International Journal of Health and Clinical Research
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A Descriptive Study of Serum Levels of 25-hydroxyvitamin D in Chronic Urticaria and its Association with Disease Activity
Get PDFAim: To study the association of vitamin D- level in patients with chronic severe idiopathic urticaria and correlate their level with severity of disease.Material and methods: This was a hospital-based study conducted over a period of 1 year with a sample size of 30 patients diagnosed to have chronic idiopathic urticaria on basis of a recurrent eruption of wheals and flare with or without angioedema for each patient urticaria activity score(UAS) was calculated. Plasma 25-hydroxyvitamin D [25-(OH)D] levels were analyzed. A deficiency in vitamin D was defined as serum 25-(OH)D concentrations <30 ng/mL. The statistical analysis was carried out by using appropriate statistical tests.Results: Serum vitamin D3 level was significantly lower in chronic urticaria subjects. The prevalence of vitamin D deficiency (<30 ng/ml) was significantly higher in patients with chronic urticaria, with the mean value being 14.46ng/ml.Conclusion: The present study showed a strong positive correlation between vitamin D deficiency and chronic urticaria. This study also warrants that each subject with chronic urticaria should be screened for serum vitamin D3 levels before initiating treatment
Post COVID manifestations and Quality of life in COVID victims: A cross sectional study
Get PDFBackground: COVID -19 pandemic had affected majority of the population across the world. Majority of the cases still complaining of post COVID symptoms. This study was undertaken to study the pattern of post COVID – 19 manifestations in this region in a group of patients attending hospital. Material and methods: An observational study was undertaken in a group of 150 patients attending a tertiary care hospital. The patients were subjected for a detailed history and thorough physical examination and the details were entered in to a proforma. The data thus obtained was compiled and analysed. Results: This study had shown than majority of cases were aged more than 50 years and most of them were females. The common post COVID – 19 manifestations included joint pain, continued loss of taste and smell, dyspnoea, Anxiety/ depression and sleep disturbances in this study. Conclusions: This study had observed continued symptoms from the episode of disease varying from mild to severe manifestations. This study urges for a comprehensive rehabilitation program for all COVID – 19 patients
To find out various pre-disposing conditions and clinical presentations amongst patients attending cardiology/ medicine
Get PDFBackground & Method: This study was conducted with an aim to find out various pre-disposing conditions and clinical presentations amongst patients attending cardiology/ medicine with nonvalvular atrial fibrillation in the setting of a tertiary level university teaching hospital the MGM Medical College & Maharaja Yeshwant Rao Hospital in Indore, M.P. The study database was accumulated by prospectively registering patients presenting to the outpatient department of the Department of Medicine, the Cardiology Clinic and the ICCU of the hospital with a diagnosis of atrial fibrillation, either chronic or paroxysmal. Result: In our study majority of the patients presented with heart failure (51%) followed by myocardial infarction (11%), and cerebrovascular accidents (9%). There were 3 patients presented with fast ventricular response, 2 patients had acute chest infection and 2 patients had syncopal attacks. One patient presented with bleeding due to warfarin overdose and one with peripheral embolism. 12% of patients were symptomatic during presentation. Other presentations are Infective endocarditis, Ventricular tachycardia, acute febrile illness, diabetes, Koch’s abdomen, aluminum phosphide poisoning and upper respiratory tract infection. Conclusion: To conclude, we found that majority of the patients with AF in the central Indian population presented with heart failure. Other major clinical presentations were myocardial infarction and cerebrovascular accidents. We found that valvular heart disease mainly the mitral valvular involvement as the most common pre-disposing condition for atrial fibrillation in this part of the country. Other co morbidities were heart failure and hypertension which was consistent with the global data
Prevalence Of Anemia And Its Characteristic Among Children Between Age Of 6 Months To 12 Years: Report From A Tertiary Care Center Of Bihar
