International Journal of Health and Clinical Research
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“A Study on Awareness Among Parents About Pneumococcal Conjugate Vaccine in Routine Immunization Program to Prevent Pneumococcal Diseases”
Get PDFBackground: This study also tried to identify the associated factors favoring the awareness and immunization coverage of this newly-introduced pneumococcal conjugate vaccine. Aim: To evaluate the parental knowledge, attitude and perception of pneumococcal disease and pneumococcal conjugate vaccine. Methods: A semi-structured questionnaire consisting of open and closed-ended questions was developed to conduct this study and Immunization status with PCV was cross-examined with the immunization card. Statistical analysis: The final dataset was analyzed using SPSS for cross-tabulation, and binary logistic regression (Chi-square test with significance level at P ≤ 0.05, will be performed to determine the association. Results: A total of 300 parents (father or mother) participated in this study,there was no significant association between awareness of PCV with father’s and mother’s education level,Association between awareness among parents about PCV and immunization with PCV (based on the eligibility of children and availability of immunization card) was assessed in this study and was found statistically significant. Conclusion: Appropriate programmatic support, wide acceptability of vaccinations, availability, and accessibility to vaccination center have a positive influence on the vaccination status of children
Survival in Patients with Brain Metastases from an Unknown Primary Tumor
Get PDFAim: To analyze the survival rate and the prognostic factors of patients with brain metastases from unknown primary (BMUP) cancers. Material and Methods: We conducted a retrospective study with 55 patients (mean age- 62.8 years and range 22–80), with male 43 patients (78%) and female12 patients (22%) at the time of diagnosis, who presented to our outpatient oncology department between June 2015 and June 2019. We made the following variables as significant prognostic factors for a prominent index of patients’ survival: age, gender, Karnofsky performance score (KPS), number of metastatic lesions, primary site and type of treatment. Patients’ survival was evaluated from plotted Kaplan– Meier curves and the log-rank test for univariate analysis. Results: The mean follow-up was 13 months (range 4–60 months). The mean survival after the diagnosis of brain metastasis was 18.7 months for this study. Lung cancer was the most common primary tumor (74.5%). The KPS and number of lesions were found to have a prognostic effect on survival. Survival analysis showed no statistical significance with age, gender, primary site and type of treatment. Conclusion: This study showed that KPS and the number of lesions affect the survival outcomes. Therefore, BMUP cancer is indeed related to poor prognosis
Ultrasound measurement of subglottic diameter for determination of microcuff endotracheal tube size and intubation outcome in paediatric cases: An observational study
Get PDFIntroduction: One of the biggest achievements of medical science is safe anaesthesia especially for children. Management of airway takes priority over any other intraoperative intervention during anaesthesia .Determination of “best -fit” endotracheal tube (ETT) is important in children to provide optimum ventilation without causing any laryngotracheal morbidity[1-4]. Aim: To investigate the 1st attempt success rate of intubation using best fit Micro cuff ETT ( MCETT) size, determined by ultrasound measured subglottic diameter in paediatric population and to compare the result with age based size table of micro cuff endotracheal tube. Materials and methods: 66 paediatric patients aged between 1‑10 year, undergoing various elective surgeries under general anaesthesia were included in the study .The subglottic airway transverse diameter was measured in the brightness (B) mode using the linear probe (range 6-13 MHz) of the USG device with the child in the supine and neutral head position. Best-fit tube ID is considered as the one with satisfactory air leak at an airway pressure of 15-20cm H2O. 1st attempt success rate of intubation using best fit MCETT size, determined by ultrasound measured subglottic diameter in paediatric population were compared with the result with age based size table of micro cuff endotracheal tube. Results and Conclusion: Comparisons of means of sizes of correct MCETT with age based table and with USG guided method revealed that both methods are good predictors for the correct MCETT size estimation (p-value<0.05). However, size of correct MCETT matched with MCETT size calculated using USG method was in 56 patients (84.8%), whereas the MCETT by age-based table selected the correct tracheal tube size in 42 (63.6%) patients with the difference being statistically significant (p=0.026). Furthermore, reliability agreement calculated by Intraclass correlation coefficient suggested that USG based methods are better than age based formulas in children with k- values of 0.939 and 0.887 respectively. Conclusion: We conclude that ultrasound appears to be a reliable predictor for the assessment of the subglottic diameter of the airway in children to estimate the appropriate size of microcuff endotracheal tube
Assessment of hashtag Covid in social media
