International Journal of Health and Clinical Research
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C-Reactive Protein As An Effective Biologic Factor In Covid-19 Patients: An Evidence Based Study
Get PDFIntroduction: Coronavirus diseas-2019 (COVID-19) has been an emerging global health threat since its outbreak. The hospitalized COVID-19 patients are monitored regularly, but anytime they could develop mild and moderate symptoms into a severe disease course is challenging. However, early identification and diagnosis of the patients progressing to severity is essential to start a more relevant treatment that profoundly would help to improve the percentage outcomes of COVID-19 recovery. The present aims to investigate the serum C-reactive protein (CRP) levels in COVID-19 patients and its prognostic value. The C- reactive protein could prove to be an effective biologic factor in COVID-19 Patients.Methods: After clinical examination of patients, routine blood investigation, for example CBC, KFT, LFT, serum electrolytes, D-dimer and CRP was done. The 5ml of peripheral blood was collected from each study subject, which was aliquoted in clot activator (Red top tube) vials until furhter processing. The separted serum was used for the crictical diagnostic estimation of CRP, using CS400 fully Automatic Biochemical Analyzer.Results: The preliminary results have shown a significant difference in CRP levels in COVID-19 patients. Significantly, the severe patients had higher CRP levels than the moderate ones p-value < 0.05, also the COVID-19 infected patients who have under lying medical conditions had higher levels of CRP as compared to the patients who were having normal conditions prior to COVID-19 infection, p-value < 0.05.Conclusion: The out come of the results indicate that the C- reactive protein could be an interesting molecule to determine early symptoms of COVID-19 Patients
To evaluate the outcome of cyanoacrylate glue in the treatment of anal fistulas
Get PDFBackground: Fistula in ano is a difficult problem that surgeons have struggled with since the time of Hippocrates. Traditional surgical techniques such as fistulectomy, fistulotomy and flaps were for a long time the only option for treatment. These procedures were associated with complications like excessive bleeding, faecal incontinence, recurrence, infections etc. But now, newer procedures and surgical techniques have been proposed for the treatment of anal fistulas. The Development of glue has raised renewed interest in sphincter-sparing techniques. The employment of cyanoacrylate glue is one of the newer promising techniques.Materials & methods: From October 2020 to October 2021, patients with fistula-in-ano who were admitted to different surgical units at Alluri Sitarama Raju Academy of Medical Sciences were the subject of the study. In accordance with the proforma, information was gathered.30 patients in total who met the requirements were enrolled in the trial.. Routine laboratory tests were performed on all individuals. The patient was posted for the procedure under spinal anaesthesia after fulfilling the requirements. The fistulous tract was cleansed with curet and saline solution.Results: With the main injection, 22 individuals were cured, and all fistulous track discharge was stopped. One more injection was needed for two patients, and one patient needed fistulectomy. One patient needed a colostomy and a fistulectomy to repair complicated fistulas that had developed.Conclusion: Patients with low anal fistulas and simple fistulas may be given cyanoacrylate adhesive as an alternative to fistulectomy. However, in order to further demonstrate their efficacy, larger series need to be examined
Role of LHRH analogue in cases of refractory mastalgia
Get PDFBackground: Mastalgia is the commonest cause of visit to the breast clinic. The present study was conducted to assess the efficacy of complete estrogenblockade (CEB) with centchroman and LHRH analog goserelin in the treatment of refractory mastalgia. Aim: To study the effect of LHRHanalogue in refractory mastalgia and to increase pain free period in patients with refractory mastalgia. Methods: This is a prospective cohortstudy conducted in the Dept.Of Gen.Surgery IGIMS ,Patna over a period of six months.The reduction of pain score ( as measured by a visualanalog scale (VAS) recorded on a breast pain chart ) to 3 or less at 6 weeks of initiation of treatment was taken as primary objective. Results:Fifty patients were enrolled in the study. The mean age of the patients was 28 years (15–45 years). The median duration of symptoms was 6 months(4–8). All of them had bilateral mastalgia. The mean pain score at start of study was 7. Conclusion: Complete estrogen blockade by means of GNRHanalogue is safe and effective for treatment of refractory mastalgia
To Determine Serum Ferritin and Lipid Profile in Type 2 Diabetes Mellitus
