International Journal of Medical Research & Review (IJMRR)
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Knowledge and Awareness of usage of Artificial Sweeteners among Indian type 2 diabetes individuals in a tertiary diabetes institute
Get PDFBackground: Diabetes mellitus is a chronic metabolic disease primarily attributable to unhealthy, untimely food habits and lack of physical activity. Good glycemic control is one of the key aspects in preventing complications. This has led to a shift in replacing sugar with artificial sweeteners amongst the diabetic population. It is not known whether this is aimed to maintain blood glucose levels or to satisfy the sweet cravings. There is lack of awareness of the type and long-term side effects of artificial sweeteners among people with diabetes.
Objectives: This study was conducted to assess the awareness and knowledge of usage of artificial sweeteners among adults with type 2 diabetes visiting a tertiary diabetes institute.
Materials and Methods: The study population involved 297 adults (≥18 years) with type 2 diabetes attending tertiary diabetes institute. Data was collected from face-to-face interview technique along with a pre-validated questionnaire.
Results: The total number of subjects (n=297) comprised 126 females and 171 males of age 18-88 with mean age of 56.5 years. Sucralose was the most popular sugar substitute amongst the subjects (45%) followed by Aspartame (32%), 13% of them are completely not aware of the type of artificial sweetener that they consumed. About 36.7% of the subjects belonged to pre-obese category with BMI 25-29.9kg/m2 with women on the upper scale. 57.91% of the respondents started consuming artificial sweeteners in the recent years i.e., between 1to 5 years. 87% of the subjects consumed artificial sweeteners in the form of pellets in tea or coffee as a medium and 51% consumed it to manage blood glucose levels. 51.2% had gastrointestinal side effects. Significant number of the subjects (81.5%) was unaware of the long-term side effects of artificial sweeteners.
Conclusions: The study findings highlight the high rate of unawareness amongst the subjects regarding the side effects of long-term consumption of artificial sweeteners. Hence, reading nutrition label on the products, judicious consumption of artificial sweeteners and nutritional education can be helpful in making wise food choices
Risk Factors Affecting Exacerbation of Bronchiectasis Leading to Hospitalisation In Patients Attending A Tertiary Care Setting
Get PDFIntroduction: Bronchiectasis is a chronic respiratory disease characterized by structural changes in airways, leading to recurrent episodes of cough with expectoration. Exacerbations are significant events associated with increased morbidity and mortality.
Aim: To evaluate factors associated with exacerbations requiring hospitalization in patients with bronchiectasis
Materials and methods: A prospective observational study was done at a tertiary care teaching hospital from December 2017 to May 2019. Demographic data, comorbidities, investigations including HRCT, sputum culture and spirometry were collected. Patients were grouped into exacerbations requiring hospitalizations and those managed as outpatients and followed up for one year. Factors associated with exacerbations were assessed and compared between the two groups.
Results: 89 patients were recruited for the study, out of which 12 patients without exacerbation during the study period were excluded. The remaining 77 patients were divided into those who needed hospitalization (37) and those managed as outpatients (40). About 48.1%required hospital admission. Factors associated with exacerbations were advanced age, isolation of organisms from sputum, FEV1 less than 50%, PPI use during the study period, concomitant COPD, vaccination with pneumococcal and influenza vaccines and high severity scores. Use of LTO2, LABA/ICS, chest physiotherapy, mucolytic agents, radiological extent and previous history of exacerbations were not associated with exacerbations leading to hospitalization.
Conclusion: Factors associated with bronchiectasis exacerbations leading to hospitalizations were advanced age, high bronchiectasis severity score, FEV1 less than 50%, PPI use and concomitant COPD. Vaccination for influenza and pneumococcus had a favourable impact in reducing hospitalization
A rare presentation of hyperhomocysteinemia and folate deciency asCSVT in young male
Get PDFIntroduction: Cerebral sinus venous thrombosis (CSVT) is a relatively rare, potentially fatalneurological condition that can be frequently overlooked due to its vague nature and its variedspectrum of clinical presentation. It’s a multifactorial condition with gender-related specific causes.It’s a rare form of venous thromboembolism representing almost 0.5-3 % of all types of stroke,affecting predominantly younger people, and females three times more commonly affected thanmales. Incidents in adults are 3- 4 million. The diagnosis of CSVT is becoming easier now days dueto advanced neuroimaging techniques. Abnormality in the thrombophilic profile is associated withenhanced risk of CSVT. It has varied etiologies such as the Hypercoagulable States (inherited) that ishyperhomocysteinemia, protein C and protein S deficiency, Antithrombin-III deficiency, Factor Vleiden mutations, autoimmune causes. Other acquired causes like CNS infection, trauma,dehydration, pregnancy, substances abuse and oral contraceptives
Distal Radial Artery Access (DRA) Vs. Transradial Access (TRA): Current Evidence
No full textIntroduction: Transradial access (TRA) is currently recommended over the transfemoral (TFA)route as default, for percutaneous coronary interventions (PCI) and coronary angiography in allpatients, by the European and American Guidelines, because of reduced risk of bleeding, vascularcomplications and mortality especially in acute and high -risk patients.
