http://aijournals.com/index.php/ajm/issue/feed Academia Journal of Medicine 2020-03-20T03:46:24+00:00 Dr. Rohit Varshney dir.journals@gmail.com Open Journal Systems <p style="text-align: justify;"><strong>Academia Journal of Medicine (AJM)</strong> is an open-access; freely accessible, online and print Bi-Annual peer-reviewed international journal publishes a wide spectrum of advanced research in different fields of clinical medicine, covering etiology, diagnosis, therapy and prognosis aspects.<br> <strong>Online ISSN: 2663-8290 | Print ISSN: 2663-8282</strong></p> http://aijournals.com/index.php/ajm/article/view/839 Clinical Profile of TB Patients on DOTS at a Tertiary Care Hospital 2019-07-24T18:26:23+00:00 Arjun H info@aijournals.com Santosh VG info@aijournals.com <p><strong>Background: </strong>Tuberculosis was considered to be among the top ten causes of global mortality and morbidity. The highest incidence of TB was found in developing countries. Estimates suggest that 32% of the world‟s population was infected with TB. In India, it was seen that TB kills more adults than any other infectious disease. 20% global burden of TB was in India.<strong> Subjects and Methods: </strong>Before initiating anti-tuberculosis treatment a detailed clinical assessment which included history and clinical examination was done. Hematological investigations like HIV test is done as per ICTC along with HBsAg. Hematological investigations included hemoglobin, WBC count, differential count, platelet count, prothrombin time and ESR. Biochemical investigations included total bilirubin, direct bilirubin, AST, ALT, alkaline phosphatase, random blood sugar, blood urea, s.creatinine and uric acid. <strong>Results: </strong>Out of the 50 patients studied, 70 % patients were sputum positive and 30 % were sputum negative. This is probably because majority of the patients studied were pulmonary tuberculosis. <strong>Conclusion: </strong>Adverse drug reaction was seen in 29 patients (58 %). One or more types of ADR was seen in these patients.</p> 2019-07-24T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/881 Clinical Profile of Snake Bite Envenomation in Patients Admitted at Tertiary Care Hospital 2019-08-13T11:18:12+00:00 N. Kotresh aijournals@gmail.com V. Sunitha aijournals@gmail.com <p><strong>Background: </strong>Snakebite envenoming is a potentially life-threatening disease that typically results from the injection of venom following the bite of a venomous snake. Sometimes envenoming can also be caused by venom being sprayed into a person’s eyes by certain species of snakes that have the ability to spit venom as a defense measure. Not all snakebites are venomous. Some snakes are non-venomous and venomous snakes do not always inject venom during a bite. <strong>Subjects and Methods: </strong>Patients were examined for complications of snake bite. Haemotoxicity was assessed based on features like bleeding from the bite site, gums, epistaxis, haemoptysis, haematemesis, rectal bleeding or malaena, haematuria, vaginal bleeding, bleeding into the mucosae, skin (petechiae, purpura, discoid haemorrhages, ecchymoses. Neurotoxicity by drowsiness, paraesthesiae, abnormalities of taste and smell, ptosis, external ophthalmoplegia, paralysis of facial muscles and other muscles innervated by the cranial nerves, respiratory and generalized flaccid paralysis. <strong>Results: </strong>Majority of the patients were farmers with 44% followed by housewives (26%). Lower limbs were the most common site of bite in our study group comprising of74% of the patients. <strong>Conclusion: </strong>Most common manifestation of envenomation is local envenomation comprising of 66%.</p> 2019-08-13T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/914 To Assess Correlation of Fasting Blood Glucose, Hb1Ac and Serum Lipid Level in Type II Diabetes Mellitus Patients 2019-08-25T14:53:34+00:00 Nagendra Singh Chauhan aijournals@gmail.com Hemendra Kumar Agrawal aijournals@gmail.com <p><strong>Background: </strong>Diabetes Mellitus (DM) refers to a group of common metabolic disorder that share the phenotype of hyperglycaemia caused due to either deficiency of insulin secretion or insulin resistance. The present study was conducted to assess correlation of fasting blood glucose, Hb1Ac and type II DM in given adults. <strong>Subjects and Methods: </strong>The present study was conducted on 134 patients with type II diabetes mellitus (DM) of both genders. Patients were subjected to estimation of fasting and random blood glucose level. Modified method of Fluckiger and Winterhalter was used for estimation of glycosylated haemoglobin (HbA1C). <strong>Results: </strong>Out of 134 patients, males were 84 and females were 50. Age group 20-30 years had 11, 30-40 years had 14, 40-50 years had 38, 50-60 years had 46 and &gt;60 years had 25 patients. The mean fasting blood glucose level in patients with good degree of control was 106.2, in fair was 164.4 and in poor was 208.2. Glycosylated hemoglobin level was good (6.74), fair (8.12) and poor (12.54). A positive correlation of fasting blood glucose and glycosylated hemoglobin level and serum cholesterol &amp; glycosylated hemoglobin level (P&lt; 0.05) was found. <strong>Conclusion: </strong>Authors found a positive correlation of fasting blood glucose and glycosylated hemoglobin level and serum cholesterol &amp; glycosylated hemoglobin level in type II diabetes mellitus patients</p> 2019-08-15T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1002 A Hospital Based Cross-sectional Study on Demographic Distribution of Both Symptomatic and Asymptomatic Patients an Art at Westren Region of Rajasthan. 