Intravenous catheter complications in hemodialysis

2016-10-03T11-22-33Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Shyamala Kumari Volabailu, Venu Gopala Delanthabettu.
Background: Vascular access, still is a problem for hemodialysis. Venous catheters are commonly used for acute angioaccess during maintenance hemodialysis in acute renal failure and end-stage renal failure patients. However, the catheters are often complicated by mechanical or infectious complications which may result in morbidity and or premature removal of the catheter. Even though, there are various studies on central venous catheters used in hemodialysis in western countries less is documented in India. Aims and Objectives: Complications of intravenous catheter used during hemodialysis in our set up. Materials and Methods: This prospective study was conducted on 110 patients selected by random sampling in dialysis units of a government district hospital from October 2014 to September 2015. Patient age, sex, history, type of kidney disease, and associated conditions were also noted according to the pro forma. Date of intravenous catheter insertion, site of insertion, and insertion complications were noted. All patients were followed up until the day of catheter removal. Date of catheter removal, reason for catheter removal, and duration of catheter days were noted. Data were collected and tabulated. Result: Only 47.8% of patients suspected with infections showed bacterial growth in catheter tip culture. However, blood culture showed bacterial growth only in 19.6% of infection suspected patients. Blood culture reported 55.6% Staphylococcus aureus growth followed by Pseudomonas (22.2%), Escherichia coli, and Acinetobacter (11.15%) growth in samples collected from infection suspected dialysis patients. Conclusion: Fever due to infections is the most common cause for catheter removal.


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Histopathological alterations in lung tissue received as autopsy specimens- a study of 410 cases

2016-10-03T10-50-55Z
Source: International Journal of Medical Science and Public Health
Nirali S Amin, Pooja Y Shah, Ravi G Patel, Varsha S Khant, Shreedhan G Prajapati.
Background: Many millions of people around the world suffer from preventable pulmonary diseases. The clinical and radiological findings in most of the respiratory diseases are nonspecific and correct diagnosis cannot be made solely from them. Histopathological examination serves the purpose in such cases. An autopsy is an important complementary tool for identifying and understanding the pathology of respiratory diseases and to find out the condition of internal organs. Objective: The objective of this study was to find out the prevalence of various lung pathologies by histopathological examination of lung tissue received as autopsy specimens. Material and Methods: The study was done on 410 lung specimens from autopsy cases received in this department over the period of 18 months. Gross findings and microscopic features were recorded. The tissue specimens were fixed in 10% formalin and processed. Paraffin sectioning was done followed by haematoxylin and eosin staining. The sections were then examined by experienced histopathologists. Result: During the period between January 2015 to June 2016, a total of 410 lungs from autopsy specimens were studied. Lung diseases were more common in males as compared to females. Most common lung pathological findings were of pneumonia (20%), tuberculosis (16.1%), emphysema (6.6%) and malignant lesions (1.7%) among the cases studied. Conclusion: Advances in diagnostic technology have not reduced the value of autopsy and a goal-directed autopsy remains a vital component in the study and evaluation of the disease process. There are large numbers of cases of preventable respiratory diseases. This indicates that the autopsy has remained an important complementary tool for identifying and understanding respiratory diseases despite recent advances in diagnostic technology.


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Assessment of nutritional status of adolescent girls residing in rural area of Belagavi

2016-10-03T10-50-55Z
Source: International Journal of Medical Science and Public Health
Sulakshana S Baliga, Vijaya A Naik, Mallapur M D.
Background: Adolescence is a period of transition between childhood and adulthood. Health and nutrition of the girls will affect the health and survival of future generation. However, there is very little information about the nutritional status of adolescents, particularly from rural areas in India. In view of the above facts, an attempt was made to assess the nutritional status of rural adolescent girls. Objective: To assess the nutritional status of adolescent girls. Materials and Methods: This one-year community-based, cross-sectional study was undertaken at a village of district Belgaum, Karnataka among 400 adolescent girls of 1019 years. Information on socio-demographic variables was collected by an interview using pre-designed and pre-tested questionnaire and anthropometric measurements were recorded for assessing the nutritional status. Result: The mean weight of adolescent girls in all age groups was better than Indian Council of Medical Research (ICMR) standards except in the ages 10, 12, and 13 years. The mean height of adolescent girls in all age groups was better than ICMR standards except in the ages 11, 12, 13, and 18 years. The prevalence of thinness in adolescent girls was 62% and prevalence of overweight was 2%. Conclusion: Majority of adolescent girls had mean height and mean weight in all age groups better than ICMR standards. More than half of adolescent girls were thin. None of the girls aged 1519 years were obese.


