Perspectives in Medical Research

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/174280

Chief Editor: Dr Srikanth Shastry
ISSN: 2348-1447 (Print); 2348-229X (Online)

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.pimr.org.in/

Browse

Now showing 1 - 20 of 98

25-Hydroxycholecalciferol levels and its equation with lipid parameters and Insulin sensitivity in obese and non-obese young adults: A pilot study
(Prathima Institute of Medical Sciences, 2022-12) Chandrika, N; SMR, Usha; Kshetrimayum, Victoria
Introduction: Vitamin D deficiency and Obesity are the two prevailing health issues of the globe, with India being no excep?on. The sub op?mal Vitamin D levels is associated with an elevated risk of a number of chronic disorders including malignancy, inflamma?on and autoimmune diseases. Obesity breeds metabolic disharmony. Recent data reports Vitamin D deficiency being more prevalent among the obese. Objec?ve: This study is undertaken to see the associa?on of Vitamin D levels with Body Mass Index (BMI), Lipid parameters and Insulin resistance in a sample popula?on represen?ng the urban Indian youth. Materials and Method: Fi?y five apparently healthy young adults of 18 to 22 years age were recruited in this study and their serum 25-hydroxycholecalciferol(25OHD), serum insulin, Total Cholesterol, High Density lipoproteincholesterol (HDL-c), Low Density lipoprotein- cholesterol (LDL-c) and Triglyceride (TGL) levels were es?mated. Insulin resistance(IR) was derived using the Homeostasis Model Assessment equa?on. Based on BMI, the par?cipants were divided into Obese group with BMI ? 25 (n=21) and nonobese group with BMI < 25 (n=34). Result: 25OHD levels were almost same in both Groups (Obese11.1 ± 4.6 ng/ml and non-obese 11.0 ± 5.2 ng/ml). Serum total cholesterol, VLDL and insulin levels were significantly increased in the Obese group(p= 0.005, p= 0.015 and p=0.054 respec?vely) when compared to the non-obese group. We found sta?s?cally significant associa?on between 25-hydroxycholecalciferol (25OHD) and TGL/HDL ra?o in the Obese group. Conclusion: In this pilot study we have unravelled the subtle onset of metabolic derangement in Obese individuals with Vitamin D deficiency.
Anesthesia Management of COVID-19 associated Rhino-Orbito-Cerebral Mucormycosis: A Prospective Observational Study
(Prathima Institute of Medical Sciences, 2024-01) Sontakke, AY; Kulkarni, VV; Nandanvankar, NN; Totawar, S
Background: Fungal infections (mucormycosis) have been reported as co-infection as well as opportunistic infection during and a?er COVID-19 (Coronavirus disease), involving the paranasal air sinuses with a high risk of morbidity and mortality. Considering the ongoing situation of COVID19 associated with mucormycosis, we presented our experience of 110 patients being, or having previously been COVID -19 positive. Methods: This study included 110 patients in which surgical resection was done for Rhinoorbito-cerebral mucormycosis (ROCM) under general anesthesia and observed for 30 days postoperatively. Results: This study included 79 male patients with the majority of 51-60 years of age group (31.81%). Most common comorbidities observed in study were diabetes mellitus (77.27 %) followed by hypertension (39.09 %) & ischemic Heart Disease (9.09 %). Majority patients had received steroids (80 %) as a part of covid-19 treatment. All patients were receiving Amphotericin B at the time of surgery. On operative table extubation was possible in 80 % of the cases while others required average ICU stay (9.83 ± 7.33 days). Inotropic support was required in 20 % of patients. Majority patients were discharged successfully (85.45 %), while 10.91 % had mortality. On 30 days follow-up frontal Sinus Abscess (6.36 %) & maggots in maxilla and sphenoid (0.91 %) were noted. Conclusion: Corticosteroids and DM are the most important predisposing factors in the development of COVID-19- associated ROCM. Perioperative anesthesia care plays an important role towards management and outcome of ROC mucormycosis. Difficult intubation is anticipated due to fungal debris and supraglo?c edema in the oropharynx of the patient
Antiphospholipid Syndrome and Lupus Anticoagulant: Where do we stand today ?
