International Journal of Health and Clinical Research
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A comparative study of theta wave in quantitative EEG among ADHD children with or without methylphenidate treatment
Get PDFAims and Objective: To assess and compare QEEG findings (mean absolute power values of theta wave) between Patients on Methylphenidate and Drug naive ADHD patients. Methodology: A total no of 78 participants included in the study 26 in each group (Drug naïve ADHD children, ADHD children taking methylphenidate more than 3 months and healthy controls). Participated in the study after taking informed consent, scalp EEG was done and then fourier transformation was done by using BESS (brain electro scan software) of the Axxonet System (India).Statistical analysis was done using SPSS software. Results: In QEEG, mean absolute power value of theta wave found increased in frontal area electrodes in ADHD children comparing to ADHD participant who were on methylphenidate treatment more than 3 months, which was statistically significant. Conclusion: Use of Quantitative EEG can allow researchers to more precisely understand the brain origins and increase understanding of Pathophysiology
Drug emergent metabolic syndrome among patients taking olanzapine: A prospective interventional study
Get PDFIntroduction: Olanzapine is one of the most commonly used atypical antipsychotic and is associated with significant deterioration of the metabolic profile among the patients taking it. Aim: To assess the emergence of drug induced metabolic syndrome among patients taking olanzapine. Materials and method: Eighty cases with diagnosis of Schizophrenia, schizoaffective disorders, bipolar affective disorder, persistent delusional disorder, unspecified nonorganic psychosis and no history of treatment with atypical antipsychotics in last 6 months were recruited from outpatient/ inpatient department of Institute of Mental Health, Amritsar, by purposive sampling after baseline screening and applying inclusion and exclusion criteria. It was a Prospective Interventional study. Patients were assessed for their metabolic profile at baseline, 2- and 4- months. Result: Statistically significant difference was found in all the metabolic parameters, including body weight, blood pressure, BMI, fasting blood glucose, fasting triglycerides and fasting HDL, after 4 months of initiating olanzapine as compared to baseline. One-fifth of the patients had attained the criteria of metabolic syndrome at the end of four months, and this ratio showed minimal variation with gender. Conclusion: Metabolic impairments have become a persisting menace with currently preferred patterns of lifestyles and drug management. Psychiatrists must be vigilant enough towards the potential metabolic side effects of antipsychotic medications so that appropriate precautions can be implemented in a timely manner. The general treatment provided to patients with severe mental illness should be at par with care provided to other patients
Incidence of failed subarachnoid block in patients undergoing caesarean section
Get PDFBackground: The narrowest, and perhaps most specific, definition of a failed spinal blockade was developed by Praxedes and Filho (2010). Neuraxialanaesthesia is the commonest, safest, and most logical choice of anaesthesia for caesarean section. Prevention of injection of wrong drug is of utmost importance. Apart from failure, wrong drug injection can cause maternal mortality (e.g., tranexamic acid.). Such errors are unpardonable and must be avoided by double checking of drugs before injection, use of prefilled syringes, and use of luer-lock connection. Objectives: To determine the incidence of failed subarachnoid block in patients undergoing caesarean section and to identify the contributory factors to the failure. Methods: The study was conducted on 1000parturientsundergoing caesarean section under single-shot spinal anaesthesia. Study women underwent either elective or emergency caesarean section with ASA II-III. 25 or 26 G Quincke type short beveled spinal needle was used. After confirmation of free-clear flow cerebrospinal fluid was confirmed the volume 0.5% hyperbaric bupivacaine decided by one attending anesthetist was injected slowly into intrathecal space. Results: Majority of patients were below 35 years (86; 86%).32% had previous caesearean section and 68% patients belong either to primigravidae or had no surgical intervention in previous deliveries. Out of 1000 patients, 4% parturients had a history of failed spinal anaesthesia. The incidence of failed spinal was 19%, highest in L3-L4 interspace, followed by 1% in L4-L5 interspace. Among the anaesthetists, the incidence of failed spinal anaesthesia was observed higher when junior resident performed the lumbar puncture as compared to certified anaesthetists. Conclusion: Greater prevention efforts by anaesthesia professional to avoid spinal anaesthesia failure will most likely lead to an improvement in failure rates. A decrease in failure rates can greatly improve the safety, care, and outcomes for the parturient and fetus
An Attempt to Compare Clinical Methods and Sonological Estimation of Fetal Weight among Term Pregnant Women at a Tertiary Care Hospital of Bihar
