International Journal of Health and Clinical Research
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An institutional experience on comparison of different Onlay approaches for urethroplasty using buccal mucosal graft
Get PDFUrethral stricture is a common disease encountered by urologist. Reconstruction of long and complex urethral strictures is technically demanding. BMG augmentation urethroplasty has become the standard of care for long urethral strictures. It is readily available and easily harvested with minimal donor site morbidity. Buccal mucosa is hairless, has a thin, elastin rich epithelium giving it excellent handling characteristics and a highly vascular lamina propria, which facilitates harvesting and imbibition. Whether to place the graft dorsally, ventrally or laterally is controversial. We conducted this Prospective study, between August 2009 and December 2011. We selected 25 cases of long anterior urethral strictures and were managed by onlay urethroplasty by different approaches. Follow up was done for 8- 20 months. 3 patients lost follow up after first visit. Post operative uroflowmetry was done in all patients after 1 month at the time of first follow up visit. Of 25 cases 21 (84%) were successful and 4 (16%) failed. In terms of success, not much significant difference was found between different approache
A cross-sectional study to study the role of Fine Needle Aspiration Cytology in Lymphadenitis: a study from tertiary care Hospital
Get PDFBackground: In patients with lymphadenopathy, the use of fine-needle aspiration cytology (FNAC) for early diagnosis and treatment is recommended due to the ease with which enlarged lymph nodes can be aspirated. The method's simplicity and lack of complexity make it a good choice. Reactive lymphadenitis, inflammation, granulomatous illnesses, and neoplastic diseases can all be diagnosed with a high degree of accuracy using this test.Aims and Objectives: This research aims to examine the FNAC results in lymphadenitis, which are frequently encountered by this population.Materials and Methods: A hundred patients were studied at the Department of Pathology, name of study place from May 1st, 2021 to August end 2021. All slides and reports were collected and reported. Age, sex, lymphadenopathy sites, and cytological analysis findings were recorded. Results: Patients with lymphadenopathy belong to 31-40 years (56%) followed by 21-30 years (26%). With a mean age of 34.56±8.12 years, females (73%) compared to males (27%). The most common site of lymphadenopathy was cervical (69%), followed by axillary (21%), inguinal (8%), and Generalized (2%). Cytological analysis revealed that the majority of the patients were diagnosed with tuberculous lymphadenitis (47%), followed by Chronic reactive hyperplasia (24%), Acute lymphadenitis (16%), and metastatic (12%).Conclusion: Fine needle aspiration is an essential modality for the initial diagnosis and management of patients with lymphadenopathy
Assessment of factors causing stress among medical students: A cross sectional study
Get PDFBackground: Stress is defined as the body's nonspecific response or reaction to demands made on it, or to disturbing events in the environment. Medical field is considered as one of the most difficult and challenging profession. This study aims to determine levels of stress in final year medical students. Methods: A web based cross sectional study, including final year (2017) medical students of tertiary care hospital at C.G.was conducted using MSSQ-40, a standardized test for determining medical student stress levels. All students from final year were briefed about the study objectives. There are total of 150 students in 2017 batch. The study was conducted in June march 2020. Total of 143 students were included for the study. Results and conclusions: Academic related stressor (ARS) received the highest score (3.27 mean score) followed by GARS (2.94 mean score) and IRS (2.81 mean score). Proper planning for self-study, seeking help from mentors in helping to plan time table. Developing peer learning, communication skills to avoid any conflicts
A study on clinical presentation of children with HIV infection in correlation with CD4 count at art centre Warangal
Get PDFAim & Objective: To understand the Clinical presentation of HIV and understand the correlation of CD4 count in children less than 14yrs at ART centre Warangal. Methodology: It was Prospective observational study, A total of 103 children were enrolled in to the study who were attending the ART centre Out Patient Department for their medical problems and routine follow up. Children who used to visit ART CENTER WARANGAL for their medical illness, regular follow up, between January 2020 and June 2021 were evaluated. An informed consent was taken from guardians. All children having manifestations of different systems, history taken, subjected to clinical examination findings noted. CD4 counts from previous records collected. Results: In the present study, most of the children attending our center are in between 7 – 12 yrs. Mean age of presentation is 10.859yrs. There is huge difference of distribution from rural to urban. Most common symptoms are fever, cough, not gaining weight, persistent diarrhea. In this study 80.5% (83) of children are symptomatic and 19.4% (20) of children are asymptomatic. Out of 21 asymptomatic children mean CD4 count is 1331.19/cu. and out of 82 symptomatic children mean CD4 count is 649.54/cu.mm. Here p-value is <0.001, which is highly significant. Conclusion: The present study indicates strong correlation of CD4 count with the condition of child (symptomatic/ asymptomatic) which means the asymptomatic children have appropriate CD4 counts for their respective age and symptomatic children have a decline in CD4 counts
