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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com, https://plus.google.com/communities/115462130054650919641?sqinv=VFJWaER0c2NCRl9ERzRjZWhxQmhzY09kVV84cjRn , ,https://plus.google.com/u/0/+AlexandrosGSfakianakis , https://www.youtube.com/channel/UCQH21WX8Qn5YSTKrlJ3OrmQ , https://www.youtube.com/channel/UCTREJHxB6yt4Gaqs4-mLzDA , https://twitter.com/g_orl?lang=el, https://www.instagram.com/alexandrossfakianakis/,

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Σάββατο, 24 Σεπτεμβρίου 2016

Beneficial effects of yogasanas and pranayama in limiting the cognitive decline in Type 2 diabetes

2016-09-24T09-13-59Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Rajani Santhakumari Nagothu, Archana Rajagopalan, Yogananda Reddy Indla, Rajesh Paluru.
Background: Out of many complications that were observed in Type 2 diabetes, cognitive impairment is the most neglected. Aim and Objectives: The aim of the present study is to assess the cognitive decline in Type 2 diabetes and to observe the role of yogasanas and pranayama in ameliorating the cognitive decline. Materials and Methods: A total of 68 Type 2 diabetic patients were recruited in the study, 34 of them did specific yogasanas and pranayama (test group) for 6 months, and the remaining age- and sex-matched 34 patients were recruited as (control group) who were not on any specific exercise regimen. Glycemic index was estimated by measuring the glycosylated hemoglobin (HbA1c) concentration with Bio-Rad apparatus and cognition were assessed using Addenbrookes cognitive examination-revised (ACE-R), which is a neuropsychological battery. Data were analyzed with unpaired student t-test. P

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Role of adenosine deaminase in diagnosis of exudative type of pleural effusion

2016-09-24T09-03-52Z
Source: International Journal of Medical Science and Public Health
R S Pushpa Kumari, B L Narsimha Reddy, V A Vipula.
Background: The diagnosis of tubercular pleural effusion remains a common clinical challenge. At least 50% of cases of tubercular pleural effusion present as primary disease without involvement of other organs. Objectives: Estimation and comparison of Adenosine Deaminase (ADA) levels in exudative pleural effusions with special reference to tubercular aetiology. Materials and Methods: Sixty patients of pleural effusions of various aetiologies formed the sample of the study. Pleural fluid analysis was done and clinical profile of each patient was taken. Total patients were divided into 6 groups consists of Tubercular pleural effusion (39), parapneumonic effusion (10), emphyema (5), malignant pleural effusion (3), pancreatic pleural effusion (2) and amoebic pleural effusion (1). Results: Incidence of tubercular pleural effusion is 65% followed by parapneumonic effusions 16.6%. Males (68.3%) are more prone to incidence of tubercular pleural effusion. Conclusion: Pleural fluid Adenosine deaminase (ADA levels are highly sensitive for tuberculous pleural effusions. ADA is diagnostic even in HIV positive patients with tubercular pleural effusion. ADA levels easily differentiate tuberculous pleural effusion from parapneumonic, malignant, pancreatic, and amoebic pleural effusions.


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Patterns of spirometry in asthmatic patients presenting with respiratory symptoms

2016-09-24T09-03-52Z
Source: International Journal of Medical Science and Public Health
Tarig H Merghani.
Background: Asthmatic patients typically show obstructive patterns on spirometry with positive bronchodilator responses; however, other spirometric patterns were also reported. Objective: to determine patterns of spirometry among asthmatic patients who attend the outpatient clinic with respiratory symptoms. Materials and Methods: A cross-sectional study was conducted among 323 known asthmatic patients (59% females) who attended the outpatient clinic with respiratory complaints. A portable spirometer (All flow, Clement Clarke International, Harlow, UK) was used for lung function measurements. Measurements and reversibility tests were performed according to the American Thoracic Society (ATS) Guidelines for spirometry measurements. Result: Normal spirometric pattern was found in only 21% of all participants, obstructive in 12%, mixed in 32%, and restrictive in 36%. The patterns had no relation with the gender or the body mass index of the participants. The majority had low FEF25 (88%), low FEF50 (83%), and low FEF25-75% (82%) indicating inflammation within the middle and small airways. Nearly half of those who showed positive FVC reversibility tests had a restrictive pattern on presentation (p

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Knowledge, attitude, and practice of pharmacovigilance among health care professionals in a tertiary care hospital: a cross sectional study

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Vinoth Kalaichelvan, Meenakshi Balasubramanian, Ezhil J. Ramya.
Background: Spontaneous reporting of Adverse drug reactions (ADRs) has played an important role in the detection of serious, unsuspected, and unusual ADRs previously not detected during the clinical trials. However, underreporting remains a major obstacle in the implementation of pharmacovigilance program. The present cross-sectional study was conducted to assess the knowledge, attitude, and practice (KAP) related to pharmacovigilance among the health-care professionals (HCPs) in Tirunelveli Medical College Hospital, Tamilnadu. Methods: To assess KAPs of Health care professionals toward pharmacovigilance and ADR reporting; a predesigned, structured, 12 item questionnaire was used. Results: A total of 200 questionnaires were distributed among the HCPs including Postgraduate, Interns and Staff nurses. 72.7% postgraduates, 54.29% interns and 52.63% of staff nurses were aware regarding the existence of a National Pharmacovigilance Program of India. 72.7% postgraduates, 65.71% interns and 52.63% staff nurses felt that ADR reporting is a professional obligation for them .Only 37.14% interns, 15.79% staff nurses and 11.4% postgraduates have been trained for reporting adverse reactions. Although all staff nurses (100%) followed by 79.50% postgraduates and 48.57% interns experienced ADR in their practice, only 31.58% staff nurses, 20.50% postgraduates and 11.43% interns have ever reported ADR to pharmacovigilance centre. Conclusions: The deficiencies in knowledge and attitude require urgent attention not only to improve the rate of spontaneous reporting, but also for enhanced safety of the patients. Pharmacovigilance should be included in the nursing curriculum and workshops should be conducted for the undergraduate and postgraduate medical students regularly.


