International Journal of Medical Research & Review (IJMRR)
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A comparative study on efficacy and safety of glycopyrronium bromide + salmeterol/fluticasone and tiotropium bromide + salmeterol/fluticasone in chronic obstructive pulmonary disease
Get PDFObjective: To compare the effect of tiotropium bromide and glycopyrronium bromide in the treatment of chronic obstructive pulmonary disease.
Methods: This was an open labeled Randomized controlled trial study. Patients diagnosed with COPD according to the Global Initiative for chronic Obstructive Lung Disease (GOLD) strategy were included in the study. The patients were divided in two groups and each group had 100 patients. Group A- COPD patients on Tiotropium bromide + Salmeterol/Fluticasone; Group B – COPD patient on Glycopyrronium bromide + Salmeterol/Fluticasone. Tiotropium bromide: 18 mcg OD, Glycopyrronium bromide: 50 mcg OD along with Salmeterol 50 mcg/Fluticasone 100mcg was given.
Results: The mean age of patients of Group A and Group B was 56.28±7.78 and 57.64±8.06 years respectively. Baseline variables were comparable between the groups. There was significant (p<0.05) difference in PFT parameters between the groups at 12 and 24 weeks except for FEV1/FVC. The mean change was higher in Group B compared to Group A from 0 week to 24 weeks. There was clinical improvement among all the patients in both the groups.
Conclusion: Once-daily GLY demonstrated similar effects to TIO when combined with SAL/FP in patients with moderate and severe COPD
A study of relationship of hyperuricemia in hypothyroid patients
Get PDFIntroduction: Hypothyroidism is a common metabolic disorder in general population. The prevalence of primary hypothyroidism is 1:100, but it may be 5:100 if patients with subclinical hypothyroidism (normal T4, raised TSH) are included.The degree of severity ranges from mild and unrecognized hypothyroid states to striking myxedema. The thyroid dysfunction increases with age, especially in women.Uric acid has been found to be significantly elevated in primary hypothyroidism in many studies. In comparison to the prevalence reported in the general population, a significant increase of both Hyperuricemia and gout was found in the hypothyroid patients. In hypothyroidism, the hyperuricemia is secondary to a decreased renal plasma flow and impaired glomerular filtrationThis study was designed for evaluation of uric acid levels in hypothyroid patients which might be helpful for clinical management of hypothyroid patients with hyperuricemia.
Objective of Study: To find out any relationship between hyperuricemia in hypothyroidism patients.
Methods:In our study, out of 100 patients, only 15 were found to have increased serum uric acid levels and only 3 had increased urinary uric acid levels. Out of these 15, 9 were females and 6 males, or can be said out of 70 females in study; only 9 were having increased serum uric acid levels.
Results: In our study, the association between hypothyroid function and hyperuricemia seems to be week.No significant correlation was found betweenT3, T4 &TSH and serum uric acid.
Conclusion: The correlation between hypothyroidism and gout still remains a matter of debate and more extensive studies need to be done to come to a definitive conclusion
Retrospective analysis of chest x-ray of patients from eastern Uttar Pradeshpresenting in Radiology department ofHind Institute Medical Sciences, Barabanki Uttar Pradesh
Get PDFIntroduction: Chest Xray is one of the most frequently asked radiological examination in patients with heart or lung problems in general medical practice. There are many studies on correlation of CXR findings and other tools of investigations like CT scan, MRI and laboratory investigations like spirometry and sputum examinations etc. The present study aims at establishing a possible correlation in rural population of Eastern Uttar Pradesh.
Methods: We have done a cross sectional study in a period of six months including 2500 patients coming for CXR. Patients were followed up to a point where radiological diagnosis was confirmed or otherwise after other investigations and clinical response.
Results: There was fairly good correlation in patients with COPD (73.15%), tuberculosis (85.8%), interstitial lung disease (63.9%) and congestive heart failure (68.6%).
