International Journal of Medical Research & Review (IJMRR)
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Role of biochemistry, cytology, and biopsy in the etiological diagnosis of pleural effusion- a clinical study
Get PDFIntroduction:Pleural effusion is the most common pleural disorder. It refers to excessive or abnormal accumulation of fluid in the pleural space. It is a commonly occurring medical problem caused by various pathological conditions. To treat patients appropriately, it is important to establish an accurate etiological diagnosis.
Material and Method: This is an observational study conducted at a tertiary health care center. The pleural effusion was assessed clinically, biochemically, bacteriologically, cytologically, and histopathologically.
Result: Tuberculosis was the most common etiology, followed by malignancy. A pleural biopsy was done in 70 patients. Pleural tissue was obtained in 65 cases. On histopathology,Malignancy was diagnosed in 15, tuberculosis in 35, and non-specific inflammation in 13 cases. Out of 35 histological proven tuberculosis cases, 26 cases had adenosine de-aminase (ADA) more than 70 u/l.
Conclusion:Every pleural effusion is not due to tuberculosis but can be due to other causes, malignancy should always be excluded. Pleural fluid cytology and biopsy can give a definite diagnosis in a significant number of cases of pleural effusion. Tuberculosis is still the most common cause of pleural effusion followed by malignancy
Comparative study of renal function test and thyroid hormone in chronic kidney disease
Get PDFIntroduction: Biochemical parameters (urea, creatinine, uric acid, T3, T4, TSH) important in prognosis, monitoring of thyroid dysfunction, and chronic kidney disease. The present study was attempted to analyze these parameters in CKD patients and a healthy control group.
Materials and methods: Fifty healthy control and 5o were chronic kidney disease subjects were taken serum urea, creatinine uric acid analyzed on the auto analyzer and T3, T4, TSH estimated on immunoassay analyzer. Ethical permission was taken from the institutional ethical committee.
Results: Level of urea, creatinine, uric acid, and thyroid hormone T3, T4, TSH were found to be significant in the present study when compared with the control group. (Þ<0.0001).
Conclusion: It was observed that levels of urea, creatinine, uric acid, and T3, T4, TSH deranged value found in chronic kidney disease subjects
Role of high-frequency USG in rotator cuff injury and its comparison with MRI
Get PDFIntroduction: Rotator cuff injury is one of the common causes of long-term shoulder pain and disability encountered in the orthopedic clinic. The spectrum of rotator cuff injury includes tendonitis, partial tears, and complete tears. They also may influence the development of the degenerative disease of glenohumeral joint and rotator cuff arthropathy.
Material and Methods: The present, prospective study entitled “Role of high-frequency USG in rotator cuff injury and its comparison with MRI” was conducted in the Department of Radiodiagnosis on a total of 100 patients who presented with signs and symptoms of shoulder joint injury in Department of Orthopedic who were then referred for USG and MRI examination to the Department of Radiodiagnosis.
Result: Mean age of the patients was 38.26±14.51 years and the majority of patients belonged to the 3rd decade (34%). About 7% of patients belonged to the 2nd decade, 18% of patients each belonged to the 4th and 5th decades of age group. Only 8% and 7% of patients in the present study belonged to extremes of age i.e. >60 years and <20 years respectively.
Conclusion: Based on the findings of the present study, it is concluded that rotator cuff injuries are commonly encountered conditions in routine practice, and males are commonly affected as compared to females
Diagnostic value of serum adenosine deaminase in Type 2 diabetic patients
Get PDFBackground: Adenosine deaminase (ADA) is suggested to modulate the bioactivity of insulin, but its clinical significance in Type 2 diabetes mellitus (DM) is not yet established. The present study was undertaken to evaluate serum ADA activity and serum uric acid levels in patients of Type 2 DM.
Aim: To evaluate the serum ADA level and to correlate ADA levels with Blood Glucose, Glycated Hemoglobin (HbA1c) levels in Type-2 DM patients.
Material and Method: It is a case control study. The subjects in this study were divided into 3 groups. Group I consisted of 50 normal healthy individuals who served as controls with no history of DM. Group II consisted of 50 patients of Type 2 DM both males & females in the age group of 40-65 years on oral hypoglycemic drugs with HbA1c <7%. Group III consisted of 50 patients of Type 2 DM both males & females in the age group of 40-65 years on oral hypoglycemic drugs with HbA1c >7 %. Serum levels of fasting blood sugar, HbA1c, ADA and uric acid were estimated in all the subjects.
Results: FBS, HbA1c, ADA and serum uric acid levels were found to be increased in the patients of Type 2 DM as compared with controls.
Conclusion: It is concluded that there is an increase in serum ADA levels with increase in HbA1c levels. Serum uric acid levels increased with moderately increasing levels of HbA1c <7% and then decreased with further increasing levels of HbA1c >7% (a bell-shaped relation)
Sonourethrogram in comparison with retrograde urethrogram in evaluation of male anterior urethra
Get PDFObjective: Imaging of anterior male urethra is usually done using retrograde urethrogram, which utilises radiation. This study utilises high resolution ultrasound which is radiation free and helps to understand urethral pathologies like strictures, chronic urethritis etc. This study also compares the utility of sonourethrogram with retrograde urethrogram and provides the advantages of using sonourethrogram. Also establishes the drawbacks of using sonourethrogram over retrograde urethrogram.
