International Journal of Health and Clinical Research
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Prevalence of comorbidities amongest h.pylori-positive patients at a tertiary care hospital, Jammu
Get PDFIntroduction: Helicobacter pylori is a gram-negative, microaerophilic bacterium usually found in the stomach. The bacterium is transmitted by feco oral route and is associated with peptic ulcer, duodenal ulcer, and gastric carcinoma. The scope of this study is to determine the prevalence of comorbidities amongest H.pylori-positive patients at a tertiary care hospital, in Jammu, which can give a better picture of the current situation and estimate the at-risk population of gastric carcinoma. Materials and Methods: This was a prospective observational study done at a tertiary healthcare hospital in Jammu, India, over 04 years (March 2016 to March 2020). Written and informed consent regarding the purpose, procedures, and risks was obtained from all patients. Data were collected by conducting a personal interview and doing a complete physical examination of the participants of the study. A structured pro forma was used and filled out after interviewing and examining the patient. The following information was collected for all the participants: age, gender, symptoms, duration, comorbidities, and durations, and any treatment patient has received. Results: Most common comorbidity was hypertension in the study group and among these patients, 138(88.46%) were H pylori positive, 2nd common comorbidity was Diabetes mellitus and among them 133(91.86%) were H pylori positive and 04 patients had CRPF and all of them were H pylori positive. Conclusion: Among all symptomatic patients enrolled in this study the most symptom was epigastric pain followed by dyspepsia and the most common comorbidities in the study group were HTN and Diabetes mellitus. A rapid urease test was performed on UGI endoscopic biopsy specimen for H pylori infestation and 78.5% of patients were found to be positive
Study of haematological changes in HIV patients in correlation with CD4 cell count at tertiary care hospital, Gujarat, India
Get PDFIntroduction: Acquired immunodeficiency syndrome (AIDS) was first recognized in 1981 and human immunodeficiency virus (HIV) was identified in 1983[1]. HIV continues to be a serious health issue in most parts of the world. In India there were an estimated 23.19 lac individuals living with HIV/AIDS by the end of 2020 with an adult prevalence of 0.22%[2]. HIV infection is characterized by progressive decrease in the number of circulating CD4+ T-helper cells. Aim: The objectives in this study were to study haematological changes in HIV patients and to correlate them with CD4 cell counts. Materials and methods: This was an observational study carried out at the Department of Pathology, at Gujarat Adani Institute of Medical Sciences, Bhuj from September 2021 to October 2021. Total 320 HIV positive patient were evaluated for various hematological parameters. Results: We studied 320 cases out of which 195 (60.93%) were male and 125 (39.07%) were females. The majority of 110(34.38%) cases were in the age group of 31-40 years.From 320 cases, 43 (13.44%) patients have CD4 <200, 112(35.00%) patients have CD4 200-500 and 165(51.56%) have CD4 >500. In present study, 25 patients have leucopenia (WBC count <=4000) among them 10(40.00%) have CD4 count <200/cumm and 7(28.00%) have CD4 count >500/cumm and 295 patients have leucocytosis (WBC count >4000) among them 158(53.55%) have CD4 count >500/cumm and 33(11.18%) have CD4 count <200/cumm. Conclusions: Hematologicalchanges are common in HIV patients. Cytopenia especially normocytic normochromic anemia is the most frequent finding followed by leukopenia. There is a significant correlation between CD4 count and leukopenia. This might be the cause of opportunistic infection in the HIV patient. That is the importance of observation of haematological parameters in HIV patient and to correct them to reduce mortality and morbidity
Comparative study of epidural 0.2% ropivacine and fentanyl with 0.2% levobupivacine and fentanyl for postoperative pain relief for modified radical mastectomy
Get PDFBackground: Effective pain control is crucial for optimal care of surgical patients.Effective post operative analgesia results in decreased stress response and also reduces risk of recurrence and metastasis in cancer patients.Epidural anaesthesia offers most post operative pain relief compared with systemic drugs.Thoracic epidural analgesia is most effective in reducing pain after thoracic and upper abdominal surgeries.In this study,thoracic epidural technique is chosen for post operative management of patients undergoing modified radical mastectomy procedure.Aims and objectives: To compare the analgesic efficacy and adverse effects after adding 0.2%Ropivacine and 0.2%Levobupivacine with Fentanyl when administered post operatively in thoracic epidural infusion for post operative pain relief. Methodology: This is a prospective randomised clinical study, approved by the institutional ethical committee.An individual consent was taken from all patients selected for the study. Total 100 adult female patients undergoing modified radical mastectomy were divided into 2 groups with 50 patients in each group.All patients belonging to ASA grade III.Patients with contraindication for epidural anaesthesia were excluded. Discussion: Thoracic Epidural analgesia offers effective postoperative pain relief for patients undergoing oncological breast surgeries.In this study we are comparing the local anaesthetics Levobupivacine and Ropivacineincombination with Fentanyl for epidural analgesia for modified radical mastectomy. Conclusion: Ropivacaine 0.2% and Levobupivacaine 0.2% concentration when combined with fentanyl were found out to be equally effective in providing postoperative pain relief with no rescue analgesic consumption, but with a significant higher incidence of hemodynamic side effects and motor blockade noted in Levobupivacaine group,which were easily manageable. There was no significant difference in sedation level and other adverse effects
