International Journal of Health and Clinical Research
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To study incidence of various conventional parameters in TMT (Chiefly ST depression)To study incidence of various conventional parameters in TMT (Chiefly ST depression)
No full textBackground&Method: The study was done on 50 adult patients with evidence of ischaemic heart disease presenting with stable angina or with angina of effort.A preliminary consultation and a clinical evaluation were done to select the cases with special attention to drug therapy. The patient was briefed about the procedure. They were given specific instructions and asked to come on the appointment date patients were called in a fasting state (light snacks about 3 hours before the test) and without consumption of any drug. Result: Taking the ate offset as 8 mts post exercise the number of cases with early onset late offset ST segment depression was 54 per cent. In the analysis of the post exercise phase 56 per cent cases had ST segment depression persisting to beyond 8 minutes in the post exercise phase of which 16 per cent went beyond 15 minutes and 8 per cent beyond 20 minutes. The offset time varied from 1 minute post exercise to 24 minutes (mean 9.14mts±5.49 mts). The ST segment depression disappeared within 8 minutes in 28 per cent cases while the offset was 8 minutes in 16 per cent cases. In 90 per cent cases, the offset time was more was more 3 mts while in 42 per cent cases the offset time was more than 9 minutes. Conclusion: Magnitude of ST segment depression more than 2 mm 80 msec after J point has a high degree of sensitivity for detecting CAD but could not classify a patient as one having severe CAD. Onset time of ST segment depression can be influenced by many factors and is thus not a useful parameter. Offset time of ST segment depression with cut off limits at 3 mts and 6 mts is a good parameter for diagnosing MVD. ST index and ST integral are very good parameters for the detection of CAD, absolute values do not correlate with severity of CAD
Lymph node FNA cytology reporting using new proposed IAC sydney system for reporting lymph node cytology- A single institution retrospective study
Get PDFIntroduction: Lymph node enlargement is a common clinical finding in a wide spectrum of diseases and its evaluation is essential for proper patient care. Fine needle aspiration cytology has been used as an initial diagnostic method in such conditions especially for infective conditions and also to differentiate between benign and malignant lesions. A standardized category based cytology reporting system was proposed by IAC in 2019 which gives 5 categories of cytological diagnosis and also provides management category for each class. Aim and Objectives: The present study aims to analyze and classify lymph node samples as per new proposed Sydney system and also to assess the risk of malignancy of each category. Material and Methods: This single institution retrospective study included lymph node FNAC cases over 5 year duration. Clinical details of all included cases were recorded. Cytology aspirate slides were reevaluated as per new reporting system. Histopathology correlation was done in cases where possible. Statistical analysis was done. Results: 1409 lymph node aspirates were evaluated with cases having slight male predominance and average age of 31.24 years. Benign category diagnosis was most common. Overall the most common diagnosis was reactive hyperplasia of lymph node. Metastatic squamous cell carcinoma was most common malignant diagnosis. Risk of malignancy calculated after histopathological correlation was highest in malignant category where it was 96.7%. Diagnostic accuracy of the new system in current study was 94.16%. Conclusion: Using standard categorical cytology reporting system will allow improved reports and clinical communication for better patient care
Effect of blood glucose levels on sensory nerve conduction parameters in prediabetics: A cross sectional study
Get PDFBackground: “Prediabetic” is an intermediate state of increased blood sugar levels and is defined by American Diabetic Association as fasting blood sugar (FBS) levels in the range of 100 to 125 mg/dL. It is increasingly viewed with early forms of diabetic neuropathy in 25-62% of cases. Multiple studies showed hyperglycaemia to change the myelin’s phospholipid, fatty acids and cholesterol content and thus modifying its fluidity, ultimately affecting the functional capacities of the nerve. This study was taken to investigate the sensory nerve conduction velocity (NCV) and latency in prediabetic healthy male adults and to study its relationship with levels of FBS in them. Materials & Methods: 60 clinically healthy prediabetic males of age 30-50 years were included in this observational study. For comparison 30 clinically age matched healthy normoglycaemic (FBS<100 mg/dl) male adults were taken as control. Demographic, anthropometric and sural