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A Study of Complications in Chronic Kidney Disease Patients on Haemodialysis at a Tertiary Care Centre
Get PDF Introduction: Chronic Kidney Disease (CKD) is a progressive condition frequently culminating in end-stage renal disease (ESRD), where hemodialysis serves as a life sustaining therapy. However, dialysis is associated with a broad spectrum of complications that adversely affect patient morbidity, quality of life, and treatment outcomes. This study aimed to assess the prevalence and patterns of dialysis-related complications and their correlation with sociodemographic and clinical factors among CKD patients at a tertiary care center. Material and Methods: A hospital based cross-sectional study was conducted in the Department of Medicine over two years (July 2023–June 2025). Ninety-five adult patients undergoing maintenance hemodialysis were included using purposive sampling. Data were collected on demographic details, comorbidities, laboratory findings, and dialysis-related complications. Complications were categorized into patient-related, technical, and vascular access-related groups. Statistical analysis explored associations between complications and clinical variables. Results: The majority of patients were aged 51–70 years (55.79%) with a slight male predominance (53.68%). Hypertension (41.05%) and diabetes mellitus (34.74%) were the most common comorbidities. Cardiovascular complications were the most frequent patient-related events (71.58%), followed by central nervous system manifestations (28.42%). Technical complications included dialyzer reactions (26.32%) and bleeding diathesis (22.11%), while vascular access-related complications comprised steal syndrome (51.58%), central venous thrombosis (18.95%), and cardiac arrest (14.74%). No statistically significant associations were observed between complications and age, gender, dialysis duration, BMI, personal history, or comorbidities, indicating multifactorial etiologies. Conclusion: Complications in hemodialysis patients are diverse, with cardiovascular, technical, and vascular access issues significantly contributing to morbidity. The absence of strong associations with clinical and demographic factors highlights the complexity of risk determinants. Early nephrology referral, individualized dialysis protocols, and multidisciplinary management are essential to mitigate these complications and improve patient outcomes.
Role of Imaging in Diagnosis of Rare Case of Hodgkin's Lymphoma
Get PDFHodgkin's lymphoma (HL) is an uncommon but highly curablepediatric malignancy, rarely diagnosed in children below ten years of age due to its subtle, nonspecific clinical presentation. We report a rare case of classical HL in a 7- year-old male presenting with low-grade fever, dry cough, pallor, and cervical lymphadenopathy. The patient had been empirically started on anti-tubercular therapy without improvement. Clinical evaluation revealed hepatosplenomegaly and widespread lymphadenopathy. Chest X-ray and abdominal ultrasonography weresuggestive of a mediastinal mass and multiple splenic lesions. Contrast-enhanced computed tomography (CECT) confirmed a large, homogeneously enhancing mediastinal mass with vascular encasement and extensive abdominal nodal involvement. Based on imaging and clinical features, the case was classified as stage IVB Hodgkin lymphoma per Lugano classification. Histopathological confirmation was achieved through lymph node biopsy revealing Reed-Sternberg cells. Multimodal imaging played a pivotal role not only in initial detection and staging butalso in identifying biopsy sites and guiding therapeutic decisions. This caseunderscores the diagnostic value of integrated imaging-including ultrasound, CECT, and PET/CT-in accurately evaluating pediatric lymphomas, especially in atypical age groups. It also highlights the risk of misdiagnosis and treatment delays when empirical therapies like ATT are initiated without confirmatory histology. Prompt imaging and tissue diagnosis are vital to ensure timely intervention and optimal outcomes. A multidisciplinary approach, integrating radiologic, pathologic, and clinical expertise, is crucial for managing such rare pediatric malignancies and improving long-term prognosis
Synthetic Seeds: A Boon for Conservationand Exchange of Germplasm
Get PDFProduction of synthetic seeds is effective for conservation and propagation of rare, endangered, critically endangered and threatened plants which are difficult to regenerate through conventional methods and due to low seed set and poor seed germination. There are some factors which discourage commercial cultivation of plants like excessive human exploitation, low germination percentage, less viability of the seeds and long gestation periods. Unsystematic collection of plants for their medicinal, ornamental, perfumery etc. and habitat destruction are potential causes of threats to natural population. The synthetic seed technology provides alternative methods for production of seeds by using various plant parts viz. shoot apices, nodal explants, somatic embryos etc. The quick development in somatic embryogenesis methods permits the use of somatic embryos in plant micropropagation as synthetic seeds. The present review discusses the need for conservation and alternative methods for conservation and exchange of germplasm through the development of synthetic seeds
