International Journal of Medical Research & Review (IJMRR)
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Acute Febrile Illnesses – Clinico-epidemiological Pattern in a Remote Geographical Location of North-eastern India
Full text linkBackground: Acute undifferentiated febrile illness (AUFI / AFI) is a common cause for patients seeking hospital care in tropical country like India. Non-specificity of symptoms and lack of appropriate diagnostics pose challenge especially in resource limited settings. Investigation into etiology and trends of AUFI provide valuable public health data to target clinical workup and guide optimal treatment.
Method: A record based descriptive study was conducted on all AFI cases presenting to a Government tertiary care centre in a tribal hilly sate of Northeast India in the year 2021.
Result: Under five children were the most affected and respiratory infections were the most common cause of fever. Enteric fever and scrub typhus were the most common cause of undifferentiated fever. However, it was a remarkable finding that no case of malaria or dengue was reported from this region. Fevers remained undetermined in 28% of cases. Undetermined fevers and scrub typhus had higher occurrence during winters while no seasonality was observed with enteric fever. Majority of the patients recovered and discharged. Case fatality rate was 0.35%.
Conclusion: The local epidemiology of AUFI can help guide presumptive diagnosis and deliver optimal patient management in these settings. Typhoid and scrub typhus to be considered as differentials for AUFI in this region
The Effect Of Umbilical Cord Milking In Reducing ROP Of Preterm Babies.
Full text linkBackground: Recent advances in neonatal care in the last decade have improved the survival rates for premature infants. Consequently, the incidence of ROP has increased in parallel. ROP is under constant epidemiological study around the world. Prematurity, low birth weight, respiratory distress syndrome, mechanical ventilation, prolonged oxygen treatment and blood transfusion increase the risk of ROP. Umbilical cord milking reduces the incidence of ROP in preterm infants by reducing the need for blood transfusions in preterm infants. Objective: To observe effect of ROP with umbilical cord milking. Methodology: This prospective observational study was carried out on neonates, in the Department of Neonatology, BSMMU after approval from IRB. Neonates admitted into neonatal intensive care unit of BSMMU satisfying the inclusion and exclusion criteria was enrolled for the study. A written informed consent was taken from parents and assurance about confidentiality was given. Neonates born before 37 weeks of gestation was assigned to either umbilical cord milking or non-milking group at a 1: 1 ratio according to a computer generated randomized sequence. After delivery of a baby umbilical cord milking was performed by holding the infant at the level of the placenta. First eye evaluation for ROP was done at 20 days of age for gestational age less than 30weeks & weight below 1200gm & at 30 days of age for gestational age more than 30 weeks & above weight 1200gm. Follow-up was continued until retinal vascularization was completed. The follow-up schedules were organized depending on the retinal findings. The retinal finding was evaluated according to the International Classification of Retinopathy of Prematurity. The patients were grouped as no ROP, mild ROP (stages I-II ROP without plus disease, showed regression), and severe ROP (zone 1 or zone 2, stage III, aggressive ROP without stages, stage II with plus disease who required treatment). Data were recorded in a preformed questionnaire and data were analyzed by statistical package for social sciences (SPSS) version 20. Results: 114 newborns were enrolled in this study. Then among 114 preterm neonates 57 were randomized to umbilical cord milking group and 57 were randomized to no milking group. Baseline characteristics were almost similar between the two groups. There were significant increase is hematocrit level 57.3 ±3.5 V 47.4 ± 4.5 (P value less than 0.001), reduction in need of blood transfusion 3.5% V 42.1% (P value less than 0.001) & reduction in ROP 3.5% V 19.3% (P 0.007). Conclusion: This study concluded that umbilical cord milking after delivery improves hematocrit level, reduces need of blood transfusion & reduces the incidence of ROP in preterm infant
Pattern of Parental Handling in Children with Emotional and Behavioural Disorders - A Cross Sectional Study
Full text linkAbstract
The role of biological and social parents in shaping the mental and physical health of a child has been well-documented. Researchers over the years have developed typologies that categorize parental behaviour into prototypes and also examined their influence on the developmental outcome. Parenting styles are often considered a characteristic of the parent which is independent of the characteristics of the developing child while parenting behaviour is considered bidirectional and influenced by early childhood or infant behaviour. An overwhelming body of evidence indicates the close relationship between parenting and childhood behaviour, as well as on the effect of various modifying factors including physiology, parental mental health, cultural differences, ethinicity, and societal factors. Cross-cultural studies in the field have so far been limited largely to developed countries even as the subject is highly relevant to developing economies with their over-stretched mental healthcare systems. The objectives of this study is to determine patterns of parental handling in children with emotional and behavioural disorders consulting the child & adolescent psychiatry clinic in a tertiary care centre, and to determine the correlation of parental handling patterns to the child’s behavioural and emotional symptoms. The present study endeavours to determine the parenting pattern among parents of children utilizing psychiatric services at a tertiary care centre in Kerala, South India
A Study of patients with Pulmonary tuberculosis and its relationship with diabetes and outcome of treatment in this patient
No full textBackground: There is synergistic effect between diabetes mellitus and pulmonary tuberculosis. India has highest number of tuberculosis patient and India has also second highest number of patients with diabetes mellitus in world. The dual curse of these two diseases may have an impact on both side as outcome of treatment and poor glycaemic control. There were many studies have been done about relationship between diabetes and tuberculosis but still there is a large gap about its synergistic effect.