Get PDFBackground: Type 2 diabetes mellitus is a major growing health concern worldwide. In recent years much is talked about the role of serum ferritin, a marker of iron stores in the body in the development of type 2 diabetes mellitus and its complications. This study was carried out to assess the levels of serum ferritin in type 2 diabetes mellitus and to find its correlation with glycaemic control. Method: Total 188 subjects were enrolled in the study, including 94 clinically diagnosed patients of type 2 Diabetes Mellitus in the age group of 35-60 years and 94 normal age and sex matched non diabetic control. All subjects were clinically examined, had laboratory investigations including fasting and 2 hour post prandial blood glucose, HBA1c%, serum ferritin and lipid profile. Statistical analysis was carried by using student’s ‘t’ test and Pearson’s correlation coefficient (r) was used to assess correlation between measured parameters. Results: The study showed that serum ferritin levels were significantly increased in diagnosed cases of type 2 diabetes mellitus as compared to age and gender matched healthy control (P = < 0.01). A strong positive correlation was observed between serum ferritin and HBA1c % (r= 0.78, P= <0.01). Serum total cholesterol, triglycerides, LDL-C and VLDL-C was significantly increased in cases as compared to control while serum HDL-C was significantly decreased in cases as compared to control. (P= <0.01) Significant positive correlation was observed between serum ferritin and parameters of lipid profile. Conclusion:The study showed increase serum ferritin levels and dyslipidaemia in diagnosed cases of diabetes mellitus as compared to healthy control which suggest that increase iron may contribute to pathogenesis and complications of diabetes mellitus. Our results provide evidence that serum ferritin levels are significantly associated with major lipid parameters and this association represents a cardiometabolic risk factor
Ocular Langerhans Cell Histiocytosis (A Multisystem Involvement of Langerhans Cell Histiocytosis)
Get PDFA 2 year old boy was referred from paediatrics OPD to Eye OPD with chief complaint of Multiple conjunctival cyst since 15 days. The patient had a prior history of recurrent chest infections. Requiring hospitalisation since 7 months of age. Upon visual acuity examination, the patient seemed to follow light.Fundus examination of both eyes were within normal limits.H& E sections of the lesions showed collection of histiocytes typical of Langerhans Cell Histiocytosis.Patient was treated with multiple cycles of Vinblastine and predinisolone as per LCH 3 guidelines. Langerhans cell histiocytosis (LCH), the most common histiocytic disorder in children. LCH lesions are granulomatous lesions consisting of pathologic “Langerhans cells” (LCs), lymphocytes (primarily T-cells), eosinophils, and macrophages. The incidence of LCH is estimated to be around 5–10 cases per million children per year and 1–2 cases per million adults per year with a male is to female ratio 1.2:1.Its pathology is ‘Misguided Myeloid Differentiation’ where state of differentiation of myeloid precursor in which activating MAPK mutation arises determines the extent and severity of disease[1]. The current standard of care for initial therapy is vinblastine/prednisone for one year
A analysis of functional and clinical outcome of pilon fracture treated with an anterolateral plate fixation in a tertiary care center: Prospective study
Get PDFIntroduction: This clinical study presents the short-term results of the Pilon fracture treated with open reduction and internal fixation through an anterolateral approach and further re-analyse the different complication rates and outcome percentages during surgical treatment through an anterolateral approach. Materials and methods: The present study is a prospective descriptive study involving 22 patients with Pilon fracture treated by ORIF through an anterolateral approach at the Department of Orthopaedics, Narayana Medical College and hospital, Nellore, Andhra Pradesh . Results: In our study, among 22 cases, the majority of patients were male (77%). The mean age group of our patients has been 40 -60 years. Right-sided injury and left-sided injury are almost equal. Functional outcome was measured using Mazur criteria. According to these, we found that 12 patients (54.54%) had excellent functional outcome, 8 patients (36.36%) had good functional outcome and 2 patients had fair functional outcome following ORIF with anterolateral plate for tibial pilon fractures and are comparable with other studies in the literature review. Discussion: In our study functional outcome was measured using Mazur ankle score. According to these we found 12 patients (54.54%) had excellent functional outcome and 8 patients (36.36%) had good functional outcome and 2 patients (9.1%) had fair functional outcome following open reduction and internal fixation with anterolateral for tibial pilon fracture
Outcome Assessment Of Arthroscopic Suture Pulls Out Fixation Of Displaced Tibial Spine Avulsion Fracture
Get PDFBackground - In this study, we describe the clinical and radiologically outcomes of arthroscopic fixation of ACL bony avulsion with suture pull-out technique using two high strength, nonabsorbable sutures.Method - This prospective study conducted on 50 patients having avulsion tibial spine fracture classified Meyers & McKeever Type II, TYPE III and IV were involved in our studyResult - The mean age of subjects was 26.32 ± 9.12 years. The majority of subjects were in the age group 21 to 30 years. 82.00% were males and 18.00% were females. 4.00% had Fall from the cycle, 82.00% had fallen from Motorbike and 14.00% had Fall While Playing. 74.00% had Type III and 26.00% had Type IV Meyers and McKeever's classification. At 3 months, the mean Post op Lysholm score was 85.12 ± 1.51, at 6 months was 96.12 ± 1.02 and at 12 months was 97.01 ± 0.98. There was a significant increase in Post op Lysholm score at 6 months and 12 months. At 12 months When compared to 6 months Post op Lysholm score, there was no significant increase in Post op Lysholm score. 4.00% had Post Op Knee StiffnessConclusion - Arthroscopic suture pull-out fixation for type III and IV tibial spine avulsion results in excellent clinical and radiological outcomes in patients with open and closed physis without any significant complications
