International Journal of Health and Clinical Research
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A machine Learning Methodology for Chronic Kidney Disease
Get PDFMost of the people in the world are suffering a lot with Chronic Kidney Disease (CKD) widely considered to be a global issue. People with heart disease, hypertension, diabetes or who have suffering from CKD family they are at risk.This is related to improved mortality and high risk of a few other conditions, including the raise of heart disease and human services. The adverse outcome of CKD can be prevented with proper early detection and management. Machine Learning (ML) aids to analyze tens of thousands of data points and produce outcomes, provides regular risk scores, precise resource allocation, and has many other applications healthcare. In this paper some machine learning techniques are used and compared namely Support Vector Machine (SVM), Naïve Bayes (NB), NB-TREE, and Iterative Random Forest (IRF). Among all these four algorithms IRF got the best accuracy of 99.4%. Here we are using IRF which provide the stable decision paths with high order interactions. Hence IRF could be used for any data to get good accuracy
Health Risk Behaviours among Students of Professional Courses In Colleges Of Coastal City Of Visakhaptnam, Andhra Pradesh - A Cross-sectional Study
Get PDFIntroduction: Youth, the productive and dynamic section of the population is considered as the most valuable human resource. It is marked with immense physiological, psychological and behavioural changes along with social interactions and relationships which leads them into multiple risk behaviours affecting their health. Objective: To assess the multiple health risk behaviours among students of professional courses in colleges and to determine their association with other covariates. Methodology: A cross-sectional study was conducted among the students aged above 18 years of professional courses in colleges located in campus of Anil Neerukonda Educational Society (ANES) in Visakhapatnam with a sample size of 402. The data was collected from the study subject by a using a pre-designed, pretested and self-administered questionnaire. Results: The mean age of the students was 21.13 ± 1.50 years. Physical activity of more than 300 minutes per week was observed in 20.9% of the students. Mobile phone usage was more than 6 hours per day in 49.2% of students. There were significant associations between gender and mobile phone usage (p=0.040), gender and time spent on social media every day (p=0.002), students of professional courses and duration of mobile phone usage (p<0.001) and students of professional courses and duration of use of social media(p<0.001). 61.4% of the students consumed fast foods as meals and the association of fast food and gender was found be significant. (p=0.016).Similarly association of soft drink consumption and gender was found to be significant.(p=0.001).3.5% of the students were involved in drunken driving.15.2% of them were found to be driving vehicles at speeds more than 100 kmph.17.9% of them used mobile phones while driving. Association between gender and road traffic accidents (RTA) was found to be significant. (p=0.001). Students of Engineering courses were more involved in RTAs then students of other courses and the association was found to be significant. (p=0.005) Significant association was present between gender and addiction (p<0.001) and between students of various courses and addiction.(p=0.046). Conclusion: Students of the professional courses in this study showed various health risk behaviours. Health education is the most effective intervention in initiating behavioural changes at the earliest which lead to prevention of development of health risk behaviours
Contribution of Laboratory Findings in Assessing the Severity of Covid-19 Infection: In A Tertiary Care Hospital
Get PDFBackground: In December 2019 first case of Coronavirus disease (COVID-19) was reported in China and then has spread across the world. With the use of biomarkers categorising patients becomes easier and can help clinicians in identifying patients with higher risk of disease progression and initiating effective management in time and thereby reducing the mortality due to COVID-19. Methods: The Data was collected retrospectively from medical records of 126 hospitalized patients diagnosed with COVID-19 from a tertiary care hospital between August and September 2020. Laboratory parameters on admission in patients who required intensive care unit (ICU) support and those who did not require ICU support were compared. Results: The patients who required ICU care (n = 47) were older (median, 55 vs. 49 years), with more underlying comorbidities (42.5% vs. 17.7%). ICU patients had higher leucocytes, neutrophils, Neutrophil to Lymphocyte Ratio (NLR), urea, creatinine, lactate dehydrogenase (LDH), and D-dimer but lower lymphocyte count when compared with non-ICU patients (p < 0.05). Conclusions: Elevated D-dimer and NLR appear to be independent biomarkers for severe COVID-19 infection. These laboratory parameters may help the clinicians to determine the patients who have a higher risk of disease progression and thus initiate effective treatment in time
