International Journal of Health and Clinical Research
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Epidemiological Profile Of Hepatitis C Virus Infection In Chronic Liver Disease Patients In Tertiary Care Hospital In Telangana
Get PDFBackground: A Significant proportion of chronic liver disease (CLD) are caused by viral infections. The major cause of non-A, non-B hepatitis is Hepatitis C virus. WHO estimates 170-200 million people are infected with HCV worldwide. Aim & Objective: 1) To study Epidemiology of Hepatitis C virus infection 2) To identify the risk factor for HCV infection. Materials & Methods: A total of 100 chronic liver disease patients attending Gastroenterology department were included in the study between January 2015 and June 2016. Demographic data and clinical findings were recorded using a structured proforma. All the samples were screened for anti HCV antibodies by ELISA (HCV MICROLISA) by following manufacturer’s instructions. Results: Out of 100 CLD Patients, 81(81%) were Males &19(19%) were Females. Male to Female ratio of the total chronic liver disease patients was 4.2:1. HCV antibodies was found Reactive in 4 patients, of which 3 were Males & 1 was Female. HCV Reactive patients belong to 40-60 Yrs of age group. 2 HCV Reactive patients belong to Rangareddy district. Surgery was found to be the major risk factor for HCV infection. Conclusion: The Prevalence of HCV in CLD Patients was 4%. Males were more commonly affected than females with 40-60yrs age group commonly affected. Surgery was found as a major risk factor and all the 4 HCV Reactive patients belonged to lower socioeconomic status
Clinico-Pathological Evaluation of Palpable Breast Lump: Hospital Based Prospective Study
Get PDFIntroduction: Breast lump remains a common complaint of females attending a surgical outpatient department. Different types of lesions ranging from inflammation to carcinoma can be presented as a breast lump. A definitive diagnosis of breast lump must be made by histopathological examination. In case of breast cancer, an early and accurate diagnosis can save the patient from metastases and may thus reduce mortality and morbidity. Aim & Objective: The objective of the present study is to evaluate the clinical profile of patients who has palpable breast lumps and a wide range of breast diseases in palpable breast lumps. Histopathology was performed on these breast lumps. In addition to histopathology, clinico - pathological correlation was also done. Material and Methods: A prospective observational study was conducted for one year in the Department of Pathology, Vivekananda Polyclinic & Institute of Medical Sciences (VPIMS), Lucknow. All patients with discrete breast lumps have undergone a triple assessment to make an early diagnosis. Surgical resection specimen includes lumpectomy and mastectomy. They were received, processed, reported and recorded in the Pathology laboratory and the data was collected and analysed. Result: All the cases had a unilateral side of the breast lump and most of the cases had a breast lump on the right side. The majority had lesion size between 2-5 cm, firm consistency, single lump/mass, spread in the outer quadrant. The clinical diagnosis was benign in 19 cases (45.2%) and malignant/suspected of malignancy in 23 cases (54.8%). The histopathological diagnosis was benign in 14 cases (33.3%), borderline in 2 cases (4.8%) and malignant in 26 cases (61.9%). Fibroadenoma was the most common benign tumour and invasive ductal carcinoma was the most common malignant tumour. Conclusion: The final histopathological examination confirmed that the few cases of clinically suspected benign breast lumps were actually borderline and malignant breast lumps. These cases confirm that the histopathological examination of a breast lump is the gold standard to establish a correct diagnosis
Epidemiology, Clinicopathology And Management Of Liver Abscess In Tertiary Care Centre
Get PDFBackground: Liver abscess is a fatal ailment in the developing areas of the country, affecting most of the young adults with certain risk factors and lethal complications and a clinical diagnostic dilemma. We have described the epidemiology, clinicopathology and management of liver abscess in our institution.Method: This is a prospective analytical, two-armed study design done in the department of General Surgery at RIMS Ranchi, involving 90 patients admitted in the indoor ward of department of General Surgery of RIMS Ranchi. The diagnosis was made on the basis of clinical findings, risk factors, lab findings and imaging evidences. All the data (gender involved, type of abscess, common risk factors, diagnostic dilemma and management) of patients were collected and compared. Furthermore, all patients were managed according to the standard protocol requiring either medical, interventional or surgical management.Result: Pyogenic abscess was found to be more common here at Rims Ranchi than the classical amoebic abscess. The commonest organism found in pus samples was Klebsiella. There was a strong correlation with low socioeconomic status, chronic alcoholism and other immunocompromised states like diabetes, other GI comorbidities and malnutrition. Among imaging, USG was found accurate and cost-effective in the diagnosis. Most of the patients went percutaneous drainage, which was found efficient in remission.Conclusion: Liver abscess present mostly with vague symptoms, and every clinician should know the loopholes that points toward its diagnosis. The study suggests early diagnosis through imaging modalities and thus prevention of most of the fatal complications
