International Journal of Health and Clinical Research
Not a member yet
3275 research outputs found
Sort by
A Hospital Based Prospective Study to Evaluate the Outcome of Very Low Birth Weight (VLBW) Neonates Discharged from District Hospital
Full text linkBackground: Birth weight is the most important determinant of perinatal, neonatal and postnatal outcomes. The main reason for increasing morbidity & mortality in VLBW neonates is due to their physiologic & metabolic immaturity. The aim of this study to assessed the morbidity and mortality profile in very low birth weight neonates in Neonatal Intensive Care Unit in District hospital in Rajasthan. Materials& Methods: A hospital based prospective observational study was conducted in the Department of Pediatrics, District hospital, Dholpur, Rajasthan, India during one year period. All VLBW neonates were included in the study after getting written informed consent from the parents for using their neonates’ clinical data for the study purpose. All VLBW neonates admitted in our NICU were enrolled in the study. Relevant details were collected which includes maternal details like their age, address, socioeconomic status, educational status, maternal weight, risk factors, gestational age, Antenatal steroids, premature rupture of membranes, mode of delivery and Baby’s details include their sex, need of resuscitation, Apgar score, gestational age, birth weight and their illness, need of mechanical ventilation and surfactant therapy were recorded. Results: Our study showed that maternal age < 18 years were 2 (2%) and most of the mothers were in the age 18-21 years – 35 (35%). Maternal hypertension being the most common cause for VLBW babies. Place of birth, mode of delivery and gender had no correlation with outcome of very low birth weight neonates (P=0.082, p=0.076, P=0.067 respectively). There is significant association of gestational age with outcome of very low birth weight neonates (P<0.05*). Conclusion: Prematurity is the primary cause behind this neonatal death. This emphasizes the need to prevent preterm deliveries. Effective preventive strategies to decrease the preterm birth can only be the next big step to decrease the perinatal morbidity rate of our state
A comparative study of vaginal and abdominal hystrectomy for enlarged uterus
Full text linkObjective: To compare outcome in patients who underwent vaginal and abdominal hysterectomy for benign enlarged uterus. Methods: In a prospective randomized study, 50 vaginal hysterectomies were compared with 50 abdominal hysterectomies performed from April 2020 to September 2021. Patients characteristics before, during and after operations were reviewed and followed up for 3 months to evaluate post op complications. Results: There was no difference in patients age, parity, uterine size and intraoperative complications between two groups. Operative time, blood loss, post op demand for analgesia and duration of hospital stay was lower in vaginal hysterectomy group as compared to the abdominal hysterectomy group. The overall complication occurred with TAH was significantly more than vaginal hysterectomy. Conclusion: Vaginal hysterectomy is safe as compared to abdominal hysterectomy in the treatment of benign gynecological disease with greater efficacy and safety even for enlarged and non prolapsed uterus
Dermatomycosis At a Tertiary Care Hospital: A Clinicomycological Study
Full text linkBackground: The prevalence of dermatophyte infections in the general population is rising today. Tinea corporis, Tinea cruris, Tinea faciei, etc. are some common names for it. Methods: For 130 clinically probable Dermatophytosis cases, samples including skin scrapings, nail clippings, hair, and hair stubs were processed. All of the samples underwent KOH mount and SDA culture. Results: The majority of the patients were men, 76 (58.46%) as opposed to 54 women (41.53 percent). The age group 20 to 30 is the most frequently affected one. The most common kind, tinea corporis, made up 66 (or 50.76 percent), followed by tinea cruris 25 (19.23 percent), tinea unguinum 18 (or 13.84 percent), and tinea capitis 10. (07.69 percent). Trichophyton rubrum was the most common isolate, accounting for 27 (38.57%) cases. It was followed by Trichophyton mentagrophytes (16.85%), Microsporumaudoni (15.42%), Microsporumgypsium (8.43%), Trichophyton violaceum (3.28%), and Epidermophyton fluccosum (01). (1.43 percent). Conclusion: Infection with dermatophytes is relatively common today. There are more men and they are mostly in the middle age range. It is most frequently observed in lower middle-class individuals, primarily manual labourers. The most typical manifestation is tinea corporis et cruris
Thyroid Profile of Women Presenting With Abnormal Uterine Bleeding (AUB): A Cross Sectional Study Done At a Tertiary Care Hospital of Bihar
