International Journal of Health and Clinical Research
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Effectiveness of intravenous ferric carboxy maltose(FCM ) in improving hemoglobin level amongst postpartum women with moderate to severe anemia in a tertiary care hospital
Get PDFBackground: Postpartum Anemia (PPA)has been defined as hemoglobin(Hb)of <10 gm% during the postpartum period. The most common cause of anaemia in the world is iron deficiency. Each ml of blood loss results in loss of 0.5 mg iron. Because FCM has a neutral pH and physiological similarity, it can be given in high doses over a short period of time with minimal danger of hypersensitive reactions, and no test dosage is necessary. The safety and efficacy of IV FCM in the treatment of postpartum iron deficient anaemia are assessed in this study. Aims & objectives: Present study was done to estimate the changes in Hb level 6 weeks after IV FCM administration in postpartum women with Hb level of 5–9 g/dl who delivered at our tertiary care institute. Materials & methods: This was a prospective observational study conducted at MGMMC & MY Hospital Indore's Department of Obstetrics and Gynecology (MP).Study was conducted after taking ethical clearance. Total 100 patients were included in present study. Patients received single dose of 1 gm IV FCM. Hb, PCV, RBC indices, Serum ferritin and reticulocyte count were reassessed on day 42 of the treatment. The data was analysed statistically. A p value of< 0.05 was considered significant for all statistical purposes. Results: In this study most common age group was 21-25 years(47%),patients with parity 2 were most common (39%).(53%)study patients had vaginal delivery,(42%)had Caesarean delivery & (5%) had instrumental delivery. Statistically significant difference was noted between baseline & day 42 values of Hb, Serum ferritin, & RBC indices. Conclusion: Administration of single dose of IV FCM offers a promising treatment for pregnant women with moderate to severe iron defeciency anemia
A Comparative Study of Lichtenstein technique with Rutkow–Robbins and Gilbert double layer techniques in inguinal hernia repair
Get PDFBackground: A hernia is defined as an abnormal protrusion of a viscus or a part of it, through the wall that contains it but without a breach in the body surface. By far the commonest variety of hernia is the protrusion of abdominal wall. Inguinal hernia most probably has been a disease ever since mankind existed. Aim: To compare the Lichtenstein technique with Rutkow–Robbins and Gilbert double layer techniques in inguinal hernia repair. Materials and Methods: This study was conducted to compare, three different techniques of Rutkow-Robbins Repair (Group-A), Gilbert double Repair (Group-B) and Lichtenstein operation (Group-C). Results: In this study, out of total 95 patients, 60 (63.1%) patients were having right indirect inguinal hernia, 30 (31.6%) patients were having left indirect inguinal hernias and 10 (10.5%) patients were having bilateral inguinal hernias. From the above data it is clearly shown that there is much higher incidence of right sided indirect inguinal hernias as compared to the left sided indirect inguinal hernias and bilateral inguinal hernias. Conclusion: Lichtenstein technique is recognized as the most advantageous method in inguinal hernia repairs
Cytology during Covid-19 Pandemic: A Retrospective Study at Government General Hospital, Mahabubnagar
Get PDFIntroduction: The Coronavirus disease 2019 (COVID-19) has greatly impacted health care delivery world wide and has changed the practice of Pathology including Cytology. During the pandemic of Covid 19, it is observed in Cytology practice to prioritise patients at high oncological risk, while deferring benign cases. Aim: The present study is an institutional experience of COVID19 impact on Cytology services carried out in this hospital. Methods: The Cytological sample types processed at the Government General Hospital, Mahabubnagar, during April 1, 2020 to 31 March 2021 were compared with those of the same period of April 1, 2019 to 31 March 2020. Results: During the Covid period the overall Cytology cases were drastically reduced, Statistically significant decrease of samples was noted in Thyroid and Lymphnode in Covid Pandemic era. A slight increase in percentage of Malignant cases was noted in Covid Pandemic era which was not statistically significant. Conclusions: Cytological examination was safely carried out in patients at high oncological risk, without postponing during COVID pandemic. As the Covid-19 infectivity has come down, Cytology can be practiced with adequate safety precautions. None of our faculty contracted Covid while doing FNAC procedure
Clinical study of diagnostic role of adenosine deaminase in pleural effusions