Aims and objectives: Distalradial artery access (DRA) via the anatomical snuffbox is a safe and feasible alternative to standardtransradial access (TRA). This review aims to study and discuss the endpoints in recent studiescomparing DRA with TRA for coronary procedures to conclude the merits and demerits of DRA Vs.TRA.
Material and Methods: The evidence from several randomized and non-randomized studiesand meta-analyses comparing DRA with TRA is reviewed. Results: Though access failures andcrossovers are reported to be higher with DRA compared to TRA; most studies have shown nodifference in vascular complications in patients undergoing procedures via DRA or TRA.
Results ofsome randomized controlled trials between DRA Vs. TRA for coronary procedures, including PrimaryPercutaneous Coronary Intervention in ST-elevation myocardial infarction (STEMI) are available andare discussed; while others are underway for evaluation of radial artery occlusion (RAO) and otherend-points.
Conclusion: DRA takes more time, and fails more often compared to TRA; though timeto hemostasis is less and forearm hematoma is unreported with DRA. The Jury is still out on RAObetween DRA Vs. TRA; but the meticulous application of RAO prevention practices is the key toachieving low RA
Opting Nursing as a Profession among B.Sc. Nursing Students in India: A descriptive survey research
Get PDFIntroduction: Nursing as a career is widely accepted to be viewed positively by society because itprovides job security, mobility, and career variety. As this paper demonstrates, the desire to helpand care for others remains the primary reason for choosing nursing in the twenty-first century.
Objective: The purpose of this paper is to determine why B.Sc. Nursing students choose nursing asa career and what factors play a role in their choice. Method and Material: Quantitative,descriptive survey research design adopted and by using convenience sampling collected 312respondents all over India. Self-questionnaires were developed in the google form, and circulatedamong B.Sc. Nursing students and information were collected.
Result: Female respondents are fourfolds more and around 51% of respondents appeared in NEET exams before joining a nursing career.Another common misconception that plagues the nursing profession is that students choose nursingas a second career after failing to gain admission to medical school.
Conclusion: In general, nursesare extremely enthusiastic about their jobs. Although there are numerous reasons why peoplechoose nursing as a profession, one constant is that nurses can make a difference in someone\u27s life,as evidenced by all of the COVID-19 cases reported from around the worl
Window of opportunity in axial spondyloarthritis: A Stitch in Time
Get PDFAxial spondyloarthritis comprising both non-radiographic axial spondyloarthritis and ankylosingspondylitis has a deleterious impact on the patient’s quality of life with a detrimental outcome ofstructural damage. Although in the current era of diagnostic advancements, axSpA can be diagnosedearly within a short period after the onset of symptoms, but still there is a delay of up to severalyears in many parts of the world. The concept of a window of opportunity is primarily derived fromrheumatoid arthritis, which is relevant in the context of axSpA based upon the early diagnosis and tocommence highly effective treatment with biologics like anti-TNF and anti-IL-17 to modify thedisease process for arresting structural damage or syndesmophytes formation. Still, challenges existfor early diagnosis of SpA in patients with low back pain which ultimately creates a barrier toeffective treatment initiation. More robust researches along with the available evidence on both theaspects of clinical and imaging factors are the way forward for the early identification of susceptibleindividuals for early intervention with a better outcome
Etiology and endoscopic profile of dysphagia in adults - Single center study at a tertiary care center in South India.
Get PDFBackground: Dysphagia is defined as difficulty in deglutition. It can be either structural or motility abnormality in the passage of food from the oral cavity to the stomach. Upper GI endoscopy is the most important tool to diagnose dysphagia and rule out premalignant and malignant lesions. The purpose of the study was to classify various causes of dysphagia.
Methods: This prospective observational study was conducted on 206 patients with complaints of dysphagia. Detailed history, physical examination was done. Upper GI endoscopy was done in all cases, and biopsies were taken if required. Oropharyngeal and neurological dysphagia were excluded from the study. The statistical analysis was performed using Microsoft Excel. The mean, percentage and proportions were calculated.
