International Journal of Health and Clinical Research
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An epidemiological study of etiology and management of abdominal pain in children: Government general hospital, Nizamabad
Get PDFBackground: One of the most prevalent childhood concerns is abdominal discomfort. It is more common in children under the age of 13 and is linked to a variety of causes and variables. The goal of the study was to look at the epidemiology, etiology, and treatment of children who presented with stomach discomfort to a tertiary level pediatric department. Methods: Over a year, 720 children visited the pediatric OP department, 100 of them satisfied the inclusion criteria and were all enrolled. Pre-schooling (3-5 years), schooling (6-10 years), and young adolescent are the three age groups studied in this study (11-13 years). Results: Abdominal discomfort was observed to be prevalent in 12.8 percent of children with OP. The majority of the participants were between the ages of 11 and 13, accounting for 53% of the total. There are 56 percent females and 44 percent boys among the 100 subjects, with 77 percent being rural and 23 percent being urban. FGID (36 percent), Gastritis (19 percent), and Worm Infestations were the most prevalent etiologies (16 percent). Conclusion: In conclusion, abdominal pain is a typical presentation in the pediatric OP department, and physicians must investigate a variety of etiologies, particularly those that require rapid management to reduce morbidity and death. With the advancement of science and technology, it is more important than ever for children needing pediatric surgical care to receive safe and effective treatment. Continuous pharmacological care services are required to improve the quality of life of children. The clinical pharmacist must increase knowledge of numerous etiologies producing stomach pain in a community environment to reduce the incidence and prevalence of abdominal pain in children
An observational analysis of clinical factors predicting ovulation induction among infertile women with Poly Cystic Ovarian Syndrome: At Tertiary care facility, Jaipur
Get PDFObjective: To identify the predictive factors for ovulation with clomiphene citrate (CC) in polycystic ovarian syndrome (PCOS) patients with infertility. Materials and Methods: A prospective observational study was carried out at the IVF centre of a teaching hospital, Jaipur between January 2019 to December 2019. Total54 patients with PCOS as per Rotterdam criteria, who attended for treatment of fertility were enrolled in the study. Patients were given clomiphene citrate in incremental doses from 50 to 150 mg per day for five days. Clinical parameters (age, duration of infertility, waist circumference, body mass index(BMI), biochemical parameters (fasting blood sugar,fasting Serum insulin, serum total testosterone, serum luteinizing hormone(LH), serum follicle stimulating hormone(FSH), antimullerian hormone(AMH) and ultrasonographic parameters - antral follicle count(AFC), ovarian volume, uterine and stromal vessels pulsatility index between ovulating and non-ovulating patients were statistically analysed. Results: Total 40.74 % patients ovulated with increasing dose of clomiphene-citrate. A statistically significant difference was observed in waist circumference, serum testosterone, LH, AMH, AFC and Ovarian stromal artery PIbetween patients who ovulated and who did not. However, no significant difference was observed with regards to patient’s age, BMI, fasting glucose, serum FSH, serum Insulin, ovarian volume and uterine artery PI. Conclusion: Factors like WC, Serum total testosterone, serum LH level, AMH, AFC and ovarian stromal artery PI could be used as tools to predict response to clomiphene-citrate in the treatment of PCOS patients. This can help clinicians in deciding more effective and patient tailored approach
A study of vitamin D levels in critically ill children
Get PDFObjectives:1. To assess the correlation between Vitamin D levels and critical illness.2. To study correlation between Vitamin D and risk of mortality through PRISM III criteria.3. To study demographic details associated with Vitamin D levels.Methodology: A prospective observational hospital based study was conducted over a period of 18 months in 100 critically ill children fulfilling the inclusion criteria. The samples were used for Vitamin D estimation using Electro-Chemiiluminescence and Vitamin D levels were classified as per the Endocrine Society recommendations. Results: In our study, there was statistically very highly significant association between PRISM score with vitamin D deficiency.There was statistically very highly significant association between PRISM score with outcome (P<0.001).The deficiency was associated with increased length of stay in the ICU. Vitamin D deficiency is frequent in critically ill children, and it is related to both morbidity and mortality. Conclusion: Variables from this short study showed statistically significant associations between severity of critically ill children and serum vitamin D levels(p<0.001). Health education on the importance of sunlight exposure of young children should be reinforced in mothers and the general community. Vitamin D supplementation should be advocated in order to prevent the morbidity and mortality secondary to critically illness, which globally contribute to morbidity worldwide
Ultrasonography and Computed Tomography Evaluation of Gall Bladder wall Thickening and it’s Histopathological correlation
