International Journal of Health and Clinical Research
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Assessment of Adjustment Problems in Persons with Spinal Cord Injury
Get PDFA traumatic injury to spinal cord presents a sudden overwhelming threat to the individual’s psychological safety which may create many adjustment problems. The early adjustment to traumatic injury is both adaptive and protective to the patient. He becomes maladaptive only when it begins to interfere with the realistic efforts and plans. It results in a sudden and profound disruption to an individual’s life. Person’s life and various factors contribute towards the evolution of adjustment problems. The present study was conducted to assess the adjustment problems in spinal cord injured patients. It was hypothesized that significant difference would be found between adjustment of SCI patients and non-SCI controls. Further it was hypothesized that acute patients would have more adjustment problems than chronic patients whereas, no such difference would be found in their respective control groups. For testing the hypothesis, an ex-post-facto research with multigroup design was adopted. A total sample of 80 subjects (SCl=40; Non-SCl=40). The participants of patient group were further divided into two groups of 20 each on the basis of duration of injury i.e. acute and chronic patient group. An equal number of participants, the key attendants of the SCI patients were taken as control group. The sample was selected from District Rehabilitation Centre at Post Graduate Institute of Medical Sciences, Rohtak on availability basis. Dysfunction Analysis Questionnaire (Parsad et al, 1985) which consists of five subscales pertaining to adjustment in five areas, i.e. personal, social emotional, vocational and cognitive was individually administered to all the participants. Data were analyzed by using t-test and Duncan’s Range Test. Findings revealed that the patient group had more adjustment problems than the control group. Further, the deterioration in adjustment was more in social and vocational areas than other areas of adjustment. The relevance of including key attendants as control group is discussed in the findings along with the implications of the study
Prevalence of inhibitors in hemophilia patients and quantitative estimation of FVIII Inhibitors in hemophilia patients of Odisha
Get PDFObjective:To know prevalence of factor VIII and IX inhibitors in Haemophilia patients and Quantitative estimation of factor VIII inhibitors in Haemophilia A patients using Bethesda Assay. Study Population: Hemophilia Patients receiving blood products and recombinant factor transfusion. Results: Total 54 cases were screened for factor deficiency and inhibitors. 42 old cases were screened and 12 new cases of Hemophilia A were screened for development of inhibitors.The mean age of patients in the study population was 14.38+8.12 years with age ranging from 9 months to 68 years. Prevalence of Hemophilia A was 92.6%, prevalence of Hemophilia B was 5.5%. There were 46% severe hemophilia A cases and 44% moderate hemophilia A cases and 10% mild hemophilia A cases. 40.74% cases had development of target joints with knee joint which was most commonly effected. Prevalence of inhibitors in Hemophilia A was 8%.It was 13% in severe hemophilia cases. 25% i.e. 1 patient was high responder with inhibitor level of 64 BU, other 3 inhibitor positive patients were low responders with inhibitor levels of 3BU, 3.2 BU and 4.4 BU. Conclusion: Severe hemophilia patients need frequent factor transfusions and are at higher risk of inhibitor development. Patients with low inhibitor levels i.e.<10BU need high dose of recombinant factor VIII. Patients with high inhibitor levels >10 BU may require Recombinant factor VII with or without immune tolerance therapy. So inhibitor screening and Bethesda assay is needed at least once in every six months for prompt treatment
Thyroid Dysfunction among Pregnant Women: An Observational Study Done Among Women Attending a Tertiary Care Hospital of Bihar