Health related Behaviour Changes in Pregnant Women during Covid 19 pandemic
Get PDFBackground: Pregnancy associated anxiety and depression is very well known for its prevalence. Pandemic like Covid 19 all the more is additive to the levels of anxiety and depression during pregnancy, specially for mothers who are concerned about feto-maternal wellbeing. This study makes an effort to analyze the health related behavior changes and psychological impact of pregnant women after Covid 19 outbreak. Methodology: Cross sectional, questionnaire based study conducted on Pregnant ladies visiting labor room and Outpatients department, RIMS, RANCHI from April 2020 to September 2020. Results: Most patients were primigravida and turned up only in third trimester. Pregnancy complications like heart disease, GDM, jaundice, PIH were present in 28% of participants. 48% participants had no family income during pandemic. 92% women wore masks, 80% practiced social distancing, 72% practiced frequent handwashing,72% practiced frequent handwashing during pandemic, 80% had no regular antenatal checkup. Almost 64% participants showed mild to moderate anxiety, 34% had moderate depression and 40 % had moderate stress.4% had severe anxiety, 2% had severe depression and 12% had severe stress. Usage of mask was inversely related to GAD7 scores, but had no correlation with EPDS scores. Rest parameters like frequent handwashing, social distancing, stressful behavior, not going out and frequent handwashing were directly related to GAD 7 and EPDS score. Conclusion: Mental health and preventive behavior of respondents could be attributed to socio demographic, social, situational, economic status, family conditions and perception of severity of Covid19
Comparative evaluation of hemodynamic changes after different doses of cisatracurium and atracurium
Get PDFBackground and aims: Neuromuscular blockers have become essential part of anaesthesiologist armamentarium. They aid endotracheal intubation, mechanical ventilation, reduce anaesthetic requirement, prevent patient movement and facilitate surgery. The ideal neuromuscular relaxant is an agent which has a quick onset time and short duration of action. We compare the efficacy of Atracurium besylate and different doses of Cisatracurium besylate for hemodynamic response during intubation and histamine response. Material and methods: Randomized trial was conducted in ninety patients of ASA grade I and II ,posted for elective abdominal surgeries were randomly allocated into three groups, of 30 patients each, depending on muscle relaxant and its doses used for intubation . Results: In our study, we found that cisatracurium with the dose of 0.2 mg/kg B.W. is better hemodynamic stable agent and lesser histamine response than cisatracurium 0.1mg/kg B.W. and atracurium 0.5 mg/kg B.W. Conclusion: Cisatracurium is lack of histamine release even at larger doses, which provides better hemodynamic stability in comparison to atracurium and other histamine releasing neuromuscular blocking agents
Study of Etiology and Outcome of Acute Kidney Injury in A Tertiary Care Hospital From South India
Get PDFBackground: The clinical manifestations of AKI are highly variable ranging from asymptomatic alterations in renal parameters to overt uremic symptoms. In rural population the common causes are tropical diseases, diarrhea, snakebite, poor obstetric care etc which are common among healthy young individuals. Many causes are potentially preventable with appropriate management. The present study was conducted in a tertiary care hospital from South India to find out the causes of AKI as there is limited data available, in particular with infectious diseases which are common in topical countries like India.Materials and Methods: This is an observational study done in patients admitted with AKI in wards and ICUs under the department of General Medicine during January 2019 to December 2019, in Maharajah’s Institute of Medical Sciences, Vizianagaram, Andhra Pradesh,India, a tertiary care hospitalResults: 144 patients who developed acute kidney injury, etiology and outcome of AKI was estimated. In our study, AKI is more common in males 86 out of 144 (59.7%) and most of them belong to age group between 30-59years (50%). Common causes of AKI in our study are infections of which urinary tract infection is most common contributing to 24.3%, followed by pneumonia (11.1%) and malaria (8.33%). The survival and death in relation to patients’ clinical presentation and baseline investigations except for blood urea was statistically significant.Conclusion: In our study population, infections were found to be the common cause for Acute Kidney Injury among which urinary tract infection was most common. There was no statistically significant difference in outcome (recovered, non recovered-CKD, death) in relation to etiology. There is statistically significant difference in outcome (mortality) with respect to clinical and laboratory profile at the time of admission
A retrospective study of characterization of cystic lesions of pancreas by computer tomography scan
