International Journal of Medical Research & Review (IJMRR)
Not a member yet
1355 research outputs found
Sort by
Prevalence of diabetic retinopathy in type 2 diabetic patients at Tertiary Hospital, Bangalore, India.
Full text linkDiabetic retinopathy is a common microvascular complication seen in diabetic patients. The global prevalence is estimated to be 22.27 %.(1)
Objective:
The aim of this study was to assess the prevalence of diabetic retinopathy in type 2 diabetic patients visiting our institute – Karnataka institute of endocrinology and research.
Furthermore, we evaluated the severity of diabetic retinopathy and factors associated with diabetic retinopathy like gender and age group.
Methods: A total of 5,363 diabetic patients attending the vitreoretina OPD at our Institute from November 1st, 2022 to October 31st, 2023 were included in our study. Data was collected using a questionnaire and a detailed dilated examination was done by an ophthalmologist (vitreoretina specialist).
Result:
A total of 5,363 diabetic patients were included in the study.The prevalence of diabetic retinopathy was 30.84 % (95% CL: 29.66-32.12). Among 5,363 patients, 3705 patients had no diabetic retinopathy (69.15%), 812 had mild NPDR (15.14%), 438 had moderate NPDR (8.16%), 152 had severe NPDR (2.83%) and 252 patients had PDR (4.69 %). The prevalence of diabetic retinopathy was higher in males (34.82%) compared to females (25.01%). The odds ratio was 1.60. The prevalence of diabetic retinopathy was higher in age group above 45 years.
Conclusion: The prevalence of diabetic retinopathy in our study was 30.84%, higher than global figures. Screening of all diabetic patients regularly and good glycemic control should be an integral part of diabetic care management to reduce the burden of diabetic retinopathy.
 
Albahkali, et al The general skeletal features of Multicentric Carpotarsal Osteolysis: what the radiologist needs to know
No full textRadiographic imaging is the first investigational step in detecting of MCTO, and the radiologist must be aware then familiar with the radiolgical features in order both to reach a prompt diagnosis and then to classify the patient’s condition at this important time for considering early management. Here we review the literature on this topic. Patients with MCTO are frequently diagnosed with JIA. Initially. Among the many published studies, some are case reports that describe the phenotypical manifestations with a brief discussion of the radiographic findings and subsequently of the genetic analysis which eventually leads to a definitive diagnosis. Some patients develop end stage renal failure, and a delay in identifying this condition can lead to unfavorable progression of the disease. In addition, we found reports of joint inflammation based on imaging and of pain relief with antirheumatics for osteolysis and bone destruction. Various studies discuss the radiological findings, including the disappearance of the carpal and tarsal bones. Others describe the genetic mutations, including MAFB, that are associated with the condition, and its possible management through the use of therapeutic drugs. A very recent description of serial radiographs taken from a young age suggests that dysfunctional bone formation can play a role in the skeletal phenotype of MCTO. The atypical radiological findings, failure to obtain remission with medical treatment and consanguinity, should guide clinicians toward diagnosis. We summarize the X-ray findings which are highly specific and can therefore differentiate between this condition and others. Further performance of genetic tests is confirmative
4Dimensional XStrain Echocardiography assessment of Left Bundle Branch Cardiomyopathy in an elderly male : A case report
Full text linkLeft bundle branch block (LBBB) is generally associated with a poorer prognosis in comparison to normal intraventricular conduction. LBBB may be the first manifestation of a more diffuse myocardial disease. The typical surface ECG feature of LBBB is a prolongation of QRS above 0.11s in combination with a delay of the intrinsic deflection in leads V5 and V6 of more than 60 ms and no septal q waves in leads I, V5, and V6 due to the abnormal septal activation from right to left. LBBB may induce abnormalities in left ventricular performance due to abnormal asynchronous contraction patterns. Asynchronous electrical activation of the ventricles causes regional differences in workload which may lead to asymmetric hypertrophy and left ventricular dilatation, especially due to increased wall mass in late-activated regions, which may aggravate preexisting left ventricular pumping performance or even induce it
The Severity of diabetic retinopathy and its relationship with duration of diabetes and hypertension
No full textObjective: This study aims to evaluate the risk factors affecting diabetic retinopathy and its severity in type 2 diabetic patients about the duration of diabetes and hypertension.
