International Journal of Medical Research & Review (IJMRR)
Not a member yet
1355 research outputs found
Sort by
Characteristics of multi drug resistant tuberculosis cases at a selected tertiary level hospital
Get PDFBackground: This study was carried out to determine the characteristics of MDR-TB cases under treatment at National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Dhaka.
Methods: This was a descriptive cross sectional study among 442 diagnosed MDR-TB patients admitted in NIDCH of which 303 MDR-TB patients were included as respondents. The respondents were selected purposively and they were interviewed with duly pre-tested research instruments.
Results: Among the study populations (303), all were resistant to H & R and 149 (57.7%) consumed standard drugs regimen contained H, R, E & S. In addition the factors related to develop MDR-TB mostly as non-compliance, overcrowding and exposure to MDR-TB were 190 (73.7%), 261 (86.1%) and 81 (26,7%) respectively. In this study, time interval between completed anti-TB treatment and diagnosis of MDR-TB found 01 to 06 years among 55.4% respondents. Moreover tools used for diagnosis of MDR-TB were found in 258 (85.1%) as smear for AFB, Gene expert tests and Culture. Age group 16 to 30 yrs 184 (60.7%), income group 10001 to 20000 taka per month 143 (47.2%), educational qualification class VI-X 72 (23.8%) and urban population 180 (59.4%) were affected more. The association between type of house, crowding status and occurrence of MDR-TB were found statistically significant (p<0.05) but source of drugs, compliance of treatment, availability of drugs and occurrence of MDR-TB shown statistically highly significant, (p<.001). Correlation with age, family income and time gap of diagnosis MDR-TB was statistically significant (p<0.05). Principal.
Conclusion: Study findings demands establishment of standard diagnostics procedures/laboratories at all secondary and tertiary care hospitals and TB clinics in the country in support of uniformity of intervention therapy
Prevalence and Antifungal Susceptibilities of Candida spp from a South Indian Tertiary Care Hospital
Get PDFIntroduction: Candida sp. is increasingly being implicated as the cause of both community acquired and Nosocomial infections. With development of new resistance patterns versus the inherent resistance present in some of the species isolated from critical care areas, the complications resulting from long term antibiotics, surgical and medical interventions and environmental colonization by the Candida sp. is becoming more prevalent.
Method: Prevalence of different species and their antifungal susceptibilities grown from various samples received in 20 months were studied using semi-automated MiniAPI kits. Results of tests done on 356 isolates were collated and analysed retrospectively.
Results: Of the 356 samples, C. tropicalis showed prevalence of 37.07% as compared to C.albicans 31.1%, C guilliermondii (11.8) and C parapsilosis (6.74%). Candida sp were found to sensitive to 5-Flucytocine and Amphotericin B. Resistance to Itraconazole was noted more than to Fluconazole.
Conclusions: Infections with Candida spp are usually of low virulence and are associated with a few well-defined risk factors as immunocompromised state, Malignancy and steroid therapy. Understanding these risk factors, identifying the species with changing trends in antifungal resistance, instituting infection control practices to reduce morbidity and mortality in critical care areas can improve outcomes
Double Trouble: an observational study of thyroid dysfunction in South Indian subjects with type 2 diabetes
Get PDFObjective: Studies conducted in subjects with type 2 diabetes have shown increased prevalence of overt hypothyroidism and subclinical hypothyroidism. Hence, we designed a study to find out the prevalence of thyroid dysfunction in south Indian subjects with type 2 diabetes.
Research Design and Methods: 400 subjects with type 2 diabetes attending the out-patient department of Karnataka Institute of Endocrinology and Research, Bangalore were randomly selected. 200 relatives who accompanied the subjects without diabetes were recruited as controls. BMI, waist circumference, blood pressure, fasting plasma glucose, post prandial plasma glucose, HbA1c, lipid profile, and thyroid profile of these subjects were determined.
Results: 400 subjects with type 2 diabetes and 200 subjects without diabetes were included in the study. They were in the age group of 25 to 75 years. Thyroid dysfunction was present in 13% of non diabetic controls. Subclinical hypothyroidism was present in 7%, overt hypothyroidism in 5% and hyperthyroidism in 1% of the controls. Thyroid dysfunction was present in 24% of subjects with type 2 diabetes. Subclinical hypothyroidism was present in 11.25%, overt hypothyroidism in 12% and hyperthyroidism in 0.75% of the 400 subjects with type 2 diabetes.
