International Journal of Advances in Health Sciences (IJHS)
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Antioxidants and Life Style Changes- A Prevention Paradigm for Coronary Heart Disease Patients
No full textOxidative stress and lipid peroxidation of LDL-Cholesterol are the well documented causes of Atherosclerosis vis-à-vis cardiovascular disease. Early risk factor modifications using Flavonoids, Anti-oxidant vitamins, moderate exercise, dietary modification and deep breathing as adjuvant alternative therapies in known Ischemic Heart Disease patients have shown multiple benefits. The prospective controlled trial study done on 73 known Ischemic Heart Disease patients by doing Exercise Tolerance Test on Tread Mill both at baseline and after 9 months of addition of alternative therapy as adjuvant. The results favored improved myocardial functions. Flavonoids were used as alcoholic extract of Terminalia arjuna along with anti-oxidants like Vitamin E, Vitamin A, Vitamin C and selenium in combination. Moderate exercise like walking, gardening, cycling were included along with dietary modification. Deep breathing for 10-20 minutes every day in the morning and evening were also added in experimental group. The improvements were seen in myocardial functions in terms of increased %age of Achieved Target heart rate (85.46±7.86 vs. 89.41± 6.63), decreased recovery time, and improved ST level changes (-1.84±0.49vs.1.25±0.81) during Exercise Tolerance Test performance after long term (9 months) therapy. There were improvements in dyspnoea scale of NYHA, decreased angina episodes, and improved quality of life. Flavonoids as alcoholic extract of T. arjuna bark and Antioxidant Vitamins were well tolerated. Minimum side effects like headache, decreased appetite were seen in some subject
Chronic Myeloid Leukemia with a novel four-way translocation t(3;13;9;22)(p21;p11;q34;q11.2)
No full textThe Philadelphia (Ph) chromosome consisting of the t(9;22)(q34;q11.2) is observed in 90% cases of chronic myeloid leukemia (CML), while complex variant translocations are observed in 2-10% of cases. In variant translocations four-way translocations are very rare, we report a novel case of four-way translocation involving chromosome# 3, 13, 9 and 22. With the help of G-banded karyotype and FISH technique, four-way translocation was identified in the present study as 46,XY, t(3;13;9;22)(p21;p11;q34;q11.2). To best of our knowledge this combination in four-way translocation is not reported so far
Gender Differences in Presentation and Phenomenology in Obsessive Compulsive Disorder
No full textIntroduction: Obsessive Compulsive Disorder (OCD) is prevalent all over the world. It is known since time of Bishop Jhon Moore. Various differences have been noted in presentation and phenomenology of OCD. We have done this study to assess presenting symptoms with clinical characteristics in OCD patients, the impact of gender on OCD phenomenology by comparing symptoms, demographics and clinical characteristics in men and women, relationship between various obsessions and clinical variables among genders and incidence of comorbid psychiatric disorders.Material and Methods: This cross-sectional study was conducted in Civil Hospital , Ahmedabad. 65 patients with obsessive compulsive disorder visiting the Outpatient Department of Psychiatry were evaluated and explained about the procedure, its purpose and were assured of confidentiality of the information. A predetermined proforma was filled for each patient.OCD was evaluated on the basis of DSM-IV-TR criteria. Severity of OCD was assessed by using Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Y-BOCS Symptom Checklist was used to assess OCD symptoms.Results: Out of 65 patients of OCD, 37 (50.9%) were males and 28 (43.1%) were females. Among clinical variables age of onset was earlier in males (mean age = 21.39 years) than females (mean age = 25.5 years). Males also took more time to consider help for OCD than females. Most common obsessions were aggression (60%) and contamination (60%) without any gender differences, while most common compulsions, checking (63.1%) and cleaning (55.4%) also were without any gender differences. Patients with mental rituals and repeating rituals had significantly more severity of OCD on Y-BOCS score
Congenital Uterovaginal Prolapse –A Rare Case Report
No full textBackground: Congenital Utero-vaginal prolapse is rare disorder commonly associated with meningomyelocele and rarely with hydrocehalus. Case Characterstics: Unbooked pregnancy with breech presentation delivered new born child with 3rd degree primary Congenital Utero-vaginal prolapse. Observation: Child had severe birth asphyxia, lumbo sacral meningomyelocele,hydrocephalus and CTEV along with genital prolapse.