(Prathima Institute of Medical Sciences, 2024-01) Trivedi, S; Verma, S; Kaur, O; Agarwal, S; Singhal, U; Singh, MB
Lupus Anticoagulant (LAC) is a group of auto antiantibodies that interfere with phospholipid dependent tests like Activated Partial Thromboplastin time (APTT) and dilute Russell Viper venom time (dRVVT) on in vitro basis. LA, anti cardiolipin antibodies (aCL) IgG/IgM, and anti-?2 glycoprotein I antibodies [a?2GPI]IgG/IgM are three diagnostic criteria for laboratory diagnosis of anti-phospholipid antibodies (aPL). The circulating aPLs in the clinical se?ng of hypercoagulability state or adverse pregnancy outcomes is termed as anti-phospholipid syndrome (APS). The laboratory diagnosis of APS is complicated, it includes constellation of tests like solid phase immunoassays for measurement of aCL and a ? 2GPI by and coagulation based assays for detection of LAC. LAC diagnosis is especially challenging in the se?ng of anti-coagulation therapy, numerous modifications to circumvent this interference have rendered success. The Thrombin generation assays [TGA] for LAC detection and estimation of LAC pathogenicity are available but are yet to be accepted as routine laboratory tests. The medley of assays like Enzyme-linked immunosorbent and chemiluminescent assays are available for detection of aCL and a?2GPI but due to the non-availability of universal calibrators and standards there is lack of harmonization between various solid phase assays. In this article we intend to highlight new recommendations of laboratory diagnosis of LAC with special emphasis on diagnosis in the se?ng of pregnancy and anti-coagulation. For risk assessment in APS other non-criteria aPL like as antidomain ?2 glycoprotein I and anti-phosphatidyl serine/prothrombin antibodies are under evaluation. There is an ongoing quest towards harmonization of detection of LAC, thus there has been succession of guidelines to meet the challenges and incorporate newly found knowledge every time, namely International Society for Thrombosis and Hematology- Scientific Standardization Commi?ee (ISTH-SSC) guidelines, followed by British Commi?ee for Standards in Hematology (BCSH), Clinical and Laboratory Standards Institute (CLSI) guidelines 2014 and finally guidelines/updates issued by ISTH- SSC in 2018
Anxiety, Depression and Stress among Medical Students during COVID- 19 Pandemic and their Coping Strategies
(Prathima Institute of Medical Sciences, 2024-01) Afreen, S; Bhuvaneswari, P; KM, S; S, P; Shaik, S.
Background: The COVID-19 pandemic has exacerbated mental health challenges among medical students, already a vulnerable group to mental health disorders. Recent evidence underscores a significant rise in anxiety, depression, and stress among this demographic globally, necessitating a deeper understanding of their mental health status and effective interventions. Objective: This study aims to assess the socio-demographic profile, prevalence rates of depression, anxiety, and stress, as well as coping strategies employed by medical students during the COVID-19 pandemic, with a focus on identifying effective interventions for managing their mental health crises. Methods: A cross-sectional study was conducted among 1st to 4th year MBBS students at ACSR Government Medical College, Nellore, during August and September 2020. Data were collected online using Google Forms, incorporating demographic details and the Depression, Anxiety, and Stress Scale (DASS-21). Descriptive statistics and chi-square tests were utilized for data analysis. Results: The study included 400 participants, 57% of whom were female, with a mean age of 23 ± 2 years. Significant proportions reported experiencing depression (20.2%), anxiety (13%), or stress (51.3%), with notable rates of past psychiatric symptoms. Coping mechanisms included video cha?ng (35%) and online entertainment (32.2%), while professional help utilization was low (5.5%). COVID-19 repercussions extended beyond mental health, impacting various facets of daily life. Conclusion: This study found various mental health challenges faced by medical students during the pandemic, emphasising the need for ongoing monitoring and psychological support. Additionally, a low rate of seeking professional help was found. Early training in handling pandemic-like situations and mental health is recommended. However, further research is necessary to track mental health progression and ensure accurate diagnosis through individual clinical assessments.
