International Journal of Health and Clinical Research
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Prognostic significance of haematoma thickness to midline shift ratio in patients with acute subdural haematoma
Get PDFBackground: Acute intracranial subdural hematoma is usually associated with the high risk of morbidity and mortality. The factors to choose the surgical procedure for hematoma are occasionally controversial. Therefore in this study we aim to evaluate the prognostic significance of hematoma thickness (mm), midline shift (mm) and hematoma thickness to midline shift ratio level in patients with acute subdural hematoma. Methods: Total 50 traumatic brain injuries with acute subdural hematoma diagnosed patients were enrolled in this study. The Glasgow coma scale (GCS) score was determined on admission and post-operative 1, 3 and 7 day. Outcome evaluation was done using Glasgow outcome scale (GOS) score at time of discharge; follow up at 1 month and 3 month. Results: The mean Glasgow Outcome Scale was 3.9 ± 0.32, 4 ± 0.47 and 4.4 ± 0.52 in mild, 3.57 ± 0.85, 4.23 ± 0.6 and 4.77 ± 0.44 in moderate and 2.77 ± 1.18, 3.89 ± 0.57 and 4.26 ± 0.56 in severe Glasgow Coma Scale at discharge, 1 month and 3 months, respectively.The hematoma thickness (mm) and Midline shift (mm) were significantly negative and Glasgow Coma Scale on admission and hematoma thickness to midline shift ratio were significantly positive correlated with Glasgow Coma Scale at post-operative day 1, day 3 and day 7. The hematoma thickness (mm), Midline shift (mm) and age (years) were significantly negative and Glasgow Coma Scale on admission and hematoma thickness to midline shift ratio were significantly positive correlated with Glasgow Outcome Scale at discharge only. Conclusion: A positive correlation between preoperative hematoma thickness to midline shift ratio and negative correlation of hematoma thickness (mm), Midline shift (mm) with postoperative Glasgow Coma Scale and Glasgow Outcome Scales were found in traumatic intracranial acute subdural haematoma
USG Guided Ilioinguinal and Iliohypogastric Nerve Block for Post-Oerative Analgesia Following Inguinal Hernia Repair
Get PDFBackground & Aims: Inguinal hernia repair is one of the commonest surgeries performed. Poorly controlled postoperative pain following herniorrhaphy might be a predisposing factor for the development of chronic pain. Use of ultrasound for nerve block enhances the success rate. Study conducted with the aim to gauge the analgesic efficacy of ultrasound-guided II-IH block in patients undergoing unilateral inguinal hernia repair. Materials and methods: Sixty patients of American Society of Anesthesiologists (ASA) grade I–II undergoing elective unilateral inguinal hernioplasty were enrolled into the study. Patients were randomly divided into two groups of 30 patients each. USG guided II-IH block performed with 15 ml of normal saline (group C) and 15 ml of 0.25% Bupivacaine (group S).VAS score was used for pain assessment. Patient who had VAS of 3 or more received i/v Pentazocine. Patients were monitored for VAS scores and total analgesic consumption for the 24-hour period. Results: II-IH block reduced VAS score at 2,4,6,8,12 hours. This nerve block with 0.25% bupivacain resulted 7.50 hours duration of analgesia. Rescue analgesia consumed less in group S. No complication observed in this study. Conclusion: Ultrasound guided ilioinguinal-iliohypogastric(II-IH) nerve block is effective and safe adjunct to multimodal postoperative analgesia after inguinal hernia repair surgeries. This reduces rescue analgesia consumption , provides good VAS score. No complication observed in any group
A descriptive study of effect of blood donation on lipid profile in healthy volunteers
Get PDFIntroduction: Blood donation is a process by which a blood donor voluntarily has drawn the blood for the shortage in the blood bank or for subsequent use in blood transfusion. There is considerable shortage of blood even in large metropolitan cities with supply being less than 50% than the requirement. Materials and methods: This is descriptive study. Blood donation camp was organized in RIMS, Ranchi. 