Outcome: The mass was reduced and both lower limbs were strapped together using crepe bandage which was applied ina mermaid fashion to prevent re-protrusion. Message: Maternal supplementation of folic acid at time of conceiving child could prevent congenital genital prolapsed
Pre-Operative Clinico-Cytological Diagnosis of Thyroid Mass Lesions (A Correlating Study)
No full textIntrodution; thyroid nodules are the common thyroid endocrine disorders particularly seen in areas, deficient in iodine content in soil, that includes Sub-Himalayan areas of India, where prevalence may be as high as 40%. Thyroid enlargement (nodular or diffuse) requires many investigations like clinical history, physical examination, Thyroid profile (T3, T4 and TSH), transcutaneous Ultrasonography and Scintiography with Tc 99m. Now a days, FNAC has surpassed most of the tests and also has become an important diagnostic tool for various thyroid abnormalities (benign or malignant). It is a highly effective method for selectingpatients for surgery, identification of benign thyroid nodules except carcinomas and differentiating benign from malignant lesions respectively. Cytological sampling without aspiration is called fine needle capillary sampling (FNCS) and capillary biopsy (FNCB).Aim and objective; To study cytomorphological smear patterns in various non neoplastic and neoplastic thyroid disorders on FNAC .And to compare diagnostic efficacy of smears in fine needle sampling (Non Aspiration) and fine needle aspiration.Materials and methods; Study was undertaken to find, role of FNAC in preoperative diagnosis of Thyroid lesions in the Department of Pathology in M.M.I M S&R Mullana, Ambala (HR) that included eighty patients over a period of one year. USG guided FNAC was done as required. Diagnostic efficacy of smears in fine needle sampling (Non Aspiration) and fine needle aspiration compared. CONCLUSION; Fine needle sampling is important diagnostic modality in sampling of superficial as well as deep seated lesions. For cystic lesions, FNAC is the procedure of choice as FNCS would lead to spillage of contents. For solidthyroid lesions, FNCS often yields specimen of text book quality and also suits children. To increase the probability of a diagnostic sample, both FNAC and FNCS may be used in selected cases, in which one technique supplements the other. So FNAC of the thyroid is a useful tool for making a correct diagnosis in majority of cases, based on clinico-cytological correlation. By combining two techniques, a better diagnostic accuracy can be achieved
The Antibiotic resistance profiles of bacterial strains isolated from inpatients and outpatients from five hospitals in Egypt
No full textBackground:Multidrug resistance (MDR) of pathogens has become a serious threat for modern human health care. The strategy for the control of antimicrobial resistance lies mainly in the implementation of effective infection control measures and antibiotic auditing.For these measures, it is important to have data on the identification and resistance patterns of clinical bacteria, and to know the magnitude of antimicrobial resistance in hospitals compared with that in the community.Objectives:Evaluation of antibiotic resistance profiles of bacterial strains from inpatients and outpatients. Materials and methods:A total of 417 isolates were obtained from inpatients and outpatients referring to five different hospital laboratories over a one-year period (2010 and 2011). Antibiotic sensitivity and MIC(minimum inhibitory concentration)were determined according to CLSI guidelines.Patient’s data was recorded.Tests for the detection of antimicrobial resistance mechanisms such as β-lactamase production, extended spectrum β-Lactamase and inducible Clindamycin resistance were performed.Results:The ratio of gram negative to gram positive bacteria was 3:1,35.5% were from inpatients and 64.5% were from outpatients.The most prevalent microorganism was Escherichia coli (25.9%) followed by Citrobacter species (19.2%),Staphalococcus aureus (14.6%) , Klebsiella species (9.4%),CON species (8.9%) and Enterobacter species (8.6%).Antibiotic susceptibility of Enterobacteriaceae isolates from inpatients and outpatients showed that the highest rates of resistance were to Ampicillin (94.4%,93.7%), followed by Ampicillin/sulbactam (84.3%,70.1%) respectively. High susceptibility to imepenem ,meropenem and amikacin was observed for isolates from both inpatients and outpatients.Enterobacteriaceae isolates from inpatients and outpatients showed 89.9% and 77.6% resistance through β-Lactamase production respectively. 71.3% from the Enterobacteriaceae isolates from inpatients were ESBL positive while 52% from the outpatients were ESBL positive.Conclusion: Our data suggest that antimicrobial resistance among Gram-positive cocci and Gram-negative bacilli is common and significant in Cairo. Antibiotic-resistant ESBL producing bacteria make up more than half the isolated Gram negative bacilli
Circle of Willis with Absent Internal Carotid Artery in Cadavers
No full textIntroduction: Circle of Willis is the balancing mechanism of blood supply to the brain between vertebrobasilar and carotid systems. Literature say, the incidence of absent internal carotid artery in Western population is .01%. This study is to find the incidence of absent internal carotid artery in Circle of Willis among South Indian population. Materials and methods: 223 cadaveric brains are utilized in this study at various medical colleges in and around Puducherry. Routine dissection instruments were used. The Circle of Willis was studied and photographed.Results: Left internal carotid artery was absent in1 brain, bilateral internal carotid artery was absent in1 brain. Conclusion: Incidence of absent internal carotid artery in Circle of Willis among south Indian population is 0.89%
Impact of dengue fever on liver function tests and to relate liver function tests with severity of disease
No full textIntroduction: Dengue fever is an ancient disease. The earliest record found today is in a Chinese encyclopedia of disease symptoms and remedies, first published during Chin dynasty (265 to 420 AD). Severe Dengue was first recognized in the 1950s during dengue epidemics in the Philippines & Thailand,.has become a leading cause of hospitalization and death among children in these regions1.Liver dysfunction as a result of dengue infection can be a direct viral effect on liver cells or an adverse consequence of dysregulated host immune response against the virus.
