International Journal of Health and Clinical Research
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Study of oral premalignant and malignant lesions in a tertiary care teaching centre of North India
Get PDFBackground :Oral malignancies are the sixth most common cancer around the globe. However, In India oral cancer is one of the leading carcinoma is squamous cell carcinoma these days. Its incidence is 12.6 per 1,00,000 population. Oral carcinoma is a common health problem with developing prevalence and mortality rates. Prevention or early finding of premalignant and oral cancer requires increased public awareness. Oral squamous cell carcinoma is the most frequent of oral carcinomas and represents about 3% of all human malignant tumours. Methods : This cross-sectional study was conducted in Government Medical College associated Hospital, Datia from February 2018 to February 2019. Total 88 patients suffering from oral lesions were included in the study both premalignant and malignant lesions. The patients were asked about the detailed clinical history and daily routine habits to eliminate exposure to known carcinogens. Result:In this study total Males were 52 and females were 36 (M:F=1.3:1). The mean age was 56.2 years. The largest number of patients of premalignant cases was between age group 41-60 years and malignant cases between age group 51-70 years. Regarding substance abuse maximum patents was tobacco was chewers then smokers then tobacco chewers as well as and some was no addiction to tobacco or smoking.Conclusion : This study explores the prevalence of oral lesions in this area and attempts to correlate the various risk factors with the lesions identified. Present studies were pattern and presentation of premalignant as well as malignant lesions in oral cavity and result of epidemiological factors and daily lifestyle habits on the scenario of oral cavity
A comparative approach of Direct lateral vs posterolateral approach to hemiarthroplasty for femoral neck fractures
Get PDFIntroduction: Adopting the direct lateral (DL) instead of the posterolateral (PL) approach in hip arthroplasty for femoral neck fracture (FNF) patients could lower the rate of prosthetic dislocation. However, little is known about how the approach influences the functional outcome.Objective- The evaluate and compare hip function, pain and complication and reoperation rates in fracture neck femur patients operated with HA using the DL and PL approach.Material and methods: In a prospective cohort study, we enrolled 185 patients with a displaced femur neck fractue. Subjects were assigned to treatment using DL (n = 102) or PL approach (n = 83) with a hemiarthroplasty (HA). Functional outcome was assessed by Western Ontario and McMaster Universities Arthritis (WOMAC) index, pain numeric rating scale (PNRS) for pain, mortality and hip complications. Patients were followed-up after 1 year. Results: We found no difference in WOMAC, PNRS and mortality. Seven patients (6.9%) in the DL group and 11 patients (13.3%) in the PL group had undergone a major reoperation (adjusted OR 0.51; 95% CI, 0.18–2.07; P = 0.23). Conclusion : In this prospective cohort study, patients treated with HA for FNF using either the DL or PL approaches had comparable functional outcome after 1 year. The PL approach had a tendency towards a lower reoperation rate
Correlation of histopathological and cytological features in proved tubercular lymphadenitis
Get PDFBackground: Changes in pattern and incidence of Tuberculosis have strikingly altered the etiology of mycobacterial lymphadenitis as children are usually more affected by atypical form while adults and geriatrics are mostly infected by M.tuberculosis.5 Diagnosis of tuberculous lymphadenitis is mostly clinical and histopathological but in some cases where microscopic appearances are not exactly typical so diagnosis becomes difficult. Material and method: The study protocol included 150 patients more than 15years belonging to both sexes. Detailed history of selected patients was taken, after this clinical examination and routine investigation were carried out. Patients below 15 years, with any chronic illness, pregnant woman, with any hepatic and renal failure were excluded from study.Result: Necrotizing granulomatous lymphadenitis was most common (66.67%) cytological diagnosis followed by granulomatous lymphadenitis (18%) and necrotizing lynmphadenitis (14.66%). Out of 150 cases 78 (52%) were positive for AFB on FNAC smears while 72 (48%) were smear negative for AFB. Lymph node biopsy was done in 42 cases. Those who were not willing common most was histopathological feature (71.4%).Conclusion: FNAC smear confirmed the diagnosis bacteriologically in 52% cases subsequent FNAC culture for AFB contributed in 11 (7.3%) cases more as an additional yield over FNAC smear
Prevalence and risk factors of scabies among school adolescents in urban Lucknow, India
Get PDFBackground: Scabies is found worldwide and affects folks of all races and social categories. Itching unfolds speedily beneath packed conditions wherever the shut body and skin contact is frequent. Establishments like nursing homes, schools, extended-care facilities, prisons, child-care facilities are standard sites of itch infestations and scabies outbreaks. The study objective was to seek out the prevalence and associated risk factors for Scabies among the adolescent school children in urban Lucknow. Methods: This cross-sectional study was conducted among adolescent school children between 1st January to 31st March 2020 in urban Lucknow. Information was collected using a pretested semi structured questionnaire. A trained medical examiner made the identification and clinical diagnosis of infection. Collected information was entered in Microsoft excel and analysed by using SPSS software version 23.0. Results: Prevalence of Scabies infection was found to be 23.33%. Age of the student, overcrowding and the type of house was found to be statistically related to the infection. Conclusions: Health education regarding personal hygiene practises is strongly recommended among school going children. Modification of environmental risk factors like overcrowding and improper dwellings, will aid in reducing the spread of scabies
