ScopeMed - RSShttp://www.scopemed.orgScopeMed RSSen-us Copyright © 2011 ScopeMed All rights reserved. ScopeMedhttp://www.scopemed.org/img/logo-scopemed-ttk.gifhttp://www.scopemed.org 2016-09-24T20-40-29Z Role of adenosine deaminase in diagnosis of exudative type of pleural effusion http://www.scopemed.org/?mno=236498 2016-09-24T20-40-30Z
Source: International Journal of Medical Science and Public Health
R S Pushpa Kumari, B L Narsimha Reddy, V A Vipula.
Background: The diagnosis of tubercular pleural effusion remains a common clinical challenge. At least 50% of cases of tubercular pleural effusion present as primary disease without involvement of other organs. Objectives: Estimation and comparison of Adenosine Deaminase (ADA) levels in exudative pleural effusions with special reference to tubercular aetiology. Materials and Methods: Sixty patients of pleural effusions of various aetiologies formed the sample of the study. Pleural fluid analysis was done and clinical profile of each patient was taken. Total patients were divided into 6 groups consists of Tubercular pleural effusion (39), parapneumonic effusion (10), emphyema (5), malignant pleural effusion (3), pancreatic pleural effusion (2) and amoebic pleural effusion (1). Results: Incidence of tubercular pleural effusion is 65% followed by parapneumonic effusions 16.6%. Males (68.3%) are more prone to incidence of tubercular pleural effusion. Conclusion: Pleural fluid Adenosine deaminase (ADA levels are highly sensitive for tuberculous pleural effusions. ADA is diagnostic even in HIV positive patients with tubercular pleural effusion. ADA levels easily differentiate tuberculous pleural effusion from parapneumonic, malignant, pancreatic, and amoebic pleural effusions.
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Sat, 24 Sep 2016 08:46:02 GMT -08:00 http://www.scopemed.org/?mno=236498
Patterns of spirometry in asthmatic patients presenting with respiratory symptoms http://www.scopemed.org/?mno=240692 2016-09-24T20-40-30Z
Source: International Journal of Medical Science and Public Health
Tarig H Merghani.
Background: Asthmatic patients typically show obstructive patterns on spirometry with positive bronchodilator responses; however, other spirometric patterns were also reported. Objective: to determine patterns of spirometry among asthmatic patients who attend the outpatient clinic with respiratory symptoms. Materials and Methods: A cross-sectional study was conducted among 323 known asthmatic patients (59% females) who attended the outpatient clinic with respiratory complaints. A portable spirometer (All flow, Clement Clarke International, Harlow, UK) was used for lung function measurements. Measurements and reversibility tests were performed according to the American Thoracic Society (ATS) Guidelines for spirometry measurements. Result: Normal spirometric pattern was found in only 21% of all participants, obstructive in 12%, mixed in 32%, and restrictive in 36%. The patterns had no relation with the gender or the body mass index of the participants. The majority had low FEF25 (88%), low FEF50 (83%), and low FEF25-75% (82%) indicating inflammation within the middle and small airways. Nearly half of those who showed positive FVC reversibility tests had a restrictive pattern on presentation (p < 0.001). Conclusion: Our findings indicate poor lung function of asthmatic patients on presentation. The bronchodilator responses were positive in a considerable proportion of those who presented with non-obstructive patterns.
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Sat, 24 Sep 2016 08:45:40 GMT -08:00 http://www.scopemed.org/?mno=240692
Beneficial effects of yogasanas and pranayama in limiting the cognitive decline in Type 2 diabetes http://www.scopemed.org/?mno=240752 2016-09-24T20-40-30Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Rajani Santhakumari Nagothu, Archana Rajagopalan, Yogananda Reddy Indla, Rajesh Paluru.
Background: Out of many complications that were observed in Type 2 diabetes, cognitive impairment is the most neglected. Aim and Objectives: The aim of the present study is to assess the cognitive decline in Type 2 diabetes and to observe the role of yogasanas and pranayama in ameliorating the cognitive decline. Materials and Methods: A total of 68 Type 2 diabetic patients were recruited in the study, 34 of them did specific yogasanas and pranayama (test group) for 6 months, and the remaining age- and sex-matched 34 patients were recruited as (control group) who were not on any specific exercise regimen. Glycemic index was estimated by measuring the glycosylated hemoglobin (HbA1c) concentration with Bio-Rad apparatus and cognition were assessed using Addenbrooke’s cognitive examination-revised (ACE-R), which is a neuropsychological battery. Data were analyzed with unpaired student t-test. P < 0.05 is considered as statistically significant. Validity was assessed by receiver operating characteristics. Results: Analysis of data indicated more cognitive scores in the test group when compared with the control group. In test group, 6 months practice of yogasanas and pranayama has also significantly brought down the high glycemic values which were observed in the control group. Conclusion: These findings allow the study to conclude that regular practice of yogasanas and pranayama has a beneficial effect on cognitive performance in Type 2 diabetic patients by stabilizing blood glucose.
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Sat, 24 Sep 2016 08:33:34 GMT -08:00 http://www.scopemed.org/?mno=240752
Acute intermittent porphyria-a diagnostic dilemma with a non-abdominal cause of abdominal pain http://www.scopemed.org/?mno=236671 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Mohamed Reshad, Khushwah Supriya, Sudhir Shyam, Honna Krishnamurthy Mithun.
Acute intermittent porphyria is a serious neurological condition that can present with different manifestations, including seizures. As seizure is a presenting feature of multiple clinical etiologies, it can also mask other symptoms, at times leading to certain possibilities being overlooked. We report a case of a 14 year old girl, who presented with seizure as the chief complaint, later on developing pain abdomen, which was eventually diagnosed to have acute intermittent porphyria.
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Sat, 24 Sep 2016 03:57:45 GMT -08:00 http://www.scopemed.org/?mno=236671
Charles Bonnet syndrome: an interesting case http://www.scopemed.org/?mno=238000 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Munish Kumar, Alok Onkar Sahu, Vijai Kumar Rai.
Charles Bonnet syndrome (CBS) characterized by formed and complex visual hallucinations that occur in visually-impaired individuals who are otherwise mentally normal. We report a case of 52-year-old hypertensive male presented to the emergency department with chief complaint of sudden onset bilateral painless complete visual loss with complex visual hallucinations. On physical examination patient was neurologically normal except bilateral complete visual loss. On MRI brain had bilateral acute infarct in occipital cortices. Follow up after two months his vision improved a little but hallucinations disappeared completely.
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Sat, 24 Sep 2016 03:56:59 GMT -08:00 http://www.scopemed.org/?mno=238000
Multifocal myxoid liposarcoma: a rare and controversial entity-case report with literature review http://www.scopemed.org/?mno=237767 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Pradosh Kumar Sarangi, Sanjay Kumar Nahak, Sasmita Parida, Jayashree Mohanty, Basanta Manjari Swain.
Multifocal soft tissue sarcoma (STS) is a rare and controversial entity, accounting for about 1% of patients with extremity STS and 4.5% of patients with liposarcoma. Multifocal presentation can occur synchronously or metachronously and is defined as the presence of tumor at two or more anatomically separate sites before the manifestation of disease in sites where sarcomas usually metastasize (e.g., lungs, liver, bone). Myxoid liposarcoma is the predominant histological type in multifocal presentation. This matter is debated as to whether this entity represent an unusual pattern of metastasis or multiple separate primary tumors as the differentiation between second primary and metastatic lesions has major clinical consequences. Recent literatures based on molecular biologic analysis of tumor clonal heterogeneity suggest metastatic nature. Multifocal myxoid liposarcoma has an aggressive clinical course with frequent recurrences and poor prognosis. Surgery remains the mainstay of treatment with adjuvant chemo and radiotherapy. Herein we are reporting a case of metachronous multifocal myxoid liposarcoma with multiple tumor sites (bilateral breasts, anterior chest wall, anterior abdominal wall, right shoulder area, left thigh etc.) which developed after one year of lumpectomy of myxoid liposarcoma of left breast. A recent review of literature pertaining to its unusual metastatic character, imaging and pathologic features is made.
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Sat, 24 Sep 2016 03:56:08 GMT -08:00 http://www.scopemed.org/?mno=237767
A case of bilateral acute angle closure attack with some unusual features http://www.scopemed.org/?mno=232425 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Bhanu Devi, Rajiv Kr Das, Supantha Bhattacharjee.
A 45 year old male presented with sudden severe pain, redness and marked diminution of vision in both eyes along with corneal oedema, pigmented KPs and raised IOP. After treatment with hyper osmotic agents, IOP came down and cornea became clear. Anterior chamber was shallow bilaterally with ring synechia. Gonioscopy revealed peripheral anterior synechiae in left eye and occludable angle in the right eye. Fundus examination was within normal limit. The patient was treated with antiglaucoma medications and steroid. Trabeculectomy was done in left eye with laser PI in the fellow eye. IOP came down within normal limits on subsequent visits with residual iris sphincter damage.
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Sat, 24 Sep 2016 03:55:24 GMT -08:00 http://www.scopemed.org/?mno=232425
Patient of carcinoma cervix presenting with oculomotor palsy due to meningeal carcinomatosis- a case report http://www.scopemed.org/?mno=237803 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Harharpreet Kaur, Kawalinder Girgila, Inderjit Kaur.
We report a case of isolated pupil involving oculomotor nerve palsy as the inaugural and the only clinical sign of meningeal carcinomatosis (MC) in a patient of carcinoma of cervix. There were no other neurological signs and symptoms except for headache. The first MRI was unremarkable but a repeat MRI after 15 days showed meningeal enhancement which pointed towards the diagnosis. The CSF was also normal. This case highlights the importance of considering MC in all patients who develop sudden ptosis due to oculomotor palsy in a cancer patient even if MRI is normal.
