International Journal of Health and Clinical Research
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Socio-demographic Profile of Victims of Fatal Head Injury in Road Traffic Accidents: An Autopsy-based Study
Get PDFIntroduction: Road Traffic Accidents (RTAs) have emerged as a new health challenge in the world which not only leads to injuries, disabilities and loss of precious human lives but also imparts a substantial economic burden on the family concerned and the nation as whole. As progress is made in the prevention and control of infectious diseases, the relative contribution of deaths from non-communicable diseases and injuries has increased. Road traffic injuries are the eighth leading cause of death for all age groups. Material and methods: This one year study was conducted in Department of Forensic Medicine & Toxicology, Mahatma Gandhi University of Medical Sciences and Technology. During this period 192 deaths were due to road traffic accident out of this 117 were as a result of fatal head injuries. Results: In the study 80% were males and 20% were females. Majority of subjects were belonging to age group of 31 to 40 years (24.8%), followed by 21 to 30 years (20%). There was no significant difference in age and gender distribution. 81.2% Subjects were brought dead and 18.8% were died after admitted to hospital. Conclusion: Road are like arteries of country. Vehicles must run for development of country and necessities of life. Injuries on head and other parts of body due to road traffic incidents are unavoidable but with scientific data, we can minimize the loss of life and misery due to death and injury. We should design our interventions based on these data and studies
Comparision of 1% chloroprocaine and 1% chloroprocaine with fentanyl in infraumbilical surgical procedures under spinal anaesthesia
Get PDFBackground: In the ambulatory setting, day by day there is an increase in the use of spinal anaesthesia. Antioxidant- and preservative-free form of 2-chloroprocaine (1%) has been re-emerged as a short-acting local anesthetic for use in spinal anesthesia.In this study,we evaluate the efficacy of 1% Chloroprocaine and 1 % Chloroprocaine with Fentanyl in spinal anaesthesia and any untoward side effects and complications associated with the study drugs and technique. Material and Methods: For this prospective, ramdomizes ,comparative study we recruited a total of 100 adult patient for infraumblical surgeries under spinal anaesthesia were randomly divided into two groups (n=50 each).Group C (n=50) received 30 mg 1% chloroprocaine with 0.5ml normal saline and Group CF (n=50) received 30 mg 1% chloroprocaine with 25mcg Fentanyl (0.5ml). Result: Faster Onset of sensory and motor blockade was seen in the group CF duration of spinal anesthesia and sensory and motor block duration is prolonged in group CF.(p<0.001) Duration ofanalgesia was significantly prolonged in the group CF when compared to group C(87.5±11 vs132.5±4.9min p<0.001) hemodynamic parameter insignificant with less side effect in both group. Conclusion: The addition of Fentanyl to intrathecal 1% chloroprocaine will increase the duration and quality of both sensory and motor blockade in spinal anaesthesia as compared to 1% chloroprocaine alone
Study of Renal Volume and Functional Changes in Unilateral Nephrectomy –Our Institutional Experience
Get PDFIntroduction: A nephrectomy is the surgical removal of a kidney, performed to treat a number of kidney diseases including kidney cancer. It is also done to remove a normal healthy kidney from a living or deceased donor, which is part of a kidney transplant procedure. Both size and functions, primarily glomerular filtration rate (GFR) and renal plasma flow (RPF), increase almost immediately following unilateral nephrectomy. Aim: To determine short term differences in contralateral renal function and volume in unilateral nephrectomy patients in our institution. Material and Methods: This is a prospective study, Observational and cross-sectional study of all patients who undergo nephrectomy for renal transplantation, malignancy and other renal diseases at Tertiary Care Teaching Hospital over a period 1 year. A total of 62 patients who undergo open or laparoscopic nephrectomy have been assessed during the study period. The detailed history of all patients has been recorded. Results: We evaluated a total of 62 patients who underwent nephrectomy for various reasons. In all types of nephrectomy, groups post nephrectomy improvement in GFR and kidney volume to a varying extent was noted. When compared to the other two groups donor nephrectomy group is showing higher