International Journal of Medical and Dental Sciences

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https://imsear.searo.who.int/handle/123456789/149627

Editor : Dr. Sukhbir Sodhi

ISSN: 2454-8952(Print), 2320-1118 (E-Print)

Frequency: 2 issues a year

Language: English

Double blind peer reviewed journal

Web site: https://ijmds.org/

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Comparative Analysis of Efficacy and Safety of Gabapentin Vs Amitriptyline in Patients of Peripheral Neuropathic Pain in Case of Diabetes Mellitus
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Kaur, R; Sehgal, VK; Sibia, RPS; Kaur, A; Kumar, A
Introduction: Diabetes mellitus frequently leads to development of peripheral neuropathies in almost 30-50% of patients and the most common type of neuropathy associated with this condition is Distal Symmetric Sensorimotor Polyneuropathy (DSPN). Gabapentin and Amitriptyline are two drugs frequently used for the treatment of neuropathic pain associated with type 2 diabetes. Aim of the study: The aim of this study was to compare efficacy and safety of Gabapentin and Amitriptyline in subjects of Type 2 diabetes mellitus with peripheral neuropathic pain. Material and Methods: A prospective, open, randomized, parallel group, comparative study was conducted in 60 patients coming to Department of Medicine, Rajindra Hospital attached to Government Medical College Patiala, to evaluate the efficacy and safety of Gabapentin and Amitriptyline in patients with diabetic peripheral neuropathic pain. The patients fulfilling the inclusion criteria were included in the study after taking written informed consent. The patients were divided into two groups of 30 cases each by simple randomization. Group I patients received Gabapentin 300 mg HS by oral route. Group II patients received Amitriptyline 25 mg HS by oral route. Therapeutic efficacy of both drugs, by using Michigan Neuropathy Screening Instrument (MNSI) was compared at the baseline and at the end of 4 months. Any adverse drug reactions of the respective drug observed in patient were also noted. All the observations thus made were statistically analysed using appropriate tests. Results: Baseline characteristics of the patients in two groups such as age, sex, duration of diabetes were similar (p>0.05). The mean age in group I and group II were 53.40±8.41 years and 57.17±8.55 years, respectively. There was statistically significant reduction in mean MNSI scores in questionnaire part and physical examination part in both the groups. Also, there was statistically significant difference between the two drugs in reducing mean MNSI score. Mean difference between two drugs in reducing MNSI score in history part (0.77±0.16, p<0.01) and physical examination part (0.75±0.19, p<0.01) favoured Gabapentin. No. of adverse drug reactions reported were significantly higher in Amitriptyline group, p value (<0.05) for the difference in ADRs between two drugs was statistically significant. Conclusion: In this study, we concluded that both drugs lead to improvement in signs and symptoms of diabetic neuropathy. Gabapentin was proved to be more efficacious than Amitriptyline. Gabapentin treated patient’s mean MNSI score at the study end point was significantly lower as compared to the Amitriptyline treated patient’s end-point score. Adverse drug reactions reported in our study were mild in both the groups and a significantly higher number of adverse effects were reported in the amitriptyline group. Dizziness and somnolence were two most commonly reported adverse drug reactions.
A Study of Prescribing Pattern in Patients of Hypertension
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Haq, F; Singh, H; Sehgal, VK; Kumar, S; Kaur, A
Introduction: Hypertension is a multi-factorial and complex disease that has both environmental and genetic determinants. It is the single most significant risk factor for heart diseases and kidney diseases. Hypertension is a leading contributor to global burden of morbidity and mortality. It is considered as a silent killer because most of the time it is asymptomatic and goes undetected. Hence, hypertensive patients should be prescribed properly. Objectives: To evaluate the prescribing pattern of anti-hypertensive drugs in patients of hypertension. Material and Methods: This was an observational, cross sectional study conducted over a period of 1 year on hypertensive patients attending the Cardiology out-patient department of Government Medical College and Rajindra Hospital, Patiala and fulfilling the inclusion and exclusion criteria. The prescriptions were evaluated. Results: 22% of prescriptions had monotherapy, amongst which beta-blockers were most commonly prescribed. Majority of prescriptions had two drug therapy (47%), among which ARB+ beta blockers (17%) were most frequently prescribed. Beta blockers +CCB (9%) was the most common Fixed Drug Combination (FDC) prescribed. ARB+beta blockers+diuretics (14%) and ACEI+ARB+beta blockers+diuretics (1%) were most commonly prescribed three drug combinations. Among four drug combinations, only ACEI+ARB+beta blockers+diuretics was prescribed to 1% patients. Hypolipidemic drugs (66%) were maximally co-prescribed. Conclusions: A high trend of polypharmacy was observed in hypertensive patients. So, emphasis is needed to reevaluate the prescribing trends in these patients.