Get PDFIntroduction: Birth weight is the greatest single factor in the survival of fetus and important factor of neonatal problems. The objective of this study was to assess the fetal weight in term pregnancies by clinical methods and by ultrasound using Hadlock’s formula and to assess the accuracy of these methods when compared to neonatal weight. Material and Methods: A prospective cross-sectional hospital based study was conducted by the Department of Obstetrics and Gynecology, Darbhanga Medical College and Hospital, Laheriasri, Darbhanga, Bihar, India. The study was conducted over duration of eighteen months between July 2020 to November 2021. 150 women were recruited for the study, but only 121 completed the study. These patients who were selected from antenatal clinics and maternity wards had their last fetal weight estimation done within one week of delivery. The study was approved by institutional ethics committee. Detailed obstetric and menstrual history was taken. The duration of gestation was calculated according to Naegle’s rule or by first trimester scan report. Fetal weight was estimated by clinical methods and by ultrasound. Results: A total of 121 consecutive women were studied. Most of the women were between 21-30 years of age and primigravida. Post-delivery, the actual birth weight of babies was between the 1900 Grams to 4150 Grams. Mean birth weight (rounded off) was 2850 ± 623.8 Grams. Maximum babies were in range of 2501 -3000 gram, followed by 3001-3500 grams. Results of the correlation analysis showed that there is a significant relationship between estimated and actual birth weights for all the methods. Conclusion: Based on this finding, combining the different methods of fetal weight prediction to improve their overall accuracy may be possible
Immunohistochemical loss of expression of estrogen receptor beta as a significant diagnostic marker in prostatic carcinoma
Get PDFBackground: Prostate is the site of two of the most common diseases in elderly men, BPH and Prostatic adenocarcinoma(PCa). Androgen dependency of prostate has long been known. But, role of estrogen in prostate and human prostate carcinogenesis has only been recently recognized. Estrogen receptor(ER) has opposing effects in prostate via two isoforms ER α and β. Current studies suggest that decreased expression of ERβ is associated with PCa, while ERα is oncogenic. But, some studies in literature showed that ERβ2 and ERβ5 promote invasion and metastasis in PCa.This study was done to evaluate and correlate the patterns of immunohistochemical expression of ERα and ERβ in patients with PCa, prostatic intraepithelial neoplasia (PIN) and BPH. Materials and methods: This study includes 69 cases of prostatic lesions, including 23 PCa and 46 BPH cases. We have done IHC with 4 markers including, p63, AMACR, ERα and ERβ in sections from formalin fixed paraffin blocks of tissues from all 69 cases. Results: IHC expression of p63, AMACR and ERβ showed statistically significant difference between PCa and BPH cases, at p value <0.005. All PCa cases showed p63-ve and AMACR +ve immunostaining and vice versa was true in all BPH cases. PCa cases showed lower ERβ expression in both epithelial and stromal compartments compared to BPH cases. No significant difference in expression of ERα between PCa and BPH cases. Conclusion: ERβ may have an antiproliferative role in prostate carcinogenesis and may be targeted for newer therapeutic options
Surgical Site Infections(SSI) in Non Traumatic Abdominal Operations
Get PDFBackground: Nosocomial infections are a matter of immense concern to healthcare sector. Control of SSI is an important area for improving quality in health care sector. Hence its important to analyse the magnitude of the problem, study preventive measures and apply them in day to day practise in health care set up. Aims and Objectives: To study incidence, evaluate risk factors of SSI and formulate preventive strategies in surgical and gynecological wards of Rajendra Institute Of Medical Sciences, Ranchi, Jharkhand. Methodology: Cross sectional study(March 2019-February 2020). Results: Most of the patients were from 20-49yrs.(75.8%). Male-female ratio was 1.42:1. Most incidences of SSI was found in duodenal ulcer repair for perforation(50%), herniotomy and herniorrhapy (42.86%), resection of volvulus of sigmoid colon(42.86%)..Cases operated by junior resident 1 (50%) and junior resident 2(64.29%) had most incidences of SSI. Extended midline incisions (45.45%) had maximum SSI and pfannensteil (21.05%) had least when taking out percentages from respective operative incisions. E.coli(muddy thin pus) was mostly present (44%) among pus discharges from wound site. Conclusion: The overall incidence of SSI was 27.42%. The risk factors associated with SSI were: length of preoperative hospital stay greater than 24 hours; a longer duration of surgery; level of contamination, comorbidity of patient, expertise of surgeon, delay in initiating surgery and level of contamination. It is important the early recognition of the risk of developing SSI in patients undergoing surgery, so that preventive measures can be adopted with the aim of reducing surgical site infections
A study of histopathological spectrum of breast lesions
Get PDFIntroduction: Breast lesions is a common problem. Incidence of benign breast lesions begins during second decade of life, peaks in fourth and fifth decade. Increased risk of breast cancer is associated with proliferative and atypical hyperplasia. Diagnostic modalities like mammography, ultrasonography, FNAC, Tru-cut biopsy are used. According to Indian Council of Medical Research Statistics, 10,000 breast cancers are being diagnosed every year in India, with more than 70% diagnosed at advanced stages. Hence, the histopathological spectrum of the breast’s neoplastic and non-neoplastic lesions was planned for better evaluation. Aim: This study evaluates the frequency, age, gender, and histopathological profile of non-neoplastic and neoplastic breast lesions. Material and Methods: This study includes patients with breast disease admitted to the surgery department, MBS Hospital - Kota, Rajasthan from January 1, 2017, to December 31, 2019. The histopathological diagnosis is based on pre-operative fine needle aspiration cytology and histopathology of a post-operative specimen. Results: A total of 602 patients with breast lesions were admitted, including 588 females (97.67%) and 14 male patients (2.32%). Peak age of lesions was 15years to 25 years (36%) including neoplastic and non-neoplastic lesions. Among 439 benign lesions, 216 lesions were fibroadenoma (49.20%), 85 were Breast abscess (19.36%), 13 were fibroadenosis (2.96%), 2 cases of duct papilloma (0.45%), 2 cases of benign phylloid (0.45%). Among 163 patients (27.08%) of neoplastic lesion, 141 were invasive duct carcinoma (86.50%). Conclusion: The pattern of breast lesions was obtained with valuable information concerning clinico-pathological profile of breast lesions