Comparison of Intrathecal 2-Chloroprocaine With Bupivacaine in Short Surgical Procedures
Get PDFBackground: In the post-Lidocaine spinal era, which went into oblivion owing to TNS, there is a need to substitute its alternative, Bupivacaine, in short surgeries to overcome its limitations. 2-Chloroprocaine is a recent introduction with claims of fast onset and recovery as spinal anaesthetic. The aim of the study is to compare the effect of spinal anaesthesia in short surgical procedures (surgeries lasting <60 minutes) between 0.5 % Bupivacaine (Hyperbaric, 7.5 mg) and 1% Chloroprocaine (40mg).Method: A prospective, randomized controlled study was undertaken with 90 patients of ASA physical status I or II undergoing short surgeries consisting of GROUP C(n=45) who received 4 ml 1% 2-Chloroprocaine (40 mg), and GROUP B(n=45) who received 1.5 ml 0.5% Hyperbaric Bupivacaine, (7.5 mg). Patients were observed for hemodynamic stability, degree and adequacy of sensory / motor block, duration of analgesia and adverse effects. For continuous variables, the summary statistics of mean± standard deviation (SD) were used. Chi-square (χ2) test was used for association between two categorical variables.Results: Mean time of onset of sensory block (Group C-1.6 ± 0.7 min, Group B-2.6 ± 0.8 min) and motor block (Group C-2.7 ± 1.0 min, Group B-3.3 ± 1.0 min) were comparable. Duration of sensory block was 113.9±13.3min (Group C), 168.0±13.1min (Group B) (p<0.001); duration of motor block was 92.7±11.2 min (Group C), 140.1±12.2 min (Group B) (p<0.001); duration of analgesia before any rescue dose was 132.5±12.2 min (Group C), 194.1±12.7 min (Group B) (p<0.001). No statistical significant differences were noted in the hemodynamic parameters between two groups at different intervals.Conclusion: Chloroprocaine has comparable onset of sensory and motor block but faster recovery, making it near ideal spinal anaesthetic agent for short surgical procedures
Prognostic Signifincance of Conduction Blocks in Cases of Acute Myocardial Infarction: A Prospective Observational Study at Tertiary Care Hospital
Get PDFIntroduction: Conduction blocks are frequent complications of acute myocardial infection. Development of complete AV block is associated with poor prognosis likely owing to the extension nature of the infarction. Bundle branch block in acute MI carries poor prognosis. This has been attributed both to the extent of myocardial damage and to the frequency of ventricular asystole. Development of conduction block worsens the outcome of acute myocardial infarction. So recognition of conduction block at an early stage, helps in appropriate treatment including pacing can be institutes at an early stage. Aims and Objectives: To study various patterns of conduction blocks and prognostic implications of conduction blocks in acute myocardial infarction. Materials and Method: A prospective observational study was done on 100 myocardial infarction patients admitted in J.A. Group of Hospitals, Gwalior over a period of January 2019 to June 2020. ECG was continuously observed in CCU and daily ECGs were done. Cardiac markers, fasting blood sugar, lipid profile, serum electrolytes were performed and data was collected. The chi square test was used and p value < 0.05 was considered as statistically significant. Result: A total of 100 patients were included. Out of 100 patients 68 had conduction blocks, out of which 50 had bundle branch blocks whereas 18 had AV blocks. Most of the acute myocardial infarction patients were males (74%). Overall hypertension and smoking was the most common risk factor seen in this study. AV blocks were more common in inferior wall MI and bundle branch blocks were more common in anterior wall MI. There is common association of inferior wall MI with RBBB compared to that of which LBBB (p<0.0001). There was statistical association between type of block and location of MI. Cardiogenic shock was the common complication seen in patients of MI with conduction blocks. Past history of MI was found to be predominant risk factor among mortality seen in 33.3%. Among bundle branch block mortality more with LBBB (23%) and among AV block mortality more with 3o AV block (50%). Conclusion: Conduction blocks were associated with increased risk of in hospital morbidity and mortality in the form of other vascular events during hospital stay. Patients with acute myocardial infarction should be observed carefully for early recognition of conduction blocks and they need close monitoring and optimum clinical care to reduce mortality and morbidity
