International Journal of Medical Research & Review (IJMRR)
Not a member yet
1355 research outputs found
Sort by
Analysis of D-Dimer Levels among Covid -19 Positive Patients in a Tertiary Care Hospital in Bangalore
Get PDFIntroduction: Pro-thrombotic changes are stimulated by Corona Virus as it has an affinity for endothelium and lung structures and this may explain its association with thrombotic events, reduction of pulmonary gas exchange, respiratory distress, and death. D-dimer is a specific marker of the breakdown of a fibrin clot and has been used as a diagnostic and prognostic marker in VTE and other coagulation disorders.
Objectives: The objective of this study was to assess the correlation of the D-Dimer levels and disease severity among COVID-19 patients.
Materials and methods: This is a retrospective study done over 6 months from July 2020 to December 2020 in a tertiary care hospital in Bangalore. All the COVID- 19 positive cases who were admitted to our hospital were audited regarding the D-dimer levels during admission and the course of the treatment.
Results: Coagulation disorder occurred at the early stage of COVID-19 infection, with 1066 (57.7%) patients having increased D-dimer levels. Out of 1846 COVID 19 patients 106 (5.7%)patients died due to complications. 106 patients who deceased, all the patients had an increased D dimer value either in the first lab test or in the consecutive tests. Among 106 patients 56(52.8%) patients had increased D-dimer at the first lab test, 32 (30.1%) had D-dimer increased at the second and 18(16.98%) in third lab tests. The increased D-dimer levels were closely associated with the progression of the disease and also the changes in the CT imaging.
Conclusion: The increase in D-Dimer levels also increased the complications in the COVID-19 patient. So it is necessary to continuously monitor D-dimer levels and labelled anticoagulation as management tools for COVID-19 disease to prevent complications and reduce interventions
Study of functional outcome in low grade spondylolisthesis operated by pedicular screw instrumentation and fusion
Get PDFBackground: Functional outcome following instrumental spinal surgery for spondylolisthesis in physically energetic patients is crucial. The present study was undertaken to evaluate the functional outcome of low-grade spondylolisthesis accompanied by low back pain with or without radiculopathy, with standard surgical procedure posterior lumbar interbody fusion with instrumentation.
Method: In this study total of 40 patients were operated on for low-grade spondylolisthesis by posterior stabilization using a pedicular screw rod system and posterior lumbar interbody fusion. All the patients were followed up till 6 months after surgery and functional outcomes were noted.
Results: Assessment of this series it was observed that, 57.5% of the patient had excellent outcome, 37.5% had a good outcome and 97.5% of the study population had satisfactory outcome (improvement in clinical results). There was a significant improvement in pain intensity, walking, lifting, standing, sleeping after surgery. The mean ODI difference between preoperative and post-operative at 6 months follow up was 36.12% (16.75). In the outcome, 62.5% of the patient consisted of severe disability and 32.5% were with moderate disability (total-95%) while postoperative 87.5% were with a minimal disability and only 2.5% of the study population had worsened i.e crippled.
Conclusion: The study concluded that surgery in form of decompression with instrumentation and posterior lumbar interbody is a safe and effective method to treat spondylolisthesis
Predictors of Prolonged Duration of Mechanical Ventilation and Mortality in Patients with Guillian-Barre Syndrome
Get PDFBackground: Nearly one-third of the patients with Guillian-Barre syndrome (GBS) require ventilatory assistance, the duration of which is variable. There are no studies from India to predict the duration of ventilatory requirement in patients with GBS which might help direct the clinician to perform a tracheostomy.
Aim: To study the predictors that determine the duration of mechanical ventilation (MV) and the outcome of GBS patients requiring MV. Materials and Methods: This is a retrospective, observational study from a referral teaching hospital. All consecutive patients diagnosed with GBS and requiring mechanical ventilation between 2009-2018 were included in the study. The demographic, clinical parameters, electrophysiological data, complications and outcome of these patients was noted. Factors predicting prolonged MV (>2 weeks) were statistically assessed.
Result: Out of 79 patients requiring MV, 45(57%) patients needed prolonged MV and tracheostomy was performed in 29(37%). On multivariate regression analysis, sepsis (p=0.02; {95%CI 1.3-24.4}), MRC sum score (p=0.01; {95% CI 0.89-0.99}) and lower albumin levels on day 14(p=0.004{95% CI 0.05-0.57}) correlated with prolonged duration of MV. On univariate analysis, axonal variant of GBS(p=0.02), presence of chronic renal disease(p=0.03) and pulmonary disease(p=0.01) were associated with significant mortality. On multivariate regression analysis, age (>60 years) (p=0.001) {95% CI 0.89-0.97}, prolonged duration of MV(p=0.02) {95%CI 0.88-0.99}, MRC sum score(p=0.01) {95% CI 1.01-1.1} correlated with poor outcome.