Study of Aesthetic Components of Smile in North Indian Males
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Goel, A; Delmotra, P; Goel, V; Shivhare, G; Chandel, R
Smile is an important physical factor for reflection of inner emotions and well being of person. People with an aesthetic smile are judged socially attractive. It would be useful to represent some desirable characteristics of the smile, which help to achieve desirable results in surgical and aesthetic oral rehabilitation. To analyze the various aesthetic components of smile, assessing the teeth displayed during smile, relationship between curve formed by incisal line of anterior maxillary teeth and the curve of lower lip, the touch of this incisal line on lower lip, the alignment of facial midline with the arch midline and compared the data with the previous studies. The study comprises of 200 North Indian males age group 18-40 years. Prior informed written consent for this study was obtained from the subjects. The exclusion and inclusion criteria for the subjects were predefined. Photographs were taken both in rest position as well as in Smile position using digital camera with high resolution. Results show that during smile the position of upper lip was average in 49% of males, alignment of upper incisal edge to lower lip was convex in 47%, tooth lower lip was non touching in 60%, no. of teeth displayed during smile was 8-10 in 68%, midline from philtrum passing through the centre of central incisors in 76% and bilateral negative space was not visible in 92% males. So, it is concluded that smile is aesthetic in North Indian males.
A Study of Efficacy and Tolerability of Rosehip Extract (Gopo) vs. Ibuprofen (a nsaid) in Treatment of Osteoarthritis in Weight Bearing Joints
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Lal, H; Singh, H; Sandhu, KS; Sehgal, VK
Introduction: Osteoarthritis is the most common form of arthritis. Osteoarthritis is a joint failure, which occurs due to pathological change in all structure joint. Aim: The aim of the study was to compare the efficacy and tolerability of Rosehip Extract and ibuprofen along with individual effect of both drugs. Materials and Methods: This was an open, randomized, prospective study to compare ROSE HIP Extract and IBUPROFEN for treatment of Osteoarthritis in 100 patients. In this study two comparative groups (50 each) were taken. First group was prescribed 400 mg TDS Ibuprofen and the other group was given Rose hip extract in the form of 275 mg capsule BD. The pain assessment was done through Womac scale and visual analogue scale. The data was collected for efficacy and tolerability for both drugs at 14 days and 3 months. Result: In ibuprofen group, the mean score of pain intensity on womac scale on visit 1 was 39.2 ± 9.58 which was decreased to 11.62 ± 4.97 in the last visit. On VAS scale on visit 1 was 7.26 ± 1.426 and was decreased to 3.36 ± 1.467 at visit 3. In rosehip group. The mean score of pain intensity on WOMAC scale on visit 1 was 38.44 ± 8.45, 30.88 ± 8.068 which was decreased to 26.68 ± 8.474. The mean score of pain intensity at on VAS scale on visit 1 was 7.02 ± 1.06, 5.84 ± 1 and was decreased to 4.6 ± 1.16 at the end of study. Conclusion: Ibuprofen is a better choice than rosehip because it had shown better improvement. Both rosehip and ibuprofen were well tolerated.
