International Journal of Health and Clinical Research
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Ocular Injuries – A Leading Cause of Preventable Blindness
Get PDFIntroduction: Ocular injures are very common and are of great variety and complexity. Besides structural and functional loss they have social, occupational and medico-legal implications. Ocular injury is an important preventable cause of ocular morbidity and blindness. Objectives: The objective of this study was to analyze the epidemiological profile of patients with ocular trauma. Material and Methods: This prospective study comprised patients presenting with ocular trauma at out-door, indoor and casualty at Jawaharlal Nehru Medical College, Aligarh from November 2007 to December 2008. An epidemiological study was performed on ocular injuries utilizing hospital eye services. It is direct culmination of MD Thesis of the first author. Results: It was found that injury was more common in urban area, males were more involved as compared to females, the left eye was more commonly affected than the right eye, most of the cases reported to the hospital within two days, in majority of the cases the cause was domestic injury, most of the injuries were due to blunt trauma and most of them were accidental in nature. Open globe injuries were more commonly associated with retinal detachments. Injury to lense capsule and delayed repair was associated with endophthalmitis. Conclusion: Prevention of blindness from eye injuries requires injury prevention, early presentation by the patient, accurate assessment and prompt referral
A community based cross sectional study of prevalence and risk factors of low birth weight
Get PDFIntroduction: Birth weight is an independent and an important factor that affects mortality, morbidity and growth and development during infancy and later life. India is accounting for 40% of the global Burdon of low birth weight babies. Multiple causative factors identified to be responsible for low birth weight. Aims & objectives: 1. To estimate the prevalence of low birth weight babies. 2. To study the association of maternal factors with birth weight. Method:The present community based cross sectional study conducted to among the urban population of Rajkot city and identify the determinants of low birth weight. Sampling population was selected by multistage sampling method. Investigator collected history of low birth weight and other determinants by verification of records and examination by house to house visit. Result:The prevalence of low birth was found 19.6. The factors like sex of the baby, birth order, birth spacing, maternal age, maternal education, regular antenatal check-up and mother’s weight gain during pregnancy were found significant determinants of LBW. Conclusion:The prevalence of low birth was high in urban area require multipronged strategy. The primary health care can diminish the determinant of the low birth weight by adequate birth interval, two-child norms, regular antenatal check-up, supplementary nutrition to mother, female literacy etc
A clinico-pathological study and management of necrotising fascitis
Get PDFAims and objectives: The objective of this study was to evaluate our experience with the diagnosis and management of necrotizing fasciitis. The study also describes the clinical presentation and microbiological characteristics of this condition as well as the determinants of mortality associated with this common surgical emergency. Materials and methods: The data for the study was obtained from patients (in patient basis) who were provisionally diagnosed to have necrotizing fasciitis and myonecrosis by clinical evaluation and who were admitted at Kurnool General Hospital, Kurnool from November 2018 to October 2020 in this cross sectional observational study. All patients were studied and clinically analysed, necessary investigations were done and appropriate treatment was given. All cases were followed up to discharge and subsequently for a follow up on one month. Results and conclusion: The incidence of necrotizing fasciitis was seen highest in age group 41 to 60 years Male to female ratio was 4: 1. Most common site of involvement was lower extremity (62%). Most common predisposing factor was minor trauma (46%) followed by snake bites (22%) and idiopathic cause (22%). Average duration between onset of symptoms and first surgery was sentence missing. Klebsiella was the most common microorganism grown on aerobic culture media. Diabetes (38%) was the common co morbid condition come across in this study. Duration of hospital stay was approximately 8 to 61 days with an average around 29 days. Mortality rate was 14
