Medico Research Chronicles
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Effect of Maternal Pre-eclampsia and eclampsia on Serum Electrolytes of Newborns in a rural tertiary care hospital in western Maharashtra
No full textAims and objectives: To study the serum electrolytes of neonates born to pre-eclampsia and eclampsia mothers in rural tertiary care hospital.
Materials and methods: This hospital-based descriptive cross-sectional study, conducted at Dr. Vitthalrao Vikhe Patil Pravara Rural Hospital over a year from September 2022 to September 2023, focused on neonates born to mothers with pre-eclampsia and eclampsia. Excluded were babies with congenital malformations and those born to mothers with other health issues.
Results: Three fourth of the PIH mothers in our study were pre-eclampsia while one fourth were eclampsia. In the present study 65% babies were preterm , 34% babies were more than 37 weeks. In pre-eclampsia mean value of magnesium was 2.9 ±0.72. In eclampsia mean value of magnesium was 4.17 ±1.38. There is highly statistically significant difference between pre-eclampsia and eclampsia.
Conclusion: Babies delivered to hypertensive mothers are more likely to experience a variety of difficulties, it is important to closely monitor
these infants in an effort to reduce morbidity and promote better growth, development, and survival
Study of growth outcome in Neonate born by eclampsia and pre-eclampsia in a rural tertiary care hospital in western Maharashtra
Full text linkAims and objectives: To study the growth outcome of neonates born by eclampsia and pre-eclampsia mothers in rural tertiary care hospital.
Materials and methods: This was a hospital based descriptive type of cross-sectional study in Dr. Vitthal Rao Vikhe Patil Pravara Rural
Hospital, Loni. It was carried out over a period of 1 year that is from September 2022 to September 2023.All neonates born to pre-eclampsia
and eclampsia mothers being admitted in Dr. B V P Pravara Rural Hospital were included in the study.
Babies born with Congenital malformation and those born to mothers with other problems like rhesus incompatibility, severe anemia, renal
disease, heart disease, connective tissue disease were excluded from the study.
Results: Three fourth of the pregnancy induced hypertension mothers in our study were preeclampsia while one fourth were eclampsia. In the present study 65% babies were preterm , 34% babies were more than 37 weeks, 54.5% babies were born via normal vaginal delivery 45.5% babies were born via caesarean section, 6 %were <1kg birth weight ,14% were in 1-1.5 kg range,79 % were in >1.5 to 2.5 kg range. In preeclampsia group 18.65% were in IUGR group whereas 81.35% are not in IUGR group. In Eclampsia group 54.15% were in IUGR group whereas 45.85% are not in IUGR group.
Conclusion: Babies delivered to hypertensive mothers are more likely to experience a variety of difficulties, it is important to closely monitor these infants in an effort to reduce morbidity and promote better growth, development, and survival
Effect of Elective Inguinal Hernia Repair on Urinary Symptoms in Men
Full text linkBackground: Urinary symptoms are frequently associated with inguinal hernias and urinary complications occur frequently following repair. Systematic assessment of post-operative urinary symptom burden in patients undergoing elective inguinal hernia repair was not evaluated yet. Therefore, the study was planned to determine the prevalence of urinary symptoms in men undergoing elective inguinal hernia repair.
Methods: This prospective observational study was conducted at the department of surgery in Dhaka Medical College Hospital (DMCH), for 12 months period. Patients with inguinal hernia who were admitted in DMCH were approached and selected in according to the inclusion & exclusion criteria. Before interviewing and before surgical procedure, informed consent was taken from each subject and ethical issues were ensured properly. The researcher did physical examination and assessment of urinary symptoms. Data were collected from a total 100 patients and recorded into a structured questionnaire. Collected data was analyzed by the SPSS 21.
