International Journal of Health and Clinical Research
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Assessment of Effect of Epidural Clonidine on Characteristics of Spinal Anaesthesia in Patients Undergoing Gynaecological Surgeries
Get PDFBackground: To assess the effect of epidural clonidine on characteristics of spinal anaesthesia in patients undergoing gynaecological surgeries. Materials & Methods: One hundred twenty patients belonging to American Society of Anesthesiologists physical status I and II who underwent gynaecological surgeries were randomly divided into 2 groups. Group I received clonidine (C) and group II received saline (S). Hyperbaric bupivacaine (15 mg) was administered intrathecally for both groups after epidural injection. Sensory and motor block characteristics, analgesia, sedation and haemodynamics were recorded in both groups. Results: Group I and group II had 60 females. The mean height in group I was 158.4 cm and inn group II was 157.3 cm. The mean weight in group I was 65.2 Kgs and in group II was 66.2 Kgs. Duration of surgery was 78.4 minutes in group I and 77.2 minutes in group II. The difference was significant (P< 0.05). Onset of sensory block at L1 (s) was 38.2 and 50.4, time to bromage 3 (s) was 55.4 and 102.3, time to 2 segment regression was 192.8 minutes and 109.3 minutes, total duration of analgesia was 312.4 minutes and 150.6 minutes and duration of motor blockage was 345.2 minutes and 124.7 minutes in group I and group II. The difference was significant (P< 0.05). VAS at 30 minutes was 1.5 in group I and 2.3 in group II, at 60 minutes was 1.4 in group I and 1.8 in group II, at 120 minutes was 2.6 in group I and 2.9 in group II, at 180 minutes was 2.1 in group I and 2.0 in group II and at 240 minutes was 1.5 in group I and 1.9 in group II. The difference was significant (P< 0.05). Conclusion: Administration of clonidine epidurally, 10 min before SAB, caused early onset and prolonged duration of motor blockade and analgesia
The role of in-vivo proton magnetic resonance spectroscopy in gallbladder cancer patients: A metabolomic approach
Get PDFBackground: Gallbladder carcinoma (GBC) is considered as a rare disease but it is the fifth most common malignancy of the gastrointestinal tract. Many diagnostic test are used to diagnose a case of GBC comprises laboratory studies and imaging tests.Proton MR Spectroscopy is able to detect and identify a large number of low concentration metabolites. It helps in detailed understanding of metabolic basis of physiology of disease and to diagnose the disease in its early stage.In this study we aim to identify the metabolides in benign malignant and normal gall bladder tissue and compare the metabolic profile of gall bladder tissue with histopathology report. Methods: The cross sectional study, total 119 patients were included in this study on the basis of well explained inclusion and exclusion criteria. Group I includes 51 patients with car cinoma gall bladder, Group II consists of 41 patients of benign gall bladder disease and Group III contain 27 patients with diseases other than hepato-biliary disease. 1H NMR metabolic profiling was done for the detection in metabolic changes. The Chi-square test, student’s t test and ANOVA were used for statistical analysis. Results: The area under curve of choline peak was significantly greater in group I (66.71) as compared to group II (14.85) and group III (5.44). The Lipid AUC and Lipid/Choline Ratio were significantly reduced in group I (222.61 and 5.01) as compared to group II (242.46 and 22.81) and group III (254.56 and 71.32). The Bilirubin total, Bilirubin Direct, SGPT, SGOT and ALP were significa ntly higher in group I. The change of MRI mass/ stone size was significantly positive correlated with choline AUC. Conclusion: The in-vivo MRS is a good tool to differentiate the malignant and benign Gallbladder tissue on the basis of metabolic profile of Gallbladder tissue with short time consuming, with no increased risk of contamination and metastasis of disease and good tool to differentiate between malignant and benign
A profile of patients registered at art centre Jayarogya hospital Gwalior, MP, India
