International Journal of Medical Research & Review (IJMRR)
Not a member yet
1355 research outputs found
Sort by
Clinical profile and comparison of SAAG with ascites fluid total protein (AFTP) in cases of ascites at a tertiary referral hospital in Maharashtra
Get PDFAims: This observational prospective study was carried out with aims of 1) study various presentations and clinical features in ascites cases, 2) assess different etiological factors, 3) compare serum ascitic albumin gradient (SAAG) and ascitic fluid total protein (AFTP) in differentiating portal hypertension related causes of ascites from others, 4) study in hospital outcome in cases of ascites.
Material and Methods: 100 consecutive ascites cases admitted in wards with clinical diagnosis and sonographic confirmation were recruited in the study. After history and detailed clinical examination cases were subjected to ultrasonography and portal vein Doppler to diagnose portal hypertension which was followed by paracentesis. Serum Albumin & total protein, ascitic fluid albumin and total protein, AFTP and SAAG was determined.
Results: Mean age of diagnosis of ascites was 42.41 ±7.72 years and maximum cases in 30-49 years age group. 68% of cases of ascites had cirrhosis of liver, 16% peritoneal (abdominal) tuberculosis, 10% chronic heart failure (CHF), 4% nephrotic syndrome and 2% had ovarian malignancy. Mean AFTP and Mean SAAG was 1.77±0.73gm% and 2.05±0.52 gm% in 78 cases of portal hypertension related ascites respectively. In normal portal pressure cases (n=22) of ascites it was 3.01±0.37 gm% and 0.72±0.19 gm% respectively. Sensitivity of AFTP and SAAG in differentiating portal hypertension related etiology from other causes was 70.51% and 92.31% respectively .Though sensitivity was less, specificity was equal ( 95.45%). Eight cases had variceal bleeding, 9 had hepatorenal syndrome and 15 had hepatic encephalopathy. Total 16 cases of liver cirrhosis with ascites died in hospital commonest cause was hepatic encephalopathy and hepatorenal syndrome
Study of placental weight in normal and pre-eclamptic pregnancies and its correlation with birth weight
Get PDFBackground: Placenta reflects the well being of the fetus and continuously undergoes a change in weight and function, to support the development of the fetus. The aim of this study was to assess and correlate the weight of placenta and fetal birth weight in normotensive and hypertensive pregnancies.
Materials and Methods: Fifty placenta each of normotensive and pre-eclamptic pregnancies were studied (n=100). After delivery, weight of placenta and fetal weight was recorded using weighing machine.
Results: In this study, 68.19% cases of low birth weight babies were found in pre-eclamptic group. Mean placental weight was 454.24 ± 47.52 grams and mean fetal weight was 2633.6 ± 302.2 grams in normal group. Whereas, in pre-eclamptic group, mean placental weight was 406.32 ± 59.33 grams and mean fetal weight was 2435.2 ± 280.56 grams. Mean placental and fetal weight were significantly lower in pre-eclamptic group, whereas, feto-placental weight ratio was significantly higher in pre-eclamptic group. A significant positive correlation was found between placental and fetal birth weight (r = 0.975, p<0.0001) in normal and (r = 0.971, p<0.0001) in pre-eclamptic group.
Conclusion: Pre-eclamptic pregnancies significantly reduce placental weight. These changes may be due to placental insufficiencies as a result of compromised uteroplacental blood flow in pre-eclamptic pregnancies. The present study shows a strong positive correlation between placental and fetal weight. So, the knowledge of this correlation will be tremendously useful in the early assessment of placental insufficiencies and also the state of fetal well being
Operative management of paediatric Supracondylar fractures of Humerus Extension type: The Results of K-wire Placement
Get PDFAim: To study the k wire placement Cross Pinning Versus Lateral Pinning technique, in terms of functional outcome and complications in the operative management of paediatric supracondylar fractures of humerus extension type.
Methodology: A total of 50 patients of supracondylar humerus fracture extension type-III were included in the study. 25 patients were operated by closed reduction with Cross K pinning fixation and 25 patients were operated by closed reduction and Lateral 2 K pinning fixation. All patients were followed up to 9 months and assessed for functional outcome and complications.
Results: The two groups were comparable with respect to age /sex/weight/height and type of fractures. All patients of crosspinning were inmobilized for three weeks whereas in lateral pining 9% patients were immobilized for 4 weeks. The two groups were compared with respect to time till union, range of movement (ROM), carrying angle and function which was done at 3,6 and 9 months. 8.33% of the patients of cross pining group had ulnar nerve injury. 66.7% had excellent results in cross pinning compared to 70.6% in lateral pinning.
Conclusion: There is no significant difference in the stability provided by the cross pinning and two lateral pin fixation method. But the medial and lateral pin fixation group shows two cases of iatrogenic ulnar nerve injury. Therefore, lateral pin fixation method for the treatment of type III supra condylar fracture requiring surgery is a reliable and safe method to avoid iatrogenic ulnar nerve injury and provides adequate stability if proper pin fixation principles are used
Elastosis in premalignant and malignant lesions of breast-A histopathological and histochemical study
Get PDFBackground: Stromal changes in all the premalignant, insitu/ microinvasive and invasive malignant lesions of breast helps in better understanding of disease process at the level of the tumor and host stromal reaction. The pattern of elastosis even correlates better with prognosis than the predicted behaviour of tumour cells.