Material & Methods: This study was done on 60 patients, came with different complaints like difficulty in micturition, obstructed urinary stream, pain in penis, increasing frequency of micturition and referred to us for retrograde urethrogram. Patients were examined with high resolution ultrasound with due permissions. Results are compared with findings of retrograde urerthrogram.
Results: Out of 60 patients, 59 had strictures shown in retrograde urethrogram either in penile, bulbar or membranous parts. Only one patient had membranous urethral stricture in retrograde urethrogram which was not shown in sonourethrogram. All other patients have shown strictures in sonourethrogram. One patient had penile urethral calculus shown in both sonourethrogram and retrograde urethrogram.
Conclusion: Sonourethrogram is equally effective as that of retrograde urethrogram especially in anterior urethral strictures. However, it underestimates or less useful in evaluation of posterior male urethral pathologies. Sonourethrogram is easily available, cost effective technique that uses no radiation in the evaluation of male urethra. It is equally effective compared to retrograde urethrogram in the evaluation of male anterior urethral strictures. Periurethral pathologies like fibrosis are better evaluated with sonourethrogram than with retrograde urethrogram. It is also important in the surgical planning and approach
Methods of teaching in Islam and incorporating certain ideas into the teaching of the modern medical Science in India: Some thoughts and some observations
Get PDFThe fast progress of the Medical Science as well as introduction of newer technologies makes Teaching in Medical science challenging. It is difficult to teach the Medical students in all the aspects of medical science and produce good, well learned, treating doctors within a span of four and a half years. Introduction of non treating branches in the final MBBS, as clinical subjects, has compounded the problem. The paucity of time to teach the treating branches in the final year, has caused confusion amongst the mind of the teachers of the treating branches. In such a scenario, we thought that it is worth to look into the ancient methods of teaching, which are still relevant in today’s world. The present activities of the MCI, is confusing. The effort of re teaching the old and senior teachers, how to teach, is failing. This necessitates re-look into the past to introduce new ideas into medical education methodology. Here we look into the system of teaching followed by the Islamic faith. Islamic scholars spread the light of knowledge to the west. They were voracious observers, readers as well as energetic writers. These scholars took the wisdom of the east to the wild of the west. Although the journal publications on the subject of Islamic methodologies are sparse, the materials available are very useful in providing an insight to the teaching methods in Islam. Following the disciplined methods, the students learn without fail and spread the gist of knowledge in the society around. It is worth to look into the methods of the teaching in this one and half millennia old system and see if some input can be made into the modern methodology of teaching in the modern Medical Education delivery in India. The available literature on the subject sheds enough light to the teaching methods in Islam. Many of these steps can be incorporated in the teaching methodology in the Medical education in India. Especially introduction of the AETCOM and the faculty development program by the MCI recently, are good in intentions but has opened up new challenges and questions. This may lead to the dilution of the criteria of the teachers of the teachers as a result the damage will be deep and permanent. We discussed some important steps as well as guidelines based on the highly successful teaching methods in Islam in this article for looking to incorporate some of these methods into the MCI Medical education system. Teaching methods in Islam have survived the taste of time and Millennia. It is high time that some of the principles be looked into and utilized to improve the Medical education in India
A study of dexmedetomidine as an adjuvant to hyperbaric bupivacaine in subarachnoid block
Get PDFBackground: No drug, used as adjuvant to spinal bupivacaine, has yet been identified that specifically inhibits nociception without its associated side-effects. Dexmedetomidines a novel alpha-2 agonist which holds promise as an intra-thecal adjuvant.
Aims: This observational study was conducted to evaluate the onset and duration of sensory and motor block as well as perioperative analgesia and adverse effects of dexmedetomidine given intrathecally with 0.5% hyperbaric bupivacaine for spinal anesthesia.
Materials and Methods: A total of 60 patients belonging to age group 18-60 yrs, urban population, classified as American Society of Anesthesiologists status I and II scheduled for lower abdominal and lower limb procedures were prospectively studied. Patients were randomly allocated to receive intrathecally either 12.5 mg hyperbaric bupivacaine plus 5 μg (0.5 ml) dexmedetomidine (group D, n=30) or 12.5 mg hyperbaric bupivacaine plus 0.5 ml NS (group B, n=30). Sensory and motor blockade charactersistics- The onset time to reach peak sensory and motor level, the regression time for sensory and motor block, time for rescue analgesia, hemodynamic changes and side-effects were recorded. Data collection was done by observation and measurement of various parameters.
Results: The onset times to reach T10 dermatome, peak sensory level and onset time to reach modified Bromage 3 motor block were similar in both groups. We found that adding dexmedetomidine intrathecally significantly prolonged sensory and motor block time. time for first analgesic request was also significantly prolonged in group BD. Statistically there were no significant differences in hemodynamic alterations and other adverse effects between the groups.