Results: Mean age of the study populations was 60.36 ± 6.87 SD (years) [age range 41-73 years]. About 74% had unilateral inguinal hernia and other 26% had bilateral hernia. Out of 100 patients, 35% patients used perioperative catheter. Only 4% patients had post-operative complications and 2% patients had the history of retention following surgery. The overall median preoperative AUASS score was 6 (range 3 – 28) which increased to 13 (5-33) 48 hours after operation. The increase was statistically significant (p<0.001). The increase in AUASS score noted across all categories of age, BPH, hernia, surgery, anesthesia and surgical technique. During 30 days post-operative follow up, eight patients were lost from follow-up and comparison between preoperative and 30 days post-operative AUASS score showed statistically significant improvement (p<0.001).
Conclusion: Significant improvements of urinary symptoms are seen following elective inguinal hernia repair. However, larger cohort study is needed to finalize the comment
Role of Pre-operative Physiotherapy in Reducing Post-operative Complications in Joint Arthroplasty
Full text linkBackground: Postoperative complications following total hip and knee arthroplasty remain a significant concern. This study aimed to evaluate the effectiveness of a structured preoperative physiotherapy program in reducing complications and improving outcomes in patients undergoing joint arthroplasty.
Methods: In this randomized controlled trial, 200 patients scheduled for primary total hip or knee arthroplasty were randomly assigned to either a 6-week preoperative physiotherapy program (intervention group, n=100) or standard care (control group, n=100). The primary outcome was the incidence of postoperative complications within 30 days of surgery. Secondary outcomes included length of hospital stay, time to achieve functional milestones, pain scores, and functional outcomes at 3 months post-surgery.
Results: The intervention group demonstrated a significantly lower incidence of postoperative complications compared to the control group (11.6% vs 22.6%, p=0.041). Mean length of hospital stay was shorter in the intervention group (3.2 ± 1.1 days vs 4.1 ± 1.5 days, p<0.001). The intervention group achieved functional milestones earlier, reported lower pain scores, and showed improved functional outcomes at 3 months post-surgery (p<0.05 for all comparisons).
Conclusion: A structured preoperative physiotherapy program significantly reduces postoperative complications and improves functional outcomes in patients undergoing total hip and knee arthroplasty. These findings support the integration of prehabilitation into standard care pathways for joint replacement surgery
Outcomes of Rivision of Total Hip Arthroplasty in Patients in Secondary Care Hospital
Full text linkBackground: Although total hip arthroplasty is a popular surgery, little is known about its outcomes.
Aim of the study: The purpose of this study was to investigate the demographics and outcomes of patients receiving primary and revision total hip arthroplasty in terms of their impact on hospital and surgeon resource use and referral patterns to a secondary care hospital.
Methods: Clinical, demographic, and economic data were collected for forty-eight consecutive patients with an infection following a total hip replacement who underwent a two-stage revision arthroplasty (Group 1) performed by one of two surgeons between January 1, 2022 and December 1, 2024, at the Department of Orthopaedics & Traumatology, TMSS Medical College & Rafatullah Community Hospital (TMC & RCH), Bogura, Bangladesh, Uttara Adhunik Medical College and Hospital, Uttara, Dhaka., Bangladesh & Enam Medical College Hospital, Savar, Dhaka, Bangladesh. During the same time period, data were collected for a cohort of 48 patients who received revision of both components due to aseptic loosening (Group 2) and 48 patients who underwent primary hip arthroplasty (Group 3).
Results: Revisions for infection resulted in longer operational times, more blood loss, and more complications compared to revisions for aseptic loosening or original total hip arthroplasty (p < 0.02). Revisions for infection were linked to increased hospitalizations, days in the hospital, operations, costs, outpatient visits, and charges within a year of the index procedure (p < 0.001). Over a five-year period, our institution saw a significant increase in referrals for infection after total hip arthroplasty (Spearman rank correlation, 1.0; p = 0.0083). However, referral rates for revision for other reasons remained relatively constant (Spearman rank correlation, 0.500; p = 0.3910).
Conclusion: Infections after total hip arthroplasty require significantly more hospital and medical resources than revisions due to aseptic loosening or original total hip arthroplasty
Analyze whether RBBB is associated with in-hospital death
Full text linkBackground: Left bundle branch block and right bundle branch block (RBBB) have been implicated with raised in-hospital and long-term mortality in patients with acute ST elevation myocardial infarction (STEMI).