Material and methods: Hospital based prospective observational study conducted at Sri Venketeswara Ram Naraian Ruia Government General Hospital; Tirupati included all NS1 Ag positive or dengue Ig M positive cases in the age group of 6 months to 12 years.
Results: Liver function tests AST, ALT and Alk phosphatase, bilirubin were deranged in children with severe dengue and dengue with warning signs compared to dengue without warning signs. Total bilirubin, AST, ALT and alkaline phophatase derangements were highly significant with p-value0.001. Enzymes are elevated significantly in severe dengue compared to dengue with and without warning signs
Conclusion: All the liver function tests (Total bilirubin, AST, ALT and Alk phosphatase) were higher in children with severe dengue compared to dengue fever with warning signs and dengue fever without warning signs .The mean AST and ALT levels were 231.31 and 201.14 U/L respectively. This differs from the pattern in viral hepatitis
Chronic Alcoholism Effects on Nerve Conduction Velocity
No full textAim: Our study is aimed to measure motor nerve conduction velocity in chronic alcoholics compared with age matched controls. Material methods: The study includes 30 chronic alcoholics with neuropathy, 30 Chronic alcoholic without neuropathy and their age matched controls. The test was analyzed using unpaired T- test Result: The study revealed a highly significant decrease (p value < 0.001) in motor nerve conduction velocity when compared between controls and Chronic alcoholic with and without neuropathy. There is also significant decrease (p value < 0.001) in motor nerve conduction velocity between patients with neuropathy and those without neuropathy. Conclusion: The observation suggests that motor nerve conduction velocity is decreased prior to symptoms of neuropathy appears. It helps in early diagnosis and treatment of neuropathy
Comparison of efficacy, safety and complications between epidural and general anaesthesia for patients undergoing percutaneous nephrolithotomy-A prospective study
No full textBackground: Percutaneous nephrolithotomy (PCNL) now a days is the treatment of choice for most renal stones .Mostly PCNL is done under general anesthesia. However, it can be done under epidural anaesthesia which can have advantages like faster discharge, reduced cost and recovery time and most important patient satisfaction including postoperative pain relief.
Aim: In the present study, we compared safety, efficacy surgical outcomes and complications between percutaneous nephrolithotomy under epidural and general anesthesia.
Materials and Method: 60 patients were divided into two groups of 30 each (GA/EA), who were undergone percutaneous nephrolithotomy under epidural and general anaesthesia. Patient’s general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. All qualitative data and quantitative data were analyzed by chi square and student’s t test respectively. P value <0.05 was considered statistically significant.
Result: The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anaesthesia group than in the general anaesthesia group (8.2±1.6 days vs. 12.5±2.8) days, respectively, (p=0.0001), Also, the postoperative fever rate was significantly higher in the general anesthesia group (82.5% vs 50%, respectively, p=0.012). The treatment cost was 30 in spinal group which was statistically significant. Also analgesia requirement on day 1 was more in GA group than EA group which was statistically significant.
Conclusion: Regional epidural anaesthesia is as effective as general anaesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays, lower rates of postoperative fever, lower analgesic requirement and treatment cost