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A Clinical Study of Newly Diagnosed HIV Patients at ICTC Center in Shri B M Patil Medical College, Bijapur with Correlation to CD4 + at Presentation
Get PDFBackground: WHO estimates that with continued escalation of HIV transmission, nearly 9 million HIV-infected people will reside in South-East Asia by the turn of the century. In India, two new infections occur every minute. National Aids Control Organization (NACO) estimates that by year 2025 the majority of new HIV infections in the world will occur in Asia and India will probably have the largest number of infected persons of any single country. The objectives is to study the baseline values of CD+ count in newly diagnosed to be infected with Human Immunodeficiency Virus (HIV). SubjectsandMethods: The present cross sectional study was conducted at Shri B M Patil Medical College and Hospital, Bijapur form March 2017 to April 2018. A total of 100 newly Diagnosed HIV Patients of all Age Group either asymptomatic or presenting with one or other opportunity infections are included in the study. Results: 39% of them were in the age group of 35-45 years. Cough fever and weight loss were the most common clinical presentation on admission. The most common opportunistic infection at presentation was Pulmonary Tuberculosis (74%). followed by Candidiasis (62%). Among the population studied, majority were in the 35-45 yr. age group (39) out of which 25 individuals had a CD 4 count of< 200 cells/3. In the patients with CD 4 Count less than 200 cell extra pulmonary tuberculosis was most common. Candidiasis was also seen in the patients with CD4 count less than 200 cell/l. Conclusion: The most common route of transmission was the sexual route, predominantly heterosexual route.. The patients being diagnosed with HIV infection present with one or more of the opportunistic infections and frequently have a CD 4+ count < 200 cells/l. This calls for increasing awareness about HIV in the general population so as to identify the disease at the earliest. 
Analysis of Hypocalcemia in Dengue and Correlation of Serum Calcium Levels with Severity of Dengue Disease
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Background: Hypocalcemia has been demonstrated in various tropical diseases, such as leptospirosis, malaria, including dengue. Calcium is believed to play a major role in the immune response in dengue. It has been proposed that the derangements of Calcium levels in the infected myocardial cells may play a major role in development of myocarditis. This study aims to correlate the serum calcium levels with severity of dengue and bradycardia. Subjects and Methods: This study was conducted on 100 dengue positive patients, above the age of 18 years, presenting to BMCRI, after obtaining informed consent. Dengue test kit was used for diagnosis which is based on rapid solid phase immunochromatographic test. Physical examination and routine investigations along with serum calcium levels were done and assessed. Radiological imaging was done wherever necessary. They were grouped into one of the three WHO categories based on severity and were correlated with serum calcium levels. Results: Out of 100 patients 65 patients had uncomplicated dengue fever while 30 had dengue fever with warning symptoms and 5 has severe dengue/ dengue shock syndrome. Chi-square test showed statistical significant association between severity of dengue and hypocalcemia. (χ2= 94.08; p=0.00). Statistical analysis revealed significant association between serum calcium levels and pulse rate (χ2= 16.01; p=0.00). Conclusion: Our study and several other studies showed that the presence of hypocalcemia correlates with the severity of Dengue illness and could be considered as one of the predictors of poor outcome. However, further studies are required in these lines that are aimed at understanding if the presence of hypocalcemia can be utilized as a prognostic indicator in dengue infection. The potential role of calcium as a treatment option, to modulate the immune system, in patients with dengue is to be explored. 
RDW as a Marker of Treatment Response in Primary Adult Nephrotic Syndrome
No full textBackground: Nephrotic syndrome has an incidence of three new cases per 100 000 each year in adults. Despite considerable advances in health care, glomerular disease constitutes one of the leading causes of renal failure resulting in considerable morbidity and mortality. In India, the histological type varies according to the demographic location, and treatment regime depends on the type of nephrotic syndrome. RDW is an inexpensive blood test and there are several studies that show a close relationship between RDW values and inflammatory activity. Our aim in this study is to test the predictive value of RDW in determining treatment response to therapy in adult nephrotic syndrome. Subjects and Methods: Newly diagnosed primary adult nephrotic syndrome patients admitted to Victoria hospital and hospitals attached to Bangalore Medical College and Research institute (BMCRI), between May 2018 to September 2020 were chosen for the study. The patients were recruited as per inclusion criteria and demographic profile, medical history, comorbidities, detailed physical examination and lab investigation such as serum creatinine, and 24 hour urine protein were recorded in the study performa . Patients who have nephrotic range proteinuria (> 3.5 gm/24 hrs) with sonographically normal sized kidneys were subjected to renal biopsy to identify the etiopathology. Following this appropriate treatment was iniated and the patients were followed up for the duration of the study. Results: Our study included 39 patients with nephrotic syndrome were treated in hospitals attached to BMCRI. Of these patients, males constituted 61.5% and females 38.5%. 53.8% of cases occurred in third decade of life. The commonest presenting symptom among these patients was pedal edema. MGN was the most common histological variant followed by IgA nephropathy and MCGN. Mean RDW values among those who were resistant to treatment was 18.58+/- 0.62 and 13.23+/- 0.74 among those who responded to treatment. Difference in RDW between the two groups was found to be statistically significant showing that high RDW values may be associated with poor treatment response. Conclusion: In our study high RDW values were found to be associated with high rates of treatment resistance. These findings suggest that RDW may be used as a useful biomarker to predict treatment response in nephrotic syndrome patients. 