postoperative GFR with kidney volume and more improvement as compared to their preoperative values. The mean difference is shown in the table for each nephrectomy group, and for each group, it has a p-value <0.05. Similarly, for RPV improvement donor nephrectomy group shows the highest mean difference, and the diseased nephrectomy group shows the lowest mean difference. The difference in means of all nephrectomy is significant and has p-value <0.05. Conclusion: The DTPA-GFR and RPV of contralateral kidney increased steadily after surgery in all nephrectomised groups. Difference in functional and volumetric outcome after unilateral nephrectomy, can be arranged in decreasing order as donor nephrectomy group, radical nephrectomy group and then diseased nephrectomy group. The change in RPV and GFR of contralateral kidney after nephrectomy will help to predict compensatory response in healthy as well as co-morbid patients
Screening of gestational diabetes mellitus (GDM) and gestational glucose intolerance (GGI) in pregnant woman from rural population
Get PDFIntroduction: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance with recognition or onset during pregnancy irrespective of treatment with diet or insulin.1 Maternal metabolic adaptation is to maintain mean fasting plasma glucose of 74.5 +/- 11 mg/dl and postprandial peak 108.7+/- 16.9 mg/dl.1 This fine tuning is possible due to compensatory hyperinsulinemia as normal pregnancy is characterized by insulin resistance. Pregnancy induces progressive changes in maternal carbohydrate metabolism. Materials and Methods: The present study was a cross sectional study undertaken to study prevalence of gestational diabetes mellitus (GDM) and gestational glucose intolerance (GGI) in pregnant women from rural population. The present study was done in antenatal clinic of Obstetrics & Gynecology (OBGY) department, at Tertiary Care Hospital. The present study was conducted from December 2017 to November 2019 for a period of 24 months. The study population was ante-natal mothers attending antenatal clinic of Obstetrics & Gynecology (OBGY) department. Therefore 700 antenatal mothers were included in the study population fulfilling inclusion and exclusion criteria. Results: It was observed that majority 485(69.28%) of the antenatal mothers were multi-gravida followed by 215 (30.71%) antenatal mothers were primigravida. It was observed that majority 345(49.29%) of the antenatal mothers were in third trimester followed by second trimester (35.57%) and first trimester (15.14%). It was observed that among 700 antenatal mothers screened 13 (1.86%) found to be GGI positive, 57 (8.14%) found to be GDM positive while 630 (90%) antenatal mothers were negative for OGTT. Conclusion: The rise in prevalence of Gestational Diabetes in the community and its associated increased risk of pregnancy and delivery complications justifies a need to screen pregnant mothers who attend the antenatal clinic. The results suggest that a policy of universal screening for GDM should be adopted in all antenatal clinics. This single step procedure is a simple economic and feasible method. It serves both for the purpose of screening and diagnosis at the same time. Due to the simplicity, acceptability, sensitivity and cost effectiveness of OGTT, it is the best method to detect gestational diabetes mellitus in high risk group
Histopathological analysis of ovarian lesions in a tertiary care centre
Get PDFBackground: The occurrence of functional or benign cysts and tumors are quite common in the ovaries. The present study assessed histopathology of ovarian lesions. Materials & Methods: 96 ovarian masses specimens obtained from gynaecological department were studied. Microsections of 5 microns thickness were taken onto glass slides and stained by standard Hematoxylin and Eosin stains. Slides were studied and classified based on WHO guidelines. Results: Age group 21-30 years comprised of 16, 31-40 years 36, 41-50 years 34 and 51-60 years 10 lesions. There were 46 non- neoplastic lesions, 40 benign neoplastic and 10 malignant neoplastic lesions. Common non- neoplastic lesions were follicular cyst in 20, inclusion cyst in 4, corpus luteum cyst in 12, ectopic pregnancy in 3, twisted cyst in 2, endometriosis in 2 and edema of ovary in 3 cases. Common non- neoplastic lesions comprised of fibroma in 20, fibrothecoma in 5, mucinous cystadenoma in 8, serous cystadenoma in 3, mature cystic teratoma in 2 and serous cystadenofibroma in 2 cases. The difference found to be significant (P< 0.05). Conclusion: Common non- neoplastic lesions were follicular cyst, corpus luteum cyst and common benign neoplastic lesions comprised of fibroma and mucinous cystadenoma. Common malignant neoplastic lesions were granulosa cell tumor and papillary serous cystadenoma