Anatomy learning made easy in COVID-19 pandemic: Online medical teaching system among the 1st year MBBS students: A Descriptive cross – sectional study
Get PDFIntroduction: Many teaching institutes adopted the online teaching system during COVID-19 pandemic. The Department of Anatomy Armed Forces Medical College had also shifted to online platform for teaching anatomy in a better way. This study was undertaking with an aim to get the student`s perspective about the efficacy of online teaching system for learning anatomy and to explore and rectify the lacunae and address the challenges faced by students and teachers. Methodology: a total of 300 students were enrolled, 150 each from 1st year MBBS of batches 2019 and 2020. Results: Findings suggested that student’s perception towards online learning was better than offline learning. However, the major challenges were problems in internet connection, practical anatomy, having to learn more points related to the topic in a short allocated time and difficulties in logging onto the online platforms. The reliability of internet connection was a major factor affecting their study of anatomy and selecting learning resources. Social media platforms especially WhatsApp were helpful in assisting students in their study and communication between themselves and their teachers, may be because of lesser use of bandwidth. However, assessments and practical demonstrations in anatomy were not same as during offline teaching mode. Conclusion: COVID-19 pandemic was disruptive to medical education. Poor Internet connection was the major bug bear faced by the students, while the social media platforms especially WhatsApp was a helpful tool in study and communication. Students urged improvement in the modes of practical teaching of anatomy and assessment
Correlation of Visual Inspection With Acetic Acid (VIA) and Colposcopy Findings With Papsmear in Evaluation of Unhealthy Cervix
Get PDFAim and objective: To correlate the findings of an unhealthy cervix in Visual inspection acetic acid (VIA), colposcopy and pap smear. Materials and methods: Present study is a hospital based study on women of age 21-65 years with abnormal symptoms and clinical findings of an unhealthy cervix and was carried out in Department of Obstetrics & Gynaecology. Ethical clearance was obtained for this study from the institution. Results: The sensitivity and specificity of Pap smear were found to be 34% and 94%. Simultaneously, colposcopy has high sensitivity and low specificity, i.e., 92% and 28%, respectively. On the other hand, the sensitivity and specificity of VIA and VILI are comparable, i.e., 64% and 68% and 42% and 40%, respectively. Although it shows a low sensitivity, Pap smear shows a high positive predictive value, i.e., 85% compared to colposcopy (56.1%) and visual inspection methods (55%). Colposcopy alone has the highest diagnostic accuracy (65%) over all other screening methods performed alone or in combination. Conclusion: We should combine Pap smear, a screening test, and colposcopic examination, which is used in suspected cases. In case of any abnormal findings, a colposcopic directed biopsy should be taken. Combined methods always lead to an increase in the sensitivity and hence maximizes the detection rate
An Observational Study on Seroprevalence of Toxoplasmosis among Voluntary Blood Donors
Get PDFIntroduction: Like bacterial and viral diseases, many parasitic diseases are also known to be more risk of transmitting by blood transfusion. Of great concern, toxoplasmosis also contributes to similar risk like other infectious diseases in different geographical regions. Materials and Methods: A cross sectional study was performed by screening the presence of antibodies against T. gondii in all blood donors received in a tertiary care teaching hospital and also obtained from medical camps. All blood samples from blood donors were routinely screened for HIV, hepatitis B virus surface antigen (HBsAg), hepatitis C virus (HCV) and syphilis. A total of 150 blood samples from healthy blood donors were collected from January 2021 to June 2021.The volunteer donors were healthy adults, screened routinely by physical examination with no history of infections in the recent past, according to the guidelines of Drugs and Cosmetics Rules, Government of India. This work was approved by the Institutional Ethics committee. Written informed consent was obtained from all participants before blood sampling. All the serum samples were tested for IgG and IgM anti-T. Gondii antibodies separately using commercially available enzyme linked immunosorbent assay (ELISA) kit and the results were interpreted by following the instructions of the manufacturer. Data were calculated with respect to donor variables and entered in SPSS and cross tabulated for descriptive and analytic statistics. The discrete variables were expressed as percentages and a p value of<0.05 was considered significant. Results: Out of the 150 donors, 36 were seropositive to IgG antibody to T. gondii, making a prevalence rate of 24%. Among the 36 sero-positive samples, 18 are O positive, 11 are B, 6 are A and 1 sample supported AB positive blood groups. None of the samples showed Rh negative in this study. Serological screening of co-infections was not done in this study. Conclusion: Consequently, because of the high seropositivity of T. gondii, the health authorities should be alerted and preventive measures should be taken
Antiboitic susceptibility pattern of common uropathogens isolated at a tertiary care hospital of Bihar
Get PDFIntroduction: Urinary tract infections (UTIs) are amongst the most common infections encountered in clinical practice. The present study was undertaken to assess the current antibiotic resistance pattern in the common uropathogens isolated in a tertiary care hospital in south India. Material & Methods: A secondary data analysis was carried out in the department of Microbiology, Jan Nayak Karpuri Thakur Medical College, Madhephura, Bihar, India, for the samples collected during January 2019 to December 2019. Samples received included mid-stream clean catch urine, suprapubic aspirate, urine collected from Foley's catheter and from the nephrostomy tube under sterile precautions, in patients who had undergone percutaneous nephrostomy. Samples were processed and isolates were identified as per standard methods. The chi-square test or Fisher's exact test was used to compare different groups. Statistical software SPSS 16.0 (SPSS Inc, Chicago, Illinois, USA) was used to analyse the data. Results: Data from a total of 1000 consecutive urine samples received in the dept during the period of data collection were included in the study. Of these, 680 (68%) were sterile, 180 (18%) showed significant growth, 20 (2%) showed insignificant growth and 120 (12%) were found contaminated. Of the 180 culture positives, E. coli was the most common isolate. The percentage of Klebsiella pneumoniae, Acinetobacter spp, Pseudomonas spp, Staphylococcus spp, Enterococcus faecalis was higher in patient females and patients with history of prior treatment with antibiotics, compared to the rest. Almost three-fourth of all E.coli isolates were found to be resistant to ciprofloxacin. Ciprofloxacin resistance was comparatively less among the other Gram-negative uropathogens like Pseudomonas spp, Proteus spp and K. pneumoniae as mentioned. Resistance to the aminoglycosides, amikacin and gentamicin was also considerable especially among isolates of Acinetobacter. Conclusion: The present results in increasing antibiotic resistance trends in UTI patients indicate that it is imperative to rationalize the use of antimicrobials and to use these conservatively
Epidural ropivacaine with fentanyl versus ropivacaine with dexmedetomidine- A comparative prospective randomized control study in lower abdominal surgeries
Get PDFBackground: Epidural neuraxial blockade reduces frequent dosing of analgesics when especially an additive is added epidurally. Epiduralropivacaine provides lesses motor blockade and for lesser duration but it is less cardiac toxic. This prospective study is about comparingadvantages and disadvantages of an epidurally given synthetic opioid, fentanyl or α2- agonist, dexmedetomidine when added with localanaesthetics ropivacaine in lower abdominal surgeries. Aim: To determine and compare the efficacy of epidural ropivacaine and fentanyl withepidural ropivacaine and dexmedetomidine. Materials and methods: This is a comparative prospective randomized control study, approved byinstitutional ethical committee. An individual informed consent was taken from all patients. All patients belonging to ASA grade 1 and 2,between age group of 18 to 50 years undergoing lower abdominal surgeries. Patients with contraindication for epidural anaesthesia, BMI >30were excluded. Total 120 patients undergoing lower abdominal surgeries were divided into Group I (60 Patients, 0.75% Ropivacaine 18ml andFentanyl 25μg epidurally), groupII (60 Patients0.75% Ropivacaine 18ml and Dexmedetomidine 50μg epidurally). Discussion: epidural blockhas advantage of extending analgesia to the postoperative period and has better hemodynamic profile.In this study we are comparing theadjuvants fentanyl and dexmedetomidine when administered with ropivacaine for epidural anaesthesia for infra umbilical surgeries. Conclusion:Addition of dexmedetomidine as an adjuvant to ropivacaine is better than fentanyl in providing sensory block, motor block and the analgesiceffect with side effects that are easily manageable