Conclusions: Hypothyroidism especially subclinical hypothyroidism is more common in south Indian subjects with type 2 diabetes. Hence, it is indispensable to investigate for thyroid dysfunction in subjects with type 2 diabetes. Failure to recognize the presence of thyroid dysfunction may be a primary cause of poor glycemic control often encountered in some subjects with type 2 diabetes, despite appropriate anti diabetic therapy. This highlights the need for the routine evaluation of thyroid function in subjects with type 2 diabetes
Estimation of prevalence and risk factors for clostridium difficile infection: a neglected pathogen in a tertiary care setting in India
Get PDFIntroduction: Clostridium difficile is a Gram positive spore bearing anaerobic bacillus increasingly associated with both community and hospital acquired colitis and diarrhoea. Among all the risk factors, inclusive of the host and the environmental factors, antibiotics are the most important ones, as validated by various studies. Patients receiving antibiotics and other drugs such as immunosuppressives, chemotherapeutics and proton pump inhibitors may also be important risk factors. The present study was planned to find out the prevalence and risk factors for Clostridium difficile associated diarrhoea (CDAD).
Material and Methods: After taking approval from ethics committee ,150 patients with antibiotic associated diarrhoea were taken as study group and 50 patients with exposure to antibiotics but who did not develop diarrhoea were taken as controls. Stool specimens were processed for both culture on Cycloserine Cefoxitin Fructose Agar (CCFA) and toxin detection by IVD Tox A+B ELISA. Risk factor analysis was done by calculating odds ratio and significance of p value among various parameters related to drugs and other factors.
Result: Prevalence of CDAD in the present study was 8.67%.Third generation cephalosporins, clindamycin, aminoglycosides, quinolones and trimethoprim sulfamethoxazole were significant risk factors for both antibiotic associated diarrhoea (AAD) and Clostridium difficile associated diarrhoea (CDAD).Use of proton pump inhibitors, immunosuppressants and prolonged stay in the hospital were other significant risk factors associated with CDAD.
Conclusion: Although CDAD occurs at a lower frequency in this setting, rational antibiotic policy and infection control measures should be followed to prevent its occurrence and nosocomial spread
Substance abuse in Children and adolescent: A Retrospective Study
Get PDFIntroduction: Drug addiction among children and adolescents is spreading very fast. The age of initiation of substance use is falling progressively.
Aims and Methods: The aim of the study was to know about the socio demographic profile of children and adolescents diagnosed with substance dependence and to assess the pattern of drug dependence. So we conducted a retrospective study in Swami Vivekananda Drug De addiction centre at Amritsar in Punjab. The diagnosis of substance dependence was made by a consultant psychiatrist after direct interview with the patient and the relatives according to International Classification of Diseases (ICD-10).
Results: The study comprised 446 children and adolescents who reported for de addiction during the study period. Majority were in the age group 16-19(95.73%), 49.5% were from urban areas and 50.5% patients were from rural areas. Out of these 36.09% were employed, 24.43% were unemployed and 39.46% were students. Our results showed more involvement of male as compared to females. As far as education status is concerned, 47.53% studied up to matric, 23.99% up to Secondary school, 12.78% up to middle, 6.95% up to primary and 5.38% were illiterate. Opioids and polysubstance use are common among them.
Conclusion: The need of the hour is to educate and counsel young children and adolescents and create awareness among the public regarding drug addiction
A hospital based cross sectional study to evaluate awareness of lifestyle interventions among hypertensive patients in Sikkim (North-Eastern State of India)
Get PDFIntroduction: Hypertension (HTN) or high blood pressure (BP) is the most important cardiovascular risk factor worldwide, contributing to around one half of the coronary heart disease and two thirds of the cerebrovascular disease burdens. Effective prevention, detection, treatment, and control of BP continue to be an important goal for health care providers. A positive impact of life-style interventions is a well known fact. Awareness of HTN remains an important concern in this mountainous and predominantly rural population.
Objective: To evaluate the awareness of lifestyle interventions among patients of hypertension. Methods: A cross-sectional study was conducted in Sikkim Manipal Institute of Medical Sciences in general medicine OPD from Jan 1. 2017 to Jan 15, 2017. All the stable hypertensive patients, attending medicine OPD aged >18 years were recruited in the study. Patients were interviewed using a semi structured questionnaire regarding knowledge of life style interventions.
Results: Among all the hypertensive patients (n = 100), 60 patients had adequate knowledge (>50%) and 40 patients had inadequate (<50%) knowledge of these interventions. Significant association between educational background and knowledge on lifestyle interventions was present. Urban population was more aware as compared to rural population Blood pressure was significantly under control in the aware population.
Conclusion: Patients knowledge on lifestyle interventions for the management of blood pressure is important. The rural population and uneducated people have inadequate knowledge on lifestyle modifications of hypertension. Structured teaching programs are needed to improve awareness about the lifestyle changes
Unilateral Pulmonary Agenesis – As a cause of respiratory distress in newborn
Get PDFPulmonary agenesis is a rare developmental defect which occurs as a result of failure of development of primitive lung bud. The onset & mode of presentation is highly variable ranging from asymptomatic cases to cases diagnosed in adulthood due to recurrent respiratory tract infections. Around 50% of cases are associated with other congenital anomalies.Isolated U/L pulmonary agenesis, if not associated with other congenital abnormalities may have fewer symptoms & long survival. Hereby we report a case of 2 days old female baby with right lung agenesis who presented with respiratory distress in neonatal period
Effect of parenteral vitamin D (D3) on albuminuria in T2DM patients
Get PDFBackground: Vitamin D deficiency is a common disorder in diabetic patients and may be a risk factor for progression of diabetic nephropathy. The aim of our study was to assess the effects of large dose of parentral Vitamin D on 24 hours albuminuria in T2DM patients. This is a first study of its kind, where we used single large dose parental vitamin D.