Application of ABC-VED analysis for inventory control in drug store of a tertiary care hospital of North Maharashtra
(Prathima Institute of Medical Sciences, 2022-08) Teli, Emaran Shaikh; Bhangale, Chetan; Momin, Kashif; Ramanand, Jaiprakash; Mahajan, Harshal
Introduction: The hospital’s pharmacy is one of the most heavily used therapeu?c services and one of the few places where a significant amount of money is spent on recurrent purchases. This underlines the need of strategically planning, crea?ng, and arranging the pharmacy to ensure effec?ve clinical and administra?ve services. Materials and Methods:Inventory control techniques like ABC, VED and ABC-VED matrix analysis were used to evaluate the annual drug expenditure at drug store of Government Medical College & Hospital Jalgaon for the financial year 2019-20. Results:Total number of drugs in inventory in Government Medical College & Hospital Jalgaon in the year 2019-20 were 334 and the annual drug expenditure was 54040462/-. Category A comprised of 49 drugs (14.7%) for which annual drug expenditure was 37286500/- i.e. 69%. 87 drugs (26%) accoun?ng to 11324859/- (20.96%) were classified as category B drugs. Category C drugs included 198 drugs comprising 59.3% of total inventory and consumed 5429103/- i.e. 10.05% of total annual drug expenditure. 39 drugs (11.7%) were classified into vital/V category which accounted for 15257089/- i.e. 28.23% of annual drug expenditure, while essen?al/E category included 127 (38%) drugs for which 30161684/- (55.81%) was incurred for their procurement. 168 (50.3%) drugs accoun?ng to 8621689/- (15.95% of total annual drug expenditure). Conclusion:The applica?on of inventory control strategies such as ABC, VED, and the ABC-VED Matrix will help in significant improvements in pa?ent care.
Assessment and Applicability of Various Elements of Quality Assurance in Histopathology Laboratory: A Study from A Tertiary Care Hospital in Eastern Region of India
(Prathima Institute of Medical Sciences, 2022-12) Mallick, Debjani; Chakrabarti, Sudipta; Gayen, Prosun
Background Quality control in histopathology is rela?vely newer concept and less understood because of its subjec?vity. Aim:The present study was conducted to assess and determine applicability of the different elements of quality assurance in the histopathology laboratory of a ter?ary care hospital in eastern region of India. Material and methods: An observa?onal, retrospec?ve and analy?c study for one year and three months was conducted. 2000 samples were selected by simple random sampling including the biopsy specimens and cell blocks received in the histopathology laboratory. Results:Of the 2000 samples, 1880 (94%) were accepted and 120 rejected (6%) due to mainly pre analy?cal factors. Of the rejected samples, 35 samples (29.2%) were without proper fixa?ve, 48 samples (40%) had incomplete requisi?on forms, 37 samples (30.8%) had incomplete/ absent clinical history. Lack of adherence to standard ?ssue fixa?on protocols were observed in 55 cases (2.75%). Inadequate preven?ve maintenance and delay in renewal of maintenance contracts were the most common cause of failure of maintenance of equipment. Improper staining was found in 35 cases (1.75%). Grossing of specimens were inadequate in 104 cases (5.2%). Concurrence in diagnosis was found in majority cases (1892 cases, 94.6%). Random case review was done with adequate precision (97.5%) and accuracy (96.6 %). Maintenance of turnaround ?me was found in most cases (1800 cases, 90%). Conclusion: Standard opera?ng procedures, training of staffs, equipment maintenance, alertness to maintain turnaround ?me and awareness, proper report documenta?on and storage are the key factors to successfully uphold quality assurance.
Assessment of coverage and compliance of mass drug administration for lymphatic filariasis in Medak District-2021
(Prathima Institute of Medical Sciences, 2023-04) Sayyad, Tajmul; Md, Mustafa Ahmed; Khaja, Azizuddin Junaidi; Bhayya, S
In India Mass Drug Administration (MDA) drive is undertaken every year. In mass drug administra?on DEC and Albendazole combina?on is used. For the strategy to be effec?ve, more than 85% of those living in endemic areas must be covered by MDA. Methods: This is a cross-sec?onal study in which family clusters were selected from rural and urban areas. Informa?on about coverage, compliance with MDA and knowledge of filariasis was obtained using a ques?onnaire. Data were analysed using percentages and propor?ons. Results: In this study, about 92.51% of the study par?cipants received DEC and ABZ tablets during MDA, of which 95.14 % of par?cipants consumed the drugs. The most common cause of noncompliance was fear of side effects. Conclusion: Coverage of the popula?on with DEC and albendazole combina?on was good but compliance needs to be improved. IEC ac?vi?es should be intensified. Local leaders should be involved in the programme to increase compliance.