Get PDFIntroduction: The diagnosis of tubercular pleural effusion is critical, because the earlier the diagnosis, the better the result. Biochemical markers aid in the early detection of tubercular pleural effusion. Such include adenosine-deaminase (ADA), interferon, and lysozyme. Among these, ADA determination appears to be the most promising due to its speed and low cost. The current study is being conducted to determine the diagnostic role of ADA in patients hospitalised with pleural effusion at hospitals affiliated with Kurnool Medical College, as well as to correlate the level of ADA in tubercular and non-tubercular pleural effusion. Methodology: The current prospective trial will last a year, from September 2020 to December 2021. All patients over the age of 18 who presented with clinical symptoms of pleural effusion and provided informed consent for the trial were included. A thorough history was taken, a physical examination was performed, and any necessary regular investigations were carried out. Results and Discussion: In our study, the mean SD in TBPE is 79.17, with a cutoff value of 40 U/L and sensitivity of 71%, specificity of 100%, PPV of 100%, and NPV of 40%. Conclusions: The levels of ADA in pleural fluid were considerably higher in tubercular pleural effusion. As a result, our findings support the concept that pleural fluid ADA estimate is particularly important in establishing an accurate and early diagnosis of pleural effusion owing to tuberculosis
Immuno-Histochemical Study of p63 Expression in Prostatic Lesions
Get PDFIntroduction: Diseases of Prostate gland are responsible for significant morbidity and mortality among adult males all over the world. This study is carried out to study the usefulness of immuno-histochemistry using p63 basal-cell marker in prostatic lesions, especially the morphologically ambiguous ones. Aims: i) To study histopathological features of prostatic lesions. ii) To study expression of p63 basal-cell marker in prostatic lesions. iii) To correlate p63 expression with histopathology. Materials and methods: A descriptive observational study was conducted at Mahadevappa Rampure Medical College, Kalaburagi, Karnataka, India from 1st July 2017 to 30th June 2020. Specimens were sent for routine histopathological analysis followed by immuno-histochemistry analysis with p63. Statistical analysis used: Chi Square test was used for qualitative data analysis and Receiver Operator Curve was used for dichotomous data. Mean with Standard Deviation was used for quantitative data analysis. The results were considered statistically significant when p value was <0.05. Results: Of 52 specimens, the age of patients ranged from 60 to 88 years and mean being 68.61 years. Majority of patients presented with complaint of overflow incontinence. We encountered 36 cases of Benign Prostatic Hyperplasia, 13 cases of Prostatic Adenocarcinoma & 3 cases of Prostatic Intra-Epithelial Neoplasia. The ability of p63 to distinguish between Prostatic Carcinoma and non-Carcinomatous Prostatic lesions was statistically significant. Diagnostic Accuracy of p63 was 96.15%. Conclusion: Ability of p63 to distinguish between Prostatic Carcinoma and non-Carcinomatous Prostatic lesions was statistically significant. It helps in distinguishing morphologically ambiguous lesions of the prostate into benign or malignant lesions
A Comparative Study on Laparoscopic and Open Appendectomy Among Patients Attending a Tertiary Care Center of Bihar
Get PDFIntroduction: Approximately 7–10 % of the general population develops acute appendicitis with the maximal incidence being in the second and third decades of life. Open appendectomy has been the gold standard for treating patients with acute appendicitis for more than a century, but the efficiency and superiority of laparoscopic approach compared to the open technique is the subject of much debate nowadays. The aim of this study was to compare the clinical outcomes (hospital stay, operating time, postoperative complications, analgesia requirement, and time to oral intake and to resume normal activity) between open appendectomy and laparoscopic appendectomy. Methodology: An observational study of patients admitted to Department of General Surgery, Madhubani Medical College & hospital, Bihar, India between January 2021 to November 2021 with the diagnosis of appendicitis was conducted. We analyzed 100 patients that met the inclusion criteria and their clinical data. The patients were divided into two groups: open appendectomy (OA) group and laparoscopic appendectomy (LA) group. OA was performed through standard McBurney incision. After the incision, peritoneum was accessed and opened to deliver the appendix, which was removed in the usual manner. A standard 3-port technique was used for laparoscopic group. The study protocol was received and approved by the Institutional Ethics Committee. Informed consent from each patient was obtained. Results: Out of the total 50 open procedures, majority (36/50) were performed for uncomplicated appendicitis and rest for complicated disease including appendiceal perforation with local or widespread peritonitis. In the laparoscopic group, 44/50 procedures involved uncomplicated disease. In our study, the mean ± standard deviation (SD) operative time of 56.4 ± 15.2 min for the LA group was longer than the mean operative time of 33.8 ± 10.2 min for open appendectomy (P <0.05). Conclusion: Our results showed the advantages of the laparoscopic approach over open appendectomy including shorter hospital stay, decreased need for postoperative analgesia, early food tolerance, earlier return to work and lower rate of wound infection
A prospective comparative study of effect of addition of dexmedetomidine 0.5 mcg/ml with 0.2% ropivacaine and 0.2% ropivacaine alone in epidural labour analgesia