Diagnostic accuracy of The Bethesda system for reporting thyroid cytopathology: A Five years Study
Get PDFIntroduction: Thyroid nodules are a common clinical problem. It is important to differentiate benign from malignant nodules. Fine needle aspiration is utilized as a preoperative diagnostic technique which is safe, simple and cost effective for triaging patients with thyroid nodules. Methods: The study was conducted at Histopathology department of B.J Medical college, Ahmedabad. It involved period of 5 years patients who presented with thyroid swelling and underwent FNAC and Histopathology. Out of these 1325 cases, 210 patients subsequently underwent surgical excision. Results of final histopathology were correlated with cytologic diagnosis. Results: Histopathologic correlation was done in 210 cases. Out of total 210 cases, 3 cases were diagnosed as Non diagnostic or unsatisfactory,199 cases were diagnosed as Bethesda II and No case was Bethesda III while 4 cases were categorized Bethesda IV and 1 case were Bethesda V and 3 cases were Bethesda VI. The incidence of malignancy in Bethesda categories through were 0%,7.53%, 0%,100%,100% and 100% respectively. Overall accuracy Of FNA cytology was 93.8% with 81.25 % sensitivity and 96.06 % specificity. Conclusion: Our study validated the accuracy of TBSRTC in our setup which is concordant with other studies. Therefore, we recommend routine use of TBSRTC for reporting thyroid cytopathology for initial workup. However, risk of malignancy was found to be significantly high in Bethesda IV, V and VI category to warrant further workup including ultrasound/thyroid scan in addition to repeat FNAC
Genetic association of CaSR (Calcium Sensing Receptor) gene polymorphism with kidney stone formation in Vindhyan region of Madhya Pradesh
Get PDFCalcium (Ca2+) is an important mediator of multicellular homeostasis and is involved in several diseases. The interplay among the kidney, bone,intestine, and parathyroid gland in Ca2+ homeostasis is strictly modulated by numerous hormones and signaling pathways. The calcium sensingreceptor (CaSR) is a G protein–coupled receptor, that is expressed in calcitropic tissues such as the parathyroid gland and the kidney, plays apivotal role in Ca2+ regulation. CaSR is importantfor renal Ca2+, as a mutation in this receptor leads to hypercalciuria and calciumnephrolithiasis. Aberrant Ca2+ sensing by the kidney and VSMCs, owing to altered CaSR expression or function, is associated with the formationof nephrolithiasis and vascular calcification. Basedon emerging epidemiological evidence, patients with nephrolithiasis have a higher risk ofvascular calcification, but the exact mechanism linking the two conditions is unclear. However, a dysregulationin Ca2+ homeostasis anddysfunction in CaSR might be the connection between the two. This reviews summarizes renal calcium handling and calcium signaling in thevascular system, with a special focus on the link between nephrolithiasis and vascular calcification. The age, sex, BMI, WHR were theparameters. As expected the nephrolithiatic patients had markedly higher levels of weight of men (P=0.3916) then women (P=0.0723) and BMIof Women (P=0.2247) and Men (P=0.3499) but both was not significantly different between patient and healthy population. Concentration of IL-18 level in malarial patient (case) and healthy population (control) is showing elevated level during infection and it was stati stically significantassociated. Overall distribution of CaSRAla 986 Ser genotypes was significantly different in healthy control group as compared to disease group(χ2=7.253, P=0.0266*). HC group showed an decrease of mutant ‘TT’ genotype as compared to Patients of Nephrolithiatic (1.11% vs. 4.37%).Similarly, wild type ‘GG’ genotype was present in significantly high frequency in HC as compared to Nephrolithiatic patients group (72.22% vs.54.37%). An odds ratio of 0.4584 in Nephrolithiatic group
A Study on Serum Ferritin and Hypothyroidism among Patients Attending A Tertiary Care Hospital With Special Emphasis On Effect Of Thyroid Hormone Replacement Therapy
