International Journal of Medical Research & Review (IJMRR)
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Retrospective analysis of poisoning cases admitted in a tertiary care hospital in North Eastern UP, India
Get PDFAims: Poisoning is a medical emergency associated with significant morbidity and mortality. This study was done to analyse the pattern of poisoning cases coming to our tertiary care centre located in the north eastern part of U.P., India. It is important to know the pattern of poisoning in a region so as to take proper actions for prevention and management of the cases.
Methods: This was a retrospective hospital record based study of poisoning patients who were admitted to our tertiary care hospital between July, 2014 to December 2015. Data of total 140 cases were analyzed for demography, type of poisoning and outcome and results were analyzed statistically.
Results: Pesticides dominated the picture amongst the rural population while urban people consumed drugs and household agents. The overall mortality rate was 4.28%. Most of the deaths were in Aluminium phosphide cases (66.66%) followed by paraquat and organochlorine.
Conclusion: In adults poisoning is mostly suicidal while children accidentally ingest substances. Pesticides, chemicals and drugs available in house are mostly used. Rural people resort to pesticides while urban population takes household articles or drugs for self harm. Mortality depends on the type of poison, amount consumed and the time lapsed in reaching a health care facility as well as how equipped is the health care facility to tackle the poisoning cases
Lesions of nasal cavity, paranasal sinuses and nasopharynx: a clinicopathological study
Get PDFBackground: A variety of non-neoplastic and neoplastic lesions of nasal cavity, paranasal sinuses and nasopharynx are commonly encountered in clinical practice. The aim of this study was to study clinical and histopathological profile of space occupying lesions of nasal cavity, paranasal sinuses and nasopharynx in a tertiary care hospital of Ranchi over the period of January 2011 to January 2012.
Materials and Methods: This was a prospective study of 90 cases of space occupying lesions of nasal cavity, paranasal sinuses and nasopharynx over the period of 12 months. All tissues after fixation in 10% buffered formalin, processed and then stained with Hematoxylin & Eosin to study various histopathological patterns.
Results: These 90 cases were broadly categorized in two categories, one category as nasal and paranasal sinus masses and the other as nasopharyngeal masses with 63 and 27 cases, respectively. These lesions were common in second and third decades of life with male predominance. Among nasal and paranasal sinus masses, there were 52 (82.2%) non-neoplastic and 11 (17.8%) neoplastic lesions. Inflammatory polyps (86.5%) were the most common among the non-neoplastic masses. Out of 27 nasopharyngeal masses, there were 23 (85.2%) non neoplastic and 4 (14.8%) neoplastic lesions. Majority of these i.e. 20 cases were of adenotonsillar hypertrophy.
Conclusion: We concluded that complete clinical, radiological and histopathological correlation helps us to categorize these sinonasal lesions into various non-neoplastic and neoplastic types. But final histopathological examination provides a confirmatory diagnosis
Clinical spectrum of acute kidney injury among hospitalized patients in coastal districts of Andhra Pradesh
Get PDFIntroduction: Acute kidney injury (AKI) is one of the important overall causes of mortality in hospitalized patients. Variability in definitions of AKI has led to gross variations in the incidence across the world. Multiple metabolic derangements in these patients can increase the mortality and morbidity. Our study aims at studying the incidence, clinical, biochemical, hematological and sonographic abnormalities seen in hospitalized patients with AKI.
Acute Kidney InjuryMethods and Material: Case records of 237 patients admitted in various departments of a tertiary care center over a three year period from 2010 to 2013, who developed AKI were included in the study. The etiologies, various hematological and biochemical test reports, ultrasonography of abdomen and treatment given was noted. Statistical analysis was done to find the pattern of AKI and the prevalence of various biochemical and metabolic abnormalities.
Results: The incidence of AKI among hospitalized patients was 1.9%. Out of 237 patients with AKI, 62% were males. 70% belonged to medical and allied specialties. The most common cause of AKI was infection related. Fever was the most common symptom (48%) and common laboratory abnormalities included anemia (70%), hyperkalemia (36%) and proteinuria (29%). Mortality in this study was 21 (9%), 73% received conservative therapy while 27% had undergone hemodialysis.
Conclusions: AKI is highly prevalent among hospitalized patients admitted in medical and allied departments. Infections top the list among the causes of AKI. Various metabolic and biochemical abnormalities are seen, most of them can be managed conservatively and up to one third may require hemodialysis
Dyslipidemia in type 2 diabetes mellitus – a major risk factor for cardiovascular morbidity
Get PDFIntroduction: Diabetes mellitus is growing worldwide like an epidemic. Early identification of cardiovascular risk factors will decrease the morbidity in type 2 diabetes mellitus. This study was done to assess the prevalence of dyslipidemia among type 2 diabetic population.