Prospective Study of Role of Endoscopic Approach in the Management of Ureterovaginal Fistula
Get PDFIntroduction: The causes of iatrogenic post-operative ureterovaginal fistulae (UVF) include ureteral laceration or transection, blunt avulsion, crush injury, partial or complete suture ligation, and ischemia due to operative devitalization of the ureteral blood supply and/or cautery injury. Traditionally, most ureterovaginal fistulas have been repaired by ureteroneocystostomy. In recent years, Endourological management is highly successful in treating ureterovaginal fistulas and ureteral stricture does not appear to be a common complication. Aim: The aim of our study was to evaluate the endourological management of iatrogenic Ureterovaginal fistula.Materials and Methods: A total of 60 patients referred to us after hysterectomy was confirmed of UVF. Once the diagnosis is confirmed, all patients underwent retrograde ureterogram and ureteroscopy with double-J stenting if stenting was not achievable, percutaneous nephrostomy (PCN) was performed, and then after 4 weeks retrograde double-J stenting was attempted. Results: About 58 (96.6%) out of 60 patients were managed successfully with retrograde ureterogram and ureteroscopy with double-J stenting and 2 (3.4%) out of 60 patients required PCN followed by after 4-6 weeks retrograde successful double-J stenting. Conclusion: Ureteroscopy and placement of double-J stent is technically challenging but is still a good option if detected and intervened early, causing minimal morbidity and discomfort. It is more effective, reliable, less invasive, and readily accepted by patients
A Cross-Sectional Study of Association between Blood Pressure and Body Mass Index in School Children Aged 11 – 15 Years
Get PDFBackground: High blood pressure in childhood and adolescence is a global public health problem and is often overlooked. It generally remains undiagnosed and untreated. The present study intended to find the association between blood pressure and body mass index among children aged 11 to 15 years. Methods: A cross-sectional study was conducted among 953 school children aged 11 to 15 years. The study was conducted between January 2020 and July 2020 after obtaining clearance from an institutional ethics committee. Weight and height were measured by standard methods and BMI was calculated. Blood pressure was measured using mercury sphygmomanometer and more than 95th centile for age, sex and height was considered to have hypertension. Results: In this study 953 school children were studied. Out of these 489 children were males and 464 were females. Children (25.7 %) were either overweight or obese. 197 (20.7 %) had an elevated blood pressure. The proportion of children with stage 1 and stage 2 hypertension was 6.1 % and 1.6 % respectively. 53.9 % of the overweight / obese children had more than normal blood pressure. There was a statistically significant relationship between blood pressure and BMI. Conclusions: The present study indicates that BMI is an important factor affecting BP levels in children. Simple anthropometric assessment to determine BMI in schools would help in predicting the risk of developing hypertension. This will help in reducing the morbidity and mortality associated with hypertension in adults
Analysis of Causes and Frequency of Blood Donor Deferral in a Tertiary Centre in North India – An Insight Into The Regional Deferral Pattern
Get PDFIntroduction: Blood donor screening should be done through a stringent process so that it ensures blood availability and accessibility while maintaining the blood safety at the same time. Donors who get rejected in the process are called deferred donors. We, hereby aimed to assess various reasons of deferral and their relative proportions and to categorize donors according to type of deferral, age and gender. Method: We performed a retrospective analysis of data of donors who presented to Department of Immunohematology and Blood Transfusion, Lady Hardinge Medical College or at VBD Camps for a period of 20 months from January 2020 to August 2021. Rate of deferral was quantified and various causes were characterised according to gender and age. Result: A total of 19,151(18,665 males,486 females) donors presented at our centre and VBD camps, of whom 17,632(92.07%) were accepted while 1,519 were deferred. Out of total donors accepted, 17,345 were males and 287 females. The percentage of deferred donors was 7.93%. Amongst 