Πέμπτη, 20 Οκτωβρίου 2016

National Conference on Basic And Clinical Pharmacology

Source: Narayana Medical Journal
Edited By T.V.S.Divyalasya and .P.RamMohan.


Antioxidant, lipid modulating and hypoglyceamic effects of the aqueous extract of Anacardium occidentale leave in streptozotocin-induced diabetic rats

Source: Journal of Molecular Pathophysiology
Sarah Onyenibe Nwozo, Ayodeji Babatope Afolabi, Babatunji Emmanuel oyinloye.
Background/Aim: Anacardium occidentale leaves are used traditionally for the management of diabetes. This study seeks to evaluate the efficacy and safety of its continuous intake for 4 weeks in streptozotocin-induced diabetic rat model in comparison with metformin a reference drug. Materials and Methods: Thirty-six male Wistar rats (130 -145 g) were randomly divided into 6 groups of six animals each. Diabetes was induced in rats by a single intraperitoneal injection of streptozotocin (STZ; 50 mg/kg bw); plant extract and metformin were given orally (60 and 125 mg/kg/ bw). Results: Diabetes induction caused a significant weight loss (23.65 %) associated with a marked rise in levels of fasting blood glucose (295 mg/dl), triglycerides, total cholesterol, low-density-lipoprotein cholesterol, lipid peroxidation and serum aminotransferase activities. Besides, glucose-6-phosphate dehydrogenase (G6PD) activities, total protein concentration, high-density-lipoprotein cholesterol and tissue antioxidants (reduced glutathione; GSH, superoxide dismutase; SOD, catalase; CAT, glutathione-S-transferase; GST, Glutathione peroxidase; GPx) were diminished in STZ-induced diabetic rats. Histopathological studies also revealed various degrees of alteration in the liver diabetic rats. The effects of A. occidentale extract were compared with metformin as a reference antidiabetic drug. Treatment with A. occidentale (60 mg/kg/ bw) extract showed a significant (P


Our clinical experiences in ultra-sound guided peripheral nerve blocks: a retrospective evaluation

Source: Medicine Science | International Medical Journal
Ulku Ozgul, Mehmet Ali Erdogan, Muharrem Ucar, Nurcin Gulhas, Mahmut Durmus.
Peripheral nerve blocks are commonly used in extremity surgeries for anesthetic and/or postoperative analgesic purposes with general anesthesia. Ultra-sound (US) guided peripheral nerve blocks that have been used in recent years provide many superiorities in comparison with other conventional methods. The objective of this retrospective study was to carry out a retrospective evaluation of our experiences regarding 400 patients on whom US guided peripheral nerve was applied at the Inonu University Faculty of Medicine, Department of Anesthesiology and Reanimation during June 2012-March 2016. Demographic data of the patients, block type, purpose of block (for surgical or analgesic), type and volume of the local anesthetic, type of US probe, needle length, block success, toxicity finding and complications were all recorded. Blocks were performed for analgesia in 16% of the patients and for anesthesia in 84%. Lidocaine+bupivacaine combination, bupivacaine+prilocaine combination and bupivacaine were used on 82%, 13% and 5% of the patients as local anesthetic agent, respectively. Linear US probe (6-13 MHz) was used for all patients. In conclusion, US guided peripheral nerve blocks provide adequate depth of anesthesia and analgesia. It was found to be safe and useful and may be a good alternative to general anesthesia.


Adult attention deficit hyperactivity disorder: a case report

Source: International Journal of Advances in Medicine
Harish Agarwal, Deeptanshu Agarwal, Priyadarshi Srivastava.
Attention-Deficit/Hyperactivity Disorder (ADHD) has been accepted undoubtedly as a neuro-developmental disorder with main symptoms of inattention, hyperactivity and impulsiveness. Adult ADHD have lots of comorbidities such as anxiety disorder, substance use, depression which obscures the diagnosis of ADHD. Hyperactive symptoms in adults, other than speeding while driving, include feeling uncomfortable while sitting through meetings, impatience waiting in line, and having workaholic tendencies.