60 healthy males who were willing to participate were selected for the study. The Inclusion criteria being age between 18 years and 25 years, weight between 50 kg and 60 kg and haemoglobin levels should be > 10 mg %. Exclusion criteria are volunteers having history suggestive of chronic illnesses like Hypertension, Diabetes Mellitus, Hepatitis B, Haemoglobinopathies, Bleeding disorders, Alcoholics, Chronic smokers, Drug abuser, H/O blood donation within last one month. The samples of 60 healthy volunteers were collected in fasting condition. With all aseptic condition, 5 ml venous blood was withdrawn and centrifuged. Separated serum was used for further analysis. Results: All the parameters of lipid profile, e.g. TC, LDL, VLDL except HDL was highly significantly decreased (p<0.001) after 7th and the effects continued till 30th day after blood donation, which was highly significantly decreased (p<0.05, HDL). It was significantly increased (p <0.05) after 7th and 30th day of blood donation. At 90th day, all values were normalised. Conclusion: Blood donation has lipid lowering effects as early as 7 days after blood donation and effects were maintained till 30th day after blood donation. During this period, i.e. on day 7 and 30, there was significant decrease in TC, LDL, TG and VLDL levels with significant elevation of HDL concentration. The lipid profile returns to normal after 90 days of blood donation in healthy volunteers
A cross sectional study of cognitive dysfunctions in patients with type 2 diabetes mellitus in a tertiary care hospital from Andhra Pradesh
Get PDFIntroduction: Diabetes mellitus (DM) represents a group of common metabolic disorders that share the phenotype of hyperglycaemia. Several types of DM exist and are caused by a complex interaction of genetics, environmental factors and lifestyle choices. The metabolic dysregulation associated with DM causes secondary pathophysiological changes in multiple organ systems. Materials and Methods: The study was a case control study which was carried out after taking informed consent. Random sampling was carried out among T2DM outpatients attending the Department of Psychiatry, Maharajah's Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh, India during the period from February 2020 to December 2020. 100 patients with T2DM and 102 age and sex matched nondiabetic controls were selected for the study. An informed written consent was obtained from all patients prior to the study. All the participants were subjected to a face to face interview during which demographic data (age, sex, education) and medical history (vitals, years of illness, significant comorbidities) were collected. Results: The demographic characteristics of patients are presented in Figure 1 and 2. The study consisted of 62% males and 32% female participants. 70 participants were in the age group of 45-50 years, 32 were between 50-55 years, 60 were between 55-60 years and 46 were between 60-65 yrs. intergroup comparison for gender and age did not show any statistical significance. The association between the presence of T2DM and MCI done using Chi square test. 44% of diabetics had MCI while 56% of diabetics had no MCI. 24% of Non-diabetics had MCI while 76% of Non-diabetics did not have MCI. The test revealed that there was a statistically significant relation between the presence of T2DM and MCI with a P value < 0.05. Conclusion: This study established that type 2 diabetes mellitus has a significant statistical association with mild cognitive impairment. This study aims to create an awareness regarding the early neurological manifestations of this rampant disease with the use of sensitive screening tools
Analysis of Thumb Print Patterns in Relation with Blood Group among Medical Students: A Cross- Sectional Study
Get PDFBackground: Dermatoglyphics or fingerprint is defined as the systematic study of natural occurring epidermal ridges and their arrangement on palm, sole and digits. A person’s fingerprint is permanent even before they are born, at about 21st week fingerprint pattern is completely developed. In 1901 Karl Landsteiner discovered Blood group system. As it is observed that dermatoglyphics and blood group typing have genetic inheritance, so we have made an effort to analyse thumb print patterns in relation with blood group. Material & Methods: A Descriptive cross sectional study was accomplished among 200 medical students from 1st and 2nd prof MBBS studing in SKMC Muzaffarpur. After obtaining written informed consent thumb print patterns were recorded using the violet stamp pad of camlin company size 15.9cm: 9.6cm. Result: Majority of subjects belongs to B (88) blood group followed by O (68), A (24) and AB (20).The majority (94%) belong to the Rh +ve blood group. Loop patterns were the most common primary thumbprint pattern followed by whorls and arches in both males & females in all blood groups. In our study we found insignificant relation between fingerprint (thumb) patterns and ABO blood group typing. Conclusion: Our results suggest that thumb print and ABO blood groups can only be assessed independently to establish the identity of an individual
Bacterial Meningitis Among Pediatric Patients Presenting With Acute Febrile Seizure: A Report From A Tertiary Care Center Of Bihar
