International Journal of Medical Research Professionals
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Editor-in-Chief: Dr. Rohin Garg
ISSN: 2454-6356 (Print); 2454-6364 (Online)
Frequency: Bimonthly
Language: English
Open Access Peer-reviewed journal
Web site: https://ijmrp.com/Default.aspx
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Item Effect of Albendazole Therapy in Parenchymal Neurocysticercosis Lesion Resolution, Lesion Load Reduction and Lesion Stage Evolution Observed on Serial Neuroimaging in Patients Presenting with Seizures(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-04) Mahajan, Arun; Singh, Harjinder; Gupta, Saryu; Kaur, Baljinder; Amandeep; Rai, Kulwant; Sandhu, Harinder Singh; Kaur, Kulwinder; Devina; Gupta, Sana; Kaur, ManvirNeurocysticercosis (NCC) is the commonest parasitic disease of nervous system in humans and single most common cause of acquired seizures in developing countries. In this study, we intended to evaluate the effect of Albendazole therapy in Parenchymal Neurocysticercosis lesion resolution, lesion load reduction and lesion stage evolution observed on serial neuroimaging in patients presenting with seizures. Albendazole was given for 1 month. Patients were followed up and neuroimaging was carried out after a 6-month interval. Temporal changes in lesion profile including lesion load reduction, lesion resolution, lesion stage evolution and seizure recurrences during the interval period were observed. After Albendazole therapy for 6 months, patients were followed up with serial neuroimaging. Lesion resolution was seen in 29.33%, lesion load reduction in 41.33% and calcified lesions in 52% cases.Item Evaluation of Mannose Binding Lectin Levels in Hypertensive Patients of Tertiary Care Teaching Hospital in Central India(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-04) Khare, Ruchi; Nigoskar, ShreyaBackground: The present study was conducted for evaluating Mannose Binding Lectin levels in hypertensive patients. Materials & Methods: The study included 100 hypertension cases and 100 controls who met the inclusion requirements. All subjects had 5 mL of blood drawn into serum tubes after an overnight fast. After letting the blood clot for 15 minutes at 3000 RPM, the serum was centrifuged out. For the mannose binding lectin test, 0.5 mL of serum had to be stored at - 20°C. ELISA technique was used for evaluating the serum mannose binding lectin levels. All the results were recorded on a Microsoft excel sheet followed by statistical analysis using SPSS software. Results: The mean Mannose Binding Lectin (MBL) in Cases was more (912.56 ± 43.51) as compared to Controls (612.18 ± 21.43) shows statistically significant. (By Un-paired T test; p>0.05). The above table shows the association of type (NYHA) of hypertension and MBL among cases. The mean MBL in Stage II was more (968.39 ± 46.41) as compared to Stage I (856.13 ± 40.56) shows statistically significant. (By Un- paired T test; p>0.05) Conclusion: The present study concludes that, high MBL levels are associated with an increased risk of coronary artery disease and are high in the serum prior to the development of hypertensive symptoms.Item A Study to Assess the Effects of Epidural Analgesia and Parenteral Analgesia on Maternal and Neonatal Outcomes Among Parturients Experiencing Slow Progression of Labour: A Comparative Study(Ibn Sina Academy of Medieval Medicine & Sciences, 2024-06) Rajak, Brijmohan Kumar; Rajak, Indra Jeet Kumar; Pandit, Raj Kishor; Singh, Ruby; Mandal, Abhay; Pajiyar, Ajay KumarIntroduction: Epidural analgesia however has been shown to be associated with maternal side effects like hypotension, hyperthermia and prolonged labour which are likely to have adverse effects on the fetal outcome, thus discouraging its use in clinical practice. Neonatal/fetal effect should be one of the most important determinants for choosing ideal analgesia. As there is no study which specifically has looked into the effects of labour analgesia on neonatal outcomes on augmentation of labour, it would be prudent to measure the impact of epidural analgesia in parturients requiring augmentation of labour and its effects on maternal and neonatal outcomes. Materials and Methods: The present study was carried among 60 labouring women with partographic evidence of slow progress of labour requiring augmentation in active phase of labour. The enrolled women were randomly allocated into group 1 in which epidural analgesia was established according to guidelines of department of Anesthesia and intensive care, PGIMER. Patients in group 2 received IM tramadol hydrochloride 1 mg/kg (with max. dose 400 mg / 24 hours) every 4 hours. All the women were monitored for 24 to 48 hours postpartum period for complication like hypotension, motor weakness, urinary retention, sedation, nausea or vomiting, allergy fever. The neonates were followed up till discharge from hospital. Results: Most common maternal complication in epidural group was numbness and in tramadol group was vomiting. All most all (93%) of women in epidural