Get PDFIntroduction: Thyroid gland is a bi-lobed endocrine gland and it secretes thyroxin (T4) and tri-iodothyronine (T3) hormones and it is under the regulation of thyroid stimulating hormone (TSH). Iron is one of the important elements required for normal functioning of thyroid gland and it is stored in the body in the form of ferritin and it is an intracellular protein. Present study is an attempt to find out correlation, if any between serum ferritin and hypothyroidism and also changes of serum ferritin level after correction of the disorders with levothyroxine therapy. Materials and Methods: A cross-sectional study was conducted by Department of Biochemistry, Darbhanga Medical College, Laheriasri, Bihar. Study was conducted from December 2021 to May 2022. Written informed consent was obtained from each participant before inclusion in the study. Prior ethical approval was obtained from the Institutional Ethics Committee. The study population comprised of 100 hypothyroid and 100 euthyroid subjects of age >18 years. Blood sample was collected from the study participants who visited the laboratory for their thyroid hormone. From the selected subjects, under aseptic precautions, 3ml of venous blood sample was drawn into a non-vacuum plain tube with clot activator. These tubes were allowed to stand for specific period of about 15-20 minutes. Then tubes were centrifuged for 3500rpm for 15- 20 min. The collected data was entered in Microsoft excel and the data analyzed by using Statistical Package for Social Sciences ver. 20.0 (IBM, Chicago). Results: The mean values of TSH were higher among hypothyroid subjects as compared to euthyroid subjects. Whereas T4, T3 and ferritin were found be lower among hypothyroid subjects as compared to euthyroid subjects. TSH, T4, T3 and ferritin showed statistically significant difference between euthyroid and hypothyroid subjects with a p value of <0.05. There was a negative correlation between TSH and serum ferritin among study subjects (r= 0.07) implying that as serum TSH levels were increasing serum ferritin levels kept on decreasing. Conclusion: In our study we found that there is a significant difference in serum ferritin levels between hypothyroid and euthyroid subjects. Hence measurement of serum ferritin before and after thyroid hormone therapy may provide useful information with regard to diagnosis and prognosis of thyroid disease
Study of red cell distribution width as a predictor of outcomes in organophosphate compound poisoning
Get PDFIntroduction: Organophosphorus compound poisoning is a widespread problem in a developing country like India, and it is a major clinical and public health concern. There have been efforts to find novel tools/markers to assess the prognosis and the use of RDW has been proposed in OPCs poisoning, wherein RDW can be used as a predictor of outcomes in OPCs poisoning. Objectives: Hence our objective was to evaluate the association of RDW with the outcome of Organophosphate poisoning. Methodology: The study consisted of 115 patients who were admitted to JSS hospital critical care due to consumption of Organophosphorus compounds. Patients were assessed and detailed history were taken and blood investigations of Complete Hemogram and Pseudocholinesterase were sent after informed consent. Results: The patients were divided into 3 groups; 1) Recovered without complications; 2) Recovered but had acute complications 3) Death; with 52% patients in group A and 27% patients in group B and 20.9% were in group C. The most common complication in the group 2 was respiratory failure.RDW as a predictor for outcomes in Organophosphate compounds has a Sensitivity of 87.5% and specificity of 51.65% with a diagnostic accuracy of 59.13%. But as an independent predictor of mortality, it was not significant. Inference: RDW can be used as a predictor of outcomes in Organophosphate compound poisoning cases as RDW was elevated in cases with complications and death and was found to be significant. But as an independent predictor for mortality, it was not significant
Economic Burden of Childhood Asthma In A Tertiary Care Setting Of North India
Get PDFBackground: Asthma is one of the most common chronic respiratory diseases with an increasing prevalence worldwide. It has huge economic and social impact. Newer medications and other therapies allow many patients to control their symptoms, but the cost of treatment can be high. In addition, the treatment of acute exacerbation and comorbidities of asthma consume considerable medical resources. Methodology: For assessing economic impact of asthma on children and their families we studied 216 children over a period of 1 year at department of pediatrics of Patna Medical College and Hospital. Both direct and indirect cost of asthma was assessed. Direct costs include inpatient care, emergency visits, OPD visits, drugs and devices and diagnostic tests. Indirect costs include school days lost, traveling cost, and productivity loss for the caretaker of asthmatic children. Results: Out of total 216 children, 65 % were male and 35% were female. Mean loss of school days because of asthma related events were 3.6 days in preceding 6 months. About 6% children required hospitalization in the preceding 6 months and 54% children had some restriction on their play activities because of asthma. The mean monthly expenditure on the therapy was Rupees 410. Conclusion: As a leading chronic childhood illness, asthma has a large socioeconomic burden on affected children and their families