Analysis of Phytochemical and High Performance Liquid Chromatography in Desmostachya bipinnata
Get PDFDesmostachya bipinnata is popularly known as holy grass. It shows antibacterial effect against gram negative and gram positive pathogens. In present investigation preliminary phytochemical screening and HPLC studies of Desmostachya bipinnata were analysed. Preliminary Phytochemical analysis showed that carbohydrates, phytosterols, saponins, Tanins , phenolic compounds, flavonoids, lignin were present. The HPLC result shows thata high peak of retention time minutes 2.5 significant 2.641 was found
Radiological approach for early diagnosis of diabetic foot disease
No full textIntroduction: Diabetic foot disease (DFD) is a serious complication of diabetes mellitus, leading to ulcers, infections, and amputations. Early detection is critical to prevent severe morbidity. This study investigates the effectiveness of various radiological modalities in diagnosing DFD at its early stages, particularly before ulcer formation.
Aim and Objective: To diagnose diabetic foot disease in its early stage and evaluate the role of different radiological modalities—especially ultrasound and MRI—in its early detection and monitoring, thereby enabling timely management and prevention of progression to advanced disease.
Materials and Methods: This prospective observational study was conducted on 96 diabetic patients with suspected early foot complications. All patients underwent ultrasound with Doppler assessment. MRI was performed in 24% of patients based on clinical indication. Imaging findings were correlated with clinical data and monitored over time. Ethical clearance and informed consent were obtained.
Results:The study population consisted predominantly of males (58.33%) aged 46–60 years (38.54%). Symptomatic presentations were more common (66.67%). Atherosclerosis was the most frequent risk factor (66%), followed by poor glycemic control (19.61%). Ultrasound detected abnormalities in 73 of 96 cases, yielding a 76% diagnostic capability. MRI identified changes in14 of 23 patients, yielding a 60% diagnostic capability. Ultrasound was effective in identifying vascular and soft tissue changes, while MRI provided detailed soft tissue and bone marrowevaluation in complex cases.Conclusion:Ultrasound is a valuable first-line imaging modality in early DFD diagnosis. MRI serves as an essential adjunct in selected cases. Integrating both into diabetic foot evaluation protocols enhances early detection and improves patient outcomes
Study of Clinical Profile of Cerebrovascular Accident in Tertiary Care Hospital
Get PDF Introduction: Cerebrovascular accident (CVA) or stroke is a leading cause of morbidity and mortality worldwide, significantly affecting quality of life and posing a heavy socioeconomic burden. The present study was undertaken to analyzed clinical profile of stroke patients admitted to a tertiary care hospital, with a focus on demographic characteristics, risk factors, and clinical presentations. Material and Methods: This observational prospective study was conducted in the Department of General Medicine, including all patients >18 years admitted with CVA between July 2023 and June 2025. Diagnosis was established using clinical and radiological criteria. Patients with trauma-related stroke, transient ischemic attacks, unstable hemodynamic status, pregnancy were excluded. Demographic data, risk factors, clinical features were systematically recorded and analyzed. Results: A total of 180 patients were studied. The majority were aged 61–75 years (77.78%), with males comprising 60% of cases. The most common presenting complaint was weakness (31.67%), followed by visual disturbances (15.56%) and seizures (12.22%). Gradual onset of symptoms was reported in 65% of patients, while 35% presented with sudden onset. A positive family history of CVA was observed in 48.33%, and personal risk factors included smoking (30.56%) and alcohol consumption (26.67%). Hypertension was the most prevalent comorbidity, with 67.78% of patients showing elevated blood pressure. Neurological evaluation revealed 69.44% of patients were disoriented, 26.11% had non-fluent or fluent aphasia, and significant motor weakness was noted in the majority, with 62.22% showing 0–2/5 power. Conclusion: The study highlights that CVA predominantly affects elderly males, with hypertension, smoking, alcohol consumption being key risk factors. Weakness and visual disturbances were the most common presenting features. Early identification of risk factors and timely intervention remain crucial for reducing stroke incidence and improving outcomes.