Comparative evaluation of efficacy and safety of Atracurium besylate and different doses of Cisatracurium besylate using peripheral nerve stimulator
Get PDFBackground and Aims: Neuromuscular blockers have become essential part of anaesthesiologist armamentarium. They aid endotracheal intubation, mechanical ventilation, reduce anaesthetic requirement, prevent patient movement and facilitate surgery. The ideal neuromuscular relaxant is an agent which has a quick onset time and short duration of action. We compare the efficacy of Atracurium besylate and different doses of Cisatracurium besylate in patients undergoing elective abdominal surgeries under general anesthesia, Considering onset time, intubating conditions and duration of action. Material and methods: Randomized trial was conducted in ninety patients of ASA grade I and II ,posted for elective abdominal surgeries were randomly allocated into three groups, of 30 patients each, depending on muscle relaxant and its doses used for intubation. Results: In present study, we found that cisatracurium with the dose of 0.2 mg/kg B.W. is better neuromuscular blocking agent for intubation than cisatracurium 0.1mg/kg B.W. and atracurium 0.5 mg/kg B.W. Conclusion: Faster onset, longer duration of action with larger doses of cisatracurium and with good to excellent intubating conditions makes cisatracurium a more promising alternative muscle relaxant agent for tracheal intubation in clinical practice
A cross sectional study of expression of CK-19 in papillary thyroid carcinoma and its association with prognostic factors
Get PDFIntroduction: Thyroid malignancies are the most common endocrine malignancy. The most common malignancy in thyroid is papillary thyroid carcinoma. About 80% of all thyroid cancers are papillary carcinoma thyroid. Papillary carcinoma typically arises as an irregular, solid or cystic mass that comes from otherwise normal thyroid tissue. Papillary carcinoma has a high cure rate with 10-year survival rates for all patients with papillary carcinoma thyroid estimated at 80% to 90%. Materials and Methods: The study was undertaken in the Department of Pathology, Jangaon district hospital, Jangaon. The study was conducted from January 2020 to December 2020. A total of 46 cases including 29 cases of papillary carcinoma thyroid, 17 cases of papillary hyperplasia. Papillary carcinoma and its variants, Beningn lesions with papillary hyperplasia was included. Other malignancy including follicular carcinoma, medullary carcinoma without papillary areas, Benign lesions without papillary hyperplasia were excluded from the study. Results: In this study most of the papillary carcinoma of thyroid occur in the age group between 20-50 years. Most of the cases were diagnosed mostly 3 rd to 5th decades. In males, out of 29 cases 5 cases were males, mostly occur above 40 years. The mean age group is 43.9 years. In this study most of the papillary lesions arises from solitary nodular swelling, in our study out of 29 cases of papillary carcinoma 19 cases arises from solitary nodular swelling,5 cases from multinodular swelling , 5 cases from diffuse thyroid lesion. Conclusion: In our study most of all papillary carcinoma and its variants shows diffuse and strong positivity against anti ck 19 antibody. Papillary hyperplasia shows negative stain except 2 cases. We conclude diffuse and strong positivity confirms that the diagnosis of papillary carcinoma thyroid. Negative stain indicates it is a benign lesion. Cytokeratin 19 is a useful marker to differntiate papillary carcinoma from other benign lesions shows papillary hyperplasia
A prospective clinical and micro-pathological study of fungal infection of ear, nose and throat in a tertiary care hospital
Get PDFIntroduction: Fungi are ubiquitous in the environment. Human beings are constantly exposed to their infection daily. The upper respiratory tract, i.e. ear, nose and throat are constantly exposed to various airborne fungal spores. Over 1,00,000 species of fungi have been described of which only 100 are recognized as pathogenic for human and animals. Materials and methods: This prospective consecutive study was done in Department of ENT, Central Hospital Ramgarh, Ramgarh. Written informed consent was taken from every patient before start of study. The study comprised of 136 patients were selected from the Outpatients Department of Otorhinolaryngology after confirmation of fungal infection. The study was carried out for a period of eight months (from July 2020 to February 2021). Results: Predisposition factors and organism isolation in ear, nose and throat of patients were showed in their percentage. Conclusion: It may be concluded that Aspergillus species were most common isolated organism in ear and nose sinusitis. Candida ablicans was common isolated organism in throat. Dentures were causative factor in establishing Candida infection. Medical therapy has begun to shift an emphasis from systemic antifungal therapy to various forms of topical treatment and immunomodulation