Methods: 40 cases of type 2 DM with duration of 8 to 12 yrs and 40 controls of both males and females in the age group of 40 to 65yrs were selected. Laboratory investigations like fasting glucose and lipid profile (fasting) were taken.
Results: In the present study the levels of fasting glucose, total cholesterol, low density lipoproteins, triglycerides were high and the levels of high density lipoproteins were low in the type 2 diabetics compared to controls.
Conclusion: Thus this study suggests the importance of early detection of dyslipidemia in type 2 diabetics mellitus and will reduce the prevalence of complications in diabetics
Spectrum of non-motor neuropsychiatric symptoms among patients with Parkinson’s disease and Parkinson plus syndrome
Get PDFIntroduction: Patients with PD often have non motor symptoms in addition to the motor manifestations of bradykinesia, rigidity and tremor. The NMSs are more often seen in patients with longer duration of disease. There is increasing realization that NMSs significantly contribute to the morbidity and increase the burden of the disease far beyond that caused by the classical motor symptoms.
Material and methods: It was a cross sectional study conducted to assess the non-motor dysfunction in 60 patients with Parkinsonism including idiopathic Parkinson’s disease and Parkinson plus syndrome who attended either the outdoor services, or were admitted in the Neurology ward of our tertiary care centre, PGIMER & Dr. RML Hospital, New Delhi, India.
Results: Out of 40 patients with Parkinson’s disease, twenty-five (62.50%) were males and 15 (37.50%) were females with mean age of 55.02 (SD ±13.56) years. Among patients with MSA, six (66.70%) were male and 3 (33.33%) were female with mean age of 62.00 (SD ±11.38) years. Out of 40 patients with PD 19 (47.50%) had minimal depression, 12 (30%) mild depression, 7 (17.50%) moderate depression and 2 (5%) severe depression. Out of 20 patients with Parkinson plus Syndrome 12 (60%), 5 (25%), and 3 (15%) patients had minimal, mild and moderate depression.
Conclusion: Parkinson’s disease and Parkinson plus syndrome are group of sporadic, neurodegenerative diseases of the central nervous system. There are only a few reports about the frequency of neuropsychiatric symptoms in patients with Parkinson disease from India and no such Indian report in patients with Parkinson plus syndrom
Spontaneous bacterial peritonitis: risk factors and relationship to serum-ascites albumin gradient in chronic liver disease patient
Get PDFBackground: Spontaneous bacterial peritonitis (SBP) is probably the best characterized infectious complication that develops in patients with cirrhosis and ascites.
Aims and objective: The present study was done to find the incidence of SBP in patients of chronic liver disease and to find its correlation with serum ascites albumin gradient.
Material and Methods: A total of 55 patients were selected for the study and divided into 2 groups; Group A - spontaneous bacterial peritonitis (SBP) and Group B -sterile cirrhotic ascites (SCA). Diagnosis was done by calculating SAAG (Serum Ascites Albumin Gradient) which reflects the differences in osmotic pressure and correlates with portal venous pressure. Total ascitic protein and ascitic -serum total protein ratio were taken as a diagnostic parameter for SBP.
Results: Maximum incidence of disease was found between 31-50 years of age. Serum albumin values in SBP (2.50±0.31 gm/dl) when compared with SCA (2.85±0.39) and total ascites albumin in SBP (0.41±0.21) with SCA (0.89±0.31) were significantly different (p<0.001, t=3.59 and p<0.001, t=6.58 respectively). No significant difference (p>0.05, t=1.17) was found in serum ascites albumin gradient (SAAG), when it was compared between SBP (2.09±0.42 mg/dl) and SCA (1.96±0.37 gm/dl).
Conclusion: In a patient of cirrhosis with ascites early diagnosis of development of SBP in a case of SCA can prevent mortality
Effect of music during exercise on rate of perceived exertion mood status
Get PDFBackground: Music has been used in boosting performance during various exercise and sports events. This present study was planned to assess the effect of music on mood status and rate of perceived exertion during jumping rope task.
Methods: The study included sixty healthy students (males 30, female 30) with a mean age of 18 ± 2 years. Subjects were randomly assigned into three different groups (n = 20 in each). Group 1 fast music (120bpm), group 2 slow music (90bpm) and group 3 no music group. Subjects jumped rope while listening to music for fifteen minutes or until they reported fatigue, whichever was earliest. Blood pressure, respiratory rate, rate pressure product and Profile of Mood Status was recorded before and after exercise.