Conclusions: Sepsis and septic shock and not the choice of immunotherapy nor the electrophysiological subtypes of GBS determined the prolonged duration of MV in our cohort, though the axonal variant on electrophysiology predicted the mortality
A Prospective Study of Profile of Agricultural Orthopaedic Injuries in North India in a Tertiary Care Centre
Get PDFBackground: Over time agriculture has transformed into an industry, both in scale and mechanization. Growing demand for agricultural yield and increasing mechanization has led to growth in the numbers of agricultural accidents and injuries causing significant morbidity and economical loss.
Aim: To study the causes, patterns, outcomes of injuries due to agricultural accidents, their effect on the productivity of the victims, and to suggest possible remedial measures, a prospective study was undertaken.
Methods: A total of 106 patients reporting agricultural injuries (AI) over 14 months in 2019-20 were enrolled and data was recorded on a pre-structured proforma.
Results: With the preponderance of male victims, educational status, skill levels, lighting & climatic conditions, intoxication and fatigue were found to be major determinants in the causation of injuries with upper limbs being the predominantly involved part (75.47%) and most of the cases ended up requiring some form of surgery (88.68%). Agricultural machinery (56.60%) was the main cause of AI and Chaff Cutter Machine caused the maximum AI (37.73%). Amputations were the most common injuries sustained (47.16%). Agricultural injuries affected the range of motion of body parts (32.07%) and work (58.49%) & household activities (49.05%); thus impairing work efficiency and economy.
Conclusion: The present study highlights the need for a robust surveillance and data analysis leading to better design of farming machinery and equipment, more relevant education and training systems, stronger legislations as well as a comprehensive rehabilitative program aimed at reducing the socio-economic burden caused by agricultural injuries
Efficacy of standard treatment protocol in recently diagnosed Lupus Nephritis at our tertiary care teaching hospital
Get PDFIntroduction: Lupus Nephritis occurred in approximately 50% of Systemic Lupus Erythematosus patients at some point during their illness and is associated with a poor prognosis.
Material and Method: A prospective observational study of 50 newly diagnosed LN cases was conducted to investigate the response of standard treatment protocol (Cyclophosphamide -NIH protocol and Mycophenolate Mofetil-MMF).
Results: Of the 50 newly diagnosed cases of LN, 94 % (n=47) were females, and 6 % (n=3) were males, with class IV LN accounting for the majority of patients 69.39 % (n=34). At six months, 36.7 % (n=11) of patients in the cyclophosphamide (CYP) group had a complete response. Only 27.3 % of patients in the MMF group had a complete response; however, this difference was not statistically significant. At the end of one year, only 56.7 % of the CYP group and 81.8 % of the MMF group had a complete response; however, this difference was not statistically significant (p=0.282). Although the initial response with CYP was better and later in the MMF group, these differences were not significant statistically. Tuberculosis or its reactivation was the most common complication during treatment, either with MMF or CYP. One patient died due to latent tuberculosis reactivation, another as a result of severe disease activity at presentation (proteinuria was 20 gm/24 hours in that patient), and the third as a result of pneumonia with septicemia.
Conclusion: Treatment with either CYP or MMF is equally effective, but underlying infection, particularly tuberculosis, should be ruled out before initiating therapy
A cross-sectional study on knowledge and perception about preventive strategies of selected vector-borne diseases among the rural population of coastal Karnataka
Get PDFBackground and Objectives: Malaria and other vector-borne diseases (Dengue, Chikungunya and Filariasis) are a major public health problem in WHO’s South-East Asia Region. Due to the growing resistance to pesticides and drugs, there is a need to set up integrated vector management strategies. These strategies should involve local communities in managing the environment to decrease the health risks and increase the sustainability of programmes to control these vector-borne diseases. Hence, an important step in disease management is educating the local community regarding vector-borne diseases and their prevention.
Objectives: To assess the Knowledge & perception regarding preventive strategies of selected vector-borne diseases among the study population.
Methods: This study was conducted in two selected villages. A cross-sectional study design was used with a sample size of 966. A questionnaire method was used to collect the data.
Results: Around 46.5% of them had good knowledge regarding preventive strategies of vector-borne diseases. Whereas, Around 42.2% and 40% of the population had average perception and high perception respectively.
