International Journal of Health and Clinical Research
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Review on Floating Microsponges: An Updated
Get PDFFloating microsponges are an approach to prolong gastric residence time, there by targeting site-specific drug release in the upper GIT for local orsystemic effect. Gastro retentive dosage forms (GRDFs) are being used from a very long time to improve therapy with several essential drugs.Floating microsponge greatly improves the therapy of stomach by releasing the drug locally and thus used for drug targeting at particular organ.This can be sustained over a longer duration of time. Floating drug delivery (FDDs)permit prolonged and continuous release of the drug to theupper part of Gastro intestinal tract (GIT) and this expressively extend the duration of drug release and improve bioavailability of drugs that havenarrow therapeutic window, by this technique dosing frequency and patient compliance is increased. The purpose of this paper is to brieflydescribe the floating microsponge drug delivery (FMDD), factors related to Floating Drug Delivery, its advantages disadvantages, and emphasisis given over its significance over conventional form of drug deliveries
Efficacy of Intravitreal Bevacizumab versus Intravitreal Triamcinolone for treatment of Uveitic Macular Edema in tertiary care hospital of Jharkhand
Get PDFBackground: Uveitic macular edema is most common cause of visual impairment in both infectious and non-infectious uveitis. It accounts for more than 30% cases of active uveitis. Purpose: To compare the effects of Intravitreal injections of Bevacizumab and Triamcinolone for the treatment of Cystoid macular edema in non-infectious uveitis. Methods: 40 eyes of 35 consecutive patients with CME associated with non-infectious uveitis were divided to 2 groups. 20 eyes were treated with 1.25mg of IVB and 20 eyes received 4mg of IVT. The clinical course of Best corrected visual acuity, Intraocular pressure and Central macular thickness by Optical Coherence Tomography was monitored for up to 6 months after the initial injection. Results: The best visual acuities were achieved 1 month after injection in both groups. In IVB group improvement in Visual acuitywas achieved in 16/20(80%) of eyes and in IVT group was 19/20(95%). In IVT group intraocular pressure was found to be raised. The Central macular thickness reduction in the IVT group wasfrom 298.52μ to 197.68μ and in IVB group was from 311.76μ to 227.13μ. Conclusion: Both IVB and IVT treatments can effectively improve Best corrected visual acuity and reduce Central macular thickness in Uveitic Cystoid macular edema patients. The Central macular thickness reduction was greater in IVT groupthan IVB group. The IVT group causes increase in intraocular pressure
Comparative study of laparoscopic appendicectomy versus open appendicectomy in appenidicitis patients
Get PDFLaparoscopy in patients with a clinical suspicion of acute appendicitis has not gained wide acceptance and its use remails controversial. Laparoscopic appendicectomy has been shown to be both feasible and safe in randomized comparisons with open appendicectomy. In addition to improved diagnostic accuracy, laparoscopic appendicectomy confers advantages in terms of fewer wound infection,less pain faster recovery and earlier return to work. However laparoscopic appendicectomy is more time consuming is associated with increased hospital costs. It has been argued that the advantages of laparoscopic appendicectomy achieved by experienced laparoscopic surgeons are marginal compared with open appendicectomy, which can also be performed by surgeons in training through a short, cosmetically acceptable incision with minimal complications and a short hospital stay. Although the most people have concluded that the laparoscopic technique is as least good as open technique, there has been considerable controversy as whether laparoscopy is superior. Aims and Objectives: In this study the different aspects, e.g. intra operative diagnosis, operating time and other advantages and complications of laparoscopic appendicectomy were observed and compared to that of open appendicectomy in our setup.Materials and Methods:The present prospective study has been carried out in the Department of General Surgery, Rajendra Institute Of Medical Sciences, Ranchi from September 2020 to August 2021. 50 patients presented in the hospital with the clinical features of acute appendicitis were selected for the study. These patients were divided into two groups in a random way, 25 patients underwent open surgery and 25 patients underwent laparoscopic surgery.Conclusion :Laparoscopic appendicectomy has the advantage to directly visualize the entire peritoneal cavity and can deal with other associated pathologies. Besides good cosmesis it has the disadvantage of being expensive and having increasing operating time. Complicated cases may have to converted to open procedure. Open appendicectomy is not only cheap and faster but also has good cosmesis in uncomplicated cases. Even the complicated cases can be managed better and has lower incidence of residual intra abdominal abscess. So to conclude open appendicectomy is safe, cost effective and remains the procedure of choice in our set up
Comparison between oral clonidine and oral pregabalin as premedication to attenuate pressor response to direct laryngoscopy and endotracheal intubation
