Student's Journal of Health Research Africa
Not a member yet
1618 research outputs found
Sort by
A Retrospective Study on Peripartum cardiomyopathy, Recent Trends and disease profile, study at tertiary centre of Bihar
Get PDFBackground: Peripartum Cardiomyopathy (PPCM) is a rare but serious cardiovascular condition that affects women in the peripartum period. The aim of this study is to comprehensively investigate the recent trends and disease profile of PPCM among patients at a tertiary center in Bihar.
Methods: A retrospective study was conducted which included 50 female participants who met specific inclusion criteria, such as being aged 18 years or older, having a confirmed PPCM diagnosis, and having complete medical records available for analysis. Data collection encompassed demographic information, clinical presentation, diagnostic criteria, echocardiographic findings, laboratory results, and treatment modalities employed. Statistical analysis involved descriptive statistics, categorical and continuous variable presentations, and the use of SPSS ver. 18 for data analysis.
Results: The mean age at PPCM diagnosis was 32.5 years, with 60% being parous and 40% nulliparous. Clinical symptoms included dyspnea (84%), fatigue (76%), and edema (70%). Echocardiographic findings revealed compromised cardiac function, with a mean LVEF of 35%. Laboratory results demonstrated elevated BNP and troponin levels. Treatment approaches were diverse, including medications, interventions, and lifestyle modifications. Complications included arrhythmias (20%), thromboembolic events (10%), and cardiogenic shock (14%). The overall survival rate was 84%, with a mortality rate of 16%.
Conclusion: The study provides valuable insights into the clinical profile, diagnosis, treatment, and outcomes of PPCM in a retrospective cohort. The findings highlight the complex nature of PPCM and the importance of early recognition and comprehensive management strategies in improving patient outcomes. Further research and awareness efforts are needed to enhance the understanding and management of this challenging condition.
Recommendations: Medical practitioners should be educated about PPCM to aid early diagnosis. Obstetricians, cardiologists, and other professionals collaborate for multidisciplinary treatment. Frequent cardiac monitoring for high-risk pregnant and postpartum women. More research on risk factors and innovative PPCM treatments
A CROSS-SECTIONAL STUDY ON WORK RELATED OCULAR INJURIES FROM A TERTIARY CARE TEACHING HOSPITAL OF CENTRAL INDIA.
Get PDFBackground
Work-related eye injuries are more common and severe in developing nations such as India due to the lack of emphasis on occupational health and workplace safety. Literature has revealed that work-related eye injuries make up 22% of all ocular trauma cases in their study on ocular trauma. Therefore this investigation was conducted to study epidemiological aspects of work-related eye injuries.
Method
The hospital-based observational study was conducted on 362 individuals seeking treatment for work-related ocular injuries at the ophthalmology department of a tertiary care teaching hospital in Shahdol town, Madhya Pradesh. All the patients received a thorough clinical assessment at the ophthalmology department after capturing the relevant baseline information.
Results
Of the total 362 subjects, the gender-wise majority (n=331, 91.4%) were males. Most (n=224, 61.8%) of ocular injuries were observed in the younger age group (20 to 30 years). A history of previous ocular injury was noted in 7.7% (n=28). Most (n=188, 51.9%) were reported from welding work followed by grinding work (n=54, 14.9%) as the second most common. Corneal foreign bodies were noted among 47 (13%) study subjects. Just removing protective gear with no reason (n=18, 38.3%), removing protective gear due to sweating (n=12, 25.5%) & protective gear being uncomfortable (n=10, 21.3%) were the three most common reasons cited for not using protective gears for eyes.
Conclusion
The study offers an understanding of the epidemiological features of work-related ocular injuries in central India. Many of these injuries can be avoided by using suitable eye protection and receiving safety training.
Recommendations
An individualized intervention program for workers with eye injuries should be implemented due to their high susceptibility to recurring injuries.
