International Journal of Medical Research & Review (IJMRR)
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Observational study to determine the pattern of distribution of stop - bang score in predicting OSA and its implication among female health care providers
Get PDFObjective: To determine the pattern of distribution of STOP-Bang score in predicting OSA and its implication among female health care providers.
Methods: In this study, we enrolled 100 female health care providers with age>20 years and excluded subjects on long term respiratory illness and with secondary cause of obesity. Detailed historyand clinical examination were done along withfilled STOP-Bang questionnaire.
Results: We included 100 subjects, the mean age was 26.23 ± 1.74 years, mean BMI was 23.18+ 1.73. Our study results, Snoring, Tiredness and observed apnea were observed more than other parameters. In the study, the significance of snoring (8% with ‘p’ value 0.006), tiredness (52% with ‘p’ value 0.000) and observed apnea (17% with ‘p’ value 0.001) was statistically significant.The most common score on the STOP-Bang questionnaire was 1point (n = 42), followed by no points (n = 41). Subjects with low risk were 57; with high risk were 2 which were statistically significant.
Conclusion: Snoring, tiredness and observed apnea play an important factor among females in STOP-Bang score which also was statistically significant.The STOP-Bang questionnaire performed adequately for OSA screening in female health care providersindicated that it could be used as an effective non-invasive screening tool for identifying subjects with high risk of OSA
A study on the non-infectious complications of continuous ambulatory peritoneal dialysis
Get PDFIntroduction: Patients with end-stage renal disease (ESRD) are treated with hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD).Non-infectious complications of CAPD are increasing in relative importance due to success in decreasing the rate of peritonitis.
Aims and objectives: Our aim was to study the non-infectious complications in patients of ESRD on CAPD and to study the impact of the non-infectious complications in the survival of CAPD catheters. Materials and Methods: A prospective study has been conducted at Regional institute of medical science, Imphal in a total of 71patients of ESRD who are already on CAPD or newly diagnosed ESRD who have undergone CAPD catheter implantation. Their detailed history, clinical examination and relevant laboratory investigations were done and the different non-infectious complications were identified and analysed.
Result: Out of the 71 patients studied 39 patients had complications like hypokalemia (15 patients), omental wrap (10 patients), catheter tip migration (6 patients), haemoperitonium (2 patients), hydrothorax (2patients), exit site leak(2patients), abdominal wall edema (1patient), catheter block(1patient).
Conclusion: In our study the most common non-infectious complication was hypokalemia followed by omental wrap and catheter tip migration. Knowledge about the common prevalent non-infectious complications of CAPD alerts the treating doctor to take up the specific corrective steps at an earlier stage, thus preventing the morbidity associated with the same. We conclude that the majority of non-infectious complications in these patients were treatable and did not interfere with the catheter survival
Clinical Profile of MDR-TB patients with special reference to kanamycin induced ototoxicity in a tertiary care hospital of eastern India
Get PDFIntroduction: MDR-TB is defined as resistance to isoniazid and rifampicin, with or without resistance to other anti-TB drugs. Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. Kanamycin, is an aminoglycoside antibiotic used to treat multi-drug resistant TB in the intensive phase.
Objective: To analyze the patients of MDR-TB with respect to age, sex and presence of comorbidities like diabetes mellitus. Also to study the incidence of hearing impairments among patients of MDR-TB receiving injectable Kanamycin.
Methods: 40 patients of MDR-TB diagnosed by sputum culture and drug susceptibility testing (DST) have been classified on the basis of age, sex and presence of diabetes mellitus. All have received injectable Kanamycin for 6months in their intensive phase (IP). Patients giving history of auditory impairments underwent pure tone audiometry (PTA) for detection of sensory neural hearing loss, if any.
Result: Out of 40 patients of MDR-TB, 30 were males and the rest 10 were females. Age ranges from 12 to 70 years among which maximum patients fell in the age group of 21-30 years (12 patients). 16 patients were diabetic. After getting Kanamycin, 8 patients gave the history of auditory disturbances and only 1 patient found to have severe sensory neural hearing loss confirmed by pure tone audiometry.
Conclusion: Prevalence of MDR-TB has been found more among males and in younger age group. Diabetes Mellitus play a major role here. Kanamycin induced hearing loss is not a very serious concern in our study
Glycemic control amongst diabetic subjects on insulin therapy: Still off target!