group were satisfied with type of analgesia and more than 77% of women reported it to be excellent. In tramadol group only 41% reported analgesia as fair and good but rest of them were dissatisfied with type of analgesia (p-0.001). Ninety three percent of women in epidural group desired to use it again in next pregnancy as compared to 20% in tramadol group. Urinary retention needing catheterization was similar in both groups. Most of neonates in both the groups had established breast feeding with in 12hrs. There was no difference between the groups in the incidence of neonatal jaundice requiring phototherapy. No neonates in either group required NICU or nursery care. Conclusion: To conclude, our study results suggest epidural analgesia might have edge over narcotic analgesics in dystocia. Neonates are more likely to get benefit. However epidural analgesia might increase second stage complications and vigilant care whenever mother on epidural analgesia is mandatory.Item Calcium and Phosphorus Metabolism in Patients with Congestive Heart Failure: A Cross-Sectional Study(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-04) Chander, Vikas; RPS, Sibia; Makkar, Gurjeen Kaur; Singh, Manjinder; Garg, Parteek; Dua, Jasmeen KaurBackground: To study the role of calcium and phosphorus metabolism including the hormones (Vitamin D and PTH) controlling them in patients with congestive heart failure. While extensive studies are available regarding bone mineral metabolism in CKD patient with regard to CVD / HF similar studies in non-CKD patients are sparce, hence the present study. Methods: A cross sectional study was done on a total of 50 patients with signs, symptoms and Echocardiographic findings suggestive of heart failure admitted in medicine wards of Government Medical College Patiala. Patients with type 2 diabetes mellitus, chronic renal disease, thyroid disease and pregnant/lactating mothers were excluded from the study. Serum calcium, phosphorus, Vitamin D and parathyroid hormone were estimated in all patients. Results: The study population consisted of 54% males, 46% females. Mean age was 61.78 +/- 9.18 years. Majority of the patients had cardiac ejection fraction in the range of 22-28%. CAD and HT were present in 58% and 66% patients respectively. Mean values for Vitamin D levels were 19.5 ng/ml. While in patients with normal ejection fraction Vitamin D levels was 29.34ng/ml, it progressively decreased with decreasing ejection fraction, patients with ejection fraction of <20% had Vitamin D levels of 8.98 ng/ml. Similarly mean value of PTH was 89.07 pg/ml and progressively increased with decreasing ejection fraction. Maximum valve of 138.27 pg/ml was found in patients with ejection fraction of <20%. Serum phosphorus value progressively increased with decreasing ejection fraction. Similar trends were found for serum calcium levels also. Conclusion: There is an association between congestive heart failure and calcium and phosphorus metabolism (along with their controlling hormones Vitamin D and parathyroid hormones). Rising levels of phosphorus and PTH and decreasing levels of Vitamin D are directly related with progressive heart failure.Item A Cohort Follow-Up Study to Determine the Occurrence of Diarrhea in Post Laparoscopic Cholecystectomy Patients(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-04) B, Ravi Shankar; D., Prasad Babu T.L.V.; V., Monisri; V., SaiSujay; E., Madhusudhan; B., Vamsi KrishnaIntroduction: Laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic gallstones. Despite notable benefits of cholecystectomy in treating gallstone related disease, the postoperative course may be affected by persistent or even new symptoms, including new onset diarrhea. Data on the effect of cholecystectomy on bowel function is sparse. The aim of this study is to determine the incidence of postcholecystectomy diarrhea (PCD) and to identify management patterns. Methods: In 253 consecutive patients who underwent laparoscopic cholecystectomy, data was obtained from clinicalrecords and telephonic survey 3 months postoperatively using standardized questionnaires. Out of 253 subjects 248 patients were telephonicall responsive and 5 patients were lost to follow up. Results: Among 248 patients 25 patients had diarrhea (12 mild, 10 moderate, 3 severe) and it was more common in men. The prevalence of diarrhea in post laparoscopic cholecystectomy patients is 10%. Twelve patients got relieved from constipationafter LC. Treatment of diarrhea was empirical and included antimotility agents plus probiotics, antimicrobial agents plus probiotics. Conclusion: Investigation for bile acid diarrhea was proposed for severe symptoms. The relationship between cholecystectomy and PCD is an undeniable fact with 10% ofpatients reporting trouble-some new onset diarrhea.Item Impact of Flipped Classroom Model for Teaching Anatomy to Dental Undergraduates(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-04) Gupta, Simran; Kumar, Keerthy Ajay; Ghaus, FarahObjective: The flipped classroom was developed in an effort to more