MGM Journal of Medical Sciences

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/152473

Editor-in-Chief: Dr Chander P Puri
ISSN: 2347-7946

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.mgmjms.com/

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Now showing 1 - 20 of 365

Achromobacter Spp.: A retrospective review of rare and emerging pathogen
(Wolters Kluwer – Medknow, 2023-01) Sinha, Soni; Raj, Nikhil; Dobhal, Shipra; Das, Anupam; Agarwal, Jyotsna
Background: Achromobacter spp. is a rare nosocomial pathogen known to cause many serious infections like bloodstream infection, osteomyelitis, meningitis, urinary tract infections, corneal ulceration, peritonitis, and endocarditis. Materials and Methods: In this study, we retrospectively analyzed all the bacteriological sample records from the bacteriology database from January 2021 to December 2021 to determine the prevalence of Achromobacter spp. Result: Nine patients with Achromobacter xylosoxidans causing bacterial infection were identified, from whom five blood samples, two pus, one respiratory sample, one central venous pressure (CVP), and one cerebrospinal fluid were found positive for Achromobacter spp., among whom one was a 6-year-old patient having the same organism from two different body sites—CVP line and cerebrospinal fluid. Five patients had coinfection with another organism, whereas acute kidney injury was the most common comorbidity. Conclusion: In our single-center experience, approximately 50% of the cases with Achromobacter denitrificans bacteremia suffered from chronic kidney disease and had a history of antibiotic therapy, hospitalization, and the presence of devices. Active research on rising trends of Achromobacter spp. needs to be promoted.
Acquired Cold Urticaria: An Under-reported Entity.
(2015-10) Rohatgi, Shaurya; Viradiya, Hitesh M; Jerajani, Hemangi Rajiv
Acquired cold urticaria (ACU) is a subtype of physical urticaria which may be primary (idiopathic) or secondary to underlying infections or cryoproteins. In addition to complete history and thorough physical examination, the diagnosis is dependent on a positive cold stimulation time test (CSTT) which is the minimum time of cold contact stimulation required to induce an immediate coalescent wheal. Although idiopathic type is seen in 96% of the cases, it is important to rule out cryoprotein by an intricate yet simple test for cryoprecipitate. The identification of cold exposure as the likely trigger for urticaria is vital because systemic anaphylactic reactions are common in patients with cold urticaria, occurring in roughly 1 in 3 patients. In addition to preventive counseling and avoidance of critical cold exposure, H1-receptor antagonists form the first line of treatment. However resistant cases may require cyclosporine, danazol or omalizumab. No individual case reports of ACU appear in Indian literature. Therefore, the authors attempt to highlight the diagnostic work-up and therapeutic options for this not so uncommon cause of chronic urticaria.
Adverse events following COVID-19 vaccination: A cross-sectional study
(Wolters Kluwer – Medknow, 2023-01) Bansod, Vaishali P; Agawane, Shubhangi U; Gawade, Sachin A; Gore, Harishchandra D; Chawla, Parvinder S
Background: Coronavirus disease 2019 (COVID-19) vaccines are essential to tear out the COVID-19 pandemic. COVAXIN and COVISHIELD were the first licensed vaccines in India for public use. For safety surveillance reporting, adverse events following immunization were an essential and integral part of the postlicensure phase for benefit- risk analysis of vaccines. Public trust in newly introduced vaccines will be strengthened by monitoring vaccine safety. So this study was planned to find out adverse events following COVISHIELD vaccination and the association of some factors with adverse events following COVISHIELD vaccination among vaccinees at vaccination centers of tertiary care hospitals. Materials and Methods: A cross-sectional study was carried out among vaccinees at vaccination centers in tertiary care hospitals. Data was collected through Google forms containing a structured questionnaire. Results: A total of 530 adverse events following immunization (AEFI) were reported by 146 (39.46%) participants, where one participant experienced more than one AEFI with the COVISHIELD vaccine. The most common reported AEFI were myalgia (104 [19.62%]), fever (104 [19.62%]), and fatigue/lethargy (104 [19.62%]), followed by pain at the injection site (80 [15.09%]). Participants who experienced AEFI with other vaccines and had a previous history of COVID-19 infection were found to be significant independent predictors of AEFI with the COVISHIELD vaccine. Conclusion: Most AEFIs were mild and lasted for a short duration, subsiding on symptomatic treatment. We found only the history of AFFI with other vaccines and previous infection with COVID-19 as significant predictors for the occurrence of AEFI with the COVISHIELD vaccine.