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Corticosteroids used in dermatology: its utilisation and cost analysis study

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Vijaykumar Lakshman Lamani, Aruna Bhushan.
Background: Drug utilization studies are powerful exploratory tools to ascertain the role of drugs in the society; they create a sound socio-medical and health economics basis for making health care decision. The study focuses on factors related to prescribing, dispensing and administration of medication. The objective was to study prescribing pattern, duration of treatment and rationality of corticosteroids used in dermatology department and to evaluate the cost analysis of prescription. Methods: A non-interventional prospective study was done in dermatology department for one and a half year. 807 inpatient and outpatient prescriptions with corticosteroids were collected. The data collected was expressed in terms of averages, ratios and proportions. Results: Out of 807 patients, 300 were male and 507 females. Total number of drugs prescribed was 2231, with average number per prescription being 2.76. Drugs prescribed by generic name 69.3% remaining 30.7% were brand names. Total of 75.1% were prescribed from essential drug list. 65.1% were dispensed from hospital pharmacy and 34.9% from outside pharmacy and betamethasone was the most prescribed corticosteroid. In our study average cost of prescription was 167.72 INR. The average cost of corticosteroids per prescription was 42.87 INR and average cost of other drug prescribed with corticosteroids was 124.87 INR. Conclusions: Use of corticosteroids drugs was found to be appropriate as per standard guidelines.


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Evaluation of antidiabetic activity of Oxalis corniculata in streptozotocin induced diabetic rats

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Arijit Dutta, Mangala Lahkar, Chimi Handique.
Background: Oxalis corniculata is traditionally well known for its versatile uses. The present study was carried out to evaluate the antidiabetic action of ethanolic extract of Oxalis corniculata in streptozotocin induced diabetic albino rats. Methods: To look for the antidiabetic effect the albino rats were divided into 5 groups, each consisting of 6 animals. Diabetes was induced by a single i.p. injection of streptozotocin at a dose of 50mg/kg body weight. Standard drug, glibenclamide and ethanolic extract of Oxalis corniculata (EEOC) at doses 200mg/kg and 400mg/kg body weight was fed to the rats and it was continued till the end of the study. The blood glucose levels were estimated on day 0, 3, 7, 14 and 21 day. The standard drug and the extract were fed from day 4 onwards. Results: The antidiabetic property of the extract has shown increasing trend with increase in dose and there was a gradual decrease in blood glucose levels with increased period of exposure to the test drug. Conclusions: Results obtained in this study substantiate the anti-diabetic activity of EEOC leaves.


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Prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus in Silchar Medical College and Hospital, Assam, India

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Devarsi Choudhury, Pinaki Chakravarty.
Background: Methicillin resistant staphylococcus aureus (MRSA) strains, usually resistant to several antibiotics, is a cause of concern in many countries. This study determines the prevalence and antimicrobial susceptibility pattern of MRSA in Silchar Medical College and Hospital (SMCH), Assam. Methods: This retrospective was conducted from January 2014 to June 2015 (1 year and 6 months) in SMCH, Assam. Four samples seen were blood, urine, pus and ear swab. Screening and confirmation of MRSA isolates were done by standard methods recommended by Clinical and laboratory standards institute (CLSI). Staphylococcus aureus strains were tested for Methicillin resistance by using oxacillin/ cefoxitin. The antibiotic susceptibility pattern of all MRSA strain was determined by Kirby-Bauer disc diffusion method. Results: Out of 724 positive staphylococcus strains, MRSA accounted for 311 cases (42.96%). Highest percentage of MRSA cases were from blood culture (61.68%). MRSA cases even showed resistance to other antibiotics like cefuroxime, amoxicillin and clavulanic acid, getamicin, levofloxacin, ciprofloxacin, ceftriaxone, nitrofurantoin, amikacin, and vancomycin. 59.50% cases of MRSA cases showed resistance to cefuroxime. Even Methicillin sensitive strains of staphylococcus Aureus (MSSA) showed resistance to antibiotics like cefuroxime and amoxicillin and clavulanic acid. Conclusions: The worst feature of MRSA is simultaneous drug resistance to many antibiotics. Measures preventing the spread of MRSA are to be enhanced as fewer options are available for treating MRSA. Hospital guidelines for proper antibiotics usage should be followed.


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Rationality of utilization of antimicrobial agents in medical intensive care unit of a tertiary care hospital

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Krishnendu Mondal, Suvadip Biswas, Aritra Ghosh, Saikat Kumar Dalui, Angana Datta, Supreeti Biswas.
Background: Patients admitted to intensive care unit receive multiple medications of different pharmacological classes due to various life threatening ailments. This study was conducted to assess the patterns of usage of antimicrobial agents in medical ICU of a tertiary care hospital and to suggest necessary modifications in prescribing patterns to achieve rational therapeutic practices. Methods: A cross-sectional observational study was carried out at ICU of the tertiary care hospital for 6 months. From the inpatient case record of ICU relevant data on prescription of each patient was collected. The demographic status, disease data and the utilization of different antimicrobial drug classes and individual drugs were analysed. Results: Of 753 patients admitted in the medical ICU during the study period, 640 consecutive patients were included for analysis. Male to female ratio was 1.45. Mean age was 63.32±17.93 years. Extensive poly-pharmacy (100%) and drugs with non-generic name (73%) noticed among the prescriptions.Average number of drugs per prescription was 12.1±2.13. Penicillins (51.87%) and cephalosporins (45.78%) were most commonly used antimicrobial drug classes. Piperacillin (37.03%), ceftriaxone (33.28%) and levofloxacin (22.5%) were commonly used antimicrobial drugs. A total of 181 prescriptions contained two and 138 contained three antimicrobial drugs. Piperacillin+tazobactam(37.03%) was the most common fixed dose combination noticed. Conclusions: Overall extensive poly-pharmacy and drugs with non-generic name noticed among the prescriptions. Few interventional programs should be aimed at control of infections, rational antimicrobial drug prescription to minimize adverse drug events, emergence of bacterial resistance and attenuating unnecessary cost.