latency and NCV were compared using‘t’ test. Relations of FBS with different variables were investigated using Pearson’s correlation test. A p value <0 .05 was taken as significant. Results: Bilateral sural nerve latency (right 3.52±1.88 ms and left 3.83±1.98ms) was significantly increased in the prediabetics compared to normoglycaemics (right 2.41±1.24 ms and left 2.48±0.79ms). NCV of sural nerves of both sides (right 50.38±18.89 m/sec and left 46.13±17.93m/sec) were significantly decreased in prediabetics as compared to normoglycaemics (right: 62.60±13.44m/sec; left: 53.95±11.93m/sec). Latency of right and left sural nerves was significantly and positively correlated with FBS levels in prediabetes (r= 0.61; p<0.01 and r= 0.33; p<0.01 respectively). Right sural nerve conduction velocity was significantly and negatively correlated with FBS levels in prediabetes (r= -0.514; p<0.01). Conclusion: Prediabetics seems to have a lower peripheral sensory NCV as compared to normoglycaemic male adults of 30-50 years of age
Prognostic and predictive significance of neutrophils lymphocytes ratio (NLR), lymphocytes monocytes ratio (LMR), Platelets lymphocytes ratio (PLR) and C-reactive protein (CRP) in patients with confirmed COVID-19 infection
Get PDFBackground and objectives: Pneumonia cases of unknown origin were recorded and reported by several local health facilities in Wuhan, China, in December 2019. The etiological agent was identified to be the SARS-CoV-2; COVID-19. Laboratory tests reveal normal or increased total leukocyte count, reduced lymphocyte count has been seen in some severe cases. PLR between severe and non-severe cases has been studied and said to have prognostic significance. NLRis another significant indicator of detecting inflammation in routine laboratory tests among Covid-19 patients which can be utilized in the diagnosis, treatment and evaluation of prognosis. In addition to NLR, CRP levels have been found to be deranged in moderate and severe Covid-19 infections. Material and Methods: 82 laboratory confirmed Covid -19 cases, diagnosed by positive RT-PCR for SARS CoV-19 RNA on nasal/ oropharyngeal swabs were included in the study. Results: The optimal cut-off values for NLR and PLR were 4.63 and 0.167 respectively. For NLR curve, the results showed that AUC was 0.848 (95% CI, 0.766 - 0.931), the Youden index was the largest 0.543, corresponding to the best cut-off value of 4.63, the sensitivity was 0.787, and the specificity was 0. 755. Similarly, for PLR the area under the curve (AUS) was 0.772 (95% CI, 0.666 – 0.879), the Youden index was the largest 0.493, corresponding to the best cut-off value of 0.167, the sensitivity was 0.636, and the specificity was 0.857.Conclusion:The present study has re-emphasized the prognostic and predictive significance of routine hematological investigations and CRP in Covid-19 patients
Assessing the effect of homocysteine compound levels and biological parameters on subjects undergoing hemodialysis
Get PDFBackground: In subjects with renal disease, levels of homocysteine are raised leading to its excretion in urine. This correlation of raised homocysteine levels to renal disease can be attributed to the possible hypothesis that raised homocysteine can lead to renal disease or correlation of homocysteine to Glomerular Filtration Rate (GFR) where only a small fraction of less than 1% is only excreted. Aim: The present study was conducted to assess the effect of Homocysteine levels and biological parameters in subjects undergoing hemodialysis. Methods: In 120 subjects including both males and females with 57 controls and 63 cases. These subjects were within the age range of 19 years to 80 years and had a mean age of 46.6±4.22 years. Homocysteine and Vitamin B6 in the serum were assessed using the technology of ELISA using spectrophotometer, whereas, for evaluating urea and creatinine, electroluminescence was used with cobasd e411. The collected data were subjected to the statistical evaluation. Results: Homocysteine was 8.59±0.96 μmol/l in controls and was 22.97±4.77 μmol/l in the test group study subject (p<0.0001). Vitamin B6 levels were significantly lower in test subjects with 159.47±14.75 compared to the controls. Urea levels were significantly higher in test subjects having the renal disease with p<0.0001. Creatinine was significantly higher in test subjects having the renal disease. Creatinine value in controls was 0.45±0.12 and in test, subjects were 8.04±2.07 with p<0.000. B6 showed a negative correlation with homocysteine. With creatinine levels, homocysteine showed a positive correlation with an r-value of 0.187 and a p-value of 0.123. A similar positive correlation was seen with the urea levels with an r-value of 0.034 and a p-value of 0.792. Conclusion: The present study concludes that the levels of homocysteine, urea, and creatinine levels are raised in subjects having renal disease undergoing hemodialysis compared to the control subjects without renal disease. Also, Vitamin B6 and hemoglobin levels were significantly lower in subjects with renal disease undergoing hemodialysis compared to the subjects without renal disease