Get PDFIntroduction: Thyroid disorders in pregnancy are usually underestimated in preference to other disorders like anemia and toxemia. However, if overlooked, it can have a detrimental effect on the mother as well as the fetus. But if left untreated, it may progress to overt hyperthyroidism and result in complications like pre-eclampsia, preterm labour, low birth weight, fetal and perinatal loss. Materials and Methods: A study was conducted in the Department of Obstetrics and Gynecology, Madhubani Medical College and Hospital, Bihar, India. The study period was 6 months. 250 antenatal women with uncomplicated intra-uterine pregnancies attending the OPD and IPD in our hospital were included in the study. This study was approved by the ethic committee. SPSS software was used for data analysis. Data was expressed as percent and mean ± SD. Results: A total of 250 women were included in the study, out of which 172 (68.8%) were primigravidas, 49 () were G2 and rest 29 (11.6%) were G3 or above. Mean maternal age was 25.2 years with a SD of 8.6 years. Most of the patients were in the age group of 20 to 25 years. 27 out of 250 patients gave a positive family history of any thyroid disorders or goiter, this comprised 10.85 of the study population. Conclusion: However, an early detection of thyroid dysfunctions and treatment of mother during gestation improves the outcome
Evaluation of role of hematological parameters in patients with Covid-19 infection : A study at private pathology laboratory
Get PDFBackground: SARS COV2 is the third known corona virus responsible for fatal respiratory illness in humans. Abnormalities in the routine laboratory tests particularly hematological tests have the potential to indicate in a quick, practical and economical way, the need for a specific laboratory test for the diagnosis for SARS COV2. Patients of covid-19 pneumonia present with a wide range of hemostatic abnormalities. These hemostatic abnormalities in COVID-19 are related with disease progression, severity and mortality. Besides these tests help in assisting the prognosis of the disease and clinical monitoring. Aims: to evaluate the role of hematological parameters in determination of COVID-19 disease severity. Settings and Design: The present study was prospective and observational study by observing the haematological parameters of 200 COVID19 positive patients. Materials and Methods: 200 Patients’ blood samples were tested for CBC (Complete Blood Count)(by 3part Mindray analyzer), coagulation profile, ESR (Erythrocyte sedimentation Rate), CRP (C Reactive Protein), Ferritin, peripheral smear examination as well as RTPCR (Reverse transcription polymerase chain reaction). Statistical analysis used: Categorical variables were expressed as frequencies and percentages. Results: 200 samples were tested for Complete blood count and significantly higher values were found in TLC, Neutrophil count as well as N:L ratio (Neutrophil:Lymphocyte Ratio), while lymphocyte values were significantly decreased. Thrombocytopenia and high ESR values were present in a significant number of patients. Coagulation profile, CRP, Ferritin values and peripheral smear findings were significantly deranged. Conclusion: Hematological and Biochemistry abnormalities in COVID 19 are significantly related with disease progression, severity and mortality
Comparison of anesthetic effects of intrathecal 1% 2-chloroprocaine versus 0.5% ropivacaine with fentanyl in urological surgeries: A randomized double-blind, interventional study
Get PDFIntroduction: Spinal anaesthesia has got inherent advantages like intense motor and sensory blockade,reliability and avoids side effects of multiple drugs. Ropivacaine is safer long acting local anesthetic having greater sensorimotor differentiation. 2-Chloroprocaine (CP) is an amino-ester local anesthetic with a very short half-life; have favorable profile for short procedures. Addition of fentanyl to the local anesthetics for intrathecal injection improve the quality and duration of sensory anesthesia without prolonging motor recovery. Aim: To investigate the anesthetic effect of ropivacaine and chloroprocaine with fentanyl intrathecally for day care urological surgeries, to assess the characteristics of sensorimotor block, mean time to first postoperative rescue analgesia, and adverse effects if any. Methods: This prospective randomized, double blind, interventional study included 30 patients of ASA grades I & II undergoing urological surgeries under spinal anesthesia with intrathecal 3 ml of 1% 2-chloroprocaine with 12.5μg of fentanyl (GroupC) or 1.5 ml of 0.5% ropivacaine with fentanyl 12.5μg (Group R). Results: Mean time to achieve sensory block at T10 level was significantly short with CP (Group C 1.875 ± 0.47, Group R 2.51±0.54 min, (p value <0.001). Mean onset time of the motor block was short with CP (Group C 2.51 ± 0.73 min, Group R 4.74 ±1.08 min, p-value <0.001). Mean duration of sensory and motor block were significantly shorter in Group C compared to Group R (104.4 ± 10.89 min vs 154.16 ± 10.58 min) and (92.96 ± 12.02 min vs 143.66 ± 10.92 min) respectively. Mean time to two segment sensory regression was longer with Ropivacaine ( Group R 118.2 ± 12.48 and Group C 79.73 ± 12.48 min). Difference in Modified Bromage score was significant at 1, 2, 3 and 4 hour postoperatively among two groups with p-value <0.05 showing early regression of motor blockage in Group C in comparison to Group R. Conclusion: Intrathecal chloroprocaine is a good alternative to long acting local anesthetic ropivacaine for short duration urological surgeries, it facilitates early ambulating with minimum side effects. Furthermore, fentanyl as an adjuvant to both ropivacaine and chloroprocaine enhances the duration of analgesia and stabilizes hemodynamic variables