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Sat, 24 Sep 2016 03:50:30 GMT -08:00 http://www.scopemed.org/?mno=237803
A clinical study to evaluate therapeutic efficacy of soft contact lenses in corneal diseases http://www.scopemed.org/?mno=226012 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Sharda Punjabi, Nutan Bedi.
Background: Therapeutic contact lenses have a wide range of uses. This study was planned to evaluate therapeutic efficacy of soft contact lenses in various corneal diseases for providing and promoting relief of pain, epithelial healing, protection, improving visual acuity. Methods: This study was conducted in ophthalmology department of a tertiary care teaching hospital after taking permission from the institutional ethics committee. Before subjecting the patient to treatment of therapeutic hydrophilic contact lens therapy for various corneal diseases, a detail clinical history and thorough local examination and certain investigations were performed and treatment given for each condition was standard. Evaluation of patient was done daily in admitted patients and after 3 days in discharge patients, then weekly for first month then follow up was done depending on underlying condition; maximum for 6 months. Patients were monitored for amelioration of signs and symptoms, improvement in visual acuity and slit lamp examination finding and change in intraocular pressure was also recorded. Results: Total 50 enrolled cases were divided in eight groups. Improvement in patients was 70% for bullous keratopathy group, 80% (Corneal perforation and descemetocoel group), 70% (corneal ulcer group), 40% (dry eye syndrome group), 66.67% (lid abnormalities group), 100% (filamentary keratitis and superior limbic keratoconjunctivitis group), 66.67% (recurrent corneal erosion group), and 100% in drug delivery group. Superficial corneal neovascularisation (10%) was found more common complication followed by infectious keratitis (6%) and lensopathy (4%). Conclusions: Soft contact lenses can be safely advocated as a part of therapy along with adjuvant conventional management with well expected improvement in the ocular corneal diseases.
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Sat, 24 Sep 2016 03:50:05 GMT -08:00 http://www.scopemed.org/?mno=226012
The role of brush cytology in diagnosing lesions of biliary tract http://www.scopemed.org/?mno=239905 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
S. Sridevi, A. Bhagya Lakshmi, B. V. S. Kartheek.
Background: Biliary brushing during endoscopic retrograde cholangiography pancreatography (ERCP) helps in the diagnosis of lesions of biliary tract. We compared the cellular and diagnostic results of various samples taken from the stricture site with the help of brushings taken from stricture site. The aim of this study was to know the age and sex prevalence in subjects suffering from biliary tract lesions and to know the role of ERCP guided brush cytology smears in diagnosing various lesions of exrtrahepatic biliary tract. Methods: It is a hospital based study conducted in the Department of Pathology, Andhra Medical College. Brush cytology smears were obtained from twenty patients and cytological examinations was conducted. All the clinical details and investigation reports were collected. Results: The age group of patients in this study ranged from 30 to 75 years. The numbers of cases analyzed during this period were 20. The mean age of presentation was 55 years. Male: Female ratio was 3:2. Majority of these cases presented with obstructive jaundice. Brush cytology smears from distal bile duct showed malignant cells hence our study revealed distal bile duct is more vulnerable to malignancy. Among all the 20 cases, 12 cases (60%) were reported as cholangiocarcinoma and the remaining 8 cases (40%) were included under benign/reactive. Among benign/reactive lesions, one case showed Micro-filarial infestation with reactive atypia of cells. Conclusions: The current study was conducted to assess the relative accuracy of brush cytology for diagnosis of malignant biliary strictures.
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Sat, 24 Sep 2016 03:49:48 GMT -08:00 http://www.scopemed.org/?mno=239905
Clinical and laboratory profile of TB-HIV co-infected patients with relation to CD4 counts in a tertiary care hospital http://www.scopemed.org/?mno=239888 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Suresh Kumar Boorsu, Venkata Subba Narasimha Myreddy, Jithendra Kandati, Muni Lakshmi Ponugoti, Mohan Rao Nandam.
Background: Tuberculosis is the commonest opportunistic infection in HIV infected individuals. Global TB report by WHO estimates 0.4 million deaths by TB in 2014 in HIV infected individuals. The clinical profile of TB in HIV infected individuals are variable from region to region based upon the prevalence of HIV in the region. The aim of the present study was to determine the clinical profile of tuberculosis and the distribution of pulmonary and extra pulmonary tuberculosis in HIV infected individuals with relation to their CD4 counts. Methods: A prospective cross sectional study was done for a period of two years from January 2013 to December 2014 at a tertiary care hospital in south India. Sputum samples were screened for Mycobacterium tuberculosis from 150 HIV seropositive individuals in the study. AFB positive smears were graded as per RNTCP guidelines. Clinical profiles of the cases in the study were noted and the Chest X ray, ultrasonogram and other relevant investigations were performed in smear negative individuals to diagnose pulmonary and extra pulmonary tuberculosis. Results: In our study 26-35 years was the major age group (37.33%) with male preponderance. Heterosexual mode of acquisition was common (88.67%) and in 6% the mode was unknown. Fever was the most common symptom (100%) followed by cough with expectoration in 84% of HIV-TB co-infected cases.44% of cases were smear positive for AFB bacilli and 57.58% were graded 3+, 65.33% of cases had pulmonary infiltrates on chest X-ray followed by 16% with effusion. Lymphadenopathy was the most common extra pulmonary involvement seen in 28.67% of cases followed by 14.67% with meningeal involvement. Overall in the study isolated pulmonary tuberculosis was seen in 43 (28.67%) patients, isolated EPTB was seen in 13(8.67%) patients and both were seen in 84 (56%) patients. In all cases of EPTB CD4 cell counts were
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Sat, 24 Sep 2016 03:49:30 GMT -08:00 http://www.scopemed.org/?mno=239888
Assessment of nutritional status among school children of Karimnagar, Telangana, India http://www.scopemed.org/?mno=239836 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
M. Kamran Shaikh, Nitin Kamble, Dhiraj Bhawnani, Samir Bele, Sita Rama Rao.
Background: Children are the country's biggest human investment for development. Quality of life of school children, by all standards continues to be poor more so in rural areas and urban slums. Hence evaluation nutritional status of the children is imperative as it is an important index of the national investment in the development of its future manpower. Nutritional status during school age is a major determinant of nutritional and health status in adult life. Globally, including India, health hazards associated with under-nutrition and micronutrient deficiencies remain major public health problems. Therefore comprehensive health care of this section will fulfils the health need of these vulnerable populations. Methods: A descriptive, cross-sectional study was conducted among children (Aged 6 to11 years) from selected government primary schools (Urban and Rural) of Karimnagar city, Telangana, India during study period November 2011 to October 2012. The calculated sample size was 820. Children were interviewed during school and examined in classrooms with the assistance of teachers. The background information of respondents was collected by personal interview and supplemental information was gathered from the school registers and parents. Nutritional status of the children was assessed by anthropometry using standardized techniques. Results: There were total 820 children out of which 410 were belonging to rural area and similar numbers of children were in urban area. Age range of the children was between 6 to 11 years. Age distributions in context to school area showed that maximum numbers of children were in age of 7 and 10 years (11.8 per cent each) in rural area and 6 and 9 years (8.7 per cent in and 10.2 per cent respectively) in urban area. Out of total children 401, (48.9 per cent) were boys and 419, (51.1 per cent) were girls. There was marginal difference observed between the proportion of boys and girls in urban and rural areas. In rural areas girls accounted for 27.1 per cent whereas in urban area boys accounted for 26 per cent of total sample. Mean caloric intake of children was deficient in relation to reference standards for all age groups and both sexes. Mean caloric intake among boys was better in early age (6 to 8 years) but in later ages their intake was less than girls as per reference. Among rural children 29.3 per cent were underweight as compared to 22.2 per cent urban children. Similarly 21.5 per cent children were stunted in rural and 16 per cent from urban areas. Conclusions: Under nutrition were the key findings of the present study especially in rural areas. Hence emphasis on primordial and primary preventive measures like health education should be given for this section of students.
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Sat, 24 Sep 2016 03:49:08 GMT -08:00 http://www.scopemed.org/?mno=239836
Efficacy of teneligliptin in type 2 diabetes mellitus http://www.scopemed.org/?mno=239745 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Riyaz Mohammed, Imran Ahmed, Asiya Banu.
Background: Teneligliptin is a novel, highly selective dipeptidyl peptidase-4 (DPP-4) inhibitor. The aim of the study was to assess the effectiveness of Metformin in combination with teneligliptin in Indian patients with type 2 diabetes mellitus who were inadequately controlled with metformin monotherapy. Methods: Patients with glycated haemoglobin (HbA1c) of 7.0–10.0% and on metformin upto 1000 mg/day were selected for the study. 400 subjects were enrolled out of which only 120 subjects were eligible for the study. In the present study 130 known diabetic patients were selected, out of which only 56 patients were eligible as per the criteria. these patients were randomly divided into two groups, group A comprises 28 patients whose baseline FBS, PPBS, Hba1c was determined and the patients were put on teneligliptin 20 mg per day apart from metformin 1gm /day, Group B comprises of 28 patients whose baseline FBS, PPBS, Hba1c were determined and these patients were already on metformin 500 – 1gm per day but there glycemic control was poor, all these patients in group b received an escalation of Metformin dose upto 2.5gm/day, to achieve glycemic control and patients were monitored closely with proper diabetic diet counselling. Results: The mean baseline HbA1c in teneligliptin group was 8.23% when compared to 8.07% in the Metformin group. The primary endpoint of the study was to monitor the changes in HbA1c levels from baseline to week 30. It was observed that the mean HbA1c for teneligliptin group after 30 weeks was 7.21% versus 7.63% in metformin group. HbA1c was significantly reduced in the Group A patients. Conclusions: In conclusion, the addition of teneligliptin to metformin treatment was effective and well tolerated in patients with type 2 diabetes. Teneligliptin has long half-life of 26.9 hours along with it also has a unique pharmacokinetic advantage which allows convenient once daily administration irrespective of food, superadded it has a dual mode of elimination via renal and hepatic, and hence can be administered safely in renal impairment patients. In mild to moderate hepatic impairment no dosage adjustment is required. The appropriate approach towards managing diabetes should be not only glycemic control but also preservation of islet cell function early and to delay progression of a disease. Teneligliptin add-on to Metformin during the early course of treatment helps in delaying the exhaustion of pancreatic islet function.
