International Journal of Advances in Health Sciences (IJHS)
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Study on assessment of thyroid status among critically ill patients admitted in a tertiary care hospital.
No full textIntroduction: Any acute severe illness can cause abnormalities of circulating TSH or thyroid hormone levels in the absence of underlying thyroid disease. Material & Methods: A hospital based cross sectional study was done among 100 critically ill patients admitted to Katuri Medical College and Hospital, Chinakondrupadu, Guntur. All critically ill patients aged above 18 years admitted to Intensive Care Unit, Emergency ward and patients suffering from Acute renal failure, Acute Respiratory failure, Congestive cardiac failure, Diabetic ketoacidosis, Septicemia and Advanced HIV infection were included. 3ml of early morning sample containing plain clotted blood were collected and sent for T3,T4,TSH estimation. The hormone estimation was done by chemiluminescence assay. Results: In the study, of 100 critically ill patients out of which 16 patients had acute renal failure, 18 patients had acute respiratory failure, 18 patients had congestive Cardiac failure, 16 patients had Diabetic ketoacidosis, 18 patients had Sepsis and 14 patients had Advanced HIV. Among 100 patients, 60% had low T3, 26% had low T4, 10% had high T4 and 4% had low TSH. Conclusions: Abnormalities in thyroid function were more common in critically ill non thyroidal illness patients
A RANDOMIZED OPEN LABEL CLINICAL TRIAL OF SAFOOF-E-MOHAZZIL IN THE MANAGEMENT OF FART-E-TADASSUM-FID-DAM (PRIMARY HYPERLIPIDAEMIA)
No full textHyperlipidaemia is a highly atherogenic lipid metabolic disorder characterized by abnormally elevated levels of circulating Cholesterol or Triglycerides in the blood. It results either from increase in synthesis or decrease in degradation of lipoproteins, which transport Cholesterol & Triglycerides, 6,7. According to Unani system of medicine there is no such description of Hyperlipidaemia found, but Abu SahalMaseehi had given the concept of dosoomat-e-khoon24. The Hippocrate, Rofas, Galen, Razes and Avicenna described the obesity (Saman-e-mufrit), which is due to the excessive phlegm (Khilt-e-Balgham). Their observation of etiological factors, presentation, complications, pathophysiology and non-pharmacological management are in close similarity to hyperlipidaemia.The corner stones of Cholesterol reduction are lifestyle modification, dietary interventions and pharmacological interventions (statins, resins, fibrates, niacins, ezetimibe etc)1,2,3,4. But all these lipid lowering agents are known to cause intolerable adverse effects and there is also a possibility of hypolipoproteinemia42,43. All these factors needs a search of the drugs which are effective, safer, having fewer side effects, cost effective and are available freely.Thus selection of test drug Safoof-e-Mohazzil (Compound of Unani Formulation) is supported by unani and some scientific literatures, which claim that it has lipolytic activity, it reduces blood pressure markedly, it works on diseases of heart, and it opens the blockage and reduces the viscosity of all humours.The present study was designed as a open labeling trial in successive patients with primary Hyperlipidaemia diagnosed on presentation, history and investigations. Thirty diagnosed patients of age between 20-60 years. Who belongs to inclusion criteria were registered, treated with Safoof-e-Mohazzil(Unani Compound) 05gm/day respectively for 90 days, and follow-up planned prior of trial, 45th day and at the end of trial. . After Intervention, most of the subjective parameters improved significantly, On objective parameters, improvement is very significant. All the biochemical parameters P=0.001. This result suggesting the effect of test drug is not only effective in lowering the Total Cholesterol, Triglyceride or LDLc but increment on HDLc, lowering of BMI and WHR. The HDL Cholesterols considered as good Cholesterols and lowering of BMI and WHR so this is also beneficial effect of test drug
Comparative Evaluation of Post Operative Analgesic Effects of Intraperitoneal Levobupivacaine Plus Dexmedetidomine and Levobupivacaine Plus Clonidine in Patients Undergoing Laparoscopic Cholecystectomy.