Get PDFBackground: Ultrasonography is usually the first preferred imaging modality for Gall bladder diseases. GB carcinoma is an important cause of thickening of the GB. USG is less sensitive in detecting GB malignancy, metastasis and staging than CT. Therefore, computed tomography (CT) is being increasingly used for early detection of GB carcinoma. Objective: Accuracy of Ultrasonography and contrast enhanced computed tomography (CECT) in correctly identifying the cause of GB wall thickening and comparing their findings with the histopathology. Methodology: After Ethical Approval this Prospective observational study was conducted in the Department of Radiology, Rajendra Institute of Medical Sciences, Ranchi over a duration of 18 months from April 2019 to October 2020. Data was entered in Excel sheet and analysed by SPSS. Results: 63 patients were enrolled, 43 were females (68.25%) and 20 were males (31.75%). Mean age of patients was 50.14 years with a standard deviation of 11.11. Mean GB wall thickness was 10.3 mm for malignant pathology with a standard deviation of 4.00. The association of focal/diffuse wall thickening with GB carcinoma was found to be significant (p− 0.001). Intra−hepatic biliary radical (IHBR) dilatation was observed in 11 patients (17.46%) and nine out of these eleven patients had GB carcinoma (p −0.002). The correlation of Loss of interface of thickened GB wall with liver parenchyma and malignancy was found to be significant (p−0.012). 7 (11.11%) patients with lymphadenopathy on Ultrasonography and CECT (p −0.0001) had a final diagnosis of malignancy on histopathology. The sensitivity of USG was found to be 70% while specificity was 66.60%. The sensitivity of CT was found to be 95.00% while specificity was 83.72%. Conclusion: Early detection of malignant cause is challenging because of identical presentations of benign and malignant conditions as wall thickening on imaging and vague clinical symptoms. Since carcinoma Gall bladder has very poor prognosis, early histopathological diagnosis following imaging diagnosis is crucial for reducing mortality and morbidity
A Hospital Based Prospective Study to Estimate the Prevalence of Thyroid Disorders in Reproductive Age Group Women with Abnormal Uterine Bleeding (AUB)
Get PDFBackground: Thyroid disorders are ubiquitous and insidious in their presentation. Abnormal uterine bleeding is a common problem and its management can be complex. Thyroid hormones play a key role in the menstrual and reproductive function of women. . The aim of this study to estimate the prevalence of thyroid disorders in reproductive age group women with abnormal uterine bleeding (AUB). Materials& Methods: A hospital based prospective study done on 50 women with complaining of menstrual dysfunction in obstetrics and gynecology department in government district hospital, Sirohi, Rajasthan, India during one year period. Routine investigations like hemoglobin, platelet count, total and differential count, ESR, blood grouping and Rh typing, RBS, Serum creatinine, and thyroid profile which includes T3, T4, TSH were performed in all patients. For quantitative type of data test of significance applied was student T test and for qualitative data chi square test was applied. P value of <0.05 was considered significant. Results: Among 50 women majority of patients belong to more than 30 years (50%) age group, followed by 21 to 30 yrs age group (36%) and less than 20 years were 14%.Mean age was 32.78 years. In menorrhagic patients majority were euthyroid (14) followed by subclinical hypothyroidism (5) and in oligomenorrhoea majority were again euthyroid (6) followed by subclinical hypothyroidism (5). Conclusion: Abnormal uterine bleeding is frequently seen to be associated with thyroid dysfunction and in majority of the patients, menstrual abnormality may even precede the occurrence of other clinical signs and symptoms of thyroid dysfunction. Unless proper evaluation of thyroid function is done among these patients, we often miss an important etiology of AUB
Unusual Congenital Deformities detected in Perinatal Autopsy- A Series of 5 Cases
Get PDFAutopsy literally means to see for one self - is the dissection and examination of a dead body to determine the cause of death and establishevolution of a disease. There are 3 main types of autopsies-(1) Medico-Legal/Forensic/coroner's autopsy, (2) Clinical /pathological autopsy, (3)Anatomical or academic autopsy. In this study we performed pathological autopsy of perinatal death cases and presenting a series of 5 cases withrare (unusual) congenital deformities along with review of literature
Evaluating the role of imprint cytology compared to histopathology in the diagnosis of ovarian tumors
Get PDFBackground: Imprint cytology is one of the techniques to evaluate intraoperative pathological diagnosis. It gives quick results and is very cost effective. The morphology is well preserved, and it is very useful for differentiating between benign and malignant lesions intraoperatively. Objective: To evaluate the diagnosis of ovarian tumors in imprint cytology and to correlate it with histopathology and assess its diagnostic accuracy for its future potential application. Materials and Methods: Imprint smears for cytology were made immediately after the gross specimen was received in the department in normal saline.Then the specimen was fixed in 10% buffered formalin and grossed for histopathological examination following standard protocols. After histopathology diagnosis, its correlation was done with the diagnosis of imprint cytology. Results: A total of 50 cases of ovarian lesions were studied.Out of these 50 cases the accuracy for benign lesionswas found to be 88.6%, 25% for borderline cases and 100% for malignant ones. Conclusion: Imprint cytology gives a rapid diagnosis and the high accuracyfor benign and malignant lesions. Considering the findings of the index study, it can be concluded that imprint cytology may be used intraoperatively in doubtful cases for a better surgical outcome in patients
