International Journal of Medical Research & Review (IJMRR)
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A A prospective, observational study of Cosmelite NextTM therapy to evaluate the efficacy and safety of a novel plant-derived combination in the treatment of Melasma at dermatological centers in Hyderabad.
Get PDFBackground and objectives: Melasma, an acquired condition of skin hyperpigmentation, is adifficult condition to treat. This study was conducted to evaluate the efficacy and safety of a novelplant-derived combination for Melasma, Cosmelite NextTM, containing a combination of silymarin(0.7%), soy Isoflavones (0.25%), pTerowhite (0.10%), kojic acid (2%), ascorbic acid (1%),niacinamide (4%) and mandelic acid (3%).
Material and Methods: This was an open-label, single-arm, prospective, multi-centre observational study at dermatological centres in Hyderabad, India.Patients diagnosed with Melasma of either gender and skin type consistent with Fitzpatrickphototypes I-IV categories were enrolled across Hyderabad, India. Outcomes included melasma areaand severity index (MASI) score, lesion score, physician\u27s global assessment (PGA) and patient\u27sglobal assessment score.
Results: In terms of the primary variable, the change from baseline scoreto 12 weeks in MASI was statistically significant (mean difference 1.46 (95% CI 1.39–1.52);p=0.001), and the decreasing trend was observed from week four onwards. Lesion scores alsodecreased from the baseline to week 12, with a mean difference of 1.46 (95% CI 1.39–1.52;p=0.001). At the end of the study period, 91% of the patients showed some improvement in thePGA, whereas 93% showed improvement in the patients\u27 global assessment score.
Conclusion:Cosmelite NextTM was safe and efficacious, and the improvements in assessment scores were seenas early as four weeks. The novel combination could be an effective alternative to conventionaltreatments such as hydroxyquinone, retinoids and steroid preparations
“A pre-experimental study to assess the effect of educational package on knowledge regarding haematopoietic stem cell transplantation among staff nurses working in selected hospital Bhopal, Madhya Pradesh”
Get PDFHaematopoietic stem cell transplantation is a greater positive impact on the treatment of life-threatening diseases. Stem cell transplantation is a lifesaving procedure for several malignant and nonmalignant life-threatening diseases, more than 40,000 stem cell transplantations are being performed annually worldwide.
Methods: pre-experimental, one group pre-test post-test research design was used for conducting a study in a selected hospital of Bhopal, Madhya Pradesh. Subjects comprising of 60 staff nurses selected by non-probability purposive sampling technique, who fulfilled inclusion criteria.
Results: Mean post-interventional knowledge (27.0 ± 6.03) is higher than the mean pre-interventional knowledge (15.5 ± 5.74). The mean difference between pre- interventional knowledge and post-interventional knowledge is 11.5. The computed ‘t’ value 15.80, 2.00, P<0.05 shows that there is a significant difference between pre-interventional knowledge and post-interventional knowledge. There was a significant association found of demographic variables in terms of working area and years of clinical experience.
Conclusion: it was concluded that the educational package was effective in enhancing the knowledge of the staff nurses. The health care professional including staff nurses also having inadequate knowledge of stem cell therapy. The skilled educative session is one of the cost-effective intervention used for educating the nurses in various aspects. This type of studies emphasize the significance of the short term courses or in-service education for nurses in advanced knowledge on stem cell transplantation and making use of facilities available in the management of the patient in day to day activities
Access recirculation and adequacy of hemodialysis in different types of vascular access
Get PDFIntroduction: Haemodialysis requires recirculation, and it happens when dialysed blood returning through the venous needle re-enters the extracorporeal circuit through the arterial needle, rather than returning to the systemic circulation. Significant recirculation should be expected, when there is an inadequate reduction in the values of urea. During End-Stage Renal Disease (ESRD), adequate dialysis is of utmost importance because it influences the morbidity and mortality of the patients. Methods and materials: The study was carried out in 200 patients who underwent haemodialysis at the dialysis unit in Kalyani kidney care centre, Erode. Patients were actively evaluated from February 2018 till November 2018. Patients were randomized and accordingly 64 patients were enrolled in category I Arteriovenous fistula (AVF), 63 Patients in category II Internal Jugular Catheter (IJC) and category III Femoral Catheter (FC) each and 10 patients in category IV Perm Catheter (PC). Success recirculation was estimated and adequacy of haemodialysis was done virtually. Calculated Kt/V was done in almost all patients. For assessing vascular access recirculation, the technique that was used was urea-based measurement (Two needles with three samples of blood). The recirculation percentage was calculated as(S-A)/(S-V) X100. For assessing the adequacy of haemodialysis, Kt/V was used where K is estimated from (Cbi-Cbo)/ (CbixQb), time duration of dialysis (t) and urea distribution volume (V) is determined from the Watson equations for men and women. Kt/V was also measured with Online Clearance Monitoring (OCM) in Fresenius machine 4000S. Results: The mean access recirculation rate was 6.3+5.1% in those with AVF, while in IJC and FC groups were 6.7+4.5% and 24.4+11.7% respectively. When the two groups were compared, AVF vs FC groups, the difference was statistically significant (p value<0.001) and in IJC vs FC groups, the difference was statistically less significant (p-value <0.001) in both AR% and online Kt/V. Conclusion: An arteriovenous2QQ2 fistula has less access recirculation, when compared to temporary catheters. On the other hand, the femoral catheter has more access recirculation, when compared to the internal jugular catheter. The difference in calculated Kt/V with the three types of vascular access has no statistical significance
Analysis of ease of insertions, its attempts and time taken to insert for i-gel and cLMA in paediatric cases.