A cytological study of enlarged supraclavicular lymph nodes through fine needle aspiration
Get PDFBackground: Enlargement of supraclavicular lymph node is due to many pathological condition such as inflammatory, hematolymphoid neoplasm and metastasis but most of the studies shows metastasis is a commonest cause. Objectives: To study the cytomorphological features in aspirate obtained and render cytodiagnosis and thus delineate the cause of supraclavicular lymph node enlargement in our setup. Material and Method: This study was carried out in the department of pathology, Sarojini Naidu Medical College, Agra for a period of 2 years. The FNAC slides were studied for cytomorphological features.Result: All age group patients were included in the study and male to female ratio of 1.4:1.The maximum number of cases were malignant (58.75%) followed by granulomatous/ tubercular (33.75%), reactive hyperplasia (2.50%), acute suppurative lymphadenitis (2.50%).2.50% cases were inadequate.Conclusion: It is concluded that FNAC of enlarged supraclavicular supraclavicular lymph node is safe, convenient and rewarding procedure. It also reduces the need of surgical biopsies and thereby reducing cast and time for final diagnosis
Emergence and Recovery Characteristics of Desflurane versus Sevoflurane in Morbidly Obese Adult Patients Undergoing Abdominal Surgery
Get PDFBackground: Early and complete recovery after general anesthesia is desirable in all patients, more so in the morbidly obese patients. All volatile anesthetics accumulate, over time, in adipose tissue. Such accumulation may delay recovery from anesthesia. The new fluorinated agents have markedly improved the quality and the time required for recovery compared with the older inhaled anesthetics. Aim: This study was done to compare the maintenance and recovery characteristics of Sevoflurane versus Desflurane in morbidly obese patient, Method: Fifty morbidly obese patients (BMI > 35kg/ meter square) requiring Abdominal surgery were randomly allocated to 2 groups (25 patients in each group)Group A received 1 MAC target concentration of Desflurane and GROUP B received 1MAC target concentration of Sevoflurane in oxygen for maintenance. EtCO2 (end-tidal carbon dioxide) was maintained between 30-40mm Hg. The MAP and HR were targeted to maintain within ± 20% of the baseline values throughout intra operative period. Results: Early recovery parameters were achieved statistically significantly(p<0.05) faster in Desflurane group in comparison to Sevoflurane group. Time for response to eye opening was earlier by 1.41 minutes, time for hand grip was faster by 1.61 minutes, time for tracheal extubation was significantly faster by 2.21 minutes in Desflurane group than Sevoflurane group. Time to state his/her own name and name of village were also significantly faster in Desflurane group by 2.76 minutes and 2.76 minutes respectively. Intermediate recovery (the time to discharge the patient from the PACU) was comparable between two groups. (p>0.05). Conclusion: In morbidly obese patients, using 1 MAC end-tidal concentration, we found that the time to emergence and early recovery from prolonged anaesthesia with Desflurane is shorter than with Sevoflurane anaesthesia
A study on correlation of serum uric acid level and glycemic control among patients of type II Diabetes Mellitus at a tertiary care center of Bihar
Get PDFIntroduction: Diabetes mellitus is a metabolic disorder which is characterized by hyperglycaemia and insufficiency of the secretion or the action of endogenous insulin. Although the aetiology of the disease has not been well defined, viral infections, autoimmune diseases, and environmental factors have been implicated. With this background, the present study was undertaken to find the correlation of the serum uric acid and the glycemic control in patients with type 2 Diabetes mellitus. The proxy indicator used for glycemic control here was glycated hemoglobin level (HbA1C). Methodology: The present case control study was undertaken in the Department of Physiology of J.N.K.T. Medical College, Madhepura, Bihar, India. The study period was 6 months that was from May 2020 to October 2020. Prior ethical approval was obtained from the Institutional ethics committee. The subjects who were included in this study were divided into 2 groups: Group A included 20 normal healthy individuals, in