Get PDFIntroduction: Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality, especially in pregnant women and young children. Approximately 50% of the population suffers from nutritional anemia as known in countries where meat consumption is low. In the present study, an attempt has been made to assess the magnitude of anemia. Methodology: The current cross-sectional study was conducted by the Department of pediatrics, Patna Medical College & Hospital, Bihar. The study encompasses 100 pediatric patients admitted during the study period from August 2012 to January 2013 between the ages of 6 months to 12 years. All children and their parents were informed about the purpose and the method of the research and the voluntary nature of participation in the study verbally and in written form. A total of 2 mL of venous blood was drawn under aseptic precautions in an ethylene diamine tetra acetate containing vacutainer. Peripheral blood smear after staining with Leishman's stain was examined under binocular microscope for count and morphology of RBC, WBC, platelets. Special investigations like electrophoresis, sickling test, bone marrow aspiration were done wherever needed. Results: Out of the 100 hemograms analyzed, 69 depicted anemic status. Infants (6 months-1 year) were found to be most commonly affected constituting to one-third, followed by school-going children (6 years-12 years), toddlers (2 years-3 years), and preschool children (4 years-5 years). Out of 69 anemic patients, majority had nonhemoglobinopathies and only 2 had hemoglobinopathies. Bone marrow examination could be done on 10 anemic children. Out of which, five children showed micronormoblastic maturation followed by three children had megaloblastic maturation, one child had normoblastic maturation, and another child had hypoproliferative bone marrow. Both the children with hemoglobinopathies were diagnosed with Thalassemia major. Conclusion: There is an urgent need to initiate specific public health action to prevent anemia considering the grave consequences of anemia and iron deficiency on the physical and mental growth and development of these children and on their long-term health
Psychiatric Morbidity in Geriatric in patients with Medical Disorders
Get PDFBackground and objective: People over the age of 65 account for twice the average number of physician interactions and three times the average number of hospital bed days compared to the general population. Geriatric medical patients are distinguished from their younger counterparts by the presence of medical comorbidities and disabilities, rather than by their age, according to research conducted by the American Academy of Pediatrics. The current investigator was unable to locate any published studies that compared psychiatric morbidity in geriatric inpatients with medical diseases to that of adult inpatients with medical disorders in either age group, which was disappointing.The goal is to This study aims to determine the prevalence and nature of psychiatric problems in geriatric inpatients with medical diseases, as well as the relationship between clinical and sociodemographic profiles in this population when compared with that of adult inpatients with medical disorders.Methods: A total of one hundred consecutive geriatric inpatients and fifty consecutive adult inpatients admitted to the medical wards were evaluated in this study. The MINI Plus and Comprehensive Psychopathology Rating Scale (CPRS) were used to assess psychiatric morbidity, the Mini Mental State Examination (MMSE), the Clock Drawing Test (CDT), and the Trail Making Test- B (TMT-B) were used to assess cognitive impairment, and the Bristol Activities of Daily Living Scale was used to assess functional status (BADLS). The Diagnostic Criteria for Research (DCR-10), which is part of the ICD-10 Classification of Mental and Behavioral Disorders, was utilised to determine a psychiatric diagnosis.Results: The prevalence of psychiatric illness in the geriatric population is 26.75 percent, while it is 35 percent in the non-geriatric population. Depressive disorders accounted for 17.5 percent of all mental diseases identified in the elderly, followed by dementia (8.75 percent), anxiety disorder (5 percent), alcohol dependence syndrome (2.5 percent), and organic delusional disorder (0.5 percent) (1.25 percent ). The duration of medical disease, the number of medical diagnoses, cognitive functioning, and functional status all have a substantial impact on the risk of developing psychiatric morbidity. In the elderly, diabetes has a high association with psychopathology. The presence of psychiatric morbidity is not associated with gender, marital status, educational level, or socioeconomic situation.Conclusion: When compared to their younger counterparts with medical problems, elderly inpatients with medical disorders have much more frequent and severe psychopathology, as well as cognitive and functional impairment. But there is no difference in the frequency or character of psychiatric diagnoses in geriatric patients with medical diseases compared to adult patients with medical disorders