Get PDFIntroduction: An approximately 36.9 million people were living with HIV globally at the end of 2014 with around 2 million new infections in2014. In this study was arranged in order to understand the clinico-epidemiological profile of patients attending ART centre. Methodology: Across sectional study was conducted at an ART center of Gajara Raja Medical College and Jayarogya Hospital Gwalior, Mp, India. The data of500 patients who is suffered from HIV/AIDS registered at ART centre from 1stAugust, 2014 to 31st July, 2015. Result: In this study total 500patients, 299(59.80%) were male, 197(39.40%) were female and 4(0.80%) sample are transgender. in this study Out of the total 500 patients,maximum 178 (35.6%) belonged to 30-39 years of age group. Out of the total 500 patients, 211(42.20%) were unemployed. IntegratedCounseling and Testing Centers (ICTCs), ICTC emerged as being the most common agency to refer HIV-positive patients into ART (67.4%)followed by private practitioners (13.4%) and government health centers (7.6%). other entry point are self referred like DOTS, STI/RTI etc.Psychosocial support, prevention and treatment of opportunistic infections (OI) including tuberculosis, and facilitating home based care andimpact mitigation. In this study was significant improvement in CD4 count, body weight after receiving the ART for an average duration 6month.Conclusion: Building on the experience of past, this phase saw a twin drive to focus on coverage among high-risk groups like commercial sexworkers (CSWs), truck drivers and IDUs as well as to make the programme multisectoral. This resulted in a strongly decentralized programmewith the responsibility of implementation vested with the states as State AIDS Control Societies (SACS) were formed
A cross sectional study to assess the pattern of food consumption among tribal women of age group of 15-49 years
Get PDFBackground: Tribal populations have some specific characteristics which are different from other tribes. They have their own tradition. In view of their habitat and food habits, they form a distinct group compared to other populations. Their food intake is influenced by vagaries of nature, with large seasonal variations, depending upon availability of agricultural and forest produce. So the current study was conducted to assess the pattern of dietary consumption in tribal women. Methodology: A community based cross sectional study, was conducted in 80 women of 15-49 years of age at the tribal areas of Chandrapur district by stratified random sampling. A set of structured questionnaire was given to the participants who consist of questions on pattern of dietary consumption. Results: Maximum (59%) participants were occupied in agriculture suggesting that main occupation of the area. 63(45.65%) were consuming cow milk Whereas 17 (12.31%) does not consume milk at all. 67(83.75%) were consumed hen eggs and all 80 (100%) individuals consumes Soyabean oil on daily basis. rice and wheat are the staple food consumed among the tribal population. 100% population consume green vegetables whereas 59 (73.79%) consumes wild vegetables (Ranbhajya). Conclusion: Tribal population follows their own tradition and dietary pattern
A Study On Risk Factors of Relapses of Nephrotic Syndrome Among Pediatric Patients at a Tertiary Care Center of Bihar
Get PDFIntroduction: Nephrotic syndrome (NS) is 15 times more common in children than in adults. NS affects13/100,000 children<16 years of age . Two-thirds of childhood NS present before the age of 6 years. Therefore, we planned this study with an objective to identify the risk factors for FR in childhood steroid sensitive NS (SSNS). Methodology: A prospective study was conducted by the Department of Pediatrics, Nalanda Medical College &Hospital, Bihar, between February 2020 to January 2021. Cases with the first episode of idiopathic SSNS in the age group of 9 months - 12 years, who followed up for at least 12 months were enrolled in the study. NS was diagnosed in accordance with standard criteria. Results: A total of 100 children with NS were included in the current study based on inclusion criteria during the study period. There was a male preponderance among the study participants. Incidence of infection and hypertension was 34% and 37%, respectively. Incidence of FR was high in 1-8 years age group. The incidence of FR was less in males than in females; but it was not significant. Majority of the children with IFR group responded to steroid therapy in <2 weeks, while the most children with FR showed response after 3-4 weeks. Conclusion: Relapse within first 6 months, associated infections and hypertension were the factors significantly associated with FRs in childhood SSNS. These factors should be kept in mind and should be well documented at the time of initial presentation of NS for the long-term management
Study on the effectiveness of transfusion program in dengue patients receiving platelet transfusion
