International Journal of Medical Research & Review (IJMRR)
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A study on efficacy of limbal relaxing incisions in correcting corneal astigmatism along with clear corneal phacoemulsification in a tertiary eye care centre in South India
Get PDFAim: The main aim of this study was to study the effectiveness of limbal relaxing incisions in correcting corneal astigmatism when combined with clear corneal phacoemulsification.
Materials and Methods: 50 eyes of 37 patients satisfying the inclusion and exclusion criteria were included in the study. After adequate pre operative workup, all patients underwent limbal relaxing incisions coupled with clear corneal phacoemulsification. The incisions were calculated based on Gills nomogram. Postoperative visual acuity and corneal topography were performed to assess the correction of corneal astigmatism.
Results: The mean age of our study population was 57.08± 10.07 years. 50 eyes of 21 males and 16 females were included in our study. The mean preoperative Uncorrected Visual Acuity was 1.0 with a standard deviation of 0.5 (in logMAR) and the best spectacle corrected visual acuity was 0.8 with a standard deviation of 0.4. The postoperative uncorrected visual acuity at 4 weeks 0.0±0.15 with a best corrected visual acuity was 0.09±0.1. At 12 weeks, uncorrected visual acuity was 0.0 with a standard deviation 0.07. There was 71.8% decrease in central corneal astigmatism after limbal relaxing incisions.
Conclusion: Therefore we conclude that limbal relaxing incisions can be used effectively in conjunction with cataract surgery to reduce the astigmatism <3 D at the corneal level and aids us in providing spectacle free optimal distance vision in patients
Oral manifestations of type 2 diabetes mellitus of Bhopal city: an observational prospective study
Get PDFIntroduction: Type 2 diabetes mellitus involves a variety of dysfunctions bringing about a few delicate tissue variations from the norm in the oral cavity. These incorporate gingivitis periodontitis, salivary dysfunction, taste dysfunction, oral fungal and bacterial infections, geographic tongue, benign migratory glossitis, fissured tongue, traumatic ulcer, lichen planus, angular cheilitis, delayed mucosal healing, dental root caries, tooth loss, mucosal neurosensory disorders, and oral mucosal lesions.
Aim and objectives: This study aims to determine the frequency of different oral manifestations in patients of Type 2 Diabetes Mellitus of Bhopal city which will expand the consciousness of oral signs of diabetes mellitus subsequently helping in speeding up the examination regarding this matter.
Methodology: This descriptive study was carried out at the Department of Medicine, People’s Hospital, hitech division, Bhopal from March 2016 to January 2017. 200 patients satisfying the inclusion criteria (diagnosed cases of type 2 diabetes mellitus of > 35 years of age) were included in the study. 84 (42%) were female and 116(58%) were male patients.
Result: The frequency of different oral manifestations seen in female diabetic patients in descending order were; gingivitis (49%), periodontitis (36.7%), dental root caries (20%), taste dysfunction (8%), burning mouth syndrome (8%), xerostomia (31%), recurrent apthous stomatitis (11%) and oral candidiasis (2%) and in male diabetic patients in descending order were; gingivitis (41%), periodontitis (29%), dental root caries (18%), taste dysfunction (9%), burning mouth syndrome (3%), xerostomia (31%), recurrent apthous stomatitis (5%) and oral candidiasis (3%).
Conclusion: It was inferred that diabetic patients are more inclined to get oral complications so health education, timely diagnosis and effective treatment should be carried out to prevent these complications
A study of the pain score following TRUS guided prostate biopsy with and without periprostatic lignocaine infiltration
Get PDFIntroduction: Prostate cancer is one of the most common cancers in Western countries and is now increasing worldwide. Transrectal ultrasound guided prostate needle biopsy (TRUS) is the standard procedure to diagnose or exclude prostate cancer. TRUS-guided biopsy is associated with several complications and discomfort. We evaluated painless yet less invasive prostate biopsy.
Material and Methods: A randomised xwas conducted in 30 consecutive men divided into two groups. Group I consisted of fifteen patients who did not receive any analgesia, and another fifteen constituted study group, Group II, who received periprostatic infiltration of 1 % lignocaine. Patient with suspected DRE findings or elevated PSA or both were advised to undergo TRUS guided prostate biopsy. Pain intensity during the procedure was evaluated using Visual Analogue Scale. A visual analog scale was used to assess the pain score. Statistical analysis of pain scores was performed using the Student t test. Chi-square/ Fisher Exact test was used to find the significance of study parameters on categorical scale between two.