2019-10-09T16:10:33+00:00 Alok Gahlot aijournals@gmail.com Pooja Gahlot aijournals@gmail.com Jitendra Acharya aijournals@gmail.com <p><strong>Background: </strong>Over the past two decades with the advent of highly active antiretroviral therapy (HAART), there is a substantial increase in the life span of HIV patients. Morbidity and mortality due to human immunodeficiency virus (HIV) continue to be major problems in developing countries like India. <strong>Subjects and Methods: </strong>The present study was a cross sectional hospital based study for a period of twelve months from 1st Nov. 2015 to 31st Oct. 2016 at ART center P.B.M. Hospital, Bikaner. 100 HIV+ patients on ART were included in the study by consecutive sampling technique. <strong>Results: </strong>We found that Maximum number of study participants in age group of 31-40 years in both study (50%) and control (42%) group. Males were higher in study (76%) as well as control (64%) group than females .Among the subjects mostly belonged to lower socioeconomic status followed by Medium and High socioeconomic status. Most of the subjects in study (92%) as well as control (94%) groups were married. <strong>Conclusion: </strong>We conclude that Males were higher in study (76%) as well as control (64%) group than females .Among the subjects mostly belonged to lower socioeconomic status followed by Medium and High socioeconomic status.</p> <p>&nbsp;</p> 2019-10-08T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1003 A Cross Sectional Study on Correlation of Quantitative C - reactive protein With CD4 Count in Patients of HIV on Art 2019-10-09T16:13:46+00:00 Alok Gahlot aijournals@gmail.com Pooja Gahlot aijournals@gmail.com Jitendra Acharya aijournals@gmail.com <p><strong>Background: </strong>Over the past two decades with the advent of highly active antiretroviral therapy (HAART), there is a substantial increase in the life span of HIV patients. Hence, the focus has now shifted to managing long-term complications of HIV infection and improving the quality of life of HIV patients, especially in developed nations. On the other hand, in developing nations, the ever-growing incidence of HIV infection has placed a huge burden on their frail economy, so there is a growing need for simplifying HIV treatment protocols and for having cheaper alternatives for monitoring disease activity. <strong>Subjects and Methods: </strong>The present study was a cross sectional hospital based study for a period of twelve months from 1st Nov. 2015 to 31st Oct. 2016 at ART center P.B.M. Hospital, Bikaner. 100 HIV+ patients on ART were included in the study by consecutive sampling technique. Out of 100 patients, 50 were symptomatic and included in study group and remaining 50 were asymptomatic and taken as controls. <strong>Results: </strong>37 (74%) patients in study group had CRP levels &gt;6 mg/lit (normal level &lt;6 mg/lit). Out of 37, 19 subjects (38% of total) had CRP level &gt;20 mg/lit. While in control group, 44 subjects (88%) had CRP level &lt;6 mg/lit.&nbsp; Only 6 (12%) subjects of control group had CRP level &gt;6mg/lit. None of control subjects had CRP level &gt;20 mg/lit. The CRP levels and CD4 count were negatively correlated in study group and this was observed to be statistically significant (p=0.04) whereas in control group, the CRP levels and CD4 counts were found to be very weakly positively correlated and this correlation was observed to be statistically insignificant. <strong>Conclusion: </strong>There was statistical significant difference between CRP range and levels in both the groups. Also statistical significant difference between CD4 count range in both the groups.&nbsp; In our study, 38% of the study group patients had CRP &gt;20 mg/l whereas 88% of the control subjects had CRP of &lt;6 mg/l.</p> 2019-10-09T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1056 A Study of Clinical and Laboratory Profile of Dengue Fever in a Tertiary Care Teaching Hospital 2019-11-13T01:58:07+00:00 Kamal Rajesh Jampana aijournals@gmail.com Atchuta Chytanya Paka aijournals@gmail.com <p><strong>Background: </strong>The incidence of dengue has grown dramatically around the world in recent decades. Year after year, the prevalence of the disease is on a rise. This study is designed to study the clinical and laboratory parameters of Dengue patients in a tertiary care teaching hospital. <strong>Subjects and Methods: </strong>Prospective observational study was undertaken in a tertiary care teaching hospital. This study was carried out for a period of two years between Jan 2017 to December 2018.Seventy-two patients were studied and analyzed. All patients with positive NS1 antigen and positive ELISA test were included in the study. Clinical, hematological and biochemical parameters were noted. <strong>Results: </strong>Of the 72 patients, majority were females (52.8 %). Fever was the most common symptom followed by other symptoms like head ache, myalgias etc. <strong>Conclusion: </strong>Dengue is an important cause of mortality and morbidity in our country. Early diagnosis and prompt management can have a positive effect on the outcome of the disease. Proper monitoring of the clinical and biochemical parameters and necessary intervention can bring down the mortality rates associated with this disease.