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Sat, 24 Sep 2016 03:38:07 GMT -08:00 http://www.scopemed.org/?mno=239745
A study on internal laryngeal nerve-its variation in the course, branching, anastamosis and relation to inferior thyroid artery http://www.scopemed.org/?mno=239762 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Sailaja K..
Background: Recurrent laryngeal nerves sometimes may not follow the classically describe course. It does not always lie in the tracheo-oesophageal groove. The relations of the nerve to inferior thyroid artery may vary. Therefore, the present study was undertaken to study the variation in the relations and branches of recurrent laryngeal nerve. Methods: The present study was undertaken in postmortem specimen from Forensic department and cadavers in the dissection hall after the ethical clearance. The specimens were collected enbloc including tongue, oesophagus and trachea. Also, the specimens were used for modified Sihler’s technique. Specimen was dissected and recurrent laryngeal nerve was identified. Its relation and branches were noted. The data regarding the number of branches, level of branching, anastomoses were expressed as percentages. Results: The nerve was seen passing posterior to the cricothyroid joint to enter the larynx. In 56% of specimens, artery was anterior to the nerve on both sides, nerve was anterior to the artery on both sides in 19%, nerve and artery was found to be ascending in the same plane side artery lateral and nerve medial in 6%, nerve divides before entry into the larynx on both sides in 68%, nerve does not divide in 75%, Division of the nerve was observed about 4cm below the joint in 6% of specimen, 3cms below the joint in 19% of specimens, 2cm below the in 19% of specimens and 1cm below the joint in 38% of specimens. Conclusions: It was found that, the nerve was lying posterior to the artery more commonly. There no significant difference between right and left sides. The division of the nerve into anterior and posterior branches before entering the larynx was observed. In half of the specimens, nerve divided before entry into the larynx.
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Sat, 24 Sep 2016 03:37:44 GMT -08:00 http://www.scopemed.org/?mno=239762
Prevalence of anemia among health science students of a university in South India http://www.scopemed.org/?mno=239742 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Subramaniyan K., Melvin George, Deepika Seshadri, Amrita Jena, N. Chandraprabha.
Background: Anemia due to iron deficiency continues to be the major public health problem in developing as well as developed countries affecting quality of life and work capacity of large population throughout the world. It is being observed that prevalence of anemia is more in students of both the genders due to several factors like improper nutrition intake, socio-economic background etc. The objective of our study was to determine the prevalence of anemia among health science students of a private university in South India. Methods: A total of 568 university students between 18-45 years participated in the study. Patients who underwent major surgery less than three months before and who had donated blood within the last three months were excluded. Baseline characteristics of all the patients were recorded. 1.5 ml of blood was collected from all the study patients for complete haemogram test. WHO criterions were taken for determining severity of anemia with determined hemoglobin (Hb) concentration. Results: Among the study subjects, 43% (n=237) had anaemia as per the WHO criteria. There was a significant preponderance of female students with anaemia as compared to males (97 vs. 68%, p=0.0001). Anaemic subjects had a higher risk of bleeding disorders as compared to non-anaemic subjects (16 vs. 12%, p=0.0001). When assessed by WHO criteria of anemia severity, majority of the anemic subjects had mild anemia and only less than two percent had severe anemia. Conclusions: Present study showed the prevalence of anemia among university health science students to be 43%. The need of the hour is to provide health education on the ill-effects of anemia and the life-style modification particularly with respect to eating habits along with nutritional supplementation.
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Sat, 24 Sep 2016 03:36:57 GMT -08:00 http://www.scopemed.org/?mno=239742
A randomised clinical study to compare the haemodynamic effects of etomidate with propofol during induction of general anaesthesia http://www.scopemed.org/?mno=239731 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Arvind Khare, Beena Thada, Mukesh Kumar Samota, Veena Mathur, Maina Singh.
Background: Induction agents are frequently associated with changes in heart rate and blood pressure and various adverse effects. Since the introduction of general anaesthesia, no ideal induction agent has yet been discovered in term of providing a stable hemodynamic with fewer adverse effects. This prospective randomized clinical study was conducted to compare propofol and etomidate for their effect on hemodynamic and various adverse effects on patients scheduled for elective surgeries during the induction of general anesthesia. Methods: 50 patients of ASA I and II of age group 18-60 years scheduled for elective surgeries under general anaesthesia were randomly assigned in two groups (n=25) receiving etomidate (0.3 mg/kg) in group E and propofol (2.5 mg/kg) in group P as an induction agent. Hemodynamic parameters were recorded at various time intervals. Any adverse effect pain on injection and myoclonus was carefully watched. VAS score was recorded for pain on injection. Statistical analysis was done using software (SPSS IBM version 20). P value was considered significant if (p0.05). Patients in propofol group showed significant fall of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and compared to etomidate (P
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Sat, 24 Sep 2016 03:36:42 GMT -08:00 http://www.scopemed.org/?mno=239731
Influence of surgical time on post-surgical visual acuity in patients undergoing small incision cataract surgery: a prospective study http://www.scopemed.org/?mno=239620 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Vasu Kamaladevi Lathika, Susan Prakash Minu, K. Skariah Charles.
Background: Cataract surgery is one of the commonest surgical procedures in Ophthalmology. This study aimed at evaluating the influence of duration of surgery on post-operative vision in patients who underwent uneventful small incision cataract surgery. Methods: All patients (66.3±8.6 years of age), who underwent small incision cataract surgery after a complete preoperative evaluation. Duration of surgery starting from draping to sub conjunctival injection of amikacin after surgery was noted. The patients were grouped based on surgical time. Best corrected visual acuity was recorded in all patients on post-operative day one and also one month after surgery. The data was subjected to statistical analysis. Results: Ninety one patients were included in this study. More number of patients (47/91) was found in group with 26-35 min surgical time, whereas only 9 patients were found in 46-55 min group. A week correlation was found between surgical timing with PSVA on 1st (r = 0.2034, 95% CI = -0.00772-0.3971, two tailed p = 0.051) or on the 30th day (r= 0.1024; 95% CI = -0.1107-0.3066, two tailed p =0.33). No significant difference was found in the PSVA of 1st day (p=0.699) or 30th day (p=0.150) when compared between the groups. However, the difference was found to be significant between the mean value of POVA between the 1st and 30th day in all groups. Conclusions: Surgical time did not emerge as a significant influence on long term post-operative visual outcome following uncomplicated Small incision cataract surgery.
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Sat, 24 Sep 2016 03:36:12 GMT -08:00 http://www.scopemed.org/?mno=239620
C-reactive protein and Apo B as better predictor of STEMI than lipid profile http://www.scopemed.org/?mno=239497 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Preshant Shrivastava, Anshul Agrawal.
Background: Total cholesterol, triglycerides, high density lipoprotein and low density lipoproteins are the recommended lipid variables for diagnosis and treatment of coronary artery disease. However, recent information shows the importance of apolipoprotein B and CRP as risk predictors of suspected CAD. Inflammation plays a major role in atherothrombosis and measurement of inflammatory markers such as CRP may provide a promising novel biochemical indicator for detecting individuals at high risk of plaque rupture. Methods: A total number of 43 cases of acute myocardial infarction with ST elevation myocardial infarction were included in this study. In this study CRP was elevated in more patients than LDL/HDL ratio (60.5% vs 20.9% respectively). Similarly, Apo B was elevated in more number of patients than LDL (72.1% vs 39.5% respectively). Also, Apo B/Apo A1 ratio was elevated in more number of patients than LDL/HDL ratio (51.2% vs 20.9% respectively). Results: In our study maximum incidence of ST elevation MI was present in age group 56-65 years with youngest of age 28 years and oldest of age 75 years. Out of 43 patients who suffered from STEMI 72.1% were males and only 27.9% were females. Out of 43 cases, 46.5% of cases had anterior wall MI, and 46.3% of the cases had inferior wall MI and only 9.3% of the cases developed anteroseptal wall MI. In our study death was encountered in only 9.3% (N – 4) of the cases. Conclusions: The results of the current study support the concept that the levels of apolipoprotein B, Apo B/Apo A1 ratio and CRP are strongly related to Coronary artery disease in addition to the conventional lipid profile.
