International Journal of Medical and Health Sciences

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https://imsear.searo.who.int/handle/123456789/150270

Editor: Col (Dr) KVS Hari Kumar

ISSN Online: 2277 – 4505

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.ijmhs.net/ >

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Aetiology of Upper Gastrointestinal Bleeding in Patients Presenting at St. Dominic Hospital, Akwatia, Ghana
(International Journal of Medical and Health Sciences, 2019-04) Nkansah, Adwoa Agyei; Duah, Amoako; Romero, Maite Alfonso
Background: Upper gastrointestinal bleeding (UGIB) is one of the commonest medical emergencies worldwide associated withsignificant morbidity and mortality and high medical care cost. Worldwide morbidity and mortality associated with UGIB rangesfrom 6-13%. There are scanty data available about the causes of UGIB from peripheral hospitals in Ghana. Aim and Objectives:The study was to determine the common causes of upper GI bleeding in Saint Dominic Hospital, Akwatia a district hospital inGhana. Materials and Methods: A hospital-based cross-sectional study conducted at endoscopy unit of St. Dominic Hospital.Patients with symptoms of UGIB referred for Gastroscopy were selected and endoscopic findings recorded. Results: Out of the400 patients who underwent gastroscopy during the study period, 107 (26.8%) had upper GI bleeding. 65 (60.8%) of them weremales and the median age was 54 years. Approximately 50% of the patients (57, 53.3%) had only haematemesis. The commonestcause of bleeding was peptic ulcer disease, 40 (37.4%). Conclusion: Peptic ulcer disease was the common cause of UGIB at theSt. Dominic Hospital, Akwatia, Ghana"
Antibiotic Resistance Pattern among common Bacterial Uropathogens Isolated in A Tertiary Care Hospital
(International Journal of Medical and Health Sciences, 2019-01) Sasikala, G.; Rajan, Reena; Mathavi, S.; Priyadharsini, R. Indra
Introduction: Urinary tract infections (UTI’s) are one of the most common bacterial infections in community and hospital settings and it is important to know the etiology and susceptibility pattern of uropathogens for optimum management of UTI’s.Aim & Objectives:This study was conducted to know the etiologyof UTI and to determine the antibiotic resistance pattern of these isolates.Materials & Methods: A prospective cross sectional study was done on 537 and 486 consecutive urine samples from January to May 2015 and 2016. Isolates obtained were identified by conventional biochemical methods and antimicrobial susceptibility testing was done by Kirby Bauer disk diffusion method as per CLSI guidelines.Results: The prevalence of UTI was 41.71% and 51.85% in 2015 and 2016 respectively. 129 (57.59%) and 148 (58.73%) females and 95(42.41%) and 104(41.27%) males were infected in 2015 and 2016 respectively.Escherichia coli (55.25%) was the predominant organism isolated. An increased resistance to norfloxacin ,ampicillin and cefotaxime were shown in 2016 compared to the antimicrobial resistance pattern obtained in 2015. All the gram negative bacilli studied were sensitive to Imipenem and Piperacillin- Tazobactam. Conclusion:Constant surveillance of resistance rate of uropathogens is necessary to formulate local antibiotic policy and to assist clinicians in the rational choice of antibiotic therapy. KEYWORDS:Urinary Tract Infection, E.coliAntibiogram ,Fluoroquinolone resistance.
Arm span and hand length: Reliable indices of stature estimation
(International Journal of Medical and Health Sciences, 2020-04) Ozioko, Onyinye Mary; Ozioko, Uche Sebastine; Abireh, Ifeanacho Ezeteonu; Ozor, Ignatius Ikemefuna; Agbo, Daniel
Introduction: Human height is a sexually dimorphic trait that can be estimated using various anthropometric indicators.Materials and Method: The study cohort which comprises of 500 (250 men and 250 women) healthy subjects who fall within theage range of 20 and 49 years, were selected randomly. Their standing stature, weight, hand length and arm span were measured.Results: Findings reveals that Height of male subjects was significantly (p<0.05) higher compared to that of females, the meanarm span values of male subjects were significantly (p<0.05) higher compared to that of females. Mean arm span values wasobserved to exceed stature. A strong positive correlation value of r=0.431 for males, r=0.747 for females was obtained in thisstudy between the height and arm span parameters. The mean hand length of males was significantly (p<0.05) higher compared tothat of the females. A strong positive correlation value between the height and hand length parameter r=0.093 for males, r=0.442for females was also obtained. A regression formula of height for males was Height=52.78 + (0.64) Arm span and for females,Height=61.2 + (0.59) Arm span was deduced. Conclusion: Arm span and Hand length are useful racial markers and will be ofclinical and forensic anthropological significance when dealing with the study population. This study shows that though both armspan and hand length can be used in estimation of the height of males and females, arm-span remains the most reliable. Theregression equations can be used in amputees or dead accident victims and can be applied in medicolegal issues with accurateresults.