</p> 2019-10-29T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1057 A Study of Clinical and Laboratory profile of Scrub Typhus in a Tertiary care Teaching Hospital 2019-11-13T01:58:53+00:00 Atchuta Chytanya Paka aijournals@gmail.com Kamal Rajesh Jampana aijournals@gmail.com <p><strong>Background: </strong>Scrub typhus, also known as bush typhus, is a disease caused by bacteria called Orienta tsutsugamushi. This ricketssial infection is transmitted to humans through the bite of infected heptombidium mite larvae. <strong>Subjects and Methods: </strong>All patients were subjected to investigations to establish cause of febrile illness. after complete physical examination routine laboratory investigations like CBC, serology for enteric , malaria, scrub typhus and USG abdomen, chest x-ray ,urine analysis and renal function tests were done in all patients. In all cases diagnosis was based on detection of antibodies using a single step rapid immunochromatography method. <strong>Results: </strong>120 patients, who were admitted with undifferentiated acute febrile illness during the study period diagnosed to be suffering from scrub typhus with positive antibodies, the following results were noted. Fever was the most common symptom seen in all the 120 patients (100%). The duration of fever ranging from one to seven days present in 94(78.3%), fever for 7-12days present in 5 (4.2%) patients and more than 2 weeks present in 5 (4.12%) patients. Headache and vomiting symptoms were the commonly associated symptoms. Generalized muscle pain (myalgia) was present in 63(52.5%) patients. Headache was present in 64 (53.3%), diarrohea was complained by 2 patients(1.7%), vomiting in 47(39.2%) patients, shortness of breath was present in 16 (13.3%) patients, abdominal pain was present in 17(14.2%)patients and skin rash was seen in 1 patient(0.8%). <strong>Conclusion: </strong>Majority of the cases of Scrub typhus are seen in the cooler months of the year and in the rainy season. It has to be considered in the&nbsp; differential diagnosis of undifferentiated acute febrile illness.</p> 2019-10-29T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1058 A Clinico-Hematological Study of Influenza Virus Infection 2019-11-06T09:38:24+00:00 Shivani Shenoy K aijournals@gmail.com Raj Shekhar aijournals@gmail.com Mary Mathew aijournals@gmail.com G Arun Kumar aijournals@gmail.com <p><strong>Background: </strong>Influenza is a seasonal infectious viral disease which accounts for approximately 3-5 million cases of severe illness and 250,000 to 500,000 deaths in a yearly outbreak. The objectives of our study were to study the various clinical presentation of influenza infection and to correlate the demographic data and clinical symptoms with hematological parameters. <strong>Subjects and Methods: </strong>95 cases which were positive by One-step RT-PCR were included in the study. Elevation of serum transaminase levels, thrombocytopenia and raised creatinine levels are important parameters which mandates vigilant follow up in patients with influenza infection. <strong>Results: </strong>The most common symptoms were fever in 88.42% and cough in 88.42% of cases. 51.57% of patients presented with anemia on admission. 11.5% of patients had thrombocytopenia of which 36.36% had elevated liver enzymes. 35.78% of cases had leukocytosis of which 32.35% had elevated liver enzymes. 15.78% of patients had raised creatinine levels. <strong>Conclusion: </strong>Authors suggested that elevation of serum transaminase levels, thrombocytopenia and raised creatinine levels are important parameters which mandates vigilant follow up in patients with influenza infection.</p> 2019-10-29T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1070 Study of Serum Ferritin and Glycated Hemoglobin in Type 2 Diabetes Mellitus 2019-11-08T01:28:34+00:00 Tanveer Ahmed aijournals@gmail.com <p><strong>Background: </strong>Type 2 diabetes mellitus is a common metabolic disorder of multiple etiologies. Increased levels of serum ferritin have been indicated to be associated with the etiology of the diabetic process, as well as in pathogenesis of various diabetic complications. The study aims to understand the relationship between the serum ferritin and glycated hemoglobin in type 2 diabetes mellitus. <strong>Subjects and Methods: </strong>The study was conducted at Medical College Hospital and Research Centre. A total of hundred cases of type 2 diabetes mellitus of the age group 30 – 70 years were taken for the study after satisfying the inclusion and exclusion criteria. Hundred healthy volunteers in the age group 30 – 70 years, sex matched during the same period was included in the study under the control group. <strong>Results: </strong>Serum ferritin level was significantly high in cases compared to controls. There was moderate correlation between serum ferritin and glycated hemoglobin. There was significant increase in serum ferritin levels in type 2 diabetics compared to the controls. There was a moderate correlation between serum ferritin and glycated hemoglobin. <strong>Conclusion: </strong>This study explores the possibility of finding serum ferritin as a marker to explain the oxidative stress process in type 2 diabetes mellitus. This valuable information would be helpful in proper medical intervention.</p> 2019-11-07T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1071 Clinical Profile of Patients with Type 2 Diabetes Mellitus at a Tertiary Care Hospital 2019-11-08T01:31:37+00:00 Tanveer Ahmed aijournals@gmail.com <p><strong>Background: </strong>Diabetes mellitus is described as a group of metabolic disorders of multiple etiology characterized by chronic hyperglycemia associated with disturbances of carbohydrate, fat and protein metabolism due to absolute or relative deficiency of insulin secretion and/or action. Diabetes mellitus is associated with significant long term sequels, particularly damage or dysfunction of various organs especially kidneys, eyes, nerves, heart and blood vessels. <strong>Subjects and Methods: </strong>A pre-structured and pre-tested proforma was used to collect the data. Informed consent was taken from all cases and control subjects. Base line data including age and sex, detailed medical history including conventional risk factors, clinical examinations and relevant investigations were included as part of the methodology. <strong>Results: </strong>The mean serum FBS level among cases was 146.94±54.99 mg % as compared to 86.71±9.71 mg % among controls. There was highly significant difference in serum FBS levels among cases and controls. <strong>Conclusion: </strong>The mean serum PPBS level among cases was 244.26±96.47 mg % as compared to 111.96±8.85 mg % among controls. There was highly significant difference in serum PPBS levels among cases and controls.