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Sat, 24 Sep 2016 03:35:44 GMT -08:00 http://www.scopemed.org/?mno=239497
Evaluation of insulin and C-peptide in diabetic patients undergoing renal dialysis http://www.scopemed.org/?mno=239269 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
P. T. Annamala, Anusha A. M., Teena Mathew.
Background: Patients with kidney failure associated with diabetes mellitus have disturbed responses of several glucoregulatory hormones. Diabetic nephropathy is the leading cause of end stage renal disease (ESRD). Renal failure is the progressive loss of function of kidney and patient requires a long renal replacement therapy, during which body’s waste products including urea, creatinine, glucoregulatory hormones and excess water are removed. Objectives of the study were to evaluate insulin and c-peptide concentrations in diabetic patients on renal dialysis and to compare the concentration of insulin, c-peptide, random blood glucose, urea and creatinine in pre and post dialysis samples of both controlled and uncontrolled diabetic patients. Methods: The study was conducted in 30 patients with diabetic kidney disease undergoing renal dialysis. The patients were grouped as controlled diabetics and uncontrolled diabetics based on their HbA1c levels. Pre and post dialysis blood samples were collected from patients. Concentration of insulin and c-peptide were analyzed by using ELISA methods. Random blood glucose (RBG), urea and creatinine were estimated by standard methods. Results: The patients were divided into 2 groups depending on their HbA1c levels as controlled and uncontrolled diabetes mellitus. The concentration of insulin, c-peptide, RBG, serum urea and creatinine showed statistically significant reduction in post dialysis samples when compared to pre dialysis in uncontrolled diabetics. But in case of controlled diabetes mellitus reduction was observed in the levels of insulin and c- peptide in post dialysis samples as compared to pre dialysis samples, but, the difference was not statistically significant. Conclusions: There are alterations in the levels of insulin, c-peptide and the glycemic status in diabetic patients during dialysis. This significant reduction may affect glucose metabolism in diabetic patients on dialysis. Hence, glycemic status should be continuously monitored in these patients.
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Sat, 24 Sep 2016 03:35:17 GMT -08:00 http://www.scopemed.org/?mno=239269
Screening for retinopathy of prematurity in neonates http://www.scopemed.org/?mno=239265 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Mitul Kasundra, Purvi Patel, Mehariya K. M..
Background: Retinopathy of prematurity (ROP) is a vaso-proliferative disorder of the retina among preterm infants. Neonates born at less than 32 weeks of gestation are at risk of developing ROP. However preterm infants born at 32 weeks or later can also develop severe ROP if they had turbulent NICU course or required prolonged oxygen therapy. Aims of the study were to determine incidence, risk factors of ROP in neonates and to determine the association of birth weight, gestational age and incidence of ROP. Methods: Prospective analytic study done in indoor patients in neonatal intensive care unit at a tertiary care center from June 2015 to May 2016. Results: Overall incidence of retinopathy of prematurity in preterm neonates is 18.4%. Incidence increases with decreasing gestational age. In preterm
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Sat, 24 Sep 2016 03:34:29 GMT -08:00 http://www.scopemed.org/?mno=239265
Colostrum feeding practices and its determinants among urban and rural mothers in Kamrup, Assam, India http://www.scopemed.org/?mno=239239 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Rana Kakati, Syeda Jesmin Rahman, Madhur Borah, Hiyeswar Borah.
Background: Colostrum is the first breast milk produced after birth and is important for promotion of health and prevention of infections of the newborn immediately after birth. Though the breastfeeding practices are well known to mothers but the necessity of colostrum feeding is still poorly understood especially by the mothers in rural areas due to various factors. The objective of the study was to find out the prevalence of colostrum feeding practices and its determinants among the urban and rural mothers of Assam, India. Methods: A cross sectional study was conducted from February-July 2014. The study was conducted by interviewing of 400 mothers having children of 0-23 months of age in both in rural and urban areas. Results: 21% of mothers in urban areas had discarded colostrum whereas in rural areas it was 29.5% .The association between colostrum feeding practices and age of the mothers (P
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Sat, 24 Sep 2016 03:34:14 GMT -08:00 http://www.scopemed.org/?mno=239239
Can peripheral blood smear examination be totally replaced by automated hematology analyser - with special reference to anemia? http://www.scopemed.org/?mno=239207 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Shivangi Singhal, Nidhi Verma, Monika Rathi, Neha Singh, Preeti Singh, S. P. Sharma, Uma Tayal.
Background: The aims and objectives of present study was to correlate typing of anemia based on RBC indices obtained from an automated analyzer with peripheral blood smear (PBS) examination and also to find out whether the number of PBS examination can be reduced with the help of automated hematology analyzer. Methods: A total of 2500 blood samples showing anemia as per WHO reference range were collected in central pathology lab of SVBP Hospital attached to L.L.R.M. Medical College, Meerut, Uttar Pradesh, India over a period of one year. Samples were reported by auto-analyzer and PBS examination simultaneously. Results: Out of total 2500 cases, there were 1623 females (64.9%) and 877 males (35.1%) with male: female ratio 0.54:1. By auto-analyzer and PBS examination, MCHC anemia (49.8%) was the commonest anemia followed by NCNC anemia (36.5%) and Macrocytic anemia (4.2%). Discordant typing of anemia between two methods was found in 284 (11.4%) cases only. These cases were diagnosed as normocytic normochromic (NCNC) anemia with raised RDW by autoanalyzer while as Dimorphic Anemia (DA) on PBS examination. Also morphological changes such as RBC inclusions, spherocytes, RBC fragments, schistocytes, nucleated RBCs were seen only on PBS examination. Conclusions: The Study concluded that even today PBS examination is very important and cannot be totally replaced by automated analyzer and both methods are complementary to each other.
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Sat, 24 Sep 2016 03:33:44 GMT -08:00 http://www.scopemed.org/?mno=239207
A study on prognostic significance of serum uric acid in acute myocardial infarction in a tertiary care institute http://www.scopemed.org/?mno=239194 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Kaushik Biswas, Subrata Halder, Ramita Sarkar, Koushik Roy.
Background: This study was done to find out any relationship between serum uric acid and AMI severity and its short-term outcome. To see the correlation between serums uric acid level with Killip Class and mortality outcome following AMI. Methods: 100 patients of AMI were included this study based on the inclusion and exclusion criteria. Detailed history, physical examination and relevant systemic examination including detailed examination of CVS system were done as per a structured proforma and necessary laboratory investigations were done. Results: 100 cases of myocardial infarction were studied, out of which 90 patients had STEMI and 10 patients had NSTEMI. There is significant difference of D0 uric acid level was observed for previous history of AMI. There is significant difference in mean uric acid level between dyslipidemic and non-dyslipidemic population. There is significant difference in mean uric acid level on D0 between diabetic and non-diabetic population. Serum uric acid level is low among patients with lower Killip class and high among higher Killip class. Lower the uric acid level, higher the percentage of survival and higher the uric acid level, higher the percentage of mortality. Conclusions: Patients of Killip class lll and lV had higher levels of uric acid as compared to patients of class l and ll. Combination of Killip class and serum uric acid level after acute myocardial infarction is a good predictor of severity of heart failure after AMI.
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Sat, 24 Sep 2016 03:00:15 GMT -08:00 http://www.scopemed.org/?mno=239194
Role of fine needle aspiration cytology and cytohistopathological co-relation in thyroid lesions: experience at a tertiary care centre of North India http://www.scopemed.org/?mno=239158 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Smita Chandra, Divya Mahajan, Harish Chandra.
Background: Fine needle aspiration cytology is considered to be simple and cost effective technique for diagnosis of thyroid lesions. However the common limitations which may be encountered in FNAC may be associated with sampling error, dual pathology, cystic change or misinterpretation of morphology. The present study was therefore conducted to study the role of FNAC in diagnosis of thyroid lesions and to study the diagnostic pitfalls which may be encountered that limit the diagnosis of thyroid lesions. Methods: A retrospective study was conducted which included all the cases of thyroid lesions in which FNAC was done either directly or under image guidance over a period of five years. The cytomorphological diagnosis was correlated with histopathology to assess the diagnostic accuracy of FNAC in diagnosis of thyroid lesions. Results: Colloid goitre was the most common benign thyroid lesion while papillary carcinoma was the most common carcinoma constituting 50.2% and 5.2% of total cases. The maximum cyto-histopathological discordance was observed in cases of autoimmune thyroiditis (38%) and papillary carcinoma was most common lesion which was underdiagnosed on FNAC. Conclusions: The study concludes that although FNAC is safe, cost effective and sensitive technique for diagnosis of thyroid lesions but vigilant cyto-morphological interpretation in association with skilful aspiration and clinic-radiological co-relation is essential to avoid diagnostic pitfalls. This is even more important in cases showing focal neoplastic pathology or presence of dual pathology. Repeat image guided FNAC with clinical follow up is recommended in cases with strong clinical suspicion of malignancy.
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Sat, 24 Sep 2016 02:59:40 GMT -08:00 http://www.scopemed.org/?mno=239158
Platelet audit: To weigh the rationality between requirement and uses in blood transfusion http://www.scopemed.org/?mno=239097 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Smita Mahapatra, Gopal Krushna Ray, Rashmita Panigrahi, Debasish Mishra, Binay Bhusan Sahoo, Pankaj Parida.
Background: Blood transfusion especially the transfusion of blood component is an important part for better patient management than whole blood transfusion. Despite various approved guidelines, non-compliance regarding rational use prevails in transfusion services. Methods: In the present study; retrospective audit was conducted for a period of six months in the department of Transfusion Medicine, SCB Medical College and Hospital revealed on 3871 number of platelets prepared. Results: Out of 3757 units of platelet issued, there was 10.9% group nonspecific platelet transfusion, 31% inappropriate platelet transfusion and 1.99% wastage. Conclusions: The goal of transfusion service is to provide adequate number of safe blood components to the patient requiring this transfusion as per clinical guideline. This can be achieved by platelet audit which plays an important tool to reduce the inappropriate transfusion in patients, by improving the practice, in adherence to guidelines and focusing the areas of pitfall.
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Sat, 24 Sep 2016 02:59:01 GMT -08:00 http://www.scopemed.org/?mno=239097
Evaluation of cord bilirubin and hemoglobin analysis in predicting pathological jaundice in term babies at risk of ABO incompatibility http://www.scopemed.org/?mno=239046 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Elango Krishnan, Raja Periasamy, Sathiya Priya Sekar.