Methods: In this study we include164 patients with pulmonary tuberculosis with age more than 18 years 72 out of 164 patients are diabetic and 92 patients are nondiabetic. Demographic details, physical and clinical examination, Blood sugar fasting and post prandial, Hba1c, x-rays chest, sputum for AFB and CBNAAT test have been done all patients then ATT given to patients and appropriate antidiabetic treatment given to diabetic patients. follow up done on to all patients on 2nd month and 6th months.
Results: In this study commonest age group for tuberculosis infection is 45-54 but in diabetic patients common age group for tuberculosis infection is 55-64. Patients of diabetic and tuberculosis commonly having elevated Hba1c and relatively poor treatment outcome reflected by sputum conversion rate 77.7%, 16.7%has failed treatment and also diabetic patients has 3+ sputum positivity.
Conclusions: In patients with tuberculosis screening of diabetes may improve treatment outcome and prevent complications by appropriate management of diabetes and tuberculosis
Dr Namrata TRUE TALES OF TEN T-PLL OVER A DECADE
No full textBackground
T- prolymphocytic leukemia(T-PLL) ,are aggressive lymphoid malignancies with unique morphologic, cytogenetic, immunophenotypic, and molecular features. T-PLL is a mature T-cell leukemia typically presenting at stages of exponentially rising lymphocyte counts in peripheral blood,accompanied by splenomegaly and bone marrow involvement. They are extremely rare ,comprising of <2% of mature T –leukemias and inherently aggressive and notoriously refractory to therapeutics.Extensive search for Indian literature on T-PLL and Immunophenotypic characterization of this entity did not yield any results. We analysed the characteristics, prognostic factors, outcomes and treatments of 10 patients with T-PLL . To our knowledge this is the largest series of T-PLL from India , this study reviews clinical, cytogentic and flow cytometric immunophenotyping findings, and differential diagnosis of patients with T-cell prolymphocytic leukemia from January 2012 to January 2022.Methods: Our laboratory received 4500 clinically suspected chronic leukemias, during a period of 10 years ,at kidwai memorial institute of oncology ,which is state cancer institute , where diagnostic flow cytometric analysis was done and leukemias were classified based on WHO 2008 criterias. Results: out of 4500 cases of Chronic lympho proliferative disorders sent for flow cytometric immunophenotyping, only 10 cases were diagnosed as T-PLL .Study period January 2012 to January 2022.Conclusions: Evaluation of immunophenotype of this rare entity by flow cytometry is a critical part of diagnosis and is a indespensible tool in distinguishing T-PLL from other mature T-cell lymphoid neoplasms.Awareness of this rare entity aids in work up
PERCEIVED SOCIAL SUPPORT AMONG ELDERLY INDIVIDUALS RESIDING IN URBAN BENGALURU: A CROSS-SECTIONAL STUDY: SOCIAL SUPPORT AMONG ELDERLY
Full text linkIntroduction
Increase in life expectancy results in an increasing elderly population which contributes to 9.3% of global population. With epidemiological transition of diseases, the burden of chronic morbidity conditions will also increase with an effect on Quality of life, which demands social support especially among elderly individuals. Hence the present study was taken up to assess social support among elderly individuals residing in urban field practice area of Bangalore Medical College & Research Institute (BMCRI), Bengaluru.
Objective: To assess the perceived social support among elderly population residing in the urban field practice area of BMCRI
Methodology:
A cross sectional study was conducted to assess the perceived social support among 100 elderly population residing in the urban field practice area of BMCRI. Simple random sampling technique was used. Data was collected using validated Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire along with socio-demographic factors.
Results: In this study, the mean age of the elderly individuals was 67.0 + 5.90 years, total social support score was 59.2 + 17.97. Perceived social support was found to be statistically significant found between characteristics gender, educational status, marital status, earning status, marital status, earning status, support obtained for medication and previous hospitalization. (p<0.05
Sonal Appliance an innovative space maintainer in management of early loss of first permanent molar: A Rare Case Report
Full text linkIntroduction: In preventative and interventional dentistry, keeping deciduous teeth until their natural exfoliation is critical. An early tooth or group of teeth loss might have a variety of effects. The first molar is the largest tooth in the mouth, it carries the most occlusal stress, and it affects the vertical distance between the mandible and the maxilla. Adolescent patients who have lost a permanent first molar (PFM) require early space maintenance. Case report: In this case report a successful use of modified distal shoe appliance was made in a patient whose 1st permanent molar was lost before the eruption of 2nd permanent molar. In circumstances when the permanent first molar is lost before the emergence of the permanent mandibular second molar, a unique device is described in this publication. The distal extension of a normal distal shoe appliance was extended distally along with a fixed bilateral appliance, a modified band and loop, and other components in this design. Conclusion: For individuals with bilateral molar loss, a modified distal shoe appliance is a promising option
Prevalence of Major Depressive Disorder among Mothers of Children and Adolescents with Attention Deficit Hyperactivity Disorder Attending a Tertiary Care Centre
Full text linkAbstract
Introduction : Attention deficit hyperactivity disorder (ADHD) accounts for the majority of referrals to child and adolescent psychiatry services because of the associated poor scholastic performance. Despite the possibility of depressive symptoms in caregivers, there is a paucity of studies on major depressive disorder among mothers of children and adolescents with ADHD in our setting
Objectives : Assessing the prevalence of major depressive disorder and the association of sociodemographic and clinical variables among mothers of children & adolescents with ADHD attending a tertiary care centre.