</p> 2019-11-07T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1072 Relationship between Smokeless Tobacco Dependence and Psychiatric Disorders 2019-11-09T01:36:52+00:00 Vijayraj N aijournals@gmail.com <p><strong>Background: </strong>The epidemiology of nicotine dependence indicates how strongly addictive a drug it is that nearly half of those who ever smoked steadily for a month become highly nicotine dependent. It is a psychoactive substance that induces euphoria, reinforces its own use, and leads to nicotine withdrawal syndrome when it is absent. <strong>Subjects and Methods: </strong>Written informed consent was taken from all the cases and controls prior to the detailed assessment. The personal data was recorded in the socio demographic data. They were administrated Modified Fagerstrom test for nicotine dependence [FTND] and those who were nicotine dependent were then screened for psychiatric morbidity using GHQ – 12 [69] screening questionnaire. <strong>Results: </strong>Among those with psychiatric diagnosis majority had Major Depressive Disorder [24%], Generalized Anxiety disorder [18%], Mixed Anxiety Depressive disorder [10%] and Alcohol dependence syndrome[14%] as compared to non-nicotine dependents. <strong>Conclusion: </strong>Severity of Anxiety and depression increased with the severity of nicotine dependence among the cases.Coping skills were not significantly different between cases and controls.</p> 2019-11-07T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1084 Clinical Profile of Patients with Rickettsial Infection: Descriptive Study 2019-11-20T13:40:04+00:00 Shivaprasad aijournals@gmail.com Krishna Kumar Naik aijournals@gmail.com <p><strong>Background: </strong>Rickettsiae along with their public health implications. They have addressed the co-circulation of differentspecies and genotypes of rickettsiae within the same endemic areas and how these observations may influence, correctly or incorrectly, the trends and conclusions drawn from the surveillance of rickettsial diseases in humans. <strong>Subjects and Methods: </strong>A total of 60 subjects, satisfying the inclusion and exclusion criteria were included in the final analysis. The sample size was calculated assuming the expected proportion of rickettsial infection as 11% among fever cases as per previously published studies, with a precision of 8% and 95% confidence level. <strong>Results: </strong>Among people with a tick bite, 3 (12.5%) people had 80 overall Weil-Felix titre. The number of people with 160, 320 and 640 overall Weil Felix titre was 4 (16.66%), 10 (41.66%) and 7 (29.16%) respectively in people with a tick bite. Among people without tick bite higher proportion of people had 80 and 160 titre. None of them had 640 titre. Statistical significant could not be tested due to zero number of subjects in one of the cells. <strong>Conclusion: </strong>Among people with pain abdomen 11 (23.91%) people had 80 Overall Weil-Felix titre. The number of people with 160, 320 and 640 Overall Weil Felix titre was 15 (32.60%), 13 (28.26%) and 7 (15.21%) respectively in people with pain abdomen. Among people without pain abdomen higher proportion of people had 80 and 160 titres. None of them had 320 and 640 titres. Statistical significant could not be tested due to zero number of subjects in one of the cells.</p> 2019-11-19T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1085 A Study on Biochemical Parametrs in Patients with Rickettsial Infection 2019-11-20T13:43:05+00:00 Krishna Kumar Naik aijournals@gmail.com Shivaprasad aijournals@gmail.com <p><strong>Background: </strong>The traditional views of tick-borne rickettsioses as endemic diseases with largely focal distributions and limited host and geographic ranges, predetermined seasonality and defined tick associations became obsolete or at least very incomplete. This expansion of awareness about the existence of other rickettsial agents with varied clinical and epidemiological attributes has been thoroughly reviewed but it has presented new challenges to the medical and public health communities. <strong>Subjects and Methods: </strong>The clinical presentation and multiple organ dysfunctions in these patients were evaluated with a special focus on the renal manifestation and hepatic manifestations. The study population included all the patients presenting fever, rash and were diagnosed with rickettsial disease by clinical examination. A total of 60 subjects, satisfying the inclusion and exclusion criteria were included in the final analysis. The sample size was calculated assuming the expected proportion of rickettsial infection as 11% among fever cases as per previously published studies, with a precision of 8% and 95% confidence level. <strong>Results: </strong>The mean AST in the 80 titre was 140.43 ± 79.92, it was 285.89 ± 184.95 in 160 titre, 364.92 ± 89.69 in 320 titre group and 579.29 ± 106.26 in 640 titre group. The mean difference of AST 145.47 in 160 titre group was statistically significant (p value&lt;0.001), 224.50 in 320 titre group was statistically significant (p value&lt;0.001), and in 640 titre group 438.86 was statistically significant. (P- Value &lt;0.001). <strong>Conclusion: </strong>The study has highlighted the need to have a high index of suspicion to enhance the diagnosis of ricketsial diseases and also the strong association between weilfelixtitre and liver and renal dysfunction.