Background: Cord bilirubin and hemoglobin analysis helps not only in predicting the pathological jaundice in ABO incompatibility but also useful for early referral and intervention for better outcome. Aim of this study is to evaluate the cord blood bilirubin and hemoglobin analysis in predicting pathological hyperbilirubinemia in newborn at risk of ABO incompatibility. Methods: In this descriptive study conducted in Government Stanley medical college between January 2016-June 2016, A positive or B positive babies born to O positive mothers with birth weight >2.5 kgs and gestational age >37 weeks were included. A total of 191 babies were studied. Cord bilirubin, reticulocyte count, hemoglobin and fourth day bilirubin were evaluated and data was analysed using Pearson’s Chi square and ANOVA. Results: Out of 191 babies, 25 (13%) did not develop any jaundice, 122 (64%) developed physiological jaundice and 44 (23%) had pathological jaundice. The mean cord bilirubin and cord hemoglobin values of newborn who did not develop jaundice were 1.35mg/dl and 15.3g/dl while the values among pathological jaundice were 3.15mg/dl and 14.97g/dl. Conclusions: Babies with cord bilirubin >1.8mg/dl and hemoglobin
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Sat, 24 Sep 2016 02:58:13 GMT -08:00 http://www.scopemed.org/?mno=239046
Effect of maternal nutritional status on the biochemical composition of human milk http://www.scopemed.org/?mno=238907 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Bina Dias, Devina P. Nakhawa.
Background: Infants normally thrive on their mother's milk. The nutrients required to sustain such a rapid growth are all supplied by breast milk alone in the first 3-4 months of life, in all infants. The composition of human milk should therefore provide a clue to the physiological needs for energy and nutrients in infants. Methods: Sixty three milk samples of lactating mothers of full term babies were assessed for the levels of lactose, protein, triglyceride and cholesterol and were compared depending on their body mass index (BMI). Results: The result of the present study showed that lactose content of the milk ranged between 4.2 gm/dl to 9.7 gm/dl, with a mean of 6.47 gm/dl. Protein content ranged from 0.6 gm/dl to 7.1 gm/dl, with a mean of 2.4 gm/dl. Cholesterol had a wide range with a minimum of 4.8 gm/dl to a maximum of 99.4 mg/dl, with a mean of 32.3 mg/dl. Triglyceride had a mean value of 8.4 gm/dl, values ranging from 1.9 to 34.1 gm/dl. Conclusions: Breast milk composition is fairly constant and is not affected by maternal nutrition, or dietary intake.
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Sat, 24 Sep 2016 02:57:49 GMT -08:00 http://www.scopemed.org/?mno=238907
Objective structured practical examination as a formative assessment tool for IInd MBBS microbiology students http://www.scopemed.org/?mno=238741 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Anuradha Mokkapati, G. Pavani, S. Manick Dass, M. Srinivas Rao.
Background: Assessment drives learning. It is well known that conventional or Traditional Practical Examination (TPE) has several limitations, especially in terms of subjectivity. In OSPE the procedures are standardized, so objectivity is ensured and also reliability maximized. Objectives of the study were to compare TPE & OSPE examination in formative assessment for IInd MBBS microbiology students on the topic culture media and to obtain feedback from students attending OSPE, and faculty. Methods: 76 students were taught about culture media and simultaneously were sensitized about OSPE and TPE, which followed the next week. Informed consent was taken. All students were randomly divided into 2 batches (TPE and OSPE) based on roll call. 71 students were tested, 33 for OSPE and 38 for TPE. Eight OSPE stations were set up with 8 culture media, plus a rest station after station 4. TPE students went for viva-voce to one examiner for same eight culture media. Both OSPE and TPE students were evaluated for a score of 20. OSPE students and the faculty were given a pre-validated questionnaire for feedback. Results: Mean scores, standard deviation (SD) and “p” values were calculated using the T-test from the scores obtained. The mean scores for OSPE and TPE were found to be statistically significant- p-value
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Sat, 24 Sep 2016 02:57:15 GMT -08:00 http://www.scopemed.org/?mno=238741
The relationship between neutrophil to lymphocyte ratio and myocardial bridge http://www.scopemed.org/?mno=238894 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Ekrem Aksu, Deniz Avci, Gurkan Cikim.
Background: Although myocardial bridge (MB) is a benign congenital anomaly, clinical trials have shown it to cause increased risk of atherosclerosis, which is a low-grade chronic inflammatory disease. The neutrophil-lymphocyte ratio (NLR) is an inflammatory indicator for mortality and morbidity in atherosclerotic heart disease. In this study, NLR was investigated in patients with MB. Methods: A retrospective evaluation was made of patients admitted to our clinic for coronary angiography from 01st January 2014 to 31st December 2015. Patients included in the study were those diagnosed with MB and no evidence of atherosclerosis after coronary angiography and patients diagnosed with normal coronary vascularity. The NLR was calculated from the biochemical and hematological parameters based on the results of pre-angiographic values. Results: Evaluation was made of 53 patients with MB (mean age: 56.70±11.45 years, 73.6% male), and 59 patients with normal coronary vascularity (mean age: 52.25±12.42 years, 39% male). No significant difference was determined between the groups in respect of biochemical or hematological parameters or in NLR values (2.34±0.88 versus 2.56±1.66; p=0.384). Conclusions: The results of this study showed no relationship between MB and the inflammatory indicator of NLR.
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Sat, 24 Sep 2016 02:56:16 GMT -08:00 http://www.scopemed.org/?mno=238894
Role of glycated hemoglobin (HBA1c) as a dual marker to predict glycemic status and dyslipidemia in type II diabetes mellitus http://www.scopemed.org/?mno=238775 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Mangala Sirsikar, Supriya, Shrabani Mohanty, Venkata Bharat Kumar Pinnelli.
Background: Type 2 diabetes mellitus (DM) is an endocrinological disease associated with hyperglycemia characterized by both insulin resistance and defective insulin secretion. Glycated hemoglobin (HbA1c) is a routinely used marker for long-term glycemic control. This study is aimed at investigating the relationship between glycemic control and serum lipid profile and to evaluate the role of glycated haemoglobin as an independent risk factor for cardiovascular diseases in patients with type-2 diabetes and to evaluate the diagnostic value of glycated hemoglobin (HbA1c) in predicting diabetic dyslipidemia as a marker of circulating lipids. The aim of the present study was to estimate glycated hemoglobin and lipid profile in patients with type 2 DM and compare it with controls (healthy subjects). The association of glycated hemoglobin with lipid profile evaluated. Methods: This study was conducted in 150 subjects, out of whom 75 were type 2 diabetes mellitus patients (cases) and 75 were non diabetic healthy subjects (controls).The sera were analyzed for HbA1c, fasting blood glucose (FBG), total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL). Results: A significantly increased level of glycated hemoglobin (HbA1c) is observed in cases compared to control. HbA1c showed direct and significant correlations with cholesterol, triglycerides and LDL and inverse correlation with HDL in cases when compared to controls. Our study also revealed a significant positive correlation between lipid profile and glycated hemoglobin. Conclusions: These findings clearly suggest that HbA1c can provide valuable supplementary information about the extent of circulating lipids besides its primary role in monitoring long-term glycemic control. Further studies are warranted to reinforce the potential of HbA1c as a biomarker for screening of high-risk diabetic patients.
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Sat, 24 Sep 2016 02:55:52 GMT -08:00 http://www.scopemed.org/?mno=238775
Thyroid hormone alteration in women with pre-eclampsia http://www.scopemed.org/?mno=237569 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Swati A. Tadas, Arun K. Tadas.
Background: Preeclampsia and eclampsia are major causes of maternal and perinatal morbidity and mortality. The obstetricians are increasingly becoming aware of the potential or adverse effects of hypothyroidism on the outcome of pregnancy. Methods: This analytical, cross sectional, case control study is designed to compare the levels of thyroid hormone in women with preeclampsia and in normal pregnant women in the third trimester. Results: Levels of total T3 and T4 in preeclamptic women were significantly lower than that of controls whereas the mean level of TSH was significantly higher in preeclamptic group than controls. Conclusions: Primary hypo-functioning of the thyroid can accompany mild preeclampsia. Estimation of thyroid hormone levels in first and the third trimester of pregnancy are recommended.
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Sat, 24 Sep 2016 02:54:47 GMT -08:00 http://www.scopemed.org/?mno=237569
Common thrombophilia markers in young patients with primary arterial and venous thrombosis http://www.scopemed.org/?mno=238770 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Monika Gupta, Megha Kathuria, Nisha Marwah, Rajeev Sen.
Background: The pathogenesis of vascular thrombotic event involves an interaction of multiple genetic and environmental factors. Genetic factors include activated protein C resistance, deficiency of natural anticoagulants protein C, protein S, factor V and antithrombin III while acquired cause include presence of antiphospholipid antibody. This study was carried out to establish the role of basic panel of thrombophilia in diagnosing the patients with primary thrombophilia. Methods: A total of 121 consecutive patients with history suggestive of arterial or venous thrombosis were included. History of risk factors including smoking, hypertension, hyperlipidemia, diabetes mellitus and family history of thrombosis were elicited. The initial tests included CBC, PT, APTT, LFT, blood sugar and lipid profile. Functional assay on thrombophilia markers were performed by means of clotting based method. Results: A total of 121 patients were studied, out of which 63 were males and 58 females. The mean age range was 15-40 years. No abnormality was detected in 75 samples, while 46 samples (38%) were positive for one or more thrombophilia markers, of which 6 had more than one thrombophilia marker. Abnormality of a single thrombophilia factor was found in 40 patients, in which two patients were also positive for lupus anticoagulant. Conclusions: An association was found between low levels of protein C, protein S and factor V and a thrombotic event. Screening of these patients using a panel of thromophilia markers can provide valuable information in primary diagnosis of inherited deficiency even in the absence of high end molecular/mutational studies.