No full textBackground and Aims: Local anaesthetics have been used widely through the intraperitoneal route, either alone or with various adjuvants, to effectively decrease the post operative pain after laparoscopic cholecystectomy and increase the duration of analgesia. Our study compared the post operative analgesic efficacy of intraperitoneal Dexmedetomidine or Clonidine added to Levobupivacaine in patients undergoing laparoscopic cholecystectomy. Methods: 90 , ASA I-II patients , who were randomly divided into three groups were enrolled in the study. Group I ( L ) received 38 ml of 0.25% Levobupivacaine + 2 ml saline, Group II ( LD ) received 38 ml of 0.25% Levobupivaciane + 0.5 microgm/kg Dexmedetomidine diluted in 2 ml normal saline and Group III ( LC ) received 38ml of 0.25% Levobupivacaine + 1 microgm/kg Clonidine, diluted in 2 ml normal saline making a total solution of 40 ml. The study solution was given intraperitoneally before removal of trocar in Trendelenberg’s position into the hepatodiaphragmatic space, near and above the hepato -duodenal ligament and in the gallbladder fossa. Visual analogue scale score (VAS ) was used to assess the quality of analgesia. Time to the first request of analgesia, total dose of analgesic in the first 24 hrs, hemodynamic parameters at various post operative intervals and adverse effects were noted. Results: VAS score at various intervals post operative, overall VAS in 24 h was significantly lower (1.57 ± 0.27, 1.63 ± 0.24, 2.25 ± 0.18 ), time to first request of analgesia (min) was longest (8.56 ± 2.15 hrs, 6.26 ± 4.28 hrs, 1.25 ± 0.89 hrs ) and mean of the total analgesic doses consumption was lowest (0.77 ± 0.63, 0.90 ± 0.66 , 2.37 ± 0.56) in Group LD than Group LC than Group L. Conclusion: Postoperative analgesic efficacy of intraperitoneal instillation of Levobupivacaine with Dexmedetomidine was found to be superior to Clonidine group and much superior to instillation of levobupivacaine alone
Teaching and Training of Unani Medical Officers in Ilaj Bit Tadbeer under State Health Society Scheme of Govt.of Maharashtra: Significance and Impacts.
No full textState health Society of Govt.of Maharashtra has assigned ZVM Unani Medical College & Hospital Pune to teach and trained Govt Unani Medical officer in Ilaj Bit Tadbeer. The College then appoints the author as chief coordinator to design a suitable programme with teaching module to fulfill the assignment. A suitable programme was designed and teaching module were prepared and submitted to the concerned authorities, which were then approved to conduct the teaching and training of the Medical Officer. The programme designed was of six days for each batch (10 delegates for each batch) based on theory and practical training with demonstration and practice sessions. Other expert faculties of college were also assigned to deliver different lectures and practical sessions. A total of 56 registered Unani Medical Officers in five batches were deputed for training out of which 47 attended and extensively taught and trained. The efficacy of this teaching and training was assessed through a pre and post training assessment test. A questionnaire based telephonic survey after one year was also conducted to assess the impact of the acquired training. The findings of these data were statistically analyzed for inferring the significance and impact of the training that is to assess the translational value of the training.
This study is being published to encourage, facilitate and promote such a kind of teaching and training during medical practice through CMEs and workshops. Further the teaching and training of different health workers including doctors is the part of community health programme and public health services. Hence such studies can serve as an evaluation mark for reference
Assessment of the Usefulness of Remedial Measures in Incompletely Immunized Children using an Information Technology Software: a Cross Sectional Study
No full textIndian studies showed 62% children under five had not received the first DTP dose. Access to health services, parental attitudes, knowledge, and practices may deny vaccination’ AIMS & OBJECTIVES :Find the reasons for partial immunization of under-five children in Thrissur District. MATERIAL & METHODS -Sample size of study was 868. Data collected by interview over internet phone from 01-05-2013 for 12 months.Vaccines given below 5 years as per IAP schedule were studied.RESULTS-Logistic regression (LR) was used to predict the reason for delayed/unvaccinated status. Odds ratio & p value was used to select the variables which have correlation. Nine variables identified were grouped as Classes with Odds ratio was found against each. The value Odds Ratio (OR) indicates the factor by which the vaccination status is related to each class when one variable is considered.CONCLUSIONS:1.Hospital delivery, order of the birth have positive effect on vaccination status.2.Age above 9 months, Parental education, possession and maintenance of immunization card , attending vaccination awareness programs and Free supply of Pentavalent vaccine by Govt have no significant positive effect.3.Fear of adverse effect, difficult terrain and inefficient health staff have no influence
Study of Papaya Dressing in Wound Bed Preparation of Diabetic Wound–A Review
No full textThis paper reviews the role of papaya (papita/Carica papaya) dressing in wound bed preparation of diabetic ulcer, during healing procedure of diabetic wound in relation to ancient Unani Medicine. Diabetic foot ulcers are common complication of diabetes mellitus. Diabetic foot ulcers are usually caused by well-known triad of complications of diabetes mellitus known as Neuropathy, Ischemic changes and Infection resulting in poor wound healing with presence of gangrenous slough over diabetic wound. Therefore, it is difficult to treat even sometimes it needs amputation of foot because of gangrenous slough collection over the diabetic ulcer. In fact, the gangrenous slough over the diabetic wound doesn’t allow healing of that ulcer. Hence, there is need to debridement of wound or clear all gangrenous slough material to allow healing of the wound.