</p> 2019-11-19T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1092 A Prospective Study of Lipid Profile and BMI as Risk Factors in MI in Young[<40 Yrs] In Rural Background 2019-11-27T06:22:35+00:00 Yadavendra C Reddy aijournals@gmail.com <p><strong>Background: </strong>In recent years cardiovascular disease is the leading cause of mortality and morbidity worldwide in both male and female is accepted. The urbanisation has made its impact on the rising incidence of MI in India. One should not overlook however that MI in rural areas has doubled as well. This study is aimed at studying the Dyslipidaemia&nbsp;&nbsp; and Body mass index as risk factors in MI in young in rural background.<strong>Subjects and Methods:</strong>This prospective&nbsp;&nbsp; observational study was done in General Medicine Department at SVS hospital during July 2007 to July 2009.Out of 100 patients admitted with MI 20 selected and studied based on inclusion and exclusion criteria.<strong>Results:</strong>The study showed patients with high LDL&gt;100mg/dl and low HDL&lt;35mg/dl were prone for MI than other individuals. Furthur it was shown that patients with BMI&gt;30 had increased risk for MI than otherwise. It was also observed that female preponderance was more compared to males.<strong>Conclusion: </strong>The study shows that dyslipidaemia and abnormal BMI do contribute to MI in young in rural background.</p> 2019-11-27T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1095 Gastrointestinal Manifestations in Patients with Chronic Kidney Disease 2019-11-27T09:45:50+00:00 Shivraj aijournals@gmail.com Venugopal.K aijournals@gmail.com <p><strong>Background: </strong>Chronic kidney disease is a silent epidemic of the 21 century. Surveys have suggestedthat as many as 16% of the adult population have CKD1. The most common, non –renal, chronic disorders in patients with ESRD are gastro intestinal disorders2. Among upper gastrointestinal lesions caused by chronic kidney disease gastritis, an esophagus is,gastric ulcers are the most prevalent lesions. Here an attempt is being made to study the upper gastro intestinal changes in chronic kidney disease and evaluate theirrelationship with the stage of CKD or GFR. <strong>Objectives: </strong>1. To determine the prevalence of various upper gastro intestinal lesions withthe use of fibro optic endoscopy.2. To evaluate the relation between the gastro intestinal lesion with the stage ofCKD or GFR. <strong>Subjects and Methods: </strong>We conducted a cross sectional study on 50 patients ,who are diagnosed to haveChronic kidney disease and being presented to OPD and admission in NavodayaMedical College and Research Center, Raichur over a period of one year. All patientswith chronic kidney disease underwent upper gastrointestinal endoscopy wereincluded in the study. <strong>Results: </strong>Majority of the subjects belongs to age group of 31 to 40 years (26%) and least belongs to 70 to 80 years age group (6%).Out of the 50 subjects, males were 28 and females were 22.Majority of the cases in our study belonged to stage IV. 84% of the cases had upper gastrointestinal involvement on endoscopic examination in our study. Erosive gastritis (26%), either antral or fundal, was the predominant lesion found on endoscopy. Majority of the subjects having erosive gastritis, had stage IV CKD (53.8%).Out of 50 cases in our study 55% of subjects had lesions of the stomach, 26% of subjects had lesions in the duodenum, 19% of subjects had lesions in esophagus. Out of 50 subjects in our study 52% were undergoing haemodialysis and 48% of subjects were under conservative management. Majority of subjects undergoing haemodialysiswere belongs to stage V. <strong>Conclusion: </strong>Majority of the patients with chronic kidney disease have upper gastrointestinal involvement on endoscopic evaluation. Erosive gastritis is the most common upper gastrointestinal manifestation in our study. Upper gastrointestinal manifestations are predominant in stage V. Upper gastrointestinal findings are frequently observed in chronic kidney disease patients on dialysis. Early diagnosis and management can reduce mortality and morbidity and prevent fatal complication like massive upper gastrointestinal bleed.</p> 2019-11-27T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1096 Prevalence of Mineral Bone Disorders in Chronic Kidney Disease Patients 2019-11-27T09:51:47+00:00 Tapas Ranjan Behera aijournals@gmail.com Bishwaranjan Mohanty aijournals@gmail.com Alisha Sahu aijournals@gmail.com Sujata Naik aijournals@gmail.com Jatindra Nath Mohanty aijournals@gmail.com <p><strong>Background: </strong>Chronic kidney disease (CKD) is a progressive loss in renal function which involves in deterioration in mineral homeostasis with disruption of normal serum and tissue concentration of phosphorus and calcium. Also changes in circulating levels of hormones-parathyroid hormone (PTH), calcitriol (1,25(OH)2 D), and fibroblast growth factor-23 (FGF-23). Here our aim is to study the prevalence of markers associated with MBD in CKD stage 3-5 patients. Patients with CKD stage 3-5 were included in this observational study with all necessary parameter. X-RAY abdomen and echocardiography was done to look for evidence of vascular and valvular calcification respectively. Statistical analysis was done using SPSS software. A total of 170 patients (128 males, 42 females)(M:F = 3:1) were included in this study with a mean age of&nbsp; 50.54 years. Among CKD stages 3 to 5, the&nbsp; prevalence of hypocalcemia&nbsp; was 22.2%, 33.3% &amp; 48.9%,&nbsp; hyperphosphatemia&nbsp; was 11.1%, 25.5% &amp; 63%, hyperparathyroidism&nbsp; was 48.1%, 67.3% &amp; 89.1%, high total alkaline phosphatase was 0%, 5.9% &amp; 45.7% , low 25-OH-vit D was 59.2%, 70.6% &amp; 79.4%&nbsp;&nbsp; respectively. Low 25 (OH) D levels, hyperparathyroidism, and hyperphosphatemia were the noticeable markers of CKD-MBD in our patients. Mineral bone disorder are common in CKD patients which start in early CKD stages &amp; worsen with disease progression that causes morbidity and decreased quality of life.