A Pharmacoeconomic Analysis to Determine the Relative Cost-effectiveness of Timolol 0.5%, Brinzolamide 1% and Brimonidine 0.2% Eye Drops in Treatment of Primary Open Angle Glaucoma/Ocular Hypertension
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Sehgal, VK; Vashisht, T; Singh, G; Sharma, N
Aim: A pharmacoeconomic analysis to determine the relative cost-effectiveness of timolol 0.5%, brinzolamide 1% and brimonidine 0.2% eye drops in treatment of Primary Open Angle Glaucoma (POAG)/ocular hypertension (OHT). Settings and Design: Comparative, open, randomized, parallel group prospective study. Materials and Methods: 60 patients of POAG or ocular hypertension were included in this study. Time period of study was 6 weeks. 60 eyes of 60 patients were included in the study. Patients were divided randomly into 3 groups of 20 each. Patients in group A, B and C received timolol, brinzolamide and brimonidine respectively. One drop of each medication was instilled twice a day at 9 am and 9 pm daily for 6 weeks. IOP was measured on day 0 at 9 am (before administration of drugs) and then at 11 am, to get baseline IOP. IOP was again measured on subsequent visits at 9 am and 11 am. Treatment outcome was number of mm Hg fall in IOP induced by the study drug. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost‑effectiveness was then calculated as the cost of drug/mm Hg fall in IOP. Statistics: Paired ‘t’ test was used to analyze the parameters within the group. Independent samples t‑test was used to compare the efficacy of drugs with each other. Results: The % reduction of brimonidine, timolol and brinzolamide at end of 6 weeks was 21.43 ± 3.06%, 24.87 ± 2.46% and 18.78 ± 1.73% respectively. Timolol was superior in efficacy to other two drugs. The difference was statistically significant between the efficacy of timolol and brinzolamide (p < 0.001) as well as timolol and brimonidine (p = 0.003). There was no statistical significant difference in the efficacy of brimonidine when compared to brinzolamide (p=0.26). Timolol (5.87 ± 0.83 Rs/mm lowering after 6 weeks) was found to be most cost-effective followed by brimonidine (46.83 ± 7.37) and then brinzolamide (60.49 ± 6.77) in lowering IOP. Conclusion: All three drugs under the present study are useful in the treatment of POAG/OHT, but timolol is a better choice than other two drugs because of greater reduction in IOP and greater cost-effectiveness.
Comparative Study to Evaluate Efficacy, Safety and Quality of Life of Metoprolol and Telmisartan versus Metoprolol and Ramipril in Patients of Hypertension
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Arora, S; Sehgal, VK; Singh, J; Singh, H
Background: Hypertension(HTN) is a major cardiovascular disease and is a major worldwide clinical problem. The prevalence of hypertension increases in urban and rural areas. The treatment of hypertension began in the 1960s with oral diuretics. The other modalities of treatment of hypertension are beta – blockers, calcium-channel blockers, alphareceptors blockers, ACE inhibitors and ARBs. The better compliance occurs with single-pill combination, and may be even double or even triple pill combination therapy should be used. Also quality of life was improved better with Metoprolol and Telmisartan as compared with Metoprolol and Ramipril. Quality of life was assessed by SF -36 Quiestionnare. Objective: To compare the effect of Metoprolol and Telmisartan versus Metoprolol and Ramipril on BP and quality of life in patients of hypertension. Material and Methods: In this prospective, open, randomized, parallel group, comparative study, 80 patients of hypertension attending the Cardiology Outpatient Department, Govt. Medical College & Rajindra Hospital, Patiala were recruited. This randomized comparative study was done on 80 patients for 4 months. Quality of Life: In my project of Quality of life, I had taken total 80 patients and the patients were divided into two groups and 40 patients each of Metoprolol and Ramipril versus Metoprolol and Telmisartan. To assess quality of life questionnaire SF-36 was administered to the patients. Results: There was a marked decrease in SBP and DBP with the use of Metoprolol and Telmisartan than Metoprolol and Ramipril. There was also no change in demographic parameters. There was significant improvement in the quality of life with Metoprolol and Telmisartan. Conclusion: Metoprolol and Telmisartan was a better choice than Metoprolol and Ramipril in treating hypertension as this combination causes more reduction in BP and little effect on HR.
