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Δευτέρα, 14 Νοεμβρίου 2016

Comparison of Effects of Magnesium Sulphate V/S Clonidine as an Adjuvant to Epidural Bupivacaine in Lower Abdominal and Lower Limb Surgeries

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Bhumika A Munshi, Ankit Munshi.
Introduction: A prospective, randomized, controlled clinical trial was carried out to evaluate the effects of Magnesium sulphate as an adjuvant to epidural bupivacaine and compared with clonidine along with epidural bupivacaine. Aims and Objective: Main objective to evaluate the efficacy of epidural magnesium sulphate & clonidine used as an adjuvant to bupivacaine. Material and method: After approval from institutional ethical committee 90 patients undergoing lower abdominal &lower limb surgeries selected and devided in 3 groups Control group, magnesium group and clonidine group and different parameters observed. Observation: Co-administration of inj. Magnesium sulphate 50 mg. or Clonidine 3µg/kg (150µg maximum) to epidural bupivacaine produced predictable rapid onset of surgical anaesthesia without significant side effects. Addition of clonidine to epidural bupivacaine produced prolonged duration of analgesia with mild sedation compared to magnesium sulphate. Conclusion: From the study it is suggested that magnesium sulphate can be a useful alternative as an adjuvant to epidural bupivacaine without any side effects.


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A Study on Clinical, Laboratory Manifestation and Effect on Major Organ System in Hypothyroidism in Tertiary Care Hospital of Surat City

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Vivek R Garg, Dipak B Solanki, Ashvin H Vasava, Jimit N Vadgama.
Background: In addition to common classic manifestation of hypothyroidism, there are many additional manifestation of hypothyroidism that is less commonly acknowledged. The present study was planned with an objective to study the clinical profile, biochemical abnormalities and effect on major organ system of hypothyroidism. Methodology: All the patients were examined & symptoms and sign of hypothyroidism noted and then subjected to investigation, which includes routine investigation (RBS, S.Creatinine, CBC, ESR, Urine Analysis, Chest X-ray, ECG, S.cholesterol, S. protein. Specific investigation like echocardiography is also advised accordingly. Results: Facial puffiness in present in 24 (48%), Pedal edema in 20 (40%) and dyspnea and chest discomfort was present in 30% of patient. Among the neurological manifestations, delayed nerve jerk was present in 8 (16%), Hoarseness Of voice in 15 (30%) and deafness and impairment of memory was present in 2% of patient. Sinus bradycardia was present in 2 cases. Low voltage ECG in 5(10%).Low voltage with T wave changes observed in 4 cases.ST-T changes in 5 patients. Left ventricular hypertrophy presents in 4 cases. Conclusion: ST-T changes in the form of flat or inverted T wave was the most common abnormality in electrocardiogram i.e.14%, Sinus bradycardia was present in 4% of cases. Menorrhagia was the most common menstrual problem observed in 20% of cases, Anemia (Hb


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Frequency and Predictors of Hepatopulmonary Syndrome in Chronic Liver Disease Patients

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Atanu Chandra, Soumya S Mondal, Sanjay K Mandal, Indranil Sen, Mithun Das, Snigdhendu Pal.
Introduction: Hepatopulmonary syndrome is not very uncommon among chronic liver disease patients in clinical practice.It is associated with shorter survival and poor liver function in cirrhotics. Although there are a large number of CLD patients in India, the exact frequency of HPS is not known & it needs evaluation. Aims: To estimate the frequency of hepatopulmonary syndrome among Indian patients with chronic liver disease, study the correlation between HPS and the severity of liver disease and assess the factors predictive for diagnosis of HPS. Methodology: A cross sectional study on total fifty patients (34 males, mean age 44.4 ± 7.3years) with chronic liver disease was conducted to diagnose the presence of hepatopulmonary syndrome. Patients were subjected to clinical examination, laboratory investigations, measurement of arterial blood gas and transthoracic contrast enhanced echocardiography. The severity of liver disease was assessed by Child-Pugh score.The diagnostic criteria for HPS were presence of intrapulmonary vascular dilatation(IPVD) documented by contrast enhanced echocardiography and alveolar arterial oxygen gradient of more than 15 mm Hg. Results:.Nine of fifty patients (18%) with chronic liver diseas were found to have contrast echocardiographic evidence of intrapulmonary vasodilatation. Hepatopulmonary syndrome was observed in seven (14%) patients.We did not find any significant correlation between presence of HPS with severity of liver disease according to the Child-Pugh score. Features like dyspnoea, orthopnea, cyanosis, clubbing, platypnoea and orthodeoxia were significantly more common in the HPS group. Conclusions: The frequency of HPS among the studied group of Indian patients with chronic liver disease was 14%. Though there was no significant correlation between presence of HPS with severity of liver disease according to the Child-Pugh score ; but presence of cyanosis, clubbing, dyspnoea and platypnoeaorthodeoxia are suggestive indicators of HPS.