</p> 2019-11-27T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1097 Study of Clinical Profile of CAPD Patients in Eastern India – A Clinical Observation 2019-11-27T09:59:07+00:00 Bishwaranjan Mohanty aijournals@gmail.com Tapas Ranjan Behera aijournals@gmail.com Sujata Naik aijournals@gmail.com Chittaranjan Kar aijournals@gmail.com Smarak Ranjan Panda aijournals@gmail.com Alisha Sahu aijournals@gmail.com Deba Prasad Kar aijournals@gmail.com Jatindra Nath Mohanty aijournals@gmail.com <p><strong>Background: </strong>The prevalence of end-stage renal disease (ESRD) requiring renal replacement therapy is rising steadily in developed and developing countries. Currently, continuous ambulatory peritoneal dialysis (CAPD) and in-center hemodialysis (HD) are the two major modes of dialysis used to treat ESRD . Only 8% of PD patients are initiated on PD directly, 92% are&nbsp; shifted from HD .There are several approaches to measuring peritoneal membrane function like&nbsp; peritoneal equilibration test (PET), the standard permeability analysis (SPA). Successful treatment&nbsp; with PD encompasses several important quality targets like Patient survival, Technique survival, Quality of life, Nutrition status. Complications includes Catheter malfunction, Exit site infection, Peritonitis, Fluid leaks. In this observational study of clinical profile of CAPD patients 40 patients were taken. Of the 40 patients included in study 72.5% were male and 27.5% were female. Various factors for preference of&nbsp;&nbsp; CAPD are&nbsp; remote places, expenditure(35%),&nbsp; cardiovascular morbidity(25%). The observations are out of&nbsp; 52 % had well maintained nutrition ,KT/V score ranges from 1.2 to 7 with mean (SD) 3.88 ± 1.59, only 22.5% have peritonitis and catheter exit site infections. None had catheter removal.&nbsp;&nbsp; All our&nbsp;&nbsp; outcome (such as correction of anemia, nutritional status, clinical well being, absence of edema) and biochemical parameters (for e.g. Peritoneal Equilibrium Test, weekly KT/V) will used to knowing the adequacy which is consistent to results of various national and international studies.</p> 2019-11-27T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1098 Evaluation of Urinary Cytokines in Idiopathic Glomerulonephritis in a Tertiary Care Teaching Hospital 2019-11-27T10:05:37+00:00 Deba Prasad Kar aijournals@gmail.com Vijay Pratap Singh aijournals@gmail.com Anupam Agarwal aijournals@gmail.com Vivek C Ganiger aijournals@gmail.com Jatindra Nath Mohanty aijournals@gmail.com <p><strong>Background: </strong>Idiopathic primary glomerular diseases include a group of disorders characterized by pathologic alterations in normal glomerular structure and function, independent of systemic disease processes. Inflammatory cytokines, including MCP-1 and IL-6, plays an important role in glomerular inflammation. In this study we determined whether the measurement of urinary MCP-1 and IL-6 might be useful in assessing the role of these urinary marker in idiopathic primary glomerulonephritis and its relationship with histopathological finding. We found in result the minimum level of MCP-1 and IL-6 was 5.6pg/ml and 7.69pg/ml and the maximum level of MCP-1 and IL-6 was 23.6pg/ml and 60.04pg/ml respectively. The mean and standard deviation were higher in nephrotic range proteinuria than nonnephrotic proteinria. Correlation of urinary MCP-1 and IL-6 with 24 hour urinary protein &lt;3.5gm and ≥3.5gm were analysed. The correlation between urinary IL-6 and histopathological finding of idiopathic primary glomerular diseases were found statiscally significant (p value &lt;0.05). In conclusion, we found that level of urinary MCP-1 was raised in patients with increase degree of interstitial fibrosis and tubulointerstitial infiltrates and urinary IL-6 was noted in high level increase with increase degree of glomerlosclerosis, interstitial fibrosis and tublar atrophy.</p> 2019-11-27T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1099 Estimation of Plasma BNP Levels in Rheumatic Heart Disease Patients at a Tertiary Care Teaching Hospital in Eastern India 2019-11-27T10:10:44+00:00 Deba Prasad Kar aijournals@gmail.com Bandita Dash aijournals@gmail.com Anupam Agarwal aijournals@gmail.com Vijay Pratap Singh aijournals@gmail.com Jatindra Nath Mohanty aijournals@gmail.com <p><strong>Background: </strong>Brain natriuretic peptide (BNP) is a cardiac hormone secreted from the ventricular myocardium as a response to ventricular volume expansion and pressure overload. Rheumatic heart disease is a major health problem, mostly in developing country like India and particularly in this part of the country. In young age group rheumatic heart disease is the most common cause of cardiac morbidity and mortality. In this study our aim is to measure BNP levels in patients with RHD and to find out whether BNP concentrations correlate with clinical and echocardiographic findings. A total of 88 patients with rheumatic valve disease having different type of single or multivalvular lesions were included in this study.&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; BNP was measured using the chemiluminescence methods (Bayer Centure, Germany) by BNP kit. 2D Echocardiography with colour Doppler&nbsp; was performed in all patients to assess the severity of the valve disease and for the measurement of pulmonary artery pressure. The plasma concentrations of BNP were found significantly higher in patients with aortic stenosis than in control&nbsp; (355.92±204.31pg/ml vs.183.39±93.51pg/ml, p &lt; 0.001). The plasma BNP level was significantly higher in NYHA class&nbsp; IV than in class I (921.50±301.93 in class I&nbsp; and&nbsp; 125.85±52.88 pg/ml, p &lt; 0.001 in class III).