A Hospital Based Prospective Study to Determine the Efficacy of Urinary Calcium to Creatinine Ratio in a Spot Urine Sample for the Prediction of Preeclampsia in Asymptomatic Pregnant Women Between 16 to 24 Weeks of Gestation
Get PDFBackground: Hypertensive disorder of pregnancy are one of the major causes of maternal and fetal mortality and morbidity. During pregnancy, by increasing intestinal absorption, decreasing renal calcium loss, and reabsorbing some calcium from the maternal skeleton the woman's body undergoes physiological compensation. The aim of this study to determine the efficacy of urinary calcium to creatinine ratio in a spot urine sample for the prediction of preeclampsia in a asymptomatic pregnant women between 16 to 24 weeks of gestation. Materials& Methods: A hospital based observational prospective study done on hundred primigravida / multigravida with singleton pregnancy within the gestational age of 16-24 weeks who came for regular ANC to OPD in government district hospital, Sirohi, Rajasthan, India during one year period. Urine Calcium-to-creatinine ratio (CCR) was calculated, and those with a ratio of less than or equal to 0.04 were considered as test positive. Descriptive statistics frequency analysis was used to describe about the data, percentage analysis were used for categorical variables and for continuous variables the mean & S.D were used. Results: The incidence of Preeclampsia was 15% and that of normotensive pregnant women was 85%. Amongst the patients who had a Urine Ca/Cr ratio <0.04, 15 women constituting 88.23% developed preeclampsia whereas 2 patients constituting 11.76% remained normotensive at term gestation. Conclusion: We conclude that a pregnant woman with a high risk factor such as nulliparity along with low urinary CCR is at high risk for development of preeclampsia. Therefore, a single urinary calcium to creatinine ratio may be an effective screening method for impending preeclampsia and may identify population at greater risk to be included in primary prevention programmers’
Primary Etiological Profile Of Hospitalized Patients With Documented Episode Of Hypoglycemia
Get PDFBackground: Glucose is a major fuel source for body tissues. Plasma glucose concentrations are maintained between 70 to 110 mg/dl in the fasting state. Homeostasis is maintained by stimulating counter hormone response and suppressing insulin secretion during hypoglycemic episodes. Any derangement in homeostasis can cause hypoglycemia. Objectives: To investigate, identify, determine and analyze the incidence of primary etiological profile of hospitalized patients. Material and methods: Patients admitted in the General Medicine wards who had at least one episode of documented hypoglycemia i.e less than 70mg/dl and age >=18 years were included and observed over a period of 24 months i.e November 2019 to November 2021.The data obtained was analyzed statistically by using chi square test. Results: In present study of 119 patients 90 were male and 29 were females. Diabetes with Chronic Kidney Disease was found to be the most common primary diagnosis.As we analyze the presence of risk factors in hospitalized hypoglycemic patents, it was found that as the number of risk factors in a patient increases, chance of succumbing to them also increases. In the category of patients having 3 or more risk factors, the death rate was 15 out of 42 which is 35.71%. Conclusions: Hypoglycemia needs to be investigated thoroughly to know the causative factor and should be treated appropriately. Hypoglycemia is an important predicting factor of mortality in cases of heart failure and sepsis
Occupational Risk Evaluation of Vibration exposed Road Construction Workers of Kolkata: An Ergo-Physiological Analysis
Get PDFWhole-body vibration is described as the influence of mechanical vibration of the environment on the entire human body. The harmfulness of vibration depends on its intensity, time of exposure, and frequency content. Vibration restricts the blood supply to the hands and fingers, which, depending on the vibration level, can contribute to an ergonomic injury. Long time exposure to vibration develops occupational injuries in the whole body of road construction workers. Therefore, this study aims to evaluate and identify the physiological morbidity of the road contractors of Kolkata, to quantify the body part damages of road contractors due to vibration, and to recommend some suitable preventive measures for avoiding occupational damage. This double-blind study followed STROBE guideline. Here, 56 male road construction workers who were exposed to vibration & 42 other forms of road construction workers of Kolkata were randomly chosen, with age range 30-48years. Their muscle& finger strength, the prevalence of Raynaud’s phenomenon, occupational vibration-induced ocular bone injury, and musculoskeletal disorders were evaluated statistically. The results of this study indicate that the experimental group was suffering from poor muscle and finger strength, low back injury, early onset of the white finger, and dry eye disease. FFA, Nailfold capillaroscopy, and DEXA Scan suggestthe onset of retinal vascular capillary damages, and porosity of bone. ANA results indicatethe presence of higher titer and greater amount of autoantibody amongst the experimental group. However, road construction workers should use anti-vibration shock- proof protection gear and should follow a work-rest cycle of about 10 minutes, when they are exposed to vibration tools