Get PDFBackground: Dengue infection results in a spectrum of clinical syndromes ranging from a mild flu-like illness to life-threatening dengue shock with bleeding and multi-organ failure. The present study was conducted to assess the effectiveness of transfusion program in dengue patients receiving platelet transfusion. Material and methods: The present study was conducted to assess the effectiveness of transfusion program in dengue patients receiving platelet transfusion. 200 clinically suspected cases of dengue were included in the study. Cases who were positive for dengue serological tests were included in the study. The age of the patient, duration of fever before admission, result of the dengue serological test, haematocrit and platelet count on admission and during hospitalization, presence of haemorrhagic manifestation like petechiae, haematemesis, melena, gum bleeding and epistaxis and admission of platelet transfusion were recorded and analysed. Results: In the present study 200 clinically suspected dengue cases, 184 cases were positive for dengue serological tests. Among 184 serologically posititve dengue cases, 156 cases were DF, 26 cases were DHF and 2 cases were DSS. 98 patients were males and 86 were females. 119 of the 156 cases with DF required platelet transfusion. Similarly 19 out of 26 DHF cases and both DSS cases required platelet transfusion. Information regarding clinical recovery or on post transfusion platelet increment was available in 155 cases out of 180 cases, because 4 patients died during hospitalization. Conclusion: The present study concluded that 184 cases were positive for dengue serological tests. 119 of the 156 cases with DF required platelet transfusion. Similarly 19 out of 26 DHF cases and both DSS cases required platelet transfusion. Clinical recovery or on post transfusion platelet increment occur in 155 cases out of 180 cases, because 4 patients died during hospitalization
A prospective study of serum adenosine deaminase and alkaline phosphatase in rheumatoid arthritis
Get PDFIntroduction: Rheumatoid arthritis (RA) is a systemic autoimmune disorder causing chronic inflammation and proliferation of the synovial tissues, destruction of articular cartilage and also affects many other sites that include the heart, blood vessels and skin. In general population the prevalence of RA is believed to range from 0.5-1.0 %. RA is reported to affect almost 1% of adult population worldwide and approximately 0.75% of adult Indian population. In India alone there are some 10 million people with RA. Materials and methods: The study was conducted at Department of Biochemistry, RIMS, Ranchi and test performed in Medall scans and lab, RIMS, Ranchi, Jharkhand. The study comprised of 30 patients of rheumatoid arthritis in the age group of 30-60 years who were diagnosed by clinical analysis, rheumatoid factor and E.S.R tests (Group 1). 60 healthy individual with no known history of any disease matched by age and sex with group 1 were taken as controls (Group 2). After taking informed consent and noting the name, age and sex, venous samples were drawn from both the groups. Results: In rheumatoid arthritis patients, serum Adenosine deaminase levels were high, the mean serum Adenosine deaminase levels were 60 ± 9.55 and in controls the mean Adenosine deaminase levels were 21 ± 3.04. The p value was significant at p < 0.001. We conclude that serum Adenosine deaminase can be used as a marker for cell mediated immunity to monitor disease activity in rheumatoid arthritis. Serum Alkaline phosphatase was found to be raised in rheumatoid arthritis, the mean serum Alkaline phosphatase levels were 291.63 ± 35.84 in patients of rheumatoid arthritis when compared to healthy controls (196.73 ± 32.71).The p value was significant at p<0.001. Conclusion: The present study has focused on investigating the serum total Alkaline phosphatase levels in Rheumatoid Arthritis Patients and The findings have indicated a raised serum Alkaline phosphatase in patients of rheumatoid arthritis when compared to healthy controls thereby suggesting the role of serum Alkaline phosphatase as a marker of disease activity in rheumatoid arthritis
Knowledge, attitude and practices towards COVID-19 among the parents of pediatric patients in a tertiary care center of mountainous region