IMPACT OF OTHER MEDICAL CONDITIONS ON PAIN AND FUNCTIONALITY FOLLOWING TOTAL HIP ARTHROPLASTY: A PROSPECTIVE COHORT STUDY.
Get PDFBackground
Total hip arthroplasty is the procedure carried out for patients suffering from arthritis. Arthritis is a painful bone inflammation that severely affects the functional ability of the hip bone. Total hip arthroplasty helps in reduction of the painful inflammation and it also helps in restoring the functional ability of the hip bone
Method
This was a prospective study including individuals who underwent total hip arthroplasty at Rajendra Institute of Medical Sciences, Ranchi. The 30 patients participating in the study underwent the total hip arthroplasty. Patients were asked to follow up after 3 months, 6 months, 12 months, and 24 months of the surgery. Preoperatively, after the surgery and during the follow-up the hip bone was assessed using WOMAC score survey form 36.
Results
Comorbidities increased with age, affecting postoperative outcomes. Higher CCI values led to poorer functional improvements and more complications, sometimes necessitating conservative measures. Older patients and those with higher CCIs had higher complication rates and readmissions. CCI rose with age, from 0.29 for patients <40 to 5.42 for those >70. Significant improvements in WOMAC and SF-36 scores were seen at the third-month follow-up, but higher CCI patients declined after six months. Patients with CCI >3 had three surgical complications, while CCI 2 patients had two complications related to infection. No complications occurred in patients with CCI 0 and 1, but one patient with a higher CCI died.
Conclusion
From this study, it was found that the occurrence of comorbidity after the THA significantly decreased patient satisfaction. Also, the higher preoperative CCI resulted in the occurrence of comorbidity, delayed improvement, decreased recovery, increased rate of readmission, and decreased satisfaction of the patient.
Recommendation
This association can guide clinicians in taking appropriate steps to intervene in the occurrence of comorbidities and treatment of the comorbidities to improve patient satisfaction
A RETROSPECTIVE EVALUATION OF TREATMENT STRATEGIES FOR UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURES IN THE ELDERLY: COMPARING PROXIMAL FEMORAL NAIL ANTI-ROTATION VERSUS PRIMARY HIP HEMIARTHROPLASTY.
Get PDFObjectives
The present investigation aims to contrast the outcomes of proximal femoral nail anti-rotation (PFNA) and primary hemiarthroplasty for treating unstable intertrochanteric femoral fractures in geriatric patients, focusing on functional outcomes, complication rates, and postoperative rehabilitation protocols.
Methods
The retrospective study, conducted at Pt. JLN Govt. Medical College, Chamba, Himachal Pradesh, contrasted the outcomes of proximal femoral nail anti-rotation (PFNA) and cemented hemiarthroplasty for unstable intertrochanteric femoral fractures (IFFs). Patients with American Society of Anesthesiologists (ASA) Grades II and III, aged over 65 years, in addition to having AO types A2 and A3 fractures were included in this study. Surgical procedures involved PFNA device insertion or hemiarthroplasty, followed by standardized post-operative protocols.
Results
The comparative analysis between the PFNA group (n = 50) and the Primary Hemiarthroplasty of the Hip (PHH) group (n = 43) revealed significant differences in treatment outcomes. Notably, the PFNA group exhibited a higher Harris Hip score at the 12-month follow-up (90.26 vs. 82.4, p = 0.016), with a larger proportion achieving excellent outcomes (36 vs. 23). Moreover, secondary outcomes, including surgical time, intra-operative blood loss, post-operative hemoglobin levels, and duration of hospital stay, favored the PFNA group, showing statistically significant differences (p < 0.00001, except for perioperative blood transfusions, p = 0.00536).
Conclusion
The findings of the investigation implied that PFNA fixation gives rise to superior clinical outcomes when compared to PHH for unstable intertrochanteric femoral fractures. This has been proven by the identification of better functional scores and reduced post-operative complications in the case of patients treated with PFNA.
