International Journal of Medical Research & Review (IJMRR)
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Quality of life of young male catheterized patients
Get PDFIntroduction: It is pointless to point out that, Per-urethral or Supra-pubic Catheter compromises the Quality of life (QoL) of young male patients. Our study is about the comparison of QoL status along with depression of catheterized state with same after removal of catheter of patients.
Objectives: In our study we wanted to quantify the quality of life (QoL) and distress experienced by patient following catheterisation and also to assess the improvement of QoL after catheter removal following surgical intervention.
Methods: We used two tools named World Health Organization Quality of Life scale (WHOQOL BREF) and Beck Depression Inventory (BDI) for this purpose.
Result: We found statistically significant improvements in all domains of QoL as measured by WHOQOL BREF and improvement in depression status as well, measured by Beck Depression Inventory (BDI).
Conclusion: As we have documented poor QoL and depression status in catheterised state and improvement of the same after catheter removal we recommend counselling of such patients regarding QoL and Psychiatry consultation for management of depression
Impact study of hygiene and health counselling as a controlling measure of iron deficiency Anemia
Get PDFBackground and Aim: Anemia is a moderate to severe public health problem in India. Coverage of anemia programmes are inadequate, safe water and sanitation status is moderate or poor, open defecation rates are significant, incidence of diarrhoeal diseases are high as a results of infection. Though poor bio-availability of iron is the root cause of iron deficiency anemia (IDA) the role parasites infection such as hookworm infection also plays a major role in IDA. There is a link between poor hygiene practices –worm infection –IDA. Hence this study was undertaken to educate women of reproductive age group (WRA) about impact of IDA and how good hygiene practice can eliminate the problem to at least some extent.
Methods and Material: Women of reproductive age group(WRA) in rural population were taken randomly for this study. They was first screened for anemia and then IDA. The ID anemic women were then randomly allocated into two groups one as experimental and another as control. Base line hematological parameters and hygiene practices were obtained from them. Only the experimental group was counselled about good hygiene practices. The final hematological parameters and hygiene practices were obtained after eighteen months and were compared for statistical significance.
Results: At the end of the study 306 women were found to be non anaemic in experimental group while in control group it was only 78 women. Statistical significant results were obtained in hygiene practices between experimental and control group.
Conclusion: Our study hence shows that good hygiene practice does play an important role in controlling anemia
A study of demographic variables affecting tubectomy in a tertiary care centre in India
Get PDFIntroduction: Family planning is one of the fundamental pillars of safe motherhood and a reproductive right. The practice of family planning is influenced by socio demographic factors.
Material and Methods: All patients undergoing tubectomy were evaluated for age, parity, religion, belonging to rural/urban areas and whether undergoing tubectomy with/without MTP. Ethical clearance for the study was taken from the Institutional ethics committee. The statistical significances of differences in different variables were evaluated by calculating p-values.
Results: Study demonstrated that majority of tubectomy acceptors (86.9%) belonged to age group of 25-30 years. Maximum no of couples (44.5%) had 3 children before opting tubectomy, next predominant group was of couple who had 1-2 children (31.2%). 96.8% of couples were Hindu and only 3.1% from Muslim community. 73.6% of the total tubectomy acceptors studied, were from rural areas, and 26.3% were from urban regions. 29% of couple had medical termination of pregnancy before sterilization.
Conclusion: More of the young population in India are opting for tubectomy. Still women with 3 children are predominating the tubectomy group. Religion has a huge impact on contraceptive practices in India. Removal of the religious taboos is essential for proper implementation of family planning programmes. Maximum of the rural people are enrolling for tubectomy. There is need to spread the usage of spacing methods amongst this group. A significant no of people opted for tubectomy only when they became pregnant with the unwanted child, hence went for sterilization after medical termination of pregnancy
Comparison of 0.5% Ropivacaine with 0.5% Ropivacaine and Magnesium sulphate in supraclavicular brachial plexus block for forelimb and hand surgeries
Get PDFObjectives: Supraclavicular Brachial Plexus is commonly used for forelimb and hand surgeries. A lot of research is going on to increase the duration of sensory and motor blockade by the addition of adjuvants with the local anesthetics. We evaluated the effect of adding magnesium sulphate to ropivacaine for supraclavicular brachial plexus blockade. Our primary parameters were the onset and duration of sensory and motor block and duration of analgesia.
Methods: 60 patients posted for elective forearm and hand surgeries under supraclavicular brachial plexus block were divided into two equal groups (Group RM and RN) in a double blind fashion. In Group RM 30ml 0.5% ropivacaine plus 150 mg magnesium sulphate in (1 ml 0.9% saline) and in group RN 1ml of normal saline was added to ropivacaine.