Ischemia Modified Albumin in Early Diagnosis of Acute Coronary Syndromes
No full textBackground: Acute coronary syndromes (ACS) pose a diagnostic challenge in patients with unpredictable baseline ECGs or without evidence of myocardial necrosis. Its early diagnosis is of utmost importance as ACS has a high mortality. The present study was conducted to know the role of Ischemia Modified Albumin (IMA) as a Cardiac Marker in the early Diagnosis of ACS. Subjects and Methods: A cross-sectional study was conducted in 86 patients presenting with chest pain of less than 3hours. A 12-lead ECG was recorded, and a blood sample was taken for IMA and cardiac troponin T(cTnT). Results of all the parameters alone and in combination, were correlated with the final hospital diagnosis and analysed. Results: IMA was found to be abnormal among 72.1% of the patients. IMA had a sensitivity of 81.58% and a specificity of 83.33% which was found to be high when compared with other parameters. The combination of IMA, ECG, 2D ECHO, cTnT, and CKMB had a sensitivity of 100% and a specificity of 16.67%. Conclusion: The present study showed that IMA is a potential diagnostic biomarker for ACS. Further studies are required to support the present findings. 
A Cross-Sectional Study on Glaucoma Awareness and Knowledge among Spectacle Users and Non Users in an Ophthalmology Outpatient Setting in Kerala
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Glaucoma remains a leading cause of irreversible blindness globally. While general population awareness studies exist, few have analysed the influence of prior interaction with eye care services through spectacle correction. Spectacle users theoretically have greater exposure to eye health education
Objectives
To compare the awareness and knowledge levels regarding glaucoma between spectacle users and non-spectacle users attending a tertiary care centre.
Methods
A hospital-based cross-sectional study was conducted from January 2021 to June 2021 in the Ophthalmology Outpatient Department (OPD) at Government Medical College Palakkad in Kerala. A total of 400 participants aged >40 years were recruited and divided into two groups: Group A (Spectacle Users, n=200) and Group B (Non-Spectacle Users, n=200). Data was collected using a pre-tested, structured questionnaire. Chi-square tests were used for statistical analysis.
Results
Awareness of glaucoma was significantly higher in Group A (62.5%) compared to Group B (21.5%) (
Neck Circumference as a Marker for Obesity and its Association with Metabolic Syndrome
Get PDFBackground: To Study the relationship of measuring neck circumference as a marker for obesity and to assess the association of neck circumfer ence and metabolic syndrome. Subjects and Methods: Patient fulfilling inclusion and exclusion criteria were diagnosed as metabolic syndrome based on criteria. A cut off value of Neck Circumference was calculated and association between increased neck circumference and different parameters of Metabolic Syndrome was evaluated. Results: 23.90% Subjects had normal NC whereas 76.10% had high NC. The mean NC among the study subjects was 38.18±2.43.High NC was seen in 62.79% males and 81.03% females. Mean age of subjects having high NC was 52.04 ±9.82 years. Mean weight for subjects was 78.37 ± 9.45 kgs. Mean BMI for subjects was 33.24 ± 5.62 kg/m2. Mean SBP was 135.21 ± 8.42 mmHg and DBP was 86.08 ± 4.98 mmHg Mean FBG was 144.78 ± 41.02 among subjects with high NC. The mean triglycerides were 163.75 ± 42.19, mean HDL was 38.96 ± 9.42, mean LDL was 114.11 ± 34.66, and mean VLDL was 33.67 ± 8.82.The ROC among the scoring system was found to be highly significant. Overall NC cut off ≥38.0cm was found to be effective for evaluation of metabolic syndrome. In the study population, among males the cutoff value was 38.5 cm while the same was found to be 34.5 cm for females The sensitivity, specificity, positive predictive value and negative predictive value of Neck circumference in the prediction of metabolic syndrome is 87%, 100%,100%, 94% respectively. The accuracy rate of Neck circumference was 84.50%. Conclusion: Neck Circumference was revealed to be a better, simpler and more reliable independent anthropometric measurement as predictor of metabolic syndrome, adiposity and cardiovascular risk than BMI. 