Recommendation
The study recommends prioritizing PFNA fixation over primary hemiarthroplasty for unstable intertrochanteric femoral fractures based on superior functional outcomes and fewer post-operative complications
AN INVESTIGATION INTO KRUKENBERG'S TUMOUR AT A TERTIARY REFERRAL CENTRE: A COHORT STUDY.
Get PDFObjectives
This study aims to distinguish women having Krukenberg cancer and confirm the significance of non-curative surgery
Methods
In this retrospective study, 107 patients with Krukenberg cancer as well as ovarian tumors were chosen from hospital records. The radiological studies were carried out by means of pre-operative abdominal/pelvic CT scans. The radiology results after evaluation by a diagnostic radiologist provided details on the size of the tumor, its metastases, the involvement of lymph nodes, and ascites extracted. Additionally, CT images were processed and standardized for analysis, including tumor segmentation and image resizing.
Results
The study included 107 patients diagnosed with Krukenberg tumors (n=58) or ovarian tumors (n=49), with 72.5% diagnosed at stage IV, highlighting advanced disease. Surgical resection was performed in 73.3% of patients, emphasizing its importance in management. Metachronous tumors occurred in 54.2% of patients, indicating metastasis of the ovarian tumor post-primary tumor diagnosis. Treatment responses varied, with 38.5% responding to systemic therapy, while 70.7 % experienced disease progression. Additionally, age and elevated CA125 levels (OR: 2.49; 95% CI: 1.50–5.43; p < 0.001; OR: 1.61; 95% CI: 1.37–2.60; p = 0.005) showed significant associations with Krukenberg tumors in multivariable analysis.
Conclusion
The study underscores the significance of surgical resection and highlights the diagnostic value of CA125 levels in managing Krukenberg tumors.
Recommendation
The study recommends further investigation into the utility of CA125 levels as a diagnostic marker and emphasizes the importance of timely surgical intervention in the management of Krukenberg tumors
POSITIVE CORRELATION OF CRP, FOLIC ACID, AND D-DIMER WITH PROGRESSION OF CKD STAGING: A CROSS-SECTIONAL STUDY.
Get PDFBackground
Chronic kidney disease (CKD) is characterized by kidney damage or a decline in glomerular filtration rate (GFR) over three months, often leading to various complications and stages of severity. Biomarkers such as C-reactive protein (CRP), D-dimer, and folic acid have been implicated in CKD progression, yet their correlation across different CKD stages remains to be fully elucidated. The study aims to do a comparative study of D-dimer, CRP, and Folic acid in different stages of chronic kidney disease.
Methods
The study employed a cross-sectional design. Serum samples from 150 CKD patients were collected and analyzed for CRP, D-dimer, and folic acid levels using standard laboratory procedures. Statistical analysis was performed using SPSS software and Microsoft Excel to assess the significance of biomarker variations across CKD stages.
Results
Serum CRP, D-dimer, and folic acid levels showed significant variances across CKD stages, displaying lower CRP and higher folic acid in CKD stage 1, and elevated D-dimer in later stages. Monitoring these biomarkers is pivotal for gauging CKD progression and severity, notably highlighting the rise in CRP and D-dimer with advancing CKD stages, and the higher folic acid levels seen in earlier CKD stages.
Conclusion
The study underscores the importance of monitoring biomarker levels in CKD progression, with CRP and D-dimer serving as potential indicators of disease severity. Additionally, the observed inverse relationship between folic acid levels and CKD staging warrants further investigation into its potential protective role against CKD progression.
Recommendations
Clinicians should consider incorporating regular assessment of CRP, D-dimer, and folic acid levels into CKD management protocols to better understand disease progression and tailor treatment strategies accordingly
A STUDY ON THE EFFECTIVENESS OF TRANSVAGINAL SONOGRAPHY AND COLOR DOPPLER IN THE ASSESSMENT OF ENDOMETRIUM IN SUBFERTILE WOMEN COMING TO A TERTIARY CARE HOSPITAL.