Post dengue Guillain Barre syndrome: a rare case scenario

Source: International Journal of Advances in Medicine
Vikram Singh Tanwar, Anjali Saini, Gagandeep Sukhija, Parminder Kaur.
Dengue fever is an emerging arboviral disease of great public health importance and has spread to all tropical and subtropical countries. Neurological involvement in dengue fever is quite unusual. Guillain-Barre syndrome (GBS) is one of the rare neurological manifestations of dengue fever which is generally under reported. We here presented with a patient who was initially diagnosed as having dengue fever, based on the clinical manifestations and high IgM titers. On the 6th day of admission, patient developed progressive limb weakness with areflexia. CSF examination showed albuminocytological dissociation and nerve conduction study suggested evidence of demyelinating neuropathy. So the diagnosis of post dengue GBS was made and intravenous immunoglobulin (IVIg) was given for 5 days. Patient responded well with the treatment. So our case report highlights an uncommon neurological complication of dengue infection in the form of GBS which has good prognosis if timely treated and responds well to the same therapy as given for the GBS due to other antecedent etiology.


Magnetic resonance imaging findings in intracranial extramedullary hematopoiesis in myelofibrosis with myeloid metaplasia: a case report

Source: International Journal of Advances in Medicine
Sandeep S., Reddy Ravikanth, Babu Philip.
The formation of blood cells in tissues other than bone marrow is known as extramedullary hematopoiesis. The most common sites of hematopoiesis are liver, spleen and lymph nodes. Extramedullary hematopoiesis can occur in various locations within the body and is characterized by soft tissue masses detected on imaging. Extramedullary hematopoiesis is a known complication of myeloproliferative disorders, which include chronic myelogenous leukemia, polycythemiavera, essential thrombocytosis and mylofibrosis with myeloid metaplasia. An intracranial extramedullary hematopoiesis is an extremely rare occurrence that frequently involves the cranial dura, falx, cerebral parenchyma, optic nerve sheath, and diploic space of skull. MRI remains the modality of choice in investigations for the same. This case report describes the intracranial MR imaging features seen in myelofibrosis with myeloid metaplasia.


Fibrous dysplasia: a case series of five cases

Source: International Journal of Advances in Medicine
Jagdale Amol, Mittal Saurav, Patel Krutik, Azhar Shaikh, Prasla Shopnil.
Fibrous dysplasia is development anomaly in which normal bone marrow is replaced by fibro-osseous tissue which characterized by deformities of the bone, fractures, nerve compression and bone pain. It is most commonly seen in young adult. In this study we report five case of fibrous dysplasia occurring at various locations with radiological interpretation.


A case series of mamushi bite and adverse effects of antiserum injection in several cases

Source: International Journal of Advances in Medicine
Makoto Kondo, Hiroyuki Goto, Shinya Yamamoto.
Eight cases of mamushi bite and associated adverse events, including serum sickness diseases, delayed response, and adverse effects of antivenom were reported at hospital from May to September 2015. Adverse effects were seen in cases 3, 6 and 7 during treatment for mamushi bite. The underlying causes for the high frequency and variety of adverse effects of mamushi antivenom, including adverse reactions and serum sickness disease, are still not fully elucidated. Mumashi antivenom can be a major contributing factor to reducing hospital stay duration. However, healthcare professionals should be aware of the potential adverse reactions to mamushi antivenom.


