International Journal of Medical Research & Review (IJMRR)
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Effect of Previous Scorpion Bite on the Ecacy of IntrathecallyAdministered Bupivacaine in Subarachnoid Block
No full textAim: To study the efficacy of spinal anesthesia in patients with previous scorpion bites and patientswith no such history.
Method: In this study, 40 patients were divided into two groups each of 20,patients with h/o scorpion bite (group -1), patients with no such history (group -2), scheduled forlower abdominal and lower limb surgeries, the subarachnoid block was given with 3.0 ml of injectionBupivacaine 0.5% heavy using 26 gauzes Quincke spinal needle. A blind observer recorded asensory block using a needle prick and a motor block using the Bromage scale.
Result: Patients whohad previous scorpion bites (group -1) had a significant failure rate of spinal anesthesia compared tothe patient with no such history (group - 2). Our study shows how in the bite group, the onset andpeak effect of sensory and motor block is prolonged statistically significantly after exposure to ascorpion bite. It also depends on the number of exposures, as shown in table 4.
Conclusion: In thisstudy, it was observed that the patients with scorpion bites had a significant failure rate of spinalanesthesia, suggesting probable resistance to the local anesthetic agents as observed in previoussimilar studies
Study of knowledge, perception, and practice of patients regarding fasting requirements for blood glucose testing
Get PDFBackground: Patient preparation is one of the least standardized parts of the preanalytic phase of testing. Fasting blood glucose requires fasting for 8-12 hours as per various guidelines and also has several other requirements. Lack of communication, understanding, or compliance regarding hours-of-fasting, water-intake, avoidance of caloric snack/beverage, the sudden change in smoking, exercise, alcohol, medication, etc. introduces preanalytic errors.
Method: To evaluate awareness, understanding, and compliance with fasting requirements, a face-to-face survey was done on outpatients in a Government Hospital in Pali, Rajasthan, India. Relatively more educated internet users were surveyed as controls through an online SurveyMonkey tool. Information collected included demographics, perception of above mentioned preanalytic factors related to fasting, and compliance.
Results: 98 patients and 187 controls participated in the study. Perception about fasting requirements ranged from 0-17 hours. 71% of patients and 35% of controls perceived that nobody explained to them the duration or nature of fasting. The different sources of information had been used in different proportions by patients and controls. For imparting understanding and compliance about duration, and other requirements of fasting, the instruction was usually incomplete but still much more effective (p-value=0.000002) than formal education level (p-value=0.024). Financial status had a weak negative association with awareness but was not significant.
Conclusion: 71% of patients and 35% of controls did not receive instructions for fasting. 40% of those instructed showed better compliance, but awareness was incomplete. The instruction was more effective than formal education in improving awareness and compliance. Improved awareness was strongly associated with receiving instruction and weakly associated with formal education but financial status showed only a weak negative association
Validity of Screening for Pre-Diabetes and Type2 DM in Patients Presenting with Oral Symptoms
Get PDFIntroduction: Type 2 DM is a major health problem in the present world with its high micro and macrovascular complications leading to increased mortality and morbidity. Our diagnosed T2DM represents the tip of the iceberg, where the hidden part places a vital challenge to the health care system.
Objectives: Various risk factors are identified to screen the population for diabetes which is still an incomplete list hence we aimed to identify the dental illness as a potent risk factor to screen T2DM and Prediabetes.
Methodology: This is an observational study in which 92 patients attending to dental clinic except for traumatic problems were screened for T2DM with random blood sugar and HbA1c.
Results: In our study we observed 22.8% pre-diabetic and 8.8% with newly diagnosed T2DM among the study population. Chronic periodontitis was accounting for more than 60% of the subjects presenting dental illness.
Conclusion: In our study we conclude that dental illness to be accounted as a potent risk factor for T2DM/Pre-Diabete
Air-conditioning guidelines for healthcare facilities during the covid pandemic
Get PDFCoronavirus disease (COVID-19) is an infectious disease caused by a newly discovered Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease spreads primarily through respiratory droplets, physical contact and contact with surfaces as well as fomites. Isolation of patients in hospitals and quarantine of contacts in separate facilities are the mainstay of outbreak containment. This pandemic has brought forward various challenges to the hospital administrators, one of the most important being air-conditioning of hospitals in the time of this pandemic
Managing COVID in Homecare – Approach to Treatment, Monitoring, and Follow-up by the Family Physician.