Efficacy And Safety Profile of Erythropoietin in Chronic Kidney Disease Patients of Vizianagaram, Andhra Pradesh
Get PDFBackground: Anaemia is a common complication of chronic kidney disease. The close relationship between haematopoiesis and the kidney was first recognized by Richard Bright in 1835 when he described the association between anaemia and chronic renal failure. Much of the morbidity in renal failure patients can be attributed to the consequences of their chronic anaemia. Aim & Objectives: The aim of this study is to evaluate the efficacy and safety of human recombinant Erythropoietin in the treatment of anaemic patients due to chronic renal failure. Methods: This study was conducted at Department of Nephrology and dialysis unit, MIMS, Vizianagaram. Study Period was from October 2013 to September 2015 who are on haemodialysis for duration of six months to two years. For this a total number of 46 participants were screened. All 46 patients were given erythropoietin [EPOFIT] manufactured by INTAS pharmaceuticals by subcutaneous route Results: Patients will undergo laboratory investigations for haemoglobin, haematocrit (Hct), reticulocytes, RBC counts, serum ferritin and TSAT at the baseline and end of the study. Haemoglobin, haematocrit and red cell count, reticulocytes, serum ferritin and TSAT will be done once in 4 weeks till the end of the study. Conclusion: Of the total 46 patients enrolled in the study, 31 patients required only regular conventional dose of 50 units /kg /dose and only 9 patients required incremental dose of erythropoietin 75 units/kg to achieve target haemoglobin level. In our study Haemoglobin increased progressively in 77% patients at 4 weeks and 23% patients at the end of 12 weeks
AEFI Related to Covishield and Covaxin: A Comparative Study in Medical College & Hospital, Kolkata
Get PDFIntroduction: Covid 19 Pandemic could be considered as most relevant health crisis throughout the world for last two years and vaccination was an important weapon for winning the battle against this pandemic. Largest vaccination drive against Covid 19 in India was launched on January 2021. But fear and misconceptions regarding AEFI regarding Covid 19 vaccines was an obstacle to this programme. In this context the present study aimed at determining and comparing proportion of AEFI following receiving Covishield and Covaxin. Method: Observational Analytic study was conducted in Medical College, Kolkata, among 220 adults (>18 years) were taking Covishield (110 participants) and Covaxin (110 participants) 1st or 2nd dose. History of AEFI related to previous dose (when participants received 2nd dose) was obtained by recall method. All participants were observed for half an hour for immediate AEFI. Telephonic interview of participants were conducted 72 hours of vaccination to obtain any AEFI following present dose. Results: Prevalence of any AEFI following present dose (2nd dose) was 58.4%, but in most cases adverse reactions were mild. AEFI following current dose was significantly more in Covishield compared to Covaxin [OR= 5.778 (3.164-10.552)] in unadjusted model, as well as where adjustment done with Demographic, Socioeconomic covariates (AOR= 6.425 (3.421-12.171) and where all comorbidities added [OR= 6.465 (3.423-12.213)]. Conclusion: Both Covid vaccines introduced in India were highly safe and well tolerated among study participants. Proportion of any AEFI following receiving present dose of vaccine was significantly less in Covaxin (which was indigenous vaccine prepared in India)
A Study On Chlamydial Cervicitis Among Women Of Reproductive Age Group Presenting To The Out Patient Department Of A Tertiary Care Centre Of Bihar
Get PDFIntroduction: Worldwide, Chlamydia trachomatis (CT) is the most common bacterial sexually transmitted infection (STI), with approximately 105.7 million new infections occurring annually. Untreated CT can lead to serious reproductive sequelae for women, including pelvic inflammatory disease (PID), tubal factor infertility, ectopic pregnancy, and an increased risk of acquiring other STIs. Hence, this study was planned to evaluate the burden of chlamydial cervicitis among women of reproductive age group attending a tertiary care centre of Bihar. Methodology: All women of reproductive age group Gynecology Outpatient Clinic at the Darbhanga Medical College and Hospital, Laheriasri, Bihar, India from January 2021 to December 2021 were included in the study. A total of 100 patients were eligible for enrolment. Ethical Committee approval for study protocol and written informed patient consents were taken for this study. Three Dacron-tipped endocervical swabs from patients. The first swab was transported to the laboratory in 0.2 M sucrose phosphate buffer chlamydial transport medium for