Get PDFBackground
Ultrasonography (USG) is a very important imaging modality for the diagnosis, treatment, and monitoring of subfertility. Grayscale USG provides structural information about the pelvic organs and color Doppler USG provides functional information along with its vascularity. Adequate blood flow via the uterine arteries and good endometrial perfusion plays a very important role in endometrial receptivity.
Objectives
The aim and objective of this study is to assess the mid-luteal phase endometrial spiral artery blood flow by TVS including Doppler, in women coming for the treatment of subfertility to a tertiary care hospital.
Results
Out of 50 patients, primary subfertility comprised 36 individuals while 14 were categorized under secondary subfertility. Most of the patients belonged to the age group of 20-30 years. Of the total number of females 56% conceived, among them 46.43% of patients conceived naturally, followed by IUI (32.14%) and then IVF (21.43%). In our study, 58% of patients presented with an endometrial thickness of over 7 mm, out of which 93.1% conceived successfully. The mean peak systolic velocity in conceived women was 13.18 ± 3.62 cm/s which was higher as compared to 11.55 ± 3.47 cm/s in non-conception menstrual cycles. Similarly, the EDV, Tmax, and Tmin were significantly higher as compared to the not-conceived group. 96.3% of the women who conceived had a lower pulsatility index (< 2.5). The best cut-off value of the resistive index was less than 0.9 for predicting conception status.
Conclusion
The combination of endometrial thickness and Doppler examination of endometrial and sub-endometrial blood flow can be used as a quick and efficient way to enhance the success of assisted reproductive techniques.
Recommendation
Due to rapid advancement in Doppler technology, it is highly recommended to perform transvaginal USG including Doppler for assessment of Doppler indices mid-luteal phase in subfertile women coming for treatment.
EXPLORING THE CORRELATION OF FASTING BLOOD GLUCOSE, SERUM UREA, SERUM CREATININE, AND DIABETES DURATION IN TYPE 2 DIABETIC PATIENTS: A CROSS-SECTIONAL STUDY
Get PDFBackground
The relationship between fasting blood glucose (FBG), serum creatinine, serum urea, and the course of diabetes provides crucial insights into the management and progression of type 2 diabetes (T2DM). The study compared the clinical and biochemical characteristics of individuals with T2DM to those of age- and sex-matched healthy controls.
Methods
Two groups of seventy people were created: thirty-five with a diagnosis of T2DM and thirty-five age- and sex-matched healthy controls. Using conventional laboratory techniques, blood samples were taken to test the levels of serum creatinine, urea, and fasting blood glucose. A significance level of P < 0.05 was applied when performing statistical analysis using the software SPSS-16.
Results
The mean age of participants was 50 years, with a standard deviation of 8.2 years. The T2DM group had a substantially higher mean fasting blood glucose level (154.7 ± 33.6 mg/dl) than the control group (92.3 ± 10.5 mg/dl) (p < 0.001). Additionally, the T2DM group had higher serum urea levels (32.5 ± 8.1 mg/dl) than the control group (21.6 ± 4.2 mg/dl) (p < 0.01). Comparably, the T2DM group had higher blood creatinine levels (1.2 ± 0.3 mg/dl) than the control group (0.9 ± 0.2 mg/dl) (p < 0.05).
Conclusion
The study found significant correlations between elevated serum urea, FBG, and serum creatinine levels with the course of diabetes in T2DM patients. These markers are indicative of poor glycemic control and renal impairment, highlighting the importance of regular monitoring and early intervention to prevent complications.
Recommendations
Early detection and management of diabetic nephropathy requires regular screening of FBG, serum urea, and serum creatinine in T2DM patients. Intensive glycemic control can enhance patient outcomes and minimize diabetes-related kidney damage
FLUORESCENCE IN SITU HYBRIDIZATION TO DETERMINE THE GENOMIC CHANGES IN CHROMOSOME 17 AND P53 GENE IN ORAL LEUKOPLAKIA PATIENT IN INDIAN POPULATION: A CROSS-SECTIONAL STUDY.
