VIMS Health Science Journal (VIMSHSJ)

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/170453

Editor-in-Chief: Dr. Sunil Natha Mhaske
ISSN: 2348-523X (Print); 2454-1982 (Online)

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.vimshsj.edu.in/

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Now showing 1 - 20 of 53

Retinal Hamartomas in a case of Tuberous Sclerosis
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Bhatt, Ruchita
A 21-year-old male patient suffering from epilepsy came for fundoscopic evaluation. Right eye showed a ?at, smooth surfaced well circumscribed, non-calci?ed translucent lesion of 1 disc dioptre size, inferior to the optic disc, obscuring underlying vessels & an opaque, calci?ed, yellow white lesion having irregular surface & margins with mulberry appearance, elevated, supero-nasal to the disc, obscuring the underlying vessels. Adenoma sebaceum, periungual ?bromas, Ash leaf macules were seen on general physical examination suggestive of tuberous sclerosis. MRI brain revealed subependymal nodules & subcortical tubers. OCT showed an optically hyper re?ective mass with retinal disorganization and moth-eaten spaces. 2D echo showed mild Left Ventricular Hypertrophy, diastolic dysfunction, trivial mitral and tricuspid regurgitation. Ultrasonography of abdomen & pelvis showed fatty liver and renal angiomyolipoma. It was interesting to note cardiac & hepatic involvement in addition to the standard tuberous sclerosis complex (TSC) major & minor diagnostic criteria
An analytical study of Comparison between Ketamine - Dexmedetomidine versus Ketamine - Propofol for Sedation in Children Undergoing Minor Cardiac Procedures in a Cardiac Catheterization Laboratory
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Mamde, Dr. Rahul; Mamde, Dr. Ambika
Background: The management of children with heart diseases has been a major challenge for cardiac anesthesiologist. The anesthetic technique to be used should be easy, safer and provide cardiac stability throughout the operation. So interventional cardiologist prefer deep sedation with the patient breathing spontaneously and painlessly in the room. Propofol, Ketamine along with other combinations drugs have been used worldwide by cardiac anesthesiologist to achieve these goals. We carried out this study to evaluate the combination drugs for pediatric cardiac procedures which are Ketamine – Dexmedetomidine (KD) and Ketamine – Propofol (KP). Methodology:This study was conducted in the Department of Cardiology. A total number of 80 cases were selected, 40 from each comparative groups of Ketamine – Dexmedetomidine (KD) and Ketamine – Propofol (KP). Patient data was categorized into age, sex, procedure done and recovery time, analgesic boluses required and hemodynamic parameters during the surgery. Results: Mean age in KD group was 5.24 ± 1.25 years and in KP group was 4.95 ± 1.86 years. There were total 24 males (60%) and 16 females (40%) in KD group and total 22 males (55%) and 18 females (45%) in KP group. Most common procedures done in both the groups was ASD for device closure done in 12 patients (30%) in KD group and 13 patients (32.5%) in KP group. There was signi?cant difference between the mean recovery time and number of ketamine boluses consumption in both the groups. (p<0.05) Heart rate was signi?cantly lower in KD group at 5, 10, 15 and 20 min post induction when compared to KP group. No statistically signi?cance was found in difference between the Mean Respiratory rate and MAP. Conclusion:Our study concludes that the use of KD combination is relatively safe, practical alternative, we did not ?nd any hemodynamic or respiratory effects during the cardiac procedures but there was some delayed recovery.
