International Journal of Health and Clinical Research
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Study of Trabeculectomy with or without Mitomycin C
Get PDFGlaucoma is a group of disorders that are characterized by widely diverse clinical and histopathological manifestations which was apparently recognized by the Greeks as early as 400 B.C. Although an association with elevated intraocular pressure is found in ‘Arabian writings’ in the 10 th century it was not until the 19th century that glaucoma was clearly recognized as a distinct group of ocular disorders. Glaucoma is one of the main blinding disease in our country. According to a World Health Organization report glaucoma is the third most common cause of blindness in the world The sample size was 50 and the study was prospective and non-randomized study. Out of 50 patients 25 patients were posted for simple trabeculectomy (Group A) and 25 patients were posted for trabeculectomy with Mitomycin- C (Group B) after taking their informed written consent. The study comparing the effects of trabeculectomy with and without mitomycin-c in glaucoma patients were undertaken in Department of Ophthalmology, Hitech Medical College and Hospital, during the period of 2019-2021. The overall goal for all glaucoma treatment is to preserve useful vision. Glaucoma is a multifactorial disease but the intraocular pressure is still the only known treatable risk factor. Substantial pressure reduction is difficult to achieve without filtering surgery
Conventional and magnetic resonance hysterosalpingography in assessing tubal patency
Get PDFAim: Conventional and magnetic resonance hysterosalpingography in assessing tubal patency. Material and methods: 50 patients, age 20–40 years, for evaluation of tubal patency were included in the study. It includes patients referred for postoperative evaluation, following reversal of tubal ligation and recurrent spontaneous abortions. The examination was done on Day 7–Day 12 of the menstrual cycle.Under strict aseptic precautions, MRI‑compatible plastic HSG 5 ‑ F microcatheter with inflatable bulb was inserted into the lower uterine cavity. The bulb was inflated with 3 cc of distilled water and shifted to MRI scan 1.5 Tesla [GE] machine. T2 W (TR: 7120 ms, TE: 90 ms, flip angle 900, slice thickness 5 mm, matrix 256 × 256) axial, sagittal, and coronal sequences were done. Results: The comparative sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], and diagnostic accuracy of MR HSG and cHSG were 100%, 99.08%, 100%, 97.5%, and 99.75%, respectively, and those of MR HSG and DL were 100%, 93.73%, 87.21%, 100%, and 96%, respectively. The Kappa agreement between MR HSG and cHSG was excellent [0.97] and a McNemar test value of 1 showed no statistical difference between the two procedures. Conclusion: MR HSG is a novel upcoming investigation method with very few pioneering studies at both national and international levels. This study is distinctive in the sense that it explores the utility and feasibility of HSG being done using MRI
Assessment of Covid-19 Patients Under Home Isolation In Rewa,M.P., India City, Madhya Pradesh
Get PDFBackground: COVID-19 causes a variety of symptoms in people who are infected. Asymptomatic persons can transmit the virus to others for an extended period. Home isolation of asymptomatic and mild symptomatic cases has been an important remedial measure by Government of India to halt the spread of COVID-19. Objectives- To assess the clinico-demographic profile and compliance to isolation practices and experiences shared by COVID-19 patients under home isolation in Rewa city. Materials and methods:A Retrospective observational study was conducted to assess home isolated COVID Positive patients during July to October 2020 by a questionnaire based telephonic interview.Results- 66% patients were males and 58% patients gave history of contact with other Covid positive patient. 96% patients showed high compliance with the isolation rules.Conclusion: Continuous observation and follow-up of the home isolated COVID-19 patients by health teams had resulted in their compliance with the isolation practices and the patients were quite satisfied with the services provided by the government
Study of morphological type of cataract in type 2 Diabetes Mellitus patients at a tertiary care centre in Karnataka
Get PDFObjective: To determine the morphological type of cataract seen in type 2 diabetes mellitus patients. Methods: Cross sectional study carried out at a tertiary eye care centre in North Karnataka from2012 to 2014. All patients with type 2 diabetes mellitus 40 years and above diagnosed as per WHO criteria were enrolled. A detailed demographic and complete ocular examination was done. Examination of anterior segment by slit lamp biomicroscopyand grading of lens opacity was done after full dilatation of pupil according to the Lens Opacity Classification System (LOCS) III system. The severity of the lens opacities, according to the photographic standards, was separated into three major groups: nuclear cataract(NC), cortical cataract(CC), and posterior subcapsular(PSC). Results: Out of the 750 patients with Type 2 Diabetes Mellitus enrolled in our study, 492 patients had cataract and 258 had no cataract. 242(60.35%) were males and 250(71.63%) were females. Prevalence of cataract in Type 2 Diabetes was 65.60%.Mixed cataract was seen in 70.52% and monotype in 29.48% patients. A combination of nuclear, cortical and posterior subcapsular cataract had highest incidence with 42.26% followed by cortical cataract with posterior subcapsular 33.43%, nuclear cataract and cortical cataract in 13.83% and lowest incidence was with nuclear cataract and posterior subcapsular cataract with 5.48%. Among the monotype cataract 68.28% of patients had cortical cataract, 25.52% had nuclear cataract and 6.21% had posterior subcapsular cataract. Conclusion: In our study two thirds of the diabetic population showed evidence of cataract and mixed type of cataract was the most commonly seen