Methods: This prospective single center study included 50 vitamin D deficient [25(OH) D <50 nmol/l] T2DM patients with an adequate glycemic control (HbA1c< 7.0%). Without any changes in anti-hyperglycemic or antihypertensive drugs, these patients were given a single high dose (600000 IU) of parenteral Vitamin D3. Then the changes in Vitamin D levels and 24 hours albuminuria were seen on follow up at 3 months.
Results: Vitamin D3 supplementation improved 24 hrs albuminuria. In this study twenty-four hour urinary albumin excretion decreased from 200.4 ± 103.3 to 198.4 ± 105.0 mg/24 hrs (p value 0.015). In males it changed from 212.1 ± 95.4 to 209.6 ± 96.9 (p value 0.046) and in females it changed from 188.6 ± 111.3 to 186.8 ± 112.9. (P value 0.041) .There was a negative association of albuminuria with Vit D levels in our study with p value =0.001 at 3 months of follow up.
Conclusion: Vitamin D3 supplementation significantly reduces 24 hour urinary albumin excretion in T2DM patients with Vitamin D3 deficiency
Role of ultrasound in diagnosis of fetal congenital abdominal anomalies: One year prospective study
Get PDFIntroduction: Congenital anomalies are important cause of perinatal and infant mortality, and are contributor to childhood morbidity. Fetal congenital abdominal anomalies are one of the most common anomalies. Ultrasound screening of fetus helps to identify these anomalies as early as possible in antenatal period and thus provides information for proper decisions during pregnancy.
Aim: To find out the incidence of congenital abdominal anomalies affecting fetus and to study the outcome in patients with fetal congenital abdominal anomalies by following them postnatally.
Material and Methods: Prospective, Observational and Non-interventional study. Ultrasound screening of 5761 fetuses were performed. Pregnancies, with ultrasound findings of fetal congenital abdominal anomalies with or without other associated anomalies, were followed up. Postnatal confirmation of anomalies were carried out by clinical examination/ imaging procedures / autopsy.
Results: Incidence of fetal congenital abdominal anomalies was 5.56 per 1000 births. Among the fetal congenital abdominal anomalies, fetal urinary tract anomalies were the most common with an incidence of 4.69 per 1000 births. Incidence of Omphalocele, Gastroschisis and Jejunoileal atresia were 5.2, 1.7 and 1.7 per 10,000 births respectively. Concordance between antenatal and postnatal diagnosis was 90.63%.
Conclusion: Antenatal ultrasound examination should be performed for all pregnant women to diagnose congenital anomalies. Prenatal diagnosis of congenital anomalies provides information for proper decisions during pregnancy, fetal intervention if available and appropriate treatment perinatally, thus improves perinatal and long term outcomes
Knowledge, attitude and practices of breast feeding in primigravida women in tertiary care hospital in central India
Get PDFIntroduction: There are gaps between UNICEF and BFHI recommendations and actual implementations of breastfeeding practices due to inadequate counseling of primigravida on breastfeeding, reflected nationally as poor infant nutritional status.
Objectives: The study aims to assess the knowledge, attitude and practices of primigravida about breastfeeding, counsel the primigravida women on the prescribed scientific breastfeeding methods, to analyze the change in their perspective about breastfeeding after counseling and to suggest recommendations based on findings.
Methods: Questionnaire based descriptive cross sectional study conducted on selected 75 primigravida with gestational age of 36 weeks or more, attending ANC OPD or admitted to NKPSIMS during April and May 2014 after consent. A structured validated pre/posttest questionnaire was administered to assess the knowledge, attitude and practices of breastfeeding of participants. Demographic variables were recorded. Pretest was conducted, followed by counseling on the importance of breastfeeding, maternal nutrition, duration of exclusive breastfeeding, mother’s and baby’s position during breastfeeding using flashcards which was followed by posttest on the same questionnaire. The data was analyzed using SPSS software Open Epi Info version 2.3 year 2009. P values < 0.05 were considered as statistically significant.
Results: Comparison of pre/posttest results showed statistically significant change in importance of exclusive breast feeding, colostrum, early initiation, suitable position and duration of breastfeeding, perception of baby’s satisfaction and stool color, maternal nutrition and breast problems during lactation after counseling.
Conclusion: Antenatal breastfeeding counseling must be strengthened by a multi pronged individualized approach, reinforcement focusing on the recommended practices of breastfeeding to promote and sustain breastfeeding