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Assessment of Metered Dose Inhaler Technique in Patients With Chronic Lung Disease at Tertiary Health Care Centre

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Prashant R Gohil, Radhika N Thacker, Darshan J Satapara, Jasu N Patel, Naresh R Patel, Zainab J Gandhi.
Introduction: Bronchial asthma and chronic obstructive airway disease are the two most common chronic lung diseases encountered at C.U.Shah Medical College. The treatment usually includes the use of bronchodilators and steroids, which are best, delivered through the inhalational route. Metered-dose inhalers are routinely prescribed for this purpose. Metered dose inhalers (MDIs) are an affective modality of treatment for fast relief from asthma flare-ups and other symptoms, and are often used by asthmatic athletes. It has got lots of benefits and some drawbacks depending on usage technique. With proper technique and training drawbacks can be minimized. The aim of this study was to assess the metered dose inhaler technique in patients with chronic lung disease at our hospitals. Method: A cross sectional study was conducted at a Tertiary Health care centre. The inhalation technique was assessed in six steps. Result: Clear evidence showed that only 28% patient could perform all the steps correctly. Percentages of people that followed individual steps properly were: preparation (90%), exhalation (55%), lip closure (70%), inhalation (58%), breath-holding (30%) and puff interval (38%). Conclusion: This study showed that a number of patients in our hospitals were unable to use metered-dose-inhaler properly and therefore indicates the need to make people aware of this technique either by counseling or arranging seminars.


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Burden of Low Birth Weight and Malnutrition among New Born Babies in Rajasthan, India

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Ajay Sethi, Devang Gandhi, Jayesh J Varia, Vipul Bhageria, Vasav Darshan.
Introduction: The goal of reducing low birthweight incidence by at least one third between 2000 and 2010 is one of the major goals in A World Fit for Children, the Declaration and Plan of Action adopted by the United Nations General Assembly Special Session on Children in 2002. The present study was planned to show the measure the prevalence of Low birth weight in tertiary care hospital. Methodology: The present study was conducted in the department of Paediatrics, S.M.S. Medical College, Jaipur in which clinical assessment & assessment of nutritional status was done among the neonates delivered at Mahila and Zenana Hospital, S.M.S. Medical College, Jaipur. All neonates delivered at the hospital and fulfilling inclusion criteria during one year period were included in the study. Results: Out of total 500 neonates, 313 (62.6%) neonates were male and 187 (48.4%) neonates were female. Maximum number (55%) of newborns were having MAC of 9 to 10 cm. Mean of birth weight of all newborns was 2.59 kg. Around 35% of infants were having birth weight of less than 2.5 kg which are considered Low Birth Weight babies. Maximum number of newborns i.e. 220 (44%) were having birth weight of 2.5 to 3.0 kg. 17.8% of newborns were having birth weight of 3.0 to 3.5 kg. According to MAC/HC ratio, 59% of newborns were well nourished (MAC/HC ratio >0.27) and 41% newborns were malnourished (MAC/HC ratio 2.2) and 24% newborns were malnourished (PI


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A Study to Evaluate of Time Since Death From Potassium Level of Vitreous Humour

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Umang P Patel, Jigneshkumar Patel, Pranav Prajapati, Ganesh Govekar.
Introduction: Estimation of time since death plays a crucial roles in law enforcement agencies in most of the unnatural deaths. Estimation of post-mortem interval from changes of potassium level in vitreous humour is more diagnostic tool for forensic field. Material & methods: We prospectively studied 200 cases having known time since death for the present study at the Dept. of Forensic Medicine & Toxicology, Govt. Medical College, Surat in the year of 2015-2016. Level of potassium in vitreous humor in all subject were analysed in Bio-chemistry laboratory on the same day and various statistical tests performed. Observation: In this study age of the subjects were mostly from 26-35 years and predominantly male gender. Samples collected for this study were from 12-24 hours of post mortem interval with linear rise of potassium level in both eyes. Conclusion: Time since death was more accurately calculated with the help of potassium concentration of vitreous humour.


