International Journal of Health and Clinical Research
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A prospective study to evaluate the functional outcome in fracture neck femur treated by cemented bipolar hemiarthroplasty in elderly patients
Get PDFIntroduction: Purpose of this research is to study the functional outcome in elderly patients of fracture neck femur treated by cemented bipolar hemiarthroplasty and to analyze the improvement in the ambulatory status of patient at variable periods of follow up. Materials and methods: This is a prospective observational study of 50 elderly patients (age ≥ 60 years) with femoral neck fractures treated by cemented bipolar hemiarthroplasty. Thorough preoperative, intraoperative and postoperative evaluation was done. Functional outcome was evaluated using Harris Hip Score at each follow up visit. Results:Out of 50 patients, 40 cases were available at the end of 12 months for final follow-up. At the final follow up, 42.50% had excellent results, 37.50% had good results, 12.50% had fair results and 7.50% had poor results. Conclusion: In elderly patients with femoral neck fracture, we recommend the use of cemented bipolar hemiarthroplasty. It provides good ambulatory ability, improves the quality of life in elderly age group and is cost-effective
Perinatal outcome in oligohydramnios diagnosed at term -A prospective study
Get PDFIntroduction: Amniotic fluid acts like a cushion and helps in growth of foetus. Decrease in amniotic fluid level is known as oligohydramnios There exists a correlation between oligohydramnios and adverse perinatal outcome in terms of low apgar score, meconium aspiration syndrome, birth asphyxia, increased rate of caesarean section for foetal distress, etc. It is the most frequent complication of pregnancy. Objectives1. To analyse the incidence of oligohydramnios by using AFI .2. To assess the maternal and Perinatal morbidity and mortality in women with low AFI.3. To evaluate the effect of oligohydramnios on APGAR score rate at birth and the rate of NICU admissions.Methods: Prospective study on perinatal outcome done in Obstetrics and Gynaecology Department of PMCH, Udaipur over a period of 2 years from January 2018 to December 2019. 115 women with oligohydramnios at or after 37 weeks of pregnancy were analysed for perinatal outcome. Detailed history taken and necessary laboratory investigations done. Amniotic fluid index measured by ultrasonography using four quadrant technique as described by Phelan et al. Results: Incidence of oligohydramnios was found to be 9.13% in the present study. LSCS was done in 52.17%, low birth weight was seen in 60% IUGR in 26.08% NICU admission in 28.75%. Conclusion: Oligohydramnios occurs frequently and needs intensive surveillance and proper antenatal care with strict vigilance during labour. Decision between vaginal delivery and caesarean section should be well balanced
Study of cardiac dysfunctions in chronic liver disease patients
Get PDFBackground: Cardiac dysfunctions are a major cause of mortality in chronic liver disease patients, especially those who undergo surgical procedures like TIPS, LT. Aims and Objectives: The present study aimed to determine the prevalence of cardiac dysfunctions in chronic liver disease patients. Methodology: The present study was conducted as an observational study at Hamidia Hospital Bhopal. The study included a total of 75 patients diagnosed as a case of chronic liver disease who were then interviewed and their demographic information and symptoms and presentation was obtained. All the patients were then subjected to detailed physical examination, cardiological assessment using ECG and 2D ECHO and blood investigations. Results: The Mean age of patients without Cardiac dysfunction was 40.3 years, whereas the Mean age of patients with Cardiac dysfunction was 46.25 years. Cardiac dysfunctions in CLD patients most commonly occurred in age group of 51-60 years and 96% cases were males and only 4% cases were females. QTc prolongation was found in 28% of patients. The prevalence of Diastolic Dysfunctions was 24% and the prevalence of Systolic Dysfunctions in CLD patients was 20 %. Conclusion: Subclinical cardiac dysfunctions are present in a significantly large number of patients with Chronic liver disease. These dysfunctions are associated with more cardiovascular complications especially when these patients are subjected to surgical procedures such as TIPS, liver transplantation. Hence there is a need for a comprehensive cardiac assessment and standardized diagnostic protocol for patients of liver cirrhosis, especially undergoing procedures such as TIPS, liver transplantation
The pattern of Microbiological Colonization of Endotracheal Tube Aspirate on Mechanically Ventilated Patients: A Clinical Study from central India
Get PDFBackground: Among intubated patients, nosocomial infection is a serious problem that contributes significantly to their morbidity and mortality. Pneumonia, a common complication of the endotracheal tube and mechanical ventilation, is one of the most important types of this infection. Aims and objectives: To study the antibiotic sensitivity patterns for the most common microorganisms isolated from the endotracheal tubes of hospitalized patients. Materials and Methods: Patients admitted to Hamidia Hospital's emergency medical ward and then intubated and assisted by mechanical ventilation due to insufficient self-ventilation were studied. For microbiological cultures and sensitivity tests, specimens were collected 48 hours after intubation using a mucous extractor and sent to the Microbiology Laboratory for processing. Results: During our study, we found that 25 percent of our patients had Ventilator-associated pneumonia. Pseudomonas aeruginosa accounts for 17 percent of positive sputum cultures, followed by klebsiella (6%) and staphylococcus aureus (2%). Conclusion: Pseudomonas was the most common organism found, followed by klebsiella and staphylococcus aureus, and the majority of the organisms were susceptible to piperacillin-tazobactam and meropenem