Get PDFBackground: Laryngoscopy and endotracheal intubation are the modern routine procedures of balanced general anaesthetic technique. Laryngoscopy and tracheal intubation induced pressor responses have been associated with increased catecholamine levels. So, it is important to find an effective means by attenuating the sympathetic response to laryngoscopy and intubation. Pregabalin decreases pre-operative stress and anxiety response to intubation. Premedication with Clonidine is to produce sedation and blunt the stress response to intubation. Aim: To compare the efficacy of Oral CLONIDINE with Oral PREGABALIN as premedication to attenuate pressor response to direct laryngoscopy and endotracheal intubation. Materials and methods: This was a prospective study, approved by the institutional ethical committee. A total of 60 patients undergoing elective surgery were selected A total of 60 patients were divided into two groups of 30 each, group C (clonidine), and groupP (pregabalin). careful preanesthetic evaluation should be done for all the patients. A valid informed consent should be obtained both for conduct of study as well as for surgery and anaesthesia. Patients should be kept nil per oral from midnight before surgery. Discussion: Induction of general Anaesthesia, direct laryngoscopy and endotracheal intubation attenuates marked cardiovascular changes and also the activity of autonomic reflex. The response may be particularly haphazard to the patients with cardiovascular and cerebral diseases. Most of the studies have reported the use of oral Clonidine premedication to prevent hyper-adrenergic and dynamic cardiovascular responses to endotracheal intubation have been successful. Pregabalin had been shown to be effective in neuropathic pain, diabetic neuropathy, acute post-operative pain and decreasing the postoperative opioid requirements. Conclusion: Clonidine was found to be more effective than Pregabalin in lowering of blood pressure and heart rate changes associated with laryngoscopy and intubation. Pregabalin when compared with Clonidine gives better postoperative analgesia, more sedation and less bradycardia
Comparison of Outcomes Among Neonates Born to Diabetic Mothers Receiving Insulin and Metformin: A Prospective Observational Study
Get PDFBackground: Indian national guidelines (2018) adopted treatment with metformin as first choice of pharmacological agent next to medical nutritional therapy during pregnancy for diabetic mothers after 20 weeks of gestation. Objectives: A prospective observational study was planned to compare outcome of neonates of diabetic mothers categorized across different treatment regimens (I: meal plan only, II: meal plan and metformin or III: meal plan and insulin). Materials and methods: 100 neonates born to mothers with diabetes mellitus (DM) were included; early neonatal outcomes such as hypoglycemia, hypocalcemia, neonatal hyperbilirubinemia (NNH), birth asphyxia, polycythemia, respiratory distress (RD), birth injuries, congenital anomalies, large for gestational age (LGA) and admission to neonatal intensive care unit (NICU) were compared across the different categories of treatment in mothers. Results: Among the 100 included neonates, 37 were born to mothers who received only meal plan; 44 to mothers who received meal plan and metformin; 19 to mothers with meal plan and insulin. There was statistically significant (Fisher’s exact test) increase in incidence of congenital anomalies (P value= 0.0000); hypoglycemia (P value= 0.023), hypocalcemia (P value= 0.00004), NNH (P value= 0.0001), RD (P value= 0.013), LGA (P value= 0.0027) and NICU admissions (P value= 0.005) in meal plan and insulin group (Group III). Binary logistic regression analysis revealed that neonates of mothers treated with meal plan and insulin had 11 times increased odds of experiencing NNH. Conclusion: There was no difference in outcomes of neonates born to mothers receiving different treatments for DM (meal plan only/ meal plan and metformin/ meal plan and insulin) except NNH
Efficacy of endometrial aspiration cytology in diagnosis of endometrial pathologies in a tertiary care centre
Get PDFIntroduction: Endometrial pathologies contribute significantly to increased morbidity and mortality in females, and still tend to remain undiagnosed till later stages. Endometrial cytology is one of the most powerful and reliable investigations in detection of various endometrial pathologies, including hyperplasia, malignancies and can be used as an early evaluative modality on routine basis.Objectives: The present study was aimed at assessing the diagnostic efficacy of endometrial aspirate cytology in the diagnosis of various endometrial pathologies in terms of accuracy, sensitivity and specificity etc., considering histopathology as standard . It also involved the study of various morphological patterns ranging across the spectrum of endometrial pathology by aspiration cytology .Material and methods: Using Karmann’s cannula, endometrial aspirate sample was obtained in 106 patients from gynaecology out-patient department and the smears were stained using papanicolaou stain. The findings of cytology were correlated with histopathology.Results: The present study comprises 106 patients. 102 out of 106 samples for cytology were adequate with an overall diagnostic accuracy of 95.1% , a sensitivity of 93.2%, specificity of 97.7%, with 98.2% positive predictive value and 91.3% negative predictive value.Conclusion: Endometrial aspiration cytology is an easy to perform, minimally invasive, safe and cheaper procedure for diagnosing endometrial pathologies. Its results are fairly acceptable with good cyto-histopathological correlation and hence can be used for screening of endometrial pathologies and malignancies
Comparing Alcohol Related Seizures And Primary Seizures In Terms Of Serum Calcium Levels