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Sat, 24 Sep 2016 02:54:17 GMT -08:00 http://www.scopemed.org/?mno=238770
Adolescent pregnancy and school health nursing program for adolescent pregnancy prevention: a qualitative study http://www.scopemed.org/?mno=239932 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Wenny Artanty Nisman, Yayi Suryo Prabandari, Ova Emilia, Elsi Dwi Hapsari.
Background: Adolescent population trends in the world continue to increase up to 2050 this trend is also followed by an increase in the adolescent population in developing countries. Aim of the study was to know the opinion the respondent about adolescent pregnancy and school health nursing for prevention of adolescent pregnancy. Methods: This study is a qualitative research. The data collection in August-September 2015 by focus group discussion, in two high schools in Yogyakarta, Indonesia. The samples were teachers, parents and students. Results: Four main themes were: view on adolescent pregnancy as something negative, the occurrence of adolescent pregnancy due to complex causes, adolescent pregnancy has a negative impact, and school health nursing addresses the needs of parents and adolescent. Conclusions: Adolescent pregnancy gives a negative impact on teenagers, parents and the fetus. Sexuality education is needed for parents and teachers. Plan of nursing cares program received support from all parties.
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Sat, 24 Sep 2016 02:36:20 GMT -08:00 http://www.scopemed.org/?mno=239932
Correlation of hemoglobin with creatinine clearance, antioxidant status, lipid peroxidation and ceruloplasmin in patients with chronic kidney disease http://www.scopemed.org/?mno=238282 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Sheeba V., Arunachalam P., Swarnalatha P. K..
Background: Anaemia in CRF is caused primarily by a combination of depressed erythropoiesis and shortened erythrocyte lifespan caused by oxidative stress. Therefore, the present study was designed to investigate the correlation between Hb concentration and antioxidant and lipid peroxidation levels. Methods: The study group consisted of 50 patients with chronic kidney disease who were on conservative treatment with the age group of 20 to 60 years. Based on the creatinine clearance values the patients were assigned in to 3 groups; Stage 3, Stage- 4 and Stage- 5 as per NKF DOQI guidelines. Control group consisted of 50 age and sex matched, non-diabetic, non-smoker healthy volunteers. About 5 ml of blood was collected and serum was used for the estimation of superoxide dismutase, ceruloplasmin and malondialdehyde and haemoglobin level using standard methods. The correlations between the different groups are performed by applying Pearson’s correlation test. The p value of ≤0.05 was taken as the level of significance. Results: A positive correlation of Hb with creatinine clearance (r=0.46, p=0.001), SOD level(r=0.4, p=0.009), serum ceruloplasmin (r=0.3, p=0.07) was observed. Significant positive correlation was found between creatinine clearance and SOD level (r=0.4, p=0.008), ceruloplasmin (r=0.3, p=0.04). A negative correlation was obtained between serum malondialdehyde levels and haemoglobin concentration (r=-0.4, p=0.007) and between creatinine clearance and MDA levels (r=-0.4, p=0.01). Conclusions: The study provides a better understanding of the biochemical parameters underlying anaemia in chronic kidney disease. The increased production of ROS and deficiency of antioxidant enzymes altered the oxidant and antioxidant equilibrium in the plasma of CKD patients.
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Sat, 24 Sep 2016 02:35:21 GMT -08:00 http://www.scopemed.org/?mno=238282
A study of clinical profile of dengue fever in a tertiary care hospital of Jamnagar, Gujarat, India http://www.scopemed.org/?mno=238503 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Yagnik H. Chhotala, Chetal M. Suva.
Background: Dengue is the most rapidly spreading mosquito-borne viral disease of mankind, with a 30-fold increase in global incidence over the last five decades. It is a major public health concern throughout the tropical and subtropical regions of the world. This is a prospective study, objective of which is to study clinical manifestations of all laboratory confirmed dengue cases admitted in the tertiary care hospital, Jamnagar, India. Methods: The study is carried out on 100 cases of dengue fever from January 2014 to November 2015. Patients those who are more or equal 12 year of age and; admitted with fever, headache, myalgia are evaluated with other clinical features and laboratory findings. Other causes of fever like malaria, enteric fever, chikungunya and respiratory infections are excluded by appropriate tests. Results: The most common presentation in our study was dengue fever without any complications (94%) and severe dengue fever (6%). Most common age group was between 20-29 years, mean age being 28.6 years with M: F ratio was 1.94:1. Most common clinical manifestation was fever observed in all patients (100%) followed by headache (98%), myalgia (97%), vomiting (49%). Warning signs present in total 28 patients out of 100. Conclusions: The study draws attention to susceptibility of the male, young adult age group. Fever, headache and myalgia are common presenting complaints.
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Sat, 24 Sep 2016 02:30:19 GMT -08:00 http://www.scopemed.org/?mno=238503
A study of the effect of personality on the moods of young adult learners http://www.scopemed.org/?mno=238290 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Pallavi Panchu, Syed Liyakath Ali, Tom Thomas.
Background: Medical education is inherently stressful and can be a source of anxiety and depression if a student fails to cope with the vast syllabus. The personality of the learner, if apt, will help him perform better as a student and doctor. It would also act as a stabilizing influence on the moods of the learners while facing academic challenges. This study was done to analyse the effects of personality on the moods, namely stress, anxiety and depression levels. Methods: The study was done using validated tools, the big 5 personality and the depression, anxiety and stress scale questionnaire (DASS). The study sample consisted of 200 first and second year medical students in an Indian medical college. ANOVA and Pearson’s correlation tests were used. Results: The results show that personality traits have a highly positive influence on development of stress, anxiety and depression and no influence of gender noted. Conclusions: In addition to academic scores, personality testing may be advised before the student gains entry into the medical profession.
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Sat, 24 Sep 2016 02:29:40 GMT -08:00 http://www.scopemed.org/?mno=238290
Comparison of dexamethasone and clonidine as an adjunct to bupivacaine in transversus abdominis plane block in patients undergoing lower segment caesarean section http://www.scopemed.org/?mno=238248 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Mitesh D. Falia, Prasad Kulkarni.
Background: A lower segment caesarean section (LSCS) commonly induces moderate to severe postoperative pain for 48 hours. Aim of the study was to compare 0.25% bupivacaine with dexamethasone and 0.25% bupivacaine with clonidine for transversus abdominis plane (TAP) block as post-operative analgesia in patients undergoing lower segment caesarean section (LSCS). Methods: A randomized prospective controlled clinical study was conducted in 104 patients undergoing LSCS. Participants were divided into two groups in which group TAP-D (n=54) received 0.25% Bupivacaine with Dexamethasone 4mg and those in group TAP-C (n=50) received 0.25% Bupivacaine with Clonidine 75mcg as TAP block at the end of surgery. The postoperative pain was evaluated by visual analog scale (VAS) for pain scoring at every 2 hours for 12 hours postoperatively. Subjective assessment of duration of analgesia was done. Results: The average duration of analgesia with TAP bock for the overall study population was 316.15 minutes. The average VAS score in patients who received TAP with dexamethasone was 1.50 which is significantly lower than those who received clonidine (1.95) (P value-0.0001). Further the duration of analgesia was 151 minutes longer in the first group who received dexamethasone TAP. In majority of the patients (84%) who received clonidine TAP, the analgesia persisted for 2-4 hours. While in patients who received dexamethasone addition, the analgesia persisted for 6-8 hours in 37%. Conclusions: TAP block is a safe and effective way of relieving postoperative pain in LSCS patients. Addition of dexamethasone to bupivacaine significantly enhances its effect in terms of block quality and analgesia duration as compared to clonidine addition.
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Sat, 24 Sep 2016 02:28:27 GMT -08:00 http://www.scopemed.org/?mno=238248
Whether retrograde pyelography mandatory for percutaneous nephrolithotomy: a randomized clinical trial http://www.scopemed.org/?mno=238193 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Manoj Biswas, Ankur Mittal, Rajeev Sarpal, Shikhar Agrawal, Ravinder Pal, Karamaveer Singh.
Background: Percutaneous nephrolithotomy (PCNL) technique was introduced a new era in the management of renal calculi, and day by day many changes occurred regarding the puncture points to an opaque stone as a guided landmark. We aim at comparing the outcome of many renal calculi with or without retrograde pyelography (RGP). Methods: In a randomized clinical trial 110 cases with opaque renal calculi for PCNL with stone in the calyces, in the pelvis, both in the calyx and pelvis, simultaneously, included in 2 year study. They were randomized in 2 groups, non RGP (56) and RGP (54), called interventional and control group respectively. Results: 2 groups are analyzed according to gender, age, duration of operation and hospital stay, past history of any surgical intervention on kidney and stone size. Outcome was evaluated with plain x-ray and USG abdomen. No differences in outcome were observed in between the two groups. Conclusions: Present findings conclude that there is no difference in major clinical outcome between the 2 groups. So we can say RGP is not mandatory for selected patients while doing PCNL
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Sat, 24 Sep 2016 02:28:10 GMT -08:00 http://www.scopemed.org/?mno=238193
To evaluate the hemoglobin concentration, lipid peroxidation and antioxidant status in patients with chronic kidney disease http://www.scopemed.org/?mno=238189 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Sheeba V., Arunachalam P., Swarnalatha P. K..