Methods: A retrospective chart analysis was done of patient data collected from the patients visiting our tertiary institute (Karnataka Institute of Endocrinology and Research) from November 1st, 2022 to October 31st, 2023. In these diabetic patients, the prevalence of diabetic retinopathy and its severity concerning the duration of diabetes and hypertension was evaluated. Diabetic retinopathy and diabetic macular edema (DME) were classified based on the International Clinical Disease Severity Scale for Diabetic Retinopathy (DR).
Result: 5363 was the total number of diabetic patients included in this study. The prevalence of Diabetic retinopathy(DR) was 13.95% with diabetes for less than 5 years, 37% with diabetes for 5 to 10 years and 58.74% for more than 10 years. In diabetic patients with associated hypertension, the prevalence of diabetic retinopathy (DR) was 36 % as compared to 28.4% without associated hypertension. In multivariate analysis for factors associated with diabetic retinopathy, the odds ratio (OR) was 3.61% (95% CI, 3.08 – 4.23, P – Value < 0.001) in patients with diabetes between 5 – 10 years and in patients with diabetes above 10 years the odds ratio (OR) was 8.69 (95% CI, 7.36 – 10.26, P – Value < 0.001) as compared to patients with diabetes < 5 years. The odds ratio (OR) for developing DR was 1.19 (95% CI, 1.03 – 1.37, P – Value 0.015) in patients with diabetes and hypertension as compared to diabetic patients without hypertension.
Conclusion: The prevalence of diabetic retinopathy is higher in diabetic patients with longer duration of diabetes and diabetic patients with associated hypertension. It is important to evaluate all diabetic patients for diabetic retinopathy and maintain good glycemic and hypertensive control. Managing comorbidities along with diabetes reduces the prevalence and complications of diabetic retinopathy
Dengue Serotypes In Manipur – Findings From A Retrospective Analytical Study In A Tertiary Care Hospital
Full text linkObjectives: As a part of on-going research programme on vector-borne viral diseases especially on Dengue, a retrospective analytical study on the occurrence and distribution of Dengue virus serotype(s) in the state of Manipur – a small state situated in the north eastern region of the Indian subcontinent was carried out at Viral Research & Diagnostic Laboratory (VRDL), Department of Microbiology, Regional Institute of Medical Sciences (RIMS), Imphal which is a tertiary care hospital.
Materials & Methods: A total of 914 blood samples from clinically dengue suspected patients were screened for the presence of Dengue infection by adopting ELISA (IgM) technique during the period from 01/06/2022 to 02/12/2022. Further, anti-Dengue IgM antibody positive samples having high Optical Density (OD) value(s) were selected and subjected to RT PCR to determine the serotype(s) of Dengue virus.
Results: Of the 914 blood samples examined for the presence of Dengue infection, 111 (12.14%) were found positive for anti-Dengue IgM antibody indicating acute infection of Dengue virus. Of the positive patients, there were 56 (50.45%) males and 55 (49.54%) females. The sex difference was found to be statistically insignificant (।z।CV = 0.016; z ˂ 1.96; P ˂ 0.05). Predominant clinical features observed among the Dengue confirmed patients included – fever (74%), headache (19%), arthralgia / joint pain (9%), myalgia (6%) and vomiting (6%) respectively. Haemorrhagic manifestation was observed in only one (01) patient. Only three (03) Dengue positive patients had the history of travelling outside the state.
The study revealed that while circulation of three (03) Dengue virus serotypes, namely DENV – 1, DENV – 2 & DENV – 3 were observed in the Tengnoupal district, the circulation of two Dengue virus serotypes i.e., DENV – 1 & DENV – 2 were evident in Imphal West & Bishnupur districts respectively. The present study also reveals the occurrence of Dengue virus serotype – 1 (DENV - 1) in Churachandpur district.
Conclusion: The present study reveals the circulation / distribution of three Dengue virus serotypes namely, DENV – 1, DENV – 2 and DENV – 3 among the studied samples. Findings from this pilot study stresses the need for continuing more in-depth studies among the population of the state towards identifying serotypes endemic/prevalent in the different districts of the state.