Full text linkIntroduction: Fifty to twenty six percent of menstrual disorders are attributed to thyroid dysfunction. The objective of this study was to study the prevalence of thyroid disorders in patient with AUB and to study the menstrual pattern in patients with thyroid dysfunction. To determine the endometrial histopathology associated with different types of thyroid dysfunction. Materials and Methods: A hospital based cross sectional study was carried out by Department of Obstetrics and Gynecology, Darbhanga Medical College and Hospital, Laheriasri, Bihar, India. The study duration was between August 2020 to January 2021 for a period of 6 months and the participants were women attending gynecological OPD with complaints of abnormal uterine bleeding. The study was performed on a sample of 100 women selected on above criteria. This study was performed after obtaining approval from the institutional ethical committee. After obtaining a written informed consent from the participants, detailed history regarding the menstrual pattern, duration and quantity of bleeding during each cycle was noted. History suggestive of thyroid dysfunction was obtained. A complete clinical examination including examination of neck for thyroid swelling and a thorough gynecological examination was performed. All the information was tabulated and analyzed using SPSS 22 version with descriptive and inferential statistics (chi square test). A P value of<0.05 was considered statistically significant. Results: The age of the study participants ranged from 22 to 63 years. The mean age was 47.8 years with a SD of 12.7 years. Almost two-third of the women was in the peri-menopausal age group. %5 of the women with nullipara, another 14% was primipara and rest was multiparous. 57% had parity of ≥ 3. Heavy menstrual bleeding was the most common menstrual abnormality found among 82% of the study participants, followed by postmenopausal bleeding and oligo/polymenorrhea. Clinical thyroid examination had positive finding only in 3 patients. Conclusion: Testing and treating for thyroid disorder would prove to be cost effective in patients with AUB particularly with non-structural causes as it would avoid many costly interventions done for AUB
Spectrum of manifestation of Primary extra nodal lymphomas - A retrospective case series and review of the literature.
Full text linkObjective: To study spectrum of manifestation and histopathological correlation of primary extra nodal NHL. Material and method: 15 cases of primary extra nodal NHL were included in this retrospective study. Clinical details include Age, gender, presenting symptoms were collected. Histopathological examination was performed. Immunohistochemistry was done based on histopathological morphology. Result: Out of the 15 subjects included in this study, 11 were male and 4 were female. 7 subjects were in the 5th decade of their lives. DLBCL (8 case) was most frequent variant of PENL followed by Anaplastic large cell lymphomas (3 case), Angioimmunoblastic T cell lymphoma (2 case) and Marginal zone lymphoma (2 case). Conclusion: Frequency of ENL is gradually increasing and has a highly variable clinical presentation. The clinician and pathologist should be aware of uncommon presentations. High level of suspicion will allow for an early diagnosis of pENL, which would in turn be helpful in improving the prognosis by early initiation of appropriate treatment
Management of Inflamed Gall bladders Irrespective of Time line- A Prospective Study
Full text linkIntroduction: Usually laparoscopic cholecystectomy is performed in symptomatic cholelithiasis as an elective procedure and is considered as a gold standard. The role of laparoscopic cholecystectomy in early stage of acute cholecystitis i.e.within 72 hours of onset of symptomsin terms of feasibility,efficacy and safety is well proved beyond doubt with secondary advantages of early recovery,shorter hospital stay,no associated complications of acute cholecystitis in waiting period,early return to work, overall beneficial for the patient and is noncontroversial now. As for as late laparoscopic cholecystectomyi.e.after 72 hours to 6 weeks is concerned, there is a lack of consensus among surgeonsbut there are certain studies in literature which clearly shows that late laparoscopic cholecystectomy is safe and feasible with all advantages of ELC if it is performed by experienced surgeons. Eventhough it is said that the severity of inflammation increases with the time but it is not always true as response to inflammatory process varies in each individual because of unique quintessence of inheritance and hence time is no more a barrier in performing late laparoscopic cholecystectomy provided surgeon is experienced and skilled in modified techniques used in the management of difficult gallbladders with frozen calot. Methods: In our study of 104 patients the intraoperative findings are almost similar in both groups irrespective of stage of acute cholecystitis and timeline.There were difficult GB with frozen calot in both group,these all were managed by intraluminal guided retrograde dissection technique with the principle that no anatomical structure passes through the lumen of GB. Results: There is no difference in surgical outcome in early vs late laparoscopic cholecystectomy in terms of safety and efficacy, even though in late phase it is technically difficult and more time consuming, needing special skill and experience and use of special modified techniques.Both groups were comparable in terms of morbidity, mortality and hospital stayindependent of time line. Conclusion: Laparoscopic cholecystectomy for acute cholecystitis during emergency admission is safe and associated with low morbidity and low conversion rate regardless of time limit
Evaluation of antigen based rapid diagnostic test in comparison to RT PCR in diagnosis of Sars CoV2 with respect to duration of illness and Ct value of corresponding RT PCR