Aging gracefully: navigating the journey of growing older
(Wolters Kluwer – Medknow, 2024-04) Olorunfemi, Olaolorunpo; Irinoye, Oluwapelumi Kehinde
This study aims to explore the concept of aging gracefully, probing beyond just physical appearance to embrace the acceptance of changes that come with age and leading a fulfilled life. This study was conducted through a review of literature from 2018 to 2023 using Google Scholar and other databases and focused on keywords such as “aging gracefully,” “navigating,” and “journey of growing older.” It identified various themes, including the journey of aging, the steps involved in aging gracefully, the significance of embracing aging, and the epigenetic theory of aging, shedding light on how individuals can traverse this path. In conclusion, aging gracefully entails preserving physical health, emotional well-being, and having a good attitude as you age. To accomplish this, we need to stay active with different kinds of workouts, eat a well-balanced diet rich in fruits and vegetables, maintain social connections, and stimulate our brain by engaging in hobbies such as reading and puzzles. Regular check- ups, stress management, skin protection, and healthy behaviors such as getting adequate sleep, reducing alcohol consumption, and quitting smoking are all vital. We should embrace the changes that come with aging and focus on the positive aspects of life to traverse this path gracefully. With this awareness, individuals can face aging with acceptance and vitality, leading life with grace and fulfillment.
Analysis of Cesarean section rates using Robson’s ten-group classification system in comparison with the MCS population reference
(Wolters Kluwer – Medknow, 2024-01) Apuroopa, T; Nimbargi, Vandana Ravindra; Dabhadkar, Suchita Vivek
Background: The escalating global prevalence of Cesarean section (CS) deliveries raises concerns. To address this, the World Health Organization (WHO) suggests employing Robson’s ten-group classification system (RTGCS) for assessing and comparing CS rates among obstetric units. The aim of our study was to assess our hospital’s CS rate per group and juxtapose it with WHO Multi-Country Survey (MCS) population reference data. Furthermore, we delve into prevalent obstetric Indications for CS and examine potential strategies for mitigating the high CS rate. Materials and Methods: This observational cross-sectional study occurred at an Indian tertiary care teaching hospital from October 2018 to May 2020. Women delivering during this period were classified based on RTGCS, and Cesarean rates were computed across various groups. These rates were then compared with the WHO’s MCS population reference guidelines. Additionally, we investigated obstetric Indications for CS within these groups. Results: Of 2994 deliveries during the study period, 42.55% were CS. Notably, group 5 (29.75%) and group 1 (21.74%) had the highest CS rates. The CS rate of nulliparous women was 40.9%. Primary CS groups frequently cited fetal distress as the reason, while group 5 showed repeat CS due to previous CS with obstetric complications, on-demand CS, and scar integrity concerns. Conclusion: Despite our hospital’s overall high CS rate, group-specific contributions align with existing research. High-risk pregnancies, previous CS cases, and preterm CS for neonatal care notably contribute. Efforts should target in reducing CS in low-risk groups.