Get PDFIntroduction: Febrile seizures usually affect children between the ages of five months and six years with a prevalence of 3-8%, which makes them the most common type of seizures in childhood. Bacterial meningitis is one of the deadliest infections, affecting both adults and children, and defined as inflammation of the meninges covering the brain. With this background, a secondary data analysis was planned to find out the incidence of meningitis among pediatric patients presenting with febrile seizures. Methodology: A retrospective cross-sectional study on 150 Patients was conducted by the Department of Pediatrics Nalanda Medical College & Hospital, Patna, Bihar. Prior approval was obtained from the Institutional Ethics Committee. The study covered all patients who were diagnosed with or suspected of having febrile seizures in the period between September 2020 to August 2021. The patients’ data were obtained from the hospital database and analyzed. Results: A total of 150 patients who presented to the hospital with febrile seizures in the period between September 2020 to August 2021 were identified, with a median age of 22.5 months. There was a male preponderance in the study population with 62.7% of patients being boys. Bacterial meningitis was suspected and lumber puncture was performed among 17 out of 150 patients, this comprised 11.3% of the total study population. Conclusion: Febrile seizures are one of the most common presentations in the pediatric emergency department. Clinical judgment and balance between risk and reward remain the cornerstone in deciding which patients are more likely to benefit from the lumbar puncture
A Study on Color Doppler and Non Stress Test as Predictor of Perinatal Outcome in Pregnancy Induced Hypertension and Intrauterine Growth Restriction in a Tertiary Care Hospital in Eastern India
Get PDFIntroduction: Antepartum surveillance to evaluate fetal health have been the focus of intense interest for more than decades. The timely detection of morbid changes in fetal status followed by adequate interventions to avoid death or disabilities, is of paramount importance.Objective: To compare the effectiveness of non-stress test and color doppler studies in the prediction of perinatal outcome in terms of mode of delivery , gestational age at delivery, birth weight , admission in neonatal intensive care unit (NICU), fetal morbidity and mortality.Material & Methods: A prospective observational study was conducted among (n=100) antenatal patients admitted in the obstetric indoor of a hospital in Kolkata, West Bengal complicated by pre eclampsia and intra uterine growth retardation (IUGR) beyond 34 weeks of gestation after matching with inclusion and exclusion criteria. Recruited participants were then divided into four groups: group A having both tests normal, group B with normal NST and abnormal doppler, group C with normal doppler and abnormal NST and group D with both abnormal tests respectively. The patients were followed by serial fetal doppler assessment and non- stress test (NST). The results of the last doppler and NST within one week of delivery were considered in the subsequent correlation with perinatal outcome. The time interval in days between the first abnormal doppler and the development of abnormal NST was used to calculate the lead time. The perinatal outcome parameters studied were mode of delivery, gestational age at delivery, birth weight, neonatal morbidity in terms of Apgar score < 7 at 5 minutes, NICU stay, and perinatal mortality. The major adverse perinatal outcomes, if any was observed amongst the four study groups.Results: 40% percent of multigravidas had a history of preeclampsia in their previous pregnancy. 18% of the study population had a combination of preeclampsia and IUGR. 38 women had both NST and doppler study normal (Group A) while both tests were abnormal in 31 patients (Group D).There were 54 women with abnormal doppler findings and 39 with abnormal NST. Brain sparing effect (BSE) was seen in 38 women. Group A had majority of cases (65.78%; 25 out of 38) with only IUGR and had the least morbidity and best perinatal outcome. Group D had the maximum number of cases having combined preeclampsia with IUGR (70.96%; 22 out of 31) and had the worst perinatal outcome associated with prematurity and low birth weight; there were only 15.78% NICU admission in the group A; in contrast 77.4% fetuses required NICU admission in group D. Only 39.4% had operative delivery for fetal distress in group A in contrast to 70.96% women in group D. There were 4 intra uterine and 13 neonatal deaths. Majority of fetuses showed abnormal doppler changes prior to NST. The lead time varied between 0-9 days with a mean of 4.11 days.Conclusion: Though both test results were effective in predicting abnormal perinatal outcome, a significant advantage of doppler over NST was it showed abnormal changes earlier than NST giving a significant lead time of up to 9 days which is important in the management of preterm high -risk pregnancies. An abnormal NST following an abnormal doppler is associated with the worst perinatal outcome. Both the tests are complimentary to one another in fetal surveillance of high -risk pregnancies
