Indian Journal of Applied-Basic Medical Sciences

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https://imsear.searo.who.int/handle/123456789/134482

Editor: Dr Janardan V Bhatt

ISSN: 0975-8917

Frequency: Semi-annual

Language: English

Published By: Basic Medical Sciences Forum

Peer-reviewed open access journal indexed in Index Medicus

Website: https://www.themedicalacademy.in/

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A Clinico-histopathological Analysis and Bacillary Index in Skin Biopsy of Leprosy : A Study
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Shah, Devanshi; Ganatra, Ayushee; Tandon, Rakesh; Shah, Priyanshi
Introduction: Leprosy is one of the leading causes of physical disabilities contributing to intense social stigmata resulting in human discrimination. This chronic infectious disease caused by Mycobacterium leprae principally affects skin and peripheral nerve. It can also include muscle, eyes, bones, testis and internal organs. Histopathology study and bacillary index is important in understanding the disease progression, diagnosis, varied manifestation and complications. Method: All cases attending the Skin OPD were examined clinically and skin biopsy specimen was obtained from clinically diagnosed cases of Leprosy and stained with Hematoxylin & Eosin and modified Fite Faraco (AFB). The clinical diagnosis correlated with histopathology in all 100 cases. Results: The age of the patients was ranged from 4 to 80 years. The male to female ratio of patients was 3 to 1. Borderline Tuberculoid was the most common presentation. Highest parity was observed in BT and Histoid leprosy. Clinico-histopathological agreement was seen in 76 (76%) cases. Conclusion: The clinical and histopathological features along with bacteriological index are useful than any single parameter in arriving definitive diagnosis and classification of the leprosy
Study of Fetomaternal Outcome in Pregnancy With Eclampsia
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Prajapati, Dipika; Panchal, Nirali; Patel, Shlok V.; Patel, Rina V.; Vagela, Nikharbhai; Panchal, Vaishali P.
INTRODUCTION: - Eclampsia is defined as an acute and life threatening convulsive condition that arises due to preeclampsia. Typically, convulsions are tonic –clonic lasting for 1-2 mins and are not due to other causes. (e.g.- epilepsy, brain tumour). Global incidence of eclampsia is 1 in 1500 pregnancies whereas in India it is as high as 1-5% of all pregnancies. Poor availability to health resources, lack of transportation, lack of knowledge regarding the various risk factors and loss to follow up of high-risk pregnancies are the major hindering factors in the reduction of rate of eclampsia. OBJECTIVES: - This study is to estimate the proportion of eclampsia, evaluate the clinical presentation, assess management and study the various foetal and maternal outcomes in patients with eclampsia coming to our institute. METHOD: - This is a prospective observational study which was conducted at our tertiary care centre. Total 7500 births were recorded in a period of one year from February 2022to February 2023. The study population consists of patients who presented to the Department of Obstetrics and Gynaecology at our tertiary institute with features of eclampsia, RESULT: - Proportion of eclampsia in our study is 0.33%. Chances of eclampsia increase in nulliparous patients (80%) during our study period. Incidence is higher during antepartum period. In the present study, 72% patients were discharged without the requirement of intensive care, where as 20% patients need ICU stay. 34% babies required NICU admission. CONCLUSION: - In low- and middle-income countries, eclampsia is one of the leading causes of maternal and perinatal mortality. Counselling and proper antenatal care play a very important role in prevention of maternal and perinatal morbidity and mortality. Early detection of preeclampsia and timely treatment with antihypertensive drugs may help in reducing the incidence of antepartum eclampsia.
A Study of Ectopic Pregnancy at Tertiary Care Hospital
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Shihora, Kartavya Y.; Vaghasiya, Meera B.; Panchal, Vaishali P.
Introduction: The word ectopic is originated from a Greek word; ‘EKTOPOS’ meaning “out of the the place”. The term “Ectopic Gestation” is applied to pregnancy where fertilized ovum becomes implanted at the site other than endometrial lining of the normal uterine cavity. Ectopic pregnancy is the leading cause of maternal morbidity in first trimester. The incidence of ectopic pregnancy is approximately 1.5-2% worldwide. Increased use of the intrauterine devices for contraception and use of assisted reproductive technologies (ART) are responsible factors for the ectopic pregnancy. Due to advance in modern technology like diagnostic laparoscopy, radioimmunoassay of HCG and ultrasonography diagnosis has become less difficult. Material and methods: This prospective study of ectopic pregnancy was carried out at Obstetrics & Gynaecology department of our institute from November 2022 to September 2023.All diagnosed cases of ectopic pregnancy were enrolled in the study. Information was collected in a pretested proforma and analyzed. Result: In this study incidence of ectopic pregnancy is 2.4/1000 live births. Out of 25 patients, 72% patients were between the age group of 21-30 years. In our study nulligarvida (36%) were found to be more prone to have an ectopic pregnancy. Amenorrhea with lower abdominal pain (90%) is the most common presenting symptom. Tubal ectopic pregnancy (96%) was the commonest site of ectopic pregnancy. Conservative medical management was done in 1patients. Multi-dose methotrexate regimen was used inpatient and were treated successfully. Laparoscopic management was done in 16%of cases. Laparotomy was done in 80%of patients. Conclusion: It has been observed that ectopic pregnancy remains the most lethal and morbid gynaecological emergency in child bearing age. Early identification of underlying risk factors, diagnosis with the essential aids like trans vaginal ultrasound and beta hCG and timely intervention in the form of medical or surgical treatment will definitely help in reducing the morbidity and mortality associated with ectopic pregnancy & improve the future reproduction outcome.