Get PDFIntroduction: Prevalence of diabetes is increasing worldwide. Good glycemic control is essential for prevention of complications of diabetes. Despite of availability of multiple medications, it is difficult to achieve good glycemic control. Insulin therapy is considered to be the best option available for attaining glycemic control. But, whether insulin therapy has achieved it is an important question to be addressed.
Objective: To assess the glycemic control in subjects with diabetes on insulin therapy.
Materials and Methods: A cross-sectional study was done at Karnataka Institute of Endocrinology and research, Bangalore, in 448 diabetic patients who were on insulin therapy as a part of their diabetic therapy. Data collected was analyzed using SPSS 22 version software.
Results: Majority of the subjects were men (61.38%) and in the age group of > 60 years (44.9%). Many of the subjects on insulin therapy had duration of diabetes > 5 years, with 36.4% having duration of 10-20 years, while another 36% had duration of 5 -10 years. Premixed insulin (81.47%) was the most commonly used insulin regimen. 82.6% of the subjects were on conventional insulin and only 13.2% were on insulin analogues. Insulin syringe was the most commonly used delivery device, with 64.7% of subjects using it, while insulin pen was used by 33.5% subjects. Despite of insulin therapy, the glycemic control was poor and 81.4% had HbA1c >8%. Only 5.7% of the subjects had HbA1c <7%. 94.9% of the subjects reported that they were regular with their insulin therapy. Only 20.1% adjusted the insulin dose by self.
Conclusions: The present study has found that despite being on insulin therapy, large percentage of subjects was unable to achieve good glycemic control
Comparison of insulin resistance scoring system with indirect methods of estimating insulin resistance in Indian type 2 diabetes subjects
Get PDFBackground: Identification of insulin resistance is very important in management of type 2 diabetes. The euglycemic insulin clamp method, intravenous glucose tolerance tests (IVGTT) and minimal model approximation of glucose (MMAMG) are standard methods of measurement of insulin resistance in research. However, they are impractical in clinical practice and are difficult to perform in population-based research studies. So, a simple scoring system was designed to estimate the insulin resistance.
Methods: 200 type 2 diabetes individuals who attended Karnataka Institute of endocrinology and research outpatient department. Fasting plasma glucose, post prandial plasma glucose, fasting insulin, lipid profile, BMI, waist circumference and BP of these subjects were checked.
Results: Out of 200 type 2 diabetes subjects 69.5% were males and age group ranging from 26 to 85 years. Duration of diabetes range from 0 to 20 years and 53% of patients had hypertension and 46.5% have hypertriglyceridemia. Insulin resistance calculated by KIER scoring system, HOMA-1, QUICKI, HOMA2 and Fasting Insulin was present in 82%, 63%, 63.5%, 33.5% and 37.5% 0f individuals respectively. KIER scoring system had a statistically significant correlation with HOMA and QUICKY indices. (P value < 0.001)
Conclusions: (1) KIER scoring system detects insulin resistance in 82% of type 2 diabetes individuals. (2) HOMA 1 and QUICKI are identical and similarly HOMA 2 and fasting insulin levels are almost identical in estimation of insulin resistance. (3) The KIER scoring system designed is very simple and economical. It takes into consideration the different factors which contribute to insulin resistance
Comparison of MRI with x-ray in the evaluation of tuberculosis of spine
Get PDFIntroduction: MRI is the most valuable method for detecting early disease and is preferred technique to define the activity and extent of infection followed by x–ray.
Aim: To evaluate MRI as a valuable noninvasive diagnostic tool in spinal tuberculosis and to correlate with plain radiograph for the early detection of spinal tuberculosis.
Material and method: This cross-sectional study was carried out on 40 patients who were suspected as cases of spinal tuberculosis. Plain X-ray were done before the MRI examination.
Results: The comparison of X-ray and MRI for evaluating spinal TB on the basis of end plate irregularity, thecal sac compression, cord compression and cord changes was statistically highly significant. It was statistically significant on the basis of Disk Space Narrowing/Disk Involvement, paravertebral Widening/Psoas abscess and Posterior Element Involvement. X-ray when compared to MRI was found to have a sensitivity of 48.72% and a specificity of 100% in detection of end plate irregularities, sensitivity of 89.47% and specificity of 100% in detection of vertebral height reduction, sensitivity of 78.79% and specificity of 100% in detection of disk Space narrowing / disk Involvement and sensitivity of 28.57% and specificity of 92.31% in detection of paravertebral widening/psoas abscess.