Get PDFIntroduction: The 2nd wave of COVID caused an unprecedented burden on health care workers and resources, calling for structured and effective management of most COVID patients in-home care by general and family physicians via digital and virtual monitoring.
Methodology: A systematic treatment approach evolved from COVID diagnosis, homecare determination and isolation, oxygen saturation and temperature monitoring documentation, guidance on proning and breathing techniques, diet and lifestyle measures, evaluating comorbidities, and prescribing appropriate medicines. Timely decision making and stratification to assess disease course and need for hospitalization based on meticulous monitoring, clinical signs and appropriate tests were followed. A balanced approach avoiding unnecessary medication and tests, and allaying panic resulting from multiple information sources, was the novel challenge for physicians. Post-COVID follow up was done for three months.
Results: The recovery rate in homecare with this approach was 97%, with only 11% needing corticosteroids in the second week. The need for hospitalization was in 3%. In the first month, > 90% had post-COVID symptoms, mainly lower energy, fatigue, weakness, reduced smell/taste and reduced work capacity. However, by the 3rd month, this reduced to 33%, with only 6% showing symptoms beyond three months. Management was conservative in the majority.
Conclusion: A systematic and rational approach to treating, monitoring and managing COVID patients at home can enable better care and recovery and limit unnecessary hospitalization. Diet and lifestyle measures, documentation of oxygen saturation and temperature monitoring, proning and breathing techniques, and psychological support are of great importance that aid recovery and enable sound clinical evaluation
Etiological classification of seizures in pediatric age group (6-12years) – MRI study
Get PDFBackground: A seizure is an occurrence of signs or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. The present study aims to study the etiological factors and clinical profile for new-onset seizures in children aged 6-12 years and to determine the frequency of Magnetic resonance imaging (MRI) abnormalities in the pediatrics age group with new-onset unprovoked seizure and those with inadequately investigated longstanding epilepsy and classify the etiology based on the MRI findings.
Methods: A prospective study involving a total of 50 patients was recruited aged between 6 to 12 years. All of them underwent neuro-imaging with MRI. Uncooperative patients were imaged following sedation and monitoring by the anesthetist. All children aged 6-12 years who presented with new-onset seizures were included. All MR images were obtained at a 3-mm section thickness except magnetization-prepared rapid gradient-echo images, which are obtained at a 1.8-mm section thickness.
Results: Of the 50 patients 28 presented with generalized tonic-clonic seizures, 12 with simple partial seizures, 10 with complex partial seizures. Generalized seizures were a more common presentation than partial seizures in children 6-12 years of age.
Conclusion: With the positivity of the MRI in the new-onset seizure in children between 6-12 years in our study gives an important aspect of the essential factor of imaging in pediatric new-onset seizures
Pulmonary function assessment in patients with type 2 diabetes mellitus
Get PDFIntroduction: Diabetes mellitus is a leading public health problem all over the world. Diabetes mellitus is a risk factor that precipitating microvascular as well as macro-vascular pathologies. Several respiratory alterations have been reported in associations with Diabetes Mellitus. Therefore, the present study was designed to determine the effect of the disease on respiratory function in patients with diabetes.
Method & material: For this study 54 Diabetes Mellitus patients were selected using simple random sampling from the diabetic clinic. 54 Non-diabetic, age & sex-matched subjects were also taken from teaching and non-teaching employees of the hospital for comparison.
Result: In our study there was a statistically significant decrease in the level of FVC in DM patients compared to healthy male subjects. There was a statistically significant increase in the level of ratio of FEV1/FVC. A more sensitive index of early disease is FEV1/ FVC ratio.
Conclusion: Spirometric values were consistently lower in subjects with diabetes mellitus than in non-diabetics. Subjects with poorer diabetic control have a worse spirometric function. We conclude that strict glycaemic control & regular breathing exercises to strengthen the respiratory muscles may improve the pulmonary function test in patients
Consumption of Commercial Dietary Products over Natural Diet – Impact in COVID Pandemic
Get PDFBackground: An adequate intake of essential minerals like selenium, iron, and zinc and the vitamins A, C, D, E, B6, and B12 are crucial to maintaining a healthy immune function. Commercial dietary products containing a mixture of some of the above-mentioned; nutrients may suffice the specific requirements in definitive groups of populations. The comprehensive impact on the Indian population with consumption of commercial dietary products in addition to natural dietary products; during the Corona Virus Disease (COVID) pandemic was assessed in this study.