A Study of Clinical Profile of Hypertension in Elderly Age Group in Tertiary Care Hospital
Get PDF Introduction: Hypertension is a major cause of cardiovascular morbidity and mortality, with prevalence exceeding 60% in those above 60 years. Age-related vascular changes, sedentary lifestyle, and reduced renal function contribute to isolated systolic hypertension, making it a key public health concern.
Aim and Objective: To study clinical profile, associated factors, and presentations of hypertension in elderly patients.
Materials & Methods: A prospective observational study was conducted in the Department of General Medicine, a tertiary care hospital, from June 2023 to May 2025. A total of 180 hypertensive patients aged >60 years were enrolled. Data on demographics, comorbidities, lifestyle, and clinical/laboratory parameters (CBC, RFT, LFT, lipid profile, ECG, fundus exam, urine microscopy, and USG) were collected. Analysis was performed using SPSS with appropriate statistical tests; p<0.05 was considered significant.
Results: Among 180 elderly hypertensive patients, most were 60–70 years, females, and from lower socioeconomic backgrounds. Obesity, physical inactivity, smoking, and alcohol use were common, along with comorbidities like diabetes and ischemic heart disease. Laboratory and imaging findings revealed dyslipidemia, renal impairment, ECG abnormalities, and fundus changes, indicating early end-organ damage.
Conclusion: Elderly hypertension is strongly associated with modifiable risk factors and multiple comorbidities. Early screening, lifestyle interventions, and comprehensive geriatric care are essential for preventing complications in this vulnerable group.
Predictive Value of Cord Blood Albumin For Neonatal Hyperbilirubinemia in Term Newborns: A Prospective Study
Get PDFAim: This study aimed to evaluate the predictive value of cord blood albumin (CBA) levels in assessing the risk of neonatal hyper-bilirubinemia (NNH) in term newborns and determine an optimal CBA threshold for phototherapy (PT) prediction. Introduction: Neonatal jaundice affects 60% of term and 80% of preterm infants. Severe cases need timely intervention to prevent kernicterus. Early discharge increases undiagnosed jaundice risk, especially in low-resource settings. CBA - Cord blood Albumin is a potential biomarker for identifying high-risk newborns, enabling early intervention and follow-up planning. Methods: This prospective observational study was conducted at Jagannath Gupta Institute of Medical Sciences and Hospital, Kolkata, over 18 months (July 2022 - December 2023). Eighty term newborns meeting inclusion criteria were enrolled. CBA levels were measured at birth, and total serum bilirubin (TSB) was assessed at 72 hours. The requirement for phototherapy was determined using AAP guidelines. Statistical analyses were conducted using SPSS version 26. Results: Of the 80 newborns, 13 (16.25%) developed significant jaundice, requiring phototherapy but not exchange transfusion. Newborns werecategorized by CBA levels: ≤2.8 g/dL (81. 8% developed jaundice), 2.9–3.3 g/dL (9.3% developed jaundice), and ≥3.4 g/dL (0% developed jaundice). A significant negative correlation (r = -0.41, p < 0.00001) was found between CBA and TSB levels, confirming that lower CBA levels were associated with higher bilirubin levels. Conclusion: CBA ≤2.8 g/dL strongly predicts neonatal jaundice, while CBA ≥3.4 g/dL is protective. CBA measurement at birth serves as a low-cost screening tool for identifying newborns at risk, guiding early discharge and follow-up decisions. Larger studies are needed to establish standardized CBA thresholds for routine screening
To Study Cardiovascular Changes in Patient of Anemia
Get PDF Introduction: Anemia is a widespread hematological disorder that significantly impacts cardiovascular health due to the reduced oxygen-carrying capacity of blood. Chronic anemia compels the cardiovascular system to initiate compensatory mechanisms, including tachycardia, increased stroke volume, and hyperdynamic circulation, which eventually predispose to structural and functional cardiac changes such as left ventricular hypertrophy (LVH), cardiomegaly, arrhythmias, and heart failure.