Full text linkBackground: SARS-CoV-2 is the third highly pathogenic corona virus introduced into mankind after Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) and Middle East Respiratory Syndrome coronavirus (MERS-CoV) in twenty-first century for which the development and validation of rapid and easy-to-perform diagnostic methods are of high priority. Objective: In this study we evaluated performance characteristics of RAT, the STANDARD Q COVID19 Ag by SD-Biosensor for rapid detection of SARS CoV 2. Material and methods: Samples were collected from 1168 patients and we performed both RAT and RT PCR and the results of RAT were compared with that of RT PCR as gold standard. Result: Detection rates of SARS CoV-2 by RAT and RT-PCR were 19.17% and 29.53%, respectively; false positivity rate was 2.67%.False positive and false negative rate was 2.6% and 13.45% respectively.RAT sensitivity, specificity, negative and positive predictive values were 63.18%, 99.27%, 97.32% and 86.54% respectively. Statistical analysis considered the calculation of sensitivity, specificity, positive predictive value, negative predictive value using standard formulae. Conclusion: A high sensitivity, specificity, positive predictive value and fairly high negative predictive value of RAT might prove to be promising in situations where pre-test probability of having infection is high
Etiology of Pyrexia of Unknown Origin on Bone Marrow Examination- In a tertiary care centre
Full text linkBackground: Pyrexia of unknown origin (PUO) has been defined by Petersdorf and Beeson as patient complaint of increased body temperature of more than 38.30C developing over a period of a ≥ 3 week before specific diagnosis including 1 week of investigation in hospital. In the present study, an attempt has was made to find out the causes of PUO based on bone marrow morphological finiding. Bone marrow examination plays an important role in early diagnosis of core cause for PUO and is the best investigating tool for haematological and non-haematological disorders in any age group. Materials & Method: It was a prospective study conducted in Department of Pathology, MGM Medical college & LSK hospital, Kishanganj, during the period of September 2019 to august 2021. All patients presenting with classical PUO whether inpatient or outpatient coming to Medical College fulfilling the criteria of Petersdorf RG et al. Results: Out of 56 patients, 35 were males and 21 were females. Age of patients varied from 2 years to 70 years. Majority of patients were in the age group of 30-44 years comprising of 32.2% of total cases. Most common diagnosis was neoplastic changes, seen in 30.3% of patients, reactive myeloid hyperplasia was seen in 21.4% cases,14.2% cases show megaloblastic anemia, iron deficiency was seen 3.6 % cases, haemophagocytosis in 5.3% cases, 5.3% cases showed hypocellular marrow. Among infections, malaria was the commonest constituting 5.3% cases. Out of total of 17 cases of neoplastic changes in bone marrow, majority of them were acute myeloid leukaemia seen in 35.3% cases. Conclusions: Bone marrow examination is most important investigation of PUO in arriving at an etiological diagnosis. The most common causes of pyrexia of unknown origin observed in children were acute lymphoblastic leukaemia, and haemophagocytosis, whereas in adults, the main causes were malignancies, reactive myeloid hyperplasia and megaloblastic anaemia . This study reflect light on the current spectrum of diseases causing pyrexia of unknown origin in this region
A study on the incidence of micro-albuminurea and left ventricular hypertrophy among hypertensive patients
Full text linkBackground: Hypertension provides both despair and hope. Despair because it is quantitatively the largest risk factor for cardiovascular diseases,is growing in prevalence, and is poorly controlled virtually everywhere. Hope because prevention is possible and because treatment can controlhypertension in all most all patients with consequent marked reduction in stroke and heart attack. Aim of study: To find out the incidence ofmicro-albuminuria and left ventricular hypertrophy among hypertensive patients without associated conditions like diabetes mellitus, stroke,ischaemic heart disease and renal diseases. Materials and methods: The Study was conducted in 97 cases who are hospitalized in AlluriSitarama Raju Academy of Medical Sciences from October 2020 to October 2021. after getting approved by the institutional ethical committee.An individual informed consent is taken from all the patients selected for the study. Discussion: Left ventricular hypertrophy andmicroalbuminuria are currently drawing a great deal of attention in the medical literature. Much of this attention derives from the fact thatalbumin excretion is a risk factor for kidney failure, stroke, and cardiovascular and all cause mortality, particularly for persons with hypertension.Conclusion: In our study 22.7 % of the study subjects had microalbuminuria and 20.6 % had left ventricular hypertrophy
Effectiveness of Transpedicular Biopsy for Spinal Lesion performed under 2D fluoroscopic guidance
Full text linkTranspedicular biopsy is becoming gold standard test for appropriate tissue diagnosis for vertebral body lesion. Most of central vertebral body lesion can be approached via transpedicular route under fluoroscopic guidance under local anaesthesia. This route is safe, efficient, cost and can be performed as day care procedure . We were able to establish appropriate diagnosis in 57/65 (87.69%) patients which is comparable other studies