Comparative Study of One Day Pre-operative Antibiotic Prophylaxis Versus Five Days Postoperative Antibiotic Coverage in Laparoscopic Cholecystectomy
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Mistry, Yashesh K.; Chandnani, Rajesh
INTRODUCTION: Antimicrobial agents were considered as magic bullets and effective tools to combat infection in various therapeutic settings. In conventional antibiotic use, antimicrobials are used for a predetermined period after therapeutic procedure to combat the infection because most often in public hospitals due to lack of maintenance of environmental hygiene & overload of surgical patients fear of SSI (surgical site infection) are more. AIMS AND OBJECTIVES: To study the wound infection rate and recognition and prevention of exogenous and endogenous sources of SSI in laparoscopic cholecystectomy, whether long term antibiotics should be given or antibiotics given at the maximum time of concentration are sufficient. MATERIALS AND METHODS: Study size and period: 50 cases, June 2023 to December 2023. Study conducted at SMIMER HOSPITAL, SURAT. Single dose of antibiotic, 1 gm ceftriaxone was administered one hour before surgery by IV route & 5 days’ course, 2 days IV and 3 days oral (cefixime). Study on patients with age group of 18-60 years both males & females with no co-morbid condition posted for laparoscopic cholecystectomy for gall bladder stones. Wound inspection done on 3rd, 5th, and 7th day. RESULTS: 1-day pre-operative antibiotic is almost as effective as to multiple dose antibiotics. Hence a single-day prophylaxis is recommended to reduce the financial burdens, the emergence of resistant strains and avoid the side effects of the drugs. However, it is of utmost importance that complete asepsis be maintained during the surgery and post-operative care, irrespective of the antibiotic prophylaxis, to achieve the most desired goal of elimination of post-operative infections, thus reducing the morbidity and mortality. CONCLUSION: Single dose antibiotic is sufficient in preventing wound infection and also so other factors like proper preoperative skin preparation, sterile surgical practice & operative theatre & good postoperative nursing care to be taken care of. Prolonged administration of antibiotics is unnecessary and costlier. Prolonged use of antibiotics is associated with emergence of resistant strains and super-infections, which can be prevented by cost-effective short term antibiotic prophylaxis
A Single Shot of Antibiotic in Laparoscopic Appendectomy
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-07) Ghantasala, Sai Deepu Jnana; Shah, Bhavin
Background: Acute appendicitis is one of the most common acute surgery events. Appendicitis must be considered in every patient who presents with acute abdominal pain. Its main treatment is surgery. However medical management before and after the surgery has an important impact on the treatment. Single or multiple-dose regimens of antibiotics may rely on the patient’s medical situation and the patient’s susceptibility to infection. The present study was therefore planned to evaluate the effectiveness and outcomes of the single dose of antibiotics in patients undergoing laparoscopic appendectomy. Aim of the study is whether a single dose of antibiotic in laparoscopic appendectomy is sufficient. Materials and Methods: The retrospective case study was conducted in Department of General Surgery, Dhiraj Hospital, SBKS, Vadodara, Gujarat, India from March 2023 -September 2023 among 50 patients scheduled for laparoscopic appendectomy. Results: Out of 50 patients, majority 80% were males and 20% were females. Most common symptom was right iliac fossa pain. Out of 50, 34 patients underwent planned laparoscopic appendectomy while 16 underwent emergency laparoscopic appendectomy. Out of 50 patients, 10 patients had SSI. In 10 patients with SSI, swab culture of the wound was done out of which 8 patients were negative and 2 patients were positive for infection. Only 10% of the patients had wound infection. Conclusion: For basic, uncomplicated acute appendicitis, single dose of prophylactic antibiotics will help in cases of laparoscopic appendectomy. There is no necessity for the post-operative administration of antibiotics.