Get PDFBackground: Alcohol- related seizures are defined as adult onset seizures that prevail in long term alcohol dependence Ethanol can cause hypocalcemia and can lead to seizures. Therefore, this study is to establish the hypocalcemia prevalence in the general convulsive population and to look if there was a threat from hypocalcemia among alcoholics. Aim of the study: To compare alcohol related seizures and non alcoholic primary idiopathic seizures in terms of serum calcium. To study the hypomagnesemia prevalence in hypocalcemic cases in both alcohol related seizures and primary idiopathic seizures. Materials and Methods: This study was a case control study done in 110 patients between November 2020 – October 2021 at ASRAM Medical college, Eluru , Andhra Pradesh. Grounded on former records and past negative neurological history , blood , radiological investigations persons were divided into cases (with alcohol history)and controls(without alcohol history).Serum calcium and magnesium levels were measured in both groups and compared. All the results were tabulated and statistical significance was calculated using pearsons chi square tests. Results: On comparing hypocalcemia persons in both cases and control groups there is no statistically significant difference (p value – 0.24). Hypomagnesemia prevalence among hypocalcemic patients in the case group is significant (p value - 0.03) but not in controls (p value – 0.56) .Conclusion: Hypocalcemia prevalence among alcohol related seizures was linked but not statistically significant while hypomagnesemia prevalence was significant in the hypocalcemic alcoholic case
Recurrence rates of Single or Double Burr Hole in Chronic Subdural Hematomas
Get PDFAim: Analysis of recurrence rates of single versus double burr holes in patients with chronic subdural hematomas.Material and Methods: The study was a prospective randomized controlled trial on patients with chronic subdural hematomas. A written consent was taken from the patient or patient party after explaining the procedure. A total of 191 patients were enrolled in the study over a period of 12-months in the Department of Neurosurgery, Patna Medical College and hospital, Patna.Results: Recurrence rates in single and double-burr-hole groups were 7.44% and 5.55% respectively, which was not statistically significant.Conclusion: The most effective procedure for the treatment of chronic subdural hematomas is single burr-hole drainage
Acetic Acid Versus Ciprofloxacin Ear Drops In Treating Chronic Otitis Media: A Comparative Study
Get PDFBackground: Chronic suppurative otitis media (CSOM), which is now presently referred to as chronic otitis media (COM), is a chronic inflammation of the middle ear cleft including the eustachian tube, middle ear proper, aditus, antrum, and mastoid air cells.Since its effects are prolonged or repeated, a chronic middle ear infection is often more destructive than an acute middle ear infection. It’s recently been classified as mucosal type (active/inactive ), squamosal ( active/inactive), and healed chronic otitis media. Ear discharge and hearing loss are the common symptoms of COM. In developing countries, COM is a leading cause of acquired hearing loss.Topical antibiotics are the foremost commonly used for treating COM which usually act by killing or inhibiting the development of micro‐organisms responsible for the infection. For COM, antibiotics alone or in addition to other treatments can be used, like ear cleaning (aural toileting).Methods: This prospective study involved all the patients with chronic otitis media mucosal type who abide by inclusion and exclusion criteria treated with diluted acetic acid ear drops in one group and ciprofloxacin ear drops in another group.A total of 100 patients were selected in a period of 10 months from January 2021 to October 2021 who visited the otorhinolaryngology outpatient department of Navodaya medical college, and were divided into two groups. 50 patients of Group A were treated with diluted acetic acid ear drops and 50 patients of group B were treated with ciprofloxacin ear drops. The pretreatment and post-treatment findings were assessed.Results: Using diluted acetic acid ear drops in treating chronic otitis media gave better results for the absence of discharge, mucosa of the middle ear, and perforation healing when compared to ciprofloxacin ear drops.Conclusion: Medical management of active COM mucosal type by irrigation with dilute acetic acid could be more effective in comparison to topical antibiotics. Acetic acid preparation can be used as preferred medical management before surgical management for obtaining a dry ear, however patient compliance is an crucial factor for a better outcome. Use of acetic acid drops is the better alternative to topical antibiotics in terms of cost-effectiveness and fewer side effects
Association of cephalometric measurements on lateral cephalograms between two groups of Rajasthan population
Get PDFBackground: Facial features differ amongst different races and ethnic groups. These different shapes of face are affected by ethnical, ecological, biological, geographical, gender, age, and nutritional factors. The lateral cephalometric radiograph is one of the diagnostic records in registering the antero-posterior and vertical configuration of the facial skeleton. This is used to produce standard mean value for skeleton, dental & soft tissue structures for different ethnic groups. Aim and Objectives1. To study craniofacial features of both Rajputs and Meenas2. To compare both features for assessing the differences in landmark identificationMaterial & Methods: A Cross-sectional descriptive type study was carried out in 100 lateral cephalograms of healthy male adults (50 Rajputs and 50 Meenas) whose age ranged between 15 to 40 years, belonging to Rajasthan. Results: Statistically significant difference was found in two linear measurements and one angular measurement between Rajputs and Meenas. Conclusion: It was concluded that two linear measurements related to facial skeleton namely Posterior facial height and maxillary base length were found to be statistically significant between Rajputs and Meenas. One of the angular measurements related to Facial Skeleton namely the Saddle Angle was also be found statistically significant