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Antibiotic sensitivity and resistance in nosocomial infection in medical and surgical intensive care units of a tertiary care hospital in north India

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Harsh Yadav, Gopal Jhalani, Kalpana Sharma, Shivankan Kakkar, Vishnu Gupta, Arvind Verma.
Background: Antibiotic resistance threatens the health of many throughout the world. It is a common problem in the ICU patients who acquire nosocomial infections. Critically ill ICU patients are most vulnerable for developing multidrug resistant nosocomial infections. Methods: Hospital based, cross sectional, descriptive type of observational study involving 311 patients admitted in ICU who were studied for development of nosocomial infections. Results: In this study, the nosocomial infection rate among ICU patients was 32.79%. The commonest organism isolated from all samples were E. coli., Acinetobacter spp., Pseudomonas sp., CONS and Staph. aureus. In these samples, it was found that E. coli was most commonly resistant to Imipenem (93.8%) and Meropenem (93.8%). Majority of CONS was resistant to Nitrofurantoin (81.0%). Klebsiella sp. was most commonly resistant to Ceftriaxone (94.4%). Pseudomonas was commonly resistant to Imipenem (94.1%) and Meropenem (94.1%). Acinetobacter sp. was resistant commonly to Amikacin (90%) and Gentamicin (90%). Staph. Aureus was mostly resistant to Amikacin (90%), Gentamicin (90%) and Cotrimoxazole (90%). Conclusions: Nosocomial infections affect about 1/3rd of the patients in ICUs. Development of antibiotic resistance to commonly used drugs becomes a major deterrent to patient outcome, increasing duration of patient stay as well as expense. Strict infection control measures like universal precautions and stringent adherence to hand washing practices; formulation of antibiotic policy; Surveillance activities, appointment of infection control practitioners; might be required for the same for which further research is advocated.


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Evaluation of effect of alcoholic extract of Tinospora cordifolia on learning and memory in alprazolam induced amnesia in albino mice

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Jyothi C. H., Shashikala G., Vidya H. K., Shashikala G. H..
Background: Tinospora cordifolia is one of the most versatile shrub with cognitive enhancing effects could be beneficial for treatment of dementia and neurodegenerative diseases like alzheimers disease. The purpose of study was to evaluate the effect of Tinospora cordifolia on learning and memory in alprazolam induced amnesia in albino mice. Methods: The study was carried out on albino mice, divided into 4 groups of 6 animals each (either sex, 3-4 months of age, weight 25-30g). Amnesia was induced by administering alprazolam (2 mg/kg body weight for 14 days) in all 4 groups for 14 days from 1st to 14th day. Group 1 was given alprazolam (2 mg/kg/p.o) alone for 14 days. In addition, group 2 was given piracetam (400 mg/kg p.o) from 8th to 15th day. Group 3 was given alcoholic extract of Tinospora cordifolia 140 mg/kg, p.o. from 1st to 15th day. Group 4 was given alcoholic extract of Tinospora cordifolia 280 mg/kg, p.o. from 1st to 15th day. The learning and memory of the animals was assessed by employing elevated plus maze (EPM) and step-down type passive avoidance model (SDA). Results: Results were compared among the different groups using one way-ANOVA followed by post hoc Tukeys test. The measured parameters were compared with standard drug piracetam. Tinospora cordifolia at 140 mg/kg (p


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Evaluation of anti-tumor activity of ethanolic extract of Glycyrrhiza glabra against Ehrlich ascites carcinoma in swiss albino mice

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Jayanthi M. K., SubbaRao V. Madhunapantula, Divya K. Reddy, K. Mryuthunjaya, Manjula S. N..
Background: Cancer is one of the most life threatening diseases which is in need of newer drug development. The use of plant products with potent antioxidant and cytotoxic activity is upcoming Studies reveal that herbal product have increased efficacy as well as decreased side effects, with this in mind the present study was undertaken to assess the antitumor activity of extracts of Glycyrrhiza glabra (GG) against ehrlich ascites carcinoma in swiss albino mice. Methods: The extracts of roots of GG was collected and acute toxicity study was done following which the antitumor effect of extracts of GG was assessed by change in the body weight, mean survival time (MST), and percentage increased life span (% ILS). MST of each group containing six mice was monitored by recording the mortality daily for 6 weeks and % ILS was calculated. The hematological parameters and biochemical assays were also measured. Results: Extracts of GG showed a significant reduction in % increase in tumor induced body weight of the mice. The % increase in life span was also significant in the higher dose of GG (500 mg/kg). The combination of GG with standard drug cisplatin had better efficacy in terms of % ILS, hematological and biochemical parameters. The results obtained were statistically significant. Conclusions: The antitumor activity studies measuring the viability of cancer cells when exposed to the ethanolic extract of Glycyrrhiza glabra showed a potent cell-killing effect, indicating the presence of anti-cancer principles in the preparation.