Assessment of Severity of Pancreatitis by Computerized Tomography Using Revised Atlanta Classifica?on and Comparison with BISAP Clinical Scoring System
(Prathima Institute of Medical Sciences, 2022-12) Sagi, Srikanth; Bharati, Keerthi
Background: Untreated acute pancrea??s can have high morbidity and mortality. It is a serious gastrointes?nal emergency. Its incidence is approximately 51.0 % and it can cause both local and systemic problems. The diagnosis usually involves laboratory tests like amylase and lipase as well as an ultrasound exam. The ideal imaging test is a contrast-enhanced CT scan. This study used scoring systems based on laboratory and radiological inves?ga?ons to determine the clinical progression and outcome. Methods : Pa?ents who were diagnosed with acute pancrea??s and in whom computed tomography was done were included. From the imaging findings, the category and subcategory of acute pancrea??s and types of fluid collec?ons were described in these pa?ents using the revised Atlanta classifica?on. BISAP score was calculated in all these pa?ents. The clinical outcome assessed in these pa?ents is the dura?on of stay in the hospital, mortality, presence of persistent organ failure, the occurrence of infec?on and need for interven?on. Finally, the correla?on between the Revised Atlanta classifica?on and BISAP score was analyzed and compared with clinical outcomes. Results: The analysis of the correla?on between Revised Atlanta classifica?on severity grade and BISAP score, among the n=57 pa?ents with mild acute pancrea??s n=56, had BISAP score less than 3 and only one had BISAP score greater or equal to three. Among the n=25 pa?ents graded as moderately severe acute pancrea??s, n=20 cases had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three. Among the n=08 pa?ents graded as severe acute pancrea??s, n=3 had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three. Conclusion: Standardizing nomenclature and facilita?ng proper documenta?on of a variety of imaging abnormali?es in acute pancrea??s is made possible by incorpora?ng the new Atlanta categoriza?on system into daily prac?ce. We can triage, predict, and treat pa?ents with acute pancrea??s with greater precision by integra?ng the new Atlanta classifica?on with BISAP clinical grading, significantly improving medical care.
Association of high blood pressure with raised homocysteine level among urban population- A case control study
(Prathima Institute of Medical Sciences, 2022-12) Junedi, Mehraj; Junaidi, Abdulazim; Yadagir, R
Introduction: Hypertension is a major risk factor for cardiovascular diseases. Raised homocysteine level is also an important independent risk factor for CVD. This study sought to determine whether there is any rela?onship between plasma homocysteine and blood pressure levels. Method: A case control study was conducted among 200 hypertensive cases and 200 normal healthy control groups. Cases were from the Department of medicine and hypertensive clinics at GMC, Barama? and similar controls were selected from pa?ents’ neighborhood. Detailed clinical assessment as well as plasma homocysteine level were assessed and compared in both. Results: Hypertensive cases had higher mean homocysteine level (21.3 ± 4.6 µmol/L) from controls (13.0 ± 6.0 µmol/L), p<0.001. Homocysteine is posi?vely correlated with both systolic and diastolic blood pressure among both hypertensive pa?ents and healthy controls. In both hypertensive subjects and healthy control, homocysteine level has weak posi?ve correla?on with DBP and moderate to strong posi?ve correla?on with SBP. The hypertensive cases had very high chance (OR=52.4) of developing hyperhomocysteinemia (>15 µmol/L), p<0.001. Conclusion: This study showed higher mean plasma homocysteine levels in hypertensive subjects than controls. Serum homocysteine concentra?ons were posi?vely associated with both systolic and diastolic blood pressure levels in a general adult popula?on.
Beyond Immunuhistochemistry: Molecular Insights Into Round Cell Soft Tissue Tumors
(Prathima Institute of Medical Sciences, 2024-12) Madoori, PK; Tejavat, S.