A Peripheral Smear Finding Beyond Cells: Cryoglobulins in a Case of Lymphoplasmacytic Lymphoma
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Karthika, KV; Tripathi, P; Pati, H; Saxena, R
A well prepared peripheral smear is an indispensable requisite for the diagnosis of hematological disorders and in some situations, non-hematological diseases. Here, we present the typical hemogram and peripheral smear findings of circulating cryoglobulins that led to the unraveling of the underlying lymphoproliferative disorder. A 51-year lady presented with symptoms of anemia since four months. Her hemogram showed anemia and leucopenia with flagging of platelet count. Peripheral smear at room temperature revealed marked artefactual changes in red blood cells including fragmentation. The morphology was better appreciated after incubating the sample at 37°C and showed normocytic normochromic RBCs, thrombocytopenia with a few lymphoplasmacytic cells and amorphous pinkish material in the background. Bone marrow examination showed near total replacement of marrow spaces by lymphoid cells positive for CD20 and CD138 and was diagnosed as lymphoplasmacytic lymphoma. Cryoglobulins can thus cause a range of laboratory artefacts which need to be recognized, warranting further search for possible underlying etiologies.
Sero-prevalence of Rubella Antibodies in Pregnant Women with Bad Obstetric History Attending A Rural Tertiary Care Hospital in West Bengal, India
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Chattopadhyay, S; Biswas, T; Chakraborty, B; Mukherjee, T; Ghosh, P; Mondal, R
Background: Rubella infection in pregnant mothers is of great concern as it acts as a teratogen causing abortions, still births, intra-uterine foetal deaths and multiple birth defects. In India, rubella causes significant bad obstetric pregnancy outcome including congenital deformities due to lack of proper surveillance and immunization coverage with rubella vaccination. Aim: To determine Sero-prevalence of rubella IgM and IgG antibodies in Bad Obstetric History (BOH) pregnant women in Tertiary Rural Medical College in Eastern India. Materials and Methods: Cross sectional study was conducted from 1st January 2017 to 31st March 2017 on sera of 100 antenatal mothers with bad obstetric history aged between 20-40 years of age group with pregnancy of ≥18 wks. Rubella IgM and IgG antibodies were assessed by ELISA. Statistical Analysis: Percentage, proportions and ᵡ2 test were applied. Results: Eleven per cent (11%) sero-prevalence for IgM antibodies and 54% for IgG antibodies was observed with maximum sero-positivity among 20-25 years mothers. Repeated abortions were the commonest pregnancy outcome. Conclusion: All antenatal cases should be routinely screened for rubella, so that early diagnosis will help in proper management and foetal outcome and strong recommendation for universal coverage of MMR in early age group of children.
Detection of Extended-Spectrum Beta Lactamases and AmpC Beta Lactamases Producing Uropathogenic Escherichia coli in a Tertiary Care Hospital
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Bakshi, R; Sehgal, VK; Kansal, P; Kaur, S
Background: The multidrug resistant among uropathogenic E. coli has become a potential threat to global health. The aim of the current study to evaluate the antimicrobial activities of nitrofurantoin and fosfomycin along with other antimicrobials against Extended Spectrum β-Lactamases (ESBL) and AmpC producer isolates from the most common organism E. coli. Methods: A total of 6046 clean catch midstream urine samples were collected and processed in Microbiology department of tertiary care hospital. The antimicrobial susceptibility of E. coli isolates was initially screened by Kirby-Bauer disk diffusion method. The resistant isolates were confirmed to be ESBL and AmpC producers by their respective phenotypic confirmatory tests of combined disc method. Results: Out of 6046 patients there were 1855 E. coli positive patients. Maximum patients in the age group of 21-30 years were 51.5% followed by 31-40 years where patients were 26%. 64.4% E. coli were isolated from female patients and 35.6% from male patients. E. coli showed higher sensitivity towards, fosfomycin (100%), imipenem (100%), nitrofurantoin (84.1%), piperacillin and tazobactam (77.3%), amikacin (76.1%) and while they showed high degree resistance pattern against Penicillin, cotrimoxazole, ciprofloxacin, norfloxacin and 2nd and 3rd generation cephalosporin. Out of 1855 E. coli, multi drug resistance was seen in 520 E. coli isolates. ESBL production was observed among 50% of E. coli isolates by combined disk method. Out of 520 isolates, 150 isolates showed resistance to one or more extended-spectrum cephalosporins and cefoxitin by Kirby-Bauer disk diffusion method. These were selected and screened for ESBL and AmpC production. Among 150 cefoxitin-resistant isolates, AmpC phenotype was detected in 100 isolates (66.6%) by AmpC disc method. The overall occurrence of AmpC in the study was found to be 19.2%. Susceptibility of ESBL and AmpC producers to fosfomycin, imipenem, nitrofurantoin and amikacin were found to be 100%, 98.5%, 89% and 75% respectively. Conclusions: There is increased prevalence of ESBL and AmpC producing E. coli. Thus, early detection of ESBL and AmpC producer E. coli by simple phenotypic methods is necessary to avoid treatment failure, where molecular techniques are not available.