Study of Clinical Profile of Patients With Atrial Fibrillation
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Rathod, Ajaykumar M; Makwana, Divyang; Patel, Ankitkumar A; Bamaniya, Gaytri H; Gummadi, Sathwik; Chaudhary, Tarun
BACKGROUND: Atrial Fibrillation is the most commonly encountered irregular heart beat (arrhythmia) in our population, and it is the disordered supraventricular (atria) event characterized by irregular heart rhythm. Therefore, the role of clinical profile in atrial fibrillation patient needs to be further discussed. In order to analysis the above issue, our study investigated the association between stroke patient and their clinical profile. METHOD: The study included 50 patient admitted in the Iccu and fulfilling the inclusion criteria. The study consists of history taking, clinical examination and biochemical assay and radiological examimation. Study subjects were selected after obtaining consent. Patient were managed according to standard guidlines. RESULTS: Most common symptom in our study was palpitation. Most common etiology was Coronary heart disease. Most common Class of drugs used in treatment were B-blockers, followed by anti-arrhythmic. Heart failure was the commonest complication seen, followed by Cardiogenic shock. Mortality was observed in patients with complications, while no mortality was observed in uncomplicated patients. Conclusion: Male patients were more common than female patients. Most common symptom in our study was palpitation. Most common etiology was more commonly seen in younger age group. Valvular etioligy was more commonly seen in younger age group. Most common valvular abnormality was mitral stenosis. Paroxysmal AF was the most common type of AF. Paroxysmal AF was mostly seen in patient with new onset AF while persitent was seen in old onset Most common class of drug used in treatment were B-blockers, followed by anti arrythmic. Heart failure was the commonest complication seen, followed by cardiogenic shock
Fundal Pressure Practice in the Late Second Stage of Labor Amongst the Healthcare Practitioners a Survey Based Study
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Shukla, Mauli K.; Doshi, Haresh U.; Singh, Kanupriya M.
BACKGROUND- Caesarean rates have increased considerably in present times. Obstetricians are performing lesser instrumental deliveries in second stage of labour due to less training and skills and fear of litigations. Uterine fundal pressure is pressure applied to a woman’s uterine fundus in the direction of the vagina during the second stage of labour with intention to promote or accelerate the time of vaginal birth. METHODS- The study was a questionnaire – based study that was carried out via google survey forms. The survey was conducted amongst 700 Obstetricians from all over India via Google forms and we received 663 replies. The survey comprised of 8 questions which include practice of fundal pressure, who gives it, success rate, station at which it was given, its use along with instrumental delivery, use of episiotomy, complications if any and lastly the number of contractions for which the fundal pressure was employed by different obstetricians. RESULTS- Fundal pressure was practiced by majority (94.9 %) either regularly or sometimes. Only few 5.1% doctors never used it. Most of the times, it was given by a healthcare worker (55.8%). Nearly one fourth of them (40%) achieved more than 70 % of success rate for vaginal deliveries. Large number of doctors, (56%) were giving fundal pressure at crowning. During instrumental deliveries 55.4 % practiced fundal pressure. Episiotomy was commonly employed (68.2%) before giving fundal pressure. There were no major complications during the procedure, except small perineal or vaginal tears. Half of the respondents practiced fundal pressure up to 3 to 4 contractions. CONCLUSION – In cases of prolonged second stage, fetal distress, failure to progress and maternal exhaustion, fundal pressure is often used to assist vaginal birth. This shortens the second stage & reduces the need for instrumental deliveries or LSCS & improves perinatal outcome. In majority cases fundal pressure gives good results in achieving vaginal deliveries. Very few cases have adverse maternal outcomes in the form of perineal tears.
Metronidazole Induced Reversible Cerebellar Toxicity – a Case Report of Uncommon Side Effects of Commonly Used Drug
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-07) Rathwa, Shubham; Chauhan, Sanket; Thakor, Vishal; Pranami, Harsh
Background :Pyogenic liver abscesses carry significant morbidity and mortality and can be difficult to treat, typically requiring drainage and broad-spectrum antibiotics to resolve. Antibiotic regimens will often take several weeks to months after drainage to clear the infection, which can put patients at significant risk for developing serious side effects from long term medication toxicity Metronidazole is a widely used antibiotic against bacteria And protozoan infections. Even though the therapeutic use of the drug is high, it is associated with some severe side effects like neurotoxicity such as optic neuropathy, peripheral neuropathy, encephalopathy and cerebella toxicity. History :We present a case of a 56-years male presented with dysarthria, who had positive cerebellar sign . Conclusion The magnetic resonance imaging findings suggestive of metronidazole induced cerebellar toxicity following metronidazole therapy for six months in a case of liver abscess. And, the symptoms resolved after cessation of metronidazole
Amyloidosis of Bladder and Ureter – A Case Report
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-07) Savalia, Charmi; Kanhere, Shubhada
Introduction :Theamylodosis is a disorder of protein confirmation and metabolism in which insoulable fibrils are deposited extracellularly in body organs causing organ dysfunction and death. It is associated with inherited and inflammatory disorders. Primary amyloidosis of bladder and ureter is a rare disease and easily confused with neoplasm. Hematuria, irritative or obstructive lower urinary tract symptoms and cystitis-like manifestations are the common clinical presentation. History :Presenting a case of 61 year old male patient having gross heamturia and irritative urinary tract symptoms. Conclusion On radiology there is a wall thickening of bladder with calcification and wall thickening of right lower ureter. Biopsy was sent to histopathology department and histopathological examination demonstrated amyloidosis of bladder and ureter.