Attitude of Health Care Workers On COVID 19 Care In a Selected Hospital Setting
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Bhattacharya, Chanu; Karandikar, Dr. Neeraj J.; Kadu, Amit
Introduction:From the First week of March 2020 till Nov 2020 the attitude of HCWs, mental health or perceptions changing regularly as the COVID-19 pandemic changing its image. New treatment, new information new training and practice changing attitude towards positivity as the death rate reducing and patient recovery rate increasing. Methods:A cross sectional study was done by a Likert type ?ve-point attitude scale by survey method and conveniently selected 120 health care workers from a single setting. Different categories of HCWs were participated namely doctors, nurses, physiotherapists, lab technicians and X-ray technicians. Results:result showed mean age of HCWs were 26.9. Female HCWs are more than male.80% HCWs attitude is favorable 20% neutral and no one have unfavorable attitude. Chai square test revealed that there is highly signi?cant association of attitude with marital status and residence area, signi?cant with age and year of experience. Conclusion:Generalization is not possible because this is single center data. But research showed maturity and better practice improves attitude. HCWs attitude improve care and recovery rates
A Comparative Study To Evaluate The Outcome Of Sutures Versus Fibrin Glue In Conjunctival Autograft Technique For Primary Pterygium Excision
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Biradar, Dr. Sonali; Tammewar, Dr. Ajay; Naik, Dr. Roopa
Background:Pterygium is degenerative condition of the subconjunctival tissue which proliferates as vascularized granulation tissue and is characterized by formation of a triangular fold of conjunctiva encroaching on the cornea leading to visual impairment, restriction of ocular motility, chronic in?ammation and cosmetic concerns. Surgical removal is the treatment of choice, but recurrence can be a problem. Now, Fibrin glue is being tried since few years to secure grafts in place of the sutures. The objective of this study was to compare duration of surgery, immediate postoperative complications which includes an in?ammation, subconjunctival haemorrhage, patient comfort, graft stability between the uses of ?brin glue versus sutures. Methods:A total of 40 patients having primary pterygium were included in the study. 20 patients were underwent pterygium excision surgery and conjunctival autografting using absorbable vicryl 8-0 suture and 20 patients underwent pterygium excision surgery and conjunctival autografting using ?brin glue. These 2 groups were compared in terms of duration of the surgery, in?ammation, degree of postoperative discomfort, subconjunctival haemorrhage and graft stability at postoperative day 1. Results:The mean surgery time in ?brin glue group was 15 minutes and mean surgery time in suture group was 28 minutes (p=0.000). Fibrin glue group had signi?cantly lesser in?ammation (p=0.001) as well as postoperative discomfort (p=0.000) compared to suture group at postoperative day 1. There was no signi?cant difference found in the degree of subconjunctival haemorrhage between the ?brin glue versus sutures groups (p=0.887 and p=0.797 at day 1). The grafts secured with ?brin glue were as stable as those secured with the sutures (p=0.745, 0.644 at day 1). Conclusion:The ?brin glue group in conjunctival autografting had signi?cantly less surgery time, which also produces signi?cantly less postoperative discomfort as well as in?ammation with grafts being as stable as those secured with sutures. Fibrin glue can be used regularly if patients can be pooled together and operated on, by making it cost effective procedure
Clinical Study of Risk Factors for Diabetic Maculopathy
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Bangal, Dr. Surekha V; Patil, Dr. Bhushan; Sharma, Dr. Akshita