Effectiveness of Kampo Medicines Against Intractable Stomatitis: A Mini-Review
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Momota, Y; Takano, H; Azuma, M
Intractable stomatitis is a chronic inflammatory disease of oral mucosa, with unclear etiopathogenesis. Kampo Medicines (KMs), i.e., Japanese herbal medicines, effectively treat stomatitis. The precise effects of KMs on intractable stomatitis are not established. We present the details of several patients with intractable stomatitis who were well-treated with KMs (i.e., Inchinkoto, Orento, Goreisan, and Byakkokaninjinto). We also review the literature on the link between intractable stomatitis and KMs. KM-related anti-inflammatory and antioxidant activity may suppress intractable stomatitis. KMs may also facilitate wound healing through increased saliva secretion. KMs may therefore be useful for the treatment of intractable stomatitis.
Morphometric Variation of Adult Human Clavicle - A Tool for Gender Determination
(Dr. J.S. Sodhi Memorial Educational Society, 2019-07) Dehiya, A; Agnihotri, G; Sharma, RK
Introduction: Bones can reflect the basic framework of human body and provide valuable information about the biological identity of the deceased. They often, survive the morphological alteration, decay/mutation and decomposition insults. An in depth, knowledge and analysis of variation in clavicular length, midclavicular circumference and weight is imperative for both clinical and forensic anthropological perspectives. Objectives: The present study was done to determine morphometric variability of adult human clavicles by using length, weight and midclavicular circumference parameters. Materials and Methods: 300 pairs of adult human clavicles of known sex obtained from cadaveric dissection and bony collections of anatomy department were utilized for the study. The length, weight and midclavicular circumference were measured. The data obtained was statistically analysed. Results: Gender specific statistical analysis for length, weight and midclavicular circumference was found to be highly significant. The side specific significance was found only in male and in female clavicles for weight and midclavicular circumference respectively. No side specific significance found for length of clavicle. Conclusions: The present study provides morphometric data for North Indians and compares observations with other populations. The study establishes that length, weight and midclavicular circumference of clavicle have a dimorphic potential. This fact can play a decisive role in forensic identifications and clinical interventions. The results are of immense significance for anatomists, orthopedic surgeons and the forensic anthropologists in their professional endeavors.
Pulmonary Sarcomatoid Carcinoma
(Dr. J.S. Sodhi Memorial Educational Society, 2018-07) Sharma, M
Pulmonary Sarcomatoid Carcinoma (PSC) is a poorly differentiated NSCLC with sarcoma like differentiation (spindle/giant cell) or a component of sarcoma (malignant bone/cartilage/skeletal muscle). WHO grading 2015, classifies sarcomatoid ca into five histological types: pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma and pulmonary blastoma.