Results: Both the groups have similar demographic profile and time of onset of senory and motor block but the duration of senory and motor blockade and duration of analgesia were significantly longer in RM group than RN group. Intraoperative hemodynamics were compareable amoung two groups and no considerable side effects were noted in both the groups.
Conclusion: It can be concluded from our study that by addition of magnesium sulphate to local anesthetics in supraclavicular brachial plexus block may increase the duration of senory and motor blockade and duration of analgesia with no appreciable side effects, however duration of onset of sensory and motor blockade was more in magnesium sulphate group
Profile of Hypernatremia in a Tertiary care hospital: A review of 175 cases over a 5 year period in a South Indian population
Get PDF0bjective: The aim of this study was to ascertain the profile of hypernatremia with an emphasis on the prevalence, development, progress and clinical outcomes in hospitalized patients.
Materials and Methods: This study was carried out at a tertiary care centre in south India from March 2011 to march 2016 and included 175 consecutive hospitalized patients who developed hypernatremia during the course of their management.
Results: A total of 5558 patients were admitted as in-patients of which 175 patients developed hypernatremia resulting in a prevalence rate of 3.14%. The majority of patients were males -130 (74.28%) and 57 (32.55%) of the hypernatremic patients were geriatric. The most common disease condition of patients who developed hypernatremia was head injury-37(21.1%) followed by respiratory disease-23(13.1%), sepsis-17(9.7%) and transient hypernatremia-17(9.7%). 21 patients (12%) ended in mortality while the rest 154 (88%) recovered and were discharged from hospital. Patients in the mortality group were found to have higher levels of hypernatremia average- 162 when compared to those that survived 151 (p<0.05).
Conclusion: While there are few reports devoted to hypernatremia in the Indian population, a standardized management protocol needs to be followed and physicians need to focus more on identifying patients who are likely to develop hypernatremia and take step to avoid it by pre-tagging and using preventive measures. This is probably one of the first studies of its kind in a south Indian population and could be an eye opener in the management of hypernatremic patients
A comparative study of MRI versus arthroscopic findings in meniscal injuries of knee
Get PDFIntroduction: Knee joint is one of the most commonly injured joints because of its anatomical structure, its exposures to external forces and the functional demands placed on it. Because of the difficulty of obtaining an accurate clinical examination in the acute setting, the incidence of such injuries is not well understood.
Material and methods: The present study was carried out in 30 patients having clinical signs and symptoms of knee injury over a period of 12 months, who were referred to the radiological department from different IPD’s and OPD’s of Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun.
Results: Diagnostic accuracy of MRI was 86.6% for medial meniscus and 93% for lateral meniscus in our study. In present study medial meniscal injuries was found in 16 patients (53.3%). Lateral meniscal injuries were found in 8 patients (26.6%).
Conclusion: In conclusion, the present study supports that MRI is helpful in diagnosing meniscal injuries. Now days patients expectations are maximal and taking into account that MRI false or misleading results can be as high as 20-30 percent in specific knee pathologies. Undoubtly new techniques and more powerful tomograms will improve MRI’s accuracy leading to better diagnostic accuracy in knee injuries
Clinical & etiological profile of acute undifferentiated fever in patients admitted to a teaching hospital in Pondicherry
Get PDFObjectives: To identify the infectious aetiology and clinical features of Acute Undifferentiated Fever among patients admitted to a teaching hospital in Pondicherry.
Design: Prospective observational study.
Subjects: 270 cases comprising all adult patients (≥18 years) admitted to the hospital with fever of less than 14 days duration, temperature ≥38ºC upon admission and non-detection of any specific foci of infection by history, physical examination and routine investigations. Previously diagnosed cases of known fevers, collagen vascular disorders, endocrine disorders, malignancies, immunodeficient states, fever of duration ≥14 days and drug induced fevers were excluded.
Methods: All patients were examined and investigated according to study protocol after an informed consent to reach final diagnosis.
Results: 38.1% cases were of Scrub Typhus aetiology, 20% cases tested positive for dengue, 14.1% cases came positive for Enteric fever and Malaria was found in 5.6% cases, all of P. vivax parasite. There was 1 case of TB, 1 case of candida infection and 1 case of Klebsiella pneumonia. 1 case tested positive for leptospirosis. Blood pathogens isolated were Pseudomonas and Enterococci with 1 case each. UTI was a frequent diagnosis with 7 cases of E. coli, 1 case of Enterococci and 1 case of Staphylococci. 1 case of HIV was detected.