Aim:To determine the association between various systemic risk factors with diabetic maculopathy. Methodology:A prospective observational study was conducted on 50 patients having diabetic maculopathy. Patients with maculopathies secondary to Vitreous Haemorrhage, Ocular disorders like Glaucoma, Uveitis, Advanced Diabetic Eye Disease, Vitreo-macular traction, maculopathy along with proliferative diabetic retinopathy, ischemic maculopathy, and history of laser treatment in last six months were excluded from the study. Data was collected using a structured proforma that included name, age, sex, occupation, height, weight, history of other systemic diseases like hypertension, investigations and treatment taken in past, family history, duration of DM, smoking, hyperlipidemia, hyperglycemia and nephropathy. Results:Out of 50 patients, 38 (76%) were males and 12 (24%) were females suggestive of male predominance. Mean age of the patient was 57.36±11.65 years in males and 56.67±10.17 years in females. Among 50 patients, 19 patients had diabetes mellitus for 6-10 years duration, 14 patients had diabetes mellitus for 1-5 years, in 12 patients for 11-15 years, in 2 patients for 16-20 years, in 2 patients for 21-25 years and only 1 patient more than 25 years. Mean duration of DM was 12.2±6.1 years. Majority of patients having maculopathy had duration of DM up to 20 years. Among 50 patients, 27 patients (54%) had systemic hypertension, 37 patients (74%) had uncontrolled blood sugar level, 29 patients (58%) were found to have hyperlipidemia and 20 patients (40%) had nephropathy. Among 50 patients, pseudophakia was noted in 7 patients (14%), obesity was noted in 21patients (42%). Eleven patients (22%) were found to have anemia, 6 patients (12%) had family history of DM and 13 patients (26%) had history of smoking. Conclusion: Hyperglycemia, hypertension, duration of DM, hyperlipidemia are the major risk factors for the development and progression of diabetic maculopathy. While anemia, smoking, obesity and family history of DM is the less signi?cant risk factors
Newer Therapies In Management of Neonatal Birth Asphyxia
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Shinde, Dr. Abhijit; Mhaske, Prof. Dr. Sunil Natha; Kumar, Dr. Sushrut
Asphyxia is an insult to the fetus or newborn due to lack 1 of oxygen or lack of perfusion to various organs.National Neonatology Forum of India has de?ned asphyxia as gasping or ineffective breathing or lack of 2breathing at 1 min of life.Birth asphyxia is one of the most important causes of neonatal brain injury whose incidence ranges from 3.7 to 9/1000 deliveries in the 3west.With the advent of therapeutic hypothermia (TH), improved outcomes are being reported in moderate HIE. TH, however, has not demonstrated improvement in outcomes related to severe HIE. . This has led clinicians and researchers to continue evaluating complementary and/or alternative therapies for infants with HIE. In this review, we will discuss current and emerging therapies in the management of HIE, other than hypothermia. With issues of access to health care and the burden of birth asphyxia shifting to developing and least developed nations, there is a need for alternative and supplementary neuroprotective agents. Low cost and easy availability along with ease of use would assist in ensuring that these therapies have global applicability. So global efforts must be taken to increase such studies as birth asphyxia is causing more morbidity & mortality globally
A correlational study on physical and mental status of lived experience of hospitalised COVID-19 patient
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Kadu, Amit; Karandikar, Dr. Neeraj J.; Bhattacharya, Smt. Chanu
Background:Some of the public health measures necessary to contain the spread of the pandemic, such as quarantines and social distancing, increase the risk of adverse psychological consequences. A recent review revealed that these risks are greater with longer quarantine periods, when there are infection fears, frustration, boredom, inadequate supplies, inadequate information, and ?nancial loss. COVID-19 pandemic to have disproportionately adverse impacts on mental health of hospitalized groups. COVID-19 is a disease, impact physically but it has been affecting much more the mental health of patient. Aim & Objectives:To Assess physical and mental status of patient during hospitalization and the correlation. To ?nd out the relationship between selected socio-demographic status Age, gender, race, ethnicity, employment, insurance, education, marital status, psychiatric therapies, health literacy, social support, ?nancial distress with the level of mental status. Methods: A cross sectional study with one centre