A Case Control Study for Diagnostic Significance of Cerebrospinal Fluid (CSF) & Serum Lactate Dehydrogenase (LDH) and Total Creatine Kinase (CK) Level in Meningitis
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-07) Parmar, Nikita; Makwana, Manisha
Introduction : Meningitis is the most common sequalae to microbial invasion of the CNS. Neurological sequalae are serious and rather common among survivors. Meningitis disturbs the blood brain barrier (BBB) and is expected to cause rise in enzymatic activity. For that reason some enzymes are used for the diagnosis in cases of meningitis. Since prompt and precise etiological diagnosis remains a challenge and often a thorough cerebrospinal fluid examination may not give a precise diagnosis, a quick and reliable test is required for rapid bedside diagnosis. This study was planned to find out the role of diagnostic significance of CSF & serum LDH & Total CK levels in meningitis. AIM : Diagnostic significance of CSF & serum LDH & Total CK levels in meningitis. Objectives : To measure and estimate the level of Cerebrospinal fluid (CSF) & Serum LDH & Total CK in pyogenic meningitis and tuberculous meningitis. Material and methods : This Case control study was carried out at Clinical Chemistry Laboratory, Medical College Baroda and Sir Sayajirao General (S.S.G.) Hospital, Vadodara. Approval of Institute’s Scientific Review Committee and Ethical Clearance were obtained from the Institutional Ethics Committee for Human Research, Medical College Baroda and S.S.G. Hospital, Vadodara. 30 diagnosed patients of Meningitis and 30 patients who were operated under spinal anesthesia (Patient who met with an accident without any major illness) between the age group of 18 to 60 years were enrolled in my study. Detailed history and record findings of examination were done as per proforma and data were recorded in proforma sheet. For laboratory investigation , 5 ml blood sample by venipunture was taken in plain vacutainer and 1 ml CSF sample by lumber puncture were collected in plain vacutainer. Blood and CSF samples were processed in clinical chemistry laboratory and tests were performed .Results: As defined in materials and methods, the study group consisted of 30 cases in group I (Clinically diagnosed cases of meningitis) and 30 age & sex matched controls in group II (Patients undergoing surgery under spinal anesthesia from Ortho and Surgery i.e patients with accidents were taken as Control).Statistical analyses were done by using unpaired Student’s t-test to find out significance of difference between two groups. The Mean ± SD of S. LDH ,CSF LDH, S. Total CK , CSF Total CK in group I and group II, were 232.10 ± 27.79 (161.0 – 280.1) IU/L, 248.68 ± 44.48 ( 148.0 – 320.8 ) IU/L, 201.34 ± 19.84 (167.8 – 236.7) IU/L, 31.80 ± 9.44 (18.2 – 56.0) IU/L, 140.01 ± 13.92 ( 115.2 – 167.0 ) IU/L, 35.73 ± 10.40 (18.9 – 66.9) IU/L, 115.87 ± 52.52 (29.0 – 198.0) IU/L, 7.89 ± 3.61 (3.9 -17.0) IU/L, respectively. There was statically significant difference found between these two groups. (P < 0.0001). The Mean ± SD of S. LDH , CSF LDH, S. Total CK , CSF Total CK in Pyogenic meningitis and Tuberculous meningitis in group I were 233.45 ± 30.43 (161 – 280.1) IU/L, 251.36 ± 46.66 (148.0 – 320.8 ) IU/L, 202.93 ± 19.70 ( 167.8 – 230.0) IU/L, 33.76 ± 9.80 ( 18.2 – 56.0 ) IU/L, 227.68 ± 17.54 ( 198.5 – 244.0 ) IU/L, 239.88 ± 38.20 (180.0 – 286.0 ) IU/L, 196.10 ± 20.93 (175.9 – 236.7 ) IU/L, 25.37 ± 3.92 (19.8 – 30.4) IU/L, respectively. There was statistically significant difference was not found in between Pyogenic meningitis and Tuberculous meningitis. (P > 0.05). Conclusion : This study was carried out to measure the levels of Lactate dehydrogenase (LDH) and Total Creatine Kinase (CK) in serum and Cerebrospinal fluid (CSF) in patients with meningitis. LDH and Total CK in serum and CSF may not be useful in differentiating types of meningitis but it may act as a corroborative evidence of meningitis. So along with routine CSF parameters CSF LDH and Total CK level may add in the diagnosis of meningitis
Cecal Diverticulitis: an Unusual Cause of Acuteright Iliac Fossa Pain—a Case Report
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-07) Sharma, Jaykumar V.; Aswani, Varsha; Bhadreshwara, Kamlesh A.; Patel, Shaishav V.; Kotwal, Dipen K.