Results: In Group 2, there was a marked reduction in the pain experienced during the procedure. The Chi-squared test for trend showed a significant association between the periprostatic infiltration of 1 % lignocaine and reduction in pain on probe insertion and on taking the biopsy (P = 0.0001).
Conclusion: The use of periprostatic infiltration of lignocaine before taking the needle biopsy significantly reduces the pain experienced by the patient during TRUS-guided prostate biopsy
A rare case of familial methylmalonic acidemia presenting with Acrodermatitis Enteropathica type of lesion
Get PDFMethylmalonic academia (MMA) is an inborn error of metabolism commonly presenting in newborns with an occurrence of 1 in 50,000 to 80,000 newborns. It has autosomal recessive mode of inheritance. It is a disorder of amino acid metabolism. MMA occurs due to defective conversion of methylmalonyl-coenzyme A (CoA) to succinyl-CoA. It presents early at around 1 month to 1 year of age. It has predominat neurologic manifestations such as seizures, developmental delay, encephalopathy, and stroke. However due to malabsorption of zinc and secondary deficiency of branched chain aminoacids it rarely presents as Acrodermatitis Enteropathica. Here we report a case of a 5 months old girl with familial MMA presenting with skin eruptions typical of Acrodermatitis Enteropathica
Inhibitory effects of copper on bacterial and fungal growth
Get PDFIntroduction: Researchers conducted a literature, technology and patent search that traced the history of understanding the “bacteriostatic and sanitizing properties of copper and copper alloy surfaces” which demonstrated that copper, in very small quantities, has the Copper alloy surfaces have intrinsic properties to destroy a wide range of microorganisms. Today copper, in the form of plumbing tube, copper or copper-alloy surfaces proved to be a significant step in decreasing the fungal and bacterial infections in hospitals.
Aims and objective: To know the bactericidal and fungicidal properties of copper for its implication in various areas in preventing nosocomial infection.
Material and Methods: Eight sterile petri dishes (four for Blood agar media and four for MacConkey agar media) and two sterile 30 ml screw capped bottles (for Sabouraud’s Dextrose agar media) were taken. Sterile copper discs were placed in four plates of Blood agar and MacConkey agar media and other four plates were without copper discs. In the same way copper piece was placed in one of the bottle with Sabourauds Dextrose agar media. Pure growths of E. coli, Klebsiella and candida were inoculated and incubated.
Results: The plates with bacterial and fungal growth were reported accordingly. The growth was significantly reduced in Plates and bottles with copper discs.
Conclusion: Copper alloy surfaces have intrinsic properties to destroy a wide range of microorganisms so copper’s use in water supplies and surfaces are recommended
Evaluation of neutrophil elastase/ alpha-1-antitrypsin ratio in different stages of chronic obstructive pulmonary disease (COPD) patients
Get PDFIntroduction: Little is known about protease, anti-protease markers in chronic obstructive pulmonary disease (COPD) patients.
Objectives: The objective of present study was to identify and try to correlate serum markers of protease and anti-protease with pulmonary functions in different stages of patients with COPD and to determine the ratio of neutrophil elastase/alpha-1-antitrypsin in different stages of COPD patients.
Methods: This prospective observational study was carried out in patients with stable COPD. Activities of serum alpha-1-antitrypsin and neutrophil elastase were measured in 220 stable COPD patients and in 60 healthy controls by ELISA method. 220 COPD patients were divided into 4 stages according to severity: stage I, II, III and IV.
Results: An increase in serum neutrophil elastase and neutrophil elastase/alpha-1-antitrypsin ratio was observed in COPD patients with the advancement of the stage. In contrast to that, decreased activity of alpha-1-antitrypsin in serum was observed in different stages of COPD and is correlated positively with lung function parameters.
Conclusion: From these findings we conclude that as the severity increases there is decrease in alpha-1-antitrypsin resulting in concomitant increase in neutrophil elastase activity causing imbalance between protease-antiprotease in COPD patients and this imbalance is associated with impairment of lung function. The neutrophil elastase/ α-1-antitrypsin ratio can tell us the severity of the chronic obstructive pulmonary disease it may be in terms of increased fibrosis of the lung. Though the magnitude of neutrophil elatase/alpha-1-antitrypsin ratio is minute, still it can be a good marker of pulmonary function in term of severity of the COPD
Effect of short term exercise on abdominal obesity and blood pressure
Get PDFIntroduction: obesity is associated with a variety of chronic diseases, including but not limited to coronary artery disease, hypertension, diabetes, and certain forms of cancer. The present study was designed to examine the effects of short-term exercise on markers of obesity.