“COVID- 19 Vaccination utilization pattern of the beneficiaries attending COVID 19 vaccination centre at a Medical college in Haryana, India”
Get PDFIntroduction: The COVID vaccination was introduced this year and there was lot of hesitancy amongst the people including health care workers. The pace of COVID vaccination increased with each passing day. No previous data was available about the utilization pattern of beneficiaries of COVID vaccination. Objective : This study was conducted to know the vaccine utilization pattern amongst general population as well as health care workers at a tertiary care health institute.Method: The beneficiaries who received COVID vaccination from 16th January 2021 to 15th June 2021 at a COVID Vaccination Centre of a tertiary care health institute in Haryana ( n= (Total = 9721).Result : Total number of beneficiaries vaccinated with 1st dose during the study period were 9721. Out of total vaccinated, 1600 (16.45%) were health care workers. Coverage of vaccination with first dose was maximum in the administrative staff (Data Entry Operators /Clerk/IT/other managers, Receptionist, Technical Staff etc) was 100 % and minimum in doctors ( 66.4 %) .Conclusion: Vaccine coverage in HCW with first dose in the study hospital was 82.27 % and for 2nd dose was 64.35% which is comparatively less to first dose. More sensitization of HCW is required to motivate them for second dose of Covid vaccination
Therapeutic Efficacy of Topical Luliconazole Versus Topical Ketoconazole in the Treatment of Pityriasis versicolor Patients: A Hospital Based Comparative Study
Get PDFObjectives: This study was to evaluate the clinical efficacy of 1% topical luliconazole versus 2% topical ketoconazole in pityriasis versicolor patients. Methods: Detail assessment and clinical examinations were performed to all patients of pityriasis versicolor.Mycological examination of all the patient was done by using skin scrapings were collected from the skin lesions to prepare for 10% KOH mount, which was examined under the microscope to note the findings as KOH mount positive or negative for Malassezia fungi. KOH mount positive or negative was noted at 0 days, 2 weeks and 4 weeks continued treatments with luliconazole and ketoconazole group patients. Results: Most of the cases were males (65%). Male and female ratio was 13:7. Majorities of patients (51%) were belonged in age group of 26-35 years. At the first days (beginning of treatment), majorities of patients 46(92%) of luliconazole group were positive for KOH mount. At 14 days treatment with luliconazole, patients had 11(22%) positive for KOH mount. And at the 28 days treatment with luliconazole, only 2(4%) patients were positive and most of the patients 49(98%) were negative for KOH mount. Similarly, in ketoconazole group patients, 47(94%) patients were positive for KOH mount in beginning of treatment. At 14 days treatment with ketoconazole 16(32%) patients were positive and 34(68%) patients were negative for KOH mount. And at the 28 days with treatment of ketoconazole 13(26%) patients were positive and most of the patients 37(74%) were negative for ketoconazole. Conclusions: Male population as well as age group 26-35 years were more prone to pityriasis versicolor infection. On two weeks of treatment luliconazole and ketoconazole had near about similar efficacy against pityriasis versicolor patients. But, on continue 4 weeks of treatment regimens topical luliconazole had more clinically efficacious than ketoconazole against pityriasis versicolor
Morphometry of The Orbital Region in Dry Skull and CT images
Get PDFIntroduction: The bony orbit is significant not only for anatomists, but also for ophthalmologists, oral and maxillofacial surgeons, and forensic experts who study the human face. The purpose of this study was to determine how the orbital index varies with race, regions, within the same race, and different times in evolution. The present study's objectives are to offer the normal reference orbital parameters for the NorthIndian population, as well as to determine the normal reference orbital parameters. Materials and Method: Materials and Method: The experiment was carried out on thirty-eight dried skulls of different ages, genders, and races. Manual vernier calipers were used to measure the length and breadth of the orbital plane. The orbital index was determined by using the formula Length /Breadth x 100 to the length/breadth ratio. To avoid interobserver and intraobserver error, the parameters were measured independently by two individuals using specified protocols. Result: To analyze all of the data collected, descriptive statistics such as mean, standard deviation, and range were computed and used to summarize the findings statistically. There were no significant differences in maximum orbital length and breadth between the right and left sides, however, there were differences in maximum orbital length on the right side (33.7 1.8 mm) and 33. 8 2.1 mm on the left side (37. 22 09 mm). On the right and left sides, the maximum orbital length and breadth were determined to be 33.7 1.8 mm and 33. 8 2.1 mm, respectively, while the maximum orbital breadth was found to be 37. 4 2. 1 mm and 37. 22. 09 mm, respectively. Conclusions: The orbital index was determined based on the length and breadth of the orbital plane. which will be useful in plastic surgery, Ophthalmology, maxillary surgery, and reconstructive cosmetic surgery of the face all benefit from the use of orbital morphometry as a baseline measurement. A thorough understanding of anatomy and its variations will aid surgeons in avoiding surgical complications throughout the procedure as well as forensic research