Conclusion: clinical advantage of dexmedetomidine is that it facilitates the spread of the block and offers prolonged post‑operative analgesia. The groups were similar with respect to hemodynamic variables and there were no significant side-effects in either of the groups. However, prolonged duration of motor blockade with dexmedetomidine may be undesirable for short‑term surgical procedures or ambulatory surgeries
A study of clinical manifestations and complications of dengue fever in medical college hospital
Get PDFBackground: Dengue, the most common arboviral disease worldwide is usually endemic but several epidemics have been recorded. Global incidence of dengue has grown dramatically in recent decades; about half of the world\u27s population is now at risk. The situation in India is reflected by occurrence of major disease outbreaks from time to time over the last few decades.
Objectives: The objective of the present study was to observe the various clinical manifestations and complications of dengue fever.
Materials and Methods: Study included 100 patients admitted to medicine ward in medical college hospital for a period of 6 months with symptoms and signs suggestive of dengue fever and those positive for NS1Ag, IgM and IgG dengue antibodies using Rapid strip test.
Results: Among 100 patients observed, majority cases were dengue fever (92%) with no mortality, 5% were dengue hemorrhagic fever (DHF) with mortality 20% and 3% were dengue shock syndrome (DSS) with mortality 67%. 71 were males and 29 were females with sex ratio 2.5:1. Maximum patients were in the age group of 18-30years. Most common clinical manifestations were fever (100%), headache (90%), abdominal pain (72%), arthralgia (65%), myalgia (64%), hepatomegaly (52%) and splenomegaly (41%). Thrombocytopenia (84%) is the most common hematological abnormality observed. Among serology positivity, majority were positive for NS1 antigen (81%), followed by IgM antibodies (7%) and mixed positivity (12%). Most common complication observed was hepatic dysfunction (33%).
Conclusion: Dengue infection is common viral infection with varying clinical manifestations from region to region and epidemic to epidemic. Even though no specific treatment available for dengue fever but early diagnosis and timely intervention will prevent complications and mortality from dengue hemorrhagic fever and dengue shock syndrome
Clinical outcome in cases of hypertensive intra-cerebral haemorrhage in relation to size of haemorrhage
Get PDFIntroduction: Stroke is amongst the leading causes of death exceeded only by heart disease and cancer. Those who survive are usually left with permanent disability. Cerebral infarction is responsible for about 80 percent of all strokes, primary intra-cerebral haemorrhage for 10 percent, subarachnoid haemorrhage for 5 percent and 5 percent cases are due to uncertain causes. Predictors of prognosis in primary intraparenchymal haemorrhage have been evaluated in numerous studies.
Objective: To observed the effect of different sizes of hematoma and utilizing them, if feasible as a marker of prognostic significance.
Material and methods: In this study we observed 60 patients from the time of admission till 30th day in various wards of Department of Medicine RIMS with hypertensive intra-cerebral haemorrhage, during the period of 2008-2009. A simple method of measuring the volume of haematoma (in cc) on the CT scan is by using the following formula: A*B*C A = longest diameter of the haematoma (in cm.), B = Diameter perpendicular to A (in cm.), C = Height (in cm) which is measured by No. of slices showing the haematoma x thickness of each slide.
Result: Total 60 patient were taken into study out of which 33(55%) were alive and 27(45%) were dead in 30 days follow up. In our study, 38 were male and 22 were female out of 38 male 22(66.66%) were alive and 16 (59.2%) dead and in 22 female 11(33.33%) were alive and 11 (40.7%) were dead. Outcome with volume of ICH using the χ2 had shown significant correlation (p < 0.005) with GCS at the time stroke onset (P<0.01), IVH/VE (P<0.01), midline shift test (P<0.01), B.P. at the time of admission (P<0.01).
Conclusion: In these study patients with hematoma volume exceeds 60 cm3, the mortality was 100%. Mean volume of hematoma in our study was 35.21 cm3
Clinical and Epidemiological profile of Anemia in central India
Get PDFBackground: The present, hospital based prevalence study has been conducted to assess the clinical and epidemiological profile of anemia in central India.
Methods: In this study 200 patients of anemia from medical out patients department and indoor wards, age between 15-70 years, randomly selected without any bias for sex, occupation, socio-economic status and duration of disease.
Results: This study shows that maximum number of patients (40%) were from age group 21-30 years. Between 15-30 years age group, prevalence of anemia was more in females than males. 57% study population have moderate anemia and 41% patients have severe anemia. Weakness & easy fatigability were most common (100%) presenting symptoms and pallor was most common (98% patients) clinical sign. Microcytic and hypochromic type peripheral smear was most common laboratory findings (59% cases). Nutritional anemia was the most common type of anemia (84%).
Conclusions: Nutritional deficiency anemia is the most common cause of anemia among population, and iron deficiency is the most common nutritional deficiency in population