Drug Delivery Through Blood Brain Barrier: Taming the Bottleneck in CNS Therapeutics
(Dr. J.S. Sodhi Memorial Educational Society, 2018-07) Sehgal, VK; Singla, R
Although many agents have therapeutic potentials for Central Nervous System (CNS) diseases, few of these agents have been clinically used because of the brain barriers. Physiological barriers like the blood-brain barrier and blood-cerebrospinal fluid barrier as well as various efflux transporter proteins make the entry of drugs into the central nervous system very difficult. Different strategies for efficient CNS delivery have been studied. This review presents the current approaches to facilitate penetration across these barriers for enhanced drug delivery to the CNS.
Study on Gender Specific Variability of Gastrointestinal, Genitourinary and Depression Related Non Motor Symptoms of Parkinson Disease
(Dr. J.S. Sodhi Memorial Educational Society, 2018-07) Dehiyan, A; Singh, S
Introduction: Parkinson’s disease is a second most common neurodegenerative disorder after Alzheimer’s disease. It affects 1% of population over age of 50 years. Three main features of PD is asymmetric onset of bradykinesia, rigidity and resting tremors. Non motor symptoms are common in patients of Parkinson’s Disease. These remain undiagnosed most of the time. Aim and Objectives: To analyse gender specific, age related and demographic variability of non motor symptoms (Gastrointestinal, genitourinary and depression related symptoms) of Parkinson’s disease. Material and Methods: Present study Included 100 cases (65 Males and 35 Females) of Parkinson’s disease presenting at department of neurology, Dayanand Medical College and hospital, Ludhiana. 30 questionnaire of non motor symptoms in hindi and Punjabi were given to patients. Gender, age, duration of non motor symptoms, Parkinson’s phenotype and complete demographic profile of each patient taken into account for study. Thereafter results were statistically analysed for all parameters. Conclusion: It is concluded that mean age and duration of non-motor symptoms were higher in males as compared to females. GI symptoms amongst non-motor symptoms were commonest and amongst GI symptoms constipation was most common and there was positive correlation of H&Y with age and non motor symptoms especially gastrointestinal, genitourinary and depression related symptoms.
Prevalence of Risk Factors of Non-Communicable Diseases in a Rural Population of Eastern Uttar Pradesh
(Dr. J.S. Sodhi Memorial Educational Society, 2018-07) Agarwal, D; Ahmad, S; Singh, JV; Shukla, M; Kori, B; Garg, A
Introduction: Over past few decade morbidities and mortalities associated with NCDs (Non-Communicable Diseases) leads to a significant loss of productive life years both in developed and developing countries. Therefore, the present study was done to determine the prevalence of common risk factors for major NCDs in a rural population of Barabanki district in eastern Uttar Pradesh. Materials and Methods: The present cross-sectional study was conducted in Satrikh block of Barabanki district. Multistage sampling was used for enrolment of the study subjects. A totalof 1824 participants aged ≥25 years were enrolled in the study. WHO STEPs- wise tool was used to collect information on behavioural risk factors like tobacco use, diet, alcohol useand associated anthropometric indices were measured. Results: Prevalence of tobacco smoking, smokeless tobacco products use, alcohol consumption, less than five servings of fruits/vegetables, more than five grams of salt intake and overweight/obesity was found to be 26.2%, 27.08%, 24.1%, 91.61%, 10.9% and 34.86% respectively. Individuals with age more than 35 years, male subjects, illiterates and those who belonged to scheduled castes/tribes were significantly (p<0.05) more predisposed to both smoked tobacco as well as smokeless tobacco use and alcohol consumption.Consumption of alcohol was significantly (p<0.05) higher among employed groups who belonged to upper and upper middle class while tobacco consumption was more prevalent in lower socioeconomic group. Consumption of salt more than 5 grams per day was significantly higher among individuals in elder age group (35-65 days), among females, those who were literate, those who belonged to other backward castes and among government employees. Conclusion: The study revealed high prevalence of non-communicable disease risk factors among adults. This indicates towards need of prompt community based preventive measures and control strategies to lower the forthcoming consequences of NCDs.