Aim and Objective: The present study aimed to evaluate cardiovascular changes in anemic patients using electrocardiography (ECG), echocardiography, and chest X-ray, with objectives to assess the distribution of anemia types, their association with cardiovascular abnormalities, and the relationship between hemoglobin levels and cardiac function.
Materials and Methods: This prospective observational study was conducted in the Department of General Medicine, G.R. Medical College, Gwalior, over 17 months (May 2023–September 2024). A total of 100 anemic patients (Hb <13 g/dL in males, <12 g/dL in females), aged 18–70 years, with equal gender representation, were included. Clinical evaluation, hematological investigations, ECG, echocardiography, and chest X-ray were performed. Data were analyzed using chi-square test to determine associations.
Results: Microcytic hypochromic anemia was most common (51%), followed by normocytic normochromic (23%), macrocytic (21%), and dimorphic (5%). Cardiovascular involvement was evident, with LVH in 61%, cardiomegaly in 59%, and ECG abnormalities in 68%, mainly ST depression with T inversion and sinus tachycardia. Significant associations linked microcytic anemia with poor sanitation and worm infestation.
Conclusion: Anemia, particularly iron deficiency type, exerts profound cardiovascular effects, with LVH, cardiomegaly, and ECG abnormalities predominating. Early recognition, correction of anemia, and routine cardiac evaluation are crucial for preventing long-term morbidity and mortality.
Clinical & Ultrasonography Based Scoring to Predict Pre-Operatively the Conversionof Laparoscopic to Open Cholecystectomy - A Prospective Observational Study
Get PDFIntroduction: Laparoscopic cholecystectomy (LC) is the standard procedure for gallbladder removal due to its minimally invasive nature and better postoperative outcomes. However, conversion to open cholecystectomy (OC) may be required in certain high-risk cases, leading to longer operative times and increased morbidity. Early identification of factors predictive of conversion is essential to improve surgical preparedness and patient counseling.
Materials & Methods: This prospective observational study was conducted at the Department of General Surgery, J.A. Group of Hospitals, Gwalior, over 18 months. A total of 330 patients diagnosed with cholelithiasis and planned for LC were evaluated preoperatively using a clinical and ultrasonographic scoring system. Parameters included gallbladder morphology, wall thickness, stone size and location, number of attacks, duration of complaints, and comorbidities. Standard laparoscopic cholecystectomy was performed, and intraoperative conversion rates were recorded. Statistical analysis was done using SPSS-25, with ROC curve analysis used to identify predictive cutoff scores.
Results: Out of 330 patients, 38 (11.5%) required conversion to OC. The conversion rate was significantly higher in patients aged 51–60 years (29.6%), those with multiple prior attacks (up to 83.3%), and those with complaints longer than 12 months (60.5%). Ultrasonographic factors such as gallbladder wall thickness >3 mm, stone at the neck, stone size ≥2 cm, and pericholecystic collection were significantly associated with conversion. A USG score cutoff of >8.5 predicted conversion with moderate sensitivity and specificity.
Conclusion: Clinical and ultrasonographic parameters effectively predict the likelihood of conversion from LC to OC. The scoring system aids in risk stratification, surgical planning, and informed consent, ensuring better outcomes and resource optimization