Supraclavicular swelling: A cytomorphological study
Get PDFSwelling in the supraclavicular region gives rise to various doubts regarding the underlying pathology. As swellings in the supraclavicular fossa are easily palpable, FNAC is considered as the first line of investigation for diagnostic evaluation of swellings at this site. The study aimed at the analysis of distribution of different causes of supraclavicular swelling on the basis of cytomorphology and to study socio-demographic features of different cytomorphological patterns. This was a retrospective study to be conducted in the Department of Pathology covering a period of two and a half year (January 2019 to June 2021). Eighty-one (81) cases of supraclavicular swellings underwent FNAC during the study period were analyzed. For each case, a minimum of two air-dried Giemsa stained smears and one alcohol fixed Papanicolaou (PAP) stained smear were studied.Out of total 81 cases, 38 (46.9%) were non-neoplastic and 43 (53.1%) were neoplastic. Non-neoplastic cases were most commonly found in young age group and neoplastic cases were commonest in 41 – 60 year age group. Males (51 cases) were more commonly affected than females (30 cases). Most common non-neoplastic lesion is reactive lymph node (32% of all cases) followed by non-tubercular granuloma cases, tubercular granuloma, cystic lesion and hemangioma. Among the neoplastic conditions there were 34 cases of metastasis, (adenocarcinoma being the most common metastasis) and 9 cases of Non-Hodkin lymphoma. Non-neoplastic cases were common in tribal population (20 out of 38 cases) and 33 cases, out 43 of neoplastic lesions were found in non-tribal population. This study showed that neoplastic conditions affected the supraclavicular region/lymph node more commonly than the non-neoplastic lesions. The cytological evaluation of such cases will certainly guide the clinician to make an appropriate treatment plan
Advances in Regenerative Endodontics: Pulp Revitalization and Future Directions
Get PDFRegenerative endodontics has become an innovative form of treatment in the field of dentistryforcing a paradigm shift in dental practice to current root canal treatment to one that views theendodontic field as biologically driven pulp regeneration. The profession focuses on theregenerative treatment of the pulp-dentin unit using the stem cell, regenerative scaffold, andgrowth factors to restore the vitality of the tooth and extend its functional life. The innovations inthe field of imaging technologies, like cone-beam computed tomography, have improved theaccuracy of the diagnostics and regenerative outcome monitoring. Moreover, the inclusion of AIin endodontics practice will provide the chance of precise selection of cases, treatment planning,and prognostication of outcomes. There is clinical evidence that regenerative protocols can playnot only a structural reinforcement role in teeth treated endodontically or have positiveindications in both immature and mature permanent dentition. Even though much has been done,there are still setbacks regarding standardization of treatment mechanisms, the promise ofdefinite results and barriers to translation. Future perspectives hold the promise of integrationbetween biomaterial science, nanotechnology and artificial intelligence-based predictivemodeling in optimizing pulp revitalization and making regenerative endodontics a full-fledgedmodality
Comparative study of 0.25% bupivacaine versus 0.25% bupivacaine with fentanyl for caudal epidural anaesthesia and analgesia in children undergoing infra umbilical surgeries
Get PDFBackground: For the purpose of controlling postoperative pain following abdominal and lower limb procedures, caudal epidurals are typically administered to children. The most popular local intrathecal anaesthetic for children is bupivacaine. To improve the quality of the intrathecal block and lengthen the analgesic effect, several adjuvants are added to the local anaesthetic. In the current study, caudal epidural analgesia and anaesthesia for children having lower abdomen surgery were compared between bupivacaine and bupivacaine combined with fentanyl. Materials and methods: This is an observational study, approved by the institutional ethical committee. An individual informed consent was taken from all patients selected for the study. All patients belonging to ASA grade 1 and 2, between the age group of 1 to 10 years posted for infra umbilical surgeries. Total 60 children undergoing infra umbilical surgeries were included and divided into two groups. Conclusion: When delivered caudally, 1μg/kg fentanyl and 0.25% bupivacaine offer adequate surgical anaesthetic and post-operative analgesia with a longer period of analgesia and no significant postoperative sequelae. It is well known that fentanyl has a quicker onset of analgesia and fewer adverse effects like nausea and vomiting