International Journal of Medical Research & Review (IJMRR)
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Cross-Sectional study of differences in phenomenology of acute psychosis with or without cannabis
Get PDFBackground: Therehas been plethora of research regarding cannabis use disorder but very few studiesreporteddemographicand phenomenological differences of acute psychosis with cannabis use to those of acute psychosis without cannabis use. This study attempted to evaluate the demographic and phenomenology differences between two groups of patients presenting with acute psychosis with cannabis use and acute psychosis without cannabis use.
Material & Method: Two group of patients recruited for study were ‘Cases with Cannabis’ and ‘control without Cannabis’ presenting with acute psychosis with preceding cannabis use and second one presenting with acute psychosis without preceding cannabis use in out-patient department of psychiatry, M. Yhospital, Indore Assessment done using rating scales.
Results: Acute psychosis with cannabis wascharacterizedby primarily polymorphic clinical picture with predominance of positive and mood symptoms both in clear and disturbed sensorium.Acute psychosis without cannabis was characterized by mixed positive and negative symptoms in clear sensorium. In ‘Cases with cannabis’ group 96.7% were males and 3.3% were females, mean age was higher (33.7%) than control (27.7%) group.
Conclusion: Acute psychosis with cannabis is characterized by primarily polymorphic clinical picture with predominance of positive and mood symptoms both in clear and disturbed sensorium. Acute psychosis without cannabis is characterized by mixed positive and negative symptoms. General symptoms of psychosis were also more in acute psychosis without cannabis
Histopathological and cytological spectrum of lymphadenopathy: a window to preliminary diagnosis
Get PDFIntroduction: Lymphadenopathy is a common clinical presentation of patients attending outdoor patient departments. The etiology varies with a wide spectrum ranging from inflammatory causes on one end to malignant on the other. In the present study, cytological and relevant histopathological diagnoses were done in 200 cases received in Department of Pathology.
Aims and objectives: The present study aimed to find out the percentage of various lesions of lymph node and their prevalence according to age group and sex of patients. It also correlated the histo-cytodiagnosis in cases where both histology and cytology were available and compared the results of present study with similar other studies.
Materials and Methods: This study was carried out in the department of pathology, Govt. medical college, Patiala. It included 200 cases of lymphadenopathies, either from Rajindra hospital or from health centers nearby. The cases were selected randomly. Lymph nodes included were of neck region, axilla, groin, from the extremities and the internal (mediastinal, abdominal and retroperitoneal). Apart from haematoxylin and eosin (H & E) stain, special stains like Ziehl–Neelsen stain and giemsa stain were done wherever needed.
Results: Out of 200 cases, 93 (46.5%) cases were of reactive hyperplasia. Females were affected more commonly than males. Tuberculosis occurred more in younger patients whereas metastases were more common in older age group. Axillary lymph node was the most common lymph node involved.
Conclusion: Histopathology gave accurate and confirmatory results than cytology. Lymph node evaluation is an integral part of patient management
A study of aspiration cytology of various thyroid lesions and histopathological correlation
Get PDFBackground: Thyroid swelling is one of most common neck swelling encountered in clinical practice. Fine needle aspiration cytology (FNAC) is a reliable preoperative screening test to differentiate between benign and malignant lesions which helps in proper management of patient and avoiding unnecessary surgeries.
Aims and Objectives: The present study was to evaluate various lesions of thyroid and classify them according to the Bethedsa system of reporting of thyroid cytopathology (TBSRTC) and to correlate FNAC with histopathology wherever possible.
Materials and Methods: This study is a retrospective study of 225 cases of thyroid swelling conducted from May 2016 to April 2017 in the department of pathology, Government Royapettah Hospital, Kilpauk Medical College, Chennai. FNAC results were correlated with histopathological diagnosis wherever surgery was done.
Results: This study includes 225 cases. Out of 225 cases of FNAC of thyroid lesions, 213 satisfactory cases were obtained. Maximum cases were benign lesion 233 cases (93.3%), malignant cases were 12 (5.3%) and 12 cases were unsatisfactory (5.3%) with diagnostic accuracy 99%, sensitivity 99% and specificity 100%.