A study of clinicopathological and etiological profile of goiter at tertiary cate centre in Kumaon region of Uttarakhand
Get PDFBackground: Goiter is one of the common manifestations in Uttarakhand region because of iodine deficiency.Objective: This study was undertaken to illustrate the clinicopathological and etiological profile of patients presenting with Goiter at Tertiary Care Hospital in Kumaon Region of Uttarakhand. Materials & methods: This hospital based cross sectional study was done in 121 patients aged >16 years presenting with goiter in Medicine, ENT OPD/ IPD, Dr. Sushila Tiwari Hospital, Haldwani District Nainital between January 2020- September 2021. Clinical features of goiter were observed, relevant investigations were done, and most probable diagnosis was made as to the reason of goiter. Results: In majority (94.21%) of patients, WHO Goiter grade 2 was observed. Majority (69.42%) of patients had hypothyroidism. Only 2.48% patients had hyperthyroidism. On FNAC majority (95.04%) of patients had Bethesda grade II. In 43.80% of patients, fine needle aspiration finding was suggestive of nodular colloid goiter followed by chronic Lymphocytic thyroiditis (27.27%) and simple colloid goiter (16.53%). Most of the cases of benign category had euthyroid or hypothyroid levels. Both cases of malignancy had euthyroid levels. Both cases of follicular neoplasms of thyroid and adenomatoid nodular thyroiditis also had euthyroid levels. (P=0.012). In majority (60.33%) of patients, probable etiology was iodine deficiency followed by Autoimmune/ Hashimoto's Thyroiditis (27.27%). Conclusion: Iodine deficiency is common in the Kumaon region of Uttarakhand leading to most cases of palpable goiter (WHO grade 2). Goiter was more common among females and in third decade of life. Benign nodules were commonest on FNAC with more proportion of hypothyroid levels followed by euthyroid levels
A study of 100 cases of PAP’s Smear examination in different age groups
Get PDFBackground: Cervical cancer is one of the most common malignancies among women in developing countries. In India, one in five women is diagnosed with cervical cancer. India has the greatest load of cervical cancer patients.Aims and Objectives: To study PAP’s Smear examination findings and compare them with different age groups.Materials and Methods: Hundred women aged 20 years and above having a history of amenorrhoea were studied in the Department of Pathology between May 2018 to December 2019. Slides were prepared and stained using the modified Papanicolaou staining method. Smear was observed for epithelial cells, red blood cells, white blood cells, bacteria, trichomonas, monilial hyphae, mucus, and neoplasm. The cervix's histology and cytology were performed to observe epithelial lining, original stratified squamous epithelium, metaplastic squamous epithelium, and cervical stroma. Cervical intraepithelial neoplasia (CIN) was also observed.Results: Majority (80%) had gynecological complaints. Out of 100 cases, 33 cases were reported normal, 56 cases were reported inflammatory, while one case was reported as metaplastic. Three cases were reported as CIN-I, 1 as CIN-II, 3 as CIN-III, and 3 as positive for malignancy. The highest incidence of dysplasia was seen between the age group 31-40 years. Smear positive for dysplasia of all degrees were found in 3rd and 4thpara, positive smears for malignancy were found maximum in 4th para, and one positive case was seen in 2nd para.Conclusion: Incidence of dysplasia was highest in the young working-age group. The Pap smear test is the most effective cervical cancer screening test since it is moderately priced, simple to do, and widely available to patients
Role of Plain Radiography and MRI in Evaluation of Spinal Tuberculosis
Get PDFBackground and purpose: Tuberculosis is one of the oldest disease prevalent in India since ages caused by Mycobacterium tuberculosis. There are many forms of tuberculosis in which spinal tuberculosis accounts for 2% of all forms.The mode of infection is through hematogenous route.The clinical features ranges from simple back pain, tenderness, stiffness, deformities of spine.The plain radiography spine is the initial modality of choice in developing countries as it it easily available and cost effective, but can’t diagnose the early changes in the disease.In the recent era CT, MRI and PET are frequently used modalities for diagnosing spinal tuberculosis. MRI can be used for early diagnosis due to its high soft tissue contrast resolution and multiplanar reconstruction can be done to identify spinal cord involvement and neural elements involvement. Early diagnosis is important to avoid bone deformities and spinal cord compression to the benefit of the patient.The aim is to study the sensitivity and specificity of radiograph and MRI in evaluating the disease manifestations of spinal tuberculosis.Methods: We studied plain radiographs and MRI spine of 60 patients who presented to radiology department with complaints of low backache.Results: Plain radiographs were used to detect bony abnormalities, paravertebral densities. MRI is used to detect soft tissue changes ,paravertebral abscesses .ADC and DWI were used to diagnose abscesses.Conclusion: MRI is superior to radiographs in identifying soft tissue changes, neural involvement, spinal cord involvement. MRI is more sensitive to detect the severity and extent of disease process. MRI is more superior for early diagnosis of Potts spine and in various stages of disease progression and follow up after treatment