Morphological and Morphometric study of Glenoid Cavity and it’s Clinical Application in Western Rajasthan Population
Get PDFBackground: Glenoid cavity (GC) is a shallow, concave and oval fossa at superolateral border of scapula and form glenohumeral joint with scapula. There is a notch present on its anterosuperior part which gives its different shape. When this glenoid notch is indistinct its shape is pear shaped, when it is distinct it looks like inverted comma shape and when it is absent its oval shape. Understanding morphometric and morphological variation of GC plays an important role for surgeon while designing and fitting of glenoid component for total shoulder arthroplasty. Aims: A morphometric study of the glenoid cavity of 120 adult dry human scapulae in Western Rajasthan Population was done to evaluate the shape and various diameters of the GC. Material and methods: 120 dry scapulae (60 Right and 60 Left) of unknown sex, were taken for the study. Damaged bones were excluded from the study. Supero-Inferior Diameter (SI-D), Antero-Posterior Diameters (AP-D1 and AP-D2) of both sides were analysed and compared by unpaired t-test. Results: Most common shape of GC was pear shaped (45.83%) followed by oval shape (35%). Least common shape was inverted comma shape (19.16%). Difference in mean SI-D of both sides were statistically insignificant while AP-D1 and AP-D2 were found statistically significant. Mean Glenoid Cavity Index on right and left sides were 64.57 ± 6.91% and 68.33 ± 6.29% respectively. Conclusions: The above study helps Orthopedicians in shoulder dislocation, fractures and treating shoulder pathological conditions like glenohumeral instability and rotator cuff pathology
A Comparative Study on the Cellular Inflammatory Indices among ICU Vs Non ICU Patients of Covid-19 in a Tertiary Hospital
Get PDFBackground: As accumulating evidence has suggested that there is an association of increased levels of inflammatory bio markers in relation to severity of covid -19 illness, the present study was planned to examine the scenario of association between inflammatory markers and severity of covid-19 illness by studying ICU and non ICU patients comparatively. Research Question: Is there a positive association between increased levels of inflammatory biomarkers and severely ill patients of covid-19 disease? The setting of the study was at Government General Hospital, (State Covid Care Hospital) Vijayawada, Andhra Pradesh. An observational study was conducted during the period from March 2021 to August 2021 on 60 ICU and 40 Non ICU patients of covid-19 by studying their socio demographic profiles and scenario of increased levels of inflammatory Biomarkers in relation with severity of illness of covid-19 disease. Results: Maximum about 52% of the admissions were confined to the age group of 41 to 60 years with the mean ± 2 SD = 47.4 ± 24.8 at 95 CI with 70:30% of sex ratio was observed among study subjects as male & female. High CRP & IL 6 levels were observed among ICU patients when compared to Non ICU patients. Further it was observed that maximum high levels of serum ferritin between 501 to 750 Micrograms/L among ICU admissions of covid-19 significantly with the P< 0.01 when compared to non ICU admissions. And also high levels of LDH between 231-600 U/ml were observed among the both groups of ICU & non ICU patients. It was also observed that related to D dimer high levels ≥ 10,000 Micrograms/ml were noticed among ICU patients only. It was concluded that high levels of inflammatory Bio markers were associated with older and severely affected covid-19 patients in this study
Knowledge, Attitude, Practices and Hesitancy regarding vaccination of children among mothers attending Urban Health Training Center at Visakhapatnam, Andhra Pradesh
Get PDFIntroduction: Immunization is one of the most important public health interventions to prevent morbidity and mortality in childhood. To further improve vaccination coverage allaying fears or doubts among parents regarding efficacy, safety and need for vaccines is vital. Hesitancy, if not addressed, can become refusal of vaccination. Hence, the present study is attempted. Methodology: it is a descriptive OPD based cross-sectional study involving mothers of children under 5 years of age attending vaccination clinic during study period. Results: Most of the mothers are educated and between the ages twenty and thirty. Most of the mothers felt that all UIP vaccines are important and all children should get these vaccines. About 17% mothers thought about either delaying or refusing vaccines. Though vaccine hesitancy was more among home-makers and educated, it was not statistically significant. Conclusions: doctors and health workers should educate parents regarding importance of giving all UIP vaccines and dispel any fears or misconceptions
Retrospective study of infection rate in cranioplasty cases at tertiary care centre
Get PDFBackground: Various studies indicate that the infection rate in post operative cranioplasty cases is up to 26%. Infection rate depends on material used for cranioplasty and it is more with metal implant material. We retrospectively reviewed the infection rate at our institute for the cases operated over last five years. Methods: we studied case records of 180 cranioplasty cases over last 10 years. Majority of the cases were operated for trauma. Cranioectomy due to non trauma causes were not included. Results: After studying these patients we found that 30 patients had post operative infection among our cases. Persistant use of same head dressing applied immediately after operation seems to be a significant risk factor for operative wound infection. The relative risk for which was 15.30. Fourteen out of 30 patients needed debridement and daily dressing with antiseptic solutions, and eight required revision of scalp flap with the help from plastic surgeon. All patients improved and did well after treatment. Conclusions: There is always a chance of infection in cranioplasty cases even after utmost antisepsis . Contamination due to trauma and application of bandage for long appears to the precipitating factors for infection. This study confirms that there needs a practice change with proper antiseptic techniques right from triage room to the post-operative care room to minimize the chances of infection