The regular papaya dressing clears all gangrenous sloughs, due to its enzymatic action. In other words enzymatic action of papaya dressing provides wound debridement naturally and gives a clean wound for healing process. In this way, the papaya dressing provides wound bed preparation. Details will be discussed in full length paper.
 
Antibiotic Resistance Pattern among Uropathogens in a Tertiary Care Hospital in Silchar
No full textUrinary tract infections (UTIs) are amongst the most common infections encountered in clinical practice with an estimated 150 million UTIs per annum worldwide. The introduction of antimicrobial therapy has contributed significantly to the management of UTIs. However the main problem with current antibiotic therapies is the rapid emergence of antimicrobial resistance in hospitals and the community. Aims: To determine the frequency and pattern of antibiotic resistance among uropathogens in a Tertiary Care Hospital in Silchar.Settings and Design: Outdoor and indoor wards of Silchar Medical College & Hospital, Silchar/ Retrospective study Methods and Material: An analysis was done on all the urine samples (1799) sent for culture and sensitivity to the department of Microbiology, SMCH, Silchar from 1st January 2011 to 31st December 2013. A total of 659 positive urinary isolates were detected from the 1799 samples. Antibiotic susceptibility was done on Mueller Hinton Agar plate by Bauer-Kirby method. Extended spectrum beta lactamase (ESBL) production was determined by the double disk approximation test and the Clinical and Laboratory Standards Institute (formerly NCCLS) confirmatory method and Methicilin Resistant Staphylococcus aureus (MRSA) production was determined by the oxacillin disc inhibition test and the Clinical and Laboratory Standards Institute (formerly NCCLS) confirmatory method.Statistical analysis used: Microsoft excel sheet was used to plot the data and prepare the graphs.Results: During the study period, 1799 consecutive urine samples were processed from OPD and indoor patients, 659 (36.63%) of these urine samples [OPD- 106 (16.08%) and Indoor- 553 (83.92%)] yielded significant growth of pathogens. Escherichia coli was the most frequently isolated uropathogen accounting for 38.54% of the total isolates. ESBL production was observed in 28.74% of E. coli strains and 40.74% of Klebsiella strains. MRSA producing organisms was found to be 28.40% of S. aureus strains. With the exception of nitrofurantoin and amoxycillin/clavulinic acid for gram negative bacteria and linezolid for gram positive cocci, resistance to agents commonly used as oral treatments for UTI was quite high.Conclusions: The study revealed E. coli as the predominant bacterial pathogen, followed by S. aureus for UTIs in Silchar Medical College & Hospital, Silchar, Assam. An increasing trend in the production ESBLs and MRSAs among UTI pathogens were noted
Acute Kidney Injury with Sepsis. A Study from a Tertiary Care Hospital.