Assessment of Demographics, Management and Outcomes of Acute Coronary Syndrome in Rural Population of India
(International Journal of Medical and Health Sciences, 2019-07) Jawahirani, Anil R.; Lohakare, Akash; Manakshe, Gajendra; Sane, Deepak; Khadse, Satish; Patil, Ashwini
Introduction: Acute coronary syndrome (ACS) comprise the majority of hospital admissions and encompass a high risk of inhospital mortality. This study aimed to understand and assess the characteristics of hospitalized ACS patients, trends in theirmanagement as per evidence based medicine, and its impact on outcome. Materials & Methods: This was a prospective,observational study conducted at a tertiary care hospital in India during January 2018 to December 2018. All consecutive patientssuspected of ACS having age ≥ 18 years were admitted. During hospitalization, a case report form was filled out for patients withdiagnosis of ACS. It included data on demographic, clinical and electrocardiographic characteristics of the patients, diagnosis &treatment modalities. Treatment outcome was mentioned in terms of TIMI grading & in hospital complications. Results: A total of112 consecutive patients admitted in cardiac ICU were enrolled. Out of them 72 (64.28%) were males and 40 (35.72%) werefemales. Mean age of study cohort was 55.98±10.68 years. Most commonly associated conventional risk factors wereHypertension and diabetes [65 (58.04%) hypertensives and 33 (29.46%) diabetics]. Medical management was offered to 78(69.64%) whereas, 34 (30.36%) underwent PTCA or CABG. TIMI flow grading assessment done in 62 patients of which 1/3rdpatients showed TIMI grade 3.Conclusion: The present study showed higher ACS prevalence among patients who were in sixth toseventh decade of life, most commonly males, and associated with conventional risk factors, hypertension and diabetes.
Bacterial profile from suspected maternal sepsis and colonization cases: A step towards prevention of neonatal sepsis
(International Journal of Medical and Health Sciences, 2019-10) Surbhi; Jain, Manisha; Mishra, Neelangi; Gaind, Rajni
Background: Transmission of pathogens can occur through direct materno-fetal contact during antepartum period or delivery.Presence of maternal reproductive tract colonization or bacterial infections during pregnancy increases the risk of puerperal sepsisand early onset neonatal sepsis (EONS). This study was thus planned to screen the etiological agents and antibiogramfromsuspected maternal sepsis/ colonization cases.Materials and methods:Data was collected over a period of 1 year (September2017- September 2018). Clinical samples-placental membrane, placental tissue, retained product of conception (RPOCs) and highvaginal swabs (HVS) received for screening of maternal sepsis or colonization were processed as per conventionalmicrobiological techniques. Antimicrobial sensitivity was performed as per CLSI guidelines.Result:A total of 2405 maternalsamples were included in the study. Only about 13.18% ( 317 samples) showed the presence of bacterial isolate, Escherichia coli(39%) was the predominant etiological agent isolated followed by Staphylococcus aureus(18%)and Enterococcus species (17%).There was an alarming level of drug resistance seen in both the gram positive and negative organisms.Conclusion:Introduction ofpathogens into the female genital tract is a major risk factor for development of uterine infections and chorioamnionitis which caneventually lead to puerperal sepsis and Early onset neonatal sepsis. EONS. As seen in the present study the organisms such asEscherichia coli and Staphylococcus aureusisolated from maternal sepsis and colonization cases are the same organismsimplicated from EONS.In view of increase in drug-resistant organisms prompt detection and treatment of maternal infectionsbecomes crucial to prevent neonatal infections.