486 females, 199 were deferred, i.e. 40.95%, while 7.07% males were deferred amongst males(1320 out of 18665). Out of total deferrals, majority i.e. 1302(85.71%) were due to temporary reasons while 217(14.29%) were deferred permanently. Overall, most common reason for deferral was low hemoglobin(514/1519 i.e. 33.84%). Amongst temporary deferrals, most common reason overall was due to low hemoglobin (514/1302, 39.48%) with low hemoglobin also being the most common reason of temporary deferral in both males(393/1111= 35.37%) and females(121/191= 63.35% ). Amongst the permanent deferrals, most common reason was due to history of High risk behaviour (46/217=21.20%). History of High risk behaviour was also the most common reason of permanent deferral in males(46/209= 22.01%) and Thyroid disorders, the most common amongst permanent deferral in females(03/08=37.5%). Majority of deferred donors belonged to the age group of 29–38 years (42.66 %). Conclusion: Estimation of incidence and causes of deferral is important to get better insight of the regional deferral pattern. Temporary causes account for the majority of deferral and such donors should be followed up for the maintenance of the VBD pool and ensuring the safety of both donors and recipients. Abbreviation: VBD= voluntary blood donation, Hb= Hemoglobin, NACO = National AIDS Control Organization. WHO= World Health Organisation
Changes in Anthropometric Indicators Using Therapeutic Food (F75/F-100) Versus Traditionally Used Home Based Food in the Treatment of Severe Acute Malnourished Children - A Comparative Study
Get PDFBackground& Objective: Shortage of suitable food, lack of purchasing power of the family as well as traditional views and taboos about what the baby should eat, often lead to a sufficient balanced diet, resulting in malnutrition. In children, malnutrition is synonymous with growth failure. Malnourished children are smaller and weigh less than they should be for their age and height. Aim of this study is to compare changes in anthropometric indicatorsbetween severe acute malnutrition (SAM) children of therapeutic food F75/F100 with traditionally used home based foods. Methods: This prospective and observational study was conducted in the Department of Pediatrics of G.S.V.M. Medical College, L.L.R. and Associated Hospitals, Kanpur. Logarithmic transformation was achieved by SPSS 20. Study was conducted between March 2011 to July 2011. Permission to perform the trial was obtained from Institutional Ethics Committee (IEC). Results: Weight gain was 7.525gm/kg/day±6.09 in hospitalized patient, whereas 1.013 gm/kg/day ±2.43 was weight gain in home treated patients. Height increase was more although statistically insignificant in hospital treated patients than in home treated patients. Increase in mid arm circumference in hospital treated was found to be highly significant. No significant increase in mid arm circumference was noticed between one at 14 days to one measured at 21 and 28 days in both the groups. Conclusion: Conclude that treatment of SAM is more effective and successful than home based therapy
Quality of life of care giver of chronic psychiatric patients with its associates
Get PDFIntroduction- Chronically ill psychiatric patients require assistance from their family members for their supervision and even in daily activity of life. Often this impose a major burden on caregivers, placing them at a great risk of mental and physical problems leading to impaired quality of life. Methodology- A cross-sectional study was conducted on 60 care givers of patients with chronic psychiatric illness. WHO-QOL BREF scale was used to assess quality of life. Chi-square test was use to find out associations. Result- Mean age of caregivers was 36.8 years with mean care giving years 22.3 years. Majority of care givers were mails with M:F ratio 5. The mean total score of QOL care givers was found excellent (87.8%) i.e. 98.37 with standard deviation 6.97. Maximum QOL score was found in physical domains followed by environmental, psychological and social domain of Qol. Social domain was most affected domain. These variation of score as per various scores was found with significant variation. On further analysis in this study no association was found between QOL scores and characteristics of care givers. Conclusion: Although in many studies quality of life of care givers was found badly affected but surprisingly in this study it was not found much affected. Social domain was most affected domain As most affected domain was found social which may be because of social stigma attached to it, so awareness in community is needed