International Journal of Health and Clinical Research
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Prevalence and risk factors of cataract in type 2 Diabetes mellitus: A Cross sectional study
Get PDFBackground& Objective: To estimate the prevalence of cataract in patients with type 2 diabetes mellitus and the possible risk factors associated with it. Methods: Cross sectional study carried out at a tertiary eye care centre in North Karnataka from 2012 to 2014. Patients with type 2 diabetes mellitus 40 years and above were enrolled. A detailed history, including data on demographics, diabetes, and ocular history, was obtained from all patients. A detailed systemic and ocular examination was done. All patients underwent biochemical tests: Fasting Blood Sugar (FBS), glycosylated haemoglobin (HbA1c) and serum cholesterol. Results: Out of the 750 patients with Type 2 Diabetes Mellitus enrolled in our study, 492 patients had cataract and 258 had no cataract. 242(60.35%) were males and 250(71.63%) were females. Prevalence of cataract in Type 2 Diabetes was 65.60%. Patients on OHA’s had higher incidence of cataract (P=0.0021). There was statistical significance between positive family history of diabetes and cataract (P=0.0271). There was no statistically significance between SBP (P=0.1108), DBP(P=0.0515) and cataract. Prevalence of diabetic retinopathy in cataract group was 78.80% and only 21.20% in non cataract group (P=0.0002). Mean FBS was 176.44mg/dl (P=0.00001) and mean HbA1c was 8.29% (P=0.00001) in cataract group and both were statistically significant. Conclusion: Nearly two thirds of the diabetic population showed evidence of cataract. Increasing age, female sex, longer duration of diabetes, positive family history of diabetes, diabetics on OHA’s agent, poor glycemic control i.e. raised FBS and high HbA1c levels were risk factors for development of cataract. Modulation of these variables may delay the occurrence of cataract in population of type 2 diabetes mellitus
Clinical Study of Posterior Urethral Valves
Get PDFBackground: Posterior urethral valves are the commonest structural cause of urinary outflow obstruction in boys.(1) It is also the most common type of obstructive uropathy leading to childhood renal failure.Aims and Objectives: To observe the clinical, biochemical and imaging patterns of posterior urethral valves and how they change after initial treatment and during follow up.To review the results of Primary valve ablation and Vesicostomy in management of Posterior urethral vales Materials and methods:We prospectively studied 28 patients from October 2015 to September 2017 with posterior urethral valves who were primarily treated at our hospital or referred from other hospitals for subsequent therapy.Results: Only two patients (i.e., 7.14%)had a prenatal diagnosis as part of antenatal ultrasound examination. Decreased urinary stream and straining to void are the most common symptoms in present study. Reflux resolved completely in 7of 16 units (43.75%), reduced in grade in 3 of 16 units (18.75%) and remained unchanged in 6 out of 16 units (37.5%).In the present study 10.71% of patients had CRF, whose age at presentation was more than 5 years of age. All these patients had serum creatinine at presentation > 2 mg/dl.Conclusion: In any male child with bilateral hydroureteronephrosis & distended bladder on ultrasonography, a diagnosis of PUV should be entertained.The management of PUV at the first outset should be, urethral catheterization, stabilization of general condition, followed by primary valve ablation.The shortterm results of Primary valve ablation are good.Vesicostomy is equally effective. Reflux tends to disappear or decrease in grade in majority following appropriate surgical management.Delay in diagnosis results in poor outcome of renal function.A much longer period of follow up is needed to understand the longterm results
A Prospective Study on Outcome of High Tibial Osteotomy Among Patients of Osteoarthritis of Knee Joint With Varus Deformity At A Tertiary Care Center of Bihar
Get PDFIntroduction: Osteoarthritis is a degenerative disease characterized by gradual development of joint pain, stiffness, swelling and limitation of movements. Osteoarthritis causes chronic disability; the degree of disability depends on the site involved and varies greatly between individual. In the present study, outcome after high tibial osteotomy has been evaluated with respect to postoperative improvement and individual goal achievement. Methodology: A prospective interventional single centre study was conducted at Madhubani Medical College & Hospital, Bihar during the period of 1 year between August 2019 to July 2020 after permission from Institutional Ethical committee. After this, the patients were followed up till 12 months. The patients included were those who had standard indication for High tibial osteotomy. Inclusion criteria to include the patients in this series were, Unicompartmental Arthritis of knee with varus deformity, good muscle strength to carry out rehabilitation and good vascular status without arterial insufficiency. During the study period, a total of 20 patients were selected and assessed preoperatively and postoperatively with Knee Society score and Functional Score sheet. Assessment and evaluation was done using a regularized custom made protocol which included the symptoms of the patients, associated medical conditions, knee society score and knee society functional score. Results: In the current study, the age of the patients had ranged from 44 – 53 years with a mean age of 48.4 years. Among the 20 patients, majorities were female with a male: female ratio of0.54:1. For majority of the patients right side of the knee was involved and 3 patients had bilateral knee involvement. 75% of the patients had grade III type of Osteoarthritis and rest 25% had grade IV type of Osteoarthritis. Conclusion: The main improvements seen in this study were related to pain reduction and an increase in the knee score and functional score after high tibial osteotomy and also delays the need for total knee replacement
Osteoporosis in postmenopausal women - A major cause of concern
Get PDFBackground: Osteoporosis is a metabolic disorder of the bones that is characterized by decreased bone density which predisposes to increased fracture risk. The disease can exist undiagnosed for a long time as it produces no distinct symptoms. Aim: To assess osteoporosis in postmenopausal women. Materials and Method: This is a prospective study conducted on Post menopausal women. Women who had undergone hysterectomy or who were on hormone replacement therapy or calcium or vitamin D preparations were excluded from the study. The participants underwent BMD measurement by Achilles Ultrasound bone densitometer. The results of BMD were analysed on the basis of T-Scores. Results: Of the 90 patients that were included in the study 42.2 % (n=38) were in the age group of 45-55years. In almost 50% of patients the duration of menopause was 6-10 years. Out of the 90 patients 10% (n=9) were normal, 44.4% (n=40) were osteopenic, 33.3% (n=30) were osteoporotic and 12.2% (n=11) were severely osteoporotic. Backache was the commonest presenting symptom in the study population. Conclusions: Quantitative ultrasound (QUS) is a rapid and in-expensive method of measuring bone density. In our study 90% of the postmenopausal women had subnormal T scores. We recommend regular BMD measurements in postmenopausal subjects for early diagnosis and treatment of osteoporosis in this vulnerable group
Phenotypic speciation of clinical isolates of Enterococci with special reference to Vancomycin susceptibility by Broth Micro-dilution method
Get PDFBackground: Enterococci, once regarded as a commensal in the gastrointestinal tract, are now emerging as an important nosocomial pathogen. By intrinsic and acquired mechanisms of resistance, they pose a significant therapeutic challenge. Objectives: This study aims to characterize Enterococci up to species level based on their phenotypic characters and study their antibiogram with special mention to Vancomycin susceptibility. Materials and Methods: A cross-sectional descriptive study was conducted in the Department of Microbiology, Andhra Medical College. A total of 47 Enterococci isolates recovered from clinical specimens like Urine & Pus are included in this study. Specimen processing and speciation were done according to standard protocols. Kirby–Bauer disc diffusion technique was used to study antimicrobial susceptibility pattern with recommended drugs including high-level aminoglycoside resistance, whereas the minimum inhibitory concentration of vancomycin was determined by the Broth Microdilution method, with reference to the Clinical and Laboratory Standards Institute guidelines (CLSI). Results: Two different species of Enterococci were isolated, E. faecalis and E. faecium accounting 86% and 14% each. All the strains were sensitive to Vancomycin, Linezolid and Teicolplanin, while all the urine isolates are also sensitive to Nitrofurantoin. Disparities were not observed between the disc diffusion technique and Broth Microdilution method in determining vancomycin resistance. Conclusion: E.faecalis and E. faecium were the predominant species in causing Enterococcal infections. To maintain the low level of resistance, improvement of antibiotic policies and hospital infection control is essential
Comparison of fibrinogen levels in diabetic hypertensives vs diabetic normotensives
Get PDFBackground: The metabolic dysregulation associated with DM causes secondary pathophysiological changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system. Aim: To compare plasma fibrinogen levels in type-2 diabetics with hypertension and type-2 diabetics without hypertension. Methods: Prospective observational study was undertaken on 200 subjects aged 40-60 years from November 2019 to October 2020 with patients of Type-2 diabetes mellitus (both old and new cases) with hypertension without having any of the complications associated with diabetes and on age and sex matched diabetics without hypertension. Results: Mean value of fibrinogen of Group 1 was 484.91 ± 49.15 mg/dl and that of Group 2 was 436.53 ± 22.61 mg/dl, the difference between the two groups being statistically highly significant (p<0.0001). Mean systolic and diastolic blood pressure in Group 1 was 127.64 ± 13.41 and 86.20 ± 7.06 mmHg and that of Group 2 was 118 ± 10.80 and 77.52 ± 7.87 mmHg, the difference between the two groups being statistically highly significant (p<0.0001). Mean Fasting Blood sugar of Group 1 was 177.91 ± 62.52 mg/dl and that of Group 2 was 197.80 ± 74.75 mg/dl, the difference being highly statistically significant (p= 0.043). Conclusion: The mean fibrinogen levels in patients with both diabetes and hypertension were significantly higher than diabetes alone, indicating that elevated fibrinogen levels are a risk factor for development of macrovascular complications and thus a marker of morbidity and mortality
A Hospital Based Randomized Prospective Control Study to Compare the Prolene v/s Polyglactin Sutures (Vicryl) for Mesh Fixation in Assessing Postoperative Chronic Pain Using VAS in Inguinal Hernia Repair
Get PDFBackground: Inguinal Hernia is one of the most common general surgical problems. Pain could be related to nerve mangling while operating. The aim of this study to compare the prolene v/s polyglactin sutures (Vicryl) for mesh fixation in assessing postoperative chronic pain using VAS in inguinal hernia repair. Materials & Methods: A hospital based prospective study done on 50 patients undergoing Lichtenstein’s repair in department of surgery at District hospital, Dholpur, Rajasthan, India during one year period. The patients were divided into two groups of 25 each as follows: patients undergoing mesh fixation with polyglactin as suture material in Lichtenstein mesh repair formed group A (study group). Patients undergoing mesh fixation with polypropylene suture material in Lichtenstein mesh repair formed group B (control group). All the patients were assessed for post-operative on the post-operative day 1, 3, 7 and also after 3 months. To grade the pain we used visual analogue score ranging from 0 to 10 considering 0 as no pain and 10 as severe pain. The categorical data were expressed as rates, ratios and percentages and comparison was carried out with chi–square tests, Continuous data were expressed as mean±standard deviation. A p-value of less than or equal to 0.05 was considered as statistically significant. Results: Our analysis showed that the incidence of postoperative groin pain at postoperative day 1, 3 in both groups were similar and statistically not significant whereas the 1 week and 3 months follow up in group A and B respectively, were significant (p<0.05). Conclusion: We concluded that; using polyglactin suture material to fix mesh is a safe, simple as well as and effective alternative to the conventional usage of polypropylene sutures for fixing the mesh in Lichtenstein hernia repair
A Hospital Based Cross Sectional Study to Assess the Socio Demographic Profile of the Patients with Leprosy
Get PDFBackground: Leprosy is a common infectious disease causing as much social problem as a medical one. It leads to variety of disabilities resulting from nerve damage, immunological reactions and bacillary infiltration. Among communicable diseases, it remains a leading cause of peripheral neuropathy and disability worldwide. Objective: To assess the Socio demographic profile of the leprosy patients attending the clinic at Shri B M Patil Medical College Hospital. Methodology: A hospital-based, cross sectional study to detect deformities/disabilities in patients with leprosy was conducted in the department of Dermatology Venereology and Leprosy of B.L.D.E.U’s Shri. B.M. Patil Medical College Hospital and Research Centre, Vijayapur, Karnataka. One hundred and forty six cases were included in the study. The study duration was from November 2014 to September 2016. Results: Among the 146 patients enrolled in the study, 85 were male and 61 were female, 10 were children, with a mean age of 38.1(±15.6) years. The mean duration of disease was 2.6 (±4.1) years. Majority of the patients belonged to lower socioeconomic (S-E) status (n=100, 68.5%) followed by middle (n=46, 31.5%). Most common type was multibacillary in 133 (91.1%) patients followed by paucibacillary in 13 (8.9%) patients. Out of 146 patients, 56 (38.4%) had the disease for 1-2 years, followed by 39 (26.7%) patients, whose disease duration was less than one year. Conclusion: Out of 146 patients, 56 (38.4%) had the disease for 1-2 years, followed by 39 (26.7%) patients, whose disease duration was less than one year
Comparison of fibrinogen levels in diabetic hypertensives vs diabetic normotensives
Get PDFBackground: The metabolic dysregulation associated with DM causes secondary pathophysiological changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system. Aim: To compare plasma fibrinogen levels in type-2 diabetics with hypertension and type-2 diabetics without hypertension. Methods: Prospective observational study was undertaken on 200 subjects aged 40-60 years from November 2019 to October 2020 with patients of Type-2 diabetes mellitus (both old and new cases) with hypertension without having any of the complications associated with diabetes and on age and sex matched diabetics without hypertension. Results: Mean value of fibrinogen of Group 1 was 484.91 ± 49.15 mg/dl and that of Group 2 was 436.53 ± 22.61 mg/dl, the difference between the two groups being statistically highly significant (p<0.0001). Mean systolic and diastolic blood pressure in Group 1 was 127.64 ± 13.41 and 86.20 ± 7.06 mmHg and that of Group 2 was 118 ± 10.80 and 77.52 ± 7.87 mmHg, the difference between the two groups being statistically highly significant (p<0.0001). Mean Fasting Blood sugar of Group 1 was 177.91 ± 62.52 mg/dl and that of Group 2 was 197.80 ± 74.75 mg/dl, the difference being highly statistically significant (p= 0.043). Conclusion: The mean fibrinogen levels in patients with both diabetes and hypertension were significantly higher than diabetes alone, indicating that elevated fibrinogen levels are a risk factor for development of macrovascular complications and thus a marker of morbidity and mortality
Study of Effectiveness of Near Peer Mentoring in Undergraduate Medical Students in a Government Run Medical College
Get PDFBackground: There is growing evidence for the positive effects of mentoring programs in undergraduate medical education in professional and personal development. Peer mentoring is a type of mentoring program in which individuals are equal in age, experience, and rank. This project was taken to introduce an immediate support network for the students of fourth semester MBBS to facilitate learning and overall development. The long term goal is to cultivate a mentoring culture at our medical college that will engage all strata of students. Methods: Two hundred Undergraduate medical students of fourth semester batch were included as mentees. Undergraduate medical students of sixth and eighth semester batch were taken as near peer mentor. After the sensitization meetings, each mentee was allotted to a near peer mentor. At the end of the mentoring period, the perceptions of the mentors and mentees about the mentoring programme were recorded. Marks of third and fourth semester examinations were compared to look for any improvement in scores. Results: 42 % of the mentees felt that they enjoyed the mentoring sessions as the near peers could understand their problems very well. Comparison of pre mentoring and post mentoring academic performance was done by analyzing the third and fourth semester theory and practical examination marks. The mean of third semester theory was 23.14 % and the same for 4th semester was 26.14 % (p<0.001). For the practical marks, the mean for third semester was 16.51 % and that of the 4th semester was 18.29 %. (p<0.001). The difference was more pronounced in cases of low achievers. Conclusions: Near-peer mentoring is a novel idea with beneficial effects on both mentee and mentors. Mentoring has some role in academic achievements of mentees, especially for low achievers. Mentors, in turn, benefit by honing of knowledge or acquiring communication and teaching skills critical for the development of a professional