Barriers to access of contraceptives by adolescents in the Keetmanshoop Urban Constituency of the //Kharas Region, Namibia
(International Journal of Medical and Health Sciences, 2020-04) Namukwambi, Rauna.N.; Kangoya, Elizabeth .N.; Muyunda, Rhodes
Background: Adolescent pregnancy remains a serious reproductive health challenge in the Namibia, as most of the adolescentpregnancies could result in poor maternal health and premature babies associated with high perinatal and neonatal death. Eventhough, Namibia provides free contraceptives in all public health facilities, contraceptives use by adolescents is still low. The aimof this study is to establish the barriers that prevent adolescents to access contraceptives in the Keetmanshoop Urban Constituencyof the //Kharas region, Namibia. Material methods: A quantitative, non-experimental, descriptive cross-sectional was conductedin two secondary schools in the Keetmanshoop Urban Constituency. Data were collected by means of a structured 5- point Likertscale self- administered questionnaire. Data was analysed using Social Package for Social Sciences (SPSS) version 25 forwindows. Results: The study revealed that the majority of adolescents (98%) had heard about contraceptives, with the mainsource of information being health care providers (48%). However, contraceptive-use among adolescents was low with 20% andthe majority used male condoms (41%) and pills (41%). The major barriers to the access of contraceptives are parental control(22%), cultural norms (15%), peer pressure (13%) and health professionals’ attitudes (11%). Conclusion: The study indicated thatthere is a low contraceptive use among adolescents. Measures that can improve access to contraceptives includes training of healthprofessionals on counselling adolescents, awareness to the parents on contraceptive use among their adolescents, continuoushealth talks and promotion of contraceptives in schools.
Cardiac abnormalities among chronic hemodialysis patients
(International Journal of Medical and Health Sciences, 2019-04) hassani, Lalla fatima ezzahra el; cheraou, Salwa; oukerraj, Latifa; fellat, Nadia; fellat, Rokya; Mohamed
Objective: The annual mortality of cardiovascular diseases of dialysis patients is higher than the general population. The tranc-thoracic echocardiography allows the evaluation of the heart structure and function within the trated patients by hemodialysis in order to identify patients with cardiovascular high risk. Methods: This work is a descriptive retrospective study. The objective is to determine the major cardiac abnormalities diagnosed with echocardiography in patients with chronic hemodialysis and to list their epidemiological, clinical and biological characteristics at the time of the study. Results: The average age of our patients is of 50.2 ± 7 years with an average hemodialysis endurance of 12.1± 2.4 years. The main etiologies of the chronic renal failure were essentially the diabete type 2, the arterial hypertension and chronic nephritis tubule-interstitial. The most cardiac abnormalities was the left ventricular hypertrophy. The presence of a systolic or diastolic arterial hypertension has been noted as a significant factor fostering the LVH within the chronic hemodialysis (p=0.002).The anemia is not said to be associated to the development of the left ventricular hypertrophy(p=0.09). Conclusions: This study revealed the etiology leading to chronic renal failure insufficiency. Echocardiography accurately diagnosed cardiac abnormalities such as left ventricular hypertrophy. The study allowed to detect the factors involved in the development of this HVG especialy systolic arterial hypertension. This result permit us to act on these factors in order to prevent the cardiovascular events to which hemodialysis patients will be exposed.
Changes in Platelet Indices in Obese and Non-Obese Individuals in a Tertiary Healthcare Facility in Uyo, Nigeria
(International Journal of Medical and Health Sciences, 2019-10) Ekwere, Timothy Amos; OlugbemiOluseyiMotilewa
Background: Obesity is associated with significant cardiovascular and thromboembolic risk largely due to increased plateletreactivity. Objectives: To determine the changes in platelet counts and platelet activation using platelet indices (MPV & PDW) inobese and non-obese patients in a tertiary hospital in Uyo, Nigeria.Methodology: This was a cross-sectional descriptive studycomprising of 191 participants recruited consecutively from the out-patients Departments of University of Uyo Teaching Hospitalover a six months period (March-August 2018). Patients were categorised into obese, overweight and normal weight based ontheir Body Mass Index (BMI). Also, 2.5mls of blood was collected from each patient and same was used to determine full bloodcount from where the platelet count and platelet indices (MPV & PDW) were obtained. Results: There was progressive increasein the mean platelet count of the patients (210.59 ± 51.6, 194.26 ± 49.8, 184.95 ± 51.7 for obese, overweight and normal weightrespectively) and this increase was statistically significant (P=0.0208). However, the mean platelet indices (MPV & PDW) wasnot statistically significant (P=0.351 and 0.933 for MPV and PDW respectively). Conclusion: Platelet counts was significantlyelevated in obese patients compared with the overweight and normal weight however, the MPV and PDW was not significantlydifferent in the three groups.