A prospective study of evaluating the prescribing pattern of antidiabetic drugs in patients with type 2 diabetes mellitus
Get PDFBackground: Type 2 diabetes mellitus (T2DM) has emerged as a major health issue, leading to an increase in morbidity and mortality rates, and this must be addressed by promoting rational drug use. Aims and objectives: To study drug utilization to assess the prescribing pattern of antidiabetic drugs in patients with diabetes and hypertension. Materials and methods: In the present prospective study, 75 patients were studied in the Department of Medicine and endocrinology, Gandhi Medical College, Bhopal, Madhya Pradesh, from January 2020 to May 2021. After recording the patient's detailed history and physical parameters, prescribing pattern of all the patients diagnosed either as T2DM or hypertension was assessed. Results: Metformin (95 %) followed by glimepiride (80%) and gliptins (70%) were the most commonly prescribed drugs. Insulin was found to be the least commonly used drug in this investigation. The most common treatment was triple-drug therapy (40%), followed by dual therapy (29.33 %). SGLT2i use was significantly higher (p=0.0006) than in patients with diabetes only. The most commonly prescribed antihypertensive medication was telmisartan (67.27%).Conclusion: Still, physician OHAs is the drug of choice for treating T2DM as metformin was the most commonly prescribed drug, followed by glimepiride
Study of uropathogens and their antibiotics susceptibility pattern in tertiary care hospital in central India
Get PDFObjective This study was undertaken to determine the spectrum of organism responsible for UTI and their antimicrobial susceptibility pattern in Mahaveer Institute of Medical Sciences and Research (MIMS) located in Central India. Methods The present study was carried out in Department of Microbiology from January to December 2021. Patients attending OPD and IPD with any complaint pointing towards UTI were included study. Freshly voided, clean-catch midstream urine was All plates were then incubated at 37°C aerobically for 24 hours. A significant growth is considered if the number of colony is ≥105 colony forming unit (cfu)/ml (12). Results Most common organism isolated were gram negative organisms.E.coli (51.67%), Klebsiella (14.76%),Enterococcus (11.40).E.coli showed low level resistance for Nitrofurantoin and Amikacin (7.79%).Pseudomonas showed low resistance for Nitrofurantoin, and Amikacin (12.51%)and Meropenem and Gentamicin (37.5%).Enterococcus faecalis showed low level resistance for Nitrofurantoin(11.76%), followed by High level Gentamicin (23.52.MRSA was highly resistant to Amoxycillin (75%). Candida species isolated from various clinical specimens were identified up to species level by standard mycological techniques (77.77 %) non albicans Candida species and (22.22 %) was Candida albicans. Conclusion Our study concludes E. coli as most common organism causing urinary tract infection with female predominance. Nitrofurantoin has showed better sensitivity against most organisms causing UTI so it can be used as initial agent for empirical treatment till culture reports are available. There is increasing resistance to commonly used antibiotics due to indiscriminate use of antibiotics without culture and sensitivity report
Right minithoracotomy approach for mitral valve replacement: A retrospective analysis of safety and effectiveness
Get PDFBackground: Mitral valve replacement (MVR) through minimally invasive approaches has grown in popularity over past few decades as it offers multiple advantages over conventional full sternotomy approach. We analysed our single centre experience of MVR through the right minithoracotomy (Mini-MVR) performed over a three year period. Methods: This study was a retrospective analytical study done at CHL hospital, Indore. Fifty eight patients undergoing MVR through the right minithoracotomy between January 2018 and December 2021 were included. Records of perioperative data were collected and retrospectively evaluated. Results: Total 58 patients were included in the study, of which 42 were females (72.4%). Mean age was 41.2+/- 8.9 years. Overall 30-day mortality was 1.72% (n = 1). Mean operative time, cardiopulmonary bypass, and aortic cross-clamp times were 261.9 ± 52.7, 149.5 ± 42.8, and 91.8 ± 24.6 minutes, respectively. Tricuspid valve annuloplasty was performed in 11 patients (18.9%). Two patients (3.45%) required conversion to median sternotomy and three patients (5.2%) underwent re-explorations due to bleeding. Median intensive care unit stay (ICU) was 36 hours and median postoperative hospital stay was 5 days. There was no incidence of stoke in any patient during hospital stay. Wound healing of chest and groin wound was excellent. Conclusions: MVR through the right minithoracotomy approach is feasible, reproducible, safe and effective with low mortality and morbidity. Mini-MVR is good alternative to conventional sternotomy. Besides certain cosmetic advantage, it avoids potentially devastating infective complications of mediastinitis/sternal dehiscence while shortening ICU and total hospital stay and reducing recovery time with early return to work
