International Journal of Advances in Health Sciences (IJHS)
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Day Care Intravenous Cyclophosphamide Therapy in Steroid Dependent Nephrotic Syndrome
No full textBackground: steroid sparing effect of intravenous cyclophosphamide in steroid dependent nephrotic syndrome Objective: To determine the feasibility of pulse intravenous cyclophosphamide (IVCP)therapy in day care setting of a secondary hospital in steroid dependent Nephrotic Syndrome children in remission.Methods: A prospective study was done on 16 steroid dependent nephrotic syndrome (SDNS) children (13 boys and 3 girls) in remission. The ages ranged from 4.5 to 12 years. Intravenous cyclophosphamide (IVCP) as pulse therapy was given every month for 6 months as per the eligibility criteria. All the children received pulse therapy at 500mg/m2/month in day care setting, oral prednisolone was tapered by 2-3 months. Kaplan Meier analysis was used to examine the response to IVCP pulse therapy.Outcome variables: Remission, Relapse, adverse effects, cost effectiveness.Results: The response was studied at the end of 2 years .56.25% attained sustained remission,25%turned infrequent relapsers,6.25%entered frequent relapser status and 12.5% remained SDNS. The mean time to remission following IVCP was 10.75+2.41 weeks (without steroids). Of the 16 children12.5%had side effects like nausea, vomiting. Thrombocytopenia and alopecia was observed in 6.25% respectively. None required MESNA.Conclusion: Pulse IVCP is beneficial in SDNS, cost effective ,with minimal side effects and can be given in a day care setting
Malignant Mucosal Melanoma of Nasal Cavity (melanic variant)
No full textMalignant melanoma of nasal mucosa and paranasal sinuses is a very rare tumor, which can be melanin producing or non melanin producing ie amelanotic variant. Rhinosinusal mucosal melanoma constitutes less than 1% of all melanic tumors and 2-8% of overall cancers developing in nasal fossae and paranasal sinuses. Patient gets medical attention very late in the course of disease due to ignorance of early mild/nonspecific symptoms in the way of high degree of local and distant invasion by the disease, and this finally leads to poor prognosis. Studies show average 5 year survival as 20-30% for cutaneous and 10-15% for mucosal melanomas. Here, we present a case of 60 yrs old male presenting with right nasal mass associated with off and on nasal bleeding. On suspicion of malignancy he was investigated, confirmed by Biomarkers study and operated after final diagnosis, Later, patient was referred to Radiation oncology for appropriate treatment
Echocardiographic changes in Chronic Malnutrition
No full textBackground: Malnutrition and its effect on muscles.Objective: This study was conducted to assess the systolic and diastolic dimensions of the left ventricle in children with chronic protein energy malnutrition and to compare them with a control group.Methods: Thirty three children with chronic malnutrition were matched with thirty-one healthy controls, which were age and sex matched. Left ventricular dimension in end diastole and in end systole were calculated by echocardiography and were matched against the healthy controls. Statistical analysis was performed by the SPSS program for windows, version 17.0. Normally distributed continuous variables were compared using the unpaired T test, where as the Mann Whitney U test was used for the variables which were not normally distributed. Categorical variables were compared using the chi- square test.Results: Left ventricular end systolic (LVEs) and end diastolic volume (LVEd) was plotted against the body surface area, as per the American Society Of Echocardiography .In our study , body surface area of cases was significantly low in cases as compared to the controls.LVEd and LVEs was significantly lower in the malnourished group (LVEs: 18.48±3.73mm, LVEd: 25.9 mm) as compared to the control group (LVEs: 20.90±3.06, LVEd: 32.2 mm).Conclusions: Significant echocardiographic abnormalities have been found in malnourished children associated with their nutritional status
Takayasu arteritis in a young male with an unusual presentation of hypertrophic cardiomyopathy and renovascular hypertension
No full textWe report a case of takayasu arteritis in a young male with an unusual presentation of hypertrophic cardiomyopathy and renovascular hypertension from National Institute of Medical sciences, Jaipur. Diagnosis of this case is made by clinical examination, CT-angiography and 2D-echocardiography
Comparison of combined intralesional Triamcinolone and 5-fluorouracil versus Bleomycin in Keloids
No full textObjective: We compared intralesional injection of 0.1ml Triamcinolone and 0.9 mL of 5-FU combination (Group A) with Bleomycin multiple jet injections of 0.1 ml of Bleomycin (1.5 IU/ml) administered to each lesion (Group B), with injection sites spaced 0.5 mm apart.Methods: Single blinded Study was conducted in Mediscope Hospital and Cosmopolitan clinic Bangalore, from June 2012 to December 2014. Group A received intralesional injection of 0.1ml Triamcinolone and 0.9 mL of 5-FU combination and Group B received multiple jet injections of 0.1 ml of Bleomycin (1.5 IU/ml) administered to each lesion (Group B), with injection sites spaced 0.5 mm apart. Eight injections were given at weekly interval. Patients were followed up at 4 weeks, 8 weeks and 16 weeks and 1 year.Results: Good results were observed in 18(72%) cases in Group A compared to 14(56%) in Group B. Frequency of complications was 6(24%) and 9(36%) in Group A and Group B respectively. Statistical significance was found by repeated measure ANOVA for height (p<0.001) and factor (p<0.001). Statistically significant evidence that final scar height was better in Group A compared to Group B.Conclusion: Combination of triamcinolone acetonide and 5-fluorouracil is superior to Bleomycin therapy in the treatment of keloids
A Profile of Sleeping Habits among College Students-A Cross-sectional Study
No full textSince the inception of mankind, sleep has been regarded as one of the most vital necessity for the human body needed for rejuvenation after a tiresome day’s work. Social activities, stressful relationships and academic commitments often end up in sleep deprivation during college life. The objective of this study was to determine the prevalent sleeping habits among college student community. This cross sectional study was carried in an educational campus of the city using a questionnaire based on Pittsburgh Sleep Quality Index (PSQI).1 Among the sample size of 1000 respondents majority of students had late bed timingsand early wake ups with the mean sleep duration of 7 hours.On sleep latency,42.9% of the participants reportedly took 15-30 minutes to fall asleep and54.7% reported waking up in the middle of the night. Most of the students thus had problems in falling asleep and maintaining a sound and uninterrupted sleep. The study concludes thatfaulty perception of sleep among student community may lead to more difficulties in later life, which if not heeded to now, may develop into social, physical, and mentalhealth problems
Risk factors for chronic kidney disease among patients attending medical OP in Government General Hospital, Guntur.