Clinical Efficacy of Concurrent Therapy with Oral FDC Tablet of Euphorbia Prostrata plus Calcium Dobesilate and Topical FDC Cream of Euphorbia Prostrata plus Lidocaine in the Management of Haemorrhoids: A Prospective, Open-Labeled Multicentric Study
(International Journal of Medical and Health Sciences, 2019-10) Khobragade, Kunal J.; Patil, C. S.; Borkar, Nilesh E.
Objective: Haemorrhoids are associated with bleeding, pain, itching, exudation and swelling. So there is an unmet need foreffective treatment by both oral and topical drugs. Hence this study was designed to evaluate the efficacy of oral EuphorbiaProstrata fortified with Calcium Dobesilate and topical cream of Euphorbia Prostrata with Lidocaine. Methods: The study was aprospective, open label, single arm, multicentric study, in 30 patients with hemorrhoids treated with oral FDC EuphorbiaProstrata extract 100 mg plus Calcium Dobesilate 500 mg and topical FDC cream of Euphorbia Prostrata extract 1% w/w plusLidocaine 3% w/w for 14 days.Symptoms like bleeding, pain, itching, exudation and swelling were assessed and scored duringand at the end of the study. Results: There was decline from the baseline value scores right from day 4 i.e. bleeding (0.97±0.15),pain (0.60±0.13), itching (0.47±0.13), exudation (0.13±0.06) and swelling (0.43±0.09); after 7 days bleeding (0.15±0.07), pain(0.12±0.06), itching (0.15±0.07), exudation (0.15±0.07) and swelling (0.19±0.08) and after day 14 the symptoms of bleeding(0.09±0.06), pain (0.08±0.06) and swelling (0.08±0.06) were almost cured while symptoms like itching (0.00±0.00), exudation(0.00±0.00) disappeared completely. There was reduction in the number of patient’s population with symptoms towards the end ofthe study. Conclusion: Oral Euphorbia Prostrata extract 100 mg fortified with Calcium Dobesilate 500 mg and topical cream ofEuphorbia Prostrataextract 1% w/w with Lidocaine 3% w/w showed maximum improvement during first 4 days of therapy andachieved total improvement till the end of therapy thus providing multimodal targeted approach to treat a multimodalhaemorrhoidal disease.
Diabetes Prediction Using Ensemble Classifier
(International Journal of Medical and Health Sciences, 2020-04) Dutta, Shawni; Bandyopadhyay, Kumar Samir
Diabetes is one of the impactful diseases that affect humans’ health rigorously. Early diagnosis of diabetes will assist health caresystems to decide and act according to counter measures. This paper focuses on obtaining an automated tool that will predictdiabetic tendency of a patient. The system proposed by this paper contains two ensemble classifiers- Voting ensemble classifierand Stacking Ensemble classifier. Both of these methods exhibits better results while compared to other classifiers. Stackingensemble classifier even performs better than voting ensemble classifier with an accuracy of 79.87%.
Evaluation of Effect of Antitubercular Drugs on Thyroid Profile in Euthyroid Individuals
(International Journal of Medical and Health Sciences, 2019-07) CG, Jagadesha; CG, Gokul
Background: India is the highest TB burden country in the world and Tuberculosis being a systemic disease, it has capacity forwide spread dissemination. Some studies done in the past provided variable evidences suggesting Thyroid dysfunction can occurfollowing antitubercular therapy, hence we have taken up this study. Methods: 50 freshly detected pulmonary and extrapulmonary tuberculosis cases were included in this study. Plasma levels of T3, T4 and TSH was measured before initiating Antituberculosis treatment (ATT) and repeated at the end of 6 months. Results: Post treatment 2(4%) subjects had change in T3 levelabove the normal reference range, no changes observed in T4 levels after the treatment. Post treatment 1(2%) subject had TSH of<0.3 Μiu/ml indicating transition in to the hyperthyroid range, majority i.e. 32(64%) subjects had TSH level within normalreference range, whereas 17(34%) subjects had TSH level above the normal reference range falling into Subclinical Hypothyroidrange. Conclusion: The common Thyroid Dysfunction seen during the study period was Hypothyroidism. Anti-tubercularmedication preferably Rifampicin probably would explain the cause for these thyroid dysfunctions noticed during the study time.
FNAC as a diagnostic tool for Tuberculouslymphadentitis at peripheral health institutions
(International Journal of Medical and Health Sciences, 2019-07) Srivastava, V.K; Jaiswal, Pooja; Tandon, P.