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Pancreatic Pseudocysts and Their Unusual Locations

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Yash Jardosh, Hinal Bhagat, Rahul Sharma, Dhwani Upadhya.
Introduction: The aim of our study was to detect the various sites of fluid collections in acute and chronic pancreatitis. Patients presenting with pancreatitis were further evaluated for pseudopancreatic cyst. Characteristics along with location of cysts were compared and unusual location for pseudopancreatic cyst studied. Methodology: A prospective study of 60 adult patients, (39 male patients and 21 female patients) with Acute and Chronic pancreatitis was undertaken from August 2015 to July 2016. CT scans of 60 patients with acute and chronic pancreatitis were reviewed. Of these in the patients with pseudocyst formation (28 of 60 patients), the location of intrapancreatic, peripancreatic and distal fluid collections in the setting of acute and chronic pancreatitis was studied. Results: Fluid collections developed in 28 of 60 patients (21 male patients and 7 female patients) for an incidence of 46.6%. Incidence of pseudocyst formation was high in age group of 50-60 yrs. (32.1%), retroperitoneal space according to location (39.2%) and alcohol was noted to be the most common aetiology (60.8%). Conclusion: Most common locations are the omental bursa and the retroperitoneal space. Pseudocysts in rare sites notably splenic parenchyma, mediastinum and left perinephric space were noted in four patients.


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Post TB Pulmonary Disability: An Ongoing Challenge for India

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Nimit V Khara, Bhavesh M Patel, Ravish M Kshatriya, Satish N Patel, Rajiv P Paliwal.
Introduction: Pulmonary tuberculosis can involve the airways, resulting in mucosal oedema, hypertrophy/hyperplasia of the mucosal glands, increased mucous secretion and smooth muscle hypertrophy. They affect the calibre of the airways, increase their resistance and decrease airflow. This study was planned to assess pulmonary disability by simple methods in symptomatic patients who were pulmonary tuberculosis survivors after successful treatment completion. Methodology: The present study was a cross sectional study, conducted at the Department of Respiratory Medicine, Pramukhswami Medical College, Karamasd, Anand. Total 53 patients fulfilling the criteria were included in the study. All patients underwent thorough clinical assessment, six minute walk test (6MWT), and spirometry for assessment of pulmonary disability. Spirometry was done after holding bronchodilators for 24 hours. In spirometry, pre-bronchodilator FVC, FEV1, FEV1/FVC and post bronchodilator FVC, FEV1, FEV1/FVC were the chief variables analyzed. Result: Out of total 53 patients, mean age of patients was 53.6 years. Maximum number of patients (14) (26.4%) were in the age group of 61-70 years. 42 (79.2%) were males and 11 (20.8%) were females. As per the WHO classification for BMI, 25 (47.2%) patients were underweight, 24 (45.3%) were in normal range and 4 (7.5%) were overweight. Spirometry pattern was normal in 3 patients, obstructive in 5 patients, restrictive in 20 (37.7%) patients and combined (mixed) in 25 (47.2%) patients. There was significant statistical difference between groups (spiometry pattern distribution) in context of mean weight. (P=

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Usefulness of Ultrasound Technology in Cases of Occular Trauma Attending Tertiary Eye Care Center in Medical College in Semi Urban Area in Gujarat