Patterns of late gadolinium enhancement in injured myocardial tissue – A descriptive single centre study
Get PDFBackground: CMR and LGE MR imaging is now been increasing used in diagnosis of various cardiac diseases and the characterization of different patterns of scarring / fibrosis of myocardial tissue. Different spectrum of enhancement can be seen in many pathophysiologic conditions including ischemic and non-ischemic causes. Methods: Late gadolinium enhancement MRI was performed in 28 patients in the age group of 13- 70 years ( mean age group of 42 ) and the patterns of myocardial delayed enhancement was analyzed in the year 2020 - 2021. Results: 14 out of 28 (50%) patients demonstrated late gadolinium enhancement. 3 out 14 (21.4 %) cases were due to ischemic causes and 11 cases ( 79.6%) due to non ischemic causes. Conclusion: Imaging of myocardial disorders encompasses a large variety of conditions including both ischemic and nonischemic diseases. Cardiac MRI sequences like LGE play a critical role in establishing diagnosis, determining prognosis, and guiding therapeutic management Categorization of abnormal delayed myocardial enhancement according to location (subendocardial, transmural, subepicardial, or mesocardial) allows differentiation between ischemic (infarct-related) and nonischemic cardiomyopathies and, in cases of nonischemic cardiomyopathy, narrowing of the differential diagnosis
Assessment of serum trace element (copper) level, as an associated risk factor in patients with chronic kidney disease
Get PDFBackground: Chronic Kidney Disease (CKD) is a progressive loss of kidney function and is a worldwide public health problem both for the number of patients and for the cost of treatment. Trace elements such as copper (Cu) is altered in CKD. We assessed 100 subjects of both sex with different age groups, among them 50 are normal healthy controls (group 1) and 50 are CKD patients (group 2) from dialysis ward (medicine) S.R.G. Hospital, Jhalawar Medical College, Jhalawar (Raj.) Serum copper was estimated using Flame Atomic Absorption Spectrophotometer (AAS). Results: Serum copper level was significantly low in CKD patients, mean ± SD (1.2041 ±0.46360) (p<0.05) when compared with the healthy control group (1.3823 ± 0.25259) (p<0.05). Gender had no significant effect on serum copper level, in males, (1.1992± 0.41431) and females (1.2146± 0.56946) (p>0.05). Conclusion: This study shows that in CKD patients, trace elements derangement is important in the primary diagnosis of trace element dysfunction and medical management of CKD
A Study on Evaluation of Predictive Value of Microalbuminuria as a Screening Tool for Pre-eclampsia Among Patients Attending A Tertiary Care Centre Of Bihar
Get PDFIntroduction: Proteinuria is a defining dysfunction of Pre-eclampsia (PE) and repeated urinalysis to screen for the condition is part of the standard antenatal care. It has been proposed to be an indicator of both the severity of disease and the prediction of its outcome. Studies have shown that the presence of microalbuminuria earlier in pregnancy is associated with an increased risk of development of PE and severe adverse maternal and fetal outcome in PE. The aim of this study was to assess the role of microalbuminuria as a diagnostic marker in PE. Methodology: The current study was conducted by the Dept of Obstetrics and Gynecology, Nalanda Medical College & Hospital, Patna, Bihar, India during August 2021 to February 2022. Ethical clearance was obtained from the ethical committee of the institution. Informed consent was obtained from all the subjects. The study incorporated 25 normotensive pregnant women as controls and 25 pregnant women between 20 and 35 years of age were selected at 24 ± 4 weeks of gestation and had PIH diagnosed by the accepted criteria of the Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy with a blood pressure of >140/90 mm Hg and proteinuria (>300 mg/24-h). Results: The mean age (with SD) of patients from normotensive and PE group was 26.4 ± 3.4 years and 27.3 ± 4.1 years, respectively. The mean period of gestation was 32.2 ± 4.2 weeks and 29.7 ± 5.1 weeks respectively for both the study cohorts. The sensitivity and specificity of the various renal function parameters in PE was calculated. The sensitivity of micro albumin was 100% and the specificity was 78.2%, both being the highest among all renal function markers except creatinine, which had a higher specificity. Urea had a sensitivity of 80% and specificity of 65.7% while creatinine had a sensitivity of 72% but had a specificity of 81.2%. Conclusion: The current created evidence that microalbuminuria is a good diagnostic marker for PIH, although it may not be preferred for grading its severity