Get PDFIntroduction: Cystic lesions affecting the pancreas are a frequent finding in clinical practice. They pose differential diagnosis which should be known and interpreted by radiologists, determining doubts concerning their etiology in many cases. Materials and Methods: In this retrospective study was conducted in Department of Radiodiagnosis, AJ institute of Medical Sciences and Hospital, Kuntikana, Mangalore, Karnataka. All patients with proven cystic lesions of pancreas who underwent CT imaging using a 64 slice GE VCT from April 2020 to April 2021 at our institution were selected. All lesions were proven either by surgery or by endoscopy guided aspiration or follow up. Results: Out of the total 47 patients, 25 patients had pseudocysts and 22 patients had neoplastic cysts proven by histopathology or endoscopy guided aspiration. The neoplastic cysts include 6 benign IPMN, 8 serous cystadenoma, 4 mucinous cystadenoma, 2 SPEN and 2 mucinous cystadenocarcinomata. All the non-neoplastic cysts were pseudocysts and were predominantly seen in males than females with high prevalence between 41-50 yrs. All of them had association with acute or chronic pancreatitis. Most (58%- 11/19) of the benign neoplastic cysts were seen in females and all the 2 malignant cysts (mucinous cystadenocarcinomas) were seen in the males. All the SPEN were seen in females. About 75% (3/4) of the mucinous cystadenomas were female. Conclusion: CT scans helps us to diagnose various cystic lesions of pancreas based on different characteristic imaging features
Factors Influencing Workplace Violence against Health Care Personnel in a Tertiary Health Care Institute of West Bengal,India, India
Get PDFBackground: Violence in health sector although being a global issue as well as an alarming burden in India, has received limited attention till now. The present study aimed at estimation of perceived causes of workplace violence (WPV) in health sector and exploration of the possible measures to prevent it. Methods: A qualitative study was undertaken in Burdwan Medical College and Hospital a tertiary health care facility of West Bengal,India, during September – December 2018 among different types of health care personnel. Six from each stratum of doctors, nurses and support staffs i.e. 18 health personnel were included as the study subjects in Focussed Group Discussions (FGD) to explore the perceived causes of workplace violence. In-depth interview were (IDI) done with 25 individual. 3 Key Informant Interviews (KII) were done among senior faculties associated with hospital administration. 3 Focussed Group Discussions (FGD) were undertaken with the 18 health care personnel comprising 6 participants in each session with the help of a predetermined FGD guide composed of some guiding questions.Results: Doctor patient miscommunication, lack of manpower, political influence was few of the salient reasons of violence in health sector.Conclusion: The study highlights several issues like behavioural aspects, communication gaps between service provider and beneficiaries, resource crisis and political as well as social factors to be causative for violence in health sector
Assessment of hand hygiene practices among rural population in Basti district of Uttar Pradesh
Get PDFBackground: Hand washing is a preventive method for prevention of most of the communicable disease. Hand washing with soap is the most effective and cost-effective method to reduce the global burden of infectious disease. Present study was conducted to study hand washing practices in rural population. Objectives: The objectives are as follows: (i) To assess the hand washing practices in rural areas (ii) To identify the factors associated with hand washing practices (iii) To determine the association between hand washing and infectious diseases. Materials and Methods: A cross-sectional study was carried out in rural area of Basti city of Uttar Pradesh to assess the knowledge, awareness and perception of hand washing practices by house to house survey during the period of July 2021 to September 2021. Data were collected by prevalidated and pre-tested questionnaire. Data were entered into Microsoft Excel and analyzed using SPSS version 17.0. Results: A total of 1245 participants were included in this study. A total of 26 participants were excluded in accordance with the exclusion criteria like incomplete information. All the participants (100%) practiced hand washing after defecation. The major source of information for motivation of hand washing was practices was family (41.9%) followed by school (38.3%) and mass media like Radio, Television etc. (19.8%). Literacy status plays significantly associated with medium of hand washing.Conclusion: Among all the study participants who practiced hand washing, majority of them used water with soap and is influenced by factors such as age, frequency of health facility visits, and previous infections. The efforts are needed to encourage hand washing practices in those who were only using water for hand washing
Efficacy and safety of topical cyclosporine 0.05% in vernal keratoconjunctivitis: Aggarwal Eye Hospital, Hyderabad
Get PDFIntroduction: While corticosteroids are an effective choice of treatment for severe vernal keratoconjunctivitis (VKC), their long-term use is restricted due to side effects. This study was conducted to evaluate the efficacy and safety of topical cyclosporine A (CsA) 0.05% in the treatment of VKC. Methods: A total of 40 patients with VKC that was resistant to topical corticosteroids, antihistamines, and mast cell stabilizers were treated with topical CsA 0.05%. Patients were evaluated at weeks 4, 8, and 12 after the initiation of therapy. Symptoms and signs observed before and after treatment were recorded and scores were assigned. Scores were assigned to symptoms and indicators, as well as the requirement for topical corticosteroids and ocular side effects. Results: Symptoms and indicators were graded on a four-point scale from 0 to 3 for all patients. Each patient was given topical cyclosporine 0.05 percent emulsion (Restasis, Sun Pharmaceutical Industries Ltd, India) four times a day, along with preservative-free artificial tears, and was followed for 12 weeks. The data was collected before the start of therapy (day 0) and at Weeks 4, 8, and 12 after treatment. The severity of all symptoms and indicators decreased statistically significantly (p<0.05) after 12 weeks of therapy. There were no significant side effects reported by the patients. Conclusion: Topical cyclosporine 0.05% emulsion treatment is a safe and effective treatment option for controlling the symptoms and signs of vernal keratoconjunctivitis in children