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Jyotindra N Brambhatt, Akshay V Sahayata, Mansi V Sahayata, Himani V Chavda.
Introduction: Ultrasound scan is a medical test that uses high frequency sound waves for imaging. Ultrasound technology is useful for diagnosis, differentiation of nature of various traumatic intraocular conditions and helpful in planning the line of management. Materials and Methods: This study was conducted after getting permission from ethical committee. study period is from January to June 2016 in the patients of ocular injuries. After primary documentation patients were examined with tourch light, Snellens chart, slit-lamp and indirect and direct ophthalmoscopic examinations. Then sent for ultra sonography in radiology department for b-scan. We planed the treatment after assessing the clinical and b-scan findings. Results: In 6 months of our study 54 patients of ocular injuries were examined. Out of 54 patients, 26(48.14%) patients having positive usg findings. The positive usg findings were vitreous haemorrhage, detachment and verities, Retinal detachment and hyphema. Clinically these findings are difficult to detect in emergency cases, So help of ultrasonography technique is required. Conclusion: Ultrasound scan is a useful imaging modality in patients with Ocular trauma for diagnosis of various ocular conditions. It will help the surgeon to plan medical or surgical treatment in majority of ocular trauma cases.


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A Study on Cardiovascular Manifestation in Leptospirosis Cases in A Tertiary Care Hospital of Surat City

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Prakash T Chand, Vivek R Garg, Mithram Z Wadia.
Background: Despite the fact that as many as 20% of patients may have associated cardiac involvement, these manifestations are seldom discussed in reviews on the clinical aspects. The present study has been carried out to know the involvement of cardiovascular system as indicator and mortality in leptospirosis. Methodology: The present study was carried out in Govt Medical College and New Civil Hospital, Surat during outbreak of Leptospirosis where all the patients with clinical suspicion of Leptospirosis were screened by IgM anti leptospira antibody ELISA (SERION ELISA), CK-MB levels, ECG changes and 2D ECHO changes. Results: It is seen that Myocarditis is maximum in more than 56 years which is about 66.6%. Out of 35 patients who were investigated with 2D echo, 18 patients (51.4%) had abnormal 2D ECHO findings. In the present study 18 patients had 2D ECHO changes in the form of reduced ejection fraction, regional wall abnormality, pericardial effusion and valvular abnormality. As the Ejection Fraction decreases the mortality increases. In EF 40-50% non survivors are 28.6%, EF 30-40% non survivors is 62.5% and EF less than


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Effect of Sudarshan Kriya Yoga on Auditory and Visual Reaction Time in Medical Students

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Sushma S Jadhav, Rupali F Bandgar, Asha D Jadhav.
Background: Yoga was found to cause a better improvement in the health of the individuals with and without ailments. Audio-visual reaction time is important indicator in cause better improvement in reaction time. Hence, this study intended to show its utility as a short course for improving the reaction time. Aim and objective : To find out effect of Sudarshankriya yoga on audio-visual reaction time in medical students by recording the audio-visual reaction time in medical students before & after Sudarshan kriya yoga practical for one month. Material and Methods: The present study was conducted on 60 practical students, who came voluntarily as subjects for the project. Their age ranged between 18 to 20 years. Audio-visual reaction time measured by apparatus designed by Anand Agencies Pune. Results: In present study there was significant (p


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CANSCORE- Important Index For Detection of Fetal Malnutrition at Birth

2016-11-14T16-26-55Z
Source: National Journal of Medical Research
Ajay Sethi, Devang D Gandhi, Shradha H Patel, Darshan K Presswala, Shefali B Patel.
Introduction: Malnutrition refers to the situation where there is an unbalanced diet in which some nutrients are in excess, lacking or wrong proportion. Simply put, we can categorise it to be under-nutrition and over-nutrition. Despite India's 50% increase in GDP since 1991,3 more than one third of the world's malnourished children live in India. The present study was conducted to assess utility of CANSCORE and it compared with other commonly used measures for defining the nutritional status at birth. Methodology: The current study was conducted by the department of Paediatrics, S.M.S. Medical College, Jaipur. All neonates delivered at Mahila and Zenana Hospital, S.M.S. Medical College, Jaipur. All neonates delivered at the hospital and fulfilling inclusion criteria during one year period were included in the study. Different indices to measure nutritional status of newborns like Birth weight to Gestational Age, Ponderal Index, Mid Arm Circumference/ Head Circumference Ratio and CANSCORE were calculated. Clinical Assessment of Nutrition Score (CANSCORE)- is done within 48 hours on the basis of superficial readily detectable signs of malnutrition in the newborn as described by Metcoff. Results: According to Birth weight to Gestational Age criteria, 116 (23.2%) newborns were malnourished (Small for Gestational Age). According to Ponderal Index, 120 (24%) newborns were malnourished (PI

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