Stress and Resilience in Health Care Workers Managing Corona Virus Disease- 2019 Patients in A dedicated COVID-19 Hospital in Mewat region of North India
Get PDFObjective: Pandemics are known to impact the mental health of the health care workers (HCWs). Impact of COVID-19 on mental health of HCWs is not yet understood completely. We studied stress and resilience among HCWs during the COVID-19pandemic, and observedlevel of stress and resilience among different job profile of HCWsin North India. Methods: We conducted a hospital based cross sectional study at a designated COVID-19 tertiary care center in rural district of North India from April 2020 to June 2020. A total of 587 HCWs were included for study. The information was collected using Semi-structured proforma and pre-validated questionnaire, Perceived stress scale (PSS) for perceived stress and Brief resilient coping scale (BRCS24) for resilience. The statistical analysis was done using statistical package for social sciences (SPSS), version 24. Results: Maximum number of participants (72.2%) reported with moderate to high level of perceived stress. 76.5% specialists were reported moderate stress followed by paramedical staff (65.7%) and junior residents (63.9%). Around 70% of junior residents have high resilient coping skills followed by specialists (53.7%) and paramedical medical staff (51.8%).Significant difference (p value = <0.000) between the PSS score and BRCS scores were found among all three job categories. No correlation was found between PSS and BRCS (p value >0.05). Conclusions: Our study indicated highest level of perceived stressandresiliencein junior residents among all the three job categories, however no relationship could be observed between perceived stress and resilience in HCWs. Higher age, female gender, specialist and COVID care duty inICU, isolation, flu OPD, triage were predictors of perceived stress. These findings should be taken into consideration for the development and implementation of interventions to mitigate the impact of sustained psychological distress among HCWs
Functional outcome of Column-specific Fixation of Complex Tibial Plateau Fractures
Get PDFBackground: Complex tibial plateau fractures are usually high energy injuries presenting with significant articular and soft tissue damage in a major weight bearing joint. The knee is a complex dynamic joint that is subjected to many forces during normal activities, so intact articular surface of tibial plateau is one of important factors to keep the geometry and alignment of the knee joint to act in harmony to perform its crucial function as a flexible weight bearing joint. Material and Methods: This prospective study was conducted in the Department of Orthopaedics, a Tertiary Care Teaching Hospital, 27 patients with displaced tibial plateau fractures with posterior column involvement were selected for the study. All age group Patients with complex proximal tibia plateau fractures & closed injuries were included in this study. Involving two or more columns were classified based on the new three column classification system, patients with normal neurovascular function before primary surgery, patients with closed fractures, patients with good soft tissue condition, and patients without serious medical diseases and obvious surgical contraindications. Result: In our study, the most of the patients were belongs to 21-30 years old 13 (48.1%). In table 2, predominant were males 92.5% and females were of 7.4%. In our study majority of patients were Three-column fractures, followed by Two-column fracture and Single-column fractures. After operative procedure, 3 (11.1%) patients got discharged on post op day-7, 14 (51.8%) patients on post op day-8, 7 (25.9%) on post op day-9 and 3 (11.1%) on post op day-10. Conclusion: Using this new column specific strategy to the treatment of these two or more column tibial plateau fracture injuries, which involves evaluation of three columns, we believe we achieved satisfactory results
A Randomized Controlled Trial of Needle Aspiration under Ultrasonographic guidance versus Incision and Drainage of Breast Abscess
Get PDFIntroduction: Breast abscess is a common cause of morbidity in women. Patients commonly present with a painful swelling of the breast and fever. Lactational breast abscess occurring during breast feeding is the result of Staphylococcus infection. Non-lactational breast abscesses are entirely different from those occurring during nursing. They occur in the peri-areolar tissues, frequently recur, and infecting organisms are a mixture of Bacteroides, Anaerobic streptococci, and Enterococci. Methods: This was a hospital based prospective randomized controlled trial. 60 patients were included in the study. 30 of them were randomized in the needle aspiration group and other 30 were treated by incision and drainage. The patients were followed up on days 3,7,14,21 post intervention and thereafter for three months on a monthly basis. Results: Our study showed mean age in incision and drainage group was 26 years, and in needle aspiration group, it was 29 years. The difference in age group between the 2 groups was not statistically significant. Requirement of analgesic was high in incision & drainage group as compare to needle aspiration group. Comparison of presence of fever between two groups was statistically significant with a p-value of 0.048. At the end of follow up patient satisfaction rate was high in needle aspiration as compare to incision & drainage. Conclusion: In conclusion it can be said that whenever and wherever the facility of ultrasound is available, serial percutaneous needle aspiration may be tried as a first line of therapy up to a maximum of three attempts, in patients whose abscess diameter <5cm and in those where the abscess diameter is >5cm, incision and drainage maybe used as first line therapy
Postoperative analgesic effectiveness of combined ultrasound guided adductor canal block with ipack (infiltration between popliteal artery and posterior knee capsule) and adductor canal block alone in patients undergoing knee arthroscopy: An observational
Get PDFBackground: Peripheral nerve blocks are ideally suited for lower extremity ambulatory surgery because of potential to block pain pathways at multiple levels. The objective of this observational studies was to assess theanalgesic characteristics of USG guided combined ACB with IPACKblock and ACB alone, in arthroscopic ACL reconstruction. Methods: This prospective observational study was conducted over a period of twenty months on 61 patients (18-65 years, ASA grade I, II, III) undergoing knee arthroscopic ACL reconstruction under spinal block who were divided into two groups. Group 1 (n=32) received combined USG guided ACB with IPACK and Group 2 (n=29) received USG guided ACB alone. Both groups received 20 ml of 0.2% Ropivacaine. Postoperative pain was assessedby VAS score at 2, 4, 8, 12, 18 and 24 hours. Results: VAS score were significantly lower in group 1 as compared to group 2 at 4, 8, 12 and 18 hours postoperatively. Mean duration of post-operative analgesia was significantly longer in group 1 than group 2 (16.5±4.57 hours vs. 10.3±2.01 hours). The difference between mean time to first rescue analgesia between the twogroups was statistically significant (p-value of <0.001). Difference in analgesic consumption in 24 hours was statistically significant between two groups. Conclusion: Combined USG guided adductor canal block with IPACK is superior to USG guided Adductor canal block alone with respect to postoperative pain scores, time to first rescue analgesia, total doses of rescue analgesia consumption and patient satisfaction. However, with regard to complications and side effects both groups were equivalent as no complication/side effect was noted in any of the groups
A Study of Histopathology of Lungs And Liver in Brought Dead Cases of A Tertiary Care Center of Bihar
Get PDFIntroduction: Autopsy is a procedure that aids to identify the changes occurring in the organs which helps to establish the cause of death and time of death. It also helps to study the ante-mortem as well as postmortem aspect of death. The importance of the study is that it highlights the pattern of various lesions in the lung and liver which are seen in the medico legal and neonatal autopsies along with histopathological examination, which were either incidental or the direct cause of the death. Methodology: A retrospective descriptive study of the medico legal autopsies was carried out in the Department of Forensic Medicine and Toxicology, Darbhanga Medical College & Hospital, Laheriasri, Bihar, India for a period of six Months that was from August 2021 to January 2022. Medico legal autopsies during that period, irrespective of age and sex, were included in this study. A total of 30 medico legal autopsies were conducted in the study period in which part of lung and liver were sent for pathological examination. Results: A total of 30 specimens of part of lung were received during the period of study. Histopathological examination was carried out in each case. Out of these, 7 specimens of lung were poorly preserved and autolyzed. Majority of the samples came from male corpses. Out of the total liver specimens (i.e., 30 cases), most of the cases on histopathological examination showed sinusoidal and vascular congestion. Grossly, these liver specimens appeared unremarkable. Conclusion: This study highlights the importance of histopathological report in lung and liver autopsy cases, especially in the cases where histopathology findings were incidental and were not considered at the time of death
Suicidal Ideation in Covid-19 Patients in Tertiary Care Centre
Get PDFBackground and Aim- Corona virus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. COVID-19 pandemic has led to unprecedented hazards to mental health globally. Social isolation, chronic stress, anxiety, fear of contagion, uncertainty & economic difficulties may lead to the development or exacerbation of stress related disorders like Depression & suicidality in vulnerable population including individuals with corona positive people admitted in covid-19 hospitals with or without psychiatric disorders, low resilient persons & people who have a family or friend who has died of Covid-19. Here in this study, we Aim to study the prevalence of Suicidal Ideation/depression in Covid-19 Patients admitted in our hospital and their correlation.Material and method- Cross sectional study & purposive and simple random sampling was considered for this study for small period on Corona positive patients admitted in the COVID isolation ward & applied Socio-demographic questionnaire, BECKS Scale For Suicidal Ideation, HAM-D Scale for depressive symptoms in COVID-19 patients admitted in Tertiary COVID Centre.Result- In this study out of total 200 Corona patients, we found that 37% of admitted COVID-19 patients are having depression and 2.5% of patients having suicidal ideas. Out of total, depression is seen in majority of females (29.6% - mild, 7.4% - moderate & 8.6% severe depression) according to HAM-D. Prevalence of suicidal ideation was seen more in male and depression increases the risk of suicidal ideation.Conclusions – According to my study, depression is seen more in young and middle-aged females & more the no of days stayed in hospital, more the prevalence of depression seen. Whereas suicidal ideation is seen more in males and more no of days stayed in the hospital, increases the chances of suicidal ideation. Also, positive correlation is seen between depression and suicidal ideation. Proper treatment of depression along with psycho education helped in relieving suicidal ideas