Methods: A cross-sectional & observational study was conducted in a group of 3699 subjects, who attended the COVID OP Department at Sri Venkateswara RamaNarayana Ruia Government General Hospital, Tirupati from the period of August and September 2020. The subjects were randomly selected and a questionnaire was posed. The data collected were analyzed using Microsoft Excel and SPSS software. The data regarding natural dietary products were obtained from Indian Food Composition Tables.
Results: The percentage of the population consuming commercial dietary products in addition to natural dietary products was 15.865%. Commonly used natural dietary products by the population were egg& milk products, vegetables followed by fruits. In our study, a significant association between gender and consumption of commercial dietary products was noted. Natural products like grains were rich in zinc, calcium while animal meat was rich in proteins, selenium, vitamin A, vitamin B12, folic acid.
Conclusions: The usage of commercial dietary products in addition to natural dietary products can be recommended in specified population groups. The consumption of commercial dietary products in addition to natural dietary products was significant concerning the female gender
Prevalence of hyperuricemia in cerebrovascular accidents and its correlation with their outcome
Get PDFIntroduction: Cerebrovascular accident or stroke is a disease of the vascular system of the brain. According to ICD 11, stroke is classified as a neurological disease and not under the circulatory system. It is the second leading cause of death worldwide. It cannot be said that high Serum Uric Acid [SUA] amongst patients with cerebrovascular accidents is directly correlated with their outcome. The present study planned to estimate uric acid levels and their association in acute stroke patients, both ischemic and hemorrhagic.
Method: A total of 100 stroke patients admitted under the neurology department were included in the study. Brain imaging (CT/MRI) was performed. The serum uric acid was estimated.
Results: Out of a total of 100 patients, 74 were males, and 26 were females. Nine patients were less than 45 years old and 91 patients were 45 and above. Thirty-nine patients had ischemic, and 61 patients had a hemorrhagic stroke, respectively. Out of 100 patients, 23 patients had normal uric acid levels (<7mg/dl). Seventy-seven patients were with high uric acid levels. The mean serum uric acid concentration in male patients was 8.48±2.7and 9.20±2.7 in females. Among the total 100 cases, 69 survived, and the remaining 31 were among the non-survivor group at the time of discharge. Mean serum uric acid in stroke survivors was 8.5±2.6 mg/dl, while in non-survivors, it was 8.6±2.2 mg/dl. There was no significant difference between the levels of uric acid among survivors and non-survivors.
Conclusions: The prevalence of hyperuricemia (>9mg/dl) amongst stroke patients was 77% in the present study. The values of serum uric acid were significantly elevated in the patients aged > 45 years. The serum uric acid values were high among the group of hyperglycemic and hypertensive patients at the time of admission. There was no significant difference between the levels of uric acid among survivors and non-survivors
Precipitating Factors of Psoriasis in North Indian Population
Get PDFAim: This study aims to study precipitating factors of psoriasis in the north Indian population.
Material & Method:Two hundred twenty-eight psoriasis patients regardless of age, sex, religion,occupation, attending the skin, and V.D. outpatients Department, B.R.D. Medical College, Gorakhpurfor were taken because of the subject of this study. The bulk of patients belonged to the Eastern U.P.and adjoining areas of Bihar and Nepal. The clinical criteria for diagnosis of psoriasis were thepresence of Erythematous and papulosquamous lesions with loosely adherent silvery-white scales.The auspitz\u27s sign was demonstrated all told the cases. The detailed clinical history and examinationwere recorded. Each patient was categorized into mild to severe psoriasis.
Result: The maximumpercentage of cases was aggravated by weather (winter), 55.26%, next to that was trauma 27.19%, and least after infections 4.35%. The summer and spring seasons showed an improved effecton the condition of psoriasis. Alcohol, smoking, and mental stress found no relation with psoriasis.In most cases, where the infection was associated with the disease, it had been aggravated only inchildren, and young adults and lesions were of guttate type. Pregnancy had no effect in 25.43% ofcases, while the disease was improved in 3.50% of patients and worsen in 4.35% of cases.
Conclusion: Psoriasis is positively correlated with the winter season and negatively associated withSummer and Spring