Medicolegal study of determination of time since death from potassium level in vitreous humour

Source: International Journal of Advances in Medicine
Chaitanya S. Kulkarni, Gajanan. S. Chavan, Avinash N. Jadhao.
Background: From the knowledge of science, various workers have established the methods of determining post mortem interval by the use of physical changes after death. Unfortunately the accuracy was low and margin of error high as evident from the literature available. Trends are now shifting towards the use of various chemical methods like estimation of electrolyte concentration of cerebrospinal fluid, synovial fluid and vitreous humour. Vitreous humour is stable, less contaminated by putrefaction, easily accessible in sufficient quantity. Thus, it is suitable to determine time since death. Methods: The present cross-sectional study was carried out in grant Govt. medical college; Mumbai on 200 cases brought to the mortuary from the period 1st January 2011 to 31st May 2013. Results: It was found that there was linear correlationship between vitreous humour potassium concentration and increasing post-mortem interval irrespective of age, sex, temperature, humidity and mode of death. Conclusions: There was linear relationship between vitreous potassium concentration and post-mortem interval. The accuracy of prediction of PMI can be improved by applying present study formula. The rate of rise of potassium level in vitreous humour was 0.23mEq/L/hr No significant difference in vitreous potassium concentration between the two eyes was noted when samples were drawn at the same PMI. There was no significant effect of age, sex, temperature, humidity and mode of death on vitreous potassium level after death.


Neurological manifestations in HIV positive patients attending tertiary care teaching hospital in Western India

Source: International Journal of Advances in Medicine
Shripad R. Kausadikar, Anand Chandak, Pramod Jha.
Background: Neurologic manifestations affecting the nervous system at all levels and stages of HIV infection are common and increasing with the extended survival of HIV-positive persons. Neurological manifestations occur due to either primary pathologic process of HIV or secondary to opportunistic infection. The neurological manifestations of HIV disease are likely to be different in Indian patients because of prevailing endemic infections, malnutrition, poverty and illiteracy. The present study was conducted to study various neurological manifestations in HIV positive patients presenting to tertiary care teaching institute. Methods: This was observational study of 100 HIV infected patients with clinical evidence of CNS involvement. A detailed clinical history and CNS examination was carried out. CD4 counts were measured and magnetic resonance imaging (MRI), brain/electromyography, nerve conduction studies and cerebrospinal fluid (CSF) examination were done as required for diagnosis. Results were analysed by using percentage and proportions whenever necessary. Results: HIV induced primary illness was present in about 27% cases, while 73% associated with secondary CNS manifestations were mainly due to opportunistic infection. The most common primary illness was distal symmetrical polyneuropathy (17%) followed by myopathy (6%). On the other hand, the most common secondary CNS infection was tuberculous meningitis (TBM; 30%), followed by cryptococcal meningitis (7%), and cerebral toxoplasmosis (4%). The commonest neurological presenting symptoms were headache (38%) whereas the commonest abnormal neurological finding was presence of signs of meningeal irritation (46.5%). The commonest abnormality found on neuroimaging was meningeal enhancement (32%). Conclusions: High index of suspicion of neurological involvement in HIV patients in all stages helps in early diagnosis and timely institution of specific therapeutic treatment which in turn may considerably reduce the morbidity and mortality due to the disease.


Effects of palonosetron and dexamethasone on postoperative nausea and vomiting in adult patients undergoing laparoscopic abdominal surgery: a randomized, double-blind, clinical trial at a tertiary care hospital

Source: International Journal of Advances in Medicine
Sifna Tahir, Altaf Ahmad Mir, Abdul Hameed.
Background: Post-operative nausea and vomiting (PONV) is one of the common problems after laparoscopic abdominal surgery. It hampers the postoperative recovery in spite of the availability of many antiemetic drugs and regimens for its prevention. We evaluated the effectiveness of intravenous (IV) palonosetron in counteracting PONV during the first 48hrs following laparoscopic abdominal surgery, using dexamethasone as the comparator drug. Methods: In this study a single pre-induction IV doses of palonosetron (75mcg) or dexamethasone (8mg) were administered to adult patients of either sex undergoing elective laparoscopic abdominal surgery. There were 40 subjects per group. The pre-anesthetic regimen, anesthesia procedure and laparoscopic technique were uniform. The primary effectiveness measure was total number of PONV episodes in the 48 hours period following end of surgery. The frequencies of individual nausea, retching and vomiting episodes, visual analog scale (VAS) score for nausea at 2, 6, 12, 24 and 48 hours, use of rescue antiemetic (metoclopramide), number of complete responders (no PONV or use of rescue in 48 hours) and adverse events were secondary measures. SPSS software version 16 was employed to using students t-test, chi-square test or fishers exact tests. Value of P