Aim of the study: The purpose of this study is to determine whether RBBB is connected with in-hospital death.
Methods: This study was a prospective observational study conducted in Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh, from August 2015 to September 2016. The study included 108 patients with RBBB (Group I) and 108 patients without RBBB (Group II). All data was collected, documented in a Microsoft Excel work sheet, and analyzed using descriptive statistics in SPSS 17.0.
Results: The average age was 54.31±12.51 years in Group I and 51.34±10.80 years in Group II. A statistically significant difference in LV ejection fraction was identified among the study subjects (p=0.001). The new, old, and age undetermined RBBB was 33.33%, 25.9%, and 40.74%, respectively. Bi-fascicular block and isolated were 40.7% and 59.3%, respectively. 37.0% were transient, while 63.0% were permanent. In all, 27.8% of patients in Group I suffered heart failure in Killip class II, compared to 13% in Group II, with a statistically significant difference (p =0.007). The mortality rate for new, old, and age undetermined RBBBs was 18.9%, 14.3%, and 25.6%, respectively.
Conclusion: Acute STEMI patients with RBBB had a greater in-hospital mortality rate than those without it. Acute STEMI patients with RBBB are more likely to develop complications such as heart failure, cardiogenic shock, ventricular tachycardia, total heart block, and the need for a temporary pacemaker
Efficacy of Biodegradable Implants in Orthopedic Surgery: A Systematic Review
Full text linkBackground: Biodegradable implants have emerged as an alternative to traditional metallic hardware in orthopedic surgery, offering potential advantages such as elimination of removal surgeries and gradual load transfer to healing tissue. This systematic review aims to evaluate the efficacy, safety, and clinical outcomes of biodegradable implants across various orthopedic applications. Methods: A comprehensive literature search was conducted in PubMed, Cochrane Library, Embase, and Web of Science for studies published between January 2000 and December 2023. Randomized controlled trials, prospective cohort studies, and retrospective studies with a minimum of 20 patients and 12 months follow-up were included. Two independent reviewers screened studies, extracted data, and assessed quality using appropriate tools. Results: Forty-two studies (n=3,874 patients) met inclusion criteria. Biodegradable implants demonstrated comparable efficacy to metallic implants in fracture fixation (union rate: 92.7% vs. 94.1%, p=0.38) and ligament reconstruction (failure rate: 3.8% vs. 3.2%, p=0.42). The overall complication rate for biodegradable implants was 12.3% (95% CI: 9.8% - 14.8%), with foreign body reaction (3.7%) being the most common. Biodegradable implants significantly reduced the need for removal surgeries compared to metallic implants (1.2% vs. 7.5%, p<0.001). Subgroup analyses revealed better outcomes in pediatric patients and low-load bearing applications. Conclusion: Biodegradable implants demonstrate efficacy comparable to metallic implants in many orthopedic applications, with the added benefit of reducing secondary removal surgeries. However, their use should be carefully considered based on patient factors, anatomical location, and mechanical requirements. Future research should focus on long-term outcomes, novel materials with improved properties, and large-scale comparative trials
A Case of Paroxysmal Supraventricular Tachycardia Clinical and Electrocardiographic Appraisal
Full text linkParoxysmal supraventricular tachycardia refers to a clinical syndrome characterized by rapid regular tachycardia with abrupt onset and termination which originates from or conducts through the atria or atrio-ventricular node. (1) We report 40- year- old male patient who underwent mitral valve replacement for rheumatic heart disease severe mitral stenosis with St Jude’s Valve who presented with recurrent palpitations. Systematic clinical and electrocardiographic analysis aids in precise non- invasive diagnosis prior to detailed electrophysiological studies
Prevalence of Asthma and COPD Overlap in Patients With Chronic COPD
Full text linkBackground: Asthma-COPD Overlap (ACO) represents a significant yet underrecognized clinical entity within the spectrum of chronic airway diseases. Understanding its prevalence and characteristics among chronic COPD patients is crucial for optimizing patient care and healthcare resource allocation.