Get PDFIntroduction: The time of Covid pandemic had mandated most of the people to be distanced individually and connected through social medias. The social medias serve as a medium to communicate about covid related issues without any barriers and assures maximum reachability Objectives: The objectives of this study were to evaluate the pattern of posts which is shared via covid-related posts and to assess the characteristics of the posts under hashtags about this worldwide pandemic among three social media platforms, namely, Twitter, Instagram, and Facebook. Methodology: This was a cross-sectional study which analysed# covid posts in Instagram, Facebook, and Twitter. Public posts related to that were searched and assessed separately. Source, popularity, credibility, type, background and other characteristics were assessed about each postwas assessed. Results: Out of 3600 posts, 3120(86.7%) were related to the study. Instagram displayed more of individual posts (40.2%) and more popular (50.4%) with positive perception (42.1%) and more credible (45.4%)compared to other social media. Also, Instagram posts were more frequent (54%) and related with the subject (42%) in comparison to other social medias.Among the credible posts 79.4% were sourced by individual, 87.5% with positive perception, 80.7% awareness related and 81.3% were images. Conclusion: The study showed that the subject covid pandemic were supported and promoted by social media mainly through images and most of the posts were popular with credibility. Also, the posts were mostly related to awareness and positively perceived by the viewers. Instagram showed more popular, individual sourced, credible, positively perceived, awareness related posts among the related posts in the study
Association of female Breast carcinoma, its prognostic factors and ABO blood group: A retrospective study
Get PDFBack ground: Association between ABO blood group antigens and cancer has been described since 1953. Association of breast carcinoma and ABO group is not clear. Aims and objectives: To study the association between blood group type and breast carcinoma, its prognostic factors and molecular subtypes. Material and methods: This is retrospective study which includes 273 breast cancer cases. Association between prognostic factors, molecular subtypes of breast carcinoma and blood group type was assessed. Results: Out of 273 cases of breast carcinoma, maximum number of cases were of O group (41.5%).Among grade 1 and grade 2 patients majority were having blood group O and grade 2 patients were having B group. All the blood groups showed tumor size of 2 to 5cms and were in stage 2 in maximum cases. Maximum cases with lymphnodal metastasis were seen in O group (45.1%).Her2 rich cases were commonly observed in B group (38%) where as Luminal A, Luminal B, and triple negative were commonly seen in O group (43.2%,46.3% and 39% respectively). Conclusion: Women with blood group O are at more risk of developing breast carcinoma followed by blood group B, A and AB. There was no statistical significance for association between the blood groups and prognostic factors of breast carcinoma. Lymph nodal metastasis was seen more in blood group O patients. Maximum number of Her2 rich cases were seen in B group whereas Luminal A, Luminal B and triple negative were seen in O group
Functional Outcome of Lisfranc Injury Managed With Arthrodesis
Get PDFPurpose- Though injuries around foot and ankle joint are seen commonly in orthopaedic outdoors and emergency rooms, but tarso-metatarsal joint injury or lisfranc injury merely accounts for 0.2% of the fractures. It is commonly seen that these injuries are missed on initial presentation and may lead to interference with daily routine activities which occurs as a result of pain, deformity. In present study can arthrodesis obviate the need for revision surgery and to see the difference in functional outcome. Method– We conducted a prospective study from 1st January 2017 to 30th June 2021 including ten patients (7 males and 3 males) with Lisfranc fractures. In our study, arthrodesis was performed in all cases. At final follow-up functional outcome was evaluated using “AOFAS- Midfoot score”, “VAS score” and radiological assessment. Results– All ten patients had good functional outcome at final follow-up and found no difficulty in routine activities. Routine clinical and radiological assessment were also done at final follow-up. Conclusion– Closed Lisfranc injuries treated with arthrodesis has good functional outcome in terms of function if managed properly
A Cross-sectional Study to assess the “Quality of Life” and their impact on employment among Diabetic foot patients in a Tertiary care Hospital in a Metropolitan city
Get PDFBackground: India leads the world with largest number of diabetic patients earning the dubious distinction of being termed the “Diabetes Capital of the World.The most frequent consequence of diabetes mellitus is diabetic foot ulcer. Quality of life is decreased by diabetic foot illness. It is linked to reduced productivity and early retirement. This research was done to assess the health related quality of life.among those who have diabetic foot ulcers, as well as to assess the impact on employment status of diabetic foot ulcer. Objectives: To assess the impact of employment status among diabetic foot ulcer patients. To assess the impact of diabetic foot ulcer on health related quality of life among diabetic foot patients. Materials and methods: This was a cross sectional observational study among 196 diabetic foot ulcer patients of either sex visiting the General surgery OPD of a tertiary care hospital in a metropolitan city.Complete enumeration method was used in this study. A semi-structured predesigned pretested questionnaire was used in this study. It contains socio -demographic details, General examination, disease and treatment related details, and employment related characteristics.A standardized questionnaire, SF-36 v2, was used to measure QOL of diabetic foot patients. Results: Majority of participants are in paid employment (n=70, 35.71%) followed by unemployed (n=58, 29.59%) then self-employed (n=38, 19.38%) and 30 (15.30%) are retired respectively. the mean days lost due to diabetic foot was 145.5±31.5 while the mean wages lost per day is Rs.322±295. Conclusion: In the present study majority of study participants had poor health related quality of life in environmental,physical and mental health.Majority of participants are in paid employment (n=70, 35.71%) followed by unemployed (n=58, 29.59%) with diabetic foot ulcer and reported of having left a job/changed job
A study on role of biochemical markers in prediction of gestational diabetes mellitusa