Analysis of real-time RT-PCR and rapid antigen test and its correlation with clinical characteristics, investigation profile, and imaging of SARI-suspected COVID-19 infections
(Wolters Kluwer – Medknow, 2024-07) Lenka, Roshan Kanheya; Patnaik, Bhabani; Patra, Jeetendra Ku; Patro, Somi; Mohapatra, Dharitri; Chayani, Nirupama; Das, Mahadev
Background: Coronavirus disease 2019 (COVID-19) continues to be a significant global public health issue. Aims and Objectives: This study aims to describe the demographic characteristics, comorbidities, clinical presentations, inflammatory biomarkers, and chest computed tomography (CT) findings of patients with severe acute respiratory infection (SARI) at a tertiary care hospital in Odisha, India. Additionally, the study aims to evaluate different COVID-19 diagnostic methods. Materials and Methods: A prospective observational study was conducted at a tertiary care hospital in Odisha, India. All admitted SARI patients underwent COVID-19 testing. Data on demographics, clinical presentations, laboratory investigations, and outcomes at 72 h were collected. COVID-19 diagnostic methods were also analyzed. Statistical Analysis: The statistical analysis was performed using GraphPad Prism 9.5. Results: Among the 830 patients studied, 305 tested positive for COVID-19. The rapid antigen test (RAT) demonstrated a sensitivity of 93.85% and a specificity of 97.43% compared to the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test. Discrepancies with RAT results were noted in cases with higher cycle threshold (Ct) values (>25). A male predominance was observed, with a mean age of 43.30 ± 15.19 years in the COVID-19-positive group and 40.95 ± 17.15 years in the COVID-19-negative group. Patients with multiple comorbidities (15.68%) had a higher susceptibility to COVID-19 infection. The COVID-19-positive group showed a significantly elevated neutrophil-to-lymphocyte ratio (NLR) (P = 0.0001) and thrombocytopenia (P = 0.001). Inflammatory biomarkers, including CRP, LDH, ferritin, D-dimer, and IL-6, were markedly elevated in swab-positive cases. Bilateral chest involvement and ground glass opacities were common radiological findings in both groups. Conclusion: In resource-limited settings, the RAT is considered an alternative screening tool for COVID-19. Initial laboratory and radiological investigations may aid clinicians in effective management of such patients.
Analyzing the quality of multiple-choice questions in microbiology for second-year MBBS students
(Wolters Kluwer – Medknow, 2024-12) Singh, Gurjeet; Singh, Raksha; Ananthakrishnan, Nilakantan
Background and Objective: According to the 2023 Graduate Medical Education Regulations by the National Medical Commission for competency-based medical education in the MBBS curriculum, 20% of assessment questions are now multiple-choice questions (MCQs) in formative and summative evaluations. This study aims to evaluate the quality of MCQs in microbiology assessment for second-year MBBS students and compare different methods for calculating the difficulty index, discrimination index (DI), and distractor effectiveness (DE) of the items. Materials and Methods: This study analyzed 20 MCQs, including 20 correct answers (keys) and 60 distractors, from an internal microbiology assessment of 150 students. The items were evaluated for difficulty index (DIF I), Discrimination Index (DI), and Distractor Effectiveness (DE) using three methods: (1) entire group analysis, (2) grouping by the upper third and lower third of students (50 in each), and (3) selecting the top and bottom 27% of students. Results: The difficulty index was calculated using the whole group, upper-third vs. lower-third, and top vs. bottom 27%. Results indicated that the whole group and upper-third/lower-third methods provided similar accuracy, while the top vs. bottom 27% selection method tended to underestimate difficulty levels. The DI, useful for distinguishing between high and low performers, was best calculated using the top and bottom 27% of students, as whole-group analysis was found irrelevant. Two methods were used to measure DE: whole-group and upper-third/lower-third. However, neither approach showed statistically significant differences (P < 0.05). Conclusion: This study highlights the importance of selecting quality MCQs with moderate difficulty, high discriminative power, and effective distractors to accurately differentiate student performance. Findings suggest that using the top and bottom 27% group is more effective than using the upper-third/lower-third group for analysis of the items.
Anesthetic Management of a Patient with Dilated Cardiomyopathy for Inguinal Hernia Repair.
(2016-07) Kulkarni, Sanhita; Ferwani, Geeta; Bahekar, Anushree
Anesthetic management of a patient with dilated cardiomyopathy (DCM) undergoing noncardiac surgery poses a challenge to the anesthesiologist as there is risk of precipitating congestive heart failure or malignant arrhythmias. The anesthesiologist must have the knowledge of its pathophysiology, clinical presentation, diagnostic evaluations, and more so regarding various drugs used during anesthesia. We report a case of DCM with severe left ventricular (LV) dysfunction posted for right inguinal hernia repair managed successfully with epidural anesthesia using ropivacaine.
