International Journal of Health and Clinical Research
Not a member yet
3275 research outputs found
Sort by
Study of Cystatin–C and its association with urinary citrates in diabetic Nephropathy
Get PDFDiabetic nephropathy is occurs due to severe complication of diabetes mellitus and its has been identified as a risk factor for cardiovascular disease (CVD) related outcomes including mortality heart failure, myocardial infarction and stroke . Metabolic changes associated with diabetes lead to glomerular hypertrophy, glomerulosclerosis, and tubule-interstitial inflammation and fibrosis. There is more risk of diabetic renal disease onset and progression with current therapies for diabetes mellitus. Hence, widespread innovation is immediately needed to improve health outcomes for patients with diabetic renal disease and can reduce chances of diabetic nephropathy. Cystatin-C is a 13 kDa cysteine protease inhibitor that is produced by cells throughout the body. Cystatin-C is abundant in serum/plasma and is readily filtered at the glomerulus. Serum levels of cystatin-C have been proposed as a useful marker to estimate glomerular filtration rate. So the the present study is aimed to evaluate the possible association between cystatin–C and urinary citrate along with other biochemical parameters in diabetic nephropathy patients. A total 46 diabetic nephropathy patients and 46 healthy ages matched; individuals between the ages of 35 to 45 years were selected for this study. All the parameters are analyzed by conventional standardized methods and compared between the two groups. The student ‘t’ test was applied for the statistical analysis and the results were expressed in mean ± SD and p <0.001 were considered as highly significant. The mean levels of cystatin –C levels were increased ,urinary citrates are significantly reduced and micro protein, urinary protein creatinine ratio and micro-albumin are significantly elevated in the diabetic nephropathy patients when compared to control group
Comparative study of limberg’s rotation flap versus karydakis procedure in pilonidal sinus surgery
Get PDFIntroduction: Pilonidal sinus regularly affects upon young males. Various etiological speculations and treatment techniques have been depicted for treating sacrococcygeal pilonidal disease (SPD), prompting ceaseless discussions about the best treatment methodology. This review was directed to look at the short and long-haul inconveniences and aftereffects of the Limberg flap with that of the Karydakis flap as cosmesis, recurrence and wound mending. Objectives: In this forthcoming randomized review, 54 patients with SPD were conceded to go through either the Karydakis flap (n = 27) or the Limberg's flap (n = 27) method amidst July 2019 and July 2020. Methods: The mean employable time for the Limberg group (55.15 ± 7.65 minutes) was more limited as compared to the Karydakis group (46.55 ± 9.5 minutes) (P). The inconvenience rate for the the Limberg group (n = 7) [26%]) was higher as compared to Karydakis group (n = 4) [14%]) (P). The visual simple scale score for post-operative agony at the activity site on the 30th day was higher in the Limberg group as compared to the Karydakis group (3.55 ± 1.25 versus 2.44 ± 1.11, P .01). The visual simple scale score for cosmesis of scars in the Karydakis group was 7.78 ± 1.92, while it was 3.47 ± 1.54 in the Limberg group at the third month (P). Length of clinic stay was fundamentally less limited in the Limberg group as compared to the Karydakis group (3.8 1.19 versus 3.40 .94 days, P<.03). Just four patients in the Karydakis group created repeat (3%), while 9 patients did as in the Limberg group (P <.151). Conclusion: Karydakis flap ought to be the favoured strategy than Limberg flap for treating simple SPD for its more limited activity time, lower torment score, more limited length of clinic stay, lower early postoperative inconveniences, and better superficial result. As far as disease repeat, no distinction was found amidst the two careful methods
Role of Blood urea nitrogen (BUN)/ Serum creatinine ratio and urine specific gravity for Early neurological deterioration in patients with Acute ischaemic stroke