Spectrum of of nasal, paranasal sinus and nasopharyngeal mass with radiological correlation at a tertiary care hospital, Gujarat, India
Get PDFIntroduction: The nasal masses are most commonly encountered condition in outpatient department of otorhinolaryngology.A sino nasal mass can have various differential diagnosis. They may be inflammatory, congenital, neoplastic (benign and malignant), traumatic in nature. Classically benign neoplasm expands and remodel bone and aggressive malignancies destroy and invade adjacent tissue with ill-defined margin[1]. Various pathologies ranging from non-neoplastic lesion to malignant tumor may present as simple nasal mass. Neoplasms of the sinuses and nasal cavity account for 0.2–0.8 % of all carcinomas. Aim: This study aims to evaluate the spectrum of nasal, PNS and nasopharyngeal diseases on histopathology and correlate their age, gender, histopathological and radiological findings. Materials and methods: This was an observational study carried out at the Department of Pathology, at Gujarat Adani Instituteof Medical Sciences, Bhuj from June 2021 to May 2022. Total 80 cases of nasal, paranasal sinus and nasopharyngeal masses were included for histopathological examination. Results: We studied 80 cases out of which 57 (71.25%) were male and 23 (28.75%) were females. From 80 cases, 63 (78.75%) caseswere non-neoplastic in nature while 17(21.25%) were neoplastic. Out of 17 neoplastic cases, 4 (5%) are benign tumors and 13 (16.25%) are malignant tumors. Radiological correlation seen in 79 (98.75%) cases out of total 80 (100%) cases. Conclusions: It can be concluded from our study that histopathological examination is mandatory for confirmatory diagnosis of any masses present in nasal, paranasal sinus and nasopharynx. Radiological investigation always play important role as it helps pathologist as well as clinician about primary diagnosis of whether benign or malignant
A prospective study on clinical and radiological resolution of community acquired pneumonia
Get PDFIntroduction: Pneumonia is a disease known to humanity from antiquity. Pneumonia is an acute inflammation of the pulmonary parenchyma that can be caused by various infective and noninfective origins, presenting with physical and radiological features compatible with the pulmonary consolidation of a part or parts of one or both lungs (Seaton, Seaton, Leitch, & Crofton, 2000). Pneumonia signifies a pulmonary inflammatory process. The most significant and striking feature of which is consolidation (Kasper et al., 2005). Materials and Methods: A prospective observational clinical study was conducted in BRIMS, Bidar a tertiary care setting during the period from January 2020 to December 2020 (1 year). All patients diagnosed as community-acquired pneumonia as per IDSA criteria were included. Treatment was started as per ATS guidelines. All patients were started on empirical antibiotic regimen as per the guidelines. No change in antibiotics were made on the basis of sputum reports unless they fail to show symptomatic improvement within 72 hours. Those with hospital acquired pneumonia or pulmonary tuberculosis were excluded. During the baseline visit, detailed history obtained and a careful clinical examination done. Results: A total number of 118 patients were enrolled in the study out of which six patients were lost to followup and two were excluded as their sputum AFB smear result was positive. Remaining 102 patients completed the study. Out of the total 102 patients, 41% were above the age of 60 years and 31% were between 46 to 60 years. The mean age of the study population was 53.49 + 15.35. Majority of the patients were (90%) males. Fever and cough were present in all the patients at the time of presentation. Dyspnoea was the next common symptom present in 73% of the patients. Pleuritic chest pain was present in 67% and wheezing in 7% of patients. Conclusion: Clinical resolution of community-acquired pneumonia occurred in 73% of patients within a period of two weeks. Radiological resolution occurred in 43% at the end of four weeks and 78% at the end of eight weeks. For those patients in whom clinical resolution has occurred, a delay in radiological resolution beyond a period of four weeks has not much clinical significance as the radiological resolution will follow eventually. Advanced age, female sex, prolonged duration of symptoms prior to diagnosis, multilobar involvement and co-existing diseases are associated with delay in resolution of community-acquired pneumonia