&nbsp;&nbsp; The independent determinants of higher BNP levels were NYHA functional class and systolic pulmonary artery pressure in multivariate analysis. Along with these results we got all other relative output which suggested that&nbsp; increased plasma BNP levels in patients with rheumatic heart disease compared with healthy subjects.</p> 2019-11-27T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1100 Renal Biopsy Findings in Lupus Nephritis and Their Correlation with Clinico-Biochemical Parameters 2019-11-27T10:16:04+00:00 Vivek C Ganiger aijournals@gmail.com Deba Prasad Kar aijournals@gmail.com Bandita Dash aijournals@gmail.com Anupam Agarwal aijournals@gmail.com Jatindra Nath Mohanty aijournals@gmail.com <p><strong>Background: </strong>This is an observational analysis wherein we contemplated renal biopsy discoveries of 50 patients of lupus nephritis (LN) and these biopsy discoveries were associated with clinical and biochemical parameters of the LN patients. The study included 50 patients of SLE diagnosed to have renal involvement. Renal biopsy was done in every one of the 50 patients and the outcomes were ordered by the ISN/RPS arrangement of LN. Clinical and biochemical parameters were examined in all patients and they were corresponded with renal biopsy discoveries. The different biochemical parameters in our investigation were-proteinuria (100%) , raised serum creatinine (56%). Mean 24 hour protein discharge was 2386+/ - 1810 mg/day at presentation.11(22%) patients had nephrotic range proteinuria and 8 (16%) patients had proteinuria &lt;1gm/day. Nephrotic range proteinuria was seen in LN Class IV and Class V. Hematuria was available most ordinarily in LN Class IV (in 100%) while none of the Class II LN patients had hematuria. Hypertension was most ordinarily connected with Class III and Class IV LN. Mean serum creatinine was 2.53+/ - 1.92 mg/dl. Mean serum creatinine was relatively higher on Class IV LN than in different classes of LN. In our examination most regular kind of renal biopsy finding in lupus nephritis was LN Class IV. Most serious kind of LN is Class IV LN. LN patients may have mixed lesions of Class IV and Class V LN, which was found in 2 patients (4%) in our investigation. LN Class I and LN Class VI are exceptionally uncommon at introduction of LN which were not found in renal biopsy in our examination.</p> 2019-11-27T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1101 Urinary Interleukin 6: A Prognostic Bio Marker in Lupus Nephritis 2019-11-27T10:28:07+00:00 Vijay Pratap Singh aijournals@gmail.com Deba Prasad Kar aijournals@gmail.com Bandita Dash aijournals@gmail.com Jatindra Nath Mohanty aijournals@gmail.com <p><strong>Background:</strong> Lupus nephritis is an frequent and potentially serious complication of SLE. It is an inflammatory disease of connective tissue and immune system, where we find organs and cells undergo damage initially mediated by&nbsp; tissue-restricting&nbsp; auto antibodies and immune complexes. Our aim was to evaluate the&nbsp; association of urinary interleukin 6 in lupus nephritis patients and validate its use as a prognostic marker. <strong>&nbsp;</strong>For this we took the complete demographic profiling of the participant patients along with all biochemical parameter were checked. For IL-6 analysis, we analyzed the whole immunological profile and correlated the level of urinary proteins, serum creatinine and urinary IL-6. The mean values of urinary IL-6 at presentation and after 6 months of treatment were calculated. Any change after 6 months was noted and correlation of Il-6 with disease activity scores was observed. Urinary IL-6 was found to be significantly high in patients of lupus nephritis than controls. Urinary IL-6 was higher in patients of severe form of lupus nephritis such as Class IV than other classes of lupus nephritis. Urinary IL-6 may be used as a prognostic marker of lupus nephritis. The patients who achieved complete remission had near normal levels of urinary IL-6 and patients with partial remission had decreased level of urinary IL-6 than at presentation&nbsp; after 6 months of induction phase treatment. But patients with no remission did not show any significant decrease in urinary IL-6 levels at 6 months. So, urinary Il-6 may be used to monitor the response to therapy.</p> 2019-11-27T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1102 Clinical Profile of Idiopathic Pulmonary Fibrosis 2019-11-29T10:44:49+00:00 Mahesh NS aijournals@gmail.com Sadanand C D aijournals@gmail.com Durga Lawande aijournals@gmail.com <p><strong>Background: </strong>The incidence of IPF was estimated at 10.7 cases per 100,000 per year for men and 7.4 cases per 100,000 per year for women in a population-based study from the county of Bernalillo, New Mexico. A study from the United Kingdom reported an overall incidence rate of only 4.6 per 100,000 person-years, but estimated that the incidence of IPF increased by 11% annually between 1991 and 2003. This increase was not felt to be attributable to the aging of the population or increased ascertainment of milder cases. <strong>Subjects and Methods: </strong>This was an observational prospective study carried out in the Department of Pulmonary Medicine, Medical College. The study included 35 patients diagnosed with IPF during the two year study period. <strong>Results: </strong>Dyspnea was the most common symptom at presentation, being present in 35 (100 %) of the patients. Cough with or without expectoration was the next most common symptom, being present in 33 (94.2 %) of the patients. Other symptoms were chest pain, fever and weight loss, and joint pains. <strong>Conclusion: </strong>Clinical prediction models are used in many areas of medicine to provide accurate prognostic information and staging of disease; such a prediction model would be useful in IPF.