Round cell so? ?ssue tumors (RCSTTs) are a diverse group of aggressive malignancies that share overlapping clinical, morphological, and immunohistochemical features, posing significant diagnos?c challenges. Recent advances in molec- ular pathology have revolu?onized the understanding and classifica?on of these tumors by iden?fying tumor-specific gene?c altera?ons. This review highlights the role of molec- ular insights in complemen?ng histopathology and immuno- histochemistry to achieve precise diagnosis, risk stra?fica- ?on, and therapeu?c decision-making. Key subtypes, includ- ing Ewing sarcoma, CIC- and BCOR-rearranged sarcomas, alveolar rhabdomyosarcoma, desmoplas?c small round cell tumor, and extraskeletal myxoid chondrosarcoma, are dis- cussed with emphasis on their molecular signatures and clin- ical significance. The advent of techniques such as fluo- rescence in situ hybridiza?on (FISH), reverse transcriptase- polymerase chain reac?on (RT-PCR), and next-genera?on sequencing (NGS) has enabled detec?on of gene?c fusions and aberra?ons cri?cal for tumor iden?fica?on and targeted therapies. Integra?on of molecular pathology with tradi- ?onal diagnos?c approaches is essen?al for improving diag- nos?c accuracy, prognos?ca?on, and therapeu?c strategies, paving the way for personalized medicine in the manage- ment of RCSTTs. Full form of ABBREVIATIONS are provided at the end.
Body image perception and self-esteem among undergraduate medical students in Nanded, Maharashtra
(Prathima Institute of Medical Sciences, 2023-04) Padmakumar, Devi; Inamdar, I.F; Gatiani, P, L; Gadekar, R.D
Introduction: Body image is the percep?on and a?tude one holds toward one’s own body, especially, but not exclusively, one’s physical appearance. The promo?on of posi?ve body image improves people’s quality of life and behaviors related to health. Social factors, sociocultural influences, media pressure, and the pursuit of an ideal body, associated with accomplishments and happiness are among the causes of changes in the percep?on of body image, leading to dissa?sfac?on. There is very less literature on these topics among males and also medical students. Objec?ves: To assess body image percep?on and the influence of sociocultural factors on it and self-esteem among undergraduate students of a medical college. Methods: A cross-sec?onal study was carried out among 192 undergraduate medical students of a medical college from June 2021 to September 2021 using a predesigned pretested self-administered ques?onnaire in English. Results: Out of 200 students included in the study the mean age of study subjects was 19.78 ± 1.39 years, of which,107(56%) were males and 85(44%) were females. The 192 students were classified as Underweight (27(14%)), Normal weight (78(41%)), Overweight (43(22%)) and Obese I (44(23%)) according to Asian WHO BMI classifica?on. BISS scores (which measure body image sa?sfac?on) were the median of the six items a?er reversescoring the three posi?ve-to-nega?ve items which were found to be 5.5(4-7) and 53% of students showed body image dissa?sfac?on. 33% (63 students) of students have thin/low body fat internaliza?on and about 77(40%) have muscular/athle?c internaliza?on.54(28%) students mostly agree about family pressure to a?ain the ideal appearance, 53(28%) feel pressure from peers and 75(39%) mostly agree with influence of media to a?ain ideal appearance. Out of the 192 students,124(64%) showed normal self-esteem, 63(33%) with low self-esteem, and 5(3%) with high selfesteem as per Rosenberg’s self-esteem score. A sta?s?cally significant associa?on was found between BMI and body image percep?on and also between Body image percep?on with sociocultural a?tudes toward the appearance and self-esteem of students. Conclusion: Body image dissa?sfac?on affects young students. In this study, about 53% of the students showed body image dissa?sfac?on. This percep?on of self has mainly been influenced by media (39%), family pressure (28%), and peer pressure (28%). Also, 33% of the students have low esteem with a significant associa?on between Body image percep?on and self-esteem.
Burden of Mental Morbidities among Health Care Workers in a Tertiary Care Hospital Of West Bengal during Third Wave of COVID-19 Pandemic: A Cross-Sectional Study
(Prathima Institute of Medical Sciences, 2024-12) Ghosh, S; Bag, S; Mondal, A; Roy, S.