data, collected with selected criteria. Fifty participants were selected for collection of livid experience expressed in local language. Study approach was mix method and Qual-quan design. Assessed by experts and evaluators. Quantitative data collected with checklist and socio demographics detail were collected from patient. Results:Result showed Qualitative themes clearly showed the mental state of patient like “I will die”. Quantitatively Physical status is signi?cantly correlated with mental status, there is a signi?cant statistical co-dependency assessed by Pearson's product moment test. Socio-demographic data age as chai square value physical status (4.54) as mental status (4.59), marital status (5.25) and social support (4.87) is signi?cantly associated with mental status, test done in 0.05 level of signi?cance. Conclusion:Though one centre data is a limitation of the study still it can be visible that COVID -19 patients need mental healing or therapy parallelly with medicines. The mental symptoms should not be secondary cure it must be primary for healing of body
Significance of Inner Nasal Valve In Septoplasty
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Bhoyar, Dr. Shraddha Subhash; Kashid, Dr. Gajanan Mohniraj; Gaikwad, Dr. Ashok; Purohit, Dr. Siddharth Ashok; Gupta, Dr. Amit Shekhar; Waghmare, Dr. Shamal Kerba; Palve, Dr. Harshala
Background: Nasal obstruction due to deviated septum is commonly treated with conventional septoplasty. This surgery however is inadequate in cases of compromised nasal valves and leads to persistent symptoms. Hence, we stressed the evaluation of nasal valves before septal surgery & studied the outcome of the patients with valve area correction. Aim:To prove the signi?cance of inner nasal valve in nasal surgery. Objective: To analyse the outcome of Open septoplasty. Methodology:A retrospective review of our patients undergoing Open septoplasty was analyzed from April 2016 to January 2021. The preoperative and post-operative evaluations were calculated & statistically analysed. Results :A total of 400 patients underwent Open septoplasty, out of which 392(98%)showed symptomatic improvement in breathing dif?culty. Also, 220 patients out of total 400 underwent cosmetic correction along with open septoplasty & 209 (95%) out of these220 were completely happy with the asthetic improvement. Conclusion:Open septoplasty and Spreader grafts is best solution to improve Internal Nasal valve angle. Rim graft to improve external valve collapse. Spreader graft also gives asthetic along with functional improvement.
Unstable trochanteric Fracture Fixation with P.F.N. augmented by T.B.W.
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-03) Patil, Dr. Vijay; Daule, Dr. Pandurang; Naikwade, Dr. Deepak
For inter trochanteric fracture Proximal Femoral Nail (PFN) is a better choice of implant biomechanically. But in communicated inter trochanteric fractures it is associated with screw breakage, cut out through femoral head, ”Z” & reverse “Z” effect and lateral migration of screws. The purpose of this study is to evaluate the results of PFN in terms of post-operative complication and failure rates in unstable trochanteric fracture with addition of 1 or 2 tension band wires. Material & Method:We did study of 21 unstable trochanteric fractures from January 2016 to November .2020. 14 patients were males & 7 patients were females. Age group between 25 to 80 was included in this group. There were 15 A0 A2 (2.2, 2.3) and 6 were A0 A3 (3.1, 3.2, 3.3). All fractures were ?xed with 25cm, 0135PFN mainly 11 mm, 12mm in diameter with addition of one or two 16 gauge tension band wire, strengthening lateral trochanteric wall and holding either communiated fragments or lesser trochanteric fracture. Results:The fracture was united in all cases with mean period of 16 weeks. Two patients developed complication of TBW (Tension Band Wire) breakage; one developed lateral migration of screws. Patients were followed till bone was united. At the end of follow up hip function were 30 (out of 40) in 80% patients by using Salvati and Wilson hip score. Conclusion: The stabilization of lateral trochanteric wall fracture and communiated fragments of inter trochanteric fractures, additional one or two TBW increases the stability of construct enhancing bony union & better results.