Conclusion: Scrub typhus was the most common aetiology of Acute Undifferentiated Fever followed by Dengue and Enteric fever
A study of functional outcome in intertrochanteric femur fractures treated by proximal femoral nailing
Get PDFIntroduction: Intertrochanteric femur fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to trivial trauma.Dynamic Hip Screw (DHS) is still considered the gold standard for treating intertrochanteric fractures by many. Proximal femoral nail is a relatively newer implant designed to treat unstable intertrochanteric fractures.The present study was conducted to evaluate functional outcome in intertrochanteric femur fractures treated by proximal femoral nailing.
Methods:The present study is a prospective study performed on 98patients of intertrochanteric femoral fractures treated by Proximal Femoral Nail (PFN)in department of Orthopedics at Shri Bhausaheb Hire Government Medical College, Dhule. Functional outcome was assessed by modified Harris hip score at the end of 6 months postoperatively.
Result: Total 98 patients were included,32 were females and 66 were males.Age group ranged from 18 to 85 years. Maximum patients (40.81%) were between 60 to 70 yrs age group. 56.12%of patients had Evans type I fracture and the rest (43.87%) had type IIfracture. Excellent outcome observed in 30.6% patients, good in 44.9%, fair outcome in 14.2% and only 10.2% had poor outcome among 98 patients.
Conclusion:It is concluded from our study that use ofPFN for treatment of intertrochanteric fractures provides agood functional outcome along with advantages in terms ofminimal blood loss, early weight bearing and few complications. It is the implant of choice for unstable intertronchanteric fractures
Biochemical and clinical variations among severe Plasmodium Vivax malaria cases: A prospective study
Get PDFContext: Plasmodium vivax is geographically widely distributed with up to 2.5 billion people at risk and an estimated 70-80 million cases every year. India contributes 77% of the total malaria in Southeast Asia. Retrospective analysis of burden of malaria showed that disability adjusted life years due to malaria were 1.86 million years. According to recent study, West Bengal contributes 11% of total malaria cases in country and is one of states where falciparum resistance to chloroquine has been confirmed.
Aims: The aim of this study was to evaluate the biochemical and clinical profile of severe and non-severe Plasmodium vivax malaria and the complications and outcome of P. vivax malaria infections as there is very limited information on age and sex specific seasonal prevalence of malaria in different paradigms in the country.
Materials and Methods: A hospital based prospective study was conducted in Medical College, Kolkata comprising of 138 patients with fever (≥37.5˚C), peripheral smear and/or rapid diagnostic tests positive for P. vivax. Previously established cases of CKD, hematological abnormalities, chronic liver diseases and neuro-psychiatric disorders were excluded from our study. Demographical, clinical and laboratory parameters including liver function test, renal function test were documented and were presented in tabular and statistical means.
Results: Jaundice was present in 22% of patients and vomiting in 32% of the patients. Hepatomegaly was seen in 16 % cases and 33% cases had splenomegaly. ARDS was seen in 16% of severe malaria cases. Acute kidney injury was seen in 8% and cerebral malaria was seen in 12% of severe malaria cases. Multi organ dysfunction was seen in12 %cases. There was 1 death in the study due to multi organ dysfunction.
Conclusion: Life threatening complications such as ARDS, AKI, cerebral malaria and MODS can be seen in P. vivax mono infections
Left ventricular dysfunction in chronic obstructive pulmonary disease
Get PDFIntroduction: The prevalence of LV dysfunction is probably high in COPD patients because this condition shares common risk factors.The diagnosis of left heart failure is difficultin the early phases of COPD and also during exacerbation due to similarities in signs and symptoms. Bio-markers like hsCRP is found to be elevated in stable phase as well as in exacerbation of COPD.
Objectives: To assess LV Dysfunction(Systolic and Diastolic) and to correlate Age, Symptoms, Duration and stage of illness, CRP with LV Dysfunction.
Methods: Total 100 patients of which 50 were age and sex matched controls not having COPD complying with Inclusion and Exclusion Criteria. After taking history and clinical examination they were evaluated for COPD and Left ventricular Dysfunction using PFT and Echocardiogram.
Results: Out of 50 patients, 37 patients (74%) had Diastolic dysfunction, of them 2 patients hadSystolic dysfunction also. 13 patients were normal.In the control group only 4 had Diastolic Dysfuncion.CRP was high in 35% (70%) of patients. In the higher age group of 50-60 years Diastolic dysfunction was significant. In patients of GOLD stage IV 5 out of 5 patients (100%) whereas in GOLD stage I and II it was in 1 case (16.66%) and21 case (80.76%) respectively. While comparing with the control group incidence of LV dysfunction parameters and CRP is more in case group.
Conclusion: There is increased incidence ofLV Diastolic dysfunction and also with advanced GOLD stage.CRP also correlates well LVDD. Therefore it is pertinent to explore LVDD in all patients with acute exacerbation of COPD and advanced disease stage