A study to assess results of laparoscopic ventral hernia repair using mesh insertion
Get PDFBackground: Laparoscopic repair is superior to open repair in terms of less blood loss, fewer abdominal wall complications and shorter hospital stay. This prospective study was conducted to assess results of laparoscopic ventral hernia repair using mesh insertion. Material and methods: This prospective study was conducted to assess results of laparoscopic ventral hernia repair using mesh insertion. LVHR technique was used as Closure. They were followed up for 2 weeks. They were followed up at 1 week, 3 weeks, 3 months. Data were prospectively recorded in Microsoft Excel and analyzed at study. Results: In the present study 40 patients were operated by this technique. Mean operating time for was 72 mins. Lower abdomen hernia was the most common. Mean length of closed HD was 9.2cm. in maximum patients grade I complications was present. Pain was present in 40 patients on trocar site after postoperative 3rd day and in 5 patients after 1st week. Pain was present in 40 patients at suture site after postoperative 3rd day, in 9 patients after 1st week, in 8 patients after 3 week and in 1 patient after 3 months. Pain was present in 40 patients at suture site after postoperative 3rd day, in 3 patients after 1st week, in 1 patients after 3 week and in 0 patient after 3 months. Seroma was not occurred. Conclusion: The present study concluded that laparoscopic ventral hernia repair using mesh is an effective and safe procedure with very low postoperative pain
A clinico-pathological study of acute appendictis with management and the role of ultrasound in diagnosis of appendictis
Get PDFBackground and Objectives: Acute appendicitis is the most prevalent cause of acute surgical abdomen, and appendiciectomy is the most often performed emergency surgery in the United States and Canada. Its diagnosis continues to be a difficult problem, made more difficult by a high percentage of negative investigations. There is currently no one reliable test that has appropriate sensitivity and specificity characteristics. The study's main goal is to analyse the clinical presentations, signs, and treatment of acute appendicitis, as well as the effectiveness of various treatments. The role of ultrasound in the diagnosis of acute appendicitis and in lowering the rate of negative appendicectomies are also discussed. Methodology: From January 2019 to October 2021, the current study included 80 patients who were clinically diagnosed with acute appendicitis and were admitted to the General Surgery Department of the Kerala Institute of Medical Sciences (KIMS), Narketpally, for emergency appendectomy. Prior to surgery, blood was drawn to check the WBC count, DC, and USG abdomen. Following surgery, all patients were subjected to a histological examination, which was considered to be the gold standard. The results of ultrasound were compared to those of HPE reports in order to determine their importance in the diagnosis of acute appendicitis. Observations: In the current study, we had 80 participants, with 61 (61 percent) of them being men and 39 (39 percent) of them being female. The age range of 20 to 29 years was the one with the greatest number of patients (33 percent ). Anorexia was discovered in 87 percent of patients, and Migrating Pain to RIF was discovered in 76 percent of patients. Nausea and vomiting were experienced by 79 percent of the patients. Tenderness in the right iliac fossa was detected in 98 percent of the cases. Patients with rebound discomfort were reported in 68 percent of cases. In 45 percent of the cases, a fever was seen. In our current investigation, the total leucocyte count was found to be high in 80 percent of the cases. In 42 percent of the cases, a shift to let was observed.All of the patients in our study were subjected to abdominal ultrasonography examination. Using Ultrasonography to diagnose acute appendicitis, the sensitivity and specificity of the test are 92.0 percent and 78.0 percent, respectively. The accuracy rate was 93 percent. For acute appendicitis, the positive predictive value (PPV) and negative predictive value (NPV) of ultrasound are 95 percent and 41 percent, respectively. In this study, the rate of negative appendectomy was 5.5 percent. Females account for the vast majority of cases (60 percent). Conclusion: Ultrasound is a non-invasive, reproducible, and safe diagnostic technique that is quick, easy, and reliable. There are no complications with ultrasound. It has higher sensitivity and positive predictive value in the diagnosis of acute appendicitis, and it lowers the rate of negative appendicectomy in the treatment of the condition