Antibiogram of Gram Negative Uropathogens in a Tertiary Care Hospital
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Davane, Milind; Mundhe, Sanjivani
Background:In wide range, urinary tract infection (UTI) is a substantial and second most popular bacterial infection affecting individuals of overall ages worldwide. The chronicity of divergent bacterial isolates and their propensity to various antibiotics may contradict widely, peculiarly in hospitalized patients, this makes the survey of vulnerability pattern extremely mandatory for correct selection of antibiotics. Objective: To appraise antimicrobial susceptibility pattern of the Gram negative organisms identified from urine cultures of hospitalized patients. Methodology:Total 500 urine samples from hospitalized patients with significant bacteriuria were surveyed. Using Blood and MacConckey agar, samples were inoculated. Further identification and investigation of organisms was done by standard Microbiological methods. Antimicrobial Susceptibility pattern was interpreted by Modified Kirby- Bauer's disc diffusion method with the group of 15 drugs as per Clinical Laboratories Standard Institute (CLSI) protocols.Results:UTIs were frequent in females 290 (58%). Familiar organism found was Escherichia coli 260 (52%) further accompanied by Klebsiellaspp.120 (24%), Pseudomonas spp.40 (8%), Proteus spp. 38 (7.6%), Citrobacter spp.25(5%) and Acinetobacterspp. 17 (3.4%). Mass of the strains were found sensitive to nitrofurantoin followed by amikacin, piperacillin-tazobactamand cotrimoxazole. Commonly prescribed fluroquinolones were found least effective for treatment of UTI. All the strains were found sensitive to imipenem. Extended spectrum beta lactamase (ESBL) was noted in E.coli and in Klebsiella spp.Conclusion:To break the continuity of non selective use of antibiotics and to intercept further development of bacterial drug resistance, proper knowledge of susceptibility pattern of uropathogens in particular area is very important before prescribing any empirical antibiotic therapy
Our Experience of Tie Over bolster and Quilting Sutures Versus Stapler fixation for Split thickness skin graft in post burn neck contracture – A Comparative study
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Chaudhari, Dr. Ganesh; Sonawane, Dr. Satish
Background:Traditional method to fix Split thickness skin graft in post burn neck contracture is Tie over Bolster dressing and Quilting sutures. We used staplers to fix split thickness skin graft. Methodology:Acomparative study conducted in 30 patients with post burn neck contracture at tertiary care hospital, Nashik over a period of 6 years. Time required for fixation of split thickness skin graft, outcome in terms of graft uptake and patients comfort level while removing sutures and stapler recorded. Results: Total 30 Patients were included in our study. Mean time required for Tie over and quilting suture was 10.53 ± 0.88 min, significantly higher than the mean time in stapler fixation 4.87 ± 0.81 min. (p<0.001). Graft take was 95% in stapler and 93% in Tie over and quilting suture. Conclusion:Fixation of Split thickness skin graft with stapler is more rapid, less time consuming also results in decreased surgical and anaesthesia time. More patient friendly while removing staplers with comparable skin graft uptake
A Cross Sectional Study to Evaluate Association Between the Duration of Diabetes and Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients in A Tertiary Care Centre
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Murade, Dr. Sneha; Swami, Dr. Amrut; Singh, Dr. Anil; Khamkar, Dr. Vikas; Swami, Dr. Shruti
Introduction: The numbers of people affected with lifestyle related diseases are increasing every day, diabetes being one of the major contributors to the increasing morbidity and mortality in the world. Diabetic retinopathy is one of the complications of diabetes which is thought to be associated with the duration of diabetes, we conducted this study to evaluate the same. Methodology:This study was conducted at Department of Ophthalmology. Total 100 cases were selected for the study and patient data was collected and analysed. Duration of diabetes and its association with diabetic retinopathy was studied. Results: There were 62 males (62%), most of the participants were more than 60 years of age (54%). Majority of the patients had diabetes for 5 to 10 years (44%) followed by 1 to 5 years (34%) and 0 – 1 year (22%). On FFAexamination, majority of the patients had no any diabetic retinopathy (52%) while rest 48 patients had retinopathy (48%). Significant association was seen between the duration of diabetes and presence of diabetic retinopathy. (p=0.002). Conclusion: We found a significant association between the duration of diabetes and diabetic retinopathy. It is important that in patients with diabetes who are not diagnosed as retinopathy by ophthalmoscopy, FFA should be done.