effectively utilize the available teaching-learning time and to better serve the needs of students by encouraging active participation. It evokes students to access study material that can be utilized by them as and when the need arises. The purpose of this study was to evaluate the efficacy of flipped classroom activities as a teaching-learning strategy. Methods: The study was conducted among dental undergraduate students of Anatomy at Jawaharlal Nehru Medical College Aligarh after taking informed consent. The students were divided into 2 groups of 17 students each during the lecture. Both groups were provided a related short video and ppt of the topic, one before the lecture and the other after the lecture. Pre-test and post-test were given to both groups. The students and teachers were then asked to provide feedback regarding this approach and the continuation of it for future classes. Results: Sixty-seven percent of students strongly agreed that flipped classes are more engaging than traditional classes. Seventy-one percent strongly agreed that more such classes should be conducted in the future. The mean ± standard deviation of the pre-test was 3.68 ± 1.43 and the post-test was 6.43±1.02. This difference was found to be statistically significant (t=12.67 and p=0.00). Conclusion: The students’ and teachers’ feedback were largely positive and suggested for the continuation of these classes in the future also.Item Cardiometabolic Risk Factors in Relation to Serum NT-Pro-BNP level: A Cross-Sectional Study Among CKD Patients(Ibn Sina Academy of Medieval Medicine & Sciences, 2024-06) Ripa, Rokhsana Alam; Islam, ShafiqulIntroduction: CKD patients suffer from increased rate of mortality and morbidity due to cardiovascular diseases, compared to general population. Cardiometabolic biomarker N- Terminal Pro-BNP has become a useful tool for quick screening and assessment for cardiovascular diseases. The aim of the present study is to find out the relationship between serum NT-Pro-BNP level and cardiometabolic risk factors among CKD patients without symptoms or history of cardiac diseases. Materials & Methods: This cross-sectional study among 149 CKD patients was conducted from January to December 2020 at National Institute of Kidney Diseases and Urology (NIKDU), Dhaka. Anticoagulant free venous blood samples were assayed for serum NT-Pro-BNP by electrochemiluminescence immunoassay. Serum creatinine, total cholesterol, triglyceride, high-density lipoprotein, calcium, phosphate, uric acid, eGFR, albumin and total protein of the study population were assessed and recorded during data collection. Results: Mean age of study population was 50.0 ± 12.4 years, male predominant (53%). Mean serum NT-Pro-BNP level was lowest (335.7 ± 213.3 pg/ml) for patients with CKD stage 1 and highest (15644.6 ± 2197.5 pg/ml) for patients with CKD stage 5. Mean serum creatinine was lowest (1.55 ± 1.54 mg/dl) for CKD stage 1 patients and highest (5.71 ± 2.75 mg/dl) for CKD stage 5 patients and this was statistically significant (p < 0.05). Mean serum total cholesterol, triglyceride, phosphate and uric acid were increased with disease severity and this increase was statistically significant (p < 0.05). Mean eGFR, serum albumin and total protein were decreasing with disease severity, and this decrease was also statistically significant (p < 0.05). Serum NT-Pro-BNP had significant positive correlation (r = 0.61, p < 0.05) with serum creatinine and significant negative correlation with total cholesterol, triglycerides, serum phosphorus, serum uric acid, eGFR and serum albumin. Conclusion: Serum NT-Pro-BNP could be the potential screening tool for CKD with cardiovascular diseases and can provide prognostic information of major cardiovascular events.Item Does HCV Seropositivity Affect Short Term Postoperative Clinical Outcome In Intertrochanteric Fracture Femur? A Retrospective Study at a Tertiary Care Center(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-02) Dahuja, Anshul; Khatri, Kavin; Kaur, Rashmeet; Kaur, Haramritpal; Singh, Jagdeep; Garg, NitishBackground: The influence of hepatitis C virus (HCV) infection on outcome of hip fracture surgery has never been studied in the past despite increasing incidence of infection as well as osteoporotic hip fractures. The purpose of our study was to evaluate the correlation between hepatitis C and perioperative outcomes of intertrochanteric fractures in elderly. Method: This was a retrospective study carried out in a tertiary care center where five years data of peri and postoperative outcome of intertrochanteric fracture HCV +ve and matched control in a ratio of 1:2 were studied. The medical and surgical complications of the two groups along with the clinicoradiological outcome were evaluated using t test, odds ratio and confidence intervals (p<.05). Results: Amount of blood loss during surgery and consequently blood transfusion was significantly higher in HCV+ve grou (255ml:185ml and 19:9 units respectively). Duration of hospital stay was 33% higher in the seropositive group. Persistent