Studying the correlation between the severity of ADHD and maternal depression.
Methods: Cross-sectional study on 150 mothers of children and adolescents aged 5-18 years with ADHD attending the Child and Adolescent Psychiatry Clinic of the Govt. Medical College, Thiruvananthapuram.
Results : The prevalence of Major Depressive Disorder among mothers belonging to the age group of 30‒39 years was found to be 20%. Across age groups, 28.7% of the subjects had minimal depressive symptoms, while 10% each had mild and moderate symptoms. We found a positive correlation between the severity of maternal depression and the child’s ADHD. The association of major depressive disorder with medical comorbidities and having another offspring with ADHD was statistically significant.
Conclusion: Owing to the statistically high prevalence of depressive disorders, routine screening for the depressive symptoms has to be considered for mothers when the children are diagnosed with ADHD, with the provision for appropriate intervention.
Keywords: Attention Deficit Hyperactivity Disorder; Major Depressive Disorder, Scholastic performance, Sociodemographic and clinical variables,
 
Randomized, Standard Controlled Study Evaluating the Efficacy and Safety of Habb-e-Waja‘al-Mafāṣil in Managing Cervical Spondylosis
Full text linkBackground and Objectives
Cervical Spondylosis is a degenerative disease of intervertebral discs and adjacent vertebral bodies of the cervical region due to wear and tear changes. Neck pain, with radiculopathy, and stiffness comprises the prime features of cervical spondylosis demanding the immediate attention and respite. Despite the advancement in pharmacological, nonpharmacological and surgical interventions, the management remains unsatisfactory due to high cost, adverse effects and unusual eventualities. Hence a clinical trial was done to evaluate the efficacy of herbal formulation, Habb-e-Waja‘al-Mafāṣil (HWM), in managing cervical spondylosis (Waja‘al-‘Unuq).
Methods
The study is an open-labeled, randomized and standard controlled trial. Sixty diagnosed patients of age group 20 to 70 years were randomly allocated, using a computer generated chart, in test group (n=30) receiving HWM (3gm), and the control group (n=30) receiving ibuprofen 1200mg/day, orally in divided doses. The severity score of clinical symptoms and signs; pain, stiffness, swelling, restriction of movement and radiological findings were analyzed at baseline and at 30 days.
Results
Both HWM and ibuprofen significantly reduced the severity score of pain, stiffness, swelling, and restriction of movement (p=<0.001) associated with cervical spondylosis after completion of treatment protocol. However, no change was observed in radiological findings in either group (p=1). Comparison to control group no significant result was noticed in test group statistically (p=>0.05), except for “restriction of movement” (p=<0.05).
Conclusion
The herbal formulation, HWM, is equally effective to conventional treatment in managing cervical spondylosis. Therefore, HWM can be prescribed as safe and cost effective alternative treatment for cervical spondylosis
Effectiveness of an information booklet on Prevention and early detection of cervical cancer in terms of knowledge among female school teachers in selected secondary schools in Mairang Town, Meghalaya State
Full text linkIntroduction: A pre-experimental study was undertaken with one group pretest posttest design to find the effectiveness of Information booklet on knowledge of female school teachers regarding prevention and early detection of cervical cancer in selected secondary schools, Mairang Town, Meghalaya State. Objectives: The main objectives of the study were to assess the knowledge of female school teachers on prevention and early detection of cervical cancer before and after administering the information booklet and to evaluate the effectiveness of information booklet on prevention and early detection of cervical cancer in terms of gain in knowledge. Material and Methods: The conceptual frame work adopted for the study was based on Health Belief Model. The sample size is 30, non-probability purposive sampling is the sampling technique adopted. The data was collected by using the structured knowledge questionnaire. Result: The findings of the study revealed that the mean posttest knowledge scores (23.17) of the teachers was higher than the pretest knowledge scores (12.83). The obtained mean difference was found to be statistically significant at 0.05 level of significance, as evident from calculated ‘t’(29)= 20.09, there by indicating the effectiveness of the information booklet regarding prevention and early detection of cervical cancer. Conclusion : The information Booklet on prevention and early detection of cervical cancer was effective for increasing the knowledg