Get PDFAim: Analysis of ease of insertions, its attempts and time taken to insert for i-gel and cLMA in paediatric cases.
Methods: We did a prospective, randomised single-blind study on Eighty patients of either sex belonging to American Society of Anaesthesiologists (ASA) physical status class I or II, between 6 months to 8 years of age, scheduled to undergo elective surgery for less than one and half hour duration under general anaesthesia. In this study we analysed the ease of insertion, attempts and time were taken to insert the supraglottic airway device.
Results: The ease of insertion observed was easy in 39(97.5%) in the i-gel group and 35(87.5%) in cLMA group in our study. The i-gel was placed successfully in 39 out of 40 (97.5%) patients in the first attempt, and achieved 100% insertion on the second attempt. Correct positioning of cLMA in the first attempt was seen in 35 out of 40 (87.5%) patients. The remaining 5 patients (12.5%) required a second attempt. The average insertion time of cLMA (12.88 ± 1.771 seconds) was longer than the average time of insertion of i-gel (9.48 ± 1.037 seconds), and these differences were highly significant statistically (p= 0.000).
Conclusion: To conclude, i-gel and cLMA is effective and safe devices for use in children. Both are easy to insert and have insignificant morbidity, however, time taken and attempts of insertions for i-gel was lesser than cLMA. Also, the ease of insertion was relatively easy for i-gel than cLMA in pediatric cases
A study to observe quantitative levels of C- Reactive Protein in Cerebrospinal fluid in patients with Meningitis as an add-on routine investigation- a case-control study
Get PDFIntroduction: C - reactive protein (CRP) is a member of the class of acute phase reactants as its level rises dramatically during inflammatory processes occurring in the body. Measuring and charting CRP values can prove useful in determining the disease progress.
Aim: To estimate the CRP level in Cerebrospinal fluid (CSF) of patients with meningitis; and to evaluate whether CRP levels could be used to differentiate the various types of meningitis in adults.
Materials and Methods: This study was a case-control study. 80 enrolled patients were subjected to a protocol that included detailed clinical history including duration of illness, symptoms and signs, history or any treatment history. Written informed consent was taken from the patients/guardian.
Results: Meningitis was more common in the 18-30 years age group. Mean values of CSF CRP were- viral meningitis (2.70 mg/L) and pyogenic meningitis (91.13 mg/L) and control group (1.54 mg/L). CSF CRP can be used as a diagnostic tool to differentiate between pyogenic and viral meningitis as it is significantly raised in pyogenic meningitis in comparison to viral meningitis (p-value <0.0001).
Conclusion: CRP in CSF is a valuable, rapid, bedside diagnostic test for differentiating between pyogenic and viral meningitis; with reasonably good sensitivity, specificity and positive predictive value. The absence of CRP in CSF rather than its presence is more important for the diagnosis of viral meningitis
Assessment of Promoter hypermethylation of APC and BRCA1 in endometrial cancer.
Get PDFIntroduction: Endometrial cancer is one of the most common cancers in women worldwide. The underlying cause of endometrial tumorigenesis remains elusive. Several genetic and epigenetic alterations are known to be involved in the carcinogenesis of endometrial carcinoma. One important and early epigenetic alteration that is attributed to endometrial carcinoma is the aberrant promoter hypermethylation of gene promoters. In this study, we have assessed the aberrant promoter hypermethylation of APC and BRCA1 in 78 endometrial cancer samples.
Methods: Histologically confirmed tumour tissue samples were obtained post-surgery and DNA was extracted. The DNA was subjected to sodium bisulfite conversion and used as a template for a polymerase chain reaction. The PCR was performed using a nested PCR followed by methylation specific PCR.
Results: A 33.33% and 46.15% methylation frequency was observed for APC and BRCA1 genes respectively. A higher percentage of methylation was observed in stage IV for APC (66.66%) and in stage II for BRCA1 (88.88%).
Conclusion: Aberrant promoter hypermethylation is an early event in endometrial carcinoma and can serve as a useful molecular marker for diagnosis and prognosis of the disease along with existing screening modalities
A Comparative Evaluation on the effect of Zinc-Probiotic combination versus Zinc alone therapy in children (3month-5year) with acute watery diarrhea attending the outpatient clinic of Sub-District hospital, Uttarakhand
Get PDFBackground: Diarrhea is the major cause of morbidity and mortality among children worldwide. Various studies were done on the role of zinc therapy and probiotic therapy in reducing the duration and severity of acute watery diarrhea. This study aimed to compare the effect of Zinc –probiotic combination versus Zinc only therapy in acute watery diarrhea in pediatric patients.
