preparation