oozing and superficial site infection were 5 and 2 fold higher than control group. Initial Harris Hip Score was significantly better in control group (74.9:67.1) whereas at 9 months the difference was insignificant (81.2:79.2). Clinical milestones like weight bearing and walking on stairs were achieved earlier in control group and time of fracture union was convincingly earlier in the control group (5.5:7.2 months). Conclusion: This is one of the initial study showingintraoperative and postoperative complications are higher in HCV seropositive patients with intertrochanteric fractures along with prolonged hospital stay, low HHS at 3 months and delayed union.Item Spirometric Analysis in Post-COVID Patients(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-04) Dua, Jasmeen Kaur; Sibia, RPS; Chander, Vikas; Gill, Harinder SinghBackground: The spread of COVID-19 has taken on pandemic proportions, affecting almost 50 million people and causing more than 1 million deaths worldwide. The COVID-19 pandemic has gained global attention owing to its rapid transmission despite extensive measures to contain it. The majority of patients developing COVID-19 pneumonia have bilateral lung involvement leading to respiratory failure or acute respiratory distress syndrome. As a new infectious disease- carrying risk of severe course and ICU admissions, it is particularly important to explore its sequelae. There has been extensive research on the acute course of disease but enough studies are not available about the long term fibrotic sequelae and its effect on quality of life. Hence the present study. Aims and Objectives: 1. To study pulmonary function impairment in post covid patients. 2. To correlate spirometry changes with the severity of SARS-COV2 infection. Methods: A prospective study was conducted in the Medicine department at Rajindra Hospital/ Govt Medical College Patiala involving patients recovered from COVID-19. The study group included all patients above 18 yrs of age who were diagnosed as COVID-positive. So 100 post-COVID patients admitted at Rajindra hospital/Govt Medical College Patiala were followed up after discharge to study the spirometric changes and risk of development of chronic lung disease. It was a prospective study where patients were analysed spirometrically at regular intervals. Results: Abnormal spirometry was present in 16% patients after 6 months of COVID infection, thus necessitating longer follow-up in all post covid patients. Among the patients with abnormal spirometry, the majority of patients were had severe COVID-19.Item Diagnostic Modality Accuracy in Suspected Appendicitis in Saudi Arabia: A Retrospective Study(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-06) Alsharef, Manar K.Introduction: Appendicitis is an acute condition that can occur at any age but is quite rare among individuals of extreme age. It is frequently common in teenagers and young adults. Conventional diagnosis was promptly made based on clinical scenario. In this study we aimed to compare the accuracy of CT versus US in diagnosis of acute appendicitis. Materials and Methodology: Our study was adopted to be conducted as an observational study using a retrospective cohort chart in a secondary hospital in Saudi Arabia. In this study, we have evaluated all files from 3005 patients, but only 220 had fulfilled our inclusion criteria. The various collected data included age, gender, clinical signs and diagnosis, symptoms and laboratory, histopathological and radiological findings which were collected by trained data collectors and reviewed by the primary study supervisors. Results: A total of 220 patients out of 3005 files merely met the inclusion criteria of the study and had their data collected as described in the methods (Table 1). The average age of the study participants was 26.2 ± 11.3 years with a range of 7–72 years. The majority of the participants were males at a proportion of about 65%. All participants were promptly diagnosed with appendicitis either clinically, histologically or both. When considering the treatment modalities, the majority of the participants underwent laparoscopic appendicectomy (63.7 %) followed by those who had open appendicectomy (30.5%). The remaining 6% underwent conservative management. Conclusion: It is reported that the common clinical features of acute appendicitis encountered in our practice and the reliability of ultrasonography and CT scans in the diagnosis of this acute condition. We have also reported that the diagnosis of acute appendicitis can still be based relatively on clinical assessment (symptoms and signs) in many experienced hands.Item To Compare the Ease of Intubation Through an I-gel Versus AMBU AuraGain: A Prospective Randomised Study(Ibn Sina Academy of Medieval Medicine & Sciences, 2024-04) Bindra, Tripat Kaur; Grewal, Tejinderpal Kaur; Soni, Sumit; Duvedi, Shuchi; GurlivleenBackground: Supraglottic Airway Devices (SAD) have become a fundamental part of difficult airway algorithms and are attaining popularity as airway management device during general