INTRODUCTION: The cecal diverticulum is a rare disease with reported incidence of 0.04% to 2.1% (1–3). 85% of diverticulum occurs more commonly in the descending and sigmoid colon rather than in cecum [1]Diverticulae of the colon are mucosal herniations in the colon wall muscle layer through (relatively weaker) points of entry of blood vessels through the colonic wall13 and are more commonly found in the sigmoid colon and descending colon. Caecal diverticulitis is a rare clinical problem, its signs and symptoms are very similar to those of appendicitis. OBJECTIVE - Here we present a case of caecal diverticulitis which was diagnosed with the help of various radiological investigations and was managed conservatively with a positive outcome. We were able to avoid operative intervention owing to the specificity of the ultrasonography and computerized tomography in ruling out other conditions that preclude conservative management.The management of diverticulitis of cecum is varied and controversial due to lack of randomized trials comparing conservative and aggressive surgical treatment methods. METHOD - A 70 year-old diabetic and hypertensive male patient presented to the hospital’s emergency department with a 72-hour history of a severe right, lower abdominal quadrant pain with accompanying nausea and vomiting. Physical examination revealed clinical signs of acute abdomen with local rebound tenderness and guarding in the right iliac fossa. An ill-defined lump of 3 × 4 cm was palpated in the RIF extending to the hypogastrium.So we diagnosed the patient with available radiological and othe modalities so we can take the decision for operative or conservative management RESULTS - Caecal diverticulitis is a rare clinical problem in the Western world, more commonly seen in the descending and sigmoid colon [2]. We were able to avoid operative intervention owing to the specificity of the ultrasonography and computerized tomography in ruling out other conditions that preclude conservative management.Solitary diverticulitis of the cecum, even if it is a rare entity, should be taken into consideration during the differential diagnosis of patients complaining of right iliac fossa pain. CONCLUSION - The use of radiological investigations such as abdominal USG and CT scan for the evaluation of the right abdominal pain is very helpful for diagnostic accuracy and avoiding unexpected findings in the operating theatre. A careful preoperative assessment to diagnose the pathology and to diminish the possibility of surgical intervention is necessary as the as the mainstay of therapy for rightcolonic diverticulitis is medical rather than operative management
Retinal Nerve Fiber Layer and Visual Field Assessment in Primary Open Angle Glaucoma – a Detailed Cross-sectional Examination
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-07) Asal, Shyam; Ghatad, Hiren; Lakum, Prayosha; Rajatiya, Yash
Aims and objectives: This study aims to comprehensively investigate the relationship between visual field impairments and Retinal Nerve Fiber Layer (RNFL) thickness across all stages of primary open-angle glaucoma (POAG). Methods” A cross-sectional observational study was conducted on primary open-angle glaucoma (POAG) patients attending a tertiary eye center in western India. Patients were categorized into groups based on Hodapp, Parrish, and Anderson’s criteria. 52 eyes (26 patients) with POAG were included in the study, comprising 26 (50%) right eyes and 26 (50%) left eyes. Result :The average age of patients in the early, moderate, and severe groups was 50.41 ± 17.06 years, 63.90 ± 8.65 years, and 59.75 ± 7.15 years, respectively. RNFL thickness was compared among early, moderate, and severe POAG cases, revealing values of 86.48 ± 9.15, 70.57 ± 8.65, and 52.93 ± 12.43, respectively. VF indices were also compared, with mean deviation (MD) values of -2.65 ± 1.29, -8.25 ± 1.87, and - 19.45±4.30 for early, moderate, and severe cases, respectively. Significant correlations were observed between structural (superior, inferior, average RNFL thickness) and functional (VF MD) changes, while nasal and temporal RNFL thickness and MD exhibited moderate correlation. Conclusion: This study demonstrated the important role of optical coherence tomography in the early detection of lost RNFL thickness in glaucoma by establishing a correlation between structure and changes, especially RNFL thickness and visual function. This finding not only improves our understanding of the development of glaucoma but also suggests the use of OCT and perimetry as important tools in clinical management
Carbon Dioxide Levels in the Breath of Smokers and Non Smokers – A Comparative Study
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-07) Chaudhary, Sheela; Bhatt, Janardan Vishvanath; Ranga, Surbhi; Makwana, Manisha