Clinical parameters in the diagnosis of acute necrotising soft tissue infections
Get PDFBackground: Necrotizing soft-tissue infections (NSTIs) are profoundly deadly. They are incessant enough that general and speciality doctors will probably be associated with the administration of something like 1 patient with NSTI during their training, yet they are rare enough that knowledge of the infection will only here and there be accomplished. Building up the diagnosis of NSTI can be the fundamental test in treating patients with NSTI, and information on all accessible apparatuses is key for ahead of schedule and accurate diagnosis. The research centre danger marker for necrotizing fasciitis score can be useful for distinguishing between instances of cellulitis, which ought to react to clinical administration alone, and NSTI, which requires usable debridement notwithstanding antimicrobial treatment.Objective: To concentrate on the relationship between clinical, lab boundaries and imaging in the diagnosis of NSTI. To break down the importance of Wong's LRINEC rules in assessing NSTI, to distinguish the comorbidities related with NSTI and to decide the meaning of progress in research centre boundaries after the inception of treatment.Methods: It is a prospective report where patients with a clinical diagnosis of complicated delicate tissue disease were enlisted and exposed to investigations at the hour of confirmation and assessed according to proforma. Subjects were isolated into NSTI and SSTI groups because of clinical elements, research facility and imaging discoveries. Intergroup examination was done to distinguish factors related to NSTI.Results: Clinical highlights like tachycardia, tachypnea, hypotension, unbalanced agony, rankles, skin putrefaction, ulceration and change in shading were all together (p150mg/L, RBS>180mg/dl, Total count>16500cells/mm3, Calcium1.4mg/dl were fundamentally connected with NSTI (p<0.05). LRINEC rules had responsiveness of 89.1% and a particularity of 94.3 %. Both X-ray and Ultrasonography are pretty much similarly explicit, however, ultrasonography was more delicate in diagnosing NSTI. Genuinely critical contrast was noted between boundaries done at confirmation and the second post usable period following resurgery.Conclusion: Previously mentioned clinical highlights and lab boundaries can be utilized to analyze, visualize and screen patients with NSTI. LRINEC is a decent apparatus in separating NSTI from SSTI. Ultrasonography is more explicit in diagnosing NSTI than X rays
Caudal regression syndrome: A rare case report
Get PDFCaudal Regression Syndrome (CRS) is resultant to anomalous development of caudal spinal cord and vertebral column segments during embryonic life. Although exact cause is not known multiple factors such as toxic, ischemic, infectious insults before 4th week of gestation are leading causes. CRS is frequently associated with maternal diabetes
Assessment of the correlation of CD4 cell counts to C-reactive protein and lipoproteins in subjects with HIV infection: A clinical study
Get PDFAims-The present study was conducted to assess any correlation existing between changes in C - reactive protein and lipoproteins with CD4 cell counts in HIV Positive patients. Materials and methods- The study was conducted on 102 HIV-positive subjects. C-reactive protein, Lipid profiles, CD4 cell counts were assessed for all subjects. The collected data were subjected to evaluation and results were formulated. Results- 102 HIV positive subjects were grouped based on CD4 cell counts in four groups, the group I CD4 count <200/μL, group II CD4 count 201-350/μL, group III CD4 count 351-500/μL, and group IV has CD4 count>500/μL. In the majority of subjects with decreased CD4 count increased CRP levels were seen with a significant inverse correlation between CRP and CD4 count. It indicates that CRP level increases with increased HIV infection severity, and with decreased CD4 count. HDL decreased in HIV-positive patients and VLDL was increased with decreased CD4 cell count. No significant association was seen in serum Triglycerides and LDL with CD4 cell count. Conclusion- The present study concludes that C-reactive protein and lipid profiles are affected in HIV-positive subjects with decreased CD4 count. Hence, regular assessment of C-reactive protein and lipid profile help in assessing disease progression, forming a treatment plan, and decreasing the risk for cardiovascular disease in HIV-positive subjects, when CD4 cell counts cannot be assessed