anaesthesia. These devices can also be used as conduit for endotracheal intubation. The study aimed to evaluate the success and ease of I-gel and Ambu AuraGain (AAG) as conduit for endotracheal intubation. Methods: 100 patients (20-60 years) were registered in this prospective, randomized study. After induction, appropriate size Ambu AuraGain/ I-gel were inserted. After confirmation of proper placement of SAD, endotracheal tube was inserted. The number of successful blind intubations, time taken for intubation through either of the SADs, number of attempts taken for effective SAD placement, time to achieve effective ventilation after SAD placement, number of attempts taken for blind endotracheal intubation, number of cases in which fiberoptic scope is used, hemodynamics and complications were recorded. Data was analyzed using chi square test and Fisher Exact Test. Results: The overall success rate for SAD placement was 100% in both the groups however insertion time was significantly shorter with I-gel(17.58±1.31seconds) compared to Ambu AuraGain (21.34±1.65seconds) (p<0.001). Success rate for blind intubation through SAD was significantly higher in I-gel group (40% in AAG and 74% in I-gel, p=0.002). The use of fiberoptic scope for intubation was similar in both the groups (60% in AAG and 76.9% in I-gel, p=0.284). Overall intubation success for I-gel was 94% and AAG was 76% (p=0.011) and time taken for successful intubation through I-gel was significantly less as compared to Ambu AuraGain (p<0.001). Conclusion: I-gel is a better conduit for endotracheal intubation than Ambu AuraGain with higher success rate and less time required for endotracheal intubation.Item Understanding Mental Health App Use among Attendees of Primary Health Care in Taif, Saudi Arabia(Ibn Sina Academy of Medieval Medicine & Sciences, 2024-02) Alkhammash, Sawsan Safar; Osman, Mugtaba; Mubarak, Ali Safer; Alalmaee, Abrar Abdullah; Al Ghamdi, Nada Hamed; Aljeaid, Eidha; Al Bogami, Safar Abdullah; AlShehri, Dhaifallah Salem; AlShehri, Abdulrhman, Salem; Alnfaie, Raed Saad KhaderBackground: Mental health apps are increasingly available and accessible to the public. Global research indicated variable rates of use among people with main barriers identified are cost, privacy concerns, and difficulty of use. Little is known about prevalence and barriers of use of mental health apps in Saudi Arabia. Method: Descriptive questionnaire-based cross-sectional survey of a sample of Saudi adult population. We adopted a multiple logistic regression modelling of data to evaluate the impact of potential barriers and facilitators on use of mental health apps. Results: The survey included (n= 636) participants. The prevalence of use of mental health Apps was (n = 80, 12.6%), with only (n = 32, 40%) found them useful. Younger age, females, separated marital status, students, history of mental illness, taking psychiatric medications, attending psychiatric services, seeing a psychologist (offline and online), and chatting to psychiatric patients online were all associated with unadjusted increase in use of mental health Apps. However, the adjusted impact on use of mental health Apps was significant only for those using psychiatric medications (odds ratio ”OR” = 0.1289, p = 0.0243), individuals who requested online psychology intervention (OR = 7.9866, p < 0.00001), individuals who believed in costliness of mental health Apps (OR = 2.9358, p = 0.00034) or difficulty using them (OR = 4.1875, p = 0.0002). Stigma and privacy concerns were not statistically impactful on use of mental health Apps. Conclusion: Use of mental health Apps is very low among Saudi patients. Those who use mental health apps remain skeptical of their therapeutic values and report concerns in terms of difficulty to use them and their cost-effectiveness. Design of effective, readable, safe, and cheap mental health apps should be attempted by health educators and mental health professionals.Item Correlation of Socioeconomic Factors with Obesity and Overweight Among School Going Adolescent Population in Rural and Urban Area(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-08) Kaur, Amandeep; Kaur, KulwinderBackground: Globally, the increased prevalence of overweight and obesity among adolescents has led to increased morbidity and premature mortality in adults due to various metabolic diseases. As adolescents comprises approximately one fifth of the total Indian population, their health status and nutrition clearly depicts the working of the country towards health and burden of diseases in future. Objectives: The objective of the present study is to study the prevalence of obesity and overweight in adolescents and to correlate various socioeconomic factors with obesity and overweight in adolescent population in district Patiala, Punjab. Methods: A cross-sectional study was conducted among 600 school going adolescents (10-19 years) from 5th to 12th class of government and private schools in rural and urban area of district Patiala, Punjab. A self-designed, semi- structured questionnaire