International Medical Publishing Group(IMPG), India
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A Study of Clinical Profile of Hypertension in Elderly Age Group in Tertiary Care Hospital
No full text Introduction: Decompensated alcoholic liver disease (DALD) is a major cause of morbidity and mortality worldwide, with complications including ascites, hepatic encephalopathy, hepatorenal syndrome, and spontaneous bacterial peritonitis. Hyponatremia, defined as serum sodium <135 mEq/L, is common in cirrhosis and strongly influences prognosis. This study was conducted to evaluate the clinical significance of serum sodium levels and their correlation with disease severity in patients with DALD.
Material & Methods: A prospective observational study was conducted at a tertiary care center from July 2023 to June 2025. A total of 180 male patients aged >18 years, diagnosed with DALD, were enrolled based on clinical, biochemical, and imaging findings. Patients with cardiac failure, chronic kidney disease, or on interfering medications were excluded. Clinical history, laboratory investigations, and imaging were recorded. Disease severity was assessed using Model for End-Stage Liver Disease (MELD), MELD-Na, and Child-Pugh scoring systems. Data were analyzed using SPSS, with p <0.05 considered significant.
Results: Among 180 patients, the majority were aged 36–50 years (62.78%), with farming as the most common occupation (27.78%). Hyponatremia (<135 mEq/L) was present in 34.44%, normonatremia in 51.11%, and hypernatremia in 14.44%. Patients with sodium <135 mEq/L demonstrated higher MELD scores (27–31 in 13.89% cases) and were more frequently classified as Child-Pugh class C (22.78%). Hyponatremia was strongly associated with severe complications, including ascites, hepatic encephalopathy, and hepatorenal syndrome.
Conclusion: Serum sodium is a simple, inexpensive, and reliable biomarker in DALD. Hyponatremia correlates with advanced disease severity and poor prognosis, emphasizing its utility in risk stratification. Integration of serum sodium into prognostic scoring systems like MELD-Na enhances predictive accuracy, supporting early intervention and improved patient management in tertiary care settings.
Study on Post Dated Pregnancy: Its Maternal and Foetal Outcome
Get PDFIntroduction: Post-dated pregnancy, defined as a pregnancy extending beyond 40 weeks of gestation, is associated with increased maternal and fetal risks. The incidence ranges from 4% to 14%. Complications include meconium-stained liquor, oligohydramnios, fetal distress, macrosomia, shoulder dystocia, and increased rates of operative deliveries. This study aims to evaluate the maternal and fetal outcomes in post-dated pregnancies to guide better clinical management and reduce morbidity.
Materials & Methods: This descriptive longitudinal study was conducted at the Department of Obstetrics and Gynecology, Tezpur Medical College, Assam, from 2023 to July 2024. A total of 106 pregnant women with gestational age between 40–42 weeks were included based on strict inclusion and exclusion criteria. Data were collected using clinical examination, ultrasonography, biophysical profiling, and monitoring tools. Mode of delivery, perinatal morbidity, and maternal complications were recorded. Statistical analysis was performed using SPSS version 23 with chi-square tests; p < 0.05 was considered significant.
Results: Among the 106 patients, the majority were aged 20–25 years. Spontaneous vaginal delivery occurred in a significant proportion, while cesarean section was required in many cases due to fetal distress and failed induction. Maternal complications included perineal tears, postpartum hemorrhage, and prolonged labor. Fetal complications observed were low Apgar scores, meconium aspiration syndrome, NICU admission, and the need for neonatal resuscitation. A statistically significant correlation was found between gestational age and increased perinatal complications.
Conclusion: Post-dated pregnancy poses significant maternal and fetal risks. Early identification and timely induction, coupled with vigilant intrapartum monitoring, can improve outcomes. Regular antenatal care and accurate dating using first-trimester ultrasound are essential in minimizing complications associated with post-dated pregnancies.
Unraveling Obstructive Jaundice: A Comparative Analysis of USG and MRCP
Get PDF Background: Obstructive jaundice, caused by mechanical blockage in the biliary system, presents a common diagnostic challenge in gastrointestinal and hepatobiliary medicine. Early and accurate identification of the underlying etiology and level of obstruction is vital for guiding treatment. Ultrasonography (USG) is often used as the first-line imaging modality due to its accessibility and cost-effectiveness, whereas Magnetic Resonance Cholangiopancreatography (MRCP) has emerged as a superior non-invasive technique for detailed evaluation of the biliary tract. Objective: To compare the diagnostic efficacy of USG and MRCP in identifying the cause and location of obstructive jaundice, and to assess their respective sensitivity, specificity, and overall diagnostic accuracy. Methods: A prospective observational study was conducted involving 40 patients with clinical and biochemical features of obstructive jaundice. Each participant underwent both USG and MRCP using standardized protocols. Imaging results were evaluated against clinical findings and, when available, ERCP data. Diagnostic metrics including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were computed. Results: Of the 40 patients, choledocholithiasis was the most common cause (52%), followed by CBD stricture (15%) and periampullary carcinoma (7%). MRCP demonstrated superior diagnostic performance with a sensitivity of 94.87%, specificity of 50%, PPV of 97.42%, NPV of 20%, and accuracy of 92.68%. In comparison, USG yielded a sensitivity of 67.75%, specificity of 33.3%, PPV of 86.6%, NPV of 10%, and accuracy of 65%. MRCP was particularly effective in detecting distal CBD lesions and rare entities like Lemmel syndrome. Conclusion: MRCP is significantly more accurate than USG in diagnosing both benign and malignant causes of obstructive jaundice. While USG remains a valuable initial screening tool, MRCP should be considered essential for comprehensive diagnostic assessment and treatment planning.