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Histomorphological spectrum of salivary gland tumors in a tertiary care hospital—A retrospective study

2016-10-03T10-50-55Z
Source: International Journal of Medical Science and Public Health
Nirali S. Amin, Smita A. Shah, Shreedhan G. Prajapati, Hansa M. Goswami.
Background: Salivary gland tumors are rare, accounting for 310% of the total tumors of head and neck region. Approximately 80% of the salivary gland tumors are found in the parotid gland and 1015% in the submandibular gland. Around 80% of parotid tumors and 50% of submandibular tumors are benign. Salivary gland tumors can show a striking range of morphological diversity between different tumor types and sometimes within an individual tumor mass. Hence, it is important to identify various histomorphological patterns and classify them accordingly. Objectives: The aim of this study was to recognize various histomorphological patterns of salivary gland tumors, their frequency, age, and site distribution. Materials and Methods: It was a retrospective study of 96 cases of salivary gland tumors, diagnosed on histopathological examination over a period of 2 years (July 2012 to June 2014) in the Department of Pathology of a tertiary care hospital. Histopathological examination was done on formalin fixed, paraffin embedded tissue sections stained with hematoxylin and eosin. Result: Out of 96 cases, 60 (62.5%) were benign and 36 (37.5%) were malignant. Benign tumors were frequent in the 3rd and 4th decade, whereas malignant tumors were common in 4th and 5th decades of life. Male:female ratio was 1.6:1. The most common site of occurrence for both benign and malignant tumors was the parotid gland. Pleomorphic adenoma was the most common benign tumor. Mucoepidermoid carcinoma (36.1%) was the most common malignant salivary gland tumor. Parotid was the most common site for mucoepidermoid carcinoma. Conclusion: Salivary gland tumors are relatively rare. Benign salivary gland tumors are more common than malignant ones. There is a male preponderance. The Parotid gland is the commonest site for occurrence of salivary gland tumors. Pleomorphic adenoma is the most frequent benign tumor whereas mucoepidermoid carcinoma is the most common malignant tumor of salivary glands. Histopathological examination is mandatory in the diagnosis of salivary gland tumors as they have a very wide spectrum of morphological patterns.


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A comparative study of sevoflurane and propofol for laryngeal mask airway insertion

2016-10-03T10-50-55Z
Source: International Journal of Medical Science and Public Health
Binita Patel, Hemangini Patel, Bansari Kantharia.
Background: Laryngeal Mask Airway (LMA) is a useful advent in the airway management, filling a niche between the face mask and the tracheal tube in terms of both the anatomical position and the degree of invasiveness. Propofol is an intravenous anesthetic agent which depresses both laryngeal and pharyngeal reflexes and provides profound relaxation of pharyngeal muscles. Incidences of agging coughing, laryngospasm are less while using propofol than thiopentone. Sevoflurane is pleasant smelling, non-irritating to the airway, has a low blood gas solubility coefficient, good muscle relaxant effect, and high inspired concentration can be given without side effects or discomfort. It allows rapid smooth inhalation induction with excellent recovery characteristics. Objective: To compare the quality of the condition provided for successful LMA insertion by sevoflurane induction with propofol induction methods. Materials and Methods: Study was carried out in 100 patients at the New Civil Hospital, Surat. Patients were randomly divided into 2 groups comprising of 50 patients each. In Group-P induction with propofol 3 mg/kg intravenously over 30 seconds and in Group-S induction have done with inhalational sevoflurane 8% and nitrous oxide 50% in oxygen. Results: The mean pulse rate before induction in Group-P was 79.92±9.18 beats/min and in Group-S it was 80.96±10.11 beats/min, p>0.05. Following LMA insertion the mean pulse rate increased in both the groups. However, the mean pulse rate did not differ significantly between the groups at any time following LMA insertion, p>0.05. The mean systolic blood pressure before induction in Group-P was 119.92±9.44 mmHg and in Group-S it was 118.40±8.60 mmHg, p>0.05. Comparing the 2 groups, this difference was insignificant. Following LMA insertion the mean systolic blood pressure decreased but mean systolic blood pressure did not differ significantly on comparing both groups at any time following LMA insertion, p>0.05. The mean SPO2% at baseline in Group-P was 99.54±0.89% and in Group-S it was 99.72±12.7%, p>0.05. The mean time for cessation of verbal communication in Group-P was 32.9±7.07 seconds and in Group-S, it was 33.7±5.13 seconds. The mean time to successful LMA insertion in Group-P was 79.4±27.63 seconds and in Group-S, it was 128.5±19.46 seconds, p