Keywords: Dengue virus, Dengue IgM ELISA, Dengue serotype (RT PCR
Influence of Family History on the Age of Onset and Complication Spectrum in patients with Type 2 Diabetes Mellitus: Familial Impact on T2DM Onset and Complications
Full text linkBackground:
Type 2 Diabetes Mellitus (T2DM) is a prevalent chronic health condition globally, with its onset and complications significantly influenced by genetic and environmental factors. This study aimed to assess the influence of family history on the age of onset and complication spectrum among T2DM patients.
Methods: This descriptive cross-sectional study recruited 500 participants diagnosed with T2DM. Data were collected through structured interviews and clinical assessments, focusing on demographics, medical and family history, age of onset, and diabetes-related complications.
Chi-Square and logistic regression analyses were employed to examine the association between family history and diabetes complications, adjusting for confounders.
Results: Among the participants, 73.8% reported a positive family history. The mean age of onset for those with a family history was significantly lower (43.8 ± 9.86 years) compared to those without (48.24 ± 9.87 years; p < 0.001). Patients with higher HbA1c levels were younger, had an earlier onset of diabetes, and a higher prevalence of hypertension. The age of onset was earlier, if more family members had a history of diabetes. Complications were present in 80.8% of the cohort, with the most common being diabetic peripheral neuropathy (70.6%). Logistic regression analysis indicated that having siblings with diabetes was a significant predictor for general diabetic complications (OR=2.589, CI: 1.481 to 4.53, p<.001), diabetic retinopathy (OR=1.981, CI: 1.20 to 3.26, p=0.007), and diabetic peripheral neuropathy (DPN) (OR=1.709, CI: 1.042 to 2.8, p=0.034).
Conclusion: The study highlights the significant influence of family history on the age of onset and the spectrum of complications in T2DM. These findings suggest the necessity for comprehensive family history assessments in clinical settings to identify at-risk individuals for early intervention and personalized management strategies
Prevalence of Anti Thyroid Peroxidase Antibody Positivity in Subclinical and Clinical Hypothyroidism subjects attending a tertiary centre in South India.
Full text linkObjective:
To estimate the prevalence of anti-TPO antibodies in subjects with subclinical and clinical hypothyroidism in subjects attending a tertiary centre in South India.
Materials and Methods:
50 subjects with subclinical hypothyroidism and 120 subjects with clinical hypothyroidism attending the out-patient department of Karnataka Institute of Endocrinology and Research, Bangalore were included over a period of one year from June 2023 to June 2024. Measurements of weight, height, and waist circumference were obtained using standardized techniques. Fasting plasma glucose, post prandial plasma glucose, HBA1c, lipid profile, of these subjects were determined. TSH, FT4 and anti TPO antibodies were estimated by chemiluminescent immunoassay.
Results:
170 subjects with hypothyroidism were studied. Amongst these subjects, 50 had subclinical hypothyroidism and 120 had clinical hypothyroidism.
Out of 50 subjects with subclinical hypothyroidism, 64% were females. 70% of patients had BMI more than 25. Waist circumference was greater than 80 cms in 96% of patients. Family history of hypothyroidism was present in 16%. Anti TPO antibody was positive in 42% of the subjects. Total cholesterol, LDL and triglyceride levels were higher in anti TPO positive subjects.
Out of 120 subjects with clinical hypothyroidism, 76.7% were females. 74.9% of patients had BMI more than 25. Waist circumference was more than 80 cms in 92% of patients. Family history of hypothyroidism was present in 24.2% of the subjects. Anti TPO antibody was positive in 69.2% of the subjects. Total cholesterol, LDL and triglyceride levels were higher in anti TPO positive patients.
Conclusions:
Prevalence of anti TPO antibody was present in 42% of subclinical hypothyroidism patients. As anti TPO positive patients progress to clinical hypothyroidism at a higher rate than negative patients, estimation of anti TPO antibodies should be an integral part of investigation of subclinical hypothyroidism. Prevalence of anti TPO antibody was present in 69.2% of clinical hypothyroidism patients. Anti TPO antibody positivity indicates autoimmune etiology of hypothyroidism and helps in follow up management of hypothyroidism. Anti TPO antibody titres does not determine the severity of clinical hypothyroidism
A prospective randomised controlled study, comparing efficacy of ultrasonography guided fascia iliaca compartment block and femoral nerve block in hip surgeries, for positioning the patient before spinal anaesthesia
Full text linkBackground: Regional nerve blocks may alleviate pain and reduce the need for intravenous opiates in patients with hip and femoral neck fractures. Current prospective randomized study compares the onset times and pain management of Ultrasonography (USG) guided Femoral nerve block (FNB) and Fascia iliaca compartment block (FICB).