Superficial fungal infections in end stage renal disease patients

Source: International Journal of Advances in Medicine
Upma Narain, Arvind Gupta.
Background: Patients with end stage renal disease commonly present a spectrum of dermatological disorders. Each one has its own unique presentation and treatment approaches. Superficial fungal infections of the skin do not account for much in the end stage renal disease patients; hence most of the reports do not discuss this issue. In the present study we analysed patients with end stage renal disease who had developed superficial fungal infections. Methods: During January 2015 to June 2016, we tried to analyse 150 patients with end stage renal disease, who developed superficial fungal infections and were undergoing haemodialysis at least thrice a week for a minimum of three months at our centre. Results: Out of the 150 suspected cases we identified, 36 cultures tested positive. The macroscopic examination of the scalp, skin and the nails revealed 2.2% Tinea capitis, 13.9% Tinea versicolor, 44.5% Tinea corporis, 8.4% Tinea mannum, 16.8% onychomycosis, 5.7% Tinea cruris and 8.5% Tinea pedis. The culture examination highlighted 44.4% Trichyopyton rubrum, 27.8% Trychophyton mentagrophyte, 2.8% Trychophyton violaceum, 2.8% Trichophyton verrucosum, 2.8% Microsporum canis, 2.8% Epidermophyton flucossum, 2.8% Scopulariopsis brevicaulis and 13.8% Malessesia). The predominant clinical abnormality observed was Tinea corporis and the prevalent fungal isolate was Trichophyton rubrum. Conclusions: The current study illustrates that a significant number of patients with the end stage renal disease had a prevalence of superficial fungal infections; hence, a prompt recognition of skin lesions and the identification of these superficial fungi may alarm us so that early and the judicious management to reduce the associated morbidity and in turn to improve the quality of life in these patients is taken.


Prevalence of electrocardiographic abnormalities in heart failure patients attending Gujarat Adani institute of medical science, Kutch, Gujarat, India: a retrospective study

Source: International Journal of Advances in Medicine
Vinit A. Thacker, Jayesh V. Trivedi.
Background: The ECG is a non-invasive and comparatively simple bedside test to perform. It is mostly utilized cardiovascular diagnostic test, and it is performed by cardiologists and other physicians who are not cardiologists. The ECG is an essential test in the evaluation of patients with heart failure. The aim was to establish the prevalence of electrocardiogram (ECG) abnormalities with heart failure patients attending department of medicine, Gujarat Adani Institute of medical science, Bhuj, Kutch, Gujarat, India. Methods: It was a retrospective study carried out department of medicine, Gujarat Adani Institute of medical science, Bhuj, Kutch, Gujarat, India. Simple random sampling technique was applied for medical records of 400 patients diagnosed with heart failure. The demographic, clinical, chest X-ray and 12-lead resting electrocardiographic (ECG) data of the patients were examined. Heart failure was diagnosed, by the modified Framingham criteria for the diagnosis of heart failure. Analysis was done using SPSS version 15 (SPSS Inc. Chicago, IL, USA) level of confidence interval and p value was set at 95% and 5% respectively. Results: The ECGs were abnormal in 92 % of the patients, and normal in 8% of the patients. The main ECG abnormalities included: left ventricular hypertrophy (42.9%), left axis deviation (39.8%), left bundle branch block (19.4%), and left atrial enlargement (25.80%). Arrhythmias seen included: ventricular extrasystoles (11.8%), atrial fibrillation (9.1%), complete heart block (5.7), and ventricular tachycardia (3.9%). Conclusions: ECG abnormalities are very frequent with heart failure patients in Bhuj, Kutch, Gujarat, India. The ECG is very helpful not merely in the analysis and etiology of heart failure but also it assists in recognizing significant complications of heart failure that might manipulate the option of treatment.