Increasing Caesarean Rates: Analysis of Indications and Possible Interventions
(Dr. J.S. Sodhi Memorial Educational Society, 2018-07) Kaur, S
Background: The alarming increase in caesarean section rates worldwide has led to a shift of focus to caesarean section rates and indications for caesarean section. The main objective of the study was to analyse the indications for caesarean section with the aim of finding viable interventions which could help decrease the caesarean rates. Methods: A retrospective study from 1st January 2017 to 31st December 2017 was conducted in which we analysed patient records of those delivering in unit III of our institute. Analysis of patient records was done and indication for caesarean was analysed. Results: A total of 496 women delivered in our unit in 2017, of these, 303 (61.09%) had a vaginal delivery and 193 (38.91%) had caesarean section. 108 patients (21.77%) had a history of at least one previous caesarean section and of these 94 (87.03%) underwent a repeat caesarean section. The primary caesarean section rate was 25.51%. Section was done for breech presentation in eleven primigravidae (5.7% of sections) and in fifteen multigravidae (7.77% of sections) including those with a previous section. Four patients had multiple pregnancy (2.04% of all sections). Eleven patients had a preterm section (5.7% of sections). Conclusion: In order to decrease caesarean rates the group that requires most focus is those in whom a primary section is being done. Few patients who have undergone at least one prior surgery are willing to take the risk inherent to a trial of labour (TOLAC). Classification and reporting of caesarean section according to the Robson ten point criteria will help in a better understanding of the indication, comparison and auditing and help to establish guidelines that can help decrease the caesarean rates.
Effectiveness of Use of Ultraviolet Sanitizing Devices for Reduction of Bacterial Colonies on Toothbrushes
(Dr. J.S. Sodhi Memorial Educational Society, 2018-07) Pasiga, BD
The use of toothbrushes plays an important role in the spread of disease and increased risk of oral infections because toothbrushes can serve as a place for microorganisms, this can occur in healthy individuals, there is oral disease, and or who have systemic disease. The purpose of this research is to know the effectiveness of uses of ultraviolet sanitation equipment on the reduction of bacterial colony on toothbrush. The type of research is laboratory experimental with. Design: Pretest and Posttest Group Design. The sampling method used is purposive sampling. As a sample is student of faculty of dentistry of Hasanuddin University amounted to 11 people. Each selected sample was then given 2 toothbrushes and 2 new tubes of toothpaste for the initial and post-intervention phase. The respondent was instructed to brush twice daily, after breakfast and before bed, and to rinse the toothbrush under running water for 30 seconds after brushing. Subjects are instructed to store their toothbrushes in disposable cups provided for the participants and left to dry. Result: There were found 9 species of bacterial colonies either breeding with Sodium Agar or Mc.Conkey or most enterobacter colony species. The effectiveness of the use of UV tools for germ decontamination was found to have significant differences in the reduction of bacterial counts before and after the use of UV sanitation (p<0.001). Conclusion: The use of sanitary UV for bacterial decontamination of toothbrush can be considered to prevent bacterial contamination on toothbrush surface, as a whole it is found there is a difference of colony average reduction before and after intervention using Ultra violet sanitation.