Introduc?on: Healthcare workers (HCWs) are constantly on the frontlines, facing the brunt of the COVID 19 pandemic in their personal, professional, and social lives. This pandemic has also taken a toll on the lives of healthcare workers over the past two years. Facing the stress and burnout since the pandemic has begun, during the third wave of the pandemic, there might be an increase in mental health issues among HCWs in this state. The aim of the study is to assess the magnitude of anxiety and depression during the third wave of COVID-19 pandemic among the healthcare workers in a ter?ary care hospital in West Bengal. Materials and methods: The observa?onal study was conducted at IPGMER & SSKM Hospital, a ter?ary care teaching hospital in Kolkata, West Bengal, over a period of one week from January 19 to January 26, 2022. A cross-sec?onal rapid survey was conducted using an online ques?onnaire containing the Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) among HCWs in the hospital using a Google Proforma through various social media groups. A total of 86 HCWs par?cipated over a period of one week. The data was analysed using SPSS 16 so?ware. Descrip?ve sta?s?cs and univariate logis?c regression were used. Result: In the present study, it was found that among 86 people, 61 of them were aged between 26-40 years, half of them, i.e., 45 people, were male, and more than one-fi?h (22.1%) (n = 86) had moderate to severe anxiety. Most of the par?cipants, i.e., 39 of them (45.3%), had clinical depression ranging from borderline to extreme. No significant associa?on of moderate to severe anxiety and depression and socio-demographic characteris?cs wasno?ced, except for the significantly higher preponderance of anxiety in female gender (p value= 0.0001). Anxiety showed a good posi?ve correla?on with depression (p value less than 0.001) and all who had severe anxiety were also suffering from either severe or extreme depression. Conclusion: An alarming propor?on of anxiety and depression was no?ced among HCWs. The prevalence of anxiety and depression (severe grade) among HCWs are 6% and 8% respec?vely. So awareness regarding their own mental health, preven?ve therapies, and proper diagnosis and treatment of cases are needed.
A Case of Hereditary Multiple Exostoses: Role of FNAC in diagnosis
(Prathima Institute of Medical Sciences, 2024-05) QSM; Nanda, A; Trivedi, S.
Hereditary Multiple Exostoses (HME) is a rare autosomal dominant bone disease. It is characterized with numerous benign osteochondromas, which grow outward from the metaphyses of long bones. In many cases it is asymptomatic but can lead to considerable number of complications, like pressure symptoms, limb deformities, and can cause psychosocial problems. Malignant transformation is rarely seen. Surgery is the main modality of treatment.This paper aims to highlight the role of FNAC in diagnosis of HME.
Case report of Primary Adrenal Insufficiency
(Prathima Institute of Medical Sciences, 2024-01) Reddy, ES; Chaitanya, K; Shailaja, S
Addison’s disease, also known as primary adrenal insufficiency (PAI), is a rare endocrine disorder characterized by a decrease in all three adrenal hormones. This case report describes a 32-year-old female who presented with generalized weakness, fatigue, weight loss, and hyperpigmentation. Based on her symptoms and laboratory findings, a diagnosis of Addison’s disease was made. She was started on hormone replacement therapy, and her symptoms improved significantly.
