International Journal of Medical Research & Review (IJMRR)
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Doppler velocimetry in dichorionic twin pregnancies and its correlation with various fetal outcome
Get PDFAim: This study was to evaluate the applicability of Doppler velocimetry to determine its correlation with fetal outcome in dichorionic twin pregnancies.
Material and methods: Doppler examination of the umbilical artery (UA) and middle cerebral artery (MCA) was performed in 57 twin pairs. Abnormal values of the umbilical artery pulsatility index (PI), umbilical artery Resistive index (RI) were above the 95th percentile and below 5th percentile for the Middle cerebral artery pulsatility index (MCA PI) and Middle cerebral artery resistivity index (MCA RI) for gestational week. The difference of UA PI ≥0.5 in twin pairs was considered abnormal.
Results: 33 subjects had a fetal discordance of greater than 15%. Birth weight was found to be significantly lower in subjects with Umbilical artery PI greater than 95th percentile for gestational age (p=0.014). Abnormal MCA RI (P=0.018) and Umbilical artery RI values above 95th percentile was significantly associated with increased risk of IUGR (intra uterine growth restriction) (P=0.036) and NICU (Neonatal intensive care unit) admission (P=0.005). Increased Umbilical artery PI values above 95th percentile was significantly associated with IUGR (P=0.003). Increased Umbilical Artery systolic/diastolic ratio above 95th percentile was significantly associated with IUGR (P=0.002), NICU admission (P=0.026) and still birth (P=0.026). Abnormal cerebra-umbilical ratio (<1.08) was significantly associated with IUGR (P=0.001) and still birth (P=0.025). Difference in pulsatility index of umbilical artery of both fetus (P1-P2 >0.5) was significantly correlated with increased degree of birth weight discordance of the twins, IUGR (P=0.001) and still birth (P=0.001).
Conclusion: Abnormal Doppler values in discordant twin fetus are more likely to be associated with abnormal fetal outcome
Quality of life in arthritis patients and its correlation with anxiety and depression
Get PDFBackground: Although the medical and economic consequences of arthritis are of great concern to researchers and clinicians, this disease also affects an individual’s capacity to live a full and active life.
Aim: To study the correlation between depression, anxiety and quality of life among Indian adults suffering from arthritis in a tertiary care centre.
Material and Methods: The study sample comprised of adults age above 30 years with clinician diagnosed arthritis (n=370). Depression and anxiety were measured using separate and validated scales. Prevalence was estimated for the sample overall and stratified by subgroups. Associations between correlates and each condition were estimated with prevalence ratios.
Result: Depression is significantly negatively correlated to quality of life (r – 0.34 P = 0.0001). Anxiety also negatively correlated to quality of life (r – 0.24 P = 0.0001). Anxiety and depressed patients differed significantly from other arthritic patients in terms of quality of life. (F value 41and P value 0.0001) subjects having both depression and anxiety had the poorest quality of life.
Conclusion: Screening for anxiety and depression should form an essential part of the clinical workup of patients suffering from arthritis. Identification of anxiety and depression in subjects suffering from arthritis will have definite implications for comprehensive management of patients
Epidemiological pattern of lung cancer in a tertiary care centre-A prospective observational study
Get PDFBackground: Lung cancer is a leading cause of morbidity and mortality worldwide. An increasing incidence of lung cancer has been observed in India.
Aim of the study: To evaluate epidemiological profile oflung cancer in a tertiary care centre, South Kerala.
Methodology: Prospective observational study, conducted at Medical College, Thiruvananthapuram, South Kerala, in 160 consecutive patients with histopathological diagnosis of lungcancer. Data on demography, symptoms, smoking status, physical findings, diagnostic modalities, histological diagnosis, and TNM stagewere recorded using a structured questionnaire. For inferential statistics, comparison between groups of qualitative variables were analysed by chi-square test and quantitative variables were compared by student t test. P value of less than 0.05 was considered as level of significance.
Results: Out of 160 consecutive lung cancer patients, 86.9% of patients were males. Male to Female ratio is 6.6: 1.50- 59 yrs was the commonest age group affected.11.3% were nonsmokers. 67.5% of smokers were having smoking index more than 500. COPD was the commonest co morbidity (58%) in the study. Adenocarcinoma (41.9%) was the commonest histological type in our study and this was the commonest histologicaltype seen in females and nonsmokers. In smokers, squamous cell carcinoma (91.3%) was more common. 66.9% of patients were at TNM stage 3 or 4 at the time of diagnosis only 5% of patients were in surgically resectable stage.
Conclusion: It was found out that Adenocarcinoma was the most frequent histopathological type and majority of patients were at advanced stage at the time of diagnosis
Comparison of CT only contour with MRI guided contouring in external beam radiotherapy for carcinoma rectum
Get PDFAim: The purpose of the study is to compare CT only contour with MRI guided contour for delineation of the gross tumour volume (GTV) in carcinoma of rectum in external beam radiotherapy.
Materials and Methods: 18patients who underwent external beam radiotherapy treatment for carcinoma rectum were selected retrospectively. For all the patients, both CT and MRI were done as a part of planning process. Two sets of GTV were generated using only CT and with MRI assistance by a single oncologist. The generated contours were then compared and quantitatively analyzed using volume analysis and dice index.
Results: The CT mean GTV was larger than the MRI mean GTV volume (68.54 ± 17.56 cc for CT versus 80.95 ± 19.19 cc for MRI). The dice index value between CT only GTV and MRI assisted GTV was 0.71 ± 0.13. The comparison of GTVs showed that the GTV_MRI was comparatively small and inside the GTV_CT except for six patients for whom GTV_MRI was marginally outside the GTV_CT.