Material and Methods: This was an open, randomized control trial in the pediatric outpatient department of Sub-District Female Hospital, Haldwani (Uttarakhand), from June 2020 till August 2020 for three months. Total 104 children aged six months to 5 years with acute diarrhea who met the inclusion criteria were enrolled and divided into 52 patients each. 1st Group A (n=52) received Zinc-Probiotics combination therapy, and 2ndGroup B (n=52) received Zinc only. Measurement of disease severity was based on the frequency of diarrhea (times/day) and duration of diarrhea (hours) after initial drug consumption. The resolution was assessed in mean remission time (time required to form solid stool from watery stool).
Result: Among the study population in group A, 62% were male, 38% were female, and in group B, 65% were male & 35% were female. Male predominance was observed in both groups. The mean frequency of diarrhea before treatment in Group A was 7.46 ± 4.1 times/day as compared to 6.69 ± 3.6 times/day in Group B. Mean duration of diarrhea in Group A was 53.5 ± 30.5 hours as compared to 57.6 ± 34.3 hours in Group B.
Conclusion: Combination therapy was more effective than Zinc only therapy in early remission and resolution of acute watery diarrhea in children
Clinical Spectrum and Management of hydatidosis – A Prospective Study
Get PDFAim: The objective of this original research article is a Clinical Spectrum and Management of hydatidosis – A Prospective Study.
Material & method: -The present study includes 150 patients with intrathoracic space-occupying lesions, of which 24 patients with Hydatid cyst 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. 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, Casoni diagnostic test and bronchoscopy were performed. Twenty-one patients operated, and successful enucleation of the cyst was done in eighteen cases by mini-thoracotomy.
Result: Maximum patients were in the age group of 41 to 50 years. The maximum age group was 60 years, and the minimum age group was ten years. Maximum age group 21-30 years, among which this has been observed. No cases were seen above 41 years of age. Hemoglobin was found adequate among the cases. Total Leucocytes count was found higher among the patients. In 63% cases, found above 10000 per microliter. ESR found raised among the patients and in 50% of cases observed more than 40 mm in 1st hour. Cough with/without expectoration, Chest pain, and Dyspnoea were observed in almost all cases. The right side of the Lung had 50% involvement; the Left side of the Lung had 37.5% involvement, whereas 12.5% bilateral involvement.
Conclusion: Mini-thoracotomy is an efficient and safe option for managing intact or ruptured solitary pulmonary hydatid cysts
A study to determine age at menarche in adolescent school girls of Indore city, M. P. India
Get PDFBackground: Menarche is a significant milestone in women\u27s life. It affects the reproductive health and well being of women. This study aims to find out the age at menarche of adolescent girls of Indore city and its relation to various factors.
Method: This was a cross-sectional study conducted in six schools of urban areas of Indore city the study group included 492 school girls of age 11 to 18 years. After taking written informed consent from the parents, data was collected on the date of birth, family size, birth order, dietary intake, social-economic status, menarcheal age. Anthropometric measurements were done and data was analyzed.
Results: Mean age at menarche was found to be 13.2+1.24 years. It was found to be significantly associated with socioeconomic status, BMI and birth order.
Conclusion: The mean age at menarche in this study is comparable to that found in other Indian studies. It is found to be significantly associated with BMI and socioeconomic status of the girl
Portal Dosimetry as a patient specific Quality Assurance tool for Volumetric Arc Radiotherapy
Get PDFIntroduction: Volumetric Arc Radiotherapy (VMAT) is an advanced technique. Calculations of VMAT plans are not so accurate even with State-of-Art dose calculation algorithms due to their complexity. Hence pre-treatment patient specific Quality Assurance (QA) of each VMAT plan is required. In the present study Electronic Portal Imaging Device (EPID) based portal dosimetry system was used for pre-treatment patient specific QA.
Material and Methods: A total of 50 patients were chosen in this study. Verification plans of each patient were calculated for portal dosimetry then executed on the EPID system to measure the spatial distribution of radiation dose. Calculated and measured dose distribution were compared to evaluate Gamma Index (GI) passing criteria of Dose Difference (DD) of 3% and Distance–to-Agreement (DTA) of 3mm, Area Gamma (γ≤) >95%, Average Gamma (Ave) <0.5% and Maximum Gamma (Max) <3.5%.
Results: The mean values of Area Gamma (γ% ≤1) were observed to be varied from 99.14±0.23% to 99.87±0.18%. The Mean Values of Average Gamma (Ave) are found to vary from 0.19±0.05% to 0.15±0.04% and the mean values of Maximum Gamma (Max) found to be varied from 1.94±0.37% to 1.59±0.41%. All the plans were passed the gamma index criteria with very good agreement. Thus the use of Portal Dosimetry for pre-treatment patient QA is found to be a very useful, quick, precise, efficient and effective pre-treatment patient specific QA tool for VMAT treatment.
Conclusion: Portal Dosimetry can be utilized for routine use for patient specific quality assurance for Volumetric Arc Radiotherapy treatment