Material and methods: This was a randomized trial in 52 overweight and obese [body mass index (in kg/m2): 25–40; waist circumference >88 cm], women assigned to 16 week interventions of short term Exercise (3 d/wk) involved treadmill walking at an intensity of 45–50% (moderate-intensity) or 70–75% (vigorous-intensity) of heart rate reserve. The primary outcome was abdominal visceral fat volume determined by the measurement of waist and hip circumferences ratio.
Results: Average height of the females under study is 159.96 cm and average weight of females before exercise is 68.92 kg, it shows that the females in our study are overweight. After exercise training program, weight, arm circumference, chest circumference, WHR and BMI decreased significantly (Z= 4.27,7.30 , 4.99, 8.51 and 3.27 respectively ). Similarly systolic blood pressure and diastolic blood pressure (Z=5.74 and 1.75 respectively) was decreased significantly after exercise training.
Conclusion: Short term exercise intervention can induce favourable changes in the body composition, but the magnitude of these changes is of limited biological significance
Unusual presentation of interrupted aortic arch: a case report and radiological review
Get PDFInterrupted aortic arch, arare congenital malformation and there is a loss of luminal continuity between the ascending and descending portions of the aortic arch. Their incidences are of 3 per million live births and manage by surgical treatment. Till now only 12 cases of isolated interrupted aortic arch reported in adults. We notify the computed tomography imaging findings of a 29-year-old femalepatients presented to our hospital. MDCT has advantages of a less scanning time with more spatial resolution and high temporal resolution. Fine anatomic structures can be evaluated by retrospective reconstruction. Within few years MDCT has become a primary diagnostic tool for evaluation of aortic abnormality. Volumetric scanning of chest done in 64 slices MDCT with plain and contrast enhanced (I.Vnon-ionic) contiguous axial images taken from chest and evaluated in appropriate window settings.
Result: Multi-detector computed tomography (MDCT) angiography with a 64 slice MDCT were performed. The aortic arch is seen interrupted, approx. 1.8cm long segment of aortic arch just after the origin of subclavian artery is not seen (absent), thick chunk of irregular calcification is seen in the region of termination of aortic arch. Descending thoracic aorta is smaller in caliber measure approx. 1.1 x 1.2 cm in diameter & shows well luminal contrast opacification. Prominent Para vertebral collaterals seen suggesting collateral filling of descending thoracic aorta. No evident contrast filled patent ductus arteriosus seen, a tubular slightly enhancing structure seen in this region
Clinical spectrum of Pediatric HIV across A.R.T. centers in Chhattisgarh
Get PDFIntroduction: Pediatric HIV is a major world health problem, which is progressing at an alarming rate. Few studies have been done about variable clinical manifestation of pediatric HIV infection in children. This study intends to know the clinical profile of HIV infection in children of Chhattisgarh, evaluate the seroconversion rates of babies born to HIV seropositive women, possible maternal, obstetrical, and feeding factors influencing them, patient’s adherence to ART and opportunistic infections in affected children.
Methods: All pediatric HIV cases from 1½ year to 14 year registered in A.R.T. centres of Chhattisgarh. Data were analysed using SPSS system version 21.
Result: A total of 414 children were evaluated from different A.R.T. centres in Chhattisgarh for final analysis. Male to female ratio is 1.38:1. Most common mode of transmission is from mother to child. Tuberculosis, Recurrent and Persistent Diarrhoea, Recurrent Pneumonia and Oral Candidiasis are common infection in most of the children.
Conclusion: Average age of diagnosis of pediatric HIV is around 7.5 ± 2.1years. Majority of children are diagnosed in stage 3. Adherence therapy to A.R.T. is good. Vertical transmission is most common mode of transmission
Asymptomatic bilateral chemodectomas: a masquerader of simple neck masses
Get PDFPatients presenting with asymptomatic neck masses to surgical OPD can have many differentials, ranging from the simplest reactive lymph nodes to aggressive malignant masses. Bilateral neck masses in a patient can be due to infective lymph nodes, salivary gland pathology, solid - cystic lesions of the neck and malignancies. Based on the anatomical site of the lesion, clinical examination still remains the first step in characterising the lesion into solid, cystic, pulsatile, non pulsatile, response to cough impulse and so on. Imaging is always a mandatory next step for the confirmation of diagnosis and to know about the morphology of the lesion with finer details. USG, CT and MRI are indispensable tools in assessing neck masses with equivocal findings on clinical examination and particularly in asymptomatic individuals where there is lack of history and thus diagnosis becomes a challenging task. One such entity is bilateral Chemodectomas where imaging plays a pivotal role in the diagnosis. We report a case of bilateral neck masses in an asymptomatic female patient which on imaging was diagnosed as a case of bilateral carotid body tumours and referred to higher centre for further management