Get PDFIntroduction: The pain of childbirth is the most painful experience for many women and maternal request is a sufficient indication for providing her pain relief during labour. The McGill pain questionnaire ranks labour pain scale between cancer pain and amputation of a digit.1 Labour pain is associated with maternal physiological responses, which are not necessarily beneficial to the foetal well-being. Materials and Methods: This prospective, comparative study was going to be conducted at Department of anesthesia, Bidar Institute of Medical Sciences, Bidar during the period of November 2021 to April 2022. The sample size obtained was 38 for each group which was rounded up to 60 for each group. So final sample size estimated was 120. Reference article for sample size calculation is made based on the study conducted by Zhao Y et al. Total of 120 parturients of age group 20-35 yrs., Heights in cm: >150 cms, full term singleton vertex presentation, previous normal vaginal delivery, consented for the study, Primigravida and multigravida of physical status ASA grade I&II, foetus having normal heart rate pattern before induction of Epidural, Cervical dilatation of 3-5 cms were included in group and divided in 2 group using computer generated randomization technique. Results: The highest sensory level in both groups was observed at T6 (p=0.190). Total drug requirement in both groups was calculated. All the subjects 60 (100%) in both the groups required first and second dose of bolus. While third bolus was required only for 50 (83.3%) subjects of RD groups compared to 60 (100%) of RS group. Fourth bolus was required only for 34 (56.7%) subjects of RD groups compared to 50 (83.3%) of RS group. Fifth bolus was required only for 2 (3.3%) subjects of RD groups compared to 12 (20.0%) of RS group. There was statistically significant difference between the two groups for third (p=0.020), fourth (p=0.024) and fifth bolus (p=0.044). The total drug requirement for RS group (32.27+- 4.91) was significantly higher than the RD group (27.46 +or- 6.53), p value of 0.021. Conclusion: Epidural labour analgesia is considered to be a gold standard for pain management during labour, when ropivacaine along with dexmedetomidine is used. Many studies have been conducted to prove the use of dexmedetomidine in obstetric anesthesia in optimal doses. This wonder drug provides excellent maternal satisfaction and good progress of labour with minimal side effects to mother and foetus
Assessment of Iron, Ferritin, TIBC and LDH Levels: A Cross Sectional Study in Hypothyroid Patients at a Tertiary Care Centre
Get PDFAim: Is to study the changes of serum ferritin, Iron, TIBC and LDH levels which may affect the thyroid functions in hypothyroid patients.Materials and Methods: Serum Thyroid profile, Ferritin levels were estimated in 100 age and sex matched controls and patients of hypothyroidism, using CLIA in Mindray. Serum Iron, TIBC and LDH levels were estimated in ERBA chem7 and the results were correlated statistically.Results: Serum ferritin levels were found to be significantly decreased in patients with hypothyroidism compared to normal subjects (p < 0.001) and TIBC levels were significantly increased.Conclusion: Hypothyroidism is associated with low serum ferritin levels. The estimation of serum ferritin may help in understanding the etiopathogenesis, diagnosis, and monitoring of hypothyroid patients
Comparison of fetomaternal outcome of gestational diabetes mellitus diagnosed by who and IADPSG criteria in teaching hospital, Kerala
Get PDFBackground: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset or first recognition during pregnancy. The prevalence of GDM ranges from 15.9- 17% among women in the state of Kerala, We compared the International Association of Diabetes and Pregnancy Study Groups and the World Health Organization criteria to diagnose gestational diabetes mellitus and compare the feto-maternal outcomes. Methods: This comparative study carried out from 1st of January 2019 to 31st of January 2020 at the department of Obstetrics and Gynaecology on 234 antenatal women. Results: The prevalence of GDM based on the present study was 6.41% and 7.69% as per the WHO and IADPSG criteria respectively .Neither significant association in the maternal/foetal complications of GDM with respect to the screening criteria nor any significant inter- group difference between the WHO and IADPSG criteria. was noted. Conclusion: There was no significant percentage of cases missed by the WHO screening method .More studies are needed to add evidence for better clinical screening of GDM cases in the Indian set- up
Comparative evaluation on the effects of balanced crystalloid solution versus ringer lactate on acid base and electrolyte status in patients undergoing elective neurosurgeries
Get PDFObjectives: To compare the effects of balanced crystalloid solution versus lactated ringer’s solution on acid base and electrolyte status in patients undergoing elective neurosurgeries Materials and methods: The study was conducted at Ananthapuri Hospitals and Research institute, Thiruvanathapuram A total of 80 patients were enrolled in the study. Randomisation was done using the sealed envelope technique. Result: Balanced Crystalloid Solutions provide stable acid base, sodium and potassium levels throughout the perioperative period. Conclusion: Being isotonic, Balanced Crystalloid Solutions can be recommended for Neurosurgeries