Background: Smoking is a major public health issue, leading to diseases like COPD, lung cancer, and cardiovascular diseases. It introduces toxic substances into the respiratory system, causing inflammation, reduced lung function, and impaired gas exchange. Measuring end-tidal CO2 (EtCO2) provides insights into respiratory efficiency and health. Objectives: Compare EtCO2 levels in the breath of smokers and non-smokers. 1. Analyze physiological mechanisms behind differences in EtCO2 levels. 2. Discuss health implications of these differences. Methods: The study involved 50 participants (25 smokers, 25 non-smokers). Smokers consumed at least 10 cigarettes daily for five years, while non-smokers had no history of smoking. A capnometer measured EtCO2 levels over 30 second of normal breathing. Statistical analysis used t-tests to assess the significance of differences.Results: Smokers had significantly higher EtCO2 levels (41.5 mmHg) compared to non-smokers (36.0 mmHg), with p < 0.001. This indicates impaired gas exchange and higher CO2 retention in smokers. Conclusion: The study highlights significant differences in EtCO2 levels between smokers and non-smokers, demonstrating the impact of smoking on respiratory health. Capnometry is a valuable tool for early detection and intervention to mitigate smoking's adverse effects.
Evaluation of Patients of Intraarticular Calcaneus Fractures Treated With Open Reduction and Internal Fixation or Closed Reduction and Percutaneous Fixation
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-07) Gandhi, Takshay; Amin, Chirag; Panchal, Shreyansh; Patel, Yash; Prajapat, Kamal
Background: Calcaneus fractures account for approximately 60% of tarsal injuries and most occur in males varying between 20–50 years of age, leading to severe impairment of day-to-day activities and complications. Patients presenting with isolated calcaneal fractures, and those sustained during high-energy injuries were commonly associated with other injuries. Within this group, Pilon-type fractures, femoral fractures, and talus dislocations were most seen. Spinal injuries are a well-documented complication of falls from height. Methodology: After radiological evaluation, preoperatively Bohler’s angle and crucial angle of Gissane were measured retrospectively. Calcaneum fractures were classified according to Essex-Lopresti and Sanders. Patients were treated surgically according to fracture geometry. Functional outcomes of fixation on intra and extra-articular calcaneum fractures were evaluated using the AOFAS Scoring system. Results: The difference between pre- and post-mean Bohler angle showed a correlation with the quality of the outcome. In all patients, the post-operative Gissane angle was less than the pre-operative, which suggested a good outcome. Subtalar joint movements (inversion & eversion) are greatly affected in displaced intra-articular calcaneal fractures. Conclusion: With good anatomical articular reduction with suitable surgical intervention along with strict post-operative rehabilitation protocol, we can achieve good to excellent outcomes
Impact of Humidity on Heavy Duty Workers Compared to Non-heavy Duty Workers a Study on Peak Expiratory Flow Rate
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-07) Ranga, Surbhi; Warhade, Veenodini; Bhatt, Janardan Vishvanath; Makwana, Manisha
Introduction: Peak Expiratory Flow Rate (PEFR) measures the highest speed at which a person can exhale and is a crucial indicator of respiratory health. Environmental factors, particularly high humidity, can impact respiratory function. This study aims to compare the impact of humidity on PEFR between heavy-duty and non-heavy duty workers, providing insights into occupational health risks and informing strategies to mitigate them. Aim and Objectives: The primary aim was to investigate the impact of high humidity on PEFR in heavy-duty workers compared to non-heavy duty workers. Specific objectives included measuring and comparing PEFR values between the two groups under high humidity conditions and assessing the prevalence of respiratory symptoms. Material and Methods: A cross-sectional study was conducted with 50 participants from the Kalol, Gandhinagar, Gujrat, India, divided into 25 heavy-duty and 25 non-heavy duty workers. PEFR measurements were taken using a standardized peak flow meter under high humidity conditions (above 75%). Demographic data and occupational histories were collected through structured questionnaires. Results: Significant differences in PEFR were found between heavy-duty and non-heavy duty workers under high humidity conditions. The average PEFR for heavy-duty workers was 350 ± 25 L/min, compared to 420 ± 30 L/min for non-heavy duty workers (p < 0.01). Symptoms like shortness of breath, cough, chest tightness, and fatigue were more prevalent among heavy- duty workers. Conclusion: High humidity significantly impacts the respiratory function of heavy-duty workers, evidenced by reduced PEFR. Implementing effective occupational health measures, such as hydration, rest breaks, and protective equipment, is crucial to mitigate the adverse effects of high humidity on respiratory health.