Anesthetic Management of Atonic Postpartum Hemorrhage with Hemorrhagic Shock and Impending Cardiac Arrest for Emergency Peripartum Hysterectomy.
(2016-04) Shewale, Hemesh; Wadke, Swetali; D’souza, Olvyna; Kaur, Sugam Preet
Postpartum hemorrhagic complication is a critical situation for an anesthesiologist. This situation requires timely and skilful anesthetic management. A massive postpartum bleeding leading to severe hypovolemic shock may result in life-threatening cardiopulmonary arrest. The treatment of postpartum hemorrhage (PPH) has two components: First, resuscitation and control of bleeding and second, identification and management of underlying cause. Here is a case report of a 20-year-old with atonic PPH resulting in hypovolemic shock and impending cardiac arrest and successful anesthetic management for emergency peripartum hysterectomy to save the life of the patient.
Anterior Circulation Stroke Following Snakebite: A Rare Presentation.
(2014-07) Sebastine, Ciji; Athale, Neha; Ghanekar, Jaishree; Hegde, Sainath
India is estimated to have the highest snakebite mortality in the world. Most fatalities are due to delay in getting the defnitive treat ment. Most snakebites are inficted on the lower limbs of farmers, plantation workers, herdsmen, and hunters in rural areas. The viper is one of India’s most commonly encoun tered poisonous snakes and envenomation following viper bite usually leads to consumption coagulopathy. Clinical characteristics include cellulites, renal failure, hemorrhagic manifestations including pituitary and intracranial hemorrhage. In the setting of viper envenomation, large-vessel thrombosis is a very rare occurrence. Also, bilateral anterior cerebral artery infarction, when unrelated to anatomical abnormalities, surgery or trauma, itself is an exceedingly rare event. The following case is an unusual one of bilateral cerebral infarction in ACA territory in an otherwise healthy individual.
Anthropometric Profile in Relation to Playing Position of Elite Indian Soccer Players.
(2015-10) Singh, Amrinder; Nigam, Arvind Deepchand; Shenoy, Shweta; Sharma, Rakesh; Sandhu, Jaspal Singh
Background: Previous literature has demonstrated that each specialized playing position may have unique physical and physiological requirements. Body fat is highly related to playing position of football players. Purpose: The purpose of the study was to examine differences among positions in body size and percent body fat of elite football players prior to the start of regular season. Subjects: The subjects of this study were 34 (10 forwards, 10 midfielders, 10 defenders, 4 goalkeepers) normal, healthy elite football players without any orthopedic, respiratory or cardiovascular problems. Methods: Anthropometric profiles of the subjects were determined by measuring height, weight, body mass index (BMI) and percent body fat. The prediction formula used to calculate percent body fat using BMI was: body fat % = (1.20 × BMI) + (0.23 × age) - (10.8 × gender) - 5.4 (R2 0.79, standard error estimate = 4.1% BF%), taking age and gender (male = 1, female = 0) into account. Results: The results demonstrated significant differences (p < 0.005) in the percent body fat among the players of different playing positions. Goalkeepers possessed highest values for body fat percentage followed by defenders and forwards while midfielders had the least body fat percentage. Conclusion: The study suggests that anthropometric characteristics differ in players of different playing positions. The differences found despite similar training protocol might be due to the physiological adaptations in the players.
Antithrombotic Therapy in Patients Postcardiac Interventions.
(2014-01) Saha, Kamales Kumar; Kaul, S K
Many primary care doctors need to know exactly how to manage antithrombotic medication of patients who have earlier undergone a cardiac intervention or surgery, if they come for a noncardiac problem. This article addresses this important issue.
Aortic Stenosis in Elderly—A Clinical and Two-dimensional Echocardiogram Correlated Study.