Materials and methods: Total 40 patients of ASA status I, II and III were randomized into two groups of 20 each: Group Fascia iliaca compartment block (FICB) received 20 ml of 0.75% Ropivacaine + 10 ml 2% LOX with adrenaline and Group Femoral nerve block (FNB) received 20 ml of 0.75% Ropivacaine + 10 ml 2% LOX with adrenaline. Patients were given the block under the guidance of ultrasound in the induction area by an anaesthesiologist and outcomes were analysed.
Results: The study finds no significant difference with regard to age, sex, weight distribution in both groups. At the time of block, the FNB group\u27s mean VAS score was 6.25 ± 2.02, while the FICB groups was 6.80 ±1.15 which are comparable. In terms of analgesia efficacy, FICB group performed better than FNB group, as shown by the mean VAS score at SAB of 1.50 ±0.94, compared to 2.05 ±0.69 in FNB group. Analgesia sets in faster in the FICB group than in the FNB group, with the former taking an average of 122.45 ±13.76 seconds to complete the SAB post block, while the latter took an average of 113.85 ± 9.83 seconds. In comparison to the FNB group, FICB demonstrated higher degree of patient acceptance and better quality of position attainment to perform spinal anaesthesia.
Conclusion: FICB is superior to the FNB in terms of pain relief and the initiation of analgesic effects is earlier in the FICB.
Key words: Fascia iliaca compartment block, Femoral nerve block, Spinal anaesthesia, Visual Analogue Scale.
 
Laparoscopic Versus Open Surgical Outcomes Repair For Inguinal Hernia- A Combined Prospective And Retrospective Cohort Study
Full text linkInguinal hernias are common and have become a common surgical problem. In recent decades, the nature of their treatment has changed and new research is constantly being conducted in this field. To find out the assessment the laparoscopic versus open surgical outcomes repair for inguinal hernia. A combined Prospective and retrospective Cohort study was carried out February 2023 to March 2024 in Department of General Surgery BSMMU. The sample size was two hundred for each arm; patients aged 18 and above without factors pre-disposing to recurrence were included in the study. The subjects were followed up for a period of one year at the end of which primary outcome assessed was recurrence. A number of secondary outcomes such as hematoma, persistent pain and return to regular activity were also assessed. Among the 100 individuals analyzed, 75 (75%) were male patients, with the majority of them falling between the ages of 41 and 55. In contrast to the open group of patients, the laparoscopic group experienced a significant increase in operative time with a highly significant statistical difference (p<0.0001), and the laparoscopic group experienced a significant decrease in post-operative pain score with an insignificant p-value. A significant statistical difference (p<0.005) was estimated among the laparoscopic and open groups of patients in terms of post-operative hospitalization. Returning to normal activities was significantly different for laparoscopic patients relative to the open group (p-value<0.001). With a high level of significance of p<0.001, laparoscopic hernia repair required less time to recover before returning to normal activities than open hernia repair (p<0.005). However, we observed that 90% of the recurrences in the laparoscopic arm were at the hands of surgeons with less than five years’ experience in laparoscopic surgery which was statistically highly significant (P value = 0.00). In the open arm however, the surgeons’ experience did not alter the outcome significantly (P value = 0.341). Thus, laparoscopic repair for inguinal hernia is a safe alternative in the hands of experienced laparoscopic surgeons
The Double Trouble: Caudal Duplication Syndrome-A rare case series with review of literature
Full text linkCaudal duplication syndrome (CDS) is a very rare disease entity. It includes a broad range of abnormalities and clinical symptoms, from single or partial duplication of the gastrointestinal, genitourinary and distal neural tube system organs to total duplication. There have been several ideas proposed to explain the complicated yet symmetrical abnormalities and the wide range of clinical manifestations of caudal duplication syndrome. In this case series we present two confirmed cases of Caudal Duplication Syndrome in our institute. The management for this syndrome is individualized and may include surgical intervention to fuse or excise the duplicated organs