Get PDFIntroduction
Oral cancer, especially squamous cell type, is common, with 274,000 instances annually. The risk of oral cancer from leukoplakia, a white patch at least 5 mm in size, has been extensively investigated. Globally, leukoplakia prevalence ranges from 2.6% to 4.1%. It usually develops after 30, peaks over 50, and is associated to tobacco, alcohol, and betel quid use. Leukoplakia-related chromosomal abnormalities can be revealed by Fluorescence in situ hybridization (FISH).
Objective
The goal of research is to clarify the genetic mechanisms behind the development of leukoplakia by examining p53 gene changes and numerical aberrations in chromosome 17 in Indian populations.
Material and methods
In this cross-sectional study, FISH was used to diagnose 50 cases of Oral leukoplakia (OLP), utilizing the " Locus Specific Identifier (LSI) TP53/Centromere Enumeration Probe (CEP) 17 FISH Probe Kit " to determine the copy number for CEP 17 (green) at the centromere of chromosome 17 and LSI TP53 (orange) at chromosome 17p13.1.
Results
Three of the fifty cases in the analysis show molecular change. In roughly 4% of instances, p53 gene amplification and chromosome 17 polysomy were present, while 2% of cases only had p53 gene deletion. In the investigation, grade 3 and grade 4 oral leukoplakia showed all aberrations, and the highest 18 subjects (n=18) out of 50 individuals (36%) had a tobacco and/or smoking addiction.
Conclusion
The research illuminates molecular abnormalities in “chromosome 17” and the “p53” gene in Indian OLP patients. The study helps bridge research and clinical practice to improve oral leukoplakia genetic diagnosis and management. This will enhance patient outcomes by preventing such events.
Recommendations
Implement routine screening for genetic alterations in chromosome 17 and the p53 gene in patients with oral leukoplakia to enhance early detection and targeted intervention strategies
PREMATURE GRAYING OF HAIRS IN PATIENTS OF SCHIZOPHRENIA SPECTRUM DISORDER, AN INCIDENTAL FINDING OR SOME ASSOCIATION BETWEEN THESE TWO ENTITIES: A CASE SERIES.
Get PDFIntroduction:
Healthy hair is a sign of general well-being and youth. This case series addresses the unique occurrence of premature graying of hair (PGH) in patients diagnosed with schizophrenia spectrum disorder. PGH is perceived as a prominent sign of aging, driven by oxidative stress, which may indicate underlying systemic oxidative stress and be associated with various progressive systemic illnesses, including neuropsychiatric disorders.
Case Presentation:
In this case series, 14 young individuals (aged 18-25 years) exhibited heterogeneous behavioral symptoms suggestive of schizophrenia spectrum disorder alongside premature graying of hair. Behavioral symptoms included social withdrawal, unprovoked anger outbursts, auditory hallucinations, and significant socio-occupational dysfunction. Additionally, some cases had a family history of psychotic disorders or past medical conditions such as seizure disorders.
Result:
Patients were diagnosed with schizophrenia spectrum disorder by a dermatologist after excluding other cutaneous and systemic causes of graying. Behavioral changes varied in duration but commonly led to socio-occupational dysfunction, prompting medical attention. The onset of PGH ranged from simultaneous to before or after the behavioral disturbances, suggesting a possible timeline of progression linked to oxidative stress.
Conclusion:
Oxidative stress appears to be a common factor in both schizophrenia spectrum disorder and premature graying of hair, potentially serving as an early indicator of schizophrenia. Early intervention targeting oxidative stress and inflammatory markers, along with current therapeutic measures, may improve prognosis. Premature graying of hair could be considered a red flag for future schizophrenia transition, warranting further research to validate this association and explore preventive measures