International Journal of Health and Clinical Research
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The Role of Magnesium Sulphate (MgSO4) In Fetal Neuroprotection
Get PDFBackground: Preterm birth is the major cause of perinatal mortality both in developed and developing countries. The prevalence of preterm birth is increasing every year and it is nearly more than 15 million preterm births worldwide according to WHO, approximately one million may die and many more may suffer from neurodevelopmental impairment. ACTOMgSO4, MagNET, PREMAG, BEAM were the large studies of MgSO4 for neuroprotection in prematurity previously. Antenatal MgSO4 can prevent neonatal seizures and neonatal deaths in preterms. Aims and Objective of the study: To evaluate the use of antenatal Mgso4 for neur protection of preterminfants. Material and Methods: This study titled “The Role Of Magnesium Sulphate (MgSO4) In Fetal Neuroprotection” was conducted in Department of Obstetrics and gynecology in ASRAM Medical College. A total 20 pregnant women between 28-32 weeks gestation presenting to the emergency department with abdominal pain associated with cervical dilatation (cervical dilatation > 4cm) at risk of imminent preterm delivery(delivery definitely planned within 24 hours) were given Mgso4 4gm iv for about 20-30 min followed by maintenance dose of 1gm/hr for a period of 24 hrs before delivery or up to delivery and all the preterm neonates born to the 20 women were followed up for one year for neonatal seizures, deaths and gross motor dysfunction. Results: Antenatal MGSO4 has better role when given at 28-32 weeks of gestation as only 2 neonates (10% of total preterms) born at 32-34 weeks gestation developed neonatal seizures. Conclusion: When antenatal MgSO4 administered at an appropriate dose with proper monitoring, there is no evidence of harm to the fetus, neonate or mother and it helps in neuroprotection of the preterms
Efficacy of Intravitreal Bevacizumab for macular edema secondary to Branch retinal vein occlusion
Get PDFBackground: Branch retinal vein occlusion is the 2nd most common retinal vascular disease after diabetic retinopathy. The most common causeof visual impairment in BRVO patient is macular edema. Purpose: To evaluate the efficacy of Intravitreal injections of Bevacizumab in patientswith macular edema secondary to BRVO. Methods: All the patients> 18yrs of age with macular edema secondary to BRVO who had treatedwith Intravitreal Bevacizumab (1.25mg/0.05ml) were analyzed retrospectively. Clinical variables including BCVA, CMT, number of injectionsand complications were analyzed. Results: 23 eyes of 23 patients (11M/12F) were included in study. The mean follow-up period was 5.8±1.7months. The mean baseline (log MAR) VA was 0.58±0.17 which was significantly improved to 0.36±0.13 at 1 month and 0.33±0.12 at 3 months.The mean CMT at the onset was 355±28.73μm which reduced to 297±28.17μm after 2 weeks of injection and 291±27.13μm at 1 month. Patientshad given an average of 2 injections. There were no adverse effects observed following injections. Conclusion: It showed a significant reductionin Central macular thickness and improvement in BCVA
The Incidence Of Retinopathy Of Prematurity At A Tertiary Hospital
Get PDFPurpose: To study the incidence and risk factors of retinopathy of prematurity (ROP).Methods: A prospective observational study of premature babies admitted in NICU with a gestational age of 32 weeks or less at birth and a birth weight of 1500 g or less was made. Sick infants were included even if they were older and heavier. ROP screening was done in 200 cases from the fourth postnatal week and was followed up.Results: The incidence of ROP was 19.5%. Most common maternal risk factor was pregnancy induced hypertension (17.9%). Low birth weight (LBW) and respiratory distress syndrome (RDS) (89.7%) were the most common risk factors in infants.Conclusion: In our study the most common risk factors were LBW and RDS
A study on dyselectrolytemia in patients with first episode of seizures
Get PDFBackground: Seizure etiology is a wide range, depending on the age, of which electrolyte abnormalities play an important role in causation. Aim: To estimate the electrolyte imbalances in patients aged more than 18 years presenting with first episode of seizures. Materials and methods: This is a cross-sectional descriptive study. The study was conducted between October 2020 - October 2021 at Alluri SitaramaRaju Academy of Medical Sciences, Eluru, after getting approved by the institutional ethical committee. Inclusion criteria: All the patients with first episode of focal or generalised seizures, with age of onset of seizures >18 years, admitted in department of General Medicine and Neurology, ASRAM medical college and hospital, Eluru from October 2020 - October 2021. An individual informed consent was taken from all the patients selected for the study. Exclusion criteria: Patients with past history of seizures. Discussion: Total number of cases studied=45. Metabolic abnormalities were most common cause of seizures in this study, seen in 21 patients (46.67%) out of which hyperglycaemia was the most common cause seen in 9 patients, followed by uremia in 5 patients, electrolyte abnormalities as in 5 patients and hypoglycaemia in 2. Out of 45 patients, 13(28.89%) had electrolyte disturbances, of which the most common abnormality observed was hyponatremia, seen in 10 patients (76.99%). Others were hypercalcemia in 1patient (7.67%), hypomagnesemia in 1patient (7.67%),hypokalemia in 1 patient. Conclusion: Among various causes of seizures, electrolyte abnormalities were most commonly seen in patients with metabolic causes