Background:Tuberculosis is a common and important public health problem in India. Fine Needle Aspiration Cytology (FNAC)is very easy, simple, quick,cheap and specific method for diagnosis of Tuberculous Lymphadenitis. The objective of this studywas to study the diagnostic yield of FNAC for diagnosis of Tuberculous Lymphadenitis by ZN staining and Cytopathologicalcharacteristics.Material and Methods: Present study was a retrospective study. FNAC/ aspiration was done in cases of superficiallymphnodes / abscess were analysed for diagnostic yield of Tuberculous etiology by ZN staining and cytopathologicalcharacteristics.Results: A total of 136 cases of superficial lymphadenitis presenting as solid swelling or abscess were subjected toFNAC examination. Smears were prepared from the aspirated material. Two separate slides prepared, stained with Giemsa and ZNstain. Total of 73 cases (53.67%) slides showed evidences suggestive of Tuberculous etiology out of which 33 (45.2%) were foundAFB positive on ZN stain. One AFB positive (not included as AFB positive in the analysis of results) slide was suggestive ofMycobact.leprae as confirmed by Fite stain.Conclusion: FNAC is a simple, safe, quick and cheap method to establish thediagnosis. Procedure is very safe, easy and can be performed by any doctor of PHI. Demonstration of AFB in the smear gives abacterilogically confirmed diagnosis very quickly. Cytological examination can further improve the diagnostic yield withoutbacteriological confirmation.
Knowledge, attitudes, and practices of kangaroo mother care among Health care professionals in Keetmanshoop District, Namibia
(International Journal of Medical and Health Sciences, 2020-01) Mhlope, Helena Ndahambelela; David, Sabina Aishe; Lukolo, Linda Nghipondoka-
Background: Kangaroo mother care (KMC) refers to the practice of providing continuous skin-to-skin contact between motherand baby, exclusive breast feeding, and early discharge from hospital. The study aim to assess the knowledge, attitude, andpractices surrounding kangaroo mother care (KMC) among health care professional (HCPs) in Keetmanshoop District; to assessthe extent to which HCPs practice KMC in the care of low birth weight (LBW) babies; and to identify challenges in theimplementation of KMC among HCPs. Materials methods: This quantitative, cross-sectional descriptive study was conducted at6 health facilities in Keetmanshoop district. A self-reported questionnaire consisting of Closed-ended questions and 5-point Likertscale was used for data collection. Statistical Package for Social Sciences (SPSS), Version 24 was used to analyze data. Results:Demographic data revealed that, 79% of participants were females and 21% were males, 30% of participants were between theage of 20 to 30, while 20% were aged between 51 to 60 years. It was discovered that 99% of the respondents believed that KMCpromotes bonding between the mother and her baby. Only 39% of health care professionals underwent training on KMC. Themajority of HCP 87% agreed that, the policy on kangaroo mother care practice is not displayed in their facilities, while 65% statedthat KMC is not effectively implemented in their facilities. Conclusion: The result revealed that, lack of policy, guidelines, andspace to accommodate mothers are the major obstacles to the successful implementation of Kangaroo Mother Care.
Lizard tail as unconventional addiction: Case Report
(International Journal of Medical and Health Sciences, 2019-10) Prasad, Shobhit Kumar; Verma, Piyush; Singh, Priti; Gupta, Rajiv
The scientific literature regarding use of reptiles for purpose getting high are sparse, and mainly from developing countries.Duringconditions like non-availability of drugs or other substances of abuse, there can be propensity for using alternative forms ofsubstances like reptiles or insects, which is determined by a milieu of factors, like personality profiles, socio-cultural milieus,availability and accessibility of substance and co-morbid psychopathology. We present a case of alcohol and cannabinoiddependence syndrome with dissocial traits admitted in a state drug-deaddictioncenter, PGIMS Rohtak describing the use of tail ofIndian lizard to get high when there was non-availability of cannabis and alcohol in jail.
Markers of Inflammation in Rheumatoid Arthritis and Osteoarthritis
(International Journal of Medical and Health Sciences, 2020-04) Chaudhari, Nutan Y.; Sontakke, A.N.