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Study of influence of nicorandil on hypoglycemic action of glibenclamide in alloxan induced diabetic rats

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Syed Mohsin Ahmed.
Background: To assess the interaction between ATP - sensitive potassium channel opener nicorandil and potassium channel blocker glibenclamide in alloxan - induced diabetic rats and to evaluate whether nicorandil antagonizes the oral hypoglycaemic action of glibenclamide. Methods: Insulin secretion involves ATP sensitive K+ channel blockade, the influence of ATP sensitive K+ channel opener was studied in combination with its blocker. Albino rats of wistar strain, weighing between 200 - 250 grams of either sex were used for the study. Diabetes was induced by injecting alloxan monohydrate 2% solution intra - peritoneally in a dose of 150 mg/kg body weight. Animals with fasting blood glucose between 200 - 300 mg/dl were selected and were divided into 3 groups of six animals each. Group I received 2% gum acacia, group II was given glibenclamide (0.5 mg/kg body weight) and group III was treated with nicorandil (0.3 mg/kg body weight) + glibenclamide (0.5 mg/kg body weight) respectively orally for 30 days. Fasting blood sugar was recorded in all rats on 1st, 3rd, 7th, 14th, 21st and 28th days. Results: Results show that glibenclamide has significantly reduced the blood sugar levels (P


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Evaluation of usefulness of seminar as a learning tool at medical undergraduate level

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Diwanshu Sharma, Rohini Gupta.
Background: Teaching methods has a major role to play in making a subject innovative, interesting and participatory for the students. In India still teaching is controlled by teacher centered classroom method. Apart from this one of the method adopted is organizing seminars for the students. Knowledge acquisition through seminars forms an essential part of medical training programme. The idea behind the seminar system is to familiarize students more extensively with the methodology of their chosen subject. Methods: A questionnaire was prepared containing ten questions and 1000 MBBS students of second, pre-final, final professional and 200 faculty members, were asked to fill up the questionnaire. It included ten questions. Results: Results showed that seminar methods of teaching-learning, is effective way of learning, which is relevant to self-development and is also interactive. It improves communication skills. Conclusions: Many of the students feel that this technique of seminar programme is helpful for them in the long run. Thus teaching by way of seminar could be an effective learning method as it involves the three major domains of teaching i.e., cognitive, affective and psychomotor skills and is thus well -accepted among the medical students.


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Drug utilization pattern of fixed drug combination of antipyretic and analgesic in paediatrics department of Gauhati medical college and hospital, Guwahati, Assam, India

2016-09-24T01-26-55Z
Source: International Journal of Basic & Clinical Pharmacology
Binita Singha, Syed Adam Mousum, Mangala Lahkar, Ajoy Borah.
Background: Fever and pain are the most common symptoms prompting patients to seek medical attention. This study was planned to study the drug utilization pattern of fixed drug combination of antipyretic and analgesic compared to paracetamol in paediatrics department of Gauhati Medical College and Hospital. Methods: It was a prescription based cross-sectional study where Prescriptions with fixed dose combination of antipyretic and analgesic and prescriptions with paracetamol were observed. Demographic characteristics such as age, sex and indications were also recorded. The data were analysed for the utilization pattern of antipyretic and analgesic combination and compared with prescriptions with paracetamol alone without any other analgesic combination. Results: Out of 266 prescriptions screened 110 were prescribed with fixed dose antipyretic- analgesic combination while 156 were prescribed with paracetamol alone. The antipyretic - analgesic combination was composed of paracetamol and ibuprofen. This combination was prescribed in most of the post-operative cases and in cases with pain for various causes. Fever was the most common condition where only paracetamol and no other analgesic were prescribed. Percentage of combination prescribed was highest in children between 10 - 14 years of age and least in infants. Conclusions: This study shows the increase utilization of antipyretic-analgesic combinations in various conditions and the preference of fixed dose combination over paracetamol increases with increase in age of the paediatric patients.


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Knowledge, attitude and preferences of pregnant women towards mode of delivery in a tertiary care center

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Shiny Varghese, Smita Singh, Gagandeep Kour, Tapasya Dhar.
Background: Delivery mechanism is a spontaneous process and requires no intervention. Advances in medical technology in maternity care have drastically reduced maternal and infant mortality. Aim of the study was to determine maternal knowledge, attitude and preferences of pregnant women towards mode of delivery in a tertiary care center. Methods: This was a prospective study conducted on 100 antenatal women in third trimester who attended the antenatal clinic in Christian Medical College and Hospital, Ludhiana, Punjab from September 2015 to January 2016.The information regarding socio-demographic profile, obstetric history, knowledge and attitude statements towards vaginal and cesarean delivery was collected. Results: Total of 100 women was enrolled in the study. Out of these, majority (47%) had secondary education. Majority of the women (89%) interviewed had positive attitude towards vaginal delivery. High rate of cesarean section was seen in patients with primary and secondary infertility as they thought that babies born by cesarean section are healthier than those delivered by vaginal delivery. The most frequently mentioned source of information about mode of delivery was family and friends. Almost half of women agreed to the statement that vaginal delivery creates a more affectionate mother and baby relationship. Economic factors play an important role in deciding cesarean birth. Conclusions: Majority of pregnant women interviewed in our institution were keen to deliver vaginally, while the remaining women due to lack of knowledge or phobia of vaginal delivery wanted to undergo a cesarean section. Improving womens knowledge about the risks and benefits of different modes of delivery can lead to a positive maternal attitude towards vaginal delivery.