was used to assess the socio-demographic profile, socio-economic status, socio-environmental factors followed by anthropometric measurement of the children. Results: The overall prevalence of overweight and obesity was found to be 12.8% and 4.5% respectively. Prevalence of overweight and obesity was 5.8% and 3.3% among males and 7% and 1.1% among females. Higher prevalence of the disease was also seen in urban area, nuclear family upper socio-economic class and lower education status of parents. Conclusion: Overweight and obesity among adolescents have multifactorial causes and need holistic approach at the earliest for control and prevention.Item A Randomized Controlled Trial of Peer-mediated Intervention for ASD Children Using Siblings as Therapists(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-06) Taman, Rihab; AlSobie, Menahi; AlZahrani, Atteya; Azam, Walaa; Alhewiti, AeshaBackground: Peer-mediated interventions (PMI) promote social interactions and communication along with functional play skills among preschool children with autism spectrum disorder (ASD). However, ASD Siblings spend most of the day with siblings with autism than do their typically developing peers. Moreover, using typically developing siblings as therapists promotes maintenance practice opportunities in natural settings, family support, and encourages generalization of trained skills. Method: This study was conducted to evaluate the effectiveness of a PMI in ASD by comparing two groups of preschool children diagnosed with ASD and were admitted to our autism Centre, each group composed of fourteen children. PMI was applied to the first group during play therapy sessions for 9-months duration in our autism Centre, where their peer coaches were fourteen-typically-developing siblings of ASD children who received sessions of peer coach training and were encouraged to interact with the fourteen ASD children of the first group using the strategies they learned. Additionally, the PMI was between the ASD child and the sibling of another ASD child, not his sibling. The second group of ASD children received ordinary rehabilitation sessions in our autism Centre during the same period of time. A standardized measurement tool assessed the children of both groups before and after the intervention. Results: Results showed a functional and statistical significant relation between the peer-mediated intervention and the improvement of social interaction, communication and functional play which has been implicated by a statistical significant difference between the two groups of our study. Conclusions: This study contributes to and extends the existing PMI research by using siblings of ASD children with normal intellectual and social-communication abilities in a preschool stage.Item A Study to Determine the Maternal and Fetal Outcome After Single Loading Dose of Magnesium Sulphate for Eclampsia(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-06) Pandit, Rajkishor; Singh, Ruby; Rajak, Brijmohan KumarIntroduction: Eclamptic seizures are a medical emergency and can arise after 20 weeks of gestation, either antepartum, intrapartum, or postpartum. They require urgent intervention to prevent death in the mother and fetus. Magnesium sulphate is the anticonvulsant of choice in prevention and control of eclamptic convulsions. Therefore, the present study was undertaken to determine the maternal and fetal outcome after single loading dose of Magnesium sulphate in comparison to standard Pritchard’s regime for prophylaxis of eclampsia. Materials and Methods: The present cross-sectional hospital based comparative study was conducted among 60 pregnant women with severe pre-eclampsia either in labor or those requiring delivery admitted in the Department of Obstetrics and Gynaecology at Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu. Patients were categorized in two groups - one group A that received only loading dose of magnesium sulphate and other group B that received standard Pritchard's regime of magnesium sulphate. Primary outcome measured were maternal complications, fetal and neonatal outcome that consist of 5 min Apgar score and neonatal admission in baby unit. Data were collected and analysed by SPSS -20 software. Differences between categorical variables were analyzed using chi-square test and p value of <0.05 was considered significant. Results: The fetal outcome in terms of apgar scores 27 at 5 minutes of birth was better in loading dose group i.e., 21 cases (70.0%) versus 15 case (50.0%) in standard regime group but this was statistically not significant as p-value was 0.114. Among 30 cases in each loading dose and standard regime group, there were total 5 neonates (16.7%) in loading dose group and 8 neonates (26.7%) in standard regime got admitted in neonatology and this was statistically not significant as the p- value is 0.347. Conclusion: The results this study showed that the loading dose of magnesium sulphate is comparable to standard Prichard's regime for prophylaxis of eclampsia. This study also concludes that there