International Journal of Scientific Study

Editor-in-Chief: Dr.Swapnil Bumb
ISSN (Print): 2321-6379 (Electronic): 2321-595X

Frequency: Monthly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.ijss-sn.com/

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Recent Submissions

Now showing 1 - 20 of 495
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    Evaluation of Basic Life Support Knowledge and Skills of Healthcare and Non-healthcare Providers
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-04) Dake, Rajesh
    Aim: Immediate bystander cardiopulmonary resuscitation (CPR) significantly improves survival after a sudden cardiopulmonarycollapse. This study assessed the basic life support (BLS) awareness, knowledge, attitude, and performance of healthcareproviders (HCP) and non-HCP before and after CPR training.Materials and Methods: This study included 4625 participants. Participants completed a pre-test to assess their knowledgeand 3 h training course that provided a theoretical background on sudden cardiac death and a hands-on CPR tutorial. Theywere asked to perform BLS on a manikin to simulate an unconscious scenario before the training. Afterward, participantsencountered the same scenario and completed a questionnaire of their post-training knowledge.Results: A total of 4625 participants were included in this study. Of which 56.54% (n = 2615) were HCP and 43.45% (n = 2010)were non-HCP. There is a significant increase in knowledge of BLS among non-HCP which is clearly evident in pre-trainingand post-training evaluation (written and hands-on). Only 0.62% employees are able to perform BLS in the correct sequencebefore the training and 76.7% employees after the training. None of the students performed BLS in the correct sequence beforethe training and 60.85% students performed well after the training. Among HCP, only 12.08% were able to perform BLS in thecorrect sequence before the training and 94.8% after the training.Conclusion: Performing BLS and attending BLS training plays a key role in attaining BLS knowledge by both healthcare andnon-HCP.
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    Effects of Intramuscular Dexmedetomidine Versus Clonidine on the Duration of Subarachnoid Block and Analgesia for Lower Limb Orthopedic Surgeries
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Bhashyam, Snehalatha; Kumar, G Prasanna; Sagar, T Prem; S, Gayathri
    Background: Alpha-2adrenergic agonists, when used simultaneously as systemic adjuvants to local anesthetics show synergisticaction and improve the quality of spinal anesthesia and prolong the post-operative analgesia. We aimed to study the effects ofintramuscular dexmedetomidine versus clonidine on the duration of bupivacaine sub-arachnoid block, post-operative analgesia,and sedation in patients undergoing lower limb orthopedic surgeries.Materials and Methods: The study design was a prospective, randomized, and double-blind study. Eighty adult consentedpatients of ASA I or II, scheduled for orthopedic lower limb surgeries under spinal block were randomized to two groups of40 patients per group. Group D received IM dexmedetomidine 1 μgkg−1, Group C received IM clonidine 2 μgkg−1, and 30 minbefore the bupivacaine subarachnoid block. The time of onset of sensory and motor block, the time required for completesensory and motor recovery, time of the first request of rescue analgesia, and sedation levels were compared between thegroups. Collected data were analyzed using the student “t” test, Chi-square test/Fisher exact test, and P < 0.05 was consideredstatistically significant.Results: The mean onset time of sensory and motor block was reduced, the mean time required for complete sensory recoverywas increased and the time of the first request of rescue analgesia was prolonged in the dexmedetomidine group comparedto clonidine group with a significant P < 0.05. Ramsay sedation score was higher in the dexmedetomidine group compared toclonidine group (P = 0.003)Conclusion: Premedication with a single dose of intramuscular dexmedetomidine before bupivacaine spinal anesthesia actsas an effective adjuvant and potentiates the quality of block and prolongs post-operative analgesia more than intramuscularclonidine.
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    Rectus Sheath Block and Subcutaneous Bupivacaine Infiltration for Post-operative Pain Relief in Midline Laparotomy
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Chouhan, Sangeeta; Mishra, Chandra Shekhar; Bhatia, Kiran; Bhargava, Sumit
    Background: The aim of the study was assessment of post-operative outcomes of rectus sheath block and comparison ofoutcomes between rectus sheath block and sub cutaneous bupivacaine.Materials and Methods: This study enrolled 58 patients who were scheduled to undergo laparotomy. Group I – 30 patientsreceived rectus sheath block using bupivacaine by placing catheters in between the muscle and posterior rectus sheath.Group II – 28 patients received bupivacaine infiltration by placing catheters in the subcutaneous plane. Visual analog scale(VAS) score, peak expiratory flow rate (PEFR), rescue analgesia, and complications were noted and follow-up of thesepatients was done.Results: Both the groups were comparable, hemoglobin concentration and anesthesiologists grades (statisticallyinsignificant). The majority of the patients from rectus sheath block group had VAS scores <5 comparing to subcutaneousinfiltration group which was statistically very significant (P ≤ 0.001). There was a statistically significant improvement ofpost-operative PEFR values in Group I as compared to Group II (P < 0.001). In Group I, 20 patients showed VAS scoreof 1 (no pain) at rest as compared only four patients in Group II. Rate of infection was more common in group receivingsubcutaneous infiltration.Conclusion: The patients from rectus sheath block group showed a statistically significant decrease in post-operative painin terms of VAS scores compared to that of subcutaneous bupivacaine infiltration group. There was statistically significantdecreased use of opioids as rescue analgesic in the rectus sheath group compared to that of the subcutaneous bupivacaineinfiltration group.
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    Study of Hematological Alterations in Malaria at a Tertiary Health Care Center of South Gujarat, India
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Shah, Pinal; Nishal, Arpita; Gamit, Sejal; Patel, Archana; Sheth, Sheetal
    Background: Malaria is a disease with a great global burden. It is one of the most prevalent parasitic infection common intropical, subtropical countries, particularly Asia and Africa. Malaria causing plasmodia is parasites of blood and hence induceshematological alterations. The hematological changes that have been reported to accompany malaria include anemia,thrombocytopenia, leukocytosis as well as leukopenia, mild-to-moderate atypical lymphocytosis, monocytosis, eosinophilia,and neutrophilia. Hence, the present study is undertaken to evaluate the various hematological parameters affected in malariaand to observe the variations, if any, in Plasmodium falciparum, Plasmodium vivax, and mixed infections.Materials and Methods: The present study was carried out in the Department of Pathology at Tertiary Health Care Centerof South Gujarat from August 2018 to October 2018. A total of 480 smear-positive malaria cases were analyzed and varioushematological parameters were studied.Results: Out of 480 smear-positive cases, P. vivax was positive in 77% of cases, P. falciparum was positive in 22% of casesand mixed infection in 1% of cases. Most of the cases were seen in the age group of 21–40 years. Anemia was seen in 53.1%of cases. Normocytic normochromic blood picture was the most common type in anemic patients (46.6%). Thrombocytopeniawas seen in 84.58% of the patients. Out of which, 75.86% were affected by P. vivax, 23.15% were affected by P. falciparum,and 0.98% were affected by the mixed infection. About 28.75% of cases showed hematological features of leukopenia, and5.2% of cases were having leukocytosis.Conclusions: Various hematological findings can help in early diagnosis of malaria which is essential for timely and appropriatetreatment which can limit the morbidity and prevent further complications
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    To Evaluate Subclinical Hypothyroidism in Type 2 Diabetes Mellitus
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) R, Aligandula Ashok; Kumar, Visampally Suresh
    Introduction: Diabetes is the most common endocrinal disorder seen in clinical practice. The prevalence of diabetes in westis between 6 and 7.6%. Type 2 diabetes mellitus is the predominant form of diabetes accounts for 90% of cases globally.Aims and Objectives: This study aims to know the prevalence of subclinical hypothyroidism in Type 2 diabetes mellitus duringthe study period of 1 year 6 months patients attending Government General Hospital/Government Medical College, Suryapet.Materials and Methods: This study was done on patients attending Government General Hospital/Government Medical College,Suryapet. The total duration of study was 1 year 6 months. Patients attending Government General Hospital who were eitherpreviously or newly diagnosed Type 2 diabetes mellitus were included in the study.Results: Fifty known or newly detected cases of Type 2 diabetes mellitus more than 30 years were selected randomly from thepatients attending to the Diabetic Clinic Government General Hospital during the study period September 2018 to February 2020.Conclusion: Subclinical hypothyroidism has been associated with a greater prevalence of cardiovascular disease and isrelatively common in patients with Type 2 DM. Hence, it effects would be exaggerated in patient with Type 2 DM.
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    Assessment of the Success Rates of Stapled Hemorrhoidopexy Intervention for Grade III and IV Hemorrhoids among Adult Patients of North India: An Observational Hospital-based Study
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Narang, Bhumika; Kumar, Niraj; Singh, Rabi Shankar; Singh, Shakti Pratap; Singh, Shankar Prasad; Srivastava, Vandana
    Introduction: Hemorrhoid disease therapy is effectively been treated with conventional excisional hemorrhoidectomy. Stapledhemorrhoidopexy (SH) revolutionized the traditional surgical approach by the introduction of the theory of dealing with the rectalmucosal prolapse by resecting a mucosal cylinder above the dentate line by means of mechanical stapling. It is a non-excisionalapproach for the surgical treatment of hemorrhoid disease.Materials and Methods: Ethical clearance was obtained from the institution. A total of 100 adult patients with Grade III/IVhemorrhoids indicated for surgery were recruited for the study purpose. Data collected were post-operative pain in the form ofVAS scale, immediate complications, duration, or length of stay in the hospital along with the time to resume work again. SPSS17.0 was used to carry out the analysis. All P < 0.05 were considered to be statistically significant.Results: The mean age of the study group was 45 ± 14.93 years. The mean length of hospital stays, postoperatively for 21%subjects, was mere 1 day; however, it was 2 days for the rest of population studied. The only complication was with 2% of thestudy population having excessive intraoperative bleeding. The mean time to return to work was 8 days. About 77% of thepatients resumed their work within 8 days of surgery.Conclusion: Within the given limitations of the study, we can conclude that SH is a successful procedure for Grade-III/IVhemorrhoids in terms of immediate post-operative complications, pain as well as the duration of hospital stay
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    Patterns of Mobile Phone use and Self-reported Health Problems among Adults Visiting a Private Dental Institute
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-04) Jadhav, Harish C; Dodamani, Arun S; Deokar, Rahul N; Bhandari, Rahul C; Khobragade, Vrushali R; Agrawal, Anoli S
    Background: Increased use of mobile phones has led to increase in the prevalence of health problems. Hence, the presentstudy was undertaken to assess the pattern of the use of mobile phone and its association with self-reported health problemsamong adults.Materials and Methods: A total of 1520 participants visiting a private dental institute in Dhule, Maharashtra, were interviewedusing a pre-tested, structured questionnaire. The questionnaire included variables such as socio-demographic details, use ofmobile phone use and its pattern, selected health problems, perceived benefits, or threats of the use of mobile phone. Dataobtained were analyzed using SPSS software.Results: The majority of the participants (87.9%) were using mobile phone for up to 3 h daily. The majority of the participants(98.3%) reported using mobile phone for calling facility followed by internet or social networking purpose (67.2%). Healthsymptoms such as headache, stressful eyes, tiredness, and painful fingers showed an increased prevalence with increase in thedaily usage of mobile phones; whereas hypertension was inversely related to the use of mobile phone. Most of the participantsagreed that they start feeling stressed or anxious without their mobile phones.Conclusion: Selected health problems showed a positive association with increasing mobile phone use. People should bemade aware of harmful effects caused due to over-indulgence in the use of mobile phone and should restrict the use of focusonly on mobile positive phones to the minimum possible.
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    Study of Correlation between Serum Sodium and Severity in Chronic Liver Disease
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Kumar, Visampally Suresh; R, Aligandula Ashok
    Introduction: The normal range of serum sodium is 135–145 mEq/L. Its homeostasis is vital to the functioning of the cell. Animbalance in the regulation of total body water can lead to abnormal sodium levels. Chronic liver disease (CLD) is associatedwith disturbance in water homeostasis leading to dysnatremias.Aims and Objectives: This study aims to study the prevalence of hyponatremia in CLD patients and to correlate the serumsodium levels and severity in CLD patients assessed by Child-Pugh score and MELD score.Materials and Methods: The study is conducted on consecutive patients admitted with CLD in medical wards (male and female)in Government General Hospital during the study period September 2018 to Febraury 2020.Results: Alcohol is the most common etiology of CLD in this study followed by hepatitis B.Conclusion: CLD is associated with abnormal serum sodium concentration. Hyponatremia is the most common abnormalityin this study
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    Gastric Carcinoma in the Young Adults: A Disturbing Trend in the Indian Population
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Muralidhar, Deeksha; Vasugi, Gramani Arumugam; Sundaram, Sandhya
    Introduction: Gastric carcinoma is an aggressive malignancy with non-specific early symptoms. It is the second most commoncause of cancer-related deaths in the world.Materials and Methods: All cases of gastric carcinomas aged <40 years presented at Sri Ramachandra Institute of HigherEducation and Research from January 2016 to December 2019 were included in this study. The presenting symptoms andoutcome were collected from medical records. Pathology reports of the included cases were retrieved and associated factorswere analyzed.Results: Out of the 177 known cases of gastric carcinoma, 17 were under the age of 40 (9.6%), out of which, 10 (58.8%)were female and 7 (41.7%) were male. The number of males was higher in the patients >40 years. Fourteen cases (82.3%)were between 30 and 40 years. Three cases (17.6%) were between 20 and 30 years of age. Helicobacter pylori associatedgastritis was seen in 6 cases (35.2%). Out of the 17 cases (41.1%), 7 were poorly differentiated. The distal stomach was thesite of the tumor in 15 cases (88.2%), 2 cases were present in the gastroesophageal junction. The most common presentingcomplaints of these patients were abdominal pain, abdominal distension, vomiting associated with food intake, and constipation,with the duration of these symptoms being 1–6 months. Two patients (11.7%) had a positive family history. Three patients(17.6%) had a positive history of substance abuse. Five patients reported a history of loss of weight and appetite. One patienthad metastasis to the liver, one to the liver, bone, and lungs, and one to the liver and esophagus. Ten patients (58.8%) weretreated with gastrectomy (subtotal/distal/partial) and two patients with esophageal gastrectomy. Most of the patients were givenchemotherapy and one was given palliative chemotherapy and radiotherapy.Conclusion: Tumors rarely occur in the young, hence malignancy is not suspected and diagnosis is delayed. This leads to ahigher mortality rate as patients present with advanced stage of the disease. This study highlighted the “shift in trend” of incidenceof gastric carcinomas in younger age group. Screening and early diagnosis and treatment are essential for young patients.
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    A Study on Orbital Cellulitis Due to Acute Sinusitis: A Multidisciplinary Approach
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) D, Senthamarai Kannan; G, Soundara Rajan; Narendrakumar, Veerasigamani; VK, Sathiya
    Introduction: Orbital infection has spread beyond the orbital septum leads to orbital cellulitis. The distinctive features of orbitalcellulitis are proptosis and limitation of ocular movements. Additional useful signs are chemosis of bulbar conjunctiva, reducedvisual acuity, afferent pupillary defect, and toxic systemic symptoms. Prompt diagnosis and treatment of orbital cellulitis is vitalas it is associated with serious complications such as cavernous venous thrombosis, visual loss, meningitis, brain abscess,and sepsis.Aims and Objectives: The purpose of this study is to evaluate clinical presentation, treatment outcomes, and post-surgicalcomplications of diagnosed case of orbital cellulitis.Materials and Methods: This is a cross-sectional study of patients with orbital cellulitis as a complication of acute sinusitis. Allthe patients were subjected to thorough clinical examination, ophthalmic and radiological evaluation. Computed tomographyof paranasal sinuses done. All the patients in this study received appropriate medical and surgical management and follow-upevaluation done at the 1st month and 3 months.Results: Orbital cellulitis due to fungal sinusitis is prevalent among uncontrolled type 2 diabetes mellitus patients in our study.Surgical management such as endoscopic sinus surgery with intravenous antibiotic therapy found to be more effective thanconservative management alone.Conclusion: Strict diabetic control, appropriate surgical and medical management, and a vigilant follow up resulted to a better outcome.
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    Assessment of Post-operative Complications, Recurrence Rate, and Patient Satisfaction After Undergoing Stapled Hemorrhoidopexy Intervention for Grades III and IV Hemorrhoids among Adult Patients of North India
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Kumar, Niraj; Narang, Bhumika; Singh, Rabi Shankar; Singh, Shakti Pratap; Shankar, Col M M R; Singh, Shankar Prasad
    Introduction: Hemorrhoids are one of the most frequent anorectal disorders encountered by clinicians in day-to-day practiceand constitute about 50% of colorectal investigations. Stapled hemorrhoidopexy (SH) represents the first dramatic change inthe treatment of hemorrhoids. Since its introduction, some researchers have raised concerns about the recurrence rate as wellas patient satisfaction. Hence, the present study was carried out to evaluate recurrence rate and patient overall satisfactionwith SH procedure at a tertiary care center in North India.Materials and Methods: Ethical clearance was obtained at the start of the study from the Institutional Review Board. A totalof 100 patients with Grade III/IV hemorrhoids were included. SH was performed as per the standard procedures. Data werecollected on complications developed post operatively at different follow-ups and an overall patient satisfaction. The data werecoded and entered into Microsoft Excel 2010.Results: Post-operative complications we observed at the 1st week were bleeding and discharge in 5%, pain in 9%, and urinaryretention in 11% of enrolled cohorts. At 1 month, hematoma formation was observed in 7.3% of total remaining patients (n = 96)and 5.2% still had post-operative pain. At 6 months, pruritus and stenosis were witnessed in 4.3% and 1.1%, respectively, oftotal remaining patients (n = 93). Recurrence rate was found 4.3% at the end of 6 months. The overall complication rates at 1week, 1 month, and 6 months follow-up were 25%, 12.5%, and 9.7%, respectively.Conclusion: The findings of our study confirm that SH is associated with a high patient satisfaction and with a lesser postoperative complications. We conclude that SH is safe with many short-term benefits.
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    A Study of Traumatic Small Intestinal Perforation: What Factors Determine Outcome?
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Mandal, Rabin; Basak, Raja
    Introduction: Small bowel injury is common after blunt and penetrating abdominal trauma resulting in significant mortality andmorbidity in a generally active population. Delay in diagnosis and treatment results in a worse outcome. Our study aims todelineate the magnitude of the problem in a tertiary care teaching hospital and determine the factors resulting in a poor outcome.Materials and Methods: This institution-based, observational descriptive study was conducted over a period of 15 months. Thesample included patients with blunt or penetrating abdominal, trauma with small intestinal perforation. Patients with concurrentmajor CNS, cardiothoracic, and orthopedic trauma were excluded from the study. Various factors likely to affect final outcomewere recorded. The appropriate surgical procedure was performed and post-operative recovery and any complications includingmortality data were recorded and analyzed.Results and Analysis: A total of 38 patients were included. Males outnumbered females. Mean age of presentation was 32.03years signifying a younger population. Motor vehicle accidents and blunt trauma were more common. Mortality rate was 18.4%.The presence of shock at admission and death was significantly related. Delay in surgery significantly increased the length ofhospital stay.Conclusion: Small intestinal perforation resulting from abdominal trauma is a condition associated with a very high mortalityand morbidity, especially in a young and active population. The efforts to reduce its incidence are beyond this discussion, butmeasures to reduce its resultant mortality and morbidity are definitely possible and feasible in a well-equipped, tertiary caresetting. This requires sincere, well-concerted efforts from all strata of government including health caregivers.
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    An Analytical Study on Communication Abilities and Schooling in Children with Cochlear Implantation
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Pootheri, Sameer; Parambil, Ardra Kaithayulla; Patani, Naisi Baby
    Background: As per the World Health Organization 2018, the new estimate of disabling of hearing loss is 466 million people.The State Initiative on Disabilities Survey (2015), Kerala, India, indicates that 2.32% of populations in Kerala, India, are affectedby some form of disabilities. Among them, 60,925 are hearing disabled based on the definition of hearing impairment in thePersons with Disabilities Act 1995. A cochlear implant (CI) is a surgically implanted electronic device that provides a sense ofsound to a person with severe to profound sensorineural hearing loss in both ears.Need for the Study: Even though the Sruthitharangam scheme was started by the Government of Kerala, India, in 2012, no studywas carried out to estimate the outcomes in terms of usage of CI, education placement, and mode of communication after CI surgery.Aims and Objectives: The aim of the study was to investigate the usage of CI, communication abilities, and schooling in CIchildren who have undergone surgery under Kerala Government free CI program. The current study was to report the usageof cochlear implantation, the education status, and mode of communication of the children who had undergone, free of cost CIsurgery from June 2012 to December 2015 in Kerala, India.Materials and Methods: The demographical data were collected from the register maintained at Government Medical College,Kozhikode, Kerala, India. The study was a cross-sectional study and the data were collected through the telephonic interview of 114parents or caregivers among 132 parents who had undergone free CI surgery from June 2012 to December 2015 at GovernmentMedical College Kozhikode. Eighteen parents or caregivers could not be contacted due to unavailability or change of contact numberand data collection was possible only for 114 parents among the 132 parents. All the children had attended a minimum of 2 years ofpost-implantation Auditory-Verbal Habilitation (AVH) from Sruthitharangam empanelled centers. Each subject was asked questionsto understand the current usage of the device, the mode of communication, type of schooling, and associated issues that affect theprognosis of CI is also considered. The obtained responses were scored accordingly and tabulated for further statistical analysis.Observations and Results: The result reveals that among the 114 CI recipients, 93.8% (107 recipients) were using CI and 6.14%(seven recipients) were non-users. These data found that all children were enrolled in school and attending in variety of educationalsettings. In that, 82.45% (94 children) were attending mainstream education and 17.54% (20 children) were going to specialschools. On further analysis of the communication, abilities showed that the majority of the children (75.43%) communicated orally,21.05% of them communicated through total communication and 3.5% of them used sign language.Conclusions: Kerala government Sruthitharangam CI program aid the majority of the children with severe to profoundsensorineural hearing loss in acquiring oral communication skills and also benefiting integration in normal schools. Steps shouldbe taken to reduce the number of non- users and also plan new strategies for better normal school integration for CI childrenunder the government scheme
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    Comparative Study on Body Mass Index between Hypothyroidism Patients and Healthy Volunteers
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) A B, Baskar; R, Venkatesan
    Background: Hypothyroidism is known to interfere with the metabolism of all the cells in the body, particularly fat metabolism inadipose tissue. This, in turn, leads to obesity. Body mass index (BMI) is widely used to assess obesity and metabolic syndrome.Obesity leads to a higher incidence of cardiovascular morbidity and mortality.Materials and Methods: Twenty-five hypothyroid subjects were enrolled (study group) from the Department of Endocrinologyand Metabolism, Govt. Rajaji Hospital attached to the Madurai Medical College, Madurai. Twenty-five normal subjects whowere age- and sex-matched with the study group were enrolled to form the control group. Serum levels of thyroid-stimulatinghormone (TSH), total circulating T4, and total circulating T3 were measured by radioimmunoassay to confirm hypothyroidism.Height and weight were measured using a stadiometer and weighing scale, BMI was calculated using Quetelet’s index formula.Results and Conclusion: The results were tabulated and analyzed by applying unpaired t-test and SPSS software version16.0. BMI values of the study group and control group were compared, but there was no statistical significance. BMI valueswhen compared with serum TSH levels within the same group, the Pearson correlation coefficient also showed no statisticalsignificance.
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    Comparison of Analgesic Effect of Fentanyl and Fentanyl with Midazolam as an Adjuvant to Intrathecal Bupivacaine in Lower Limb Surgeries
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Kuldeep, Sunil; Singh, Malkhan; Chauhan, Sunil; Sharma, Siddharth
    Introduction: Coadministration of drugs with synergistic effects considered one of the methods to increase the effectivenessof analgesia. The aim of this study is to evaluate the efficacy of midazolam to potentiate the analgesic effect of fentanyl as anadjuvant to bupivacaine.Materials and Methods: This is a hospital based prospective, randomized, double-blind interventional control study conductedat SMS medical college and hospitals, Jaipur. A total of 90 patients were enrolled in the study. They were allocated into threegroups, 30 in each. A total of 3.7 ml study drugs injected in each group. Intraoperative monitoring of hemodynamic parameters,duration of surgery, onset of sensory and motor block, duration of analgesia, sensory and motor block, and incidence of adverseeffects was done and compared.Results: There was no significant difference in mean pulse rate, systolic blood pressure, diastolic blood pressure, and meanarterial pressure (P > 0.05). The mean duration of surgery in Group A, B, and C was 101.3 ± 13.08, 92.93 ± 15.28, and 95.93± 16.03 min, respectively (P > 0.05). The mean onset time of sensory block in Group A was 7.29 ± 1.23, in B 4.92 ± 0.60, andin C 4.79 ± 0.91 min (P < 0.05). The mean onset time of motor block in Group A was 8.75 ± 0.55, in B 7.79 ± 0.42, and in C7.57 ± 0.29 min. In Group A, mean time of sensory block was 194.4 ± 6.80, in B 236.60 ± 12.79, and in C 254.30 ± 7.32 min. InGroup A, mean duration of motor block was 180.2 ± 5.22, in B 188.7 ± 4.04 and in C 199.6±6.69 min. In Group A, mean durationof analgesia was 215.7 ± 14.6, in B 445.8 ± 18.92, and in C 522.3 ± 16.33 min. The incidence of adverse effects was insignificant.Conclusion: We conclude that midazolam potentiates the effect of fentanyl in terms of prolonged duration of analgesia andprolonged motor and sensory block when used as an adjuvant of bupivacaine without any significant hemodynamic compromise.