No full textBackground: Patients with Chronic Kidney Disease (CKD) are at high risk for progression to end stage renal disease (ESRD). Progress to kidney failure or other adverse outcomes could be prevented or delayed by early detection and treatment. Material & Methods: A hospital based cross sectional study was conducted in Government General Hospital, Guntur for a period of 3 months from October 2014 to December 2014. A total of 230 subjects were selected randomly and interviewed using a pre designed questionnaire. Individuals aged 18 years & above and willing to participate in the study were included in the study. Questionnaire included details regarding demographic factors, CKD risk factors and life style factors. Results: With regards to risk factors for chronic kidney disease (CKD), present study observed that diabetes was seen in 16.6%, hypertension in 21.4% and overweight & obesity in 23.5%. Renal calculus and UTI was seen in 5.3% and 6.5% of the study population. Conclusions: Present study found a very high prevalence of risk factors for chronic kidney disease among the study population. It is important to note that some of the risk factors are amenable to modification through lifestyle changes.
 
Primary Angiosarcoma of breast- A case report with review of literature
No full textAngiosarcoma is rare, accounting for less than 1% of all malignant mammary lesions. The prognosis is usually poor due to high rates of local recurrence and early development of metastases. We report a 40 year old woman with a highly vascular mass on radiology, she presented with bony metastases at presentation. Core biopsy of the breast mass performed twice showed only haemorrhage and necrosis. Due to biopsy she developed ulceration and presented with nipple discharge. Frozen section done from the base of the ulcer was haemorrhagic and inflammatory. Cytology of nipple discharge too showed inflammation & haemorrhage. Finally mastectomy was done and histopathology showed angiosarcoma of intermediate grade. Immunohistochemically the tumor showed positivity for CD31, multifocal substantial positivity for CD34,FLi-1 diffusely positive and negative for cytokeratin. Ki 67 proliferation index – upto 60-70% in foci, IHC confirmed Angiosarcoma intermediate to high grade. Angiosarcoma is a rare tumor which is difficult to diagnose on core biopsy of breast. A highly vascular breast mass should always be considered malignant until proven otherwise. Surgical treatment seems to be the best course of action
Association between C3435T Polymorphism of MDR1Gene with Childhood Acute Lymphoblastic Leukaemia and Its Impact on Therapy Response
No full textIntroduction: Acute lymphoblastic leukemia (ALL) is the major pediatric malignancy of all childhood cancers. P glycoprotein (P-gp) is encoded by multidrug resistance 1(MDR1) gene. Many studies have been conducted to investigate possible role of MDR1 C3435T polymorphism with leukemia risk. Methods: Using PCR-RFLP technique, we investigated 100 children (50 cases newly diagnosed with ALL and 50 control subjects) forMDR1 C3435T polymorphism.Results: The homozygous mutant type (T/T) was 32% in ALL patients compared with 12% in controls. It was associated with occurrence of ALL (Odds ratio (OR), 95% confidence interval (CI); 6.1, 1.6-24.6; P=0.002). The mutant heterozygous CT genotype was also more frequently represented among patients 48% compared with 42% in controls. The difference was statistically significant (p =0.04). In addition calculated OR revealed 2.6 fold increased risk of ALL. The wild C/C genotype was associated with worse response to treatment than all mutant genotypes (TT+CT) with p =0.02. Conclusion: MDR1 C3435T polymorphism including CT and TT genotypes are associated with increased risk of childhood acute lymphoblastic leukemia. The CC genotype may be connected to poor response to treatment and poor prognosis
Effect of exposure to cleaning agents on pulmonary function tests in hospital cleaning workers in Jaipur
No full textCleaning products are widely used both at work and in the home. These products have become an indispensable part of modern life, as they are used on daily basis in nearly all workplaces and homes Occupational exposure to cleaning workers leads to development of various pulmonary disorders, work related asthma being most the important of them. The aim of present study was to evaluate lung functions among Hospital cleaning workers and to compare with the control group. Thirty young Hospital cleaning workers and thirty controls that were similar in all respects to the study group were chosen. PFT were carried out on Hospital cleaning workers, and controls by using computerized Spirometry ‘Spiroexcel’. The data obtained was analyzed using Student‘t’ test.The study showed that PFT parameter s FVC, FEV1, FEF25-75% and FEV1/FVC were all significantly less in Hospitalcleaning workers. So it is concluded in the study that cleaning products produces changes in the lung functions and decreasing lung function parameters of Hospital cleaning workers