International Journal of Medical Research & Review (IJMRR)
Not a member yet
1355 research outputs found
Sort by
Impact of Structured Lifestyle Intervention Program with Antigravity Exercise on Glycemic Control in People with T2DM
Get PDFIntroduction: Diabetes mellitus (DM) is a common endocrinopathy and assumes significance for its ability to adversely affect the various internal organs. It can also derail the immune system of the affected. Abnormal insulin secretion and/or utilization, leads to hyperglycemia which has adverse effects on the heart, blood vessels, kidney, nervous system, eye and skin. To assess the effectiveness of structured vs unstructured lifestyle modification therapy in glycemic control (change in HbA1c value from baseline to the end of the intervention) in people with T2DM.
Methods: This study is a randomized, controlled, parallel-group study with lifestyle modifications as intervention. Study was conducted for between Feb 2019 to Dec 2019 in the Department of General Medicine, Government Headquarters hospital, Tirupur.
Results: A total of 70 participants, 30 to 60-year-old, diagnosed with T2DM for more than a year with HbA1c levels > 6.5 %, on a background of oral antidiabetic agents were enrolled after obtaining the informed consent. Mean age of Group A and Group B found 49.17±7.42 and 51.92±9.1. Male were predominant in the study. Mean weight, Mean FBS, Mean PPBS and Mean HbA1c are statistically significant between groups (p<0.05) at baseline. Group B with unstructured physical activity with walking, was beneficial (HbA1c reduction 0.30 %; p = 0.024), but no significant decline in HbA1c, whereas, in Group A with structured antigravity exercise, is associated with a significant HbA1c decline of 1.2 %. (p = 0.07865).
Conclusion: Structured antigravity exercise training was more efficacious than unstructured physical activity in achieving controlled HbA1c levels. Although both structured and unstructured training provide benefits, only the former was associated with significant reductions in HbA1c levels. Hence, T2DM patients should be advised to follow structured antigravity exercise training & focused dietary intervention program
Role of Low Environmental Temperature in Peptic Ulcer Development
Get PDFPeptic ulcers are described as acid-induced lesions found in the stomach and duodenum caused by the imbalance between the defending factors of the mucosa and the attacking factors such as hydrochloric acid in gastric juice, with Helicobacter Pylori (H. Pylori) and Non-Steroidal Anti-Inflammatory Drugs NSAIDs. They exhibit seasonal patterns in their occurrence, with higher occurrence in winter and spring and a low occurrence in summer. Temperature plays a major role in their occurrence, some of which have resulted in increased morbidity in some number of diseases, such as gastrointestinal bleeding, caused by an increase in air pressure, dry air (relative humidity) occurring from cold air, and also its actions on the protective effect helicobacter pylori in the human body. Their actions excite the adrenal gland marrow and the sympathetic nerve, causing rapid secretion of adrenaline and non-adrenaline, angiotensin II and endothelin, resulting in damage to the mucosa epithelial, caused by the contraction effect of the adrenal agents on the duodenal mucosa and blood vessel. It causes low expression of Epidermal Growth Factor Receptor (EGFR), Epidermal Growth Factor (EGF), Heat Shock Protein (HSP) 70, Occludin, Nitric Oxide Synthase (NOS), in the gastric mucosa, in extremely cold temperature than those in extremely hot temperature, increasing the gastric acid secretion in extremely cold temperature than in extremely hot temperature. Therefore, this review aims to give general insight into the role of low temperature in peptic ulcer development and further consideration in the treatment of peptic ulcer diseases
Crowdsourcing applications addressing diseases and public health: a perspective on COVID-19 infestation
Get PDFThe spread of the COVID-19 disease with an unprecedented speed into humans, and the global scale of its occurrence over multiple geographic locations, since December 2019, in Wuhan, China, has sparked off extensive confusion and debate in public health, giving it the status of a pandemic. The inability of restraining the outbreak in the early stages, has multiplied the disease risk to fatal complications. Crowdsourcing technique can conglomerate crowd knowledge for solving problems revolutionizing health care by use of internet sources, data mining, e-health trackers, etc. to collect and assess data faster to the rate of spread of infection, directly from a point source (individual-level). The present study provides perspectives on crowdsourcing in alignment with health care and public health services by critically comparing strengths and challenges with traditional methods. For the same 3 models have been designed by the authors, for improvement in public health care, in the wake of the COVID-19 infestation
Acute myocardial infarction in post COVID-19 patients
Get PDFThe SARS-CoV-2 infection has caused mortality in different populations; in addition, morbidity with immunological, hematological and/or cardiovascular compromises has been reported, with acute myocardial infarction (AMI) standing out. A literature search was conducted in databases to determine existing evidence regarding AMI in post-COVID-19 patients. It was found that initially AMI was described in some patients during the disease; however, a recently published case series showed that it could occur in recovered patients, secondary to systemic and procoagulant inflammation over time, suggesting further research in this area
A Study of Obesity and Sleep Disordered Breathing
Get PDFIntroduction: Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality and various Cardiovascular risk factors. Obesity is strongly linked with respiratory symptoms and diseases like dyspnea on exertion, obstructive sleep apnea syndrome (OSAS). This study has been undertaken to analyze the severity of hypertension in obese patients, sleep-disordered breathing (SDB) in obese patients, to analyze whether SDB is a risk factor for hypertension in obese individuals and to correlate how many obese hypertensives have correctable SDB.