Objective: This study aimed to determine the prevalence of ACO in patients with chronic COPD and characterize its clinical, functional, and inflammatory features compared to COPD alone.
Methods: We conducted a cross-sectional observational study across multiple respiratory care centers between January and December 2023. A total of 312 patients with confirmed COPD underwent comprehensive assessment, including spirometry, inflammatory biomarker measurement, and clinical evaluation. ACO was diagnosed based on standardized GINA/GOLD criteria, requiring both major and minor criteria fulfillment.
Results: Among 312 COPD patients, 87 (27.9%) met the diagnostic criteria for ACO. ACO patients were significantly younger (61.2 ± 7.9 vs 64.3 ± 8.9 years, p=0.006) and had lower smoking burden (28.4 ± 12.6 vs 35.7 ± 15.3 pack-years, p=0.001) compared to COPD-alone patients. ACO patients demonstrated higher bronchodilator reversibility (18.4% vs 7.2%, p<0.001), elevated blood eosinophils (385 ± 142 vs 198 ± 89 cells/μL, p<0.001), and increased FeNO levels (42 vs 22 ppb, p<0.001). They experienced more frequent exacerbations (median 2 vs 1 per year, p<0.001) and required more hospitalizations (median 1 vs 0 per year, p=0.002).
Conclusions: ACO affects a substantial proportion of COPD patients and presents with distinct clinical and inflammatory characteristics. The higher exacerbation frequency and healthcare utilization in ACO patients emphasize the importance of early recognition and appropriate therapeutic intervention. These findings support the implementation of systematic screening approaches and individualized treatment strategies for this unique patient population
Surgical Outcome of Short Segment Instrumentation including Fracture Vertebrae of Thoracolumbar Burst Fracture
Full text linkBackground: Fractures of the thoracolumbar region are the most common injuries of the spine; among them burst fractures are the most frequent. Several studies were done to see the surgical outcome in thoracolumbar burst fracture hence surgery was recommended for better outcome. So, the current study was aimed to evaluate the clinical, functional and radiological outcome of short-segment pedicle screw fixation including the fractured vertebral body. Objectives: The aim of the study was to evaluate the surgical outcome of short segment pedicle screw fixation including fracture vertebrae of unstable thoracolumbar burst fracture with incomplete spinal cord injury. Methods: In this prospective observational study, a total of 62 cases were studied from May 2019 to May 2021 through non randomized purposive sampling. All the patients were between 15 to 60 years of age and operated within 21 days of fracture by posterior decompression & stabilization by short-segment pedicle screw fixation including the fractured vertebral body. Postoperative functional outcome was assessed clinically by ASIA, ODI, VAS, Denis Work Scale, Macnab criteria and radiologically by Cob’s kyphotic angle, kyphotic deformation, Beck index & Bridwell criteria. Postoperative follow up was conducted at 6th, 12th & 24th weeks. Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: The mean age was 31.42±11.2 years with male dominancy (74.19%). Most of the cases were manual workers (51.61%). FFH was the most common cause of injury (80.65%) and L1 was the most common level of injury (54.84%). The mean duration between injury and operation time was 14.45±3.72 days. Regarding improvement of ASIA grade, 1 grade in 46 (74.19%) cases, 2 grade in 2 (3.23%) case, no improvement in 14 (22.58%) cases were seen. Complications were hemorrhage 2(3.23%), dural tear 2(3.23%), CSF leak 2(3.23%), urinary retention 4(6.45%), skin infection 2(3.23%) and bed sore 2(3.23%). Conclusion: Thoracolumbar burst fracture with incomplete spinal cord injury can be treated with short-segment pedicle screw fixation including the fractured vertebral body effectively. This method offered a better kyphosis correction, no instrument failures, appraisable clinical and functional recovery, reduce pain and improve working status with early rehabilitation