A comparative study between collagen dressing and silver sulphadiazine dressing in scald burn with special reference to wound healing and hospital stay: A hospital-based retrospective study
Get PDFBackground: Scald burn is usually a first- and second-degree burn and usually more common in children, especially from the accidental spilling of hot liquids. Collagen dressing is a standard dressing material for scalds due to the faster healing of scald burn wounds. Aim and Objective: To compare the efficacy of collagen dressing over silver sulfadiazine dressing in scald burn cases. Materials and methods: This retrospective study was conducted in J.K. hospital Bhopal, including 30 patients with scald burns. These patients were treated with either collagen dressings or silver sulfadiazine dressing taking 15 patients in each group. Result: A total of 30 patients were included. In the silver sulphadiazine group, 73.3% of patients belonged to the paediatric age group, 53.3% of patients were male and 46.7% were female, the average number of dressings was 12.5, the average time for complete healing of the wound was 14.5 days, average hospital stay was 16.7 days and split skin grafting required in 3 patients. In the collagen dressing group, 60% of patients belonged to the paediatric age group, 60% of patients were male and 40% were female,the average number of dressings was 2, the average time for complete healing of the wound was 12.3 days, average hospital stay was 13.7 days and split skin grafting required in 1 patient only. Conclusion: Collagen dressing is one of the advancements in burn care with rapid wound healing, reduced number of dressing changes, reduced hospital stay, minimal complications and minimal need for split skin grafting
Comparison of single stage and two stage capsulorhexis in intumescent cataract surgery: A prospective study in a tertiary eye care center in Eastern India
Get PDFIntroduction- In eyes with intumescent cataracts, creation of continuous curvilinear capsulorhexis is difficult due to high intralenticular pressure and there is high chance of radial extension of capsular tear. Aim- To compare the results of conventional single stage and two stage capsulorhexis in intumescent cataract surgery. Material and method- A prospective, randomized, interventional study done in a tertiary eye care institute, RIO RIMS Ranchi, India. Seventy four patients of intumescent cataract undergoing phacoemulsification were randomized into two groups. Group I underwent conventional single stage continuous curvilinear capsulorhexis. Group II underwent two stage capsulorhexis in which, initially rhexis of 2.5-3mm size was made and after decompressing the lens, rhexis was enlarged to 5-5.5mm. The data was analyzed using SPSS for Windows software (version 18.0, SPSS Inc., Chicago, IL, USA). Group differences in the continuous variables and categorical variables were analyzed using the student’s T test and the Fisher’s exact test respectively. Result- The study included 74 eyes of 74 patients (41 female and 33 male). Group-1 included 36 patients and group-2 included 38 patients. Radial extension of rhexis occurred in 19.4% and 5.26% of cases in group I and group II respectively. This difference was statistically significant (p< 0.05). Argentinian flag sign were seen in 3 eyes (8.3 %) in group I and in 1 eye in group II (2.6 %). None of the patient in either group had posterior capsule rupture. Conclusion- Two stage capsulorhexis is safer than single stage capsulorhexis and helps to prevent radial extension of capsulorhexis and makes surgery uneventful
Role of Transvaginal ultrasonography in the diagnosis of abnormal uterine bleeding: A hospital-based study