Background: Oxidative stress plays an important role in the progression of CKD as well as in many of the complications associated with the disease. ROS promotes inflammation, accelerated ageing, fibrosis and apoptosis leading to progression of CKD. Therefore, the present study was carried out to evaluate the serum markers for early diagnosis of patients at different stages of chronic kidney disease. Methods: The study group consisted of 50 patients with chronic kidney disease who were on conservative treatment with the age group of 20 to 60 years. Based on the creatinine clearance values the patients were assigned in to 3 groups; Stage 3, Stage- 4 and Stage- 5 as per NKF DOQI guidelines. Control group consisted of 50 age and sex matched, non-diabetic, nonsmoker healthy volunteers. About 5 ml of blood was collected and serum was used for the estimation of superoxide dismutase, ceruloplasmin and malondialdehyde and haemoglobin level using standard methods. The data was analyzed by applying student’s t test. The p value of ≤0.05 was taken as the level of significance. Results: The haemoglobin concentration in all the 3 CKD stages was found to be significantly decreased (p
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Sat, 24 Sep 2016 02:27:41 GMT -08:00 http://www.scopemed.org/?mno=238189
Profile of adverse drug reactions in patients on anti-tubercular drugs in a sub Himalayan rural tertiary care teaching hospital http://www.scopemed.org/?mno=238138 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Atal Sood, Rekha Bansal, Aradhna Sharma, Himani, Suruchi Bhagra, Dinesh Kansal.
Background: Tuberculosis is a major public health problem, with one out of three people in the world are infected with Mycobacterium tuberculosis. The prevalence of MDR TB in India is 2-3% among new cases and 12-17% in reinfection cases. One of the reasons for MDR may be noncompliance to treatment due to adverse drug reactions. The present study was conducted to find out ADRs in patients on antitubercular treatment (ATT) under pharmacovigilance programme of India (PvPI). Methods: This was a retrospective observational study. Data was collected through voluntary reporting by health-care professionals (HCP) in standard IPC-PvPI prescribed suspected ADR reporting form and analyzed for 100 patients on ATT. Causality assessment was done using WHO causality assessment scale. Results: The maximum ADRs were reported in adults with a mean age of 40.79±16.79 years. Males (n=66) outnumbered females (n=34). There were 62% MDR-TB on DOTS-plus regimen, followed by 35% on Cat1 ATT for pulmonary and extrapulmonary tuberculosis cases and XDR-TB accounted for 3% of the total cases. The commonest ADRs in patients on MDR treatment were related to CNS 44 (27.5%), followed by Gastrointestinal system 31 (19%), psychiatric 20 (12.5%) otovestibular 13 (8%) and ophthalmic ADRs being the least in frequency 1 (0.6%). In contrast patients on Cat 1 ATT the ADRs involving Gastrointestinal system 44 (44%) followed by CNS 12 (12%), psychiatric 0% and ADRs related to otovestibular manifestations being the least 1 (1%) frequency. Conclusions: ADRs involving different organ systems were seen in both categories with varied frequency. Adverse drug reactions add to hospitalization expenses, insurance costs and increase in work loss days besides addition to patient suffering and loss of compliance. Prior knowledge can help in better prescriptions and prevent valuable resource loss.
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Sat, 24 Sep 2016 02:27:13 GMT -08:00 http://www.scopemed.org/?mno=238138
Safety and efficacy of hybrid platform design sirolimus eluting stent system in percutaneous coronary intervention in ST elevation myocardial infarction patients at 1 year after treatment http://www.scopemed.org/?mno=237834 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Louie Fisher, Ashish Indani, Poonam Bhutada.
Background: STEMI is among the most complex and dramatic clinical presentation of coronary artery disease. The highest risk of mortality and stent thrombosis is observed in the subjects undergoing primary PCI. Choice of stent is often critical in Primary Angioplasty in Myocardial Infarction. GenXsync (MIV Therapeutics India Ltd, Surat India) is a stent having hybrid stent platform biodegradable polymers with the confidence of Sirolimus. The primary objective of this study was to establish safety and efficacy of GenXsync Sirolimus Eluting hybrid design stent in STEMI. Methods: A total of 73 patients of STEMI undergoing PCI were enrolled from June 2013 to January 2014. The average door to balloon time was 30±0.04 minutes with the minimumbeing15 minutes and maximum of 2 hours 44min. Most of the patients (69/ 73: 94.52%) underwent primary PCI. One patient (1.37%) was taken up for PCI after successful thrombolysis and two patients had to undergo rescue PCI after failed thrombolysis. All subjects underwent PCI with GenXsync Sirolimus Eluting hybrid design stent. Total 79 stents were used (average 1.08±0.38 stent per patient). The subjects were followed up for one year after discharge. Results: There were 80.82% (59) males, 41.09% (30) diabetic, 27.39% (20) hypertensive, 52.05% (38) current smokers and 2 (2.74%), patients with chronic renal disease. The cardiac history was significantly complex, characterized by prior coronary artery disease in 4 (5.48%), prior MI in 5 (6.85%) including prior PCI in 2 (2.74%), congestive heart failure in 1 (1.37%), ST depression in 71 (97.26%), complete heart block in 4 (5.48%) and left bundle branchblock 1 (1.37%). At admission, 4 (5.4%) patients had cardiac arrest. Among the patients 32 (43.84%), 34 (46.58%), 7 (9.59%) had single, double and triple vessel disease respectively. Average Troponin I was 55.20± 59.34 and by Killip classification, the subjects with class I, class III and class IV were 65 (89.04%), 4 (5.48%), 4 (5.48%) respectively. At discharge there were 3 (3.34%) Major adverse cardiac events and at 1 year, there were 5 (5.48%) major adverse cardiac events. There were no acute stent thromboses. All subjects received dual antiplatelet therapy for one year (Aspirin and one among Clopidogrel, Prasugrel or Ticagrelor at the discretion of the operator). There were total of 2 (2.74%) stent thrombosis events between discharge and 1 year, including in 1 subject who discontinued Antiplatelet therapy within 1 year. None of 4 deaths including 2 cardiac were practically related with the device and procedure. These 4 deaths were due to cardiogenic shock (1), during MVR surgery (1), During surgery on leg, due to major bleeding (1) and Due to pre-existing CHF (1). Conclusions: In contemporary practice of percutaneous coronary intervention in ST Elevation Myocardial Infarction, Genxsync stent was associated with low risks of stent thrombosis and MACE.
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Sat, 24 Sep 2016 02:26:39 GMT -08:00 http://www.scopemed.org/?mno=237834
The most frequent diagnosis on patients undergoing hemodialysis http://www.scopemed.org/?mno=239378 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Intansari Nurjannah, Fitri Mailani.
Background: Hemodialysis is a routine medical intervention for patient with chronic renal failure. Patients may responds differently when they undergoing this procedure. Investigating nursing diagnosis and collaborative diagnoses during hemodialysis procedure need to be explored. The objective of this research is to determine the sequence of nursing diagnosis and the collaborative diagnosis identified among kidney disease patients who are undergoing hemodialysis. Methods: This case study research involving 62 respondents. Research was conducted between June and July 2015. The respondents’ cases were studied to determine what nursing diagnoses and collaborative diagnoses, using a six-step diagnostic reasoning method. Results: Result of this study showed 27 nursing diagnoses and 7 collaborative diagnoses experienced by the patients. The six most commonly experienced nursing diagnoses were: activity intolerance (100%), nausea (96.8%), risk for impaired skin integrity (91.9%), impaired urinary elimination (82.3%), insomnia (77.4%), and sexual dysfunction (58.1%). Conclusions: There were 27 nursing diagnoses and 7 collaborative diagnoses that were experienced by patients who were undergoing hemodialysis.
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Sat, 24 Sep 2016 02:26:06 GMT -08:00 http://www.scopemed.org/?mno=239378
A study on length, position, variations in arterial supply and nature of lumen of appendix at different stages of life http://www.scopemed.org/?mno=237847 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Jessy Rose George.
Background: The appendix or vermiform appendix is a blind-ended tube connected to the cecum, from which it develops embryologically. Since, the morphology of human appendix greatly varies at different age groups; the present study was undertaken to record the length, position, variations in arterial supply, nature of lumen of appendix at different stages of life. Methods: The morphology of human appendix was studied in 100 specimens of varying age groups after the ethical clearance. The length, position, variations in arterial supply, nature of lumen of appendix at different stages of life was recorded. Results: Present study showed that female appendices were slightly shorter (by around 1 cms) than male appendices of same age group. Also there was a gradual increase in the length of the appendix till the early 4th decade and then showed a gradual decrease. Single appendicular artery was observed in most of the cases whereas double appendicular arteries were observed only in few cases. The origin of the arteries showed variation in both cases. Conclusions: The lumen of the appendix of a young person often appears somewhat 3 cornered instead of circular but in adults usually rounded and in advancing years it may become obliterated by connective tissue replacing its mucous membrane as well as fitting its lumen.
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Sat, 24 Sep 2016 02:00:53 GMT -08:00 http://www.scopemed.org/?mno=237847
Induction properties of propofol and etomida: a clinical comparative study http://www.scopemed.org/?mno=237809 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Santosh M. Onkarappa, Sarika M. Shetty, Nalini Kotekar, Viswanathan P. N..
Background: Propofol is a non-opioid, non-barbiturate, sedative hypnotic agent with rapid onset and short duration of action. However induction of anaesthesia with propofol is associated with pain on injection and dose dependent hypotension especially in patients above 50 years and with pre-induction hypotension. Objective of the study was to compare the induction properties, hemodynamic variables and side effects of etomidate and propofol during induction of general anaesthesia. Methods: 60 patients undergoing elective surgeries under general anaesthesia were randomly allocated into group P (n=30) who received propofol and group E (n=30) who received etomidate as intravenous induction agents. Induction time, hemodynamic variables like pulse rate, systolic blood pressure, diastolic blood pressure, mean blood pressure following induction were recorded. Side effects like pain on injection and myoclonus were noted. Results: In this study we found that the onset of induction, pain on injection and incidence of myoclonus were statistically insignificant in both groups. Increase in pulse rate was statistically significant in propofol at 1 and 3 mins when compared with etomidate. Fall in mean arterial pressure at 1 min was statistically significant with etomidate and with propofol at 3 and 5 min. Conclusions: Etomidate was a better alternative as an intravenous induction agent when compared with propofol.