A Cross Sectional Study to Evaluate Decision to Delivery Interval in Emergency Caeserian Section at a Tertiary Care Hospital
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Gade, Dr. Pramod R; Vazifdar, Dr. Sharmeen K; Aher, Dr. Gautam S.
Background:One of the main factors affecting maternal morbidity and mortality is the decision to delivery interval (DDI) that is, the time taken from the decision to take the patient up for caesarean section to the delivery of the fetus. Method:This is a retrospective observational study conducted over a period of twelve months where 370 patients were studied. Results:No delay was seen in 49.2% cases whereas most delay was noted after decision by obstetricians to transfer patient to OT(22.2%). Conclusion:In order to get favourable maternal and fetal outcome decision to delivery interval should be within 30 minutes and this can be made possible if factors like results of blood investigations and cross matching of blood can be made available on time.
Maternal and neonatal outcome in pregnancy bbeyond 41 Weeks of Gestation: Observational study
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Misal, Dr. Asmita; Gavali, Dr. Urmila; Aher, Dr. Gautam S.
Background: Pregnancy beyond term is associated with adverse maternal and perinatal outcome. The aim of the study was to estimate the maternal and perinatal outcome in pregnancies at and beyond 41weeks of gestation. It was a prospective study of 140 patients with pregnancy beyond Methodology:41weeks fulfilling the eligibility criteria and admitted and delivered in department of obstetrics and gynaecology at a tertiary care hospital. We examined its association with following outcomes: age, parity, genetic factors, bishop's score at admission, mode of delivery, induction rate, meconium stained amniotic fluid, oligohydramnios, perinatal and neonatal morbidity, perineal tear, postpartum haemorrhage, maternal morbidity and mortality etc. Results:Out of 140 patients, majority was the age group of 21-25 years, 68 (48.6%) patients were primigravida while 72 (51.4%) patients were multigravida. Maximum patients 65% were not in labour whereas 35% were in labour. In 51 (36.4%) patients mode of delivery was caesarean section, in which most common indication being foetal distress in 25.5% followed by meconium stained amniotic fluid in 17.6%. In present study perinatal morbidity like stillbirth, RDS were 2.86% & 25.8% respectively. Maternal morbidity like PPH, tear and wound infection were 4.31%, 6.4%, 0.7% respectively. Conclusions: With Regular antenatal check-up, incidence of post term pregnancy can be decreased and labour induction should be considered at 41weeks to prevent maternal and perinatal complications.
Beta Thalassemia Major with Diabetes Mellitus: A Case Report
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Mhaske, Dr. Sneha; Shinde, Dr. Abhijit; Shinde, Dr. Sonal; Kothari Dr. Ramesh; Misal, Dr. Ganesh; Kumar, Dr. Sushruta; Mhaske, Prof. Dr. Sunil Natha
Thalassemia occurs due to defects in normal hemoglobin production. Globally it is most common inherited anaemia. Diabetes is a complication of b-thalassemia major. We report a case of Diabetes mellitus in a known case of beta thalassemia major. Patient had undergone splenectomy 1 year back. Patient is taking chelating agent Defasirox 1000mg orally once a day in the morning. Family history reveals, born through third degree consanguineous marriage. The patient was then subjected for laboratory examination reveals BSLwas 490, urine ketone 2+, urine sugar 3+, ABG was normal, HbA1c was 13 & 3 month old report of serum ferritin 1200 ng/dl. TFTand GH studies normal. Multidisciplinary management was instituted. Blood sugar level got controlled over subcutaneous insulin. Patient may have landed in Diabetic ketoacidosis but was promptly diagnosed & treated. This case is presented for its rarity. Due to increase in life expectancy of patient with thalassemia major, patient will expose more years of hyperglycemia and diabetes. Sustaining metabolic control and controlling cardiovascular risk factors helps to prevent future complications.