Conclusion: FNAC is an effective tool for diagnosing various thyroid lesions as it is safe, cost effective and initial diagnostic modality that avoids unwanted surgeries
Case report of a rare case of Non-hodgkin Lymphoma presenting as sternal mass
Get PDFPrimary or metastatic tumors of the chest wall constitute 5% of all thoracic tumors and lymphoma comprises about 2% of all chest wall tumors. We report a case of a 23year old male presenting with anterior chest wall mass for the past 6 months which was slowly growing in size. There was no other symptoms of respiratory difficulty, cough, and hemoptysis. HRCT chest revealed soft tissue attenuated lesion in mid chest wall and infiltration to the anterior mediastinum with erosion of sternum and the 8th rib. FNAC of the site revealed Non-Hodgkin Lymphoma. Diagnosis is based on morphological features, FNAC, cell block
Interrelation between birth weight, body mass index, insulin resistance, C-Reactive Protein-hs, adiponectin and leptin in children (Age 10 to 20 years)
Get PDFBackground: India is projected to have one of the largest populations of obese children over the next decade. Birth weight reflects maternal nutrition and fetal programming which may be a leading cause of obesity. Adipokines also play an important role in development of obesity, inflammation and insulin resistance. The aim of this study is to evaluate serum adiponectin, leptin in Indian school-going children in the age group of 10–20 years. This study also describes distribution of adipokines concentrations and examines the inter-relationship of adipokines with birth weight, body mass index (BMI), C - reactive protein high sensitive (CRP-hs), and insulin resistance (IR).
Methods: A cross-sectional study involves a total of 200 school going children between the age group of 10-20 yrs. Fasting plasma glucose, insulin, adiponectin, leptin, CRP-hs, were measured for the school going children and birth weight was recorded.BMI was defined as weight (kg) divided by height (m) squared. Insulin resistance was assessed using the homeostasis model (HOMA-IR).
Results: Children with higher BMI had higher birth weight and insulin. Obese children had lower adiponectin and higher leptin levels suggestive of an inverse association with adipokines. Children with higher BMI had lower glucose.
Conclusion: Leptinan indicator of fat mass induces insulin resistance and inflammation. The derangement observed in all related parameters including insulin resistance, leptin, adiponectin and CRP-hs were due to high fat mass. However, the relationship of birth weight and adipokines needs further evaluation
Association of subclinical hypothyroidism with atherosclerosis in central India
Get PDFIntroduction: Overt hypothyroidism is widely recognized as a risk factor for atherosclerosis and cardiovascular disease, but recently sub clinical hypothyroidism has also shownas an independent risk for it. Subclinical hypothyroidism also has close association with dyslipidemia and lowgrade inflammation leading to atherosclerosis which can be assessed by carotid intimal medial thickness.
Objective: The objective of the study was to explore the correlation of subclinical hypothyroidism with atherosclerosis in the form of dyslipidemia, C Reactive Protein and Carotid Intimal Medial Thickness in patients of central India.
Methods: This study was conducted at department of medicine in GMC, Bhopal. It was a case control study among which 100 patientswith raised TSH and normal T3/T4 values were included as cases in the study and 50 controls with normal TSH/T3/T4 were taken. Three groups were made according to TSH values as euthyroids (<5.5), Subclinical Hypothyroids group 1(5.5-10) & group2(>10) and their fasting lipid profile, C Reactive Protein levels and Carotid Intimal Medial Thicknesswere measured.
Results: We compared the Subclinical Hypothyroids with euthyroids subjects in which lipid profile was highly significant (<0.01)and showed positive correlation in both groups of Subclinical Hypothyroids except for high density lipoprotein.In cases where TSH(>5.5) the CRP was found to be significantly associated showing presence of low grade in flammation in these patients. The study also showed that mean Carotid Intimal Medial Thickness was higher in Subclinical group as compared to euthyroids but only when TSH(>10).
Conclusion: This study concludes that subclinical hypothyroidism is characterized by dyslipidemiawith increased Carotid medial intimal thickness value and positive CReactive Protein suggesting the future development of cardiovascular disease in these patients
Pulmonary function, white blood corpuscles & haemoglobin levels in asymptomatic light smokers and non-smokers
Get PDFContext: Smoking, a risk factor for several diseases has also been reported as the largest preventable cause of morbidity and mortality globally. Tobacco smoking is associated with a decrease in lung function in smokers when compared to non-smokers.
Aims: To study and compare pulmonary function, WBC count and Hb levels in asymptomatic light smokers and non-smokers.
Settings and Design: Case control study.
Methods and Material: Patient relatives or subjects who had come for health check with a known history of smoking and apparently asymptomatic were recruited as our study subjects (n = 49). Healthy volunteers were also recruited from patient relatives. Subjects without any known history of smoking were selected as controls (n = 50).
Statistical analysis used: Data was analysed using SPSS V-19. P value ≤0.05 was considered significant.