Histomorphological Spectrum of Splenectomy Specimens in a Tertiary Teaching Hospital:A Seven Year Study
(Dr. J.S. Sodhi Memorial Educational Society, 2017-02) Banerjee, A; Datta, A; Das, Sh
Background: Spleen is the largest organ of the mononuclear phagocytic system and is involved in all systemic inflammations, generalized hematopoietic disorders, and many metabolic disturbances. Splenectomy is frequently indicated where diagnosis is already established and the purpose of surgery being largely therapeutic in nature. Objectives: The study aims to highlight the histomorphological patterns in the surgically resected splenectomy specimens received in our centre and to correlate with the clinical indications. Materials and Methods: This was a seven year study of all splenectomy specimens received at histopathology section of Department of Pathology in a tertiary care hospital. All the histopathology slides were reviewed by the authors and the microscopic findings were studied and correlated with clinical data. Results: Twenty two (22) spleen samples were received during the study period with a M:F=1: 1.2 . The age range was 2 years to 60 years. The highest number of splenectomy cases was in the age group of 11-20 years followed by 0-10 years age group. The majority of the cases of splenectomy were indicated for thalassemia (14 cases, i.e. 63.64% of all cases), followed by traumatic rupture and secondary malignancy with 2 cases each (9.09% cases each), one case each for splenic infarct, myelofibrosis, ITP and splenic tuberculosis. Conclusion: Thalassemia was proved to be the commonest indication of splenectomy, followed by traumatic rupture and secondary malignancy in the spleen. Larger studies are needed for better understanding of this important organ and unnecessary splenectomies may thus be avoided
A Study of Prevalence of Aerobic Bacteria and Fungi in Sputum Specimens of Patients with Post Tubercular Bronchiectasis
(Dr. J.S. Sodhi Memorial Educational Society, 2017-02) Kumar, G S; Lal, S B; Laxmikanth, M
Background: Patients with Post TB bronchiectasis colonize many aerobic bacteria and fungi and lead to an increase in exacerbations and decrease in quality of life. Objective: To study the prevalence of aerobic bacteria and fungi in sputum specimens of patients with post tubercular bronchiectasis and to find out the local antibiotic sensitivity and resistance patterns. Materials and Methods: This prospective observational study was carried out over a period of one year comprising of 50 patients with post Tubercular Bronchiectasis who were above 18 yrs, completed ATT smear negative and HRCT showing bronchiectactic changes. Identification of organisms from sputum samples were done by classical aerobic microbial staining and culture methods. Descriptive and inferential statistical analysis was carried out in this study. Results: This study comprises of the 50 patients with a larger group of individuals under the age group of 51-60 (30%), along with bronchial colonization of aerobic bacteria being 78% and growth of fungi being 2%.Among the 39 patients,16 patients (32%) had grown Pseudomonas aeruginosa, 12 patients(24%) had grown Klebsiella pneumoniae, 8 patients(16%) had grown Streptococcus species and rest 3 patients(6%) had grown staphylococcus species. The Antibiotic resistance noted highest being Amikacin (56.4%), piperacillin-tazobactam showing the least (2.6%) and highest sensitivity with imipenem(100%). Conclusion: This study signifies that prevalence of aerobic bacteria, especially Pseudomonas aeruginosa and Klebsiella pneumonia was common in patients with post tubercular bronchiectasis. The Antibiotic resistance noted highest being Amikacin (56.4%) and sensitivity with imipenem(100%). In patients colonizing Pseudomonas aeruginosa, there was significant decline in lung function.
Pathobiological Characteristics of Intestinal and Diffuse-Type of Gastric Carcinoma-Retrospective Study of Gastric Cancers
(Dr. J.S. Sodhi Memorial Educational Society, 2017-02) Priyadharshini, M; Narmadha, R; Dhanalakshmi, S; Natarajan, R; Subitha, S,; Suganthi, C; Padmavathy
Background: Gastric carcinomas have various pathological features. Based on patterns of growth and invasiveness, however, they fall into two types: diffuse type and intestinal type. These two types of carcinoma appear to be different in their histogenetic origins. Objectives: To analyse various types of gastric cancer reported in last five years. To compare the features of intestinal and diffuse type gastric carcinoma including gross appearance, staging, grading of tumor. Materials and Methods: This was a retrospective study of 324 gastric cancer which were surgically resected and received over 5 years. The tumors were divided into groups according to their gross and microscopic patterns. Gross appearance was classified based on Borrmann classification. Microscopic features evaluated include tumor cell type, extent of invasion, degree of maturation, formation of glandular structures, nodal metastasis. Results: Totally 320 cases of gastric cancer were received of which 218(68%) were male, 102(32%) were female. Gastric cancers are rare below the age of 30 years. Comparing the type of gastric cancer intestinal type were 269(84%), diffuse type were 24(7.5%) and other type of gastric cancer including GIST, lymphoma, mucinous adenocarcinoma were 27(8.5%). Younger patients have higher stage of lymph node metastasis in diffuse type, but not for the intestinal type. Conclusion: Gastric cancer more common in male (M:F= 2:1) and most frequently seen in 5th decade. Intestinal type constitutes the most common type of gastric tumor. Gross appearance of diffuse type was predominantly infiltrative (79%).

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