Introduction: Rheumatoid arthritis is characterized by local and systemic effects of inflammation while osteoarthritis is aninflammatory degenerative disorder of joints. A wide range of inflammatory markers are implicated in pathogenesis of rheumatoidarthritis and osteoarthritis as a consequence of persistent imbalance between pro- and anti-inflammatory immune mechanisms,leading to chronic inflammation. Hence the present study is an attempt to estimate the levels of serum ceruloplasmin , C-reactiveprotein (CRP) and rheumatoid factor (RF) factor as inflammatory markers in serum of rheumatoid arthritis and osteoarthritispatients and compare them with normal healthy controls. Materials and Methods: Serum ceruloplasmin was estimated byspectrophotometric method while serum C-reactive protein and RA factor were detected using agglutination test in thirty patientsof rheumatoid arthritis ,osteoarthritis and age and sex matched healthy controls each were included in the study. Results:Significant increase in ceruloplasmin was observed (p<0.0001) in rheumatoid arthritis and osteoarthritis as compared to healthycontrols and in that especially ceruloplasmin was more elevated in rheumatoid arthritis than osteoarthritis. C-reactive proteinwas found to be positive in rheumatoid arthritis and osteoarthritis and none of the controls. RF factor was found positive inrheumatoid arthritis and none of the osteoarthritis and controls. Conclusion: There was increased level of serum ceruloplasmin inthe patients with rheumatoid arthritis and osteoarthritis. C-reactive protein and RF factor was found to be positive in rheumatoidarthritis while C-reactive protein was found to be positive in rheumatoid arthritis and osteoarthritis. These findings suggest apossible role of these inflammatory markers in the pathogenesis of rheumatoid arthritis.
New polypyrrole based bio-sensors for Bio-impedance measurement
(International Journal of Medical and Health Sciences, 2019-07) Telipan, Gabriela; Pîslaru-Dănescu, Lucian; Ion, Ioana
Objective: The main task of this work consists in an obtaining polarizable, dry mode, of bio-impedance sensors for non-invasiveECG monitoring, that work without any skin preparation or gel use, in two constructive models, based on conductive organicpolymer polypyrrole and polypyrrole with Ag nanoparticles (NP), as sensitive materials. Methods: The polypyrrole wassynthetized by chemical oxidative polymerization using FeCl3 as oxidant agent. For sensors fabrication two technological variantshave been chosen, a first variant realized by photolithographic method consisting in a substrate of Printed Circuit Board (PCB)with interdigitated copper electrode with step of 0.25 mm and over a distance of 12 mm and two pads. The polypyrrole orpolypyrrole with Ag NP dissolved in ethyl alcohol was deposed on the substrate by dipping method. The second model consists ina polypyrrole powder pressed at a hydraulic press at 10 tones/cm2 of force where one site was deposed a layer of Ag ink forconduction. Results: The performance of bio-impedance sensors were accessed by impedance skin-sensor interface withfrequency in the range of 10 - 300 kHz measurements. The influences of technological fabrication as shape and geometry as wellas the sensitive materials that used, in terms of impedance were analyzed. Conclusions: The introduction of Ag NP in polypyrrole,led to a better behavior, in terms of conduction and impedance response. For all tested sensors, the impedance decreases with thefrequency with a good linearity.
Non Invasive Evaluation of Residual Disease in Women of Locally Advanced Breast Cancer after Neoadjuvant Chemotherapy
(International Journal of Medical and Health Sciences, 2019-04) Nikunj, Maj (Dr)Vasu
ackground: The aim of this study was to evaluate the role of Neoadjuvant Chemotherapy (NACT) in Locally Advanced Breast Cancers (LABC) by correlating the clinical and radiological findings before and after NACT. Methods: A prospective study conducted over a 2yr period, enrolled patients with LABC. All patients were evaluated clinically and radiologically before and after completion of NACT. Breast lump size, axillary nodal metastasis and features of locoregional involvement were recorded. The incidence of complications and locoregional recurrence were also noted. Results: Out of total 100 patients, maximum(n= 72) showed partial response ( PR) and 02 showed no response. There was a decrease in mean tumor size (4.91cm vs 2.74 cm, p=<0.001) on clinical examination and (4.14cm vs 2.24cm, p= <0.001) on radiological evaluation. Mean lymph node size decreased to (1.34cm vs 0.04 cm, p= <0.001) on clinical examination and (9.95mm vs 0.52m, p=<0.001) on radiological evaluation. There was no case of locoregional recurrence on follow up. Conclusions: The implication of this study is that NACT helps in down staging of the tumors and for better clinical evaluation, both physical examination and radiological evaluation should be routinely used in the patients of LABC undergoing NACT.