Get PDFIntroduction: AUB (Abnormal uterine bleeding) affects approximately one in every three women during their reproductive years. AUB is a considerable health care burden not only for women but their families and has a definite effect on their quality of life. Aim: To compare the ultrasonographic, hysteroscopic and histopathological findings in patients with abnormal uterine bleeding. Material and Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynaecology, Indraprastha Apollo Hospital, New Delhi, from July 2018 to June 2019. The women who came to the OPD with the complaint of AUB in the one year period and met the eligibility criteria as per our study. TVS was performed in 126 patients presenting with complaints of abnormal uterine bleeding followed by hysteroscopic biopsy or curettage. The specimens were sent for histopathologic examination. Results: Mean age = 43.95±8.48 years. Maximum number of cases 53 (42.0%) were found to be para 2. Most common presenting complaint was found to be menorrhagia (n=53; 42%) followed by post-menopausal bleeding (n=30, 24.0%). The Mean Endometrial Thickness was 9.79± 4.84 mm. The diagnostic specifications of TVS taking histopathological examination as gold standard were: sensitivity = 64/77= 83.1%, specificity 39%, positive predictive value 68%, Negative predictive value 59% and accuracy 66%. Hysteroscopy has a sensitivity of 87%, specificity of 51%, positive predictive value of 74%, negative predictive value of 71.4% and diagnostic accuracy of 73% in diagnosing aetiology of abnormal uterine bleeding. Conclusion: Both transvaginal sonography and hysteroscopy are good diagnostic modalities for investigation of women with Abnormal Uterine Bleeding. However, hysteroscopy has an edge over TVS in diagnosing aetiology of AUB in terms of high sensitivity, specificity and negative predictive value
Correlation of N-terminal pro-brain natriuretic peptide levels in non-alcoholic fatty liver disease
Get PDFBackground: Many organ systems are found to be affected in NAFLD including heart.NT-pro BNP determination has been proven to be useful and accurate for ruling out the diagnosis of heart dysfunction. Aim: To characterize the correlation between NT-proBNP and nonalcoholic fatty liver disease (NAFLD). Method: For this study, 60 cases of NAFLD were examined and evaluated in Department of Medicine, N.S.C.B. Medical College & Hospital, Jabalpur (M.P.) All study subjects were examined by same radiologist for detecting fatty liver and grading by ultrasonography of abdomen; and all patients undergo fibroscan by same technician for measuring liver stiffness measurement . Similarly, NT-proBNP levels were also measured using a commercially available immunochemical system. Result: Our study shows that NT-pro BNP levels are significantly lower in patients of NAFLD without diastolic dysfunction(mean±SD46.17±18.74) and compared to NAFLD patients with diastolic dysfunction(160.89±42.11). Conclusion: Difference in NT- pro BNP levels was significantly observed in NAFLD patients with or without diastolic dysfunction. Therefore, NT ProBNP can be used as a diagnostic tool for diagnosis of NAFLD in patients without diastolic dysfunction
Sexual Dimorphism in Clavicle Using Sternal and Clavicular End Morphometry: A Cross Sectional Study
Get PDFIntroduction: Forensic anthropology can play an important role in identification of human remains in cases of natural or manmade calamity. The various manifestations of the morphological features in the skeleton which manifest differently according to sex and statistical differences, forms a basis for sex assessment. In cases, where the recovery of whole body or complete skeleton may not be possible, the forensic anthropologists have to give their opinion based upon the available skeletal remains. Objective: The purpose of the study was attempted to evolve a formula to enable the assessment of sex in clavicles and to know about the comparative differences between right and left clavicles of known sex, by using the various metrical parameters. Materials and Methods: A cross sectional study was conducted in Western Maharashtrian medical college. During the study, a total of 200 adult dried clavicles extracted from cadavers used during dissection. Maximum clavicular length was measured by digital caliper. Identification point were calculated from the actual range whereas Demarking point, a calculated range, was calculated by using the formulae Mean +/- 3SD because this range covered maximum sample size (99.75%) and gave more accurate results. Results: In the present study, the mean of the length of the clavicle was found to be 141.63 in males and 128.70 in females. The mean of the male subsets has been found to be greater even when the sample was categorized into right and left. The maximum length of clavicle was statistically significant when compared with the clavicle of females. Conclusion: Determination of sex the clavicle has a great medico legal importance to the forensic people. And it also helps the orthopaedic implant manufacturers and orthopaedic surgeons to decide correct size and shape of plates and intramedullary nails for clavicular fractures in open reduction method