To Study the Prevalence of Asymptomatic Bacteriuria and other uropathogens in diabetic patients in a tertiary care hospital-A Prospective study
Get PDFIntroduction: Asymptomaticbacteriuria (ASB) is defined as the presence of at least >105 colony forming units (CFU) per ml of 1 or 2 bacterial species in clean-voided midstream urine sample from an individual without symptoms of a urinary tract infection like dysuria, frequency, urgency, abdominal distention or fever.E.coli,K. pneumonia, P.mirabilis, P.aeruginosa, S. saprophyticus, E.faecalis are the leading cause of ASB. Aims and objectives: To study the prevalence of bacteriuria and other uropathogens in patients of diabetes mellitus, association of ASB with age ,gender,duration and complications of diabetes. Materials and method:120diabetic patients were studied.Thereurinalysis, FBS,PPBS,AST,routine investigations and USG abdomen were analysed. Data analysis using SPSS software. Result: Prevalence of ASB amongst diabetic patients was found to be 25.83%(31/120).Most of the participants were in the age group of 41-50 years .Female and males were 56.66% and 43.33% respectively. Maximum participants were having >10 yrsduration of diabetes. There was significant correlation of ASB with nephropathy with p value 0.002.Proteinuria,leucocyturia and glucosuria were also significant, tested by fischer exact test .There was no significant correlation of ASB with age ,gender, duration of diabetes and type of diabetes. E.coli was the uropathogen isolated in our study followed by Klebsiella and candida. Conclusion: The prevalence of ASB in diabetes was 25.83%. E.coli, Klebsiella and Candida were the pathogens commonly identified. There was significant association with glucosuria ,proteinuria, leukocyturia and nephropathy with ASB
Efficacy of platelet-rich plasma versus corticosteroid injection in treatment of lateral epicondylitis of elbow
Get PDFIntroduction: Lateral-epicondylitis, or tennis elbow, is a familiar term used to describe a variety of symptoms surrounding the lateral aspect of the elbow. Lateral epicondylitis is an inflammatory condition that arises at the origin of the common extensor tendon of the forearm at or below the lateral epicondyle. This is one of the most common chronic disabling conditions in the elbow. A variety of treatment options have been proposed for lateral epicondylitis like rest, activity modification, non-steroidal anti-inflammatory drugs, counterforce braces, massage, physiotherapy, laser treatment, extracorporeal shockwave treatment, acupuncture, ultrasound treatment, and botulinum toxin type A injection. Previously, the injection of corticosteroids was considered the reference treatment in lateral epicondylitis. Currently, Platelet-rich plasma (PRP) is considered an ideal autologous biological component derived from blood. Materials and methods: This was a prospective study of about 160 patients including104 females and 56 males who were diagnosed with lateral epicondylitis for the period from October 2019 to October 2021 in the Department of Orthopaedics at a tertiary care teaching hospital. The purpose of this study was to compare the effectiveness of injecting platelet-rich plasma with injecting corticosteroids for treatment for lateral epicondylitis. Results: The comparative study of management of lateral epicondylitis with platelet-rich plasma vs corticosteroid injection shows that a single injection of platelet-rich plasma improves elbow pain and functional activities more efficiently than injecting corticosteroids into the lateral epicondylitis. These improvements were maintained over in our follow-up period without any significant complications
Factors affecting outcome among patients with abdominal trauma: Report from a tertiary care centre of Bihar
Get PDFIntroduction: India is the leading country in the number of deaths due to Road Traffic Accidents. Abdomen is the third most common injuredregion requiring surgery. To combat this problem, it is know contributing risk factors, so that public awareness problems on ways to preventincidence of such fatality may be implemented with fruitful outcome. With this background, a study was planned to focus on factors influencingoutcome among such patients. The study results will help in early identification of negative determinants and reduce the mortality.Methodology:An epidemiological study was conducted by Department of General Surgery of Mata Gujri Memorial Medical College & Lions Seva KendraHospital, Kishanganj, Bihar. The study included all the patients who were admitted in the surgical wards of the hospital with abdominal traumaduring the time period of 1 year.Prior ethical clearance was obtained from Institutional Ethical Committee.Results: A total of 142 patients wereincluded in the current study. The mean age of the patients was 37.3 years with a SD of 11.4 years. There was a male preponderance. Majority(71.1%) were blunt trauma with RTA being the most common cause of trauma. The spleen (22.5%) followed by liver (11.9%) was the mostcommonly affected solid organ, and the most commonly affected hallow viscous was the small intestine (32.3%), ileum in blunt injury andjejunum in penetrating injury. Post-operative complications were noted among 69 patients that constitutes to 48.6% of the total study population.16 out of 142 patients died. Mortality was significantly higher among patients who were brought to the hospital after 12 hrs and those who hadsevere NISS score while admission.Conclusion: Abdominal trauma is a not uncommon in casualty in multiple trauma patients. As most commoncause of this trauma is RTA, it is the need of the hour to strengthen traffic rules to minimize such injuries