Conclusion: MRI is a better and more Informative imaging modality in evaluation of patients of Pott’s spine providing the diagnosis earlier than conventional methods
Phenotypic heterogeneity of impacted third molar tooth: family case study
Get PDFTooth impaction is a pathological condition where a tooth fails to attain its normal functional position. The present study aims to highlight the phenotypic heterogeneity of impacted third molars in a Caucasian family, to investigate the characteristics of the dental phenotype, to evidence the diversity of dental phenotype, and to identify the inheritance mode of the condition. Detailed anamnesis, clinical examination, complementary tests (panoramic radiographs), family study and pedigree analysis. Phenotypic characteristics of impacted third molar tooth in our family case report was: Severe horizontal impaction of the mandibular right third molar, Angular impaction of the maxillary right third molar and angular impaction of the maxillary left third molar, Angular impaction of the mandibular left third molar and partial eruption of the maxillary right third molar, Horizontal impaction of the mandibular left third molar and Angular impaction of the mandibular left third molar. The inheritance mode of the impacted third molar tooth in the family case report was: from mother to both daughters’ transmission, from mother to both sons’ transmission, and from mother to daughter transmission. Family study and pedigree analysis are very important for illustrate the genetic basis of impacted teeth
Incidence of contrast induced nephropathy among patients undergoing coronary interventions
Get PDFBackground: Contrast media (CM) used during diagnostic and therapeutic percutaneous procedures is eliminated by the kidneys. A study has been planned to find the adverse effects of contrast agents on renal system.
Methods: This was a hospital based cross sectional study, conducted in the department of general medicine, GSL Medical College. Individuals >25 age, both gender with heamoglobin concentration of > 10mg/dl were included. Exclusion criteria was also followed. Iodixanol or iohexol was used, administered at the rate of 80 – 100 ml per participants. Blood samples were collected standard techniques before the procedure and 48 hours after the procedure for serum creatinine levels. Renal function was assessed by estimating creatinine clearance using the Cockcroft-gault formulae. As per national kidney foundation participants were divided in to 4 categories normal, mildly impaired, moderately impaired and severely impaired renal function; p<0.05 was considered as statistically significant.
Results: Out of 80 study subjects, CIN was increased with age, identified in 37.9% diabetics, 48.3% smokers, 41.4% alcoholics; statistically there was no significant difference. In the normal category 34.5%, 41.4% in mild category, 24.1% in moderate renal dysfunction category developed CIN, association was statistically significant.
Conclusions: With these findings we conclude that overall increase in the incidence of CIN with age and no influence of gender as well as conditions like diabetes and hypertension
Spinal anesthesia during cesarean section and persisting low back pain: a cross sectional study in West Bengal, India
Get PDFBackground: Spinal anesthesia related spinal injury can be a major issue in elevating back pain. Several evidences have established this process as a significant contributor of back pain; though contradictions are also present. This study aims to focus on the consequences of back pain associated with the effects of spinal anesthesia that have been received before several years.
Methodology: 48 housewives are included in this study (20 subjects for vaginal delivery and 28 subjects for spinal anaesthesia induced cesarean section) based on convenient sampling method through assessing their socio-economic status and other attributing criteria. Pain detect tool was used to track back pain status and a semi structure questionnaire was used to explore other considerations.
Results: Results have shown significant differences in pain responses after receiving spinal anesthesia (exposed group) than control group. Subjects have reflected significant differences in their pain perception scores.
Conclusion: This study concludes that subjects have shown significant higher pain perception levels after receiving spinal anesthesia compared to general anesthesia. Decision of Cesarean section delivery should include patient’s previous pain conditions and current need. Acute care in post surgical pain should be immediately addressed even after several months of the surgery
Analysis of central axis and build up region dose calculated by different dose calculation algorithms used for radiation treatment planning
Get PDFIntroduction: Computerized Treatment planning system (TPS) is an integral part of radiation treatment procedure. The main part of treatment planning system is a calculation algorithm incorporated in the Treatment Planning System. Various algorithms used in the TPS have capabilities and limitation on specific situations.
Objective: The objective of the work is to analyse the depth dose distribution generated by different dose calculation algorithms used in TPS in regions of low and high dose gradient.
Materials and Methods: Four different dose calculation algorithms used for treatment planning such as Modified Clarkson, Sector integration, Fast Fourier Transform, Convolution- Superposition algorithm were used to generate the percentage depth dose distribution in a water phantom up to 25 cm depth. The values are compared with experimental results using Radiation Field Analyser. The PDD values also generated at build up region and the values were compared with experimental results using a Parallel plate ionization chamber.
Results: The results show that the dose calculated by different algorithms shows difference at build up region and at larger depths