A Descriptive Study of Intraoperative Complications in Manual Small Incision Cataract Surgery
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Khatwani, Dr. Divya; Tammewar, Dr. Ajay; Murade, Dr. Sneha; Naik, Dr. Roopa
Background:In India and other developing countries, senile cataract is the most common cause of reversible blindness. In developed countries, phacoemulsification is a preferred option. It is an expensive procedure which requires high surgical training. Manual small incision cataract surgery (MSICS) is a safe and affordable technique. It involves lesser surgical time and the instrumentation is easier to maintain. This study is undertaken to know the intraoperative complications involved in this technique and the management of these complications. Methodology: Atotal of 50 cases were studied from October 2020-January 2021. It is a hospital based, descriptive cross-sectional study. Results:Intraoperative complications occurred in 10 cases (20%). It included iris prolapse in 3 cases (6%), tunnel related complications in 3 cases which included premature entry in 2 cases (4%) and button holing in 1 case (2%), Descemet membrane detachment in 1 case (2%), intraoperative miosis in 1 case (2%), intraoperative hyphema in 1 case (2%), capsule related complications in 1 case (2%) and PC rent in one case (2%).Conclusion:Manual small incision cataract surgery is well suited in our country, where there is backlog of cataract cases. It is an effective, affordable technique which involves lesser surgical time.
To study the cost-effectiveness of clinical screening with ultrasonography (USG) of hip for diagnosing developmental dysplasia of the hip (DDH) in new borns
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-06) Daule, Dr. Pandurang M; Zarekar, Dr. Ganesh G.; Mhaske, Dr. Sunil Natha; Bhate, Dr. Shreya N.
Aim: To study the cost-effectiveness of clinical screen with ultrasonography (USG) of hip for diagnosing developmental dysplasia of the hip (DDH) in new borns. Methodology: Prospective study was conducted in DVVPF's Medical College and Hospital, Ahmednagar over a period of two years. Term new borns had (i) target scan at 6 weeks—family history of DDH or breech presentation—and (ii) early scan—abnormal clinical screen. Results: In all, 58 babies had USG scan. Five early scans (Graf's classification; three Type IIA, one Type IIC and one Type IIIB] and 15 target scans (Type IIA) were reported abnormal. All Type IIADDH had subsequent 12 weeks' scans normal. Babies with Type IIIB and IIC had hip reduction surgery at 6 and 16 months of age, respectively. At cost Rs. 200 INR/- scan, total Rs. 1,47,200/- INR was incurred against two possible hip replacements prevented. Conclusion: Universal clinical screen with USG of hip can aid in early diagnosis of DDH in newborns. Large population-based studies from developing countries need to look in its cost-effectiveness.
Impact of Educational Intervention on Rational Antibiotic Use In Pediatric Ward
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-09) Dharma, Dr. Makarand; Vahadane, Dr. Sachin; Bhate, Dr. Shreya; Shinde, Dr. Abhijit
Introduction: Introduction: Antibiotics are a class of natural and synthetic compounds that inhibit the growth of or kill other microorganisms. Overuse of antibiotic is one of the most important factors for the development and spread of resistance in the hospital, as well as in the community. Present study was designed to describe antibiotic use in children and to assess the impact of an educational intervention on antibiotic prescription. Methodology:The present study was conducted in pediatric ward of a tertiary care institute. The study population included two groups of children – each having 250 children. The first group consisted of 250 consecutive children admitted in one unit of the pediatric ward and they were analyzed for antibiotic use without any prior priming of the members of the unit regarding rationality of antibiotic use. This was followed by an intervention in the form of a 3hour workshop for all members of the unit. The second group included another 250 children consecutively admitted in the wards after this intervention. Results:In Pre intervention group 55 (44%) children received antibiotics in rational way, while in Post intervention group 90(60.40%) children received antibiotic in rational way. One hundred and thirty-six children (49.4%) received antibiotics for respiratory tract infections, this being the commonest disease for which antibiotics were received. As seen in the table, unindicated use of antibiotic was significantly reduced in Post intervention group (p = 0.03).Conclusion: The present study included 500 children. There were 285 (57%) males and 215 (43%) females. Amongst these 500 patients, 178 (35.6%) were below 1 year of age. This group had the highest number of patients. In the Pre intervention group, 55 (44%) children received antibiotics rationally, while in Post intervention group 90(60.40%) children received antibiotic rationally
