International Journal of Medical Research & Review (IJMRR)
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Alcohol Withdrawal Syndrome
Get PDFAlcohol withdrawal syndrome is a cluster of symptoms occurring when someone detoxes from alcohol. Alcohol dependence is one of the commonest psychiatric disorders, second only to major depression
Incidence and clinical profile of coronary artery disease in patients with rheumatic heart disease undergoing valvular intervention
Get PDFBackground: We aimed to determine the overall prevalence of coronary artery disease (CAD), atherosclerotic risk factors and clinical profile of patients with rheumatic heart disease (RHD) undergoing valvular interventions in Asian Indians.
Method: This was an all comers, observational, prospective study of 757 rheumatic patients, who underwent coronary angiography (CAG) prior to percutaneous balloon valvulotomy, surgical valvular repair or replacement from July 2011 to December 2013. Among them who had significant CAD (stenosis ≥50%) (Group A), were compared with similar number of age and sex matched patients of RHD without CAD (Group B).
Result: The overall prevalence of CAD in the patients undergoing valvular intervention was 9.1% (66.7% males, 33.3% female; mean age 55.20±8.6). The CAD incidence in patients with mitral, aortic and both valve replacement were 24.1%, 10.8% and 6.1% respectively. The prevalence of smoking habit (33.3% vs. 20.9%), diabetes (24.6% vs. 3.1%), hypertension (21.7% vs. 6.8%), postmenopausal status (65.2% vs. 18.4%), family history of CAD (17.4% vs. 8.3%) and aortic valve disease (10.1%) was significantly higher in group A as compared to group B except for obesity (11.5% vs. 18.7%).
Conclusion: Prevalence of CAD in patients with valvular heart disease in western population of Asian Indians is 9.1%. Coronary angiography should be performed in patients having CAD risk factors, irrespective of the valvular lesion involved
An analysis of ocular features and vision loss at presentation and after treatment in systemic lupus erythematosus in 60 patients
Get PDFIntroduction: Systemic lupus erythematosus (SLE) is a chronic, inflammatory, multisystem autoimmune disease and ocular involvement occurs in several forms. It may be the first indicator of underlying SLE. Early identification and precise treatment of the disease can reduce blindness. The objective of this study was to analyze the causes of visual loss before and during treatment.
Methods: This is a retrospective cohort study on 60 patients over 2 years in multispecialty, tertiary eye care hospital. Ophthalmic examination and routine and ancillary investigations were performed. Patients were followed up for at least one year to assess the progress of ocular features, their response to treatment and development of complications. Case records from a referral practice in patients with systemic lupus erythematosus, with diagnosis of dry eye, peripheral ulcerative keratitis, episcleritis, scleritis, uveitis, retinitis or optic neuropathy were analyzed.
Results: In our study, the incidence of episcleritis was most frequent followed by dry eye, retinopathy and keratitis. Age group affected was 34 to 52 years and more in women. Scleritis was associated with decreased vision and maximum complications. Following treatment, cataract was the commonest cause of blindness.
Conclusion: Our study showed the presence of simultaneous, multiple ocular complications which make treatment and follow up very crucial to avoid blindness. Ocular signs that occurs in SLE can be vision threatening and requires immediate assessment and management by an ophthalmologist. Drugs used to treat SLE may also cause blindness and coordinated treatment between rheumatologist, physician and ophthalmologist needs to be adopted
Maternal solubility test and high performance liquid chromatography of newborns in combination as a better neonatal screening protocol for sickle cell disease
Get PDFIntroduction: The incidence and prevalence of sickle cell disease in India is high and they are major health problem in India. Neonatal detection and prophylactic management can reduce morbidity and mortality in childhood. A study is therefore planned for analyzing maternal solubility test and HPLC of newborn as effective screening protocol.
Material and Method: The infants born of solubility positive mothers were taken for hemoglobin analysis using Biorad Hemoglobin variant by high performance liquid chromatography (HPLC) at birth and the test was repeated at six months of age. Data were analyzed using appropriate statistical method.