Get PDFIntroduction: The disease-causing virus (a member of the corona virus family) was named severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) and the disease was referred to as COVID-19. This disease soon crossed China’s boundaries and became a global health emergency. Similar to Middle East respiratory syndrome corona virus (MERS-CoV) and severe acute respiratory syndrome corona virus (SARS-CoV), this virus causes pneumonia, which can be fatal in severe cases. Materials and Methods: A cross-sectional study was conducted on 262 parents orguardians of Pediatric patients who visited pediatric OPD of GMC DODA during March-April2021.The participants were given adequate information about theobjectives and purpose of the study and informed consent was taken. Those parents or guardians, who agreed totake part in the study, were assessed in a quiet room adjacent to pediatric OPD. Results: A total of 262 parents or guardians ofchildren whovisited the pediatric OPD completed the surveyquestionnaire. The mean age of participants was 32.15(SD = 7.69) years ranging from 18 to 65 years. Of total,60.1% were female and remaining 39.9% were males. Conclusion: This study concluded that the participants had goodknowledge, positive attitude and sufficient practice towardsCOVID-19. Knowledge was higher in participants with higherlevel of education. The findings are useful for policy-makersto consider a comprehensive specific group target for healtheducation programs for COVID-19 prevention and control
Evaluation of mediastinal mass lesions by computed tomography
Get PDFIntroduction: Tumors (benign to severely malignant), cysts, vascular anomalies, lymph node masses, mediastinitis, and mediastinal fibrosis are only few of the disorders that impact the mediastinum. The aim of this study was to examine the computed tomographic characteristics of mediastinal mass lesions in plain and contrast-enhanced scans, as well as the distribution of mediastinal masses and their extension to adjacent structures, and to compare CT findings with pathological diagnosis whenever possible. Materials and Methods: Present study was conducted on 42 cases in the age between two to seventy years for a period of November 2019 to March 2021 in the Department of Radio-diagnosis, Alameen Medical College, Bijapur, Karnataka, referred patients from Medicine, Surgery, and evaluated through detailed history, necessary physical examination and computed tomography are carried out using CT scan-GE 16slicescannerwithboth Plain and Contrast study. Results: CT with a diagnostic accuracy of 83% is a highly useful modality for the investigation of mediastinal masses. Majority of the masses, showed heterogeneous enhancement, i.e., 45% followed by homogenous enhancement; 26% non enhancing masses constituted 12%. Conclusion: CT plays a significant role in the assessment of various mediastinal pathology, regarding diagnosis, distribution pattern and mass effect on adjacent structures
Demographic and clinical characteristics of COVID-19 mortality in Southern India-A single centre observational study
Get PDFBackground: COVID-19 pandemic has spread worldwide with new variants of viruses and reinfections. As we have to live with COVID-19,public health efforts should focus on preventing avoidable mortalities. The mortality with COVID 19 shows marked regional variation; henceregional studies are needed. Objectives: Our study analyses the demographic and clinical characteristics of deceased COVID-19 patients, whichare critical for developing geographic-specific public health interventions to reduce mortality. Materials and methods: We conducted aretrospective observational study from 1 April 2020 to 31 August 2021 in Kerala, India. We analysed 1201 death summaries of laboratoryconfirmedCOVID-19 deaths and included 1076 cases for the study. Results: Mean age of the deceased was 65.7 years (SD: 14 years). Of thetotal deaths, 65.9% were males. The mean duration between the onset of symptoms to admission in our hospital was 4.9 days (SD 3.7 days, IQR5 days). The most frequent presenting symptoms were breathlessness (68.2%) and fever (57.3%). 90.1% in the study group had at least onecomorbidity. Diabetes (53.5%) was the most common comorbidity, followed by hypertension (52.3%). Diabetes was also the most frequentcomorbidity reported in COVID-19 deaths among young (≤40 years), pregnant and vaccinated groups. Conclusion: The elderly, males andpatients with underlying comorbidities, especially diabetes, die disproportionately due to COVID-19. Health intervention strategies likevaccination, promotion of healthy lifestyle to control comorbidities and awareness programmes for COVID appropriate behaviour should beprioritised in these vulnerable populations