Non Immune Hydrops Fetalis
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Aghara, Savan; Santoki, Drashti; Vaghasiya, Meera; Patel, Akash; Joshi, Jayun
INTRODUCTION: Hydrops Fetalis is an accumulation of extracellular fluid in fetal body civilities like pleural, pericardial, Scalp and in body wall [1]. First case of hydrops fetalis was identified by Ballantyne. Edit Potter differentiated between immune hydrops fetalis from nonimmune hydrops fetalis [2]. NIHF is associated with accumulation of extracellular fluid in fetal body Cavities like pleural effusion, pericardial, scalp, body wall with increased skin thickness of more than 5mm. Due to generalized subcutaneous edema and placental enlargement. When first described HF constituted 20% of all cases, but with effective anti D prophylaxis for immune Hydrops, NIHF constitutes 90% cases of fetal Hydrops [3]. NIHF incidence reported as 1 in 3000 pregnancies [4]. Approximately 50% of fetuses with non-immune hydrops fetalis die in utero, and about half of the live born infants survive. Routine Ultrasound has been recommended as the initial diagnosis of NIHF. Placental thickness should be measured in all cases to rule out placental edema. 3D scan helps in determination of Facial dysmorphology which May give clue to inborn errors of metabolism and Cystic hygroma may be in cases of Aneuploidy, fetal Echocardiography, examination of maternal blood for fetal erythrocytes, amniocentesis and sampling of Fetal blood. We report two of NIHF fetuses about 16-18 weeks of gestational age. OBJECTIVE: Goal of our study is to find out etiology and outcome of pregnancy with non-immune hydrops fetalis. RESULTS & CONCLUSION: A detailed Ultrasound with AFI and Doppler study is most useful in diagnosis of hydrops fetalis and underlying condition responsible for that. Test for fetal infection and antibody in maternal serum is helpful in identifying infective etiology. Amniotic fluid study is costly but most sensitive for karyotyping to identify chromosomal abnormalities. Once condition is identified than a patient referred to higher center for better availability of neonatal care. Outcome of babies is poor in a case who survive till term pregnancy.
Effect of General Anesthesia With Epidural Versus General Anesthesia Alone on Requirement of Inhalational Agents and Peri Operative Analgesic in Patient Undergoing Major Abdominal Surgery
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Patel, Alpa; Parikh, Ushma; Desai, Ruchiben Maheshbhai
Background: Abdominal onco surgeries are of longer duration and patients may experience severe pain peri operatively. We have hypothesized that patient will require more IV analgesic drugs like opioids, if only general anaesthesia is given, but need for IV analgesic will be reduced if Epidural anaesthesia is combined with General anaesthesia. Here we have compared 32 patients (sixteen from each group) undergoing major abdominal onco surgery under general anaesthesia alone versus epidural along with general anaesthesia with use of Ropivacaine and Fentanyl for epidural infusion, and observed that patient with general and epidural anaesthesia required smaller dose of IV opioids and minimal use of inhalational agent intra operatively. Methods: • Objectives are: Need of inhalational agent, to asses perioperative pain relief and need of iv analgesic drugs in patient undergoing major abdominal onco surgeries under epidural with general anesthesia as compared to general anesthesia only. • After Institutional Ethics committee approval (IEC/BU/133/FACULTY/2/251), CTRI registration (CTRI/2022/02/039912) and patient’s consent, 32 patients were randomly allocated in Group GA (n=16) and Group EG (n=16), undergoing major abdominal onco surgeries. Group GA receiving general anaesthesia only, Group EG receiving epidural with general anaesthesia. Parameters mentioned in aims and objectives were compared. Results: Study revealed statistically significant difference between two groups, with mean value for use of Sevoflurane was 26.88 in EA with GA group and 44.94 in GA only group with P value <0.001. Conclusions: EA with GA group required less inhalational anaesthetic agent and iv analgesic agents as compared to GA group only.