Conclusion: The study showed that using MRI guidance for GTV delineation in carcinoma rectum is preferable and more accurate as compared to CT-only imaging because of superior soft tissue contrast
A study of cognitive dysfunctions in patients with thyroid disorders
Get PDFBackground: Many primary endocrine disorders have notable effects on cognition. Patients with a wide range of thyroid gland abnormalities often present with combined emotional and cognitive symptoms.
Aims and Objectives: To evaluate the cognitive dysfunctions in patients suffering with thyroid disorders. To compare the cognitive dysfunctions in patients with thyroid disorders such as hypothyroidism, hyperthyroidism and subclinical thyroid states.
Materials and Methods: A Purposive sampling was undertaken from the outpatient department of Endocrinology, Narayana Medical College & Hospital, Nellore, Andhra Pradesh. The study included the patients with thyroid disorders and Normal healthy controls. The sample of the study comprised of 60 participants. Out of this 60 participants 30 were diagnosed with thyroid disorders and 30 volunteers who accompanied with patients without evidence of any thyroid disorders who were willing to participate in the study were selected as controls.
Results: The mean SMMSE scores among the cases was 19.4 (± 4.65) and among the controls was 28.1 (± 1.67). The DSST scoring of the cases and controls had shown that the mean 68.1 (± 19.4) and controls was 95.3 (± 3.94). The mean (± SD) TMT - A scores of the cases was 25.8 (± 6.23) and controls was 20.5 (± 2.58). The mean TMT – B scores of the cases was 114.8 (± 51.03) and controls was 68.9 (± 19.2). Summary &
Conclusions: The means of SMMSE, DSST, TMT – A, TMT – B scores have shown statistically significant difference between the patients with thyroid disorders and normal healthy controls
MRI in head and neck tumours
Get PDFHead and neck cancer are prevalent reason for cancer. Compared to CT, MRI has better tissue, spatial and contrast resolution, Non-ionizing radiation, Non-invasiveness, Multiplanar imaging and soft tissue definition
Unicentric castleman’s disease of neck node in old age- rare presentation of a rare disease
Get PDFCastleman’s disease is an uncommon lymphoproliferative disorder that may be unicentric or multicentric disease. We are reporting a case of 75 year old female presented with left level 3 cervical lymph node, whose final diagnosis was unicentric castleman’s disease. This presentation is uncommon because unicentric castleman’s disease is usually seen in younger adults and it usually affects lymph nodes in chest or abdomen. People with localized Castleman’s disease are usually cured by surgical removal of the affected lymph nodes
Role of Information Communication and Technology (ICT) in the Treatment of Brain Ailments
Get PDFThe emphasis on understanding the human brain and its functioning has been captivating since ages. Rising to this challenge, it gives us an insight of who we are. Significant and profound research is taking place in medical field to understand the structure and functioning of the brain in micro detailing aspect. There are many techniques and methodologies used in the study and diagnosis of brain ailments. ICT has proven to be a strong and supportive hand in this field for better understanding and analysis. In this paper the role of ICT in the field of neuro-sciences has been elaborated
Comparison of local anaesthesia versus spinal anaesthesia for peri anal disorders
Get PDFBackground: Peri anal disorders are associated with high morbidity and can be managed surgically both under spinal as well as local anaesthesia.
Objectives: The study evaluates the results of anal surgery when performed under local anaesthesia as compared to spinal anaesthesia with respect to parameters like post operative pain, nausea, vomiting, analgesia requirement, voiding problem and bleeding.
Material and Methods: The study included 50 patients divided in two groups (A and B) of 25 each. The patients of group A and group B were operated under local and spinal anaesthesia respectively. The patients were assessed postoperatively at 6 hrs, 8 hrs and 12 hrs on day one and then on subsequent days for different parameters like post operative pain, need and duration of analgesia required, bleeding, voiding problems and associated nausea.
Result: The results of two groups were then compared and analysed. In group A 56% of patients required analgesia 8 hourly as compared to 40% in group B. No analgesics were required 3 days after the surgery in both the groups. Difficulty in voiding was seen in 12% of patients in group A as compared to 28% in group B. There was no post operative bleeding except for 4 patients in group A. Most of the patients of group A had hospital stay of 2.3±0.46 days postoperatively while those in group B stayed for 3.4±0.53 days.
Conclusion: The study reveals favoured local anaesthesia over spinal anaesthesia for peri anal surgeries because of simplicity in administration of anaesthetic agent, less need of analgesia, lesser hospital stay, lesser incidence of nausea and vomiting and no need for catheterisation
Ultrasound evaluation of fetal central nervous system anomalies and its correlation with postnatal outcome
Get PDFIntroduction: CNS anomalies are the most serious congenital abnormalities. Ultrasound is an effective and non invasive modality of prenatal diagnosis of these anomalies. The purpose of the current study was to determine the frequency of CNS anomalies and its postnatal outcome.
Objectives: Present study was undertaken to find out the incidence of CNS anomalies in utero by ultrasound and to confirm them by autopsy or postnatal examination.
Materials and Methods: Ultrasound scanning of 5761 pregnant women was performed. Pregnancies with ultrasound findings of CNS anomalies were followed up. Prenatal findings were compared with postnatal findings and confirmed by autopsy wherever possible. In case of live birth post natal findings were noted.
Results: Ultrasound detected 50 anomalies in 42 cases. Ultrasound findings were exactly matching in 90%. 4 cases had variations 3 on autopsy & 1 on postnatal USG.
Conclusion: The incidence of CNS malformations on ultrasound was 0.73%. Autopsy and postnatal findings showed high degree of correlation with prenatal ultrasound findings