Conclusion: We conclude that CXR is tool of reasonable sensitivity however there is sizeable possibility of false positive and negative cases
Role of tissue engineering in oral & maxillofacial surgery – a review
Get PDFTissue engineering can be defined as the “reconstitution of tissue and organs, in vitro for use as model systems in basic and applied research, or for use as grafts to replace damaged or diseased body parts or body functions”. Biomaterials have been used as replacement tissues and grafts have been used to reconstruct defects in craniofacial region till Uristmade the first attempt of producing exogenous bone with the help of bone morphogenetic proteins. The success of tissue engineering over the field of all transplantation is that conceptually a three-dimensional functional tissue is designed. This field has become a boon to the Cranio Maxillofacial surgeons and has provided them with a supplement to existing treatment for reconstruction of Oral & Craniofacial region. The purpose of this article is to present an overview of the various uses of tissue engineering in the field of Oral and Maxillofacial Surgery
Incidence and management of foreign bodies in aerodigestive tract in a tertiary level
Get PDFIntroduction: Foreign body (FB) ingestion and aspiration is a life-threatening condition which is quite common in children. It is important to diagnose foreign body aspiration early as delay in its recognition and treatment results in high morbidity and mortality. The objective of the present prospective study was to study foreign bodies in aerodigestive tract on the basis of history, examination, and investigation, their incidence, type of foreign body, site of lodgment, common symptoms with which presented, and the nature of the problem in dealing with these patients during the management.
Materials and Methods: A total of 86 cases of FB in aerodigestive tract admitted in ENT ward of Bundelkhand Medical and Hospital were included in the study. The symptoms, site and radiographic findings were recorded for each patient. Various procedures were used for removal of various FB at different locations. Majority of these procedures were performed under anesthesia.
Results: Of all admitted foreign body cases (86 cases), incidence was more for males (63 cases) than for females (23 cases). Likewise, it was encountered more commonly in the age group of 1-10 years. FB were removed smoothly and successfully in all cases. Overall outcome was excellentwith minimum morbidity and no mortality. According to the site of involvement, hospital stay was varied.
Conclusion: In this study, it is evident that FB in aerodigestive tract is a common clinical problem in otorhinolaryngological practice. Although, some presents with serious and life-threatening emergencieswhilemany does not have an immediate problem of airway. Higher incidence of foreign body in children can be prevented by educating the parents about keeping the articleaway from reach of children and observing the activity of the child
A study of demographic profile of HIV positive patients attending ART centre SGMH Rewa, Madhya Pradesh
Get PDFBackground: Caused by Human Immuno-deficiency virus, leading the patient’s immune system vulnerable to various infections and neurological disorder, AIDS have transformed into a socioeconomic and developmental concern. With the increasing population of India, the HIV epidemic will soon be a major cause of concern. The objective of the present study was to observe the demographic profile of HIV positive patients attending ART Centre at the Department of Medicine at Sanjay Gandhi Memorial Hospital & Shyam Shah Medical College, Rewa (M.P.) in year 2012-2014.
Material & Methods: This was a data-based study. In this study total 1224 cases of all age group were taken, these patients were registered in ART center in between Jan. 2010 to Dec.2012. A pre-formed questionnaire (proforma) was made to enquire about socio-demographic-economic variables. The patient and their spouse were interviewed, examined and investigated according to pre-designed proforma with special reference to their occupation, spouse HIV status and high-risk behaviour.
Results: In this study total number of ART attendees (patients) were 1224 and out of these total patients, 7.27% (n=89) were children (<15years) and 92.73% (n=1135) were adult (>15 years). Out of 89 children, 5.15% (n=63) were male and 2.12% (n=26) were female and out of 1135 adult patients, 53.26% (n=652) were male and 39.46% (n=483) were female. M/F ratio in children was 2.4/1 and M/F ratio in adult patients was 1.3/1.
Conclusion: As the present study was done in rural area, where hygiene was poor and sanitation was bad and environment was dusty, that is why infectious complications were more common in the present study
Endovascular Management of Acute Superior Mesenteric Artery Thrombosis in a Delayed Setting
Get PDFAcute mesenteric ischemia [AMI] is a life-threatening situation, the diagnosis of which is often missed in early stages. Late diagnosis often precludes endovascular management as the primary treatment. The authors here present a case of seven days history of acute mesenteric ischemia in a young female, who not just benefited from endovascular management, but also a major surgical intervention was avoided andwas discharged from the hospital uneventfully. The decision to consider a patient for endovascular management in a late stage, requires a good interdisciplinary communication and successful outcome in such a scenario is rarely achieved
Comparative study of postoperative analgesia by epidural ketamine and ketamine plus dexamethasone in lower limb orthopedic surgery
Get PDFAim & Objectives: To compared the effect of ketamine and combination of ketamine plus dexamethasone on the duration of postoperative analgesia and to evaluate the effect of dexamethasone on postepidural backache and other complications.
