International Journal of Medical Research & Review (IJMRR)
Not a member yet
1355 research outputs found
Sort by
Effects of Escitalopram on C reactive protein in patients of depression
Get PDFObjective: To study the anti-inflammatory activity of Escitalopram in newly diagnosed patients of depression.
Materials and Methods: 100 Newly diagnosed patients of Depression as per ICD 10 (International classification of diseases) DCR (Diagnostic criteria for research) were selected for study after applying strict inclusion and exclusion criteria. Baseline Hamilton depression rating scale (HAMD) and baseline C reactive protein (CRP) was assessed and antidepressant treatment was started. After 8 weeks, again HAMD and CRP were assessed.
Results: Mean of Baseline CRP was higher in patients in those who have no response after antidepressant treatment and it was significant. The relationship between baseline HAMD and baseline CRP was found to be significantly positively correlated. Mean HAMD was significantly reduced after 8 weeks of antidepressant treatment. Mean CRP was significantly reduced after 8 weeks of antidepressant treatment. The relationship between baseline CRP and reduction in HAM D (in baseline and after 8 weeks of treatment) found to be negatively correlated and it was significant.
Conclusion: Escitalopram reduced C reactive protein in depressed patient and result was significant
Epidemiological profile of poisoning patients in the emergency department of a tertiary care teaching hospital in South India
Get PDFBackground: Poisoning is a global public health issue and one of the common causes for visiting an emergency department (ED). A high index of suspicion based on etiology and clinical features is required to diagnose different types of poisons and their compounds.
Aims: To define the epidemiological profile of patients registered in the ED with complaints of ingestion of poison, and to identify different types of poisons consumed, the duration of hospital stay and mortality due to these poisons.
Methods: A retrospective analysis of patients presenting to the ED with complaints of poisoning. All patients registered in the ED with complaints of consumption of poison were included in the investigation. Patient charts with snake bites or scorpion stings were excluded. The medical charts with a discharge diagnosis of Poisoning during the study period were identified using the ICD-10-CM diagnosis codes categories T36-T65. Data was collected in a preformatted questionnaire.
Results: In this study, 317 patients were enrolled, with a female predominance of 54.8%. Thirty-one percent of the patients are 15 to 24 years old, and 11.35% are below five years. Thirty percent were students, 18.3% housewives and 6.62% were farmers, with 59.3% having access to poisons at their homes, 19.87% from the pharmacy and 14.9% from a neighborhood store. The intent of poisoning in 85.8% of the patients was suicidal. 34.7% patients ingested pesticides, 30.28% patients, presented with tablet overdose, 14.82% patients consumed rodenticides and insecticides, and 3.47% patients presented with oleander seed poisoning. About 32.17% of the patients were admitted to ICU. Nearly 53.94% patients were discharged within three days of hospitalization. The mortality rate due to poisoning was 4.1%.
Conclusion: This research article defines the epidemiological profile of poisoning patients registered in the emergency department, along with the common poisons used, duration of hospital stay and mortality due to poisoning
Eighth Nerve Dysfunction in Type 2 Diabetes Mellitus
Get PDFIntroduction: Hearing impairment is one of the under-recognized complications of diabetes that affects the cognitive performance and quality of life. The study was conducted to estimate the prevalence of hearing impairment and analyze the type, degree and pattern of hearing impairment in diabetic population.
Materials and Methods: The study was conducted as a case-control study including 50 diabetic patients and 20 healthy individuals after exclusion of confounding factors. Hearing assessment was done using pure tone audiometry.
Results: The prevalence of hearing impairment in diabetics of age 35-65 years was 74% compared to normal population (15%). 7 out of 13 diabetic patients in the age group of 35-45, 19 out of 37 diabetics in the age group of 45-55 & 11 out of 13 diabetics in the age group of 55-65 had hearing impairment. 9 out of 12 diabetic patients having HbA1c of < 7 and 28 out of 38 diabetic patients having HbA1c of >7 had hearing impairment. 21 out of 27 patients with diabetes duration of <1 year, 6 out of 11 patients with diabetes duration of 1-5 years, and 10 out of 12 patients with diabetes duration >5years had hearing impairment. Out of 37 diabetic patients who had hearing impairment, 24 (64%) had diabetic neuropathy.
Conclusion: Eighth nerve dysfunction is common among diabetics. Its prevalence among the diabetics increases with age and positively correlates with the duration of diabetes and presence of diabetic peripheral neuropathy. However, its prevalence did not show positive correlation with the HbA1c levels
Prevalence of invasive Trichosporonosis by Trichosporon asahii and other Trichosporon species and their antifungal susceptibility pattern in Chhattisgarh
Get PDFIntroduction: Trichosporonosis is usually known to cause superficial mycoses, but now it is emerged as an opportunistic infectious disease. Trichosporon species is fairly uncommon fungus but can cause fatal mycosis in immunocompromised patients.