Clinical profile and outcome of severe P. Falciparum malaria

Source: International Journal of Advances in Medicine
Ramrao Mundhe, Maroti S. Karale, Chandrakant Usendi, Siddhant Yadav.
Background: Malaria is a public health problem in more than 90 countries. According to the latest estimates of WHO, released in December 2015, there were 214 million cases of malaria in 2015 and 438 000 deaths. The aim was to study clinical profile and outcome of severe falciparum malaria in patients at tertiary health care centre. Methods: In this prospective study, total 125 clinically diagnosed severe malaria cases admitted during period of November 2013 to October 2015, were enrolled excluding patients below 12 years of age. Detailed history and clinical examination was carried out to assess clinical severity and complications of malaria. Results: Of the 125 cases studied 110 cases were of severe malaria produced by Plasmodium falciparum infection diagnosed on peripheral smear examination or by antigen detection test. The remaining 15 cases were excluded from the study. In this study, seventy six (69.1%) cases were males and thirty four (30.9%) cases were females, with male: female ratio of 2.23:1. Common symptoms found were fever, chills and rigors, altered sensorium, jaundice and nausea or vomiting while most common complication was jaundice, seen in 45.45%. Mortality due to severe falciparum malaria observed was 13.63%. Conclusions: In this study of severe falciparum malaria, most common symptoms found were fever, chills and rigors, altered sensorium, jaundice, nausea and vomiting while most common signs were pallor, splenomegaly, icterus, hepatomegaly, bleeding tendencies and in a few cases neck stiffness and hypotension. Jaundice, renal failure, impaired consciousness and cerebral malaria were most common complications of severe falciparum malaria.


Real world experience of GenXSync™ sirolimus eluting coronary stent system in patients with long coronary lesions: outcome of the GEL registry

Source: International Journal of Advances in Medicine
Hiremath M. S., C. N. Makhale, Abhishek Gorlawar, Ashish Indani, Poonam Bhutada, Murlidhar Bendale.
Background: The study aimed to assess the immediate (procedural outcome) and long- term clinical (Cumulative hierarchical MACE up to 2 years) and angiographic outcomes (late lumen loss at 8 months) in the patients undergoing angioplasty with at least one 40 mm GenXSync SES. (Indian Study Regulatory ID CTRI/2014/07/004783). Methods: This single centre prospective study included 26 real-world coronary artery disease (CAD) patients with long and very long lesions (38 lesions, 48 stents). All patients were treated with one or more 40 mm GenxSync sirolimus eluting stent (SES). All the subjects were followed up for 2 years including angiographic follow-up at 8 months. Angiography data was evaluated and reported by an independent angiographic core-lab. Subset analyses were performed for all 40mm long stents and 40mm with small diameter stents. Results: The procedural success was observed in 94%. The acute gain was 2.25±0.53mm in stent and 2.09±0.71mm in segment despite of long and complex lesions including CTO. At 2 years, there was only 1 (3.84%) MACE (binary restenosis at 8 months) and stent thrombosis. At 8 months late lumen loss was in-segment 0.15±0.30mm and in-stent 0.14±0.17mm (p = 0.06). The 40mm stents subset, revealed acute gain of 2.21±0.58mm in-stent and 2.01±0.74mm in-segment. The late loss was 0.16± 0.31mm and 0.13±0.17mm in-stent and in-segment respectively. In 40mm stent with small diameter subset, the acute gain was 2.19±0.42mm in-stent and 1.69 ± 0.59mm in-segment and late lumen loss was 0.10±0.18mm in-segment and 0.13± 0.33mm in-stent. Conclusions: The results of real world long lesions PCI revealed efficacy, safety and procedural success observed with GenXSync stent comparable to other reported studies.