Results: Two hundred and six patients were included in the study. Out of 206 patients, 127 were females, and 79 were males. The mean age was 43.62 years. The commonest age group was 21- 40 years contributing 41.7% cases, followed by 41-60 years contributing to 30.8% cases. Benign etiology (n= 141) was more common than that of malignant (n= 65). The commonest benign etiology was reflux esophagitis (n =54) followed by esophageal candidiasis (n= 38). The commonest malignant etiology was adenocarcinoma of the esophagus (n= 38), followed by squamous cell carcinoma (n= 24).
Conclusions: The upper GI endoscopy is effective and safe modality to diagnose dysphagia. Benign etiologies were more common among females, but malignant causes were more common among males. The incidence of esophageal malignancy increases with advanced age
Clinicopathological analysis of 33 cases of laryngeal carcinoma with their response to COVID19 virus
Get PDFBackground: laryngeal carcinoma is a common cancer of the head and neck region. Lifestyle, signs and symptoms, including those of COVID-19, clinical and histological features of the lesions were highlighted in this study to increase the understanding of this fatal cancer, which will decrease the high morbidity and mortality rates associated with it.
Methods: This study was conducted at the Department of Otorhinolaryngology, 33 cases of laryngeal cancer presented from January 2017 to July 2019 were included in this study.
Results: the leading age group of subjects was 51-60 years. Smoking was a significant risk factor in 100% of cases. Most of the patients presented with hoarseness of voice followed by dysphagia. The glottic area was the commonest site (72.7%) for laryngeal cancer and squamous cell carcinoma seen in 100% of patients. Most of the cases showed a well-differentiated tumour with 39.9% of patients and presented in stage I (42.4%). Only a few cases (9%) had cervical lymph node metastasis at the time of presentation. And only four patients developed COVID-19 infection post laryngectomy, their symptoms were mild upper respiratory tract infection, and their chest x-rays were clear. All of them healed without any severe complication of CVOID-19.
Conclusions: Early detection of laryngeal cancer is associated with a good prognosis. This early detection is based on good history, clinical examination, and invasive and non-invasive investigation. Post laryngectomy care may play an essential role in protecting the patient from serious complications of COVID-19 infection
First Trimester Screening by Ultrasonographic Markers For Prediction of Preeclampsia
Get PDFAim- To correlate association of ultrasonographic markers in antenatal patients with subsequent development of preeclampsia Material Method - 131 pregnant women, in first trimester of pregnancy were investigated for their uterine artery Doppler and placental volume. These patients were followed up till term for the development of preeclampsia. Results: Out of 131 antenatal cases 20.61% developed preeclampsia. Uterine artery Pulsatility index >95th percentile(>2.3) with mean 2.08±0.43(p value 0.0001) predicted pre eclampsia with sensitivity of 51.85% with specificity of 95.19%. Similarly Resistance index of Uterine artery >95th percentile(>0.8) with mean 0.771±0.084(p value 0.018) predicted pre eclampsia with sensitivity of 48.15% and specificity of 87.50% . Placental Quotient <10th percentile (<0.81) with mean 0.89 (p value 0.0001)predicted pre eclampsia with sensitivity of 40.74% and specificity of 96%.On combining all three ultrasonographic parameters the sensitivity for prediction of preeclampsia was increased to 70.37% with specificity of 86.54% with PPV of 36.74% % and NPV of 96.34% %.
Conclusion: Maternal ultrasonographic markers like Uterine artery PI, RI, Placental Quotient levels vary between normal pregnancies and those that subsequently developed preeclampsia. Thus our study concludes that first trimester screening with ultrasonographic markershave high sensitivity, specificity and negative predictive value in detection of preeclampsia
A study to determine Calorie and protein intake in adolescent school girls of Indore city, M.P., India
Get PDFIntroduction: Adolescence is a significant period of human growth and maturation. This period ofrapid growth requires a well-balanced diet. An inadequate diet and unfavourable environmentadversely influence the growth resulting in short stature and low lean body mass. Not muchattention has been paid to adolescents by nutrition-related programmes. Hence, this study wasplanned to assess the dietary intake of adolescent girls.
Method: This was a cross-sectional studyconducted in five schools in urban areas of Indore city. The study group included 400 school girls ofage 11 to 18 years. After taking written informed consent from the parents, data was collected onpersonal information, dietary intake and socioeconomic status. Anthropometric measurements weredone, and data were analyzed.
Results: The calorie intake in this study ranged from 69% to 86% ofR.D.A. Mean protein intake ranged from 71.5% to 73.7% of R.D.A., and mean iron intake rangedfrom 50% to 71.4% R.D.A. All the girls were consuming an inadequate amount of calories, proteinsand iron.
Conclusion: All the adolescent girls in this study had low intakes of calories, iron andprotein, which is comparable to that found in other Indian studies