A study on clinical presentation of umbilical and paraumbilical hernia in adults
Get PDFAim & Objectives: To study clinical presentation of umbilical and paraumbilical hernia in adult i.e distribution with respect to age and sex and mode of presentation. Methodology: External abdominal hernia surgeries; constituted 32.39% of total major OT cases at GIMS &District Hospital Kalaburagi from Aug 2015 to July 2018. Results: Umbilical hernia constituted 8.6% of external abdominal hernia. Paraumbilical hernia formed 66.6% of umbilical hernia with supra umbilical being more common. Out of 30 patients, 17 patients were between age group 31 to 50 years. 20 patients were females, ratio being male: female 1:2. Swelling around the umbilicus was the main common presentation with pain in the swelling in half of the cases. Minimum duration of complaints at the time of presentation was 6 days, and maximum duration was 7 years. Majority of umbilical hernia patients i.e 80% patients presented with irreducibility. I patient had skin ulceration, 3 patients had intertrigo, I patient had inflamed hernia and I patient had obstructed paraumbilical hernia. Obesity and multiparity were most common associated risk factor. 7 patients had chronic cough due to COPD and one patient had Wo ascites, which was well controlled at the time of presentation. Mayos repair was most common operation performed for umbilical hernia repair, done in 23 patients. simple transverse repair was done in 5 patients umbilicus was preserved in 4 cases, with small hermal sacs. In one patient mesh repair was done. In I patient with obstructed paraumbilical hernia, emergency surgery with simple transverse repair was done. In all cases prolene No. 1 was used for repair. In maioritv of the cases defect was more than 1.5 cms. 5 patients had 2 defects in the limb of skin Incision lines. 30 patients with umbilical hernia contained small bowel for omentum or both . In cases general anaesthesia was used and tn5 cases spinal anaesthesia was given. Peri operative antibiotics were used in all cases. In 25 cases redivac suction drains were used. In 5 patients who needed little dissection, no drain was kept. Wound infection was the most common post operative complications, occurred in 13.3% of cases. Seroma occurred in I patient, and hematoma occurred in I patient- 19 patients stayed in the hospital for less than 8 days, 5 patients for 9 to 14 days and 6 patients for 15 to 21 days respectively. Conclusion: Surgery is the treatment of choice in all cases. The classic repair is that proposed by Mayo. In healthy individuals surgical repair with better non absorbable suture material given good results with a low recurrence rate
Efficacy of disinfectants on biofilm production in catheter related infections
Get PDFBackground: Biofilms are complex microbial communities that are frequently connected with the colonisation of clinically relevant medical devices such as intravascular and urinary catheters. Approximately 82 percent of nosocomial septicaemias are caused by biofilm-producing bacteria colonising these catheters. Disinfectants with broad range multiple target activity are widely used in hospitals for skin antisepsis in order to successfully prevent nosocomial infections. The physician can combat catheter-related infections earlier if the right disinfectant strength and contact duration are used. Objectives: To isolate and identify various biofilm producing organisms among catheter- related infections and to evaluate the effect of disinfectants i.e., 0.5% chlorhexidine, 70% alcohol and povidone-iodine against such organisms. Methodology : Over a 12- month period, 110 catheter samples taken from 100 in-patients were investigated at the Department of Microbiology, Govt Medical College,Nalgonda. The samples were handled in accordance with industry standards. The microtitre plate method was used to detect biofilm formation, and the effect of disinfectants was studied by incubating biofilms with 0.5 percent chlorhexidine, 70% alcohol, and povidone-iodine for 1, 5, and 10 minutes. Results : A total of 50 organisms were isolated. Predominant organisms isolated from intravascular catheters were Candida spp. (78.4%) and Coagulase negative staphylococci (18.42 %); from urinary catheters were Coagulase negative staphylococci (30%) andP. aeruginosa (10 %). 96.2% of isolates were biofilm producers. Incubation with 0.5% chlorhexidine, 70% alcohol led to a reduction of biofilm optical density after a contact time of 1 min and for povidone-iodine, biofilm optical density reduction was observed after 5 min. Chlorhexidine exhibited significant biofilm reduction in 96.4% clinical isolates, followed by povidone-iodine 92.8% and 70% alcohol (91.6%). Conclusion: The disinfectants reduced the biofilm at the different time intervals investigated, but none of them completely eradicated the biofilm. In catheterrelated infections, chlorhexidine was more efficient than povidone-iodine and 70% alcohol at reducing biofilm. This study underlines the need for skin antisepsis prior to catheter insertion and strict hand hygiene procedures before the formation of biofilms