Vocal Pathologies and “GERD” Association in a Tertiary Care Centre of Assam
No full textBackground: Vocal pathologies can arise due to multiple etiologies, with gastroesophageal reflux disease (GERD) emerging as a significant extralaryngeal factor. This study evaluates the epidemiological profile and the association between GERD and vocal pathologies in patients attending a tertiary care voice clinic in Assam.Methods: A cross-sectional observational study was conducted on 100 patients presenting with voice disorders. Demographic details, clinical history, systemic comorbidities, and laryngoscopic findings were recorded. The Reflux Symptom Index (RSI) was used to assess the presence and severity of GERD.Results: Among the 100 patients, 59% were females. GERD was present in 70% of cases. A strong correlation was observed between GERD and vocal fold pathologies, particularly vocal fold edema (41%), nodules (25%), and polyps (19%). The age group most affected was 46–60 years (30%). Lifestyle factors like tobacco (78%) and caffeine (89%) intake were prevalent.Conclusion: GERD is significantly associated with a spectrum of vocal cord disorders. Early diagnosis using RSI and fiberoptic laryngoscopy, along with GERD management, is essential in preventing chronic vocal injury
A Clinical Study of Treatment Outcomes in Patients with Liver Abscess in a Tertiary Care Hospital
Get PDF Introduction: This study investigated treatment outcomes in 200 patients with liver abscesses over 1.5 years at a tertiary care hospital.
Materials & Methods: Patient demographics, clinical presentations, treatment methods, and outcomes such as abscess resolution, complications, and hospital stay duration were examined.
Results: Results revealed that antibiotic therapy alone was successful in 72% of cases, particularly for abscesses smaller than 5 cm and in patients who were hemodynamically stable. Percutaneous drainage was employed in 20% of patients, demonstrating a high success rate with minimal complications, and was most effective for abscesses that were not amenable to antibiotic treatment alone. Surgical intervention was required in 8% of cases, especially for large or multi-loculated abscesses, or those with complications like rupture or sepsis, resulting in longer hospital stays and a higher complication rate compared to less invasive treatments. Factors influencing outcomes included abscess size, patient comorbidities, and initial response to antibiotics.
Conclusion: The study underscores the significance of early diagnosis and individualized treatment plans in achieving favorable outcomes for patients with liver abscesses. A multidisciplinary approach is recommended for managing complex cases to optimize patient outcomes and minimize complications. The study suggests the need for further prospective research to refine treatment strategies and improve patient care in liver abscess management.
Efficacy of Using Voiding Time as A Uroflow Parameter for Detecting Urinary Obstruction in Men with Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasiaia
Get PDFIntroduction: Benign Prostatic Hyperplasia (BPH) is a common condition in aging men characterized by prostate enlargement that causes bladder outlet obstruction, leading to Lower Urinary Tract Symptoms (LUTS) such as frequency, urgency, weak urine stream, and incomplete bladder emptying. Accurate assessment of urinary obstruction is essential for appropriate management; however, conventional diagnostic tools like pressure-flow studies are invasive and expensive. Therefore, identifying a simple, non-invasive, and cost-effective parameter such as voiding time may provide an alternative diagnostic approach.
Aim & Objective: To evaluate the role of voiding time as a uroflowmetric parameter for detecting urinary obstruction in men with LUTS secondary to BPH and to determine its correlation with the severity of obstruction assessed by urodynamic and clinical parameters.
Materials & Methods: A cohort of men diagnosed with BPH presenting with LUTS underwent uroflowmetry to record voiding time along with other parameters such as peak urinary flow rate (Qmax). These findings were compared with urodynamic study results and clinical assessments to analyze the correlation between voiding time and the degree of urinary obstruction.
Results: The study demonstrated a significant association between prolonged voiding time and increased severity of urinary obstruction. Patients with longer voiding times exhibited reduced Qmax values and higher obstruction grades on urodynamic evaluation.