Get PDFIntroduction: Diabetes mellitus is a disorder of carbohydrate metabolism. It is caused by a combination of hereditary and environmental factors characterized by either inadequate secretion or inadequate action of insulin. Both pre gestational and gestational diabetes pose many risks to the mother and fetus. In addition to traditional risk factors, several biochemical markers like glycated hemoglobin HbA1c, fasting and postprandial blood sugars and inflammatory markers like c reactive protein, cytokines, pregnancy associated plasma protein-A, which are implicated in pathophysiology of GDM and involved in mechanism related to insulin resistance or chronic inflammation have been studied to predict risk of developing GDMearly[16]. Aims: To diagnose GDM in early trimester with the help of certain biochemical markers like Fasting blood sugar, Postprandial blood sugar, glycosylated hemoglobin HbA1C and C Peptide. Methodology: This is a prospective study done in 200 Pregnant women in early trimester who attended OPD in King George Hospital, Visakhapatnam. With informed consent, these pregnant women are subjected to detailed clinical examination and before 20 weeks subjected to fasting blood sugars, postprandial blood sugars, HbA1C,C – peptide estimation &were followed up with regular antenatal checkups and appropriate antenatal care and at about 24 -28 weeks of period of gestation 75 g oral glucose tolerant testwas done according to the standard protocols for testing regarding concentration and amount of glucose,fasting and timing of blood sample collection. Based on the results of this test, included pregnant women are categorized into GDM (cases) and non GDM group (controls) with cutoff value of 75g glucose tolerant test being 140 mg /dl. Results: The mean values of the selected biochemical markers were significantly higher in GDM cases when compared to controls.The mean FBS,PPBS, HBA1C and C-Peptide of first trimester in GDM cases were 86.76mg/dl,122.76mg/dl,5.4g%,3.4647ng/ml respectively. Conclusion: Gestational Diabetes mellitus is a very common global health problem which is significantly increasing universally with changing life style habits.This increasing rate and it’s effect on maternal and fetal health makes the concept of EARLY DIAGNOSIS of GDM, a very crucial part to our health system .Pregnant women with fasting blood glucose more than 86.76 mg/dl, PPBS more than 122.76 mg/dl, HbA1C more than 5.4g%in first trimester, c peptide more than 3.4ng/ml have to be cautious and are at risk of developing GDM in late trimester and hence followed up carefully. The above Reference cut off values of markers included in our study are yet to be established by further studies with larger population
A prospective randomized trial on alkalinized lignocaine preloaded endotracheal tube cuffs to reduce emergence cough following brief surgery
Get PDFBackground and Objectives: Endotracheal intubation is required during general anesthesia to secure the airway. As a result of coughing during emergence, patients have hypertension, tachycardia, elevated intracranial and intraocular pressure, bronchospasm, wound dehiscence, and surgical bleeding. Our goal is to determine whether alkalinized lignocaine preloaded endotracheal tube cuffs are effective at reducing the emergence of cough following minor surgery.Methods: This prospective randomized controlled trial was conducted on ASA grade I and II patients between the ages of 25 and 50 after gaining approval from the institutional ethics committee, They were scheduled for a variety of short-duration surgeries under general anesthesia at Alluri Sita Rama Raju Academy Of Medical Sciences Hospital for one year. A total of 100 patients are divided into two groups, Group AL, and Group S (50 patients in each Group). Group AL: (study group) these patients received preloaded (alkalinized lignocaine in ET cuff 90 min before intubation) 2% alkalinized lignocaine in the ET cuff, volume decided by minimum occlusion volume technique. Group S: (control group): these patients received normal saline in the ET cuff after intubation.Results: Patients in the AL Group had a mild cough in 12% of the population, while Patients in the S group had a mild cough in 14%, moderate cough in 10%, and severe cough in 4% of the group population. Emergence cough is significantly less in the AL group compared to the S Group (p=0.39).Conclusion: Alkalinized lidocaine in ETTs preloaded with the same solution before surgery appears to significantly lower the incidence of emergency cough during short surgical procedures. Eliminating the pressor reaction also lessens emergence agitation and offers hemodynamic stability during extubation
Incidence of day care discharge in laparoscopic cholecystectomy and correlation with pacu scores: A feasibility study
Get PDFIntroduction: Laparoscopic cholecystectomy has overpowered open cholecystectomy for the treatment of gall bladder disease. The concept of Day Care surgery along with ERAS is very useful in a developing country like ours because it leads to cost containment and better utilization of the health care resources. This study was conducted to co relate PACU scores with discharge feasibility in laparoscopic cholecystectomy patients. Method: The study was conducted with 48 patients undergoing laparoscopic cholecystectomy. The patients undergoing laparoscopic cholecystectomy either under general or regional anaesthesia, ASA I and II were included in this study. A standard general anesthesia protocol was followed. Modified Aldrete score and PADSS score were assessed to confirm readiness for discharge. Results: 43patients were discharged on the same day of surgery. Mean hospital stay after surgery of the patients who were discharged on the same day of the procedure was 9 ±0.74 hours. 5 patients were kept admitted.Of these 5, 3 recovered completely and discharged within 48hrs while 2 had readmission. PACU scores correlated well with all patients. Conclusion: Right selection of patient, proper pre-op optimization of comorbid conditions, good postop analgesia, and proper utilization PACU scoring system can promoteday care Laparoscopic Cholecystectomy