International Journal of Health and Clinical Research
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Depression in “Alcohol Dependence Syndrome’’: Undiagnosed comorbidity-A cross -sectional study in tertiary care general hospital in Delhi- NCR
Get PDFThis study was done to know and evaluate the presence of Depressive disorder in diagnosed case of alcohol dependence syndrome. A total of 60 cases who met the “ICD- 10 criteria’’ for Alcohol dependence syndrome and acontrol group of 60 subjects from the general population were assessed. This studyfocused on determining the prevalence of Depressive disorder among alcohol-dependentsubjects. A standardized diagnostic tool was used for making the psychiatric diagnosis using ICD-10 DCR. In this study,the frequency of occurrence of depressive disorders in alcohol dependent subjects was: Major Depressive Episode – 15% , Dysthymia –5%
A comparative study between laparoscopic and open cholecystectomy with early post-operative course and complication
Get PDFBackground and objectives: Although laparoscopic cholecystectomy has quickly gained popularity as a viable alternative to open cholecystectomy, it should have a safety profile that is comparable to or better than that of open surgery.The purpose of this study was to compare open cholecystectomy versus laparoscopic cholecystectomy in terms of surgical time, blood loss during surgery, early post-operative course and complication, antibiotic and analgesic requirements, and patient satisfaction after the procedure. Methods: A total of 40 consecutive individuals under the age of 70 who presented with calculous cholecystitis but no evidence of CBD stones were randomised to either open or laparoscopic treatment. Cholecystectomy is a surgical procedure that removes the gallbladder. The information was gathered and examined. Results: Statistically, the two groups were comparable in terms of demographic and clinical characteristics. Complications and blood loss were not significantly different across the groups. In the laparoscopic group, the median duration of pain was 2 days, with a visual analogue scale for pain of grade 2 in the laparoscopic group, but it was 5 days and grade 3 in the open group. The median length of hospitalisation was much lower in the laparoscopic group (median 4 days vs to 7 days in the open- chest group). Conclusion: Most important were the reduced post-operative discomfort and shorter period of analgesia intake, as well as the more quick recovery and shorter hospital stay that resulted from LC
A Hospital Based Cross Sectional Study to Detect Deformities/Disabilities in Patients with Leprosy
Get PDFBackground: Leprosy is a common infectious disease causing as much social problem as a medical one. It leads to variety of disabilities resulting from nerve damage, immunological reactions and bacillary infiltration. Among communicable diseases, it remains a leading cause of peripheral neuropathy and disability worldwide. Disabilities and deformities are of major concern as it triggers social, economic and psychosocial problems of leprosy patients. Early identification can lead to prevention of progression of the deformities and also help in providing rehabilitation in advanced cases. Objectives: To detect deformities and disabilities in leprosy patients and grading them according to WHO deformity and disability grading system (2007). Method It was a hospital-based, cross sectional study. One hundred and forty-six patients with leprosy attending the Dermatology, Venereology and Leprosy out- patient department of a tertiary care hospital were included in the study. Detailed history was taken and all patients were examined for all kinds of deformities of hands, feet and face. Slit skin smear and biopsy was done in all new cases. Results: Among the 146 patients enrolled in the study, 85 were male and 61 were female, 10 were children, with a mean age of 38.1(±15.6) years. The mean duration of disease was 2.6 (±4.1) years. A statistically significant (p <0.001) number of patients with deformity presented to hospital by 2 years of onset. Proportion of deformities was greater in males, in farmers and in people belonging to lower socio-economic status (p=0.008). Multibacillary patients had higher rate of deformities of hands and feet and a statistically significant (p=0.006) number of MB patients had grade 2 ocular deformity (WHO 2007). Conclusion: Various deformities can be detected by clinical examination and simple tests. Early identification of disease and deformities can help in educating the patients about leprosy and thus prevention of progression to adverse sequelae
Diagnostic accuracy of fine-needle aspiration cytology of thyroid gland lesions by using The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC): A retrospective study from January 2019 to August 2021 in tertiary care institute
Get PDFBackground: Fine needle aspiration cytology (FNAC) plays important role in diagnosis of thyroid lesions properly. However conventional reporting method of thyroid cytology do not have standardize format. To overcome this hurdle because of lack of standardization and to facilitate communication between cytopathologist and clinician, "The Bethesda System for Reporting Thyroid Cytopathology" (TBSRTC) was proposed at Bethesda in 2007. Aims: Main Objective of this study was to classify and study thyroid FNACs according to TBSRTC, calculate malignancy risk and to determine the distribution of diagnostic categories and subcategories, to analyze and study cytological features of thyroid lesions. Materials and methods: All the FNAC of thyroid lesions came during January 2019 to August 2021 were classified in to six categories of TBSRTC. Distribution of cases in each category was calculated. Cytopathology analysis was carried out and classified according to TBSRTC categories. Results: During the study period, total of 147 thyroid FNACs were reported according to TBSRTC. Non diagnostic(ND), benign, atypical follicular lesion of undetermined significance(AFLUS), follicular neoplasm(FN), suspicious of malignancy(SM) and malignancy were reported in 6.8%, 80.9%, 0%, 6.8%, 2% and 3.5% cases respectively. Conclusion: Use of TBSRTC guideline for thyroid Cytopathology reporting helps to improve communication and give diagnostic criteria between cytopathologist and clinician leading to most effective management. Also interlaboratory comparative results provide data in a standardize pattern to compare between all different studies related to cytology of thyroid lesions
A Retrospective Analysis of Biopsied Infectious Jaw Lesions in Eastern Indian population
Get PDFBackground: Reports of a series of central jaw tumours in children are uncommon. Hence, there is no way to forecast their biological behaviour, treatment, or prognosis in this region of the world. Purpose: The goal of this study was to find out how common jaw lesions are in Eastern India. Methods: From January 2020 to December 2021, biopsy data and microscopic sections of all jaw biopsies seen in a selected hospital in Eastern India were reviewed. The three primary groups included Group 1 as developmental/inflammatory/reactive lesions, Group 2 as cystic lesions, and Group 3 as tumours and tumour-like lesions. Odontogenic and nonodontogenic subgroups were created from Groups 2 and 3. Results: A total of 385 instances were looked at. There were 385 cases in all, with 115 (29.9%) in group 1, 178 (46.2%) in group 2, and 92 (23.9%) in group 3. Radicular cysts were the most often biopsied jaw lesions (n = 95; 24.7 percent), followed by chronic apical periodontitis (n = 59; 15.3 percent), dentigerous cysts (n = 51; 13.2 percent), and keratocystic odontogenic tumours (n = 30; 7.8%). Chronic apical periodontitis was the most common lesion in group 1 (n = 59; 51.3 percent). Odontogenic cysts (n = 166; 93.3 percent) were more common than nonodontogenic cysts (n = 12; 6.7 percent) in group 2, with radicular cysts (n = 95; 53.4%) being the most common lesions. In group 3, odontogenic tumours (n = 61; 66.3%) were more common than nonodontogenic tumours (n = 31; 33.7%). Keratocystic odontogenic tumours were the most common kind of lesion in this group (n = 30; 32.6 percent), followed by ameloblastoma (n = 17; 18.5 percent). In this study, only three malignant tumours were discovered. Conclusions: Cystic and inflammatory jaw lesions are more common than tumours and tumour-like lesions in India. Periapical inflammation was found to be the most common cause of inflammatory lesions in the jaw. The majority of cystic and tumorous jaw lesions were caused by odontogenic factors. Odontogenic tumours that were locally aggressive were more common than those that were not. Jaw tumours that were malignant were uncommon
Correlation of Inflammation and Anemia in Patients on Hemodialysis
Get PDFIntroduction: Anemia and inflammation are majorly observed complications in patients on hemodialysis (HD). Present study assessed that inflammation that affects the haemoglobin levels in patients with chronic kidney disease (CKD) stage 5 on maintenance HD and to evaluate the degree of anemia.Methods: A retrospective observational study was conducted in CKD patients aged 18-89 years. Previous hospital records were reviewed to note baseline clinical co-morbidities, pre- and post HD -session body weight, dialyzer type, blood flow rate, dialysis time, dialysis prescription (dry body weight, dialysis time, dialysis modality, and dialysate and heparin dose). Results: Out of 46 patients on HD, 31 and 15 were dialyzed with the arteriovenous