Objective: This study is an attempt to know prevalence of invasive trichosporonosis and its antifungal susceptibility.
Materials and Methods: All patients with a culture that was positive for Trichosporon species from February 2012 to February 2015 were included. Routine mycology works up done and suspected Trichosporon sp. were confirmed by automated miniAPI system. Antifungal susceptibility test was done for Fluconazole (F), Itraconazole(Itr), Voriconazole(V), Flucytosine(5Fc), AmphotericinB (AMB) done by minimum inhibitory concentration (MIC) method by ATB Fungus3 ( Biomerieux, France).
Result: 41 Trichosporon sp. was isolated from clinical specimen. Trichosporon asahii was the most common isolate (29 out of 41, 70.7%), followed by T. mucoides (5 of 41, 12.2%), T. inkin (2 of 41, 4.9%) and other Trichosporon sp. (5 out of 41,12.2%). Out of 41, 20 cases were proven to cause invasive trichosporonosis. Most invasive infections were associated with indwelling catheter (95%), associated bacterial infection(85%), ICU stay (85% each), prior antibiotic use (75%), cancer (65%), neutropenia, steroid use (55% each) and chemotherapy(50%). Amphotericin B was less susceptible against Trichosporon isolates whereas azole had good in vitro activity. Sensitivity of T.asahii towards Fluconazole, Itraconazole, Voriconazole, Amphotericin B and Flucytosine was 72.4%, 51.7%, 86.2%, 51.7% and 66.8% respectively.
Conclusion: T. asahii and other unusual Trichosporon sp.species also cause invasive trichosporonosis. For optimal therapy for trichosporonosis azoles can play a potential role
The diagnostic utility of FNAC in palpable lesions of breast at a tertiary care centre
Get PDFBackground: Breast lumps constitute a significant proportion of surgical cases in both developed and developing countries. Fine Needle Aspiration Cytology (FNAC) is a simple, minimally invasive, cost effective, outpatient based and a rapid diagnostic method for breast lesions. The aim of the present study was to study the cytological spectrum, cytohistological correlation and diagnostic accuracy of aspiration cytology (FNAC) in palpable breast lesions. Material and
Methods: This was a prospective study done in the department of Pathology, L.N. medical college, Bhopal, India from January 2016 to December 2016. FNAC of 300 cases of palpable breast lesions were done and reported by expert pathologist. The histopathological specimen when available were reported by other pathologist without prior knowledge. Sensitivity, specificity and accuracy of FNA diagnosis were then analyzed.
Results: A total of 300 cases of breast lesion were diagnosed on FNA, out of them histopathological correlation was available for 150 cases. Benign breast lesions are more common in younger patients in 11-30 age group and Malignant breast lesion are more common in old age group patients of 41-60 yrs age group. Benign breast lesions were found in 215 cases (71.66%); among which fibroadenoma (41%) was the commonest lesion observed. Malignancy was observed in 63 cases (21%); among them, Ductal carcinoma was the predominant lesion (17.66%). The sensitivity, specificity and diagnostic accuracy of FNAC for malignant lesion is found to be 98.3%, 98.9% and 98.7% respectively.
Conclusion: FNAC is an effective and valid tool as first line diagnostic modality in preoperative diagnosis of malignant and benign breast lesions
The current role of imaging in the prenatal diagnosis of fetal achon-droplasia medical management and dental implications
Get PDFWe present the case of a patient with the following diagnosis: 29 weeks pregnancy in evolution, fetal achondroplasia with orofacial manifestations: macrocephaly, domed forehead, depressed nasal bridge, maxillary hypoplasia and general manifestations: short fingers, swelling of the back of the hand, increased angle between the femoral head and the femoral shaft, dorsal swelling of the foot, micromelia. The diagnosis was established prenatally after an ultrasound complex investigation and confirmed postnatally. We emphasize the increasingly important current role of the prenatal ultrasound investigation in early diagnosis of congenital anomalies like fetal achondroplasia and in the correct multidisciplinary management of cases
Clinical study on efficacy of infliximab on severity and occurrence of acute anterior uveitis in HLA-B27
Get PDFAim: To study the efficacy of Infliximab on the severity and occurrence of Acute Anterior Uveitis in HLA B27 positive patients.