Clinical and demographic profile of COVID-19 patients- A cross-sectional study from a tertiary care medical college hospital from South India
(Prathima Institute of Medical Sciences, 2022-12)
Background: Acute respiratory illness with fever and respiratory symptoms such as cough and shortness of breath comprise the main clinical presenta?ons of Corona virus disease (COVID-19).Clinical manifesta?ons in COVID-19 shows significant regional varia?ons. Objec?ve of the study: To study the demographic and clinical profiles of laboratory confirmed COVID-19 pa?ents in South India Methods: In this cross sec?onal study,pa?ents diagnosed with COVID-19 by reverse transcriptase-polymerase chain reac?on (RT-PCR) test were taken up for the study.History of fever,throatpain,cough,breathlessness,malaise were taken.Blood pressure,respiratory rate,oxygen satura?on were recorded.Data on co-morbid illnessness like diabetes,hypertension,renal disease were also noted .All these were correlated to assess the clinical course of COVID-19 Results: Of the total 518 pa?ents,257(49.6%) pa?ents were in the age group of 46 to 65 years and 309 (59.7 %) pa?ents were males. History of fever was present in 349(67.38%) pa?ents and cough was present in 291 (56.17%) pa?ents. Throat pain and running nose was present in 291 (56.2%)and 110 (21.23%) pa?ents respec?vely. Heart rate was between 60 and 100 beats per minute in 472 (80.3%) of pa?ents and 102 (19.7%) pa?ents had respiratory distress with respiratory rate ?24. Oxygen satura?on was between 90-93% in 57 (9.85%) pa?ents and 87(16.8%) pa?ents were on oxygen support with 21(4.1%) pa?ents on non-invasive ven?la?on. A total of 291(56.2%) pa?ents were treated with steroids. Diabetes mellitus was present in 214(41.3%), hypertension in 150 (29%) pa?ents. Case fatality rate was 2.1% Conclusion: Severe disease and lower oxygen satura?on was associated with older age and co-morbid diseases par?cularly diabetes
A Clinical Study and Management of Non Traumatic Acute Abdomen
(Prathima Institute of Medical Sciences, 2022-04) Vaswani, Rajesh; Meena, Sunil Kumar; Meena, Omeshkumar; Dhaka, Ankit Kumar; Meena, Satya Narayan; Kumar, Ankit
Background: The acute abdomen is a condi?on that demands urgent a?en?on and treatment, ranging from trivial to life threatening condi?ons. The aim of this study was to know in detail the epidemiology and outcome in nontrauma?c acute abdomen. Methods: An ins?tu?on based, cross-sec?onal study was conducted from December 2019 to April 2020, at Department of General Surgery Govt. Medical College Kota Rajasthan. The study included 100 cases of non-trauma?c abdomen. Results: Non- trauma?c acute abdominal pain was more common in 2ndto 6thdecade of life. The males to female ra?o is 2.85:1. Hollow viscus perfora?on (30%) forms the commonest cause of acute abdomen followed by acute appendici?s, Sub acute intes?nal obstruc?on, renal/ureteric colic, cholelithiasis, pancrea??s, non-specific pain abdomen, OBG related pathology, liver abscess, Meckel’s diver?culi?s and splenic abscess in 24%, 23%, 8%, 4%, 3%, 3%, 2%, 1%, 1% and 1% respec?vely. Sixteen pa?ents managed conserva?vely. Most common surgical procedures done were exploratory laparotomy with needful for hollow viscus perfora?on and open/laparoscopic appendicectomy for acute appendici?s. Conclusions: Proper history taking, clinical examina?on with suppor?ve imaging findings are most important to narrow the differen?al diagnosis and for immediate interven?on to limit morbidity and mortality.
Clinicopathological profile of hyperpigmented skin lesions- A prospective study
(Prathima Institute of Medical Sciences, 2022-12) Aryasomayajula, Sirish; Danda, Manimala; Gude, Aswini; Pyadi, suneetha; Mamillapalli, Padmapriya; Epari, Kiran kumar; Gudeli, Vahini; A, Ramkrishna B.
Introduction: Hyperpigmentation is one of the most common reac?on to inflammatory, benign and malignant lesions of the skin. These disorders comprise heterogeneous group of diseases of epidermal and dermal hyperpigmenta?on divided into various types according to e?ology and pathology. Correct diagnosis of these hyperpigmented lesions is linked to histopathologic examina?on of skin biopsies with clinical correla?on. Aim: To study the spectrum of hyperpigmented skin lesions with reference to age and sex distribu?on. Materials and Methods: This prospec?ve cohort study was conducted at Department of Pathology, at Alluri Sitaramaraju Academy of Medical Sciences, Eluru, Andhra Pradesh, India, which included 80 pa?ents who were clinically diagnosed with hyperpigmented skin lesions in all age groups from July 2014 to August 2016. Frequency and percentage sta?s?cs was used to present the results. Results: Out of 80 cases, 34 cases of inflammatory lesions, 23 cases of benign lesions and 23 cases of malignant lesions were reported. Among the post inflammatory lesions the majority were classical Lichen planus. Conclusion: Most common lesion was lichen planus and its variants with highest incidence in females and age group greater than 60 years. Histopathological diagnosis with clinical correla?on aids in effec?ve management of the pa?ents.
Cluster of Neurofibromatosis Cases in Remote Area of Northern Karnataka: A Case Series
(Prathima Institute of Medical Sciences, 2024-05) K, Y G; Mohammed, WJ; R, KS
Tumours of the nerve system and skin are hallmarks of neurofibromatosis, a neurocutaneous condition. One class of inherited illnesses known as phakomatoses includes neurofibromatosis type 1 (NF1) or von Recklinghausen disease. It may show up anywhere in the body, including the skin, eyes, bones, and organs. We report a visually recorded seven cases of NF1 from same area. Every single patient had some kind of skin symptom. We describe the presence of several isolated neurofibromas, café au lait macules, axillary and inguinal freckling, neurological or cognitive dysfunction, and Lisch nodules in 100% of the eyes as ocular symptoms. Also, a rare occurrence of plexiform neuroma seen. Rare and familial presentation and similar cases in the same region, these findings collectively underscore the complex nature of the patient’s medical presentation, necessitating a multidisciplinary approach to management and care.
Coeliaco-Mesenteric Trunk– A Rare Anomaly of the Coeliac Trunk
(Prathima Institute of Medical Sciences, 2024-05) Vamshi, V; Naidu, P V; Jyoti, Phukan M; Du?a, R
The Coeliaco-mesenteric trunk, characterized by the shared origin of the coeliac trunk and the superior mesenteric artery, represents a rare but clinically important anatomical variation within the abdominal vasculature. Knowledge of variations of the abdominal vascular system and their origins is of great importance to surgeons to ensure optimal patient outcomes and also to mitigate the potential complications that may arise due to this lack of knowledge. Present case: During routine dissection for 1st year MBBS (2022-23), of the abdominal region of a 60 year-old male cadaver, there was an unusual presentation of multiple blood vessels at the level of origin of the coeliac trunk. Upon further dissection, the superior mesenteric artery was found to be originating from this group of arteries. This artery was found to be passing through mesentery upto transverse colon. No other distinct blood vessel was found at the level where the superior mesenteric artery usually originates. Conclusion: This case underscores the importance of thorough pre-operative assessment and awareness of anatomical anomalies to facilitate safe and effective management strategies
Comparative Efficacy of Baclofen and Diazepam in Treating Spasticity Following Acquired Spinal Cord Injuries: A Randomized Controlled Trial
(Prathima Institute of Medical Sciences, 2024-05) Thiyagarajan, H; Kadhir, Veluchamy K; Rajagopal, S; Mahato, RK.
Introduction: Spasticity is a pervasive and debilitating condition. Anti-spastic medications like Baclofen and Diazepam are most commonly used for spasticity management. Objectives: The study aimed to evaluate and compare the efficacy of Baclofen with that of Diazepam in the management of spasticity following acquired spinal cord injuries. Methods: In this randomised open-label study involving 60 patients, 30 patients received 5 mg of oral Baclofen thrice daily and 30 patients received 5 mg of oral Diazepam thrice daily for the management of spasticity. The extent of spasticity was measured by Modified Ashworth Scale (MAS). The efficacy of these drugs was measured with the mean improvement in the above parameters on days 7, 14, 28, 56 and 90 from the start of pharmacotherapy. Results: Baseline muscle spasticity scores were comparable. At the endpoint, mean improvement in tone of right and le? hip flexors (1.43 vs. 0.87), hip adductors (1.30 vs. 0.87), knee flexors (0.80 vs. 0.37), ankle plantar flexors (0.80 vs. 0.37) and ankle dorsiflexors (1.23 vs. 0.93) were significantly higher in Baclofen group (p<0.05), while the tone of right and le? hip abductors, hip and knee extensors showed no significant difference among the groups. Conclusion: Baclofen was found to be superior to Diazepam in terms of efficacy, especially for flexor spasticity of lower limbs in acquired spinal cord injuries.

Browse

Browsing Perspectives in Medical Research by Title

Results Per Page

Sort Options