Conclusion: Even though only half of the population had good knowledge regarding preventive strategies for vector-borne diseases. Most of them had average to high perceptions about preventive strategies. Hence to increase their knowledge many camps and health education activities should be conducted on vector-borne diseases and should mainly emphasize community participation to increase their awareness. So that it leads to better practice which in turn will lead to a decrease in vector-borne diseases
The outcome of platelet-rich plasma injection therapy in chronic plantar fasciitis
Get PDFBackground: Plantar Fasciitis is a frequently encountered problem in the everyday practice of orthopaedics. Treatment of Plantar Fasciitis is challenging to treating surgeon. Various conservative non-invasive treatment modalities are available like rest, casting, night splinting, NSAIDs. If conservative management fails then corticosteroid injection over the medial tuberosity of calcaneum is an effective treatment. But in recent years Platelet-rich plasma (PRP) has proved to be a safe alternative approach with less complication. This study aims to find out the effectiveness of PRP injections in Plantar Fasciitis.
Material and Method: In this study, 60 patients with Plantar Fasciitis were included. Regular follow up was done at an interval of 4 weeks, 8 weeks and 6 months after PRP injection. Pain intensity was measured before and after injection on every follow up using the Visual Analogue Scale (VAS). Patients who have undergone at least 4 weeks of conservative treatment were included in the study.
Results: After analysis of data, the average VAS score before injection was 7.01±1.35. Whereas at the end of the last visit (i.e. 6 months) average VAS score reduced to 2.2±1.25. This difference was statistically significant (ANNOVA test p <0.0001).
Conclusion: we concluded that injection of PRP is a safe, convenient and effective approach to treat chronic Plantar Fasciitis
A rare case of iii cranial nerve palsy - mucormycosis involving the right maxillary and ethmoidal sinus
Get PDFIIIrd Cranial nerve palsy, known as oculomotor nerve palsy, may result from various causes, however, the etiology remains unknown in some instances. This case report aims to present the authors\u27 experience with a case of IIIrd cranial nerve palsy, together with a review of the literature. Many etiologies have been associated with isolated oculomotor nerve palsies. We report the case of a patient who presented with right maxillary and ethmoidal sinusitis with IIIrd cranial nerve palsy associated with mucormycosis. Careful examinations to rule out other causes must be done and then treatment with antifungals should be considered after early diagnosis
Study on the correlation between Vitamin D and HbA1c in type 2 diabetes mellitus
Get PDFBackground: Type 2 diabetes mellitus (DM) is associated with increased morbidity and mortality due to the development of complications, especially due to poor glycemic control. Besides its role in calcium homeostasis, Vitamin D has been involved in the pathophysiology as well as glycemic control of type 2 DM.
Methods: 100 patients diagnosed with type 2 DM were included. Vitamin D levels along with glycosylated haemoglobin were measured in all the individuals.
Results: Vitamin D deficiency was observed in 48% of the patients. Vitamin D levels were not associated with markers of glycemic control (HbA1c).
Conclusions: Hypovitaminosis D was observed nearly in half of the patients with type 2 diabetes, suggesting a potential for vitamin D supplementation in type 2 DM patients
Prevalence of Bronchogenic carcinoma in the North Indian Population
Get PDFAim: This original research article aims to study the Prevalence of Bronchogenic carcinoma in the North Indian Population.
Material & Method: The present study includes 150 patients with intrathoracic space-occupying lesions, of which 42 patients with bronchogenic carcinoma were seen at SS hospital Banaras Hindu University, Varanasi, UP. Most of the patients studied were from the thoracic surgery section, while few patients were taken from other departments of SS hospital. The age of those patients varied widely, starting from 10 years to 60 years. The bulk of the patients were young adults and middle-aged persons, with 35 males and seven females. During this study, patients were investigated in systemic order with the progression of symptoms from the onset, development of latest symptoms and treatment taken before if any, history of tuberculosis, chronic cough, smoking, and contact with were recorded. The patient\u27s vitals were recorded, and routine pathological investigation including blood count, hemoglobin and specific procedure like radiological method, sputum and bronchoscopy were performed.
Result: Maximum patients were in the age group of 41 to 50 years. Forty-two patients were diagnosed with Bronchogenic carcinoma, a definitive diagnosis was confirmed by Clinical & Radiological (chest X-ray & CT Scan) in 24 (16%), by Bronchoscopic examination & Biopsy in 15 (10%) and by thoracotomy in 03(2%). The maximum age group among the cases were 41-60. The most common symptom was Cough with expectoration in 33 patients (78.5%), followed by Haemoptysis and Dyspnea in 30 cases (71.4%). Fever was least common with 6 cases. It was observed that 18 patients (43%) had the habit of smoking for more than 18 years.
Conclusion: This study provides a framework for assessing the prevalence of bronchogenic carcinoma in the North Indian population and proves that smoking is a potential risk factor in bronchogenic carcinoma. Prevalence of Bronchogenic Carcinoma among all cases of Intrathoracic Lesions Cases 28 % and among all subjects who undergone for screening in one year – 2.84