</p> 2019-11-29T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1103 Management of Idiopathic Pulmonary Fibrosis Cases at a Tertiary Care Hospital 2019-11-30T01:58:21+00:00 Mahesh N aijournals@gmail.com Sadanand C D aijournals@gmail.com Durga Lawande aijournals@gmail.com <p><strong>Background: </strong>The clinical history of the disease is quite variable; there is usually a slow physiological deterioration, but in some patients there is a faster decline in lung function and death occurs within 6-12 months after diagnosis. Others experience an acute exacerbation during the course of the disease with a sudden worsening of respiratory symptoms, hypoxemia and the appearance of new radiological infiltrates without an identifiable cause. Despite different types of clinical course, IPF is inevitably associated with a poor prognosis, with a median survival of 2-3 years. <strong>Subjects and Methods: </strong>Age, sex, occupation, address (including phone number) was noted down. A detailed occupational history was sought, enquiring about the age at start of the occupation, exact nature of work, any history of exposure to fumes, gases, dust, etc, any other person in the work place suffering from similar complaints etc were obtained. <strong>Results: </strong>Majority of the patients were treated with steroids alone 22(62.8%). 10(28.5%) patients were treated with steroids with azathioprine.&nbsp; 3(8.5%) patients were treated with pirfenidone. <strong>Conclusion: </strong>Majority of the patients, 17(48.5%) out of 35 patients, expired during the study period. 5(14.2%) patients were lost to follow up and the outcome was not available. 10(28.5%) patients remained stable, while 3(8.5%) patients worsened. None of the patients improved during the study period.</p> 2019-11-29T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1113 Evaluation of CT Finding in heat stroke patients 2019-12-04T18:54:25+00:00 Sanjay Kumar aijournals@gmail.com Dharmendra Prasad aijournals@gmail.com <p><strong>Background: </strong>To describe the neurological manifestations and neuroimaging of heatstroke patients.<strong>Subjects and Methods: </strong>We extracted data&nbsp; retrospectively&nbsp; from&nbsp; patients’&nbsp; files&nbsp; and&nbsp; described their neurological manifestations and radiological features. An experienced brain-imaging&nbsp; radiologist&nbsp; reviewed&nbsp; and&nbsp; analyzed&nbsp; patients’&nbsp; radiographs&nbsp; to&nbsp; report&nbsp; on&nbsp; signs&nbsp; of&nbsp; abnormality.<strong>Results: </strong>This group included fifteen patients; eight males (53%) and seven females (47%), with an average age of (51.2 ± 10.1) years. Seven patients underwent brain imaging (CT scan), yet abnormal findings were detected in one patient images only. On the initial CT it showed bilateral thalamic and brainstem diffuse hypo-densities. The follow-up CT scans showed acute hemorrhage in the pons and 4th ventricle. There was third intra-ventricular extension of blood, with mild hydrocephalus.<strong>Conclusion: </strong>The study presented non-specific neurological findings that were associated with heatstroke patients. These findings may affect management and potential complications prognosis.</p> 2019-12-04T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1114 Evaluation of Incidence of Hepatitis C in Health Care Workers 2019-12-04T18:58:16+00:00 Sanjay Kumar aijournals@gmail.com Dharmendra Prasad aijournals@gmail.com <p><strong>Background: </strong>Hepatitis C virus infection continues to be a major public health problem warranting high priority efforts for control and treatment. Aim: An observational, cross-sectional facility-based study was conducted to measure the prevalence of HCV infection and to identify risk factors associated with HCV infection among health care workers.<strong>Subjects and Methods: </strong>A total of 109 participants were selected. It conducted through stratified random sampling. For the analysis, Z-test and Fisher’s exact test were used. All participants in this study were tested for HCV marker (Anti-HC).<strong>Results: </strong>The positive for Anti-HC was found to be 1.8% (2/109), which was found among nurses and paramedics. The results showed association between Anti-HC positivity and blood transfusion, frequency of blood transfusion and exposure to sharp injuries, P values ( 0.003, 0.0001 and 0.029) respectively.<strong>Conclusion: </strong>Prevalence rate of Anti-HC was found to be low in HCWs (1.8%). The prevalence rate was found among nurses and medical engineers. Blood transfusion, frequency of blood transfusion and exposures to sharp injuries to be risk factors with Anti-HC positivity.</p> 2019-12-04T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1129 To Analyze the Association between the Polymorphism of NOS3 Gene VNTR in ADPKD 2019-12-12T03:06:51+00:00 Shiva Nagendra Reddy Annapareddy aijournals@gmail.com Pratap Duggirala aijournals@gmail.com <p><strong>Background: </strong>Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder, and it is mainly associated with renal cyst formation. Endothelial nitric oxide plays a crucial role in the control of local hemodynamics and systemic blood pressure. Thus, it has been proposed that gene coding for endothelial nitric oxide synthase (eNOS) could have a modifying effect on hypertension and related complications in autosomal dominant polycystic kidney disease (ADPKD). As endothelial dysfunction and oxidative stress are evident early in ADPKD patients, eNOS holds therapeutic promise in the treatment of ADPKD.<strong>Objectives: </strong>The aim of the present investigation is to determine the association between NOS327-bp VNTR in ADPKD patients and also investigate the role of progression of renal disease in ADPKD.<strong>Subjects and Methods: </strong>In the present study,<strong> we </strong>investigated by studying the rural population of 50 ADPKD patients and 90 unrelated healthy controls admitted in Dept .of Nephrology, NRI Medical College &amp; Hospital,&nbsp; Andhra&nbsp; Pradