International Journal of Medical Research & Review

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https://imsear.searo.who.int/handle/123456789/149620

Editor in Chief : Dr. D. Sharad Gedam,

ISSN: 2320–6012(Print)

Frequency: 6 issues a year

Language: English

An Journal of Shishu Mangalam Child Care Centre, Bhopal, India

Open Access Peer-reviewed journal

Web site: https://www.ijmrr.in/ /

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A case of lateral medullary syndrome with unilateral selective thermoanaesthesia
(Siddharth Health Research and Social Welfare Society, 2019-02) Mujeeb, V; Tyagi, A; Jambunathan, P
A 42-year-old female was admitted to tertiary care teaching hospital with history of headache, vertigo, difficulty in swallowing both liquids and solids, vomiting, gait ataxia, drooping of left eyelid, inability to feel hot and cold on right side of body and diplopia of forty-fivedays’ duration. Clinical examination and neuroimaging were suggestive a posterior circulation stroke, with lateral medullary syndrome.The patient had selective thermoanaesthesia on the right side, including the face, which is an atypical finding, given the clinical setting.
Open label case control prospective study to evaluate the impact of aceclofenac on antihypertensive action of amlodipine and ramipril in hypertensive patients with osteoarthritis
(Siddharth Health Research and Social Welfare Society, 2019-02) Babu Raman, R; Khare, A; Kumar, D; Ghosh, D; Tripathi, N; Srivastava, D; Prakash, V; Seemant, S
Objective: To study the impact of aceclofenac on antihypertensive action of amlodipine and ramiprilin hypertensive patients with osteoarthritis in an open label case control prospective study. Methods: This was an open label case control prospective study. Hypertensive patients on either amlodipine or Ramipril were included in control groups. A total of 120 patients were included in the study and divided into 4 groups: Group A- Hypertensivepatients on Ramipril; Group B – Hypertensive patients with concomitant osteoarthritis taking Aceclofenac and Ramipril; Group C– Hypertensive patients on Amlodipine and Group D- Hypertensive patients with concomitant osteoarthritis taking Aceclofenac and Amlodipine. Results: At the end of the first month (phase I), the ramipril subgroup in the control group had a mean systolic blood pressure of 136.73±3.80 which was an 8.19% decrease from the baseline and it was found significant (p<0.05). The systolic blood pressure measurements at the end of the second month (phase II) in the control groups revealed further fall in mean systolic blood pressure. The cases of osteoarthritis on aceclofenacand ramiprilshowedan increase in BP. The mean Systolic BP was 159.2 ± 5.816.An increase of 9.74%from the base line and 16.09% was noted at the end of phase-I (P<0.5). Patients on aceclofenac and amlodipine in contrast showed a fall in BP from base line in phase 0 and their mean systolic blood pressure at positive in of second month of phase-II was 142.07± 2.43 about 1.88% fall baseline and 2.94% increase in BP compared to Phase-I. Almost similar observations were recorded for diastolic blood pressure. Conclusion: The interaction of NSAIDs on the antihypertensive action of the ACE inhibitors is significantly greater than their blunting action on the calcium channel blockers.
A study of relationship of hyperuricemia in hypothyroid patients
(Siddharth Health Research and Social Welfare Society, 2019-02) Jat, A; Khare, A; Patel, N
Introduction: Hypothyroidism is a common metabolic disorder in general population. The prevalence of primary hypothyroidism is 1:100, but it may be 5:100 if patients with subclinical hypothyroidism (normal T4, raised TSH) are included.The degree of severity ranges from mild and unrecognized hypothyroid states to striking myxedema. The thyroid dysfunction increases with age, especially in women.Uric acid has been found to be significantly elevated in primary hypothyroidism in many studies. In comparison to the prevalence reported in the general population, a significant increase of both Hyperuricemia and gout was found in the hypothyroid patients. In hypothyroidism, the hyperuricemia is secondary to a decreased renal plasma flow and impaired glomerular filtrationThis study was designed for evaluation of uric acid levels in hypothyroid patients which might be helpful for clinical management of hypothyroid patients with hyperuricemia. Objective of Study: To find out any relationship between hyperuricemia in hypothyroidism patients. Methods:In our study, out of 100 patients, only 15 were found to have increased serum uric acid levels and only 3 had increased urinary uric acid levels. Out of these 15, 9 were females and 6 males, or can be said out of 70 females in study; only 9 were having increased serum uric acid levels. Results: In our study, the association between hypothyroid function and hyperuricemia seems to be week.No significant correlation was found betweenT3, T4 &TSH and serum uric acid. Conclusion: The correlation between hypothyroidism and gout still remains a matter of debate and more extensive studies need to be done to come to a definitive conclusion.
Profile of thyrotoxic patients presenting as pyrexia of unkown origin: An observational case study from a tertiary care hospital
(Siddharth Health Research and Social Welfare Society, 2019-02) Ahmad Pala, N; Mohd, A; Bhoughal, B
Objective: To study the profile of thyrotoxic patients evaluated for pyrexia of unknown origin (PUO). Methods: 25 patients, who were evaluated for pyrexia of unknown origin and found to have thyrotoxicosis as the cause for fever, were managed as per the recommended protocol and followed for 12 months. Results: All the patients were presumed to have infectious fever and had received antibiotics prior to diagnosis. Out of 25 patients, 20 (80%) had subacute thyroiditis (SAT) and 5 (20%) had hyperthyroidism (4 had Graves disease and 1 toxic adenoma). Patients with hyperthyroidism received thionamides and β- blockers. 50% patients with subacute thyroiditis received analgesics, 25% received steroids only and 25% received a combination of analgesics and steroids. Early-onset transient hypothyroidism occurred in 40% patients with SAT, permanent hypothyroidism was less common and only 15% of patients were receiving levothyroxine therapy after one year of follow-up. Conclusion: Thyrotoxicosis should always be included in the differential diagnosis while evaluation of patients with PUO. Most of the patients with thyrotoxicosis are wrongly misinterpreted as infectious PUO and given unnecessary antibiotics. Early-onset transient hypothyroidism is common in SAT compared to permanent hypothyroidism. Although, symptomatic relief is achieved with analgesics and steroids but does not prevent the development of hypothyroidism.
Diagnostic value of serum adenosine deaminase in Type 2 diabetic patients
(Siddharth Health Research and Social Welfare Society, 2019-02) Kundu, D; Sen, S; Paul, A; Chatterjee, A; Sarkar, P; Chakrabarti, I
Background: Adenosine deaminase (ADA) is suggested to modulate the bioactivity of insulin, but its clinical significance in Type 2 diabetes mellitus (DM) is not yet established. The present study was undertaken to evaluate serum ADA activity and serum uric acid levels in patients of Type 2 DM. Aim: To evaluate the serum ADA level and to correlate ADA levels with Blood Glucose, Glycated Hemoglobin (HbA1c) levels in Type-2 DM patients. Material and Method: It is a case control study. The subjects in this study were divided into 3 groups. Group I consisted of 50 normal healthy individuals who served as controls with no history of DM. Group II consisted of 50 patients of Type 2 DM both males & females in the age group of 40-65 years on oral hypoglycemic drugs with HbA1c <7%. Group III consisted of 50 patients of Type 2 DM both males & females in the age group of 40-65 years on oral hypoglycemic drugs with HbA1c >7 %. Serum levels of fasting blood sugar, HbA1c, ADA and uric acid were estimated in all the subjects. Results: FBS, HbA1c, ADA and serum uric acid levels were found to be increased in the patients of Type 2 DM as compared with controls. Conclusion: It is concluded that there is an increase in serum ADA levels with increase in HbA1c levels. Serum uric acid levels increased with moderately increasing levels of HbA1c <7% and then decreased with further increasing levels of HbA1c >7% (a bell-shaped relation).
Prognostic significance of primary tumour volume in nasopharyngeal carcinoma – a single institute study
(Siddharth Health Research and Social Welfare Society, 2019-02) Shamsundar, S; K.P., J; S., N; K., A; Nanda, R; Thejaswini, B
Introduction: Nasopharyngeal carcinoma is very uncommon in the southern part of India, the age-adjusted incidence rate is less than 1 per 1,00,000 population. This study is undertaken to evaluate the outcome of nasopharyngeal carcinoma and its correlation with Primary tumor volume. Material and methods: Total of 50 non-metastatic nasopharyngeal carcinoma patients treated with concurrent chemo radiation between January 2013 and December 2015 were included in the study. All patients were treated via IMRT with dose of 66-70Gy, along with concurrent chemotherapy. Initial tumour volume was measured from CT based contouring and mean dose delivered was calculated. All patients were followed up for survival, relapse and metastasis. Results: The median follow up for the group was 24 months. The median Gross tumor volume of primary disease and nodal disease was 61.6 cubic centimetres and 35.4 cubic centimeters respectively. The 2 year Disease free survival and Overall survival for the entire group was 64% and 68% respectively. There was significant difference (p-0.018) between disease free survival of low volume disease group (LVD) which was 78 % as compared to high volume disease (HVD) group 52 % at 24 months, similarly Overall survival was also significantly better (p-0.015) in LVD group as compared to HVD group 80% vs 55% at 24 months. Among the treatment related factors adjuvant chemotherapy significantly improved the outcome in HVD group but no difference was seen in LVD group. Conclusion: Our patients had large volume primary disease, the OS and DFS was significantly better in LVD patients, adjuvant chemotherapy after concurrent chemoradiotherapy had no additional benefit for LVD patients but improved DFS and MFS in HVD Patients.
To study the level of congestion in Pre anesthetic Check up (PAC) clinic and use of Self-answering Pre-operative questionnaire to decongest it
(Siddharth Health Research and Social Welfare Society, 2019-02) Kumar Singh, M; Bhatia, K; Tobin, R; Waindeskar, V; Kumar, A; Sharma, P
Background: Aim of the study was to reduce congestion in PAC clinic, which is the direct indicator of efficiency of the hospital. 1) To study overall waiting time in the PAC clinic. 2) To suggest action to improve the waiting time in PAC. Methods: Prospective, Descriptive study, 40 patients in each group. Group “R” = Patients registered for PAC clinic, who’s all vitals and clinical assessment was done after arrival to PAC clinic as routine practice. Group “Q” = Patients were provided Self-answering Pre-operative in waiting area and whose vital parameters were taken before arrival to PAC clinic by a trained staff. Data was recorded for both the groups. Results: We found in our study that average waiting time that is total time from registration to completion of PAC in OPD clinic was statistically significantly less in QT-1 (Group “Q”) in comparison to RT-1 (Group “R”). We found in our study that average Doctor – Patient time that is time of interaction with Doctor during PAC in OPD clinic was also statistically significantly less in QT-2 (Group “Q”) in comparison to RT-2 (Group “R”). Conclusion: Present study was planned to reduce congestion in OPD for pre-anesthesia checkup for elective surgery or procedure. Patient satisfaction comes automatically as a byproduct with the achievement of the goal of the study. Time is money in the present scenario and thus best utilization of time with efficient outcome is the prerequisite of any good management.
A morphometric study of adult human trachea in West Bengal population
(Siddharth Health Research and Social Welfare Society, 2019-02) Datta, D; Kundu, D; Pal, S; Das, A
Background: Keeping in view the great variations in different dimensions of the human trachea and its remarkable clinical importance, the present work was undertaken. It included the study of dimensions of adult trachea of both sexes in West Bengal population. In addition, an effort was made to establish their relationship with selected external measurements. Methods: This was a cross-sectional, observational study on 60 cadavers. Relatively disease-free fresh adult cadavers were selected from West Bengal population. Study variables were tracheal length, internal transverse diameter and internal anteroposterior diameter. Selected external measurements were height and sternal length. Results: In males, the highest correlation was observed between tracheal length and height (r = 0.800), and tracheal length and sternal length (r = 0.799). In females, the highest correlation coefficient was found between tracheal length and height (r = 0.809). Conclusion: Different formulae were obtained by linear regression with all measurements being in centimeters. Therefore, it is possible to predict the tracheal dimensions from simple external measurements.
Clinical outcome in cases of hypertensive intra-cerebral haemorrhage in relation to size of haemorrhage
(Siddharth Health Research and Social Welfare Society, 2019-02) Kumar Singh, A; Kumar, A; Kumar Verma, V; Uraiya, D
Introduction: Stroke is amongst the leading causes of death exceeded only by heart disease and cancer. Those who survive are usually left with permanent disability. Cerebral infarction is responsible for about 80 percent of all strokes, primary intra-cerebral haemorrhage for 10 percent, subarachnoid haemorrhage for 5 percent and 5 percent cases are due to uncertain causes. Predictors of prognosis in primary intraparenchymal haemorrhage have been evaluated in numerous studies. Objective: To observed the effect of different sizes of hematoma and utilizing them, if feasible as a marker of prognostic significance. Material and methods: In this study we observed 60 patients from the time of admission till 30th day in various wards of Department of Medicine RIMS with hypertensive intra-cerebral haemorrhage, during the period of 2008-2009. A simple method of measuring the volume of haematoma (in cc) on the CT scan is by using the following formula: A*B*C A = longest diameter of the haematoma (in cm.), B = Diameter perpendicular to A (in cm.), C = Height (in cm) which is measured by No. of slices showing the haematoma x thickness of each slide. Result: Total 60 patient were taken into study out of which 33(55%) were alive and 27(45%) were dead in 30 days follow up. In our study, 38 were male and 22 were female out of 38 male 22(66.66%) were alive and 16 (59.2%) dead and in 22 female 11(33.33%) were alive and 11 (40.7%) were dead. Outcome with volume of ICH using the χ2 had shown significant correlation (p < 0.005) with GCS at the time stroke onset (P<0.01), IVH/VE (P<0.01), midline shift test (P<0.01), B.P. at the time of admission (P<0.01). Conclusion: In these study patients with hematoma volume exceeds 60 cm3, the mortality was 100%. Mean volume of hematoma in our study was 35.21 cm3.
Extra corporeal shock wave lithotripsy in renal and ureteric stones: an institutional experience
(Siddharth Health Research and Social Welfare Society, 2019-04) Choudhury, S; Pramanik, S; Jana, D; Kumar, Pal, D
Introduction:Urolithiasis is one of the most common clinical conditions in the history of medicine. Treatment methods include conservative, surgical treatment and extracorporeal shock wave lithotripsy (ESWL). Several stone characteristics are known to affect outcome of ESWL such as fragility, Hounsfield unit, size, site, composition etc. No study has been done till now regarding the efficacy and safety of ESWL in eastern Indian patients. Objectives: To assess the efficacy and safety of ESWL in the management of patients with renal and ureteral stones. Methods: 112 outpatients were treated with ESWL. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance. Result & Conclusion: The authors found significant association between the size and number of stones with fragmentation status. The authors found that stones of more than 11mm size are more resistant to ESWL. Authors found statistically significant association between the number of ESWL sessions with fragmentation status. However, more than 3 sessions also did not help much. It was also found that complications were more in partially fragmented group and more adjunctive procedures were required in partially fragmented group. The authors also noticed that the stented or non stented status and total number of shocks were not significantly associated with the fragmentation status of stones.
The Role of Procalcitonin in the Diagnosis and Prognosis of Severe Surgical Patients with Sepsis
(Siddharth Health Research and Social Welfare Society, 2019-04) Zheng, D; Liu, N; Ma, J; Chen, L; Tai, Q; Xu, G
Purpose:To investigate the clinical significance of serum procalcitonin (PCT) concentrations and related indicators of infection in the early diagnosis and prognosis of severe surgical patients with infection. Methods: This study included 77 critically ill patients taken from the Surgery Department to the Intensive Care unit between June 2015 and July 2017. Patients were divided into control, sepsis and septic shock groups, and their serum concentrations of PCT and related indicators of infection were compared. Results: PCT levels increased significantly from the control to the sepsis group and from the sepsis to the septic shock group (P<0.01 each). There were no significant differences in white blood cell (WBC) count, neutrophil percentage and body temperature among the groups (P>0.05). Receiver operating curve (ROC) analysis showed that the areas under the curve (AUC) for PCT, WBC count, neutrophil percentage and body temperature were 0.949, 0.657, 0.640 and 0.656, respectively. PCT, with 0.52 µg/L as the cut-off concentration, had the highest performance in the diagnosis of severe surgical sepsis, with a sensitivity of 96.1%, a specificity of 92.3% and a Youden index of 0.884. Conclusion: PCT concentration is diagnostic of infection in severe surgical patients, has high specificity in the early diagnosis of sepsis, and can reflect the severity of infection.
Role of tissue engineering in oral & maxillofacial surgery – a review
(Siddharth Health Research and Social Welfare Society, 2019-04) Angeline, L R; T., R; Balasubramaniam, S
Tissue engineering can be defined as the “reconstitution of tissue and organs, in vitro for use as model systems in basic and applied research, or for use as grafts to replace damaged or diseased body parts or body functions”. Biomaterials have been used as replacement tissues and grafts have been used to reconstruct defects in craniofacial region till Uristmade the first attempt of producing exogenous bone with the help of bone morphogenetic proteins. The success of tissue engineering over the field of all transplantation is that conceptually a three-dimensional functional tissue is designed. This field has become a boon to the Cranio Maxillofacial surgeons and has provided them with a supplement to existing treatment for reconstruction of Oral & Craniofacial region. The purpose of this article is to present an overview of the various uses of tissue engineering in the field of Oral and Maxillofacial Surgery.
Treatment non-compliance and government aided health schemes : a boon or a curse
(Siddharth Health Research and Social Welfare Society, 2019-04) M.V., M; Pawar, Y
Purpose: In this study we tried to analyze the prevalence of non-adherence to radiation treatment, the factors behind the unplanned breaks and the evaluation of strategies to overcome such breaks. Materials and Methods: Between January 2017 to October 2017, 486 patients were registered for radical radiotherapy of which 91 patients with unplanned treatment break were identified. We analyzed the social, economic, educational, and therapeutic barriers that led to treatment interruptions. Results: 91 patients of 486 patients registered for radical radiotherapy with unplanned treatment break were identified. The age of such patients ranged from 30 to 85 years with a median age of 52.5 years. 61 were males and 30 were females. 39 patients were from urban areas and 52 belonged to rural area. Of these 91 patients 85 patients were receiving cashless treatment based on BPL cards and 6 were cash paying patients. 52 Patients had Head and neck, 23 had gynecological, 7 with breast and 4 patients had esophageal cancers. Majority of patients in our study had treatment breaks during the mid to end phase of a radical radiotherapy schedule with the onset of Grade II or III acute reactions. Conclusion: As majority of patients were supported by government schemes without any binding factor, some compelling factors like blocking the BPL cards to avail other benefits, or to impose some kind of penalties to avoid wastage of government efforts and resources.
Endovascular Management of Acute Superior Mesenteric Artery Thrombosis in a Delayed Setting
(Siddharth Health Research and Social Welfare Society, 2019-04) Saxena, A; Srivastava, P
Acute mesenteric ischemia [AMI] is a life-threatening situation, the diagnosis of which is often missed in early stages. Late diagnosis often precludes endovascular management as the primary treatment. The authors here present a case of seven days history of acute mesenteric ischemia in a young female, who not just benefited from endovascular management, but also a major surgical intervention was avoided andwas discharged from the hospital uneventfully. The decision to consider a patient for endovascular management in a late stage, requires a good interdisciplinary communication and successful outcome in such a scenario is rarely achieved.
Trends of transfusion transmittable infections among voluntary blood donors in a cardiac care hospital, Bengaluru, India
(Siddharth Health Research and Social Welfare Society, 2019-04) Shivalingegowda, S; Banandur, Nanjundappa, K; Kannan, U; Cholenahalli Nanjappa, M
Introduction: Transmission of infectious diseases through donated blood is of concern to blood safety as transfusion forms an integral part of medical and surgical therapy. Blood transfusion carries the risk of transfusion-transmittable infections including HIV, hepatitis–B etc. Screening of voluntary donors who represent healthy population serves as a predictor for these dreadful diseases in healthy population. Materials and Methods: This retrospective study was conducted at the blood bank of Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru. Data were analyzed for a period of 7 years from January 2011 to December 2017. All voluntary donors including replacement donors of our blood bank were screened for Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) and Syphilis infection by using ELISA. Results: The most common infection was Hepatitis B (0.69%) followed by Syphilis (0.34%) and HIV (0.0736%) and least with HCV (0.04%) in our study. Conclusion: This study has shown a decrease in seroprevalence for HIV and increase in seroprevalence for HCV over 7 years study period.
Correlation of blood sugar and lipid parameters with carotid intima media thickness among patients with type II diabetes mellitu
(Siddharth Health Research and Social Welfare Society, 2019-04) Kanakaraju, K; Seetharaman Ranganathan, R; R., S.
Background: Of the various non invasive imaging methods available, arterial intima media thickness measurement obtained by B mode ultrasound is currently recommended by the American Heart Association as being relatively safe, non invasive and inexpensive method of assessing sub clinical atherosclerosis, and being an independent predictor of atherosclerotic events. Aim: To study the correlation between glycemic and lipid levels with carotid intima media thickness among patients with type II diabetes mellitus. Methodology: A prospective longitudinal study was conducted for a period of one year. Patients in the age group of 30 to 70 years with type II diabetes for more than 2 years were included as our study subjects. A total of 100 patients were included as our study subjects. Anthropometric measurements, blood sugar parameters and lipid parameters were measured as per the guidelines. Carotid artery intima media thickness was measured by B mode ultrasound having an electric transducer with a mid frequency of 7.5 MHz. Scans were performed on both the right and left extracranial carotid arteries by trained personnel. The IMT values were measured in six well defined arterial segments- near wall and far wall of distal 6mm of common carotid, the carotid bulb and proximal 6mm of internal carotid artery of both sides. The final IMT considered was the average of the IMT values at the 12 sites examined. Results: A multivariate analysis was performed to assess the various factors influencing the increase in the thickness of CIMT and among that we found a significant correlation had occurred with the factors like BMI, waist hip ratio, fasting and post-prandial blood sugar, HbA1C and among the lipid parameters LDL, total cholesterol and triglycerides had shown a statistical significant correlation (p<.05), whereas factors like age, gender, hypertension status, duration of diabetes and HDL cholesterol among the lipid parameter did not show a statistical significant correlation with CIMT (p>.05). Conclusion: CIMT measurement can be used as a regular screening tool in diabetic patients for the early detection of atherosclerosis among them.
Role of grey scale ultrasound and Colour Doppler findings to differentiate ectopic pregnancy from corpus luteum cyst of pregnancy
(Siddharth Health Research and Social Welfare Society, 2019-04) Kaur, N; Kaur, I; Bansal, A; Kaur, P
Introduction: Ectopic pregnancy and corpus luteum cyst are two most common differential diagnosis in a patient with UPT positive and no sonographic evidence of intrauterine pregnancy. Aim: To diagnose ectopic pregnancy and to differentiate ectopic pregnancy from corpus luteum cyst of pregnancy on the basis of grey scale ultrasound and colour Doppler findings. Material and Methods: This was a hospital based prospective study carried out on a study group of 40 patients with UPT positive and clinical features suggestive of ectopic pregnancy over a period of two years.Grey scale ultrasound and colour Doppler parameters were studied. Results: Out of 40 patients,30 were diagnosed with ectopic pregnancy and 10 with corpus luteum cyst. Ectopic pregnancies had thicker walls as compared to corpus luteum cysts. Most of the ectopic pregnancies had hyperechoic walls as compared to ovaries (80%) and endometrium (60%). Free fluid with echoes was seen in the pelvis in 70% ectopic pregnancies whereas most of the corpus luteum cysts (80%) had no free fluid. Most of the corpus luteum cysts (70%) had clear internal echotexture whereas ectopic pregnancies were mostly lacy or solid.Yolk sac was seen exclusively in ectopic pregnancy (30%). RI <0.4 and RI >0.7 was found to be highly specific for diagnosing ectopic pregnancy. Conclusion: Wall thickness of the mass, echogenicity of the wall as compared to ovaryand endometrium, internal echotexture of the cystic mass, presence of yolk sac and presence of free fluid with echoes are significant ultrasound parameters which help to differentiate between the two. RI <0.4 and RI >0.7 was found to be highly specific for diagnosing ectopic pregnancy.
Role of Multiparametric MRI in Diagnosis of Prostate Cancer
(Siddharth Health Research and Social Welfare Society, 2019-04) Mathur, M; Bains, R; Kaur, R; K. Badhan, R; K, S; Mittal, D
Aims: The main objectives of our study were to evaluate the role of Multiparametric MRI (mp-MRI) in diagnosis of carcinoma prostate and to compare the various MRI sequences used in MRI in evaluating carcinoma prostate with histopathological diagnosis kept as reference standard. Materials and Methods: This prospective cross-sectional study of 40 patients was performed by using various sequences used in mp-MRI i.e. T2 weighted imaging (T2WI), Diffusion Weighted Imaging (DWI), Magnetic Resonance Spectroscopy (MRS) and Dynamic Contrast Enhanced study (DCE). Findings of mp-MRI sequences were compared with histopathological diagnosis. Statistical analysiswasperformed using SPSS computer statistical program for window release 16. Results: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of DCE in diagnosing carcinoma prostate were 88.89%, 50.00%, 94.12% and 33.33% respectively where assensitivities, specificities, PPVs, NPVs of DWI and MRS were same in our study i.e. 94.44%, 75.00%, 97.14% and 60.00%respectively. Overall sensitivity, specificity, PPV, NPV of mp-MRI by combining these sequences were found to be 97.22%, 75%, 97.22% and 75% respectively. Diagnostic accuracies of DWI, DCE and MRS were 92.5%, 85% and 92.5% respectively and overall diagnostic accuracy after combining these sequences in mp-MRI was 95%. Conclusions: mp-MRI including all the sequences has very good role in evaluation of carcinoma prostate. Diagnostic accuracy of mp-MRI increases when all sequences used together to assess prostatic lesions, so all the sequences should be used together in prostate cancer evaluation rather than using individual sequences.
Clinical spectrum of AKI in chronic liver diseases
(Siddharth Health Research and Social Welfare Society, 2019-04) Purohit, A; Pahawa, N; Vohra, R; Goswami, S; B., R; Malviya, V; Shukla, V; Parashar, S; Mishra, A; Agrawal, A
Introduction: Acute kidney injury (AKI) is a heterogeneous syndrome of different aetiologies, and often multifactorial. Occurrence of Acute kidney injury in patients with chronic liver disease is frequent finding which makes prognosis of CLD even poorer. Material and methods: A prospective cohort observational study on 100 adult patients of chronic liver disease with AKI conducted over a period of 24 months from August 2016 to August 2018 at Sri Aurobindo medical college and postgraduate institute. Detailed clinical examination and biochemical tests were done. Univariate and multivariate logistic regression (odds ratio) analyses were used. Result: 87% are males and 13 % are females. The most common cause of cirrhosis is alcoholic 77% followed by hepatitis Bvirus related 10%, unknown etiology 7%, hepatitis C 3%, NASH 2%, Wilson 1. The most common sign of decompensation of liver is jaundice 78% followedby ascites 70%, hepatic encephalopathy 37% and upper GI bleed 30%. Distribution of child class as a prognostic indicator showed the maximum no. ofpatients found in class C 56% followed by class B 34% and class A 10%. Conclusion: Acute kidney injury is very common in chronic liver disease patient in our hospital and majority of them have intrinsic cause of AKI
Retrospective analysis of chest x-ray of patients from eastern Uttar Pradeshpresenting in Radiology department ofHind Institute Medical Sciences, Barabanki Uttar Pradesh
(Siddharth Health Research and Social Welfare Society, 2019-04) Khare, R; Khare, A
Introduction: Chest Xray is one of the most frequently asked radiological examination in patients with heart or lung problems in general medical practice. There are many studies on correlation of CXR findings and other tools of investigations like CT scan, MRI and laboratory investigations like spirometry and sputum examinations etc. The present study aims at establishing a possible correlation in rural population of Eastern Uttar Pradesh. Methods: We have done a cross sectional study in a period of six months including 2500 patients coming for CXR. Patients were followed up to a point where radiological diagnosis was confirmed or otherwise after other investigations and clinical response. Results: There was fairly good correlation in patients with COPD (73.15%), tuberculosis (85.8%), interstitial lung disease (63.9%) and congestive heart failure (68.6%). Conclusion: We conclude that CXR is tool of reasonable sensitivity however there is sizeable possibility of false positive and negative cases.

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