Get PDFBackground: Early neurological deterioration (END) after ischemic (stroke-in-development [SIE]) is related with less fortunate results. Past investigations have exhibited a connection between status of hydration and the improvement of SIE. In this study, we tried the speculation that rehydration treatment, managed based on urine specific gravity (USG) discoveries, may lessen the advancement of SIE. Research have been done conducted previously on the danger elements for mortality in sepsis patients. In any case, there has been no epidemiological study examining the ramifications of blood urea nitrogen (BUN)/creatinine proportion (BCR) on the visualization of basically sick sepsis patients. Methods: The present investigation is an observational prospective study where a study investigation of convalescents with Acute Ischaemic Stroke between June 2021 and October 2021 had been conducted. Patients with recently analyzed AIS who experienced delayed hospitalization for somewhere around a month were considered for this study. Results: Among the 183 patients who had been enrolled in this study, Early Neurological Deterioration was detected among 38 (21 %) patients. This study found the National Institutes Health Stroke Scale score to be a dissociated risk element. Among the markers of relative dehydration, BUN/ creatinine was determined as a dissociated risk element. Along with this, hypodensity size and brain edema of the middle arteria cerebri territory on brain CT was observed as dissociated endangerment. Conclusions: This study has call attention to a possible relationship between relative dehydration with END alongside other parameters vis-à-vis stroke severity, extent of hypodensity, and brain edema
Comparision between transabdominal and transvaginal sonography in various gynecological disorders
Get PDFObjectives: To assess the diagnostic accuracy of Transvaginal sonography as compared to transabdominal sonography in various gynecological disorders. Methodology: Total number of 100 patients attending OPDs with various complaints were selected by random technique of the study. All the patients have informed consent and thorough clinical examination including general, systemic and pelvic examination was conducted after taking a detailed history then the patients underwent transabdominal sonography and transvaginal sonography followed by one of the procedures like fractional curettage, dilatation and curettage and abdominal hysterectomy (with or without conservation of ovaries) or conservative management with regular follow up. Results: Our analysis, showed that transvaginal sonography had high diagnostic accuracy when compared to clinical examination 70% of fibroid, 8% of ovarian cyst, 100% paraovarian cyst, and 66.6% cases of endometrial polyp were missed by clinical examination. 50% of PID were misdiagnosed by clinical examination which were diagnosed as ovarian cyst. There was statistical significant difference of TAS findings with TVS findings of patients (P< 0.05). There was statistically highly significant difference of clinical findings with TVS findings of the patients (P<0.01). Conclusion: The final outcome is that transvaginal ultrasonographic examination is an important non-invasive investigation, can be used as important diagnostic method in various gynecological disorders as it has got a high diagnostic accuracy in small pelvic masses where transabdominal sonography is helpful in evaluating large pelvic masses
Barotrauma, timing of Tocilizumab and Invasive ventilationas predictors of mortality with inflammatory markers and comorbidities in critically ill COVID-19 patients: A retrospective study
Get PDFBackground-Invasive mechanical ventilation is one of the important parameters inpredicting mortality.Mechanically ventilatedCOVID‑19 patients are at a higher risk of barotrauma. Objectives- to determine we the outcomes, factors and predictors associated withintensive care unit (ICU) mortality among critically illCOVID‑19 patients. Methods- A retrospective, observational study conducted in a tertiary level ICU.After approval of the hospital ethics committee, thedata of COVID‑19 patients requiring ICU admissionbetween February 2020 and November 2020 wereanalysed. A total of 563 patients were admitted and included in the study. Universal sampling was done. SPSS (version 22.0) was used for analysis. Results-563 COVID‑19 patients who required ICU admissionswere analysed. Their mean age was 55.9 ± 14.0 yearsand 72.8% of them were males. Hypertension (39.6%)and diabetes (36.6%) were the major comorbiditiesobserved.We observedbarotrauma in 12 (2.1%) patients. A higher proportionof non‑survivors had barotrauma than survivingones (4.3% vs. 1.4%, P = 0.040).we observed no significant difference in survivorsand non‑survivors with respect to the use oftocilizumab (P = 0.07). Conclusion-higher age, the presence of comorbidities, increasedlevels of inflammatory markers, use of mechanicalventilation, barotrauma and the timing of tocilizumabare associated with an increased risk of in‑hospitalmortality in COVID‑19 patients. It is recommended thatfollowinggentlesuctioning of ventilated patients, close monitoring ofrespiratory rate and tidal volume during weaning, andthe judicious use of cough suppressants may reducethe risk of barotrauma