Study of C-reactive protein in patients with acute myocardial infarction attending tertiary care teaching hospital in Saurashtra region of Gujarat, India

Source: International Journal of Advances in Medicine
Shripad R. Kausadikar, Hina A. Mehra, Krishnakant P. Pathak.
Background: Acute Myocardial Infarction is a major contributor to morbidity and mortality globally. A growing body of evidence supports the concept of local and systemic inflammation playing a critical pathophysiologic role in progression of atherothrombosis and occurrence of infarction. Objectives of the study were to assess the role of serum C-reactive protein (CRP) levels in patients with first acute myocardial infarction attending tertiary care teaching hospital. Methods: A cross sectional study was carried out from October 2009 to September 2010 in tertiary care teaching institute in Saurashtra region, Gujarat, India. A total of 50 patients admitted to intensive cardiac care unit with a diagnosis of acute myocardial infarction were enrolled. Serum CRP levels were sent at 6 hrs to 36 hrs of chest pain. Patients were assessed for early complications as well as left ventricular function on Echocardiography. Results were analysed using appropriate statistical methods. Results: In this study, the mean age of presentation of acute myocardial infarction was 52.7 years which is a decade younger than in previous studies. CRP levels were found to be elevated in 79.4% of patients with anterior wall myocardial infarction. Raised CRP levels were associated with greater incidence of (50%) early complications after acute myocardial infarction. Raised CRP levels were also associated with a LVEF


Evaluation of pulmonary functions in patients of type-2 diabetes mellitus

Source: International Journal of Advances in Medicine
Maroti Karale, Bhanudas Karale, Chandrakant Usendi, Sadanand Kamble.
Background: The review of literature revealed conflicting documentation regarding the effect of type-2 DM (diabetes mellitus) on pulmonary functions. Some authors have reported normal pulmonary functions and even concluded that spirometry testing is not at all necessary in diabetic patients. Some studies have shown abnormal pulmonary functions in patients of DM. Moreover, the duration of DM and glycemic control have varied impact on the pulmonary functions. The present study was undertaken to resolve the conflict and also to explore the pulmonary functions in type-2 diabetics of this cross section of population. Methods: The pulmonary function tests FVC, FEV1, FEV3, PEFR and MVV were performed in 50 type-2 diabetics and 50 controls by computerized medspiror using standard laboratory methods. The data was documented statistically analyzed. By giving suitable class intervals, intra-diabetic groups were made to assess the effect of extent duration of diabetics on pulmonary function test. Results: Pulmonary functions FVC, FEV1, FEV3 PEFR and MVV were decreased in type-2 diabetes mellitus. Duration of type 2 DM was significantly associated with decrease in FVC, FEV1%, PEFR and MVV. Conclusions: Longer duration of type 2 diabetes is significantly associated with reduction in pulmonary functions FVC, FEV1%, PEFR and MVV which underlines the respiratory system as one of the target organs of type-2 diabetes mellitus.


Prevalence of depression and associated risk factors among the elderly in rural field practice areas of a tertiary care institution in Katihar, Bihar