Primary Autoimmune Hemolytic Anemia Due To Warm Reactive Autoantibodies: A Rare Case Report
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-09) Shinde, Dr. Abhijit; Shinde, Dr. Sonal; Kumar, Dr. Sushrut; Kothari, Dr. Ramesh; Mhaske, Dr. Sneha
Autoimmune hemolytic anemia (AIHA) is an acquired form of hemolytic anemia in which autoantibodies target red blood cell (RBC) membrane antigens, inducing cell rupture (lysis). It affects both pediatric and adult populations, although its presentation in childhood is relatively rare, with the annual incidence [3]estimated to be approximately 0.8 per 100,000 individuals under 18 years old . Here we report one such a rare case of autoimmune hemolytic anemia due to primary warm reactive autoantibodies in a 3 year old female child. As there was presence of hemolysis in peripheral blood smear & other investigations also, Direct coomb's test was done & it came out to be positive which was suggestive of autoimmune hemolytic anemia, as following laboratory reports are suggestive of continuous destruction of RBC & after introduction of steroids parameters of hemolysis came out to be normal suggestive of warm reactive autoantibodies type of AIHA. Clinically also patient improved & her urine colour also became normal after when prednisolone started. Patient also did not have any features of secondary causes of warm autoantibody like Systemic lupus erythematous, immunodeficiency disorders, ulcerative colitis & lymphoproliferative disorders so it was considered primary or idiopathic. W-AIHAtends to have a chronic course and is not expected to subside without treatment. It can be a fatal disease, with a mortality rate of up to 4% in children, either because of the acuity of the presentation or because of being refractory to treatment and requiring multiple lines of therapy with frequently associated toxicity. Fortunately, our patient responded to steroid therapy.
An analytical Study to Evaluate the correlation between Serum Uric Acid Levels and Deaths in Acute Myocardial Infarction Patients At a Tertiary Level Institute Catering to Rural Population of Western Maharashtra
(Dr. Vithalrao Vikhe Patil Foundation Ahmednagar, 2021-09) Baravkar, Dr. Jalindar; Parkhe, Dr. Shivnath; Kopurwad, Dr. Satish M; Swami, Dr. Amrut A.
Background: Cardiovascular diseases are the number one cause of mortality all over the world. Elevated serum uric acid is highly predictive of mortality in patients with heart failure or coronary artery disease. We conducted this study to assess serum uric acid levels on admission as a potential predictor of short-term mortality (7 days) in acute myocardial infarction patients. Methodology: Total of 200 patients diagnosed with the myocardial infarction (MI) in our hospital along with 200 age and gender matched controls were selected for this study. The clinical history, examination, ECG changes and biochemical markers were evaluated on day 0, 3 and 7. Association with Killips class and mortality in STEMI / NSTEMI cases was done. Results:The study had 200 cases and 200 controls. The mean age of cases was 62.54 ± 18.24 years and controls were 61.94±17.25 years. There were majority males among both cases 114 (57%) and controls 112 (56%). The patients were classified using Killip's class. Majority belong to class I 98 (49%) followed by II 42 (21%). There were 26 (13%) of class III and 34 (17%) into class IV. There is significant difference seen between uric acid levels of cases and control on day 1, 3 and 7 (p<0.001). There was 25% mortality (50 deaths) seen among the cases. There was association seen between Killips class III & IVand mortality, there was higher mortality seen in STEMI as compared to NSTEMI (i.e. p<0.05). Conclusion:Our study concludes that the serum uric acid (SUA) levels have significant association with Killip's class and mortality in Acute Myocardial Infarction cases.

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