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    Epidemiological Profile of Stroke in Central Kerala
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Abhilash, Somasundaran; Potty, S. Narayanan
    Background: There is a rising trend in the incidence of stroke among Keralites, but proper data regarding the same are scarce.To date, no study has been published delineating the epidemiological profile of stroke in Central Kerala harboring a populationof more than 5 million.Objectives: The objectives of the study were to characterize the clinical profile, risk factors, type, and etiology of stroke inCentral Kerala.Methodology: A prospective cohort study was conducted in the Department of General Medicine in Amala Institute of MedicalSciences, Thrissur, Kerala, from January 2014 to January 2015 that evaluated 464 patients admitted with a diagnosis of stroke.Based on clinical examination and brain computed tomography/magnetic resonance image findings, patients were classifiedinto ischemic and hemorrhagic stroke subtypes and enrolled.Results: Of the total 464 patients, 44.6% were female and 55.4% were male. A maximum amount of cases were observed inthe age group between 61 and 70 years. Among them, 63.6% of patients were hypertensive, 45.5% were diabetic, 12.7% hada cardiac disease, and 0.6% of patients had peripheral vascular disease. The incidence of hemorrhagic stroke was 27.8% andischemic stroke was 72.2%. Most of the ischemic strokes were due to large artery atherosclerosis.Conclusion: Our study has shown that systemic hypertension followed by diabetes mellitus was the prime risk factor contributingto stroke among Central Keralites. Tobacco use is widely prevalent among males in Central Kerala which could account forthe increasing incidence of stroke among males. There is an urgent need to improve the lifestyle of people, especially in theage group between 61 and 70 years who were the most susceptible to stroke by implementing proper monitoring and controlof modifiable risk factors.
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    A Study to Assess the Clinicopathological Spectrum of Acute Complications of Diabetes Mellitus in Relation to Hypertension
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Lala, Kunal; Lala, Divya; Bhati, Viren; Patil, Smita
    Introduction: The prevalence of diabetes mellitus has been dramatically increasing worldwide, making it an extremely costlychronic disease, both in terms of patient morbidity and health-care expenditure. As many non-communicable diseases havesimilar pathophysiologic mechanisms, so the clinicopathological spectrum and incidences of complications may be expectedto be different from that observed in the general population. However, not many studies are available in this regard. Therefore,this study was conducted to assess the clinicopathological spectrum of the acute complications of diabetes mellitus in relationto hypertension.Materials and Methods: This cross-sectional, analytical study was conducted on patients admitted in the ICU with the acutecomplication of diabetes mellitus. One hundred patients aged more than 18 years were included in the study. Relevant medicalhistory and investigations were recorded.Results: The mean diastolic BP was significantly lower in hypertensive patients. More proportion of hypertensive patients hadderanged creatinine.Conclusion: From the present study, it can be effectively concluded that the epidemiological and clinic-pathological profile ofthe patients having acute complications of diabetes mellitus is significantly different in hypertensive patients than in the nonhypertensives. Further studies need to be done in this regard.
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    Correlation between Hypothyroidism and Systemic Arterial Blood Pressure: A Case–Control Study
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) AB, Baskar; R, Venkatesan
    Background: Hypothyroidism has been known to be associated with changes in systemic arterial blood pressure. Diastolicblood pressure (DBP) is known to be elevated causing proportionate reduction in pulse pressure.Aim: The aim of the study is to find out the correlation between systolic blood pressure (SBP), DBP, pulse pressure (PP), andmean arterial pressure of hypothyroid patients and normal individuals.Materials and Methods: This case–control study was conducted in Government Rajaji Hospital attached to Madurai MedicalCollege, Madurai. Twenty-five hypothyroid subjects were enrolled for the study (study group) from the department of endocrinologyand metabolism. Twenty-five normal subjects who were age and sex matched with the study group were enrolled for the study(control group). Serum thyroid-stimulating hormone (TSH) levels were estimated in all the subjects. Arterial blood pressure wasrecorded in all the subjects in the sitting posture and the results obtained. The results are tabulated and analyzed by applyingunpaired “t” test.Results and Conclusion: Among the blood pressure parameters, only PP showed a positive correlation between the studygroup and control group. SBP, DBP, and mean arterial blood pressure showed no significance.
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    A Clinical Study of Anterior Sylvian Point and Use of Anterior Sylvian Point For Surface Mapping of Frontal Horn For Intraoperative Emergency Ventricular Tapping
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Krishnan, AG Santhana
    Introduction: Anterior sylvian point (ASyP) had a constant relationship with a point in the skull just posterior to the “H”-shapedpterion over the squamous suture called the anterior squamous point (ASqP).Objectives: The objectives of this study were as follows: (1) To confirm and establish the cisternal nature of ASyP and itsrelationship to other important neural and sulcal structures along the sylvian fissure. (2) To confirm the relationship of theAntSyP (ASyP) with the external cranial landmark ASqP for surface mapping of frontal horn for emergency ventricular tapping.Materials and Methods: Forty adult human brains (20 – right side and 20 – left side), both male and female, were observedduring surgery in Government Theni Medical College. Reliability of frontal horn tapping using the apex of Paine’s trianglefrom ASyP as the entry point was analyzed using the following steps. Exposure of pterion by the standard FTP trauma flapincision. Standard FTP craniotomy opening of the skull and dura mater and observing for ASyP relation to ASqP. A catheterwas introduced through the apex of the Paine’s triangle identified using the surgical tapes to form a 2.5 cm isosceles trianglefrom the ASyP. A study of the relationship of ASyP to the external cranial surface, middle cerebral artery (MCA) bifurcation,and frontal horn of ventricles was done.Conclusion: It could be safely concluded that ASqP is a reliable external cranial landmark for ASyP. ASyP can be the referencepoint for Paine’s triangle and hence Paine’s point. Hence, Paine’s point could be used to tap the frontal horn in emergentsituations. Furthermore, MCA bifurcation can be reached by ASyP cisternal dissection.
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    Hangman’s Fracture of the Cervical Spine: A Prospective Study
    (International Research Organization for Life & Health Sciences (IROLHS), 2020-07) Rajadurai, O R Jeff Walter; RJ, Oral Roberts; M, Thangapandi; M, Pooja; PK, Sukanthi
    Introduction: Hangman’s fracture is the second most common fracture of all the C2 vertebral fractures. It has been observed,which accounts for 55% of cervical fractures. They form 23–25% of (C2) axis fractures.Materials and Methods: All Type II and IIa hangman’s fractures operated were included in this study. Twelve patients (eightmen and four women) between 20 and 60 years of age diagnosed with unstable hangman’s fracture, treated, and followed upin our department were included in the study. Ten patients were injured in road traffic accidents, and two were injured due tofalls from height.Results: The total number of patients included in the study was 12, the age range from 20 to 60 years; male-to-female ratiois 8:4. All patients presented with neck pain. In Type II and IIa cases, the anterior approach was made in ten cases, where thereduction was achieved with traction. In anterior cases, the reduction was maintained after fixation.Conclusion: The anterior approach with primary internal stabilization is the appropriate option for unstable Type II, Type IIahangman’s fracture in cases was preoperative reduction that could be achieved. Using the anterior approach with the primaryinternal fixation of these fractures, solid fusion was achieved in all cases.