Role of vitamin D in management of depression
Get PDFBackground: Major depressive disorder (MDD) is a common psychiatric disorder leading to severe dysfunction in multiple spheres of life. Etiopathogenesis of MDD is multifactorial with multiple inconclusive theories including putative role for vitamin D so it has been investigated as a potential strategy for the prevention and/or treatment of depressive symptoms. Method: A longitudinal study in patients of Major Depressive Disorder as per DSM-5 attending the psychiatry outpatient department (OPD), from March 2018 - June 2019 of a tertiary care center was planned. Sociodemographic data was collected .Level of vitamin D was assessed at 0 and 12 weeks. . Patients were divided into 2 groups i.e. cases (patients with low vitamin D) and controls (patients with normal vitamin D). Cases were further divided into 2 groups, out of which one group was supplemented with vitamin D(60k/week) and the other group was not supplemented with vitamin D. All the above groups were given antidepressant (Sertraline) with benzodiazepines (Lorazepam) according to clinical assessment. Severity of the disease was assessed using MADRS and HAM-A at 0,4,8,and 12 weeks. Result: Out of 78 patients who were enrolled in the study, low vitamin D level was seen in 76.9% of the patients. At 0 week out of 60 cases, 30% had mild depression, 70% had moderate depression, while none of the cases had severe depression and 8.33% had mild anxiety ,55.00% patients had moderate anxiety, 36.66% had severe anxiety. Analysis of mean MADRS and HAM-A scores was done by taking into consideration all the three groups i.e. cases with vitamin D supplementation, cases without vitamin D supplementation and controls using ANOVA test at 0 and 12th week through which it could be seen that there was significant difference between all the three groups at 0 week but not at 12 week. Conclusion: Patients with low vitamin D levels are more likely to have depression than general population but there appears to be no beneficial effect of vitamin D supplementation in management of depression
Role of Ghrelin and Adiponectin among Type 2 Diabetes mellitus patients attended at Tertiary care teaching hospital
Get PDFIntroduction: Diabetes mellitus (DM) refers to a bunch of disorders of metabolism that share the phenotypic sign of hyperglycaemia. Different variants of DM are caused due to the interaction of various genetic factors with environmental factors. Methods: overall total number of 50 patients with type 2 DM, aged from 20-60 years attending OPD of a tertiary hospital was taken into study, whose blood glucose level before meals was [≥ 120 mg/dl] and after meals was [≥ 140 mg/dl], taking oral hypoglycaemic medicines only and not taking insulin therapy was included in the examination. Result Overall, 50 patients of age group from 20-60 years were taken in the examination. among which type 2 DM was more predominant in the employed group from 51-60 years (48%) thereby 41-50 years (34%). It was seen that 52% of patient of type-II diabetes mellitus had history of same complaint in the family. From the research, polyuria (52%) and polydipsia (48%) were the commonest symptoms seen in the patients suffering from DM. According to the drug therapy recommendations, Biguanides (92.1%) and Sulfonylurea (87.2%) were the commonest prescribed oral hypoglycaemic medicines amongst entire oral hypoglycaemic group of medicines, followed by thiazolidinediones (19.2%), Dipeptidyl peptidase-4 inhibitors (16%), α-glucosidase inhibitor (3.2%) and meglitinides (1.9%) individually. Conclusion: The increasing pattern of inactive daily life routine and more occurrence of overweight has put up enhancement in the individuals of diabetes, which contributes to enormous requirement of hypoglycemic drugs and motivating corporations to spend much on research and development for producing targeted formulae
A study of central edge angle of wiberg of acetabulum radiologically, among Haryanvi population
Get PDFThe present study was conducted in Department of Anatomy, on 200 persons (100 males and 100 females) of all age group of Haryana region. The AP view of radiographs of right and left hip joints were taken after written consent. The central edge angle of wiberg of both hips were measured. The mean CE angle of wiberg in males was 37.52±4.75 degree in right side and 40.25±7.75 in left side. Similarly in females 36.45±7.47 degree and 39.34±6.96 in right and left side respectively and mean value of central edge angle of wiberg was more in males as compared to females both in left and right hip. . Hence knowledge of these parameters of hips can be used for better understanding of osteoarthrosis and acetabular dysplasia prevalence