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Bacteriological profile of acute bacterial meningitis at a tertiary care hospital of North India

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Amresh Kumar Singh, Ankur Kumar, Vivek Gaur, Kusum Jasuja, Jayesh Pandey, Ruchi Mishra.
Background: Acute bacterial meningitis (ABM) is one of the most severe and potentially life-threatening infectious diseases. It is defined as an inflammation of the meanings, globally distributed as either sporadic or epidemic forms. ABM remains a major cause of mortality and long-term neurological sequel worldwide. Objective of the present study was undertaken to evaluate the bacteriological analysis in term of pathogens frequency and their sensitivity pattern in the cerebrospinal fluid of acute meningitis patients at a tertiary care hospital in eastern Uttar Pradesh, India. Methods: The study was carried out at a tertiary care hospital from June 2014 to November 2015 irrespective of age group. A total of 3803 samples of cerebrospinal fluid (CSF) from clinically suspected cases of meningitis were subjected for bacteriological analysis. Results: During the study period, a total of 3803 CSF samples were studied. Out of these, 343 were confirmed as bacterial meningitis based on Gram staining and or culture showing 9.01% incidence. ABM was more common in paediatric patients than adults. The most common organisms were Gram positive (66.18%) bacteria. Conclusions: Acute bacterial meningitis is a medical emergency and making an early diagnosis and providing early and accurate treatment, are lifesaving and to reduce morbidity. This study may play an important role in the diagnosis and more accurate treatment for the ABM patients.


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A morphometric study of adult human atlas vertebrae in South Gujarat population, India

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Nitixa P. Patel, Deepa S. Gupta.
Background: The atlas (C1) has undergone many structural modification and located at critical point close to the vital centres of the medulla oblongata which can get compressed by a dislocation of the atlanto axial complex or instability of the atlanto axial joint. Knowing of various dimensions of atlas vertebrae are very important for the development of instrumentation related to atlas vertebrae. Methods: In this study, total 100 dried, unbroken atlas vertebrae of unknown age and sex were evaluated in department of anatomy of medical colleges of South Gujarat. All dimensions were measured in bilateral manner using Digital Vernier Callipers with 0.01mm resolution. Results: The mean width of atlas was 71.19 mm. The mean distance between lateral margins of both transverse foramina was 55.48 mm and the inner distance was 44.77 mm. The mean for anteroposterior diameter of vertebral canal of atlas was 28.16mm and transverse diameter was 26.63 mm. The height of anterior arch was 10.21 mm and posterior arch was 8.68mm. The mean for height of facet for dens was 8.96mm and width was 9.18 mm. The mean of anteroposterior diameter of right and left superior articular facet was 20.73 mm and 20.86 mm and transverse diameter was 11.34mm and 11.39mm. The mean of anteroposterior diameter of right and left inferior articular facet was 17.89mm and 17.77mm and transverse diameter was 14.97mm and 15 mm. The mean thickness of vertebral artery groove (VAG) for right and left side was 4.15mm and 3.99mm and width was 8.26 and 8.1 mm. The length of VAG-inner edge (D1) for right and left side was 10.34mm and 10.3mm and length for outer edge (D2) was 14.93mm and 15.1mm. Conclusions: The observations of present study helps in improving understanding of various bony dimensions which could facilitate diagnosis and preoperative planning while operating close to important structures like nerve roots and the vertebral artery and will allow for more accurate modelling of South Gujarat, India.


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A case control study of possible additional risk factors for chronic alcoholic pancreatitis

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Sri Vengadesh Gopal, Ashley Solomon, Jaahnavi Konidala.
Background: Chronic pancreatitis (CP) is characterised by irreversible damage to pancreas leading to endocrine and exocrine insufficiency with considerable morbidity. Etiopathogenesis is multifactorial with interplay between genetics & environmental toxins. Alcoholism is more commonly associated with chronic pancreatitis. But it is not very clear why only certain proportion of the alcoholics develop pancreatitis. So this study was conducted to find the possible additional risk factors involved in alcoholic pancreatitis. Methods: A total of 30 patients with alcoholic pancreatitis from a tertiary care hospital in Pondicherry, India were enrolled and compared with age matched alcoholics without pancreatitis. The diagnostic criteria for alcoholism were based on diagnostic and statistical manual of mental disorders (DSM) criteria IV of alcohol consumption >80gms/day for a period of 5 years or more and chronic pancreatitis was based on significant clinical findings and positive ultrasound findings of pancreatitis. Questions regarding additional risk factors of pancreatitis like smoking, blood group and Diabetes mellitus were asked and recorded using the standard questionnaire. Results: Smoking history was noted in 73% of cases and 63.4% of controls. Non O blood group was noted in 56.6% of cases and 46.6% of controls. 10% of cases and 6.6% of controls gave history of diabetes before the development of pancreatitis. The additional risk factors were almost similar in both the groups and there was no statistical difference. Conclusions: It was concluded that there is no statistically significant additional risk factors for chronic alcoholic pancreatitis noted in present study and a study with a large sample size for an extended period is recommended.


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Debridement with high speed burr reduce more colonies of Staphylococcus aureus in chronic osteomyelitis of rabbit’s tibia compare to debridement with curettage

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Su Djie To Rante, Henry Ricardo Handoyo.
Background: Chronic osteomyelitis has been a difficult problem for the patient and for the treating physician. Chronic osteomyelitis is defined by most authors as osteomyelitis with symptoms that have been present for more than 1 month. Chronic osteomyelitis also defined by an infected dead bone within compromise soft tissue. An aggressive debridement and specific antibiotic treatment is first choice for chronic osteomyelitis. The purpose of this study was to assess the reduction in the number of colonies of Staphylococcus aureus after debridement with a high speed burr compared to debridement with curettage. Methods: This study is an experimental study was designed using a randomized post-test only group design. A total of 42 rabbits inoculated his right tibia with 0.1 ml Staphylococcus aureus 107 CFU / ml, and then inserted with K-wire intramedullary. Two weeks after inoculation, chronic osteomyelitis occurs, grade 3 and 4 radiologically. Then 10 rabbits were sacrificed without debridement, colonies of germs counted as control, 16 rabbits was performed debridement with curettage and 16 rabbits was performed debridement with high speed burr. Three weeks after debridement, 32 rabbits was sacrificed and counted for final germs colonies. Results: The results obtained from debridement with high speed burr and debridement with curettage, number of colonies of Staphylococcus aureus is less than the number of controls colonies, with a value of p = 0.006 (p