Materials and Methods: This is a prospective observational study done on 30 patients with acute anterior uveitis who were HLA B27 positive presenting to Uvea and Retina Services at Regional Institute of Ophthalmology Government Ophthalmic Hospital, Chennai between April 2013 to May 2015. Of which 16 patients were on Infliximab therapy (3-5mg/kg) for Ankylosing Spondylitis, 6 patients were on Tablet Sulfasalazine for the articular symptoms of Ankylosing Spondylitis and 8 patients were not on any medication and were retrospectively diagnosed as HLA-B27 positive. A detailed history, systemic examination, ocular examination using Slit lamp, 90D biomicroscopy, blood investigations for HLA B27 and MRI Sacroiliac joint was done. Patients were started on topical corticosteroids and cycloplegics, the response noted and followed up for 3 months.
Results: Severity of uveitis did not show any variation between groups that were on infliximab and sulfasalazine and those who were not on any treatment. Patients in the three groups responded dramatically well to topical corticosteroids and cycloplegics.
Conclusion: Infliximab (3-5mg/kg) regime used for the control of symptoms of Ankylosing Spondylitis neither prevents the occurrence nor decreases the severity of Acute Anterior Uveitis in HLA-B27 patients. Further studies are needed to establish the safe and effective dosage of Infliximab to prevent the occurrences of Acute Anterior Uveitis in HLA B27 patients
Altered PTEN expression as a diagnostic marker for the earliest endometrial precancerous changes
Get PDFIntroduction: Study was planned to investigate PTEN gene expression in endometrial hyperplasia and carcinoma as analyzed by immunohistochemistry.
Material and Method: This study was conducted on 80 endometrial samples in the Department of Pathology, Gandhi Medical College, Bhopal (January 2012 to August 2016)
Results: 5 out of 5 cases of proliferative endometrium, 3 out of 5 cases of secretory endometrium, 37 [84%] out of 44 cases of simple and complex endometrial hyperplasia without atypia, 8 out of 15 cases of simple and complex endometrial hyperplasia with atypia and 3 out of 11 cases of endometrial carcinoma showed positive PTEN expression.
Conclusion: PTEN is a major gene involved in the pathogenesis of endometrial carcinoma. Our data suggest that decreased PTEN expression was a marker of earliest endometrial pre-cancer lesion and we propose that use of PTEN immunostaining in a clinical setting may be informative in identifying premalignant lesions that are likely to progress to carcinoma
Role of imaging in evaluation of intestinal obstruction
Get PDFIntroduction: Small bowel obstruction (SBO) is a common clinical entity that occurs secondary to mechanical or functional obstruction of the small gut, preventing normal passage of its contents. It constitutes 20% of all surgical emergencies for acute abdominal pain and a common cause for hospitalization. Plain abdominal X-ray and ultrasonography were used for initial examination. Now, Computed tomography is the modality of choice for preoperative evaluation of SBO.
Aims and Objectives: To evaluate the diagnostic accuracy of various imaging modalities namely plain x-rays of abdomen, ultrasound and computed tomography in the diagnosis of intestinal obstruction with reference to a) The presence or absence of obstruction b) The level of obstructionc) The cause of obstruction.
Materials and Methods: It was a hospital based prospective study in which X-Ray and ultrasonography were done as an initial modality for screening and Multi Detector Computed Tomography (MDCT) scan was done later on for detailed evaluation. Relevant history, clinical examination and routine investigations were done.
Results: Acute intestinal obstruction: CT scan was found to be superior in predicting a fully correct diagnosis (78%) when compared to ultrasound (29%) which in turn was found to be superior to plain films which provided fully correct diagnosis only in 10% of the cases. Subacute intestinal obstruction- In 62.5 % cases of sub acute intestinal obstruction CT scan provide fully correct diagnosis whereas in none of the cases did ultrasound or plain films provide fully correct diagnosis.
Conclusion: CT was found to be superior to ultrasound and plain films in finding out the presence, level as well as cause of obstruction
Unusual near- miss case of atonic postpartum haemorrhage in GMC Chandrapur (Dawn from death to life)
Get PDFA maternal near- miss is an event in which a pregnant woman comes close to maternal death, but does not die. A 8 months gestation third gravida patient was admitted in GMC Chandrapur in preterm labor with intrauterine death. It was an uneventful delivery and as she was a high risk patient for postpartum hemorrhage, all preventive measures were taken. Unfortunately she landed up in atonic PPH for which her subtotal obstetric hysterectomy was done but within one hour she landed up in cardiac arrest, was revived with CPR and her internal iliac artery ligation was done. Postoperative course was uneventful and she was discharged on 10th postoperative day. The aim of this report is to stress the need for strict vigilance of PPH and cardiac arrest and prompt intervention involving multidisciplinary team which led to salvaging the precious life of a mother