Results: A total of 100 mothers were positive on solubility test, their infants underwent Hb analysis by high performance liquid chromatography. 74 infants shows normal hemoglobin variants while 19 were heterozygous for Hbs (sickle cell trait) and 7 babies were homozygous for HbS at birth. On follow up at 6 month of age cases were reanalyzed by HPLC , 12 cases were lost in follow up, 7 cases who were heterozygous for sickle cell turned out to be homozygous for sickle cell, and of those with normal reports 7 cases were homozygous.
Conclusion: Maternal solubility test and HPLC of newborn at birth is good screening protocol for sickle cell anemi
Clinical profile of lung cancer in rural medical college of Maharashtra (India): a prospective study of three years
Get PDFAim: To Study the clinical, radiological & histological profile of lung cancer.
Meterial & Methods: 94 patients who presented with cough, haemoptysis, chest pain, breathelessness, and having radiological features consistant with bronchogenic carcinoma subjected to sputum cytology, bronchoscopy, CT thorax & FNAB depending on need.
Results : Highest incidence of lung malignancy was found in age group of 51-70 years (35.10%). Male :female ratio was 3:1. 54(57.44%) were smokers & 40 (42.55%) were non-smokers. Cough (88.33%), breathelesness (85%) and chest pain (48.33%) were the commonest presentation . Sputum cytology was positive in 8.33%. Endobronchial mass found in 40 (48.19%), vocal cord palsy in13(15.66%), trachial external compression in 8 (9.6%) ,widened carina in 19 (22.8%), bronchial external compression in 14(16.66%). BAL cytology was positive in 58.49% (31/53), brushing was positive in 60% ( 15/25) . Commenest presentation was lung mass (61.66%) on CXR and peripherial tumour 54 (57.45%) on CT. Adenocarcinoma was the commenst small cell carcinoma (48.33%), 50 (53.19 %) patients presented stage IV disease.
Conclusion: Associated risk factors, symptoms, and investigations like CT guided FNAC, BAL cytology are enormously important to diagnose lung cancer in early stage so that further mortality & morbidity can be minimized
Laparoscopic transabdominal preperitoneal versus open mesh lichtenstein repair of inguinal hernia: a comparative analysi
Get PDFBackground: Inguinal hernia repair is a commonly performed surgery usually managed by open surgical mesh repair. Nowadays many patients are demanding laparoscopic hernia repair. Laparoscopic hernioplasty has a shorter rehabilitation, but it is a technically difficult procedure. It is unclear if it has advantages over open tension-free mesh repair.
Methodology: This prospective study of 80 patients is done at Jawaharlal Nehru Medical College Hospital, A.M.U., Aligarh from January 2012 to November, 2014. 50 patients underwent Lichtenstein tension free mesh repair while on 30 patients TAPP was performed.
Results: Out of 80 patients 7 patients were lost to follow up at 2 weeks. 47 patients in Lichtenstein group and 26 patients in TAPP group were followed for 6 months. Average operation time was 39.3±16.4 minutes for the Lichtenstein group and 51.4±15.8 minutes for the TAPP group. Postoperatively, pain score was 6.5±3.5 in lichtenstein group as compared to 5.8±1.5 in TAPP group. Because of lesser postoperative pain, the TAPP patients got significantly fewer analgesics than the Lichtenstein patients (2.4 ± 1.0) versus (3.5 ± 1.3) doses. TAPP patients needed significantly fewer admission days than Lichtenstein patients (2.5±0.6 versus 1.8±0.5 days, respectively). TAPP patients returned to work earlier as compared to Lichtenstein group (11.7±4.9 days versus 14.8±4.2 days respectively). Short term and long complications were similar in both groups.
Conclusion: Laparoscopic hernioplasty (TAPP) is superior to Lichtenstein tension-free hernioplasty in terms of postoperative pain, hospital stay and return to daily activity
Central line associated Bloodstream Infections
Get PDFCatheter associated blood stream infections are common entity in ICU setting. Indeed it is having 1-13 % prevalence rate in various studies
Dengue serology–role of NS1 antigen: evaluation and future prospect
Get PDFIntroduction: According to the estimates, nearly 70% of the disease burden occurs in Asia and is on constant rise. Dengue virus infection has emerged as a major public health concern across the globe in terms of mortality, morbidity and public health cost.