fistula (AVF) and tunneled cuffed catheters (CTC), respectively. The mean age was 54.59 years and majority had diabetic nephropathy (39.1%). Patients of AVF group showed decreased c-reactive protein (CRP) levels [10.49 (13.25) Vs 26.69 (20.0) mg/L] and higher dialysis vintage (35.50 vs. 15.07 days) as compared to CTC group. A significant negative correlation of CRP with hemoglobin (p<0.0001) and serum albumin (p=0.0005) was observed. CRP levels showed a positive correlation with erythropoietin resistance index (ERI) (p=0.0025). The mean serum CRP levels in patients having hypoalbuminemia (28.87 mg/L) were significantly elevated as compared with patients with normoalbuminemia (10.61 mg/L) (p<0.001). The mean ERI in patients with parathyroid hormone (PTH) value >300 pg/mL was comparatively higher (17.85) as compared to patients with PTH value <300 pg/mL (12.46).Conclusion: Reduced inflammation improves anemia and nutritional status of patients on HD. AVF should be considered as first option for dialysis access
Extradural Hematoma: A Case Series of Patients Presenting To A Tertiary Care Center of Bihar
Get PDFIntroduction: India is undergoing major economic and demographic transition coupled with increasing urbanization and motorization. Among the top ten causes of mortality in the country, head injury was the tenth cause two decades back. The aim of this study was to analyze various causes, clinical presentations, factors influencing presentations and to evaluate the postoperative outcome in patients with head injury with an extradural hematoma before surgery and to formulate recommendations for improvement of therapy and suggestions for the future. Methodology: This is a prospective observational Study which included 50 patients admitted at Patna Medical College & Hospital, Patna, Bihar over the past one year that was January 2022 to December 2022 with head injury, diagnosed to have traumatic extradural hemorrhage. Prior ethical approval was obtained from the institutional Ethics Committee. The study included all patients between age groups of 5 to 70 years. The study evaluated initial outcome, excluding long term outcome. Collected data were entered into and analyzed using Statistical Package for Social Sciences (SPSS) Version 21.0 (IBM, Chicago). Results: A total of 50 cases were included in the study. Maximum patients suffering from EDH were in the age group of 21-30 years. The mean age was 29.3 years with a standard deviation of 8.2 years. There was a male preponderance with a male to female ratio of 5.25:1. The most common mode of injury among the patients was road traffic accident (78%) and 64% of cases of RTA occurred under the influence of alcohol. Conclusion: The present study concludes that, road traffic accident was the commonest mode of causative agent for EDH. Alcohol influence had a significant contribution in the causation, revealed by present study series and proved a social evil. So, early presentation to hospital with mild to moderate GCS has good clinical outcome with minimal disability
Prospective study of homocysteine level in cerebrovascular disease in non diabetic patients at tertiary care centre
Get PDFIntroduction: Stroke is one of the major cause of morbidity, mortality and disability all over the world. There are studies which suggests that elevated serum homocysteine is an independent risk factor for stroke. Various factors have been been proposed by different studies for this. Material and methods: A prospective study was carried on 60 cerebrovascular accident patients over a period of 18 months at Gajra Raja medical college and JAH Group of hospital Gwalior from Jan 2020 to Jun 2021. Clinical information including age, sex, history of current evidence of hypertension (HTN, diabetes Mellitus (DM) , history of cardiac disease, life style, diet pattern, family history of vascular diseases were recorded for all subjects. Serum homocysteine was estimated by enzymatic method. Results: In this study of 60 patients with cerebrovascular accidents, 36 were males and 24 were female patients. Most patients were between 4th to 6th decade of life.There was no statistically significant difference between age/sex and stroke with relation to serum homocysteine. There were 18 out of 40 hypertensive patients who had hypertension. The difference was statistically significant (p value <0.05). seventeen out of 43 patients with vegetarian diet had raised homocysteine level, 5 out of other 17 patients were on mixed diet who had raised homocysteine. The difference was statistically significant (p value<0.05). Nineteen out of 39 patients with sedentary lifestyle had raised homocysteine levels and 3 out of 21 with active lifestyle had raised homocysteine levels. The difference was statistically significant (p value <0.05). Eleven patients were smokers. Out of them 04 (06%) had raised homocysteine level and 49 were nonsmoker patient. Among them, 18(30%) had raised homocysteine level. The difference was statistically insignificant. (p value >0.05). Serum homocysteine levels were elevated in cerebrovascular accident patients significantly, both in cases of infarct and hemorrhage. Further serum homocysteine levels were higher in patients with sedentary lifestyle, hypertension, vegetarian and obesity. Serum homocysteine did not show any relation with age, sex, alcohol and smoking. Conclusion: Hyperhomocysteinemia is an important risk factor for cerebrovascular accidents. Hence, it should be to investigate all cases of cerebrovascular accidents and also in those who are at risk of developingstroke
Morphometric and Volumetric Measurements of the Paranasal Sinuses among the population of the Bareilly region
Get PDFBackground: In the field of sinus surgery and anatomy, the size and shape of the paranasal sinuses vary widely. The volume of paranasal sinuses offers more accurate values and closest to their natural measurements and contributes to diagnosing sinus pathologies. Present study was aimed to evaluate the morphometric relationship between right and left side sinuses and measured the volumetric changes in these sinuses according to the age and gender of the patients. Materials and Methods: The morphometric and volumetric measurement of the paranasal sinuses were carried out with the help of CT scans in 300 patients (163 male and 137 female) considered to have a preliminary diagnosis of paranasal pathology, and direct coronal sections imaging was performed in all patients. In addition, limited axial scans parallel to the orbitomeatal line with the patients in the supine position were carried out whenever required. Reformatted CT images were also studied in all planes. Results: The mean volumes of frontal sinus was 8.3 ± 5.7 cm3, mean volumes of the maxillary sinus was 18.5 ± 6.4 cm3, mean volumes of the ethmoidal sinus was 7.1 ± 4.2 cm3and sphenoid sinus measured as 6.9 ± 4.5 cm3 volume respectively. The gender-wise comparison of volumes of paranasal sinuses was statistically significant (P < 0.05). However, the average volume of paranasal sinuses in elderly patients shown a gradual decrease. Conclusions: The morphometric and volumetric analysis of the paranasal sinuses is, highly variable and dependent on many other structures and probably always will be challenging.The uniqueness of this research study was that the volumetric measurement anatomical changes of the paranasal sinuses could be compared in the direction of the advancing age
An Observational Study To Compare Males And Females Undergoing Thrombolysis For Acute Myocardial Infarction At A Referral Centre Of Bihar
Get PDFIntroduction: Cardiovascular diseases (CVDs) are among the major causes of morbidity and mortality globally. According to a report, ischemic heart disease caused 1.3 million deaths in adults aged 15 to 59 years. With this background, this study was planned to compare effects of gender on outcome of patients presenting with acute myocardial infarction. To remove the effect of age as confounding factors, this study included postmenopausal women and age matched males as the study population. Methodology: An observational follow-up study with 100 postmenopausal women as a study group and 100 age-matched men as a control group (in 1:1 ratio) was undertaken on patients of ACS admitted in the Department of Internal Medicine of Nalanda Medical College and Hospital, Patna, Bihar, India. The study duration was 1 year from January 2021 to December 2021. Postmenopausal women above 45 years of age and men more than 45 years of age diagnosed with ACS (as per European society of cardiology guidelines), [29] were included in the study. The diagnosis considered for inclusion was ST elevated acute myocardial infarction presenting to the hospital within 12 hours of onset of pain. Collected data was entered and analyzed using Statistical Package for Social Sciences (SPSS, IBM Chicago) ver. 21.0. Results: The mean age of postmenopausal women in the study was 62.7 ± 7.1 years and of men was 61.9 ± 8.2 years. Chest pain was the predominant symptom among both women and men. Previous myocardial infarction (MI), smoking and heavy alcohol consumption, and obesity were significant risk factors among men compared to postmenopausal women, while hypertension was the most common risk factor among women. Both hypertension and diabetes were seen more among women compared to men, however not statistically significant. Conclusions: Public awareness on identification of such symptoms can reduce the pre-hospital delay which is an important determinant of morbidity and mortality in ACS