Results: A statistically significant difference was found in total leucocyte count in smokers (P = 0.004) when compared to non-smokers. There was also a statistically significant increase in absolute neutrophil (P = 0.021), monocyte (P = 0.004) and eosinophil (P = 0.075) counts in smokers. FEV1/FVC (P = 0.005) and FEF 75 (P = 0.027) was significantly higher in non-smokers when compared to smokers. No significant difference was observed in haemoglobin concentration and differential leucocyte count, pulse rate, systolic pressure, diastolic pressure and rate pressure product among the two groups.
Conclusions: The present study gives ample evidence for the damage to the respiratory system along with activation of immune system as evident from a significant lowering of small airway patency and increased white cell count
Awareness of palliative care among general practioners of Bhopal: a cross sectional study
Get PDFIntroduction: Palliative medicine is one of the developing medical specialities. This study was undertaken to enquire about the level of awareness regarding various aspects of palliative care among general practitioners of city of Bhopal.
Material and method: This study was undertaken with the help predesigned questionnaire among the general practioners enquiring them about various aspects of Palliative medicine.
Results: The opinion about diseases requiring palliative care varied to large extent. Majority of subject reported pain control as the main objective of palliative care. There were varied response to various other aspects of palliative care but majority had considered it important.
Discussion: Palliative care is an important aspect of comprehensive care which needs to be given to terminally ill patients. Awareness regarding same variable even among doctors and improved awareness through various means is essential to improve quality of life of patients and their families facing the problems associated with life-threatening illness
Use of Latent autoimmune diabetes in adults clinical risk score in type 2 diabetes
Get PDFBackground: Subjects with type 2 diabetes may harbour islet auto antibodies and this has implications on progression of disease and therapeutic options. Clinical tools to distinguish antibody positive individuals are essential to guide the therapy.
Objective: To develop a clinical risk score in subjects with Type 2 Diabetes to identify LADA.
Methods: We studied 100 persons aged between 25 to 65 years diagnosed as Type 2 Diabetes by FBS>126mg/dl and C-peptide >0.6 ng/ml.
Results: 17% of Type 2 Diabetic individuals were GAD positive. 11 were males and 6 were females. GAD positivity in the 25 to 34 years age group was 16.3%, 35 to 44 years age group was 20.8%, 45 to 54 years age group was 21.1%, and in >55 was 0% respectively. GAD positivity with respect to the duration of diabetes 0-5 years, 5-10 years and >10 years was 18.2, 12.3 and 20% respectively. 82.4% of GAD positive type 2 diabetes individuals had BMI <25 kg/m2 and age of onset of diabetes <50 years. Mean BMI, waist circumference and fasting C-peptide were 24.86±4.66, 87.55±10.78 and 2.49±1.41 in GAD negative Type 2 Diabetics. Mean BMI, waist circumference and fasting C-peptide were 21.65±3.46, 80.20±10.03 and 3.04±3.66 in GAD positive Type 2 Diabetics. All 17 GAD positive patients had LADA clinical risk score of 2 or more, So this score should be used in the clinic to suspect LADA patients.
Conclusions: LADA clinical risk score is ≥2 in all 17 GAD antibody positive subjects with Type 2 Diabetes. So this scoring system can be used as a tool to suspect LADA patients in the clinical setting. A multicentre study is necessary to further validate this scoring system
Three port versus four port laparoscopic cholecystectomy- a prospective study
Get PDFIntroduction: Cholelithiasis is the most common and important cause of biliary tract disease. In today’s world, laparoscopic cholecystectomy is the gold standard treatment for gallstones. Decrease in the size or number of ports provide better results in laparoscopic cholecystectomy.
Objective: We aim the study to find out feasibility of three port lap cholecystectomy over four port lap cholecystectomy regarding post-op pain, duration of surgery, conversion rate, hospital stay and complications.
Materials & Methods: Patients who fulfilled the inclusion criteria were included. 76 patients enrolled for the study and divided into two groups as 3 port and 4 port. Surgical preformed assessment proforma used to collect the data.
Results: The mean age of the studied patients was 46.38 years with female preponderance. The Mean operative time for three ports was 66.90 minutes and for four ports it was 75.45minutes. Mean duration of post-operative stay for three port was 4.66 and for the conventional group it was 5.30.
Conclusion: Patients who underwent the three port technique had a lesser hospital stay compared to patients who underwent the conventional 4 port technique. Patients had less postoperative pain, lesser requirement of analgesics in three port group. 2 patients from the 4 port group had fever 48 hours after surgery