Aims & Objectives: This study was undertaken to evaluate the significance of NS1 Ag detection in dengue IgM negative sera as marker for early detection and to compare the rapid detection test kits (RDT’s) with Enzyme linked immunosorbent assay (ELISA).
Material & Method: A total of 5283 samples from, were screened for dengue serology by Immunochromatography based lateral flow assay for presence of IgM and IgG anti Dengue antibody and NS 1 Ag. Results of 169 samples were further confirmed using ELISA technique for NS1 Ag in an attempt to compare RDT’s with ELISA.
Results: Out of 5283 samples screened, 146/5283 (2.76%) tested positive for dengue antibody, out of which 85/146(58.21%) were positive for DEN Ig M and 61/146(41.78%) showed presence of both IgG and IgM. Out of 5137 seronegative samples, 1930(37.57%) were positive for DEN NS1 Ag. Overall, sensitivity of RDT was 100.00%, specificity-90.16%, PPV- 94.73%, NPV-100.00 % and Efficiency of test -96.44%.
Conclusion: NS1 Ag assay holds promise as useful tool in early diagnosis for detecting dengue infection during acute phase of infection when IgM antibodies are not formed to the detectable levels. Also, accurate and affordable diagnostic tests are a crucial component of combating this debilitating mosquito-borne infection
A clinical study of the effects of cilnidipine and amlodipine in hypertensive patient focusing on pedal edema
Get PDFIntroduction: Many Calcium channel blocker drugs for control of hypertension are available. New drug Cilinidipine is available and approved for treatment of hypertension. It acts by blocking both L-type and N-type voltage-dependent calcium channels. The neural N-type blockade leads to stoppage of the secretion of norepinephrine and it also depresses sympathetic nervous system activity. The aim of the study is to assess the effect of cilnidipine and amlodipine on hypertensive patient.
Method: Clinidipine (n=50) and Amolodipine (n=50) were given once daily and BP was measured daily before and after the medicine in 100 hypertensive patients on OPD basis in GDMC, Dehradun.
Result: Only 4 patients (n=50; 8%) in cilnidipine group developed edema within 10 days of therapy, while 32 patients (n=50, 64%) developed with edema within 10 days of treatment in amlodipine group.
Conclusion: Cilnidipine is also associated with less incidences of pedal edema which is main complaint of patient. It controls BP better with less reflex tachycardia and decrease in morning surge
Correlation between lipid profile and myeloperoxidase levels in type-2 diabetes mellitus
Get PDFIntroduction: Diabetes mellitus is the most common endocrine disorder caused by absolute or relative deficiency of insulin. Chronic hyperglycemia and enhanced oxidative stress have been implicated in the pathogenesis of diabetic vascular complications. These patients are more prone to adverse cardiovascular events which occur due to the accelerated rate of atherosclerosis in diabetic patients. Myeloperoxidase apart from playing a major role in innate immunity has been implicated in the various stages of atherosclerosis namely initiation, progression and plaque rupture. The objective of the study was to estimate the plasma myeloperoxidase activity in type-2 diabetics and to establish a correlation between plasma myeloperoxidase activity and lipid profile and glycated haemoglobin (HbA1c) in the study population.
Methods: Plasma myeloperoxidase activity was estimated by spectrophotometric method using O-dianisidine dihydrochloride as substrate. Lipid profiles, HbA1c and blood sugar was analysed in an auto- analyser.
Results: There was a statistically significant increase in plasma myeloperoxidase activity in diabetic patients when compared with non-diabetic individuals (p<0.001). There is a significant positive correlation between plasma myeloperoxidase activity and serum triglyceride levels in the study population (p < 0.001).
Conclusion: Plasma MPO activity was significantly higher in the diabetic patients when compared with non-diabetic controls. There is significant positive correlation between MPO activity and serum triglyceride levels