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Managing a surgical unit using google drive - a feasibility study

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Ashley Solomon C., Sri Vengadesh Gopal.
Background: Managing a surgical unit can be a daunting task. Being a consultant in a teaching hospital only adds to the challenge. One of the main challenges in running a unit is to have an effective channel of communication between the various members of the surgical team. Many medical errors have their origin in the lapse of communication. We are living in the era of telecommunication explosion where we have access to innumerable instruments of communications, all converged into a single device - The Smart phone. In this article we present the various challenges that are faced by a surgical unit and how a simple free to use software can be used to overcome some of those challenges. Methods: Electronic patient management software was created with the google drive software which is free to use. It was used to prepare various documents involved in the management of a surgical unit such as operation theatre list, Operation notes, Discharge summary and the team members were given a questionnaire regarding the ease of use of the software. The average time taken and the data usage for each of the activities were calculated. Results: A total of 30 residents and interns who worked in the unit during the study period answered the questionnaire. All the members of the team adapted favourably to this system. The cost involved and the data usage are minimal. Conclusions: It is feasible to use google drive as a patient management system by a surgical unit to organise work. This system is efficient, secure and cost effective.


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Association of non-alcoholic fatty liver disease and coronary artery disease

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Biswajit Majumder, Viral Tandel, Sandip Ghosh, Sharmistha Chatterjee.
Background: Nonalcoholic fatty liver disease (NAFLD), a feature of metabolic syndrome is a highly prevalent condition worldwide. Patients with NAFLD have a higher mortality when compared to general population. Many investigators have shown a close relationship between NAFLD and cardiovascular disease which contributes to the total mortality associated with NAFLD particularly in Western population. This study was therefore conducted to evaluate whether NAFLD independently affects angio-graphically proven coronary artery disease in Asians. Methods: The severity assessment of fatty liver disease was done by ultrasonography and was graded with increased severity from 0 to 4. Coronary angiography was performed to detect the presence or absence of significant coronary artery disease and modified Gensisni score, which determines the severity of coronary atherosclerotic involvement in individual patients was calculated. Results: Statistical analysis showed that Fatty liver disease was significantly higher in patients with significant coronary artery disease than in non-significant coronary artery disease group. When analyzed on basis on severity of fatty liver disease, modified Gensini score was significantly higher in group with fatty liver grade 2-3 than in group with fatty liver grade 0 or 1. Logistic regression analysis further showed that severity of fatty liver disease had independent effect on coronary atherosclerotic involvement. Conclusions: From our current study it can be reasonably said that NAFLD may be an independent risk factor for developing arteriosclerosis. This hypothesis should be verified with larger studies in different population groups.


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Fixed drug eruptions: causing drugs, pattern of distribution and causality assessment in a leading tertiary care hospital

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Rahul Saini, Bhawana Sharma, Prem Kumar Verma, Seema Rani, Garima Bhutani.
Background: It is bitter truth that there is no drug in this world which is without an adverse drug reaction (ADR). After the clinical trials when the drug comes in market or when it is taken by variety of population then actual reality of the drug comes out about its efficacy and adverse drug reactions. Fixed drug eruption is also one such type of ADR in which a specific type of lesions occurs over the skin after the drug is taken. Methods: We have conducted a clinical, observational study, in BPS Government Medical College, Khanpur Kalan, Sonepat, Haryana, India over a period of eight months. In that period we have found 159 patients having adverse drug reactions. Patients of both genders, under all age group were included in the study. Results: Out of 159 adverse drug reactions reports 69 (43.39%) were cutaneous adverse drug reaction report, 45 (28.30%) cases were of fixed drug eruption (FDE). Out of these 45 cases seen, there were 4 males (8.88%) and 41 females (91.11%). Flouroquinolone antibiotics like ciprofloxacin, ofloxacin and norofloxacin were the most common drugs causing fixed drug eruption followed by nitroimadazole antibiotic like metronidazole, tinidazole and NSAIDS like diclofenac, paracetamol and meftal spas in our study. FDE are more common in upper limbs extremities followed by lower limb extremities than face and trunk. Causality assessment was done with the help of WHO UMC scale and we found that association was possible in all the cases. Conclusions: Fixed drug eruptions are one of the major types of adverse drug reactions and should be assessed and reported.


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Pattern of dyslipidaemia in human immunodeficiency virus infected patients- a study from rural tertiary care hospital in central India

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Nisar A. Wafai, Khwaja Saifullah Zafar, Manoj Kumar, Prem S. Singh, Sudhir K. Yadav.
Background: HIV/AIDS is a major health problem affecting the whole globe. With introduction of highly active antiretroviral therapy longevity of HIV patient have increased and they are subjected to high cardiovascular risk as age increases due to various risk factors. Of these dyslipidaemia is one of important risk factor and HIV patients have different degree of deranged lipid profile. Various studies have shown different lipid derangement in these patients but most of them were conducted in urban areas, so this study was conducted to look for lipid profile in HIV patients who are resident of rural areas. Methods: This study was conducted on 66 HIV infected or AIDS cases. Each case was subjected to history taking, through clinical examination and fasting lipid levels. Dyslipidaemia was a classified using NCEP/ATP III guideline. Results: Of total 66 cases, there were 39 male and 27 female with average age of 37 years. Hypercholesterolemia was present in 50% of patients, hypertriglyceridemia in 36.4%. LDL and VLDL were raised in 37.9% and 36.4% respectably while HDL was found below 40 mg/dl in 37.9% of the patients. S. total cholesterol, HDL and LDL was found to have positive correlation while S. TG and VLDL have no significant correlation with CD4 count. Conclusions: Present studies have shown high prevalence of dyslipidaemia in different WHO clinical stage with variable correlation with CD4 count.


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Pancytopenia: a clinico hematological study

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Priti Singh, Ramesh Chandra Mohanty, Raghumani Mohanty, Sadaf Alam.
Background: Pancytopenia is very common consequence of many haematological diseases. It is the shortage of all types of blood cells. It happens in many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. It has different causes and severity based on which the treatment is directed and prognosis is implicated. Main objective of the study was to study the clinical presentations in pancytopenia due to various causes; and to evaluate hematological parameters, including bone marrow. Methods: It was a prospective study, and 50 pancytopenic patients were evaluated clinically, along with hematological parameters and bone marrow aspiration in Hematology Unit, Department of Pathology, Hi-Tech Medical College and Hospital, Bhubaneswar, Orissa, India during the period of October 2013 to September 2015. Results: Among 50 cases studied, age of patients ranged from 1 to 80 years with commonest age group being 41-50 years, and male predominance. Most of the patients presented with generalized weakness, pain abdomen and bleeding. Bone marrow aspiration was conclusive in all cases. The commonest marrow finding was hypocellularity followed by hypercellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was aplastic anemia (44%), followed by mrgaloblastic anemia (20%). Conclusions: The present study concludes that detailed primary hematological investigations along with bone marrow aspiration in cytopenic patients are helpful for understanding disease process and to diagnose or to rule out the causes of cytopenia. These are also helpful in planning further investigations and management.


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A study of trucut biopsies of hepatic lesions with special reference to immunohistochemistry and special stain

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Veenaa Venkatesh, Vinuta Uvaraj, Karthikeyan T. M..
Background: Hepatocellular carcinoma is one of the most common malignancies that account to about half a million deaths yearly and is the third leading cause of death. 80% of these cases are seen in the Asian- Pacific region. Aims of the study were to study the role of immunohistochemistry in differentiating primary from metastatic neoplasms of liver and to evaluate the usefulness of reticulin in differentiating benign from malignant lesions of liver. Methods: 46 cases of hepatic neoplasms reported were taken. Immunohistochemistry was done using the markers Alpha Fetoprotein (AFP), Hep Par 1, Cytokeratin 7 and Cytokeratin 20. Reticulin stain was done in 10 difficult cases to differentiate neoplastic from non-neoplastic lesions of liver. Results: AFP was positive in 18 cases (84%), 20 cases were positive for Hep Par 1 (92%). Among the metastatic neoplasms, the most common expression was cytokeratin 7 positive/ cytokeratin 20 negative expressions which were observed in 54% of cases. Reticulin fibres in the benign processes revealed one-cell thick liver plates, whereas in dysplastic and carcinomatous deposits, they showed thickening of the hepatic cell plates which appeared as two or three cell-cell thick plates. Conclusions: Alpha Fetoprotein and Hep Par 1 are found to be useful in diagnosing hepatocellular carcinomas; and Hep Par 1 is more sensitive than Alpha Fetoprotein. Cytokeratins 7 and 20 were useful in assessing the primary tumour to some extent in case of metastatic carcinomatous deposits of liver. If adequate liver biopsy sample is received, an extended panel of markers can be used to find the site of primary with more accuracy. Reticulin stain can be used in cases where there is difficulty in differentiating neoplastic from non-neoplastic lesions of liver.


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Prevalence of haemoglobinopathies in anemic females

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Promil Jain, Vinod Kumar, Rajeev Sen, Shilpi Bhargava.
Background: The β-thalassemias and various other hemoglobinopathies are a major health problem in India. An accurate diagnosis of patients suffering from β-thalassemia syndrome and other hemoglobinopathies is important for prevention and management of major hemoglobin disorders. High-performance liquid chromatography (HPLC) is a highly sensitive and specific method for the accurate diagnosis of thalassemia and other hemoglobinopathies. Methods: Present study was conducted on 1400 females of reproductive age group for screening of hemoglobinopathies in a rural block of north India. Patients were evaluated for presence of anemia with detailed hematological workup. Anemia cases were further screened by HPLC system for presence of any hemoglobinopathy. Results: 855 subjects out of a total of 1400 were found to be anemic. 359 patients had normocytic normochromic anemia, 399 had microcytic hypochromic picture, 37 had macrocytic picture, while 60 patients had dimorphic anemia. 47 cases were detected positive for various types of hemoglobinopathies. 36 patients were positive for β-thalassemia trait/ heterozygous forming the major portion (76.5%), while one (2%) patient was β-thalassemia intermedia / homozygous and was non-transfusion dependent. 3 patients were positive for HbE heterozygous and hereditary persistence of fetal hemoglobin each, two for HbD Punjab, one each for HbS heterozygous and Hb Lepore. Conclusions: The detection of various hemoglobinopathies is the key to diagnosis and proper treatment of various types of anemia. Antenatal screening should be an integral part of workup in pregnant females to prevent morbidity related to hemoglobinopathies like thalassemias.


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Effect of traffic air pollution on spirometeric parameters in Eastern Uttar Pradesh population, India

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Vinay Singh, Devesh Kumar, Farhat Ali, Gaurav Kumar.
Background: In the present era of the 21st century there are lots of discussion on environmental population and its impact on life and various clinical studies done to find out the effect of air pollution on respiratory physiology, particularly pulmonary functions. Pulmonary function tests give valuable information about lung physiology in health and disease. In the present study to assess the pulmonary function test between the population groups exposed to traffic related air pollution. Methods: A cross sectional retrospective cohort study was conducted in B R D Medical College. It was done on 73 males, out of which 35 were traffic policeman (15 smokers, 20 non- smokers) and remaining 38 belonged to non- exposed control group (15 smokers, 23 non-smokers). Pulmonary function tests (PFTs) were performed with computerized spirometer. The respiratory parameter was recorded and analyzed. To check statistical of data student t-test was performed. Results: Comparison of ratio FEV₁/FVC among two populations, revealed lower values for Traffic policeman group. This difference was significant among the non-smoker (P=0.0061), while not significant among the smoker (P=0.3419). Conclusions: The respiratory parameters were changed due to traffic related air pollution. So traffic related air pollution can be a risk factor in the development of respiratory obstruction.


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Simple detection of Bacillus anthracis spores by precipitation method with goat antibody anti anthrosa

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
M. L. Edy Parwanto, Alfred Pakpahan, Hosea Jaya Edy.
Background: Bacillus anthracis has a potential for biological weapon or bioterorism. Attack of Bacillus anthracis is very fatal, and the distribution is very easy and cheap through the spores. The aim of this was study to detect the spores of Bacillus anthracis. Methods: Bacillus anthracis isolates were grown on serum agar and then sheep blood medium, to stimulate capsule formation. Spores which formed painted using the method of Schaefer and Fultton. The methods of precipitation and immuno-chromatography were used to spores detection of Bacillus anthracis. Results: Painting with Schaeffer and Fulton method showed that spores of Bacillus anthracis are green. Precipitation reaction between spores of Bacillus anthracis with goat antibody anti anthrosa was resulting in a silver white color. Anthrosa of Bacillus anthracis spores was detected by means of immuno-chromatography using goat antibody anti anthrosa. The molecular weight of anthrosa is ±148 kDa. Conclusions: The methods of precipitation and immuno-chromatography using goat antibody anti anthrosa can be used to detection of Bacillus anthracis spores. Goat antibody anti anthrosa can react positively with Bacillus anthracis spores.


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Chiggerosis: an emerging disease

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Meenu Meena, Shivraj Meena.
Scrub typhus is a zoonotic disease caused by orientia tsutsugamushi,is a very less known cause of fever of unknown origin (FUO). It was first observed in Japan where it was found to be transmitted by mites. The disease was called as tsutsugamushi (tsutsu means dangerous and mushi means insect or mite. This disease is endemic to a geographically distinct region, so called tsutsugamushi triangle, which includes northern Japan and eastern Russia in the North to northern Australia in the South and to Pakistan and Afghanistan in the West. Clinical picture consist of high grade fever, severe headache, myalgia, lymphadenopathy and maculopapular rash on the trunk and then on extremities. A necrotic eschar at the inoculating site of the mite is pathognomic of scrub typhus. Incubation period is 1-3 week. Patients may develop complication like interstitial pneumonia, meningoencephalitis and myocarditis. Diagnosis is often missed because clinical manifestations are similar with other febrile tropical infection.it is diagnosed clinically based on sign and symptoms, serologically molecular methods can be used for their rapid identification as well as for epidemiological purposes. However public health importance of this disease is underestimated because of difficulty in clinical diagnosis and lack of laboratory methods in many geographical areas. Drugs like chloromphenicol and tetracycline effectively treat scrub typhus. No vaccine is available for Scrub typhus but many vaccines using Sta47 and Sta56 antigens are under trial as a recombinant vaccine.


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Applications of ultrasound in the low and middle income countries

2016-09-24T01-16-18Z
Source: International Journal of Research in Medical Sciences
Poonam Vohra, Kusum Jasuja.
With the easy availability, portability and durability of ultrasound, rapid improvement in bedside and Radiologist-performed ultrasound is seeing increasing use in rural, underdeveloped parts of the world. Physicians, and medical officers have demonstrated the ability to perform and interpret a large variety of ultrasound exams, and a growing body of literature supports the use of point-of-care ultrasound in developing nations. We review, by countries, the existing literature in support of ultrasound use in the countries with low and middle income group and training guidelines currently in use, and highlight indications for emergency ultrasound.


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STUDY OF COMPARTMENT PRESSURE IN SUSPECTED CASES OF ACUTE COMPARTMENT SYNDROME IN LEG

2016-09-23T23-58-24Z
Source: International Journal of Current Research and Review
Naresh Kumar, Sandesh Chaudhari.
Background: The present study has been done on the patient with suspected cases of increased compartment pressure in leg with history of trauma, using Whiteside needle manometer technique to make early diagnosis and early intervention to save the limb1. Materials and Methods: The study has been conducted over 40 patients in the age range between 10-45 yrs from April 1999 to March 2000. The compartment pressure of the injured leg has been measured using Whiteside needle manometer technique from the time of admission till the pressure came to normal or till the patient need decompression of the compartments. Result: This series shows that compartment syndrome is not an uncommon complication of leg fracture. The site of fracture found to affect more in upper third 23(57.5%) than in middle third 14(35%). In lower third 2(5%) cases and only 1(2.5%) case of segmental fracture both bone leg were affected. High energy trauma 2 was the common 37(92.5%) cause of raised intracompartmental pressure than low energy trauma 3(7.5%). Conclusion: This series shows that compartment syndrome is not an uncommon (7.5%) complication of leg fracture. The raised compartment pressure is mainly seen with the fracture affecting the upper third of leg. The patient needs to be monitored for at least 72 hr. following trauma. The critical pressure of fasciotomy is the raising value of compartment pressure of 30 mm Hg3. with clinical signs and symptoms. It is important to release of all the four compartments of leg within 6 hrs. of the diagnosis of acute compartment syndrome for better prognosis.


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