Source: International Journal of Advances in Medicine
Sneha Soni, Mukesh Shukla, Manish Kumar.
Background: Despite depression is one of the most common emerging psychiatric morbidity among elderly now days, yet the depressive symptoms are not diagnosed appropriately. The objective of the study was to estimate the prevalence of depression and identify associated risk factors in the elderly population. Methods: A community based cross-sectional descriptive study was conducted from January 2013 to December 2013 in villages under field practice area of Katihar Medical College in the state of Bihar, India. Multistage sampling technique was employed, and a total 450 elderly persons were interviewed after obtaining written informed consent. Subjects with score >20 on the mini-mental state examination, were assessed for depression using the Short Form Geriatric Depression Scale. Study variables included bio-social parameters such as age, gender, literacy status, occupation, socioeconomic status, financial dependency and marital status. Results: The prevalence of depression in the study population was 39.6%. Mild depression was present in one-fourth (24.4%) of the study population followed by moderate depression (11.55%). Even 3.7% of the elderly were severely depressed. It was significantly higher in females (p = 0.00), those who were single (p = 0.00), those who belonged to upper socioeconomic strata (0.00) and were financially dependent on others. Conclusions: The study revealed the need for development of community based comprehensive strategy for early diagnosis and prompt treatment of depression among elderly as well as to promote mental health.


Profile of hyponatremia in a tertiary care centre in North India

Source: International Journal of Advances in Medicine
Mahim Mittal, Deepshikha, Hunny Khurana.
Background: Hyponatremia is the commonest electrolyte imbalance. Hyponatremia is a heterogenous disorder and classified into hypovolemic, euvolemic and hypervolemic types depending on the volume status of the patient. Approach is based on etiology and type of hyponatremia. The aim of the present study was to determine the profile of hyponatremia in adult patients including underlying etiology, type, clinical features and outcome Methods: The study was conducted at BRD medical college Gorakhpur, India between July 2014 to August 2015 after approval by the ethical committee. Consenting patients >18 years of age with hyponatremia (


Trends in the clinical and hematological profile of patients with dengue fever

Source: International Journal of Advances in Medicine
Tejas N. Modi, A. Santosh Sriram, Amit D. Mehta, Pankaj S. Patil.
Background: World Health Organization (WHO) estimates that 50-100 million dengue infections occur every year with 22000 deaths. The increasing magnitude of the problem together with its changing epidemiology is an important public health concern. The aim of the present study was to evaluate clinical profile, hematological profile, biochemical profile and outcome of dengue fever and to determine the relationship between clinical profile and hematological profile. Methods: This is a retrospective, observational, hospital-based study. 369 patients, aged more than 12 years, admitted between 1st January to 31st December 2015 with dengue fever were studied for clinical profile including documented bleeding manifestations/bleeding tendencies, hematological profile, biochemical profile and outcome. Results: Dengue cases occurred at higher frequency in 12-30 year age (81.30%), in males (M: F ratio- 2.35:1) and in rainy season (87.26% from September to November). Common presentations on clinical, radiological, haematological and biochemical profile were: fever (100%), headache (73.98%), bodyache (71.81%); hepatomegaly (66.93%), pericholecystic oedema (48.23%), distended GB (38.21%); thrombocytopenia (92.68%), leucopenia (58.26%) and raised liver enzymes (79.94%) respectively. Bleeding manifestations were observed in 48.61% cases of which petechiae (74.68%) was the commonest followed by epistaxis (7.59%), gum bleeding (2.16%), melena (2.16%) mainly. Mean duration of fever prior to hospitalization was 5.06±1.70 days. Mean nadir of platelet count was on 6.83±1.47 day from onset of illness (1st symptom-fever) and 1.77±0.89 day of hospitalization.100% patients had good recovery. Conclusions: Maximum prevalence of dengue was in young, in males and in rainy season. Thrombcytopenia, leucopenia, hepatomegaly, raised liver enzymes-aspartate aminotransferase (AST) and alanine aminotransferase (ALT), pericholecystic oedema are prima facie of dengue. Prompt diagnosis and immediate specific treatment with maintenance of platelet count and haemostatic function gives good recovery.