(2015-10) Thanedar, Rohan; Joshi, Swapnil; Biswas, Tushar Kanti
Introduction: Aortic valve stenosis (AS) is a common disease in elderly. The prevalence of severe AS in the general population is 2% in 72 years and increases to 8% in 85 years old. With the aging of the population, these patients will be seen more and more in clinical practice. Several clinical factors have been found to be associated with the presence and the progression of the stenosis. Aims: To study clinical and echocardiography (ECG) profile of aortic stenosis in elderly. To evaluate etiologies of aortic stenosis in elderly. To study comorbidities in association with aortic stenosis in elderly. Method: Randomized prospective study of 100 patients. Conclusion: Though increasing age is likely to increase the degenerative changes, elderly patients of 61 to 71 years are the commonest group with aortic stenosis (symptomatic as well as asymptomatic) in the present study. Male sex is more associated with aortic sclerosis and stenosis. There are significant correlation of past smoking, and present smoking in development of aortic sclerosis and stenosis. Hypertension, coronary artery disease, diabetes mellitus are common comorbidities associated with aortic sclerosis and stenosis.
Arrays to detect Erring Factors of Endometrial Origin in Endometriosis.
(2015-01) Bhusane, Kashmira; Gajbhiye, Rahul; Chaudhari, Uddhav; Sachdeva, Geetanjali
Endometriosis is an estrogen-regulated chronic inflammatory disease, characterized by the presence and growth of endometrium-like tissue in extrauterine locations. Its prevalence is 6 to 10% of women in the general population, and 35 to 40% of women with pain and/or infertility. Endometriosis is manifested in different forms, of which peritoneal endometriosis, rectovaginal endometriosis and ovarian endometriosis are most common. Several investigations have been conducted to investigate the genetic basis of endometriosis. However, these studies have been unsuccessful in identifying robust genetic variants associated with endometriosis. On the contrary, the advent of whole genome cDNA microarray approach has allowed for the identification of genes that display modulation in their expression in an endometriotic tissue. Several biological pathways involved in the pathogenesis of endometriosis have been identified. This review article compiles the inferences drawn from high throughput investigations of endometriotic tissue.
Assessing the Gap in Policies of Human Resources, Quality and Communication for Indian Teaching Hospitals.
(2015-01) Mishra, Archana; Doke, Prakash P
Introduction: Teaching hospital is one of the apex bodies of Indian hospital system, which is catering to much desired healthcare needs of both rural and poor urban society. Objectives: The study examines the status of Indian teaching hospitals both government and private in the changing global scenario by assessing the gaps in their management practices based on three core parameters, i.e. human resource management, quality improvement and patient safety, and communication and patient relation through their adherence to documentation and policy with respect to the expected norms nationally and internationally. The standards were chosen from Joint Commission of International Accreditation (JCIA) in concurrence with National Accreditation Board for Hospitals and Healthcare Providers (NABH) to ensure comprehensiveness and appropriateness to Indian environment. Design and settings: Eleven teaching hospitals were selected from the 6 divisions of Maharashtra (minimum 1 from smaller division and 2 or above from larger division). The medical superintendent was interviewed from each 11 hospital. The responses were given scores, such as 10, 5, 0 (full, partial, no compliance). Results: The overall scores for policy/documentation were 6.29 ± 1.96, 5.00 ± 3.06 and 2.95 ± 2.48 for HRM, quality and communication respectively, among teaching hospitals. Moreover, there were significant gaps among all 6 standards of human resource management (HRM) [F(5,60) = 24.217, p < 0.001], quality/ safety [F(5,60) = 21.524, p < 0.05] and communication [F(10,55) = 10.455; p < 0.05] on their own. Indeed, these hospitals were found to be significantly behind the global standards. Conclusion: Teaching hospitals comply with norms of staff, qualifications and department-wise infrastructure as part of Medical Council of India (MCI) regulations, which is prerequisite for global standards. So by designing hospital’s policies with inclusion of some cost-effective approaches, these hospitals can attain quality services.