Methods: A total of 200 obese patients were randomly selected from the outpatient department. Berlin\u27s questionnaire and the Epworth sleepiness scale score (ESSS) were used to assess sleep-disordered breathing (SDB). Asian classification of obesity suggested by the World Health Organization was used for the assessment of BMI. All statistical analysis was carried out using the SPSS version20, and Appropriate Statistical tools were applied wherever required, like a test of proportion, Chi-square test etc.
Results: Out of 200 subjects, 116 were male, and 84 were female. The majority of the study population (70.0%) had suffered from obstructive sleep apnea, while the rest (30.0%) had mixed sleep apnea. The mean spread of age for total selected subjects (N=200) was 45.64±12.75 years. The body mass index (BMI) between 40 and 50 kg/m2 in 49.0% obese patient. Systemic hypertension prevailed more in male (81.0%) obese subjects than female (77.4%) obese subjects. The most significant risk factor for predicting hypertension was moderate type sleep apnea (p<0.005) followed by the age of the (p<0.007) obese patients that were confirmed strongly significant on the statistical ground.
Conclusion: Obesity has a very high and proportionate correlation between sleeping disordered breathing. Obstructive sleep apnea is the predominant sleep-disordered breathing in our study population. Sleep-disordered breathing is very much correctable in the obese hypertensive population by weight reduction and risk factor control
Study of vitamin d levels in patients with type 2 diabetes mellitus
Get PDFIntroduction: Diabetes is defined as a disturbance in intermediary metabolism manifesting as chronic sustained hyperglycemia, primarily due to either an absolute or a relative lack of insulin. Many epidemiological studies have demonstrated an inverse relationship between vitamin D levels and diabetes mellitus. However, there is a paucity of literature regarding the levels of vitamin D in type 2 diabetes, which is common in our community. This study was taken up to shed more light on this issue.
Material and methods: This was a cross-sectional study conducted at NRI Institute of Medical Sciences, Sangivalasa, Visakhapatnam district. Cases of Type 2 Diabetes Mellitus attending to the outpatient department, diagnosed as per the ADA criteria of 2011, between the ages of 31 and 75 years constituted the material for the present study.
Results and conclusion: Vitamin D levels were found to be significantly lower in the study group (19.91±7.0 ng/ml) as compared to the control group (32.22±4.0 ng/ml)
Serum ferritin, serum LDH and d-dimer in correlation with the outcome in Covid-19.
Get PDFBACKGROUND: Early detection of comorbidities, severe patients with SARS-COV-2 and helpful diagnostic tools is very important for individual treatment and helps us in assessing the outcome of moderate to severe patients.
METHOD: In our study we have included 108 patients with RT-PCR positive for SARS COV-2 and the samples for D-dimer, Sr. LDH and Sr.ferritin were sent and analyzed.
RESULTS: the effect of D-dimer, serum LDH and serum ferritin individually and combinedly showed in our study there was no significant difference between D-dimer and the outcome however there was a significant p-value of <0.001 with serum LDH and the outcome, and p-value of 0.016 with serum ferritin and outcome.
CONCLUSIONS: When the markers individually analyzed they showed a significant association between outcome and markers, in elevated O2and normal patients. Mean D dimer, serum ferritin and serum LDH were high among subjects who required NIV and low among subjects who required O2, on Room air and intubated respectively. In hospitalized patients with respiratory distress, we recommend clinicians closely monitor serum ferritin, serum LDH and D-dimer and also other markers of severity, WBC count, lymphocyte count, platelet count, IL-6 as markers for potential progression to critical illness, has been under the study, however our study sample being 108, a study with a larger number of samples required to predict the outcome
Myocardial Dysfunction in Elderly Patients Admitted with Non-Cardiac Diagnosis in Intensive Care Unit
Get PDFBackground and Objectives: The diagnosis of acute coronary syndromes can be challenging in patients admitted with the non-cardiac disease to the Intensive Care Unit (ICU). The study aimed to determine the clinical profile of critically ill elderly patients developing myocardial injury who were admitted to ICU for non-cardiac diagnosis.
Materials and Methods: The retrospective study subjects are 130 patients admitted to the medical ICU. Within 24 hours of admission to ICU a detailed history, a 12 lead ECG, CK-MB, Cardiac troponin T was done and as required based on ECG findings and development of clinical symptoms.
Results: Our study showed that 35 out of 130 patients developed acute myocardial injury. 13 out of 35 patients who had myocardial injury had a fatal outcome. The prevalence of hypertension, diabetes mellitus, history of CVA, history of IHD and COPD reached statistical significance (p<0.001) between the two groups of patients who developed myocardial injury and who did not develop a myocardial injury. In patients with multiple comorbidities, the presence of factors like hypoxia, hypotension and the use of vasopressors increases the risk of mortality.
Conclusion: All elderly patients who are hospitalized with or without multiple comorbidities with an acute form of stressors must be evaluated aggressively for precipitants and adequately treated to prevent myocardial injury
Role of liquid-based cytology and cell block study of pleural fluid in the evaluation of cases of malignant Pleural effusion with special reference to immunohistochemistry
Get PDFIntroduction- Lung cancer is the most common primary tumor associated with malignant pleural effusion (MPE). In this study, we aim to use cell remnants for cell block preparation after performing liquid-based cytology (LBC) of effusion fluid. Immunohistochemistry was helpful to evaluate those cases having diagnostic dilemmas in LBC and cell block.
Method: It was a cross-sectional, prospective, single institution-based study, conducted in the department of Pathology in collaboration with the Department of Respiratory Medicine IPGMER & SSKM Hospital, from January 2018 to June 2019 in the institution.
Result: Most of the study population were in between the age group of 51 to 60 years with male predominance and with fever and cough being the predominant symptoms. Liquid-based cytology was positive for malignancy in 58% of cases and suspicious of malignancy in 22% of cases of malignant pleural effusion and it had 95.35% sensitivity, 58.82% specificity in diagnosing malignant pleural effusion.LBC was done followed by cell block preparations are studied further by Immunohistochemistry.
Discussion: Morphological features were better identified by the cell block method when compared to LBC. Multiple sections can be obtained for special stain or IHC study which bridges the gap between cytology and histology
Prevalence Of Tuberculin Skin Test Positivity In Patients Of Early Rheumatoid Arthritis- Study from a tertiary care centre in North India.
Get PDFObjective: To assess the prevalence of tuberculin skin test (TST) positivity in early rheumatoid arthritis patients (< 6months disease duration) using Tuberculin sensitivity testing in a TB endemic country.
Method: Included in this cross-sectional study were 200 patients of early rheumatoid arthritis divided into three groups- treatment naïve, patients on methotrexate only and methotrexate plus low dose corticosteroids.
Results: 200 early RA patients and 60 healthy controls were included in this study. The median age of the study population was 43 years (IQR 33-51) with a mean disease duration of 3.4 ± 2.1 months. 54 patients (27%) with early RA and 22 healthy control (36.7%) had TST positive (p=0.1).
Conclusion: Tuberculin positivity is low among patients with early RA as compared to the general population. The use of low dose steroids or methotrexate doesn’t affect the tuberculin anergy