Aims and Objectives: The present study is undertaken to emphasize the importance of stromal changes (elastosis) and to predict the prognosis and behaviour of tumor cells.
Study design: The study was conducted on 90 patients of breast lesions (66 cases of invasive malignant breast lesions and 04 cases of insitu breast lesions and 20 cases of proliferative breast lesions).
Material and Methods: The tissue for histopathological studies were collected in 10 % buffered formalin solution .The paraffin wax blocks were made and 4-5 µ thick sections were cut and stained by H & E and special histochemical stains.
Result: Moderate degree of elastosis was found to be associated with maximum number of invasive malignant breast lesions Proliferative breast lesions and insitu malignant lesions showed mild to moderate degree of elastosis. Consistent results were obtained in Grade II malignant lesion where moderate to marked degree of elastosis was seen.
Conclusion: In all cases of early invasive and invasive malignant lesions of breast, elastosis as a indicator of stromal change should be carefully studied and included in predicting the final outcome along with histological types to get the better results
Outcome of ultrasound guided foam sclerotherapy (UGFS) treatment for varicose veins: A four years retrospective study at a tertiary care hospital in north India
Get PDFObjective:The purpose of this study was to determine the outcome and rate of recurrence for varicose veins treated with ultrasound-guided foam sclerotherapy (UGFS).
Methods:Data was collected from hospital records. Patients treated with UGFS for superficial venous insufficiency were included in the study. Total 361 legs in 241 patients, out of which 121 patients with unilateral limbs and 120 patients with bilateral limbs were found to be treated by this method.
Results:Out of these 361 legs great saphenous vein (GSV) varicosity was found in 88 legs, short saphenous vein (SSV) in 76, GSV & SSV both in 63, others 134. 264 legs with primary varicosity while 97 were with recurrent. In 294 legs clinical CEAP was 2-3 while in 67 legs it was 4-6. Saphenofemoral junction (SFJ) incompetence was found 60 legs, saphenopopliteal junction (SPJ) incompetence in 68, only perforator’s incompetence was in 56, SFJ with perforator’s incompetence 61, SPJ with perforator’s 29 and no incompetence was noted in 87 legs.Outcome at 6 months was 96.23% while treatment failure and recurrences were noted in 2.77 % of legs. Complications which were noted at 1 week were superficial skin necrosis in 3.04%, pain at injection sites in 15.23%, superficial thrombophlebitis in 16.62%, bruising in 12.18%, skin staining in 11.08%, superficial vein thrombosis (SVT) in 9.97% while no DVT was noted in any of the treated legs.
Conclusion:On conclusion it was found that UGFS is a popular office based treatment modality, safe, effective, easy and improvement in venous signs and symptoms. Even on recurrence patients easily accepts retreatment with this method. Furthermore it is associated with lesser pain, anesthesia requirements; time off work and driving gives it additional advantage
Factors affecting visual outcome in traumatic cataract and its associated ocular injuries - A hospital based study
Get PDFBackground: Ocular trauma is a major cause of visual impairment throughout the world, although little is known about the factors that affect the visual outcome in traumatic cataract in developing countries.
Aims and Objectives: To find out the associated ocular injuries and the factors affecting final visual outcome of patients with traumatic cataract.
Material Methods: This prospective hospital based study was conducted on 40 patients of traumatic cataract. Patients were managed with lens extraction and intraocular lens implantation. Regular follow up of patients was done and best corrected visual acuity and post operative complications were assessed at the end of six months.
Results: Our study showed that majority (50%) of patients were in the age group of < 20 years with male preponderance. visual outcome was significantly better in younger age group (< 20 yrs) than the older group (> 20 yrs) ( p = 0 .03). There was no significant difference in final visual outcome of traumatic cataracts caused by penetrating or blunt trauma ( p = 0.73). Corneal tear was most common associated ocular damage followed by uveitis, lens matter in anterior chamber.
Conclusions: Age of the patient affects final visual outcome after surgical treatment of traumatic cataract but type of trauma (blunt / penetrating) had no significant effect on final visual outcome. Corneal tear was most common associated ocular damage
Cytogenetics abnormalities in acute leukemias of ambiguous lineage: First report of complex variant philadelphia translocations
Get PDFBackground: Acute leukemias of ambiguous lineage (ALAL) are incompletely characterized and are very rare, accounts< 4% of acute leukemias . In most leukaemias the cytogenetic and molecular genetic changes have emerged to be diagnostic as well as prognostic importance. Due to Lack of diagnostic criterias, it is difficult to establish cytogenetic features in ALAL. In present study we reviewed chromosomal aberrations, their molecular background, their prognostic relevance of ALAL & summarized some new chromosome aberrations along with probable mechanism of complex variant translocation.