Assessment of Anxiety and Depression Among Patients with COPD
Get PDFBackground: The aim is to assess anxiety and depression among patients with COPD. Subjects and Methods : One hundred five adult patients in age ranged 20-60 years of either sex diagnosed with COPD were included. Parameters such as name age, smoking habit, history of alcoholism, duration of treatment, type of family, education and occupation etc. was recorded. The level of anxiety and depression among patients was recorded. Results: Out of 105 patients of COPD, males constituted 45 (39.2%) and females 65 (61.8%). The level of anxiety was low in 68, moderate in 25 and severe in 12. Depression was found to be normal in 23, mild in 30, borderline in 11, moderate in 25, severe in 6 and extreme in 5 patients. A significant difference was observed (P< 0.05). 52% literate and 68% illiterate had low and 48% illiterate and 32% illiterate had moderate/ severe anxiety. 66% married and 45% unmarried and 34% married and 55% unmarried had low and moderate/ severe anxiety respectively. 65% employed and 62% unemployed had low, 35% employed and 38% unemployed had moderate/ severe anxiety. 80% smokers had low and 20% had moderate/ severe anxiety respectively. 61% alcoholics had low and 39% had moderate/ severe anxiety respectively. >5 years of treatment was seen in 47% having low and 53% had moderate/ severe anxiety respectively. A significant difference was observed (P< 0.05). A significant difference was observed in education, smoking and duration of treatment in patients of COPD having depression (P< 0.05). Conclusion: Most of the COPD patients had moderate anxiety and depression. 
A Study on Effect of Laughter on Pulmonary Functions among Elderly People
No full textBackground: Laughter Yoga has become a very popular form of exercise and is primarily practiced in groups. Laughter is initially forced as a physical exercise by maintaining eye contact with other members in the group and promoting childlike playfulness. This soon leads to real, spontaneous laughter. Laughter Yoga is the one only technique that allows adults to achieve sustained hearty laughter without involving cognition. The objective is to study the effect of laughter on pulmonary functions in elderly people. Subjects and Methods: This study was done under ICMR STS research Programmed for Undergraduate students at Dr D Y Patil Medical College, Pune from June 2016 to October 2016. A total of 60 study subjects aged more than 60 years of age were selected for the purpose of the study. The Pulmonary functions were tested by using instrument ‘Spirotech before and after the laughter therapy for 4 weeks. Results: Immediately after a good bout of laughter FVC and PEFR were increased but not statically significant FEV1 was statically significant immediately after good laughter. All three pulmonary functions FVC, FEV1 and PEFR were statically highly significant after regular laughter therapy practice for 4 weeks. Conclusion: Laughter is beneficial for pulmonary functions when practiced regularly in our study laughter therapy for 4 weeks proved beneficial ruling out all age sex and ethnic differences. 
Assessment of Serum Lipid Profile in Patients with Hypertension
No full textBackground: Hypertension had a global burden on 26.4% of the adult population in 2000, and projections reveal a rise to 29.2 per cent by 2025. Given its high prevalence and associated risks of progression to cardio-vascular disease (CVD) and stroke, early diagnosis becomes crucial. The present study was undertaken for assessing serum lipid profile in patients with hypertensive patients. Subjects and Methods: A total of 50 patients with confirmed diagnosis of essential hypertension were enrolled. Another set of 50 age and gender matched subjects were taken as healthy controls. Complete demographic and clinical details of all the subjects were obtained. Blood samples were obtained from all the subjects and were sent to laboratory where autoanalyzer were used for assessment of serum lipid profile. All the results were recorded in Microsoft excel sheet and were analyzed by SPSS software. Results: Mean Triglycerides among the patients of the essential hypertension group and control group was 1.36 and 1.15 respectively (p- value < 0.05). Mean total cholesterol levels among the patients of the essential hypertension group and control group was 4.96 and 4.05 respectively (p- value < 0.05). Conclusion: Serum lipid profile is significantly deranged in essential hypertension patients. 
To Correlate Socio-Demographic Factors with Glycemic Control and Awareness of Complications among Diabetes Mellitus Patients
Get PDFBackground: Diabetes currently affects more than 62 million Indians, which is more than 7.2% of the adult population. The average age on onset is 42.5 years. Nearly 1 million Indians die due to diabetes and its complications every year. Education is one of the key components in ensuring better treatment and control of diabetes. There is also evidence to show that increasing knowledge regarding diabetes and its complications has significant benefits including increase in compliance to treatment, thereby decreasing the complications associated with diabetes. Subjects and Methods: It is a cross sectional study, which included 430 diabetic patients attending general medicine OPD of Subbaiah institute of medical science and hospital, who met the inclusion and exclusion criteria. Data was collected using self-designed questionnaire and entered in excel sheet and compared using SPSS Ver 21. The aim is to study the association between glycemic control and socio-demographic variables in our study population, to study the association between awareness of complication in diabetes with socio-demographic variables. Results: Our study included 430 diabetic patients who attended medicine OPD of Subbaiah institute of medical science and hospital. Of which 206 (47.6%) were male and 227 (52.4%) were females. We had 254 (58.7%) of rural patients and 179 (47.3%) of patients from urban side. In our study we found that coronary vascular disease (47%) was most known complication, followed by retinopathy (39.9%) then by nephropathy (37%), and by neuropathy (30%). Awareness about peripheral vascular disease was least among our study population. Hypoglycaemia symptoms were reported more in the rural population than urban population. Regarding glycaemic control 44% of patients had their sugars between 200 to 300 mg/ dl. There was no statistical significant difference in blood sugar levels between urban and rural population. Conclusion : Awareness of complication of diabetes was low in our study group. There was no significant difference in awareness of diabetic complication and glycaemic control between the urban and rural population. Hence irrespective of place of residence people needs to be educated regarding diabetes, its chronicity and need for regular monitoring of blood sugars to avoid its complication from developing.