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Sat, 24 Sep 2016 02:00:24 GMT -08:00 http://www.scopemed.org/?mno=237809
Correlation of integrated pulmonary index with clinical observation in unilateral and bilateral spinal anaesthesia in geriatric patients http://www.scopemed.org/?mno=238650 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Damla Mermer, Guldem Turan, Ceren Koksal, Berna Ayanoglu Tas, Firdevs Karadogan, Nur Akgun.
Background: In present study, we aimed to determine the role of integrated pulmonary index (IPI) in monitorising geriatric cases that have spontaneous ventilation under unilateral and spinal block during partial hip prosthesis and total knee arthroplasty. Methods: 24 patients who were over 65 years of age and with ASA I-IV, femoral neck fracture, intertrochanteric fracture and in whom gonarthros had developed were simply randomised into two groups. Values of blood pressure, pulse rate (PR), SPO2, EtCO2, respiratory rate (RR), IPI were recorded. Unilateral spinal block was administered with 7.5 mg, 0.5% bupivacaine and 25 mcg fentanyl in Group I and with 12.5 mg 0.5% bupivacaine and 25 mcg fentanyl in Group II. Values were recorded in intervals of 5 and 15 minutes and continued to be recorded from the moment of cement application. Preoperative mask ventilation or intubation need was recorded. Results: For EtCO2, bilateral spinal block scores at post-cement 15 minutes; postop 5 minutes were found to be high providing that they were within the clinically normal limits compared to the unilateral scores. A correlation between IPI and SpO2, EtCO2, respiratory rate, pulse rate was identified. In both groups, IPI was found to be in normal range and a correlation was identified through clinical observation. Conclusions: IPI might be the sole numerical value in early identification of clinical correlation and respiratory failure. For the IPI monitor is small and easy to be handled along with its screen that shows many parameters together makes the device be easily used.
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Sat, 24 Sep 2016 01:59:47 GMT -08:00 http://www.scopemed.org/?mno=238650
Thyroid dysfunction in metabolic syndrome: the ensuing storm http://www.scopemed.org/?mno=236632 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Subhashree Ray, Samir Sahu, Anirban Poddar.
Background: Metabolic syndrome was initially defined as a constellation of hypertension, hyperglycemia, android obesity and gout. Thyroid dysfunction is characterized by altered thyroid stimulating hormone levels with normal or altered thyroid hormone levels. The aim of the study was to observe thyroid hormone levels and thyroid stimulating hormone levels in a cohort of patients with established metabolic syndrome and to report significant variations if any. Methods: 54 established cases of metabolic syndrome satisfying the IDF criteria were included in the study along with 54 ages and sex matched healthy controls. Results: Amongst the controls 92.6% were euthyroid, 5.6% were hypothyroid, 1.9% were subclinical hypothyroid. Among cases 64.8% were euthyroid. Thyroid dysfunction was found to be prevalent among 35.2% metabolic syndrome patients. Conclusions: Present study clearly reveals a higher incidence of thyroid dysfunction in metabolic syndrome. Metabolic syndrome and thyroid dysfunction are both considered as independent risk factors for cardiovascular disease. Therefore presence of both these entities in an individual increases the risk of a cardiovascular compromise. Hence assessment of thyroid function in metabolic syndrome might serve as a risk assesment tool to identify individuals predisposed to cardiovascular disease early, thereby resulting in a timely intervention.
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Sat, 24 Sep 2016 01:59:17 GMT -08:00 http://www.scopemed.org/?mno=236632
Study of relation of serum magnesium level with glycemic control in diabetes mellitus http://www.scopemed.org/?mno=237760 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Subrata Halder, Koushik Roy, Kaushik Biswas, Priyankar Biswas, Ramita Sarkar.
Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Several distinct types of DM are caused by a complex interaction of genetics and environmental factors. This study was done to evaluate the relation between serum magnesium and glycemic control in diabetics. Methods: 50 patients of T2DM were included this study. Detailed history, physical examination and relevant systemic examination were performed and necessary laboratory tests FBS, PPBS, HbA1c, magnesium level were done Results: The mean age (mean± SD) of the patients was 49.82±7.38 years with range 29-58 years and the median age was 51 years and Male 32 (64%), Female 18 (36%), M:F= 1.78:1. In this study, statistically significant correlation was found between level of magnesium and age (p=0.04). In present study no statistically significant association was found between level of magnesium and sex (p=0.738). In high magnesium level (≥1.7), mean BMI 25.08±2.82 whereas mean BMI 24.25±2.87 in low magnesium level (
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Sat, 24 Sep 2016 01:58:43 GMT -08:00 http://www.scopemed.org/?mno=237760
Prevalence of hypertension in school going children in tea garden community in Dibrugarh town, Assam, India http://www.scopemed.org/?mno=237729 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Abhijit Dastidar, Smriti P. Dutta, Hiranya Saikia.
Background: The disease burden of hypertension among workers in tea gardens is large, despite the community not being obese. Consumption of high quantity of common salt (NaCl) is considered to be the main factor. Therefore it is expected that prevalence of hypertension and level of blood pressure would be higher among these group of children. Hence the present study was taken to determine the prevalence of hypertension in apparently healthy, asymptomatic school children of tea garden workers in the age group of 6-12 years. Methods: Blood pressure was recorded in the right arm in the sitting position by using a standard Hg sphygmomanometer using appropriate cuff sizes. Three readings were taken at an interval of at least 5 minutes and the average of these three readings was considered as the blood pressure of the individual. Average SBP or DBP levels that are greater than or equal to the 95th percentile for sex, age, and height was taken as hypertension. Results: The prevalence of systolic, diastolic and both systolic and diastolic hypertension are 3.86%, 1.71% and 4.29% and 2.62%, 0.37% and 5.24% in boys and girls respectively and the overall prevalence of hypertension was found to be 9.0% (systolic 3.2%, diastolic 1.0% and systolic and diastolic 4.8%). Conclusions: The high risk children need to be considered for close follow ups for modification of risk factors by advising lifestyle changes like reduction in intake of salt.
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Sat, 24 Sep 2016 01:58:09 GMT -08:00 http://www.scopemed.org/?mno=237729
Fine needle aspiration cytology of breast lesions and correlation with histopathology http://www.scopemed.org/?mno=237711 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Ramesh S. Waghmare, Shubhangi D. Sakore, S. B. Rathod.
Background: Breast carcinoma is the leading cause of death due to cancer in women. It is difficult to determine whether a lump is benign or malignant from clinical assessment. Fine needle aspiration cytology (FNAC) is a convenient and rapid procedure. Hence the present study was carried out to correlate fine needle aspiration cytology and histopathology of breast lesions. Methods: A study consisting of fine needle aspiration cytology (FNAC) 134 of breast lesions and their histopathological correlation was conducted at tertiary health center in rural area, over a period of three years. The diagnostic accuracy of this series was assessed and compared with data obtained from the Indian and international literature. Statistical analysis like sensitivity, specificity, positive predictive value, efficiency, and negative predictive value were carried out. Results: The diagnostic accuracy of this series i.e. sensitivity 88.24%, specificity 100%, positive predictive value 100%, efficiency 95.52%, and negative predictive value 93.2% was compared with similar studies in literature. Conclusions: FNAC is an effective modality for the diagnosis of breast lesions. It is a safe, simple, and cost effective outpatient procedure associated with negligible complications. It helps the clinicians for early diagnosis and specific management thus reducing morbidity and mortality.
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Sat, 24 Sep 2016 01:57:40 GMT -08:00 http://www.scopemed.org/?mno=237711
Effect of leg wrapping on haemodynamics and associated complications in caesarean section: a randomised prospective study http://www.scopemed.org/?mno=237620 2016-09-24T20-40-30Z
Source: International Journal of Research in Medical Sciences
Prajnyananda Das, Sumita Swain.
Background: Spinal anesthesia in cesarean section has a rapid onset of action, reliable and provides good surgical conditions, however there is risk of placental hypo-perfusion proportional to the degree of sympathetic block. Inspite of traditional preventive measures (fluid preload, fluid co-load, left lateral tilt, and ephedrine prophylaxis) post spinal hypotension is difficult to avoid. In this study efficiency of pre block leg wrapping in preventing hypotension and associated complications in parturients have been evaluated. Methods: 60 patients posted for elective cesarean section under spinal anesthesia of ASA grade Ι and ΙΙ under spinal anesthesia were allocated two groups with or without leg wrapping with elastic bandage. All of them received 10ml/kg ringer’s lactate preloading, spinal anaesthesia in sitting position and haemodynamic monitoring done. Complications like hypotension managed with intravenous phenylephrine. Results: There was statistically significant difference in degree of hypotension found between the two groups. Incidence of hypotension in Group A (leg wrapped) is 13.33% where as in group B (leg not wrapped) is 63.33%. There is significant difference in incidence of nausea, vomiting and shivering in both the groups. Conclusions: Leg wrapping with elastic crepe bandage is cheap, easy, readily available, non-invasive, and non-pharmacological method, can be recommended in addition with preload and left uterine displacement for preventing post spinal hypotension and its subsequent adverse effect on the mother as well as on a baby and can be of great value in routine practice.
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Sat, 24 Sep 2016 01:56:56 GMT -08:00 http://www.scopemed.org/?mno=237620