Design and Methods: Present study from Kidwai state cancer institute concentrated on cytogenetic findings of ALAL, especially B+Myeloid MPAL cases, more so regarding complex variant phildelphia chromosome translocations summarised diagnostic criteria based on WHO 2008 classification, clinical, immunophenotyping and molecular features, along with treatment & follow up.
Results: Among 32 cases of ALAL cases, 28 MPAL cases reported in the present study 13 cases were B/Myeloid, followed by B+T MPAL, T+Myeloid .4 cases of undifferentiated and unclassifiable leukemias were reported. B/myeloid MPAL were in majority, 13 cases. Cytogenetics abnormality was detected in 4 cases of B/myeloid MPAL. 3 cases were Ph +, another case was hyperdiploid, surprisingly out of 3 Ph+ cases, 2 cases (66.6%) showed complex variant Phildelphia chromosome.
Conclusion: B+MYELOID MPAL revealed significant cytogenetic abnormalities. Although Ph+ is reported in MPAL, complex variant Ph with 4 or 3 way translocations are not reported in ALAL especially in B/Myeloid MPAL .Immunophenotyping & cytogenetics in ALAL should be mandatory. Multiple levels of genetic heterogeneity exist in these leukemias with variant Ph translocations. Prognosis improves when treated with Imatinib
Obstructive sleep apnea and excessive day time sleepiness as measured by epworth sleepiness scale
Get PDFIntroduction: Many patients search for medical care for symptom of a sleep disorder, obstructive sleep apnea hypopnea syndrome (OSAHS). Currently overnight polysomnography is the gold standard for diagnosis of OSAHS. However, the test is costly and time taking, accessible in big cities only and is not always well accepted by patients. Therefore approximately 95% of the patients with sleep disorders are not diagnosed. Although subjective, the Epworth Sleepiness Scale may contribute to analyze signs and symptoms. It is easy to be applied, fast and free of charge. The purpose of our study was to evaluate Epworth Sleepiness Scale Scores and AHI in obese patients and to compare these parameters.
Methods: The present study is an observational study which was conducted in the Department of Pulmonary Medicine, People’s College of medical Science & Research Centre, Bhopal from Oct. 2013 to April 2015. Randomly selected 100 patients with BMI ≥23 fulfilling inclusion and exclusion criteria were assessed in the study.
Result: In our study we took 100 patients, 5 of them have ESS score <9 and 95 patients have ESS >9.In mild AHI group 2, patients were in ESS< 9 group and 6 patients were in ESS >9 group. In moderate AHI group 2 patients were in ESS score <9 group and 25 patients were in ESS >9 group. In severe AHI group only 1 patient were in ESS< 9 group and 64 patients were in ESS >9 group.
Conclusion: We concluded that ESS shows correlation with AHI for severe and normal levels, but not for mild and moderate levels
CT Guided FNAC of lung mass – A retrospective study of Disease Spectrum
Get PDFCT guided FNAC is a well established method in the cytological diagnosis of pulmonary lesion. Aim: Aim of our study is to evaluate the pathological spectrum of disease in lump through CT guided FNAC. Material & method: 69 causes were evaluated retrospectively for a period of 4 yrs. Result: out of 69 cases 52.1% were male. Mean age was 54. 34 years. 65.2% having malignant lesion & 34.7% have benign. Adeno CA was the predominant malignant tumour. Conclusion: CT guided FNAC can diagnose pulmonary lesion fairly accurately leading to less morbidity & mortality as treatment can be started early
Knee arthroscopy postoperative analgesia by multimodal cocktail regime
Get PDFBackground: Post-operative knee pain management have become a challenge to provide early relief and pain free postoperative care to the patient. Adequate analgesia influences the early rehabilitation of the patient and hospital stay.Many factors have been implicated to influence post arthroscopy pain such anesthetic technique, residual effects of perioperative analgesia, patient pain threshold, preoperative pain level, the use and duration of tourniquet exsanguination, surgical trauma involved, volume of drug injected, the experience of the surgeons, the sex of the patient and the postoperative activity level of the patients.The purpose of this study is to assess the efficacy of the multidrug regime for management of postoperative pain during first 24 hours.
Methods: In our study 57 patients of both the sexes were evaluated for postoperative pain following various elective arthroscopic knee surgeries such as ligament reconstruction, cartilage procedures and diagnostic arthroscopic procedures. Patients were evaluated for pain using visual analogue score at 6th hour,12th hour and 24 hours’ post-operative. A cocktail prepared of multidrug was used for the study.
Results: The new cocktail regime provides adequate analgesia with no patients requiring additional analgesia for first 12 hours and only 2 patients whose VAS [visual analogue scale] was greater than 4 required additional analgesia at the end of 24 hours postoperative.
Conclusion: Multi drug cocktail regime provides a good analgesic for post-operative knee arthroscopic surgery without the need of rescue analgesics. Intra articular local analgesia reduces overall use of parenteral analgesics and also helps in quicker rehabilitation