Conclusion: Voiding time shows potential as a simple and practical indicator for detecting urinary obstruction in men with BPH-related LUTS. Its use could facilitate early diagnosis and timely management, improving patient outcomes and quality of life. Larger-scale studies are warranted to further validate its diagnostic utility
Molecular Approach to Repair Damage on Streptozotocin Induced Diabetic Rats
Get PDFStreptozotocin- induced diabetic rats used as model to design drug for the treatment of diabetes and its related cardiac disease. The research was designed to investigate the differential expression of specific gene in diabetic rats treated with novel protein isolated from extract of Eugenia jambolana seeds used as trial therapeutic compound for drug development. Diabetes increases oxidant stress and doubles the risk of dying after myocardial infarction, but the mechanisms underlying increased mortality are unknown. Rats with streptozotocin-induced diabetes developed profound heart rate slowing and doubled mortality compared with controls after myocardial infarction Streptozotocin induces diabetic rat treated with Eugenia jambolana extracts had increased cell survival, maintained normal heart rates, and were resistant to diabetes-attributable mortality after myocardial infarction. Heart tissues from STZ induced diabetic rats were subjected to RNA extraction for gene expressionby using real time RT-PCR. Three diabetic cardiac-specific genes of interest such as IGF-1, VEGF and ANG-1 were chosen and the expression level of these genes has examined and the abnormal expression of genes in STZ induced diabetic group would be rescued by the protein of Eugenia jambolana based therapy. Gene expression of VEGF, ANG-1 and IGF-1 was upregulated after administrated protein of Eugenia jambolana (EJ) evidenced by RT-PCR. Administration of protein of Eugenia jambolana to diabetic rats significantly enhances survival, proliferation, and the angiogenic ability to improved function in a diabetic animals confirmed plant protein might be useful for the management of the diabetic cardiomyopath
Surgical Management of a Giant Papillary Thyroid Carcinoma: A Case Report
Get PDFIntroduction: Giant goitres are uncommon thyroid enlargements that may extend over decades, often resulting in compressive symptoms and aesthetic concerns. Although most long-standing goitres are benign, the potential for malignant transformation exists. Early diagnosis and timely surgical management are crucial to prevent complications and ensure optimal outcomes.
Case Presentation: We report a case of a 63-year-old female who presented with a massive anterior neck swelling that had been progressively enlarging over a period of 20 years. Clinical evaluation and ultrasonography were performed, followed by fine needle aspiration cytology (FNAC), which suggested a follicular neoplasm. The patient was planned for surgical excision under general anesthesia.
Results: Intraoperatively, a well-encapsulated, highly vascular thyroid mass was identified and successfully excised. The specimen weighed approximately 4 kg (8.81 lbs). Histopathological examination confirmed the diagnosis of papillary thyroid carcinoma with areas of cystic degeneration. The postoperative course was uneventful, and the patient recovered without complications.
Conclusion: This case highlights the rarity of giant goitres and underscores the importance of early diagnosis, careful preoperative assessment, and meticulous surgical planning. Even in long-standing goitres presumed benign, the risk of underlying malignancy should be considered. Timely surgical intervention not only minimizes morbidity but also facilitates early detection and treatment of occult malignancies, thereby improving patient outcomes
Heavy metal Cd affecting nodulation and leghaemoglobinproteins in soybean and chickpea
Get PDFCadmium, one of the heavy metal soil pollutants, affects nitrogen fixing efficacy of legumes adversely. Nodulation in soybean reduces with Cd induced stress. The heavy metal effect in terms of root nodulenumber gets substantiated in cumulative manner from vegetative to flowering to pod filling stage of the crop. Increased amino acid content of soybean root nodules was highest at flowering stage and dose dependent also. The increase in level of this metabolite also coincided with nodular senescence and age related changes. Leghaemoglobin content of root nodules lowers significantly both in soybean and chickpea with higher doses of Cd. Brown coloration of root nodules was an indicator of the Lb degradation noticed at flowering and pod filling growth stages in the presence of heavy metal. Such changes lower crop productivity due to ineffective nodulation and the lesser availability of nitrogen in Cd polluted soil
Diversity and Virulence Profile of Aeromonasfrom potable water
Get PDFAeromonas spp. are autochthonous in the aquatic ecosystem and some of them has been increasingly found, in patients with various diseases like enteritis, wound infection and even septicemia in amphibians, reptiles, frog, fish and in patients with impaired immunity. There are different virulence factors like aerolysin, hemolysins, cytotoxins, enterotoxins, proteolytic activity, lipolytic activity, gelatinase, slime production, DNases, and adhesions. These virulence factors are used as survival means, self defense mechanism and establishment of pathogenicity. They are also capable of forming biofilm and are found multiresistant, although free cells of Aeromonas may be relatively susceptible to disinfection; populations associated with biofilms may survive high chlorine dosing. Thus water distribution systems should be monitored to check the quality of water and for the purpose of public healt