Assessment of anti-inflammatory activity of Tridax procumbens in wistar rats
(Wolters Kluwer – Medknow, 2022-10) Prakash, Sandeep; Suman, Rajesh Kumar; Chandra, Gulab; Yadav, Priti; Kumar, Manish
Background: Tridax procumbens Linn. is a spreading herb found throughout India. Tridax procumbens is known for several potential therapeutic effects like antiviral, antioxidant, anti-infective, wound healing, insecticidal and anti- inflammatory, hepatoprotective, and antidiabetic. Novel therapies for inflammation are essential to overcome the adverse effects of existing anti-inflammatory drugs. Thus, this study was designed to evaluate anti-inflammatory activity in the experimental animal. Objective: To evaluate anti-inflammatory efficacy in experimental animal Materials and Methods: Tridax procumbens plant leaves were taken for the study. The Plant extraction was prepared by using the Soxhlet apparatus. The ethanolic extract was used as a test drug. Indomethacin and Dexamethasone were used as control drugs. Wistar rats weighing 150g to -200g were used in the study. Results: At dosages of 200 and 400 mg kg-1 , the ethanolic leaf extracts of Tridax Procumbens demonstrated substantial anti-inflammatory activity against Irish Moss-triggered inflammation. After 3 hours, 400 mgkg-1 showed a significant reduction in inflammation (48 percent), with the impact increasing after 3 hours (52 percent). The anti-inflammatory efficacy of Tridax Procumbens ethanol (EtOH) extracts was substantial and comparable to that of indomethacin (10 mg/kg). Tridax procumbens ‘s Ethanol (EtOH) leaf extract at a dose of 200 and 400 mgkg-1 , demonstrated considerable anti-inflammatory action. The average weight of granulomatous surrounding tissue in the threading was considerably smaller in the Tridax procumbens extraction group after 7 days than in the comparison group. The 400 mg kg-1 dose was shown to be the most effective of the two. the greatest reduction in the production of granuloma tissue. Tridax procumbens at doses of 200 mg/kg and 400 mg/kg resulted in substantial reductions in granuloma weights of 38.16 ± 0.04 (7.4 percent inhibition) and 34.58 ± 0.04 (16.1 percent inhibition), respectively. The lower dose of 400 mg/kg resulted in a little lesser reduction in granumola weight than the conventional medication dexamethasone (28.92 ± 0.04). (29.8 percent inhibition). Conclusion: The present study concludes that Tridax Procumbens possess anti-inflammatory effects in animal models.
An Assessment of Computer Literacy among Students of a Private Medical College in Navi Mumbai.
(2014-10) Waingankar, Prasad; Anjenaya, Seema; Taralekar, Radha; Thatkar, Pandurang
Background: Due to the diverse background of medical students in India and the different levels of knowledge and usage of computer, a prior assessment is necessary for improving use of computers in training tomorrow’s health professionals. Objectives: To assess computer literacy and computer use among medical students of a private medical institution. Methodology: In a cross-sectional study conducted in 2012, students of MBBS course participated. A prestructured questionnaire in paper format collecting detail information about background, resources and a computer use scoring system based on frequency of use of computer applications was administered. Measures of central tendency and dispersion were used along with analysis of variance (ANOVA) to analyze the data with the help of Epi Info and statistical package for social sciences (SPSS) Results: A total of 524 students were surveyed of which 375 (71.5%) were local, from Mumbai, while 149 (28.5%) were from different states of India. Total 425 (81%) students gave history of having computer as a subject during schooling. Out of 149 nonlocal students, 42 (28.2%) were not exposed to computer during schooling. All 524 students had some or other time used either desktop or laptop; however, 39 (7.5%) of were not confident of using basic computer applications. One hundred and eighty-seven (35.7%) students regularly visited cyber café while 135 (25.8%) students were found visiting e-library of the college. There was significant difference in computer usage score in the students who had computer as a subject during schooling (p < 0.001). There was no significant gender or age difference in computer usage. Also, there was no significant difference in usage among students from Mumbai and rest of country. Conclusion: In view of improving the skills of future health professionals, the use of computers should be an integral part of medical curriculum in India. The database handling, an important skill for tomorrow’s health professionals, needs special attention. The medical colleges in India should have e-libraries with easy access to students.
Assessment of glycated hemoglobin levels in non-diabetic subjects with recently diagnosed hypo and hyperthyroidism
(Wolters Kluwer – Medknow, 2022-07) Narayanan, Sujesh K.; Pillai, Renjith G.