Variation in Anatomical Position of Vermiform Appendix in 100 operative cases among North Indian Population
Get PDFAcute Appendicitis is the most common abdominal surgical emergency. Luminal obstruction of the appendix progresses to suppurative inflammation and perforation, which causes generalised peritonitis or an appendix mass/abscess. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa. Atypical presentations are particularly common in preschool children. A clinical diagnosis is possible in most cases, after a period of active observation if necessary; inflammatory markers and an ultrasound scan are useful investigations when the diagnosis is uncertain. Treatment is by appendectomy after appropriate fluid resuscitation, analgesia and intravenous antibiotics.its different positions presents with different clinical presentation this will leads to misdiagnosis appendicitis with other medical or surgical conditions and diagnosis will be delayed
Awareness and knowledge of Venereal Diseases and Sexual health among Youth attending a Sexually Transmitted Disease Clinic in India
Get PDFBackground: Sexually Transmitted Diseases (STDs) are a major health problem in both developed and developing countries. They are of concern because of their high prevalence and potential to cause permanent complications if not treated timely and effectively. Awareness is particularly important in youth as they are at the highest risk of various STDs including HIV/AIDS. Social stigma, and lack of knowledge of symptoms and complications, may prevent them from accessing Health care. Aim: The present study focuses on assessing awareness about Sexual health and knowledge about STDs among Youth attending an STD clinic in India. Materials and Methods: After taking informed consent, 25 patients attending an STD clinic in the age group of 18-24 years were assessed using a close-ended anonymous questionnaire related to family type, education, marital status, sexual exposure and orientation, awareness about STDs and their prevention, possible complications, attitude towards sex education. Results: Awareness about STDs other than HIV/AIDS, symptoms, and possible complications of STDs was low. Although 10 patients knew that condom is protective against acquiring STDs, only 4 used them during their first sexual encounter. The leading source of sexual health knowledge was teachers followed bymedia. Conclusion: Sex education should be emphasized for all adolescents and youth to fill the gaps in knowledge about transmission, symptoms,and complications of various STDs and to overcome the stigma associated with accessing health care for treatment of STDs
Comparison of intrathecal 2-chloroprocaine with bupivacaine in short surgical procedures
Get PDFBackground: In the post-Lidocaine spinal era, which went into oblivion owing to TNS, there is a need to substitute its alternative, Bupivacaine, in short surgeries to overcome its limitations. 2-Chloroprocaine is a recent introduction with claims of fast onset and recovery as spinal anaesthetic. The aim of the study is to compare the effect of spinal anaesthesia in short surgical procedures (surgeries lasting <60 minutes) between 0.5 % Bupivacaine (Hyperbaric, 7.5 mg) and 1% Chloroprocaine (40mg). Method: A prospective, randomized controlled study was undertaken with 90 patients of ASA physical status I or II undergoing short surgeries consisting of GROUP C(n=45) who received 4 ml 1% 2-Chloroprocaine (40 mg), and GROUP B(n=45) who received 1.5 ml 0.5% Hyperbaric Bupivacaine, (7.5 mg). Patients were observed for hemodynamic stability, degree and adequacy of sensory / motor block, duration of analgesia and adverse effects. For continuous variables, the summary statistics of mean± standard deviation (SD) were used. Chi-square (χ2) test was used for association between two categorical variables. Results: Mean time of onset of sensory block (Group C-1.6 ± 0.7 min, Group B-2.6 ± 0.8 min) and motor block (Group C-2.7 ± 1.0 min, Group B-3.3 ± 1.0 min) were comparable. Duration of sensory block was 113.9±13.3min (Group C), 168.0±13.1min (Group B) (p<0.001); duration of motor block was 92.7±11.2 min (Group C), 140.1±12.2 min (Group B) (p<0.001); duration of analgesia before any rescue dose was 132.5±12.2 min (Group C), 194.1±12.7 min (Group B) (p<0.001). No statistical significant differences were noted in the hemodynamic parameters between two groups at different intervals. Conclusion: Chloroprocaine has comparable onset of sensory and motor block but faster recovery, making it near ideal spinal anaesthetic agent for short surgical procedures