Clinical and Epidemiological study of Landry Guillian – Barre’ syndrome and its Complications
Get PDFBackground- Acute inflammatory polyradiculoneuritis, the Guillain-Barre’ Syndrome (GBS) has come to be accepted as a clinical entity, although the boundary between it and chronic inflammatory demyelinating polyneuropathy has given rise to discussion. Objectives-To study the various epidemiological, clinical features of patients admitted with Guillain-Barre’ Syndrome and complications in these patients. Methods-All adult patients, diagnosed as Guillain-Barre’ Syndrome, who strictly complied with the NINCDS criteria, admitted to Christian Medical College and Hospital, Ludhiana from 1st July 1988 to June 30th 1993 were included in this study. This includes a retrospective study of four years and prospective study of one year. Ninety seven patients entered the study. SPSS(Version 22.0) was used for analysis. Results-the incidence of GBS was more in the younger group. 70% of our cases were below 40 years of age. 80.34% were males and 19.65% were females.The agriculturists formed the maximum number of patients (32%) under study followed by students (22%) and house wives (16%).upper respiratory tract infection was present in the maximum number of patients (72.8%).dysautonomia was seen in 54.6% of patients. Twenty one patients (21.6%) received prednisolone and 4 (19%) of the groupexpired. 76 patients (78.2%) did not receive prednisolone and 21 (27.6%) patients expired in this group. Conclusion-There was no significant difference in the outcome of patients who received and who did not receive prednisolone as the treatment modality
Cutaneous and Ocular Menifestations of Herpes Zoster Opthalmicus: A Hospital Based Study
Get PDFBackground: Herpes Zoster Ophthalmicus (HZO) occurs due to reactivation of latent varicella zoster virus within the gasserian ganglion involving the ophthalmic division of the trigeminal nerve. HZO often has a chronic course with significant ocular morbidity as eye is considered potentially serious of all sites of herpes zoster owing to its delicate nature. AIM: A hospital-based epidemiology study to describe skin and ocular changes in herpes zoster ophthalmicus (HZO), its prevalence and risk factors. Material and Methods: A Retrospective analysis of patients seen in the ESICMC,KALABURGI from September 2019 to September 2021 with a clinical diagnosis of HZO. They were subjected to a detailed general and ocular examination and were treated medically with close follow Results: A total 38 patients with HZO were included in the study. Which is 10% of the total cases of herpes zoster. The mean age of onset( 23-80) was 65. Most patients were immune competent (83%) and presented on day 2 day 5 of illness. Male had more prevalence than females . Majority had initial presentation of vesicles, (70)%followed by pain. Eye manifestation was observed in 68% of the individual. Conjunctiva (60%) was the most common ocular structure involved followed by Cornea (45%). Anterior uveitis (20%) was complicated by hemorrhagic uveitis and orbital apex syndrome with total external ophthalmoplegia. Post herpetic neuralgia was the commonest complication seen . Conclusions: This study highlights the prevalence of HZO, presentation,risk factors, course of the disease and its ocular involment. .The potential manifestations of HZO are myriad. Development of serious inflammatory complications was associated with delay in therapy. Hence timely diagnosis and management are critical in limiting ocular morbidity
A study to evaluate the efficacy of left lateral tilt in preventing hypotension after spinal anesthesia in elective caeserian section patients
Get PDFIntroduction: During caesarean delivery, post-spinal hypotension is a typical complication among women. Post-spinal hypotension is thought to be caused by Aortocaval compression caused by the fetus. It's unknown whether left lateral tilting improves maternal cardiac output following “subarachnoid block (SAB)”. The goal of this study is to see the efficacy of the left lateral tilting in preventing hypotension after spinal anesthesia in elective C- section patients . Material and Methods: We piloted a prospective study with 50 age matched subjects admitted for the C-section. The clinical findings like systemic vascular resistance, stroke volume, cardiac output, heart rate and Mean arterial pressure that are affected at the various lateral tilts of (30º,15º) were compared to supine position. The values were collected preoperatively, after the SAB and after the delivery. The data was analyzed using the ANOVA test deliberating P<0.05 as significant. Results: We observed no significant difference in the cardiac parameters before the surgery between the supine and for the lateral tilt angles of 15 and 30 