Results: There was a significant increase in cardiorespiratory parameters, in group 1 (P<0.05) compared to Group 2 and Group 3. Results, also revealed significant decrease in fatigue and negative mood dimensions (P<0.001 for both) in group 1. Rate of Perceived exertion assessed after completing the exercise task was significantly lower in the group 2 compared to other two groups.
Conclusion: It is concluded that exercising combined with upbeat fast music may have a positive effect on various mood parameters and cardiovascular parameters during exercise, but the same need not be true with regard of rate of perceived exertion
Clinical and cyto-histopathological study of Hansen’s disease in teaching government hospital in Mahakausal Region
Get PDFBackground: Hansen’s disease still remains a significant public health problem worldwide, especially in developing countries like India. Patients suffering from Hansen’s disease can remain undiagnosed for a longtime, because of long incubation period, over dependence of clinical expertise and a lack of rapid and simple diagnostic tool. Cytology is an inexpensive, rapid and accurate procedure for diagnosis of skin lesions of Hansen’s disease.
Aims: The aim of this prospective study was to assess the usefulness of Cytopathology in early diagnosis of Hansen’s disease and to correlate the cytological smear findings with clinical and histopathological features.
Methods: The study is a hospital based prospective study carried out in the Department of Pathology and Department of Skin, VD, Leprosy, N.S.C.B. Medical College & Hospital, Jabalpur (M.P.) .Patients with new skin lesions were selected for the study. Fine needle aspiration cytology was performed and aspirates were evaluated for cytology and punch biopsy was collected.
Results: Out of 50 cases, most patients belonged to 20-40 yrs of age, of which 35 (70%) were males and 15 (30%) were females. Borderline Tuberculoid was the most frequent morphologic type seen in both sexes. The clinical and cytological correlation was seen in 88% tuberculoid leprosy, 93.7% of borderline tuberculoid, 33% of borderline lepromatous leprosy and 66% of lepromatous leprosy. While clinical with histopathological correlation revealed 100% specificity in tuberculoid leprosy, borderline tuberculoid and 100% in Histoid leprosy, 66.6% in borderline lepromatous, 83.3% in lepromatous leprosy and 80% in indeterminate leprosy in our study. Concordant results between cytology and histopathology was seen in majority of cases (84.8%) studied. The overall cytodiagnostic accuracy has been 92%.
Conclusion: Our study demonstrates that FNAC is a safe, simple, rapid, less-invasive, OPD procedure for early diagnosis and classification of leprosy in majority of cases
A rare complication seen in a child diagnosed with acute lymphoblastic leukemia: Isolated penile gangrene
Get PDFLeukemia is the most common cancer seen in children with acute lymphoblastic leukemia, accounting for 80% of all childhood leukemias and 24% of all cancers in children. The intensive chemotherapy regimen used in the treatment is often associated with a number of complications. Thromboembolic events in the form of coagulopathy and thrombosis have been reported in patients of acute leukemia undergoing chemotherapy. In the present study, we report the case of a 10-year-old boy with acute lymphoblastic leukemia (ALL) who developed dry gangrene of the penis while on chemotherapy. Dry gangrene of the penis is a rare complication, in view of the presence of extensive collateral circulation in the region. This presentation may be correlated to a rare thrombotic complication, associated with hypercoagulable status seen in leukemic patients undergoing chemotherapy
The adventures of ‘Ascaris lumbricoides’ - An intrepid traveller
Get PDFHepatobiliary ascariasis is an underestimated & unforeseen corollary of gastrointestinal ascariasis particularly common amongst the endemic populations. A high index of suspicion coupled with the increased use of ultrasonography & endoscopic procedures have unravelled this deviant sequel of helminth infestation. Conservative measures with meticulous sonographic surveillance remain the preferred first-line treatment for worms confined to the biliary ducts; with, endoscopic and surgical interventions being reserved for the persistently symptomatic or when complications ensue. Gall bladder ascariasis however mandates aggressive endoscopic/ surgical measures in most cases due to poor inherent response to pharmacotherapy alone. We hereby present the study of a 10 years old female child with the sonographic, MRCP, per-operative & histopathological correlates of hepatobiliary ascariasis. The bizarre eventuality of the worm migrating from the gastrointestinal tract and traversing across the intrahepatic ducts to ultimately lodge within the gall bladder (as demonstrated on consecutive scans & confirmed per-operatively ) , especially across narrow calibre childhood ducts is a singular affair and hence consigns exclusivity to our case