C. trachomatis PCR assays. Two swabs were placed in two screw cap test tubes containing 2 ml pleuropneumonia-like organism (PPLO) broth for detection of Ureaplasma spp. and M. hominis. Statistical analysis was done using SPSS ver. 21.0 (IBM, Chicago). Results: C. trachomatis was detected in 17% of patients with urogenital infections. C. trachomatis infection was significantly associated with vaginal discharge, abdominal pain, low back pain, burning micturition and dyspareunia. Of all samples collected, 61 showed positive growth. Apart from 17 C. trachomatis positive samples, 20 were positive for Ureaplasma spp., 11 for M. hominis, 2 for N. gonorrhoeae, 1 for T. pallidum and 2 were HIV seropositive. Co-infection with Ureaplasma and M. hominis was detected in 8% of patients by PCR. Conclusion: Screening for C. trachomatis isolates could be useful for epidemiological characterization of circulating C. trachomatis strains in the community and could provide additional information for vaccine development
To assessand and compare the effect of two doses of chloroprocaine with buprenorphine for saddle anaesthesia in perianal surgery
Get PDFIntroduction: Saddle block is effective in patients experiencing perianal surgery in terms of postoperative recovery and analgesic consumption within 24 hours after surgery. Chloroprocaine was developed to meet the need for a short acting local anaesthetic that is reliable and has a favorable safety profile. Objectives: To study two different doses of chloroprocaine with buprenorphine for saddle anaesthesia in perianal surgery. Material and Methods: 100 Patients of ASA Gr I & II were taken for perianal surgeries are kept in sitting position under all aseptic and antiseptic precautions SAB was given using 25/23G spinal needle in sitting position. A fixed dose of chlorprocaine with bupernorphine was injected in L4-L5 intervertebral space. Patients were assessed for pain score on VAS in post operative period.Patients were monitored for pulse , BP, respiratory rate , SPO2at regular intervals on a prestructured proforma. All the data were entered in master chart and statistically analysed. Results: Mean age of patients in Group A was 41.47 ± 9.06 years whereas in Group B was 35.66 ±12.12 years. The study groups comprised of 68 males and 32 females. Mean heart rate of patients in Group A group in preoperative was 55.52±6.14 whereas in group Group B was 54.80±5.79. Mean HR in Group A and Group B was found statistically insignificant (p=0.547). Mean SBP in Group A in preoperative was 102.9 ±22.41 and in Group B was 101.2±4.79.When we compared the mean SBP in Group A and Group B was found statistically insignificant (p=0.601) and Mean DBP in Group A in preoperative was 83.62±4.79 and in Group B was 83.12±8.7. When we compared the mean SBP in Group A and Group B it was found statistically insignificant (p=0.722). Mean RR in Group A in preoperative was 16.54 ±0.67 and Group B was 16.48 ±0.64 and Mean RR in Group A in intraoperative was 17.1 ± 0.83 and group B was 17.14±078. In our study we compared the mean time taken to achieve sensory block. In group A it was 2.54±0.50 min.. In group B the mean time taken to achieve sensory block was 2.38 ±0.49 min. It appears that 0.8ml Chloroprocaine might causes faster onset of sensory block and the difference between group A and B is statistically significant (p=0.0001). VAS score was significantly high in Group A as compared to Group B at 2nd and 6th hours respectively. Whereas VAS score was comparable at 12 and 24th hours in both the groups as revealed by insignificant p values. Conclusion: From our observations and data analysis we reach to the conclusion that for saddle block with higher dose we can allow surgery for longer time but the duration of postoperative analgesia remains same in both the group
Serum leptin concentration in impaired glucose tolerance and recent onset type ii diabetes mellitus, relationship with anthropometry and lipid profile
Get PDFDiabetes as well as pre-diabetes or impaired glucose tolerance increases the risk of cardiovascular disease by 2–3 times and increases by as much as 50% the risks of non-cardiovascular mortality associated with this condition. This study aim is to measure serum leptin levels in correlatation with anthropometry and lipid profile in pre- diabetes, non-diabetic and diabetic men and women. A cross-sectional study has been carried out in a total of 45 subjects for 20 subjects of pre-diabetes , 20 subjects of diabetic and 5 non- diabetic, south Indian rural 23 women and 22 men. Anthropometry was done for all the subjects with calibrated weighing machine, height scale etc. There is strong association between anthropometry and leptin resistance in both impaired and diabetic groups. In women both groups well correlated with total cholesterol and LDL. Increased serum Leptin levels/ leptin resistance was more evident in pre- diabetics when compared to non-diabetic and recent on set diabetes men and women