Background: Thyroid disorders are highly prevalent in the general population and generally manifest as hypothyroidism or hyperthyroidism. Glycated hemoglobin (HbA1c) is commonly used for the assessment of the long-term glycemic status of diabetic patients. But the HbA1c concentration not only depends on prime glycemia but some other factors. Aims and Objectives: The objective of this study was to measure glycated hemoglobin and thyroid hormone levels and aimed to determine the effects of hypo and hyperthyroidism on glycated hemoglobin in non-diabetic patients. Materials and Methods: This case-control study was conducted on 70 euglycemic individuals each newly diagnosed with hypo and hyperthyroidism. Seventy age and gender-matched controls were recruited. Baseline HbA1c was estimated by high-performance liquid chromatography (HPLC) and thyroid status was measured by chemiluminescent immunoassay (CLIA) method in all cases and controls and then compared. Results: HbA1c values were found to be significantly higher in the hypothyroid group (P < 0.001), whereby its values in hyperthyroid subjects showed no significant difference from controls (P = 0.17). A positive correlation (r=0.67) exists between the levels of thyroid-stimulating hormone (TSH) and HbA1c in hypothyroid patients, but no significant correlation (r= -0.07) was observed for hyperthyroid subjects. Conclusion: HbA1c may not be a reliable indicator of glycemic status in patients with hypothyroidism, and so HbA1c results should be interpreted with caution in such patients.
Assessment of hemodialysis stressors among patients undergoing maintenance hemodialysis
(Wolters Kluwer – Medknow, 2024-12) Michael, Dhanya; John, Molly; Samuel, Usha; Lakshmi, G.
Background: Hemodialysis patients often face considerable physical and psychosocial stressors, which can negatively impact their quality of life. This study aims to assess these stressors among hemodialysis patients in selected hospitals in Kerala, India. Materials and Methods: A cross-sectional, quantitative study was conducted with 222 hemodialysis patients. Participants were chosen through purposive sampling based on predefined inclusion criteria. Data were collected using self-reported methods, employing the validated Hemodialysis Stressor Scale to evaluate 32 physical and psychosocial stressors. Descriptive statistics were used to summarize demographic data and stressor scores, whereas correlation analysis was conducted to identify relationships between variables. Results: The most frequently reported physical stressors were arterial and venous punctures [mean (M) = 1.4, standard deviation (SD) = 1.1] and muscle cramps (M = 0.97, SD = 0.72). For psychosocial stressors, fluid restrictions (65.3%, M = 2.49, SD = 0.80) and dietary limitations (54.1%, M = 2.21, SD = 1.00) were the most prominent. Correlation analysis showed a moderate association between age and both physical and psychosocial stressors, with older patients experiencing higher levels of stress. Conclusion: The study highlights that fluid and dietary restrictions are hemodialysis patients’ most significant psychosocial stressors, whereas arterial and venous punctures are key physical challenges. These findings underscore the importance of developing interventions to reduce these stressors and improve patients’ quality of life.
Assessment of Impact of Environmental Causative Factors on Severity of Asthma in Children.
(2014-10) Karki, Sharad; Suman, Rajesh Kumar; Mohanty, Ipseeta Ray; Mohanty, N C; Deshmukh, Y A
Objective: The present study evaluated the association between environmental factors and severity of asthma in children. Materials and methods: Questionnaires were specifically designed factoring patients’ demographical profile, socioeconomic status, causative environmental factors and severity of asthma. Results: A total of 100 patients were interviewed who visited our pediatric department complaining of asthma symptoms. Maximum children were of the age group between 6 and 10 years (29%). The ratio of male (64%) was more than female (36%). Maximum patients belong to middle class family (33%) and lower middle class (29%). Among children cold/respiratory illness (87%) followed by exercise and sports (70%) was the most common environmental trigger for asthma. Asthma symptoms worsened during day time and winter season in this group. Conclusion: A significant positive association between environmental asthma triggers: smoke (p = 0.035), strong smell (p = 0.008), cold/respiratory illness (p = 0.035), hot/cold air (p = 0.03) and severity of asthma in children was observed. Winter season worsened the asthma symptoms (p = 0.047) in children.

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