The Relationship Between eNOS & CCR2 Gene Polymorphism in Chronic Kidney Disease Patients
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Shah, Prasen; Upadhyay, Puneet; Darda, Shubham; Vatsraj, Dharmendra J.; Trivedi, Shaival
Background/Aims: A significant public health concern, chronic kidney disease is frequently brought on by hypertension, diabetes, nephrotoxic drugs and glomerulonephritis. It is possible that some patients' CKD develops earlier than expected even with appropriate treatment, suggesting the possibility of genetic factors contributing to the disease's development. Materials and Methods: The present study was conducted in the OPD and male and female medicine wards of Dhiraj Hospital, Pipariya, Vadodara, India. The Study duration was 6 months. Based on careful clinical assessment and judgement of treating physician patients having chronic kidney disease with age >18years were selected on the basis of KDIGO Classification of CKD. Results: During the study period, out of 146 patients selected, 62 met the criteria for the CKD in which CCR-2 and eNOS gene polymorphism were tested and compared. Conclusions: The investigation of the relationship between CCR-2 and eNOS and the aetiology of chronic kidney disease (CKD), as well as the age at which CKD onset and duration were compared, is a novel discovery in this study. The results of this study show a substantial relationship between the eNOS TT genotype and the CCR-2 GA genotype and stages of renal disease, as well as CKD and declining renal function. However, in the Indian population, CCR-2 and eNOS expression are unaffected by the age at which a disease first manifests, the length of the illness, or the etiology of CKD.
Significance of MRI in the Evaluation of Epilepsy Patients
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Jain, Preksha; Jain, Shreya; Bhardava, Vishal Kumar
Background/Aims: Recurrent seizures that are not brought on by a sudden systemic or neurological injury are the hallmark of epilepsy, a chronic illness.1 The clinical manifestation of aberrant, excessive neuronal activity originating in the cerebral cortex's grey matter is an epileptic seizure.2 A paroxysmal change in neurologic function brought on by abnormally high neuronal electrical activity is known as a seizure.1 The superior soft tissue contrast of MR imaging, which permits a detailed representation of anatomy and eliminates the beam-hardening artefact in the basal brain that is present with CT, has made it the most valuable and diagnostically valuable tool for preoperative localization of epileptogenic focus. Additionally, MR imaging allows for multiplanar imaging.1 Material and methods: A prospective study was carried out at the Radiodiagnosis Department at Dhiraj Hospital, SBKS MI&RC, Vadodara, Gujarat. All individuals who had clinical symptoms and indicators of epilepsy and were sent to the Department of Radio-Diagnosis. The MRI scanner used for the study was the Siemens. Using the 1.5T SIEMENS MAGNETOM-ESSENZA system, MRI scans were performed on each subject. The study aimed to include a minimum of 100 cases; however, there is potential to include more cases based on availability throughout the study time. 220 cases in all were examined. Results: In our study 220 patients who were clinically diagnosed of epilepsy were undergone MRI examination of the brain. The MRI findings were normal in 100(45.4%) cases and revealed spectrum of abnormalities in 120(54.5%) cases. The common abnormalities were cerebral infarction with gliosis (22.2%), infections –NCC (8.6%) and tuberculoma (2.7%), cerebral atrophy (7.2%), venous thrombosis (3.6%), developmental malformations (3.1%), cavernomatous malformations (1.8%), glioma (1.82%), meningioma (1.3%), tuberous sclerosis (0.9%), viral encephalitis findings (0.4 %) and AV malformation (0.4%)were among the abnormal findings. Conclusion: We conclude that MRI plays a significant role in patients presenting with epilepsy with MRI epilepsy protocol to confirm or rule out any organic or developmental lesions. In our study, it was observed that most common neuroimaging abnormalities associated were cerebrovascular diseases & infections. Most common age group in our study was 16-30 years with male predominance.
Benign Epithelial Proliferating Breast Lesions: A Histopathological Research
(FORUM: Fraternity of national Research & pUblication Society of Medical sciences, 2024-01) Ganatra, Ayushee; Shah, Kaivalya; Shah, Devanshi; Tandon, Rakesh
Background/Aims: A range of conditions known as benign epithelial proliferative breast lesions are brought to the attention of clinicians as palpable lesions discovered during a physical examination or as imaging abnormalities. The pathological categorization and management of benign proliferative breast lesions will be reviewed in this topic. Women taking postmenopausal hormone replacement treatment have shown mammographic changes suggestive of physiologic proliferative abnormalities [4,5]. Women who have already received breast irradiation have far less of an impact from hormone replacement treatment on the look of their breasts on mammograms. Material and methods: A study using cross-sectional observation was carried out at the Pathology department at Dhiraj Hospital, SBKS MI&RC, Vadodara, Gujarat. Results: The study was conducted for 18 months. The study included 119 cases of benign proliferative epithelial breast lesions. Women in their second decade of life had the majority of the lesions. The majority of patients only experienced one unilateral breast lump, no pain, and no discharge from the nipples. Conclusion: Women frequently suffer from benign epithelial proliferative breast disorders. despite the fact that the study found a lower frequency of premalignant atypical hyperplasia lesions, it is still essential to thoroughly investigate all cases of breast lesions in order to rule out the risk of breast cancer.

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