is statistically no significant difference in maternal and fetal outcome between loading dose group and standard Pritchard's regime group.Item Association of Serum NT-Pro-BNP Level with Echocardiography Results Among CKD Patients: A Cross Section Study at NIKDU in Dhaka Bangladesh(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-08) Ripa, Rokhsana Alam; Islam, Shafiqul; Haque, Mohammad Farhadul; Kibria, Golam; Faysal, Amanur Rasul Md.; Chowdhury, Ayub AliBackground: Mortality of CKD patients remains high because of high prevalence of cardiovascular diseases among them. Identifying serum biomarkers that are useful in profiling cardiovascular risk is an important goal in the treatment of CKD patients. The aim of the present study is to assess the relationship between serum NT-Pro-BNP level as a biomarker and Echocardiography findings among CKD patients without symptoms or history of cardiac diseases. Method: This cross-sectional study among 149 CKD patients was conducted from January to December 2020 at National Institute of Kidney Diseases and Urology (NIKDU), Dhaka. Serum NT-Pro-BNP levels were measured for each study subject. All patients had a comprehensive M-mode, two- dimensional, and doppler echocardiogram. Association between serum NT-Pro-BNP levels and echocardiogram findings were assessed. Result: Mean age of study population was 50.0 ± 12.4 years, male predominant (53%). Mean serum NT-Pro-BNP level was lowest (335.7 ± 213.3 pg/ml) for patients with CKD stage 1, which significantly increased with the progression of CKD stages, reaching highest (15644.6 ± 2197.5 pg/ml) for patients with CKD stage 5. There was statistically significant (P < 0.05) reduction in LVEF with increasing severity of CKD and significant negative correlation (r = - 0.316, p < 0.001) between serum NT-Pro-BNP level and LVEF. Mean IVSTd and PWTd, both significantly (p < 0.05) increased with the progression of CKD stages. Significant positive correlation was seen between serum NT-Pro-BNP and IVSTd (r = 0.361, p < 0.001) and between serum NT-Pro-BNP and PWTd (r = 0.448, p < 0.001). Conclusion: NT-Pro-BNP has the potential to be used routinely as a screening tool for patients with CKD for cardiac structural and functional abnormalities.Item An Observational Cohort Study on Prescription Patterns of Intravenous Albumin Use in Different Indications of Liver Disease(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-02) B., Ravi Shankar; B., Lakshminikhila; G., Sailipi; Rampally, Vijay; E., Madhu SudhanIntroduction: Albumin is administered 20% as a part of treatment in various indications associated with decompensated liver disease. Methods: The study was conducted on patients over six months. Data were collected from 50 patients including males and females who are administered 20% albumin for liver cirrhosis. Disease severity before and after albumin infusion was calculated using prognostic tools like Child-Pugh and MELD-Na scoring system. Results: Among 50 patients, a major percent of patients were found to be HRS (28%) for albumin infusion and few extended indications were noticed; Decompensated liver cirrhosis without any other complications (18%), HE (18%), Hyponatremia (16%). After albumin infusion for six months, prognostic tools (CPT and MELD-Na scores) and laboratory parameters (serum creatinine, serum sodium, serum albumin) were significantly improved with P-value less than 0.05. Conclusion: Albumin usage has increased in some extended indications like decompensated liver cirrhosis without any other complications, hyponatremia, hepatic encephalopathy. Doses used in the present study were significantly less (when compared to standard doses as per the clinical guidelines) to minimize the adverse effects of albumin primarily pulmonary edema due to volume overload. Our study was consistent with the ANSWER trial where 20% albumin was used for the long term in decompensated liver cirrhosis.Item Prevalence of Obesity and Undernutrition Among Adolescents and Their Dietary Habits: A Cross Sectional Study in a Tertiary Care Centre(Ibn Sina Academy of Medieval Medicine & Sciences, 2023-06) Kaur, Amandeep; Kaur, Harshindar; Kaur, Avneet; Kaur, AmanpreetOriginal Research Article. 5 | P a g e Int J Med Res Prof.2023 May; 9(3); 5-10. www.ijmrp.com Prevalence of Obesity and Undernutrition Among Adolescents and Their Dietary Habits: A Cross Sectional Study in a Tertiary Care Centre Amandeep Kaur1, Harshindar Kaur2*, Avneet Kaur3, Amanpreet Kaur4 1Assistant Professor, 2Associate Professor, 3,4Post Graduate Student, Department of Pediatrics, Government Medical College, Patiala, Punjab, India. ABSTRACT Background: World Health Organization (WHO) defined adolescence as a period of life ranging from 10 to 19 years old which is the transition from dependent childhood to independent adulthood. According to the 2019–21 National Family Health Survey (NFHS-5), the prevalence of obesity among women and men increases. Overweight and obesity in younger age group lead to various non-communicable diseases in the future. The studies on adolescent dietary intake and prevalence of obesity are limited in north India, so the aim of this study was to check the prevalence of obesity among adolescents their dietary intake, type of food intake, impact of these dietary habits on prevalence of obesity and to predict the chance of metabolic syndrome among adolescents in tertiary care centre. Materials and Methods: It was a cross-sectional descriptive study design conducted on 1000 adolescent patients aged 10- 15 yrs of rural and urban area from OPD or IPD in Government Medical College, Patiala, Punjab from August 2022 to April 2023, total 9 months. The patients or their parents who gave consent and aged 10 to 15 years were included in this study. Adolescents with diagnosed cases of any chronic disease as congenital heart disease, chronic renal failure, chronic liver failure or any blood disorders and had physical deformities were excluded from this study. Results: Out of these 1000 patients, 530 patients were of normal weight, 260 were underweight. Overweight and obesity were seen in 110 and 100 patients respectively. 54.55% of overweight and 70% of obese patients belonged to upper middle class as compared to well-nourished patients among them 69.8% belonged to upper lower class (p value of 0.021). Cereal intake was 300 - 400 grams per day among 56.6% of well-nourished patients as compared to underweight (53.85%) overweight (63.64%) and obese patients (70%) consumed 200 -300 gram of cereals per day that was statistically significant (p value= 0.04). 40% of obese and 81.8% of overweight patients took junk food three times per week a s compared to 51% of normal weight patients did not consume junk food (p value of 0.001). Hypertension was seen in 60% of obese patients, 18.18% of overweight patients (p value of 0.001). Fatty Liver by ultrasonography was seen in 70% of obese, 54.5% of overweight as compared to only 13.2% of normal weight patients had fatty liver. (p value of 0.001). Conclusion: Our results reveal that the incidence of overweight and obesity is increasing among adolescents. Multiple factors are associated with adolescent obesity like sedentary lifestyle, working parents, improper diet, eating junk food and frequent restaurant visits. Our study observed the obese patients had deranged lipid profile, hypertension, increase liver enzymes and fatty liver on ultrasonography. So, all these factors are known for increasing risk of metabolic syndrome and other non-communicable diseases in future.Item Assessment of Maternal Consequences of Caesarean Section: A Retrospective Study(Ibn Sina Academy of Medieval Medicine & Sciences, 2020-01) Singh, Nisha; Ranjan, PiyushBackground: Rates of caesarean delivery continue to riseworldwide. Maternal preferences are an important influence ondecisions about mode of delivery. At present, evidence oflonger-term complications of caesarean delivery has not beenadequately synthesized to allow fully informed decisions aboutmode of delivery to be made. Hence; the present study wasundertaken for assessing maternal consequences ofcaesarean section.Materials & Methods: Data record of a total of 130 womenwas enrolled in the present study. These 130 women werebroadly divided into two study groups as follows: Group 1:Primary elective group (n=58), and Group 2: Failed vaginaldelivery (n=72). Complete demographic details of all thesubjects were obtained from the data record files. An excelchart was prepared and outcome and complications wererecorded systematically.Results: Overall, out of 130 females, complications were foundto be present in 18 women (13.85%). However; among patientsof Group 1, complications were found to be present in 5patients (8.62%) while among patients of Group 2,complications were found to be present in 13 patients(18.06%). On comparing statistically, overall prevalence ofcomplications was significantly higher among patients of group2. Uterine corpus was the most common maternal complicationwas found to be present in 2 patients of group 1 and 4 patientsof group 2.Conclusion: Emergency caesarean section is associated withsignificantly higher risk of maternal complications incomparison to elective caesarean procedures.Item A Rare Case Report on the Role of Anaesthetist in Management of Homicidal Cut Throat Injury(Ibn Sina Academy of Medieval Medicine & Sciences, 2020-03) Vats, Jyoti; Dhillon, Abhilasha; Yadav, PushpaHomicidal cut-throat injuries are potentially life threateningbecause of the many vital structures that course through thisarea. Management of homicidal cut-throat injuries requires amulti-disciplinary approach. The role of an anesthesiologist ininstituting an airway using an endotracheal intubation ortracheostomy before wound exploration and repair oftransected tissues, is challenging, as, such injuries are most ofthe time associated with distortion of the normal anatomy ofthe airway. Anaesthesiologist is pivotal in securing a definitiveairway in such cases thereby facilitating the wound explorationand surgical repair. We present a patient who was the victimof a homicidal cut-throat injury.