Methods: 50 patients (ASA I and II) posted for elective surgery of lower limb in orthopedics, were divided at random into two groups of 25 each. Patients in group I received Inj. Ketamine HCl 0.3 mg/kg diluted in 10 ml normal saline while patients in group II received ketamine HCl 0.3 mg/kg and dexamethasone 8 mg diluted in 10 ml normal saline postoperatively through epidural catheter. The relief of pain and perioperative sequelae were compared.
Results: Groups were compared with respect to quality of epiduralanaesthesia and pain relief as felt by the patient. The quality of epidural anaesthesia was found adequate in 80% cases of group 2 and 76% cases of group 1. Pain relief was 20% excellent and 76% good in group 2 and 12% excellent and 68% good in group 1. In group I the mean duration of pain relief after epidural injection of ketamine 0.3 mg/kg was 363.91±180.94 min and in group II after epidural injection of ketamine 0.3 mg/kg with dexamethasone 8 mg was 582.63±182.03 min. These values differ markedly and are statistically highly significant (p<0.001).
Conclusion: Ketaminecan be used epidurally safely for rapid onset and is effective for prolonged postoperative analgesia with minimum side effects and high acceptability. The duration can be further prolonged with the addition of dexamethasone and the incidence of postepidural backache is also minimised with dexamethasone
Evaluation of Some common clinical factors in extensive vitiligo- a case control study
Get PDFIntroduction: Vitiligo is a common depigmenting disorder with profound stigma. Prevalence of vitiligo is 0.5% to 1%. Information about association of progressive vitiligo are well known. Prognostic factors of vitiligo also enlisted. However, little information is available on the risk factors for developing extensive vitiligo.
Aims and Objectives: Aims of the study was to identify – factors which are associated with extensive vitiligo (involving more than 5% of the body surface area). The following risk factors were evaluated, Onset before 20 years of age, Duration of disease greater than 2 years, Presence of Koebner’s phenomenon, Family history of vitiligo, Presence of leucotrichia and Mucosal involvement.
Materials and Methods: A case control study were designed. Patients with Vitiligo > 5% body surface area involvement were classified as cases and <5% body surface area were labeled as controls. The frequency of evaluating associated clinical factors among the cases and controls were used to evaluate the extensive vitiligo’s association with risk factors (disease risk associated exposure).
Results: Two hundred and eleven patients were evaluated. The mean age at onset was 19.07+13.51 (+SD) years. Acrofacial vitiligo was the commonest type of vitiligo. Duration of disease more than 2 years, presence of Koebner’s Phenomenon, Family history, Symmetry of lesions, milky white colour of lesion, presence of Leucotrichia, mucosal involvement and Acrofacial type vitiligo had statistically significant (p<.05) association with extensive vitiligo. Ratio of the odds of the outcomes in two groups was noted significant with Duration of disease more than 2 years, Koebner,s Phenomenon, Mucosal involvement and Leucotrichia.
Conclusion: This case-control study has demonstrated a weak association between extensive vitiligo and duration of disease greater than 2 years. It has also indicated that koebner’s phenomenon, mucosal involvement and leucotrichia are additional risk factors
A Pathologist’s perspective of penile carcinoma – an institutional study at Indian Red Cross Hospital, Nellore
Get PDFBackground: Penile cancer is an unusual malignancy with higher incidence rates in developing countries like India when compared to the Western world. Incidence varies from 0.7-2.3 cases per 100,000 men in urban India and 3 cases per 100,000 men in rural India. In spite of its rarity, it forms a suitable medical model for theranostics. Given this relevance we put forward our departmental experience in a rural Indian setup.
Materials and Methods: This is a retrospective three year study of penile SCC patients managed in Indian Red Cross Cancer Hospital, India. Data was compared with similar studies across the world.
Results: 23 patients were diagnosed with squamous cell carcinoma of penis during the period of study. We witnessed in this study that a relatively younger age of presentation and early stages prevailing. Higher percentage of involvement of prepuce and body was also noted.
Conclusion: Consideration of prognostic histopathological factors may help to tailor appropriate management in this infrequent malignancy