No full textIntroduction: The combination of sepsis and acute kidney injury constitutes a particularly serious medical problem. this study will throw some light on the sepsis patients going in for acute kidney injury and their clinical profile and clinical outcome of these patients. Material & Methods: Present observational study was conducted under the Department of Medicine, NRI Medical College and Hospital. A total of 50 patients were selected and the duration of the study was from November 2012 to September 2014. Inclusion criteria: All patients with evidence of sepsis and acute kidney injury above l3 years of age , both male and female. Exclusion criteria: Patients with chronic kidney disease. Sepsis was defined according to ACCP/ SCCM (American College of Chest Physicians / Society of critical care) and acute kidney injury defined according to RIFLE criteria. Results: Among the total cases, moderate sepsis was seen in 20 cases (40%), severe sepsis in 19 cases (38%) and shock in 11 cases (22%). With increasing age, the severity of sepsis increased which was found to be statistically significant (p<0.001). Association between mortality and oliguria showed that Acute Kidney Injury in septic patients with oliguria has increased mortality than no – oliguric AKI ( p < 0.0001)
Multidrug-resistant Hospital-associated Infections in pediatric intensive care units
No full textBackground. The enormous burden that multi-drug resistant hospital acquired infection (MDR- HAI) lay on the lives in pediatric intensive care unit (PICU) in developing countries is scarcely studied. The present study was conducted to assess the incidence, epidemiological profile, underlying risk factors and outcome of children in PICU infected with MDR- HAI
Methods.This is a prospective cohort study conducted in 2 pediatric intensive care units in Cairo University Pediatric hospital. The study was conducted from 1st January 2015 to 1st of January 2016. All children who developed HAI defined, according to the CDC were included in the study.
ResultsThe present study encompassed 378 patient admitted to the intensive care over a period of twelve months. 57 patients developed 106 episodes of infection, making the incidence of HAI 28%.
Ages were between 1- 144 months. (56.1%) were males while 25 (43.0%) were females.
The number of infection episodes was 106 (range 1 – 7, with mean + SD 1.6 – 1.1). 98 were MDR infections, while 8 were non-MDR organisms. The incidence of MDR-HAI was 92.45%
Infection with gram negative strains occurred in 89 (83.9%) of cases, while gram positive infections occurred in 17 (16.19%) cases. Acinetobacter spp (26.4% ), and Pseudomonas spp (25.5%) were the most common gram negative infections. VAP occurred in 55 cases (51.9%), BSI occurred in 17 (16.0%) cases, while CLBSI occurred in 16 (15.2%), HAP in 7 (6.6%) surgical wound infection in 5 (4.7%), CRUTI in 4 (3.8%) and VP shunt infection in 2 (1.9%) .The insertion of ETT was statistically significant for the development of MDR-HAI (P value 0.049). Klebsiella was significantly related to non-MDR infection (p value < 0.001)
Conclusion:The incidence rate of MDR-HAI was alarming with high mortality rate. Gram negative bacteria were the most common organisms causing the infection with VAP being the most commonly prevalent. The insertion of ETT was a risk factor for MDR-HAI. The presence of malnutrition associated with MDR-HAI heralded mortality
Occupational Radiation Monitoring in Tertiary Health Institutions of Northwestern Nigeria
No full textTitle: Occupational radiation monitoring in tertiary health institutions of northwestern Nigeria
Objective: To determine knowledge of occupational radiation monitoring and level of personnel radiation monitoring in some tertiary institutions in Northwestern Nigeria.
Methods: A prospective cross-sectional survey design was adopted for this study. It was carried out for a period of 4 months, from December 2014- March 2015. Questionnaires were distributed to radiologist, radiographers, darkroom technicians, and nurses who work in the radiology department of the selected hospitals in this study. Data analysis was done using statistical package for social sciences version 16.0 where descriptive statistics was used for analysis.
Result: A total of 68 questionnaires were distributed and 62 were returned, giving a response rate of 91.2%. There were 55 (88.7%) males and 7 (11.30%) females with age ranged from 20-49 years with a mean age of 24.5 years. There were 18 (19.00%) radiologist, 32 (51.60%) radiographers, 12 (19.40%) darkroom technicians and 0 (0.00%) nurses in the study.
Conclusion: This study found an appreciable level of knowledge on occupational radiation monitoring among radio-diagnostic staff in northwestern Nigeria and there was an appreciable level of radiation monitoring in northwestern Nigeria, although much still need to be done on the practice of radiation protection