the age group 40-65 years, of either sex and without any family history of DM. Group B included 20 diagnosed patients of Type 2 Non-Insulin Dependent Diabetes mellitus (NIDDM), who were in the age group 40-65 years, of either sex, from the same population. Results: The mean age of the patients in group A was 31.8 ± 7.9 years and that of patients in group B was 33.6 ± 6.8 years. In the control group, there was a slight male predominance with 55% being male, while in the study group, female dominant with 75%. There was no statistical difference between both the groups based on gender and age. The mean FBS level of group A was 76.2 ± 8.3 mg/dl and that of group B was 144.9 ± 62.4 mg/dl, which was significantly higher than that of group A (p < 0.05). Conclusion: In conclusion, our study suggests that there is an increase in the serum uric acid levels with an increase in the HbA1C levels. This showed a positive relationship in Type 2 Diabetes mellitus
Study of serum lipid profile: An observation between criminality and psychosis in relation to aggression
Get PDFBackground & aim: Aggressive and violent behavior is being increasingly viewed as a public health problem and violence prevention has become one of the most pressing issues facing our society today. Our aim was to find correlation between lipid profile, criminal behavior and psychosis. Method: The present study involved 120 participants consisted of four groups. Each group consisted of 30 subjects. This study was done in two different places. One is at Circle jail Choudwar, Cuttack and second place is at in-patient Department of Psychiatry MHI, S.C.B medical college, Cuttack. First study group was male convicted prisoners selected at Circle Iail Choudwar having no psychiatric illness .The control group for this was selected from general population. The second study group was male psychotic patients having criminal record. The control group for this was selected from same ward, of male psychotic patient having no criminal record. The objective was to study the serum lipid profile of each group and it's relationship in criminality, psychosis and aggression. All the subjects in first study group and its controls were screened with General Health Questionnaire (GHQ-12).All the subjects in second study group and its controls were assessed with Overt Aggression Scale (OAS) for scoring of aggression and Brief Psychiatry Rating Scale (BPRS). Results: The criminal group without psychiatric illness showed significantly lower cholesterol (p=0.010) than general population and also lower than the psychotic in-patients without history of crime. The psychotic in-patient group with criminal records showed significantly lower cholesterol (p=0.001) than psychotic patients of no criminal record and also lower than non-psychotic criminal offenders. The psychotic criminal offenders showed lowest mean cholesterol than all other three groups. Conclusion: Our study proves a causal connection between low cholesterol and behavioral problem arising out of criminality, psychotic aggression
“A comparison of epidural levobupivacaine 0.5% with racemic bupivacaine 0.5% for lower abdominal surgery” A study on morphometric study of nutrient for aminaoffibula
Get PDFBackground and objectives: In the leg, the fibula is placed lateral to the tibia. Because of its length, biomechanical stability, reduced donor site morbidity, and predictable vascular pedicle, the fibula is the bone of choice for grafting and rebuilding major defects after tumour removal. The study's objectives are as follows: (1) to locate and describe the site, number, and orientation of fibula nutritional foramina. (2) To look for differences in the location, position, and quantity of nutrition foramina in the fibula. Methods: The study sample consisted of 100 dry adult human fibulae (107 right and 93 left) from Kakatiya Medical College's Department of Anatomy. Fibulae were gathered from our institution's undergraduate medical students at KMC, Warangal. The data relevant to the aforementioned criteria were recorded, subjected to statistical analysis, and photographed. Results: In the present study of 100 dry adult human fibulae, noted;i. The absence of nutritional foramen (NF) in 12 (6%) of the fibulae.ii. A single nutritional foramen was found in 87 (87.0 percent) of the fibulae.iii. Nearly 8 percent of the fibulae had twin nutrient foramen.iv. 1 (1%) fibulae had triple nutrient foramen.v. The total number of nutrient foramen in 94 fibulae was 100.vi. The most common site of nutritional foramen was on the medial crest in 42 (43.75 percent) of the fibulae and the least common on the anterior border in 1 (1.04 percent).vii. 90 (95.0 percent) of the foramen were located in the middle region of the fibula.viii. h88 (93.61%) foramen were directed away from the developing end (AFGE), 15 (15.94%) towards the growing end of the fibula.Interpretation and conclusion: The number of nutrient foramen varied by 13.5 percent in the current study. Orthopaedic and plastic surgeons can plan the vascularised fibular graft at the middle third of the shaft with accurate anatomical knowledge about the location and distribution of the nutrient foramen