Response rate to vaccination against Hepatitis B virus among health care workers at St. Dominic Hospital, Akwatia, Ghana
(International Journal of Medical and Health Sciences, 2019-10) AmoakoDuah; Nkansah, Adwoa Agyei; Evelyn, Amoako; Maite, Alfonso Romero; Rafiq, Okine; Duah, Francisca
Background: Hepatitis B is a major contributor to the burden of infectious diseases worldwide. Many preventive measures havebeen employed, however, active immunization with hepatitis B vaccine remains the single most important hepatitis B preventionmeasure. WHO recommends that all health care workers (HCWs) should be vaccinated against HBV. However, proportions ofindividuals do not respond to the recommended standard three dose of HBV vaccination and remain susceptible to theinfection.Objectives: This study was to assess the response rate to vaccination against HBV among health care workers and todetermine predictors of non-response to HBV vaccine in HCWs. Methods and Materials: A prospective study carried out at theSaint Dominic Hospital, Akwatia, involving 100 HCWs from 29th August, 2018 to 4th June, 2019. All the participants received thestandard protocol of 3 intramuscular injections of HBV vaccine (Engerix B) at 0, 1, and 6 months. Qualitative and quantitativeserum anti-HBs was determined 1-2 months after the last injection in order to detect the responders and non-responders.Results:Majority (54.0%) of the participants were males. The Median age of the study participants was 35 (29, 47) with age range of 20-65 years. Out of the 100 HCWs 90 (90%) were responders and 10 (10%) were non-responders to hepatitis B vaccine. Nonresponders had increased odds of being female, though this was not statistically significant (COR=1.47 (0.42 - 5.17).Conclusion:All HCWs should undergo confirmatory testing of immune response after completion of scheduled standard HBV immunization.This will ensure safety of all HCWs against HBV infection.
A Review of Corporate Social Responsibility Programmes Conducted in a Large Public Hospital in a Metropolitan City
(International Journal of Medical and Health Sciences, 2020-01) Prasad, Priyanka S.; Supe, Avinash N.; Deshmukh, Hemant
Background: Through Corporate Social Responsibility (CSR), a company achieves a balance of economic, environmental andsocial objectives and is also mandated by Indian law. CSR can help in strengthening healthcare in public hospitals catering to theneedy population. Aims: This study documents the various CSR activities going on in a large tertiary care teaching and publichospital in a metropolitan city, challenges in their implementation and effectiveness of such activities. Materials and Methods:Cross sectional questionnaire based descriptive study in a large public hospital in Mumbai, India. A questionnaire was distributedto nine departments which had received CSR support in the year 2017-18. Details recorded were the kind of initiatives andamount received, difficulties faced in implementation, mode of implementation, its effectiveness and number of people benefittedby the activity. Results: In all, companies have provided a total funding of Rs.10,18,24,940 in a year. Difficulties were faced dueto lack of knowledge of the procedure and clear guidelines for CSR implementation. Approximately 84,251 indoor patients and20,77,146 OPD patients were directly or indirectly benefited by these activities. Conclusions: Public hospitals are best settingswhere companies can implement their CSR activities for healthcare of the poorer sections of society, thus fulfilling their socialobligations in a fruitful way. In view of the advantages of CSR, a dedicated CSR department and guidelines for CSR utilisationneed to be set up with adequate expertise and responsibilities.
Ruptured Sinus of a Valsalva Associated with Autosomal-Dominant Polycystic Kidney Disease in a young male
(International Journal of Medical and Health Sciences, 2019-01) kumar, Basant; Sihag, Bhupendra Kumar; Guleria, Vivek Singh
Autosomal-dominant polycystic kidney disease (ADPKD) is a systemic hereditary disorder characterized by localized cellular proliferation and extracellular matrix abnormalities resulting in both renal and extra renal manifestations, with multiple structural flaws such renal cysts, cerebral and aortic aneurysms, annulo-aortic ectasia, and valvular insufficiency states. Association between Autosomal-dominant polycystic kidney disease (ADPKD) and ruptured sinus of Valsalva aneurysm (SVA) has rarely been documented before. We herein report a case of Autosomal-dominant polycystic kidney disease (ADPKD) who presented with shortness of breath, was diagnosed as a case of ruptured sinus of Valsalva aneurysm (SVA) and defect was closed successfully.

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