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Cross sectional study of knowledge of cervical cancer and awareness, knowledge and vaccine acceptance human papillomavirus vaccine among school girls of government and private school of Central India

2016-10-03T03-01-31Z
Source: International Journal of Community Medicine and Public Health
Sachin Parmar, Bhagwan Waskel, Sanjay Dixit, Geeta Shivram, Ananad Patidar, Sreelakshmi Suresh Babu, Vipin patel.
Background: Cervical cancer is the second most common cancer worldwide and in India, it is the number one killer cancer among women. About 500,000 women are diagnosed with cervical cancer contributing to around 270,000 deaths, across the globe every year. Out of these, the burden of 230,000 (85%) deaths is owned by developing countries, with bare minimal resources to cope with the situation. In India alone there are an estimated 132,000 new cases and 74,000 deaths each year. The discovery that human papillomavirus (HPV) is responsible for virtually all cervical cancers opens exciting new possibilities for controlling this disease. Methods: Randomly 300 girls were selected from private and government schools of central India aged between 16-18 years a semi structured questionnaire was provided to asses knowledge of cervical cancer and awareness, knowledge and vaccine acceptance HPV vaccine among the school girls. Results: Total 85% of the students are aware about cervical cancer overall. (80% of Government school students and 90% of the private school students) but only 43% of the students have heard about HPV overall,53% of the students know that cervical cancer is preventable, and 54% of Pvt. School students know that it is preventable. 50% of the students are aware that there are screening methods for cervical cancer, only 3% of the students are aware of all the modes of transmission and 72% are aware about Sexual intercourse is mode of transmission. 39.3% are aware that multiple sexual partners are a risk factor for HPV infection and 38.2% are aware that unprotected sexual intercourse is a risk factor. Only 8.9% are aware that first intercourse at young age is a risk factor and only 13.45% are aware that other STDs are also a risk factor for HPV infection, 55% of the students was aware about availability of vaccine against HPV. 54% of the students are not aware that the vaccine is available in India. Conclusions: The low level of knowledge indicates that the larger population of less educated women is in greater lack of awareness. During this survey we accessed a population that has not been widely studied and our observations leads to conclude that the absence of an active national cervical screening and awareness program has resulted in the lack of basic knowledge about important risk factors for cervix cancer even among the literate population of school girls.


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Cardiovascular profile of aluminium phosphide poisoning and its clinical significance

2016-10-03T00-46-49Z
Source: International Journal of Advances in Medicine
Sudhir Kalawat, Vibhuti Thakur, Ashok Thakur, N. D. Punjabi.
Background: Aluminium phosphide is a solid fumigant pesticide and it has currently aroused interest with increasing number of poisoning cases in past three decades. Over the time it has become an effective and widely used medium for suicide and homicide. Aluminium phosphide has highly effective killing power. Death is due to its direct toxic effect over the heart leading to peripheral circulatory failure .Aluminium phosphide poisoning affects the most of the organs. Early symptoms include nausea, vomiting, retrosternal and epigastric pain, dyspnea, anxious, agitation and smell of garlic breath. Methods: 50 patients, who were admitted in MICU, following consumption of aluminium phosphide tablets were included in the study. Patients clinical evaluation was done as per standard. PaO2 was noted with pulse oxymeter. Troponin I, ECG and echo of the patients was done to study the cardiac toxicities and pathological reports were correlated. Results: Out of 50 cases, ECG was normal in 20 cases and abnormal in 30 cases-sinus tachycardia was most common finding (24%) while heart block was least (4%). On echo, hypokinesia was seen in 40% cases, decreased ejection fraction in 8% cases and normal echo was seen in 12% cases. Serum troponin test was positive in 26%. Out of 50 cases, 19 died and rest 31 cases survived. Conclusions: AgNO3 test, ECG and pulse oxymetry are bed side, cost effective tools and should be done in all cases. Echocardiography is a useful tool to evaluate cardiac function and cardiac anatomy. Whenever it is available, it must be done in cases of aluminium phosphide poisoning. Serum troponin-I test should be done to assess significant myocardial damage. Thus, proper clinical work out along with relevant investigations and management as per standard protocol may save many more lives.


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