Descriptive Study of the Clinico Etiological Patterns of Stasis Dermatitis in Railway Employees Attending Tertiary Care Hospital
Get PDFBackground: Stasis dermatitis is a common chronic inflammatory disease of skin that occurs on the lower extremities due to chronic venous insufficiency and may be a precursor to various skin changes like eczema, venous ulceration and rarely lipodermatosclerosis. This study was done in exclusively railway workers whose occupation demands prolonged standing/sitting/actively moving to assess the clinico-etiological patterns and evaluate the demographic profile of Stasis dermatitis. Objective: To assess Clinico etiological patterns and demographic profile of stasis dermatitis. Materials and Methods: This is an Prospective observational study conducted in Tertiary care hospital for duration of six months. First 100 patients attending Dermatology outpatient department of age more than 20years with clinical features of stasis dermatitis are selected for the study. Results: Among 100 patients, 79(79%) were male and 21(21%) were female patients with male-to-female ratio of 4: 1 and mean age of incidence was found to be 40 years. The most common risk factor was found to be prolonged standing (76%) and most of the patients had complaints of itching (90%). Perforator vein incompetence was found in 36 % of patients. Conclusion: Our study highlights the significant association between venous skin changes and various risk factors. The present study proves the importance of other risk factors like prolonged standing, obesity in producing varicosities, eczematous skin changes. Many patients with chronic venous insufficiency present to dermatology department very late with skin changes of lipodermatosclerosis and venous ulcer. Hence, to identify the high-risk patients at very starting stage is important to avoid disease complications
Analgesic Efficacy of Addition of Clonidine to Bupivacaine in Transversus Abdominis Plane Block(TAP) for Pot Operative Analgesia in Laparoscopic Appendicectomy
Get PDFBackground: Pain is the commonest symptom encountered postoperatively and hence multimodal analgesia is tried to overcome it. Objectives: To compare bupivacaine and bupivacaine plus clonidine in transversus abdominis plane (TAP) block for postoperative analgesia in patients undergoing laparoscopic appendicectomy under spinal anaesthesia. Methods: Sixty ASA I and II patients in the age range of 18-60 years undergoinglaparoscopic appendicectomy were randomly divided into two groups, who were operated after giving spinal block using 2.5 ml of 0.5% hyperbaric bupivacine and 25ug of fentanyl. At the end of surgical procedure tranversus abdominis plane (TAP) block was given by giving 25 ml of injection bupivacaine 0.25% in group I and 25 ml of 0.25% of bupivacaine with 1 ug.kg-1 of clonidine in group II. SPSS (Version 22.0) was used for analysis. Results: Demographic characteristics like age, weight, sex, ASA class and diagnosis were comparable in both groups. SBP, DBP and HR were less in group II than in group I and was statistically significant (p-value<0.05). The overall mean VAS score in group I was 3.03 ± 1.57 and group II was 1.72 ± 1.02 with p-value of 0.0005 and hence better quality of analgesia in group II. The duration of analgesia which was calculated by mean time for first rescue analgesia in group I was 6.38 ± 2.56 hours and group II was 14.23 ± 4.63 hours with a p-value of <0.0001 and the difference was statistically significant. None of the patients had any episode of bradycardia or hypotension. Conclusions: Addition of clonidine 1 ug.kg-1 to 25 ml of 0.25% bupivacaine compared to 25 ml of 0.25% bupivacaine alone in transverse abdominis plane (TAP) block improves quality of analgesia, increases duration of postoperative analgesia and decreases postoperative analgesic requirements with minimal side effects