degrees. However after the anesthesia significant variation of the cardiac parameters was noted in the supine position than supine position before the SAB. While after the SAB in the lateral tilt the MAP, Cardiac output, and Stroke volume were significantly greater compared to the supine position at both the angles of the left tilts. There was no difference in the values between the two tilt positions. After the delivery MAP, Cardiac output, and Stroke volume significantly increased in the supine position while the heart rate lowered significantly compared to the supine position after the SAB. Conclusions: The hypotension commonly seen among the pregnant women after the SAB can be prevented by the lateral tilt positions at both the 150 and 300 angles. Hence this position is encouraged for the after the C-section
Study of dermatological manifestations in neonates attending a tertiary healthcare centre
Get PDFBackground: Skin of newborn can be a considerable source of information about infant’s health and promptly alerts the physician regarding serious diseases. Since neonatal skin and adult skin differ in physiology and pathological presentations, neonatal skin conditions require special attention. Aim: This study highlights the pattern of various neonatal dermatoses in a tertiary care healthcare center. Materials & Methods: The study was conducted in a tertiary healthcare center where 804 neonates delivered/visiting in the institute were included and observed for any kind of dermatological condition. After taking informed consent from parents, thorough examination was done and observations were noted in a preset proforma. Result: Among the patient in our study, males were 54% (324) and females were 46% (276). Overall most common neonatal dermatoses was desquamation of skin (396, 66%) followed by Mongolian spots(390,65%), Erythema toxicum neonatorum (162,27%), sebaceous gland hyperplasia (120,20%). The most common dermatoses in full term neonates were Mongolian spots(354,73.8%), desquamation of skin (324,67.5%), ETN(162,33.8%) while in pre term babies, desquamation of skin was followed by SGH, physiological jaundice, Impetigo and Mongolian spots. (24,26.7% each). Conclusion: Skin disorders in neonates require considerable knowledge of pediatric medicine. Hence, the study assesses the pattern of neonatal dermatoses
observational study on the relationship between vitamin d level and hip fractures
Get PDFBackground: Vitamin D (25OHD) is essential for maintaining calcium homeostasis and inadequate levels have been associated with negative musculoskeletal as well as extraskeletal effects. Individuals at especially high risk of developing hypovitaminosis D are the elderly. Hip fractures are devastating injuries that most often affect the elderly and have a tremendous impact on both the health care system and society in general. Aims: To identify patients with hip fractures and to attain the vitamin D levels in these patients. To correlate the between the hip fractures and levels of vitamin D and evaluate factors associated with the same study subjects. Materials and methods: The study was a descriptive type of study and was conducted between October 2019 and July 2021 in Dr VRK Womens Medical College and Hospital & SIMS, Hyderabad. Patients who fulfilled the inclusion criteria, were included in the study. Once the diagnosis of hip fractures were made then following test were done on day one of admission -Haemoglobin, Calcium, Phosphate, ALP, Vit D by CLIA method. Results: In this study we found that male were 39 patients and female of 41 patients, this shows almost equal prevalence of hip fractures in both males and females. The age in this study showed a mean of 69.91 overall, 68.51 and 70.74 for male and female patients respectively. Range was between 51 to 94 for both male and female patients. This study shows that the frequency of hip fracture in males and females were comparable and most of the patients presented to the hospital between 2nd to 7th day post injury .the most common co-morbidity was Diabetes Mellitus and many had more than one co-morbidity. It was also noted that anaemia was prevalent in both male and female patients and the overall vitamin D deficiency was 79% of the total no of patients with more predominant (51.25%) in female patients. Conclusion: The vitamin D status and other parameter were studied in this study which was conducted in Dr VRK Womens Medical College and Hospital. Treatment of the vitamin D deficiency decreases the chances of fall, morbidity condition and financial burden on the patient when fractures occur. The treatment of vitamin D deficiency will improve the quality of life overall. Hence the need for food fortification and supplementation in elderly indian population[1-5]