International Journal of Health and Clinical Research
Not a member yet
3275 research outputs found
Sort by
A Study of fine needle aspiration of thyroid lesion by the 2017 bethesda system for reporting thyroid cytopathology and their correlation with thyroid function test - A prospective study
Get PDFIntroduction: Fine needle aspiration cytology is initial investigation for the diagnosis of thyroid lesions. The revised 2017 Bethesda system for reporting thyroid cytopathology provides a category based reporting system for FNAC of thyroid lesions. Thyroid function test also plays important role to manage patients. The present study was undertaken to categorise all the thyroid lesions according to Bethesda system into 6 categories and correlate with Thyroid function test. Material and Methods: The study period was from January 2020 to June 2021. During the study period, a total of 100 cases of thyroid fine needle aspirations were collected and categorized according to “The 2017 Bethesda System for Reporting Thyroid Cytopathology”. It was easy to classify the result in 6 categories. Later these cases were followed up with their thyroid profile test. Result: A total of 100 cases were studied, out of which 83 patients were females and 17 were males, with Female to Male ratio of 4.8:1. with a mean age of 35.96 years. Among 100 cases, non neoplastic category II lesions were the major proportion constituting 79%, category I unsatisfactory smears were 1%, category III 0%, next highest percentage of cases were in category IV with 14%, category V had 1% cases and category VI had 5% of cases. Patients with hypothyroid were 23%, patients with euthyroid were 68% and 9% patients were in hyperthyroid condition. Conclusion: The revised 2017 Bethesda system is an excellent reporting system for thyroid FNA. Both Bethesda categories and TFT are independent variables and there is no correlation between the
A To evaluate the effects of intrathecal clonidine as adjuvant to 0.5% bupivacaine (heavy) in lower abdominal surgeries
Get PDFBackground -Regional anaesthesia is one of the most preferred technique for lower abdominal and lower limb surgeries. It allows the patient to remain awake and minimizes problem associated with airway management. The technique is simple to perform and the onset of anaesthesia is more rapid than epidural anaesthesia, allowing the surgical incision to be made sooner. Clonidine, an α2 adrenergic agonist, has a variety of different actions. Clonidine has antihypertensive properties and the ability to potentiate the effects of local anaesthetics[10]. Clonidine has been shown to result in the prolongation of the sensory and motor blockade and the reduction in the amount or the concentration of local anaesthetic required to produce post-operative analgesia present study was designed to evaluate the effects of clonidine as an adjuvant to 0.5% bupivacaine (heavy), given intrathecally for prolonging the duration of analgesia. Materials and Methods-Present clinical study was conducted at MGM Medical college, kamothe, Navi Mumbai, the study was undertaken to compare the efficacy of clonidine as an adjuvant to 0.5%bupivacaine (heavy) for subarachnoid block in lower abdominal surgeries. It was prospective randomised control study done on 60 patients undergoing elective lower abdominal surgeries. Onset of analgesia was assessed by loss of sensation to pin prick every 30 seconds till the level of T10 dermatome was achieved. Following scales where used to assess duration of action of the drug Modified Bromage Scale, Visual Analog Score , Sedation Score. Results and Conclusion- The prolongation in duration of analgesia in clonidine group was statistically significant (p<0.05). It also prolongs the duration of motor blockade and analgesia in addition produces sedation with haemodynamic stability
Perception of Phase I MBBS students on newly implemented Early Clinical Exposure (ECE)
Get PDFBackground: Early Clinical Exposure (ECE) fosters exposure of the medical students to the patients as early as the first year of medical college and provides a clinical context and relevance to basic sciences learning. Objectives: To assess perception of phase I MBBS students on newly implemented ECE of Curriculum Based Medical Education (CBME) program by National Medical Commission. Material & Methods: A longitudinal educational interventional study was conducted on 150 phase I medical students in the Department of Anatomy. Six ECE sessions of three hours each containing case scenario, videos and simulated patient were conducted according to GMER-2019. Six didactic lectures were taken by the same faculty. MCQ based post-test was taken after each session. Feedback of students to know their perception regarding the ECE sessions was collected. Results: Phase I MBBS students perceived the ECE sessions of Human Anatomy very well. Students agreed that the ECE sessions of Human Anatomy helped them in understanding the correlations of applied anatomy of these topics and found it to be interesting. Students had better retention of the topics covered by ECE. The mean post test score of the students after the ECE sessions was 8.14/10, where as mean post test score after didactic lecture was 7.31 /10. The difference was statistically significant. Conclusion: Newly implemented ECE provide better retention of the topics and is a good tool for understanding the correlation of applied human anatomy for Phase I MBBS students
A Study to evaluate BMI in relation to hypertension amongst Young Adults: A Cross-sectional Study
Get PDFBackground: Pre-hypertension (HTN) in adolescents and young adults is an important risk factor for developing HTN in future. Increased body mass index (BMI) and physical inactivity may have an adverse effect on blood pressure (BP) in adults which can lead to cardiovascular complications later in life. This study was conducted to assess BP in relation with different obesity indicators. Aims: To study BMI, waist-to-hip ratio (WHR), systolic BP-to-height ratio (SBPHR), diastolic BP-to-height ratio (DBPHR), and BP in medical students. Materials and Methods: A cross- sectional study was conducted on 222 medical students. All the students were interviewed with predesigned questionnaire; BP, weight, height, waist and hip circumference were measured. Results: In 73.9% of the subjects BP was normal, 26.1% were pre-hypertensive, and there was no case of HTN. Mean systolic BP was 115.37 ± 8.21 mmHg, and mean diastolic BP was 75.70 ± 7.00 mmHg. Mean BMI was 21.72 ±3.64 kg/m2. 50% of the subjects were in the category of 0.85-1 WHR obese. For SBPHR (0.71 in male and 0.75 in female), sensitivity was 64.1%/68.4% and specificity was 80.8%/70.9%. And for DBPHR (0.46 in male and 0.49 in female), sensitivity was 64.1%/89.5% and specificity was 61.5%/67.4%, respectively. Conclusion: Out of 222 medical students, 2.7% were in obese Class I and 17.1% were in preobese/overweight category; 50% were in 0.85-1 WHR obese category, which indicates an alarming sign. We can propose SBPHR/DBPHR cutoff 0.71/0.46 in male and 0.75/0.49 in female
An Epidemiological study of Deaths in poisonous snake bite in Eastern India
Get PDFBackground: Snakes have always managed to grab human attention and have been an object of fear since historic civilization. Snake bite is an important occupational and rural hazard because India has always been a land of Exotic snakes. In West Bengal common poisonous snakes are Cobra, Viper and Krait. It is a fact that in spite of heavy morbidity and mortality, very little attention is paid by the clinicians to this occupational hazard. Aim: To study the prevalence of poisonous snake bites in part of West Bengal with reference to age, sex, occupation, part of body bitten, time of bite and seasonal variation, and the types of poisonous snakes common in this locality. Methods: This was a retrospective study conducted between1st April 2013 to 31st March 2014 at a tertiary health care center in West Bengal. Results: Most of the cases (66%) were belonging to the age group 15-34 years. Male are having twice the incidence than the female (M: F ratio 2.12:1). Maximum cases were from rural areas i.e.72 %. In 66 % cases snake bite occurred during night time and most of the cases i.e. 82% occurred during rainy season. Conclusion: Snake bite is a common life-threatening emergency in this area. Delay in hospitalization is associated with poor prognosis. Co-ordinated multidisciplinary approach is needed for proper management of snake-bite victims. Meticulous autopsy examination helps to find out the exact cause of death behind it
Evaluation of urine cytology in diagnosis of bladder tumor – An institutional study of 54 cases
Get PDFIntroduction: Bladder cancer is a common neoplasm in middle and old age. Urine cytology is simple quick cost effective method can be used for screening of urothelial neoplasm. It is a non invasive method with fair accuracy in high grade neoplasm. Aims & Objectives: The aim of this study was to correlate between urine cytology and histology in diagnosis of bladder tumor. Materials and methods: It was a descriptive observational study, conducted in Department of Pathology, Calcutta National Medical College & Hospital from June 2014 to May 2016. We assessed 54 cases of clinically & radiologically suspected cases of bladder tumor. All the clinical, radiological data were documented. Urine samples were processed by standard methods for Leishman & PAP stained smears. Cytological finding were reported four categories and correlated with final histological diagnosis of the bladder tumor. Results: Among the 54 total cases of bladder tumor most common were high grade urothelial carcinomas. Overall sensitivity of urine cytology was 42.86%. Sensitivity was found less in papilloma and PUNLMP. Specificity and predictive value of urine cytology were 80% and 95.45% respectively. Conclusion: Exfoliative urinary cytology represents an essential tool in diagnosis of bladder tumor with high positive predictive value though its sensitivity is low as compared to histopathology
A Study On Urinary Microalbuminuria And Serum Uric Acid In Patients Of Type 2 Diabetes Mellitus At A Tertiary Care Hospital Of West Bengal
Get PDFIntroduction: Diabetes mellitus is a chronic metabolic condition characterized by hyperglycemia, and protein and fat metabolism derangement. About 40 % of people having type 1 diabetes (T1DM) as well as 5-15 % of people with type 2 diabetes (T2DM) experience end-stage renal disease (ESRD). With this overview, this study was undertaken to assess the significance of microalbuminuria and uric acid in the early detection of renal involvement among patients with T2DM. Materials and Methods: This cross-sectional study was carried out by Department of Internal Medicine, Malda Medical College and Hospital, Malda, West Bengal, India between August 2019 to July 2020. 150 diagnosed patients of type 2 Diabetes Mellitus in the age group of 25-75 years, coming in medicine OPD were taken as cases and 150 age and sex-matched normal persons were taken as controls. The clearance was obtained from the Ethical Committee of the Institution. The patients obtained informed and written consent, with the clarification of the study protocol. The demographic and biochemical parameters were compared in both cases and control by conducting unpaired t-test. Statistical package for Social Sciences (SPSS) ver. 20.0 was used for data analysis. Results: Out of 150 cases studied, there were 55 males and 95 females whereas there were 47 males and 103 females in controls. The mean urine microalbumin (mg/g creatinine) in cases and control was calculated to76.6 ± 65.5 and 22.8± 7.6, respectively. The mean serum uric acid (mg/dl) was 6.2 ± 1.2 and 4.3 ± 0.8, respectively for cases and controls. The mean serum creatinine (mg/dl) 1.2 ± 0.5 and 0.9 ± 0.7, respectively. The age group, BMI, FPG, 2hPG, urine microalbumin were higher in cases as compared to control and the difference was statistically significant (p<0.05). Conclusion: Diabetic nephropathy is amongst the most serious diabetes complications and the major cause of end-stage renal disease. Strict glycemic control, microalbuminuria monitoring, and serum uric acid monitoring with better management may delay diabetic nephropathy
A Study on Heart Failure with Preserved Ejection Fraction among Patients of Type 2 Diabetes Mellitus in a Tertiary Care Hospital, India
Get PDFIntroduction: Diabetes is associated with several diabetic-related abnormalities and increased retention of sodium (up regulation of sodium-glucose co transporters) which increases the risk of onset or worsening of heart failure. With this background, the current study was planned to study the prevalence of type 2 diabetes mellitus among patients presenting with heart failure with preserved ejection fraction. Materials and Methods: It was a prospective observational study among patients visiting outpatient department and IPD of Nil Ratan Sircar Medical College & Hospital, India from October 2016 to September 2017. The study was pre-approved by Institutional Ethics Committee and the study was conducted after obtaining permission accordingly. Sample size was 100 patients between 30 and 90 years both male and female. The patients who satisfied inclusion and exclusion criteria have been identified and included in this study. Quantitative data thus obtained have been analyzed and exported to statistical software SPSS ver. 20.0. The continuous variables have been presented as mean ± standard deviation. Results: A total of 100 patients between 30 and 90 years, both male and female who met the inclusion criteria were selected for the study. Majority belonged to the age group of 61–70 years with mean age 63.5 ±7.2 years. 53 were men and 47 were female. Diabetes was present in 51 patients. Majority had ejection fraction between 55 and 60% and mean was 57.3± 6.7%; mostly with normal or near normal systolic function. The elevated mean LVMI indicated LV hypertrophy and decreased mean E/A indicated LV diastolic dysfunction, often produced by diabetes. Mean E/E’ was 9.2 ± 5.4. Grade-2 (DD2) diastolic dysfunction patients were maximum in number comprising 47% followed by Grade-1 (DD1) diastolic dysfunction among 44%, and only 9% had Grade-3 (DD3) diastolic dysfunction. Conclusion: Etiology and treatment approach of HFpEF differs from that of HFrEF. Moreover, diabetes mellitus is the modern day epidemics. Hence, if further studied by multicenter, prospective, longitudinal studies, this association may be used to identify the population at risk
Correlation of primary tumor FDG uptake with clinicopathologic prognostic factors in invasive ductal carcinoma of the breast
Get PDFIntroduction: 18F-fluoro-2-deoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) has become an important tool in the evaluation of patients with invasive breast cancer by revealing the functional properties of breast tumors[1]. The maximum standardized uptake value (SUVmax) measured with FDG PET is a sensitive indicator for metabolic activity in breast cancer[2-10], which can be used to assess tumor aggressiveness and is associated with prognostic factors, such as the histological type, histological grade, immunohistochemical factors, and proliferation index[11,2-10]. PET with F-18 FDG has been widely used in clinical practice for the diagnosis, staging, treatment monitoring, and detection of disease recurrence in breast cancer patients[12]. Aim/purpose: To correlate clinicopathologic variables (tumor size, histologic grade, TNM stage, status of the hormonal receptor (ER, PR, HER2 expression) with PET-CT parameters such as maximum standardized uptake value(SUVmax). Materials and methods: This was a hospital based prospective cross sectional analytical study conducted for 19 months at Apollo Hospitals, Hyderabad. In the total of 70 participants after explanation of the procedure study and taking written informed consent who were diagnosed with invasive ductal carcinoma of the breast during the study period undergoing FDG PET CT scan, 55 participants were included for the study in accordance to inclusion and exclusion criteria. 15 participants were excluded. Patient was assessed for age, menopause status, tumor size (T), tumor grade (G), hormone receptor status (ER, PR, Herer2neu) and stage. Patient undergoes FDG PET CT for diagnostic evaluation. Measurement and assessment of FDG pSUVmax (mean + S.D.) in primary tumor of ductal carcinoma of the breast and correlation with clinicopathologic variables was done. Results: SUVmax was higher in the participants with higher tumor stage andhighertumorgrade.TheSUVmaxvaluesforT4stage, pTNMstageIVandGrade3 tumors were respectively 20.4 ± 2.0; 17.1 ± 3.5; and 13.2 ± 3.2. SUV max was also higher i nparticipants who were ER and PR negative(13.2±3.0; ±5.4), premenopausal women, patients with higher tumor stage, higher histological grade - poorly differentiated tumors, ER and PR negativity, triple negative receptor status and positive axillary lymph node status. Conclusion: The study demonstrates that SUVmax values are related to the recognized histopathologic and immuno histochemical prognostic factors in breast cancer predictability of predictive and prognostic factors before treatment is of importance in terms of deciding the therapeutic approach. In preoperative assessment of patients with breast cancer, PET/CT scanning is inadequate in examining axillary lymph nodes; however,it may prove beneficial in displaying the biologic characteristics and behavior of a tumor
Reduction in spinal induced hypotension with ondansetron in parturients undergoing caesarean section
Get PDFBackground: 5 HT-3 receptors are believed to be involved in the mechanism of post spinal hypotension. Prophylactic use of 5 HT-3 receptor blocking agents should attenuate hypotension associated with spinal anesthesia. Aims and Objectives: To study efficacy of ondansetron on hemodynamic parameters, nausea and vomiting and neonatal APGAR score in parturients undergoing caesarean section. Materials and Methods: Sixty parturients scheduled for elective caesarean section under spinal anesthesia were divided into two groups to receive ondanseton Group 1(n=30) or normal saline Group 2(n=30): prior to spinal anesthesia. Hemodynamic parameters (heart rate, systolic and diastolic blood pressure) and oxygen saturation were recorded at baseline, at 1,2 minutes after spinal anesthesia, and then after every 2 minutes interval up to 20 minutes followed by 5 minutes interval up to 40 minutes. Dose of intravenous phenylephrine and atropine used during the procedure, neonatal parameters (APGAR score) were recorded. Statistical analysis was done by students t-test for continuous variables and Fischers test and chi-square test for categorical variables. All p values were two-tailed. Results: Patients in Group 2 had lower heart rate as compared to patients in Group 1(p value<0.05). Systolic, diastolic and mean blood pressure were also lower in Group 2 as compared to group 1(p value<0.05). Vasopressor requirement was more in group 2 as compared to group 1.(pvalue<0.05) The incidence of nausea and vomiting was higher in group 2 as compared to group 1(p value<0.05). Neonatal APGAR scores were comparable between the two groups. Conclusion: Prophylactic ondansetron 4mg provided better hemodynamic stability and incidence of nausea and vomiting in patients undergoing caesarean section under spinal anesthesia without any effect on APGAR scores