Study to determine various echocardiographic abnormalities and its correlation with CD4 count in patients with HIV infection at tertiary care hospital in Mumbai, India

Source: International Journal of Advances in Medicine
Sushma S. Gaikwad, H. Bhamare, D. S. Asgaonkar.
Background: The prevalence of echocardiograhic abnormalities in HIV/AIDS patients is uncertain in India. Early screening and prompt treatment are important to prevent significant morbidity from cardiac involvement and to promote long term health in PLHIV. Hence the present study was undertaken to determine various Echocardiographic abnormalities and their correlation to CD4 counts. Methods: This prospective cross-sectional study was carried out in the BYL Nair Hospital, Mumbai during the period of Nov 2011 to Oct 2012. A total of 150 adult patients (age >18 years) were included. Their demographic, clinical data along with routine investigations, CD4 count, and 2D ECHO using Philips iE 33 were carried out and recorded. Echocardiographic criteria for various abnormalities were applied as per American Society of Echocardiography Guidelines. Data was analysed by using SPSS 13 software. Results reported as percentage or mean±standard deviation and p value


Antibiotic resistance pattern of bacterial enteritis among hospitalized children in Ardabil: a single center experience

Source: International Journal of Advances in Medicine
Manouchehr Barak, Mohsen Arzanlou, Behnam Babapour, Lida Ghorbani.
Background: Gastroenteritis is one of the most important diseases in all parts of the world; and more dangerous among children, elderly, people who are undernourished and those who live in worse conditions. This study was set up to assess the antibiotic resistance pattern of bacterial enteritis among hospitalized children in Ardabil. Methods: This prospective cross-sectional study was carried out on 52 children who were referred to Bu- Ali hospital with dysentery in 2014. Results: Among all 52 collected Stool samples, 33 (63.4%) yielded Shigella. The most common Shigella isolate was S. flexneri (n = 17, 48.6%). Of 52 cases, 61.5% were boy, with the average age of 4.8 years. In the antibiogram, Ciprofloxacin and Gentamiycin were the most sensitive antibiotics to Shigella spp. and Co-trimoxazole and Azithromycin showed the highest resistance. Also, Imipenem, Ciprofloxacin and Gentamicin were the most sensitive antibiotics to E. coli and Co-trimoxazole showed the highest resistance. Finally, Azithromycin, Ceftazidime and Nalidixic acid were the most sensitive antibiotics for Salmonella group D. Conclusions: The results showed that different bacterial species showed maximum sensitivity to different drugs whereas the majority of them were resistant to Co-trimoxazole.


Factors associated with anti-retroviral therapy adherence among people living with HIV visiting IRT Perundurai medical college hospital link ART centre, Perundurai, Tamilnadu, India

Source: International Journal of Advances in Medicine
Mohankumar Vedhanayagam, Rajesh Rajagopalan, Balamurgan Bhavani Rajendran, Sendhil Sengodan, Senthilkumar Sengodan.
Background: National AIDS control organisation aims to provide wholesome management to PLHIV. This is ensured by universal access to free and comprehensive care, support and treatment in health delivery facilities across the country by dynamic linkages and referral mechanism for monitoring, mentoring, decentralization and specialized care and treatment. Objective of the study was to analyse factors associated with ART adherence among PLHIV visiting IRT Perundurai Medical College Hospital link ART centre, Tamilnadu, India. Methods: A prospective observational study was conducted during June 2015 to May 2016. All PLHIV receiving ART drugs as per protocol from LAC were included. Results: 139 clients were registered for treatment and follow up till May 2016 in our centre. 31 were transferred to nearby ART, link ART centres. Currently 98 (38 male; 60 female) were utilizing our services. Majority of the patients were on ZLN followed by TLE and ZLE. Most of clients were from rural areas belonging to low or low middle income group. Common occupation was found to be farming and cattle rearing. Most women were housewives. The average age in present study was 38.3 years. Oldest was 73 years old male and youngest 10 years old female. Family support and benefits of ART drugs tops the list of facilitators; supply chain, alcohol issues, family issues were commonly observed barriers. Conclusions: Our results supported the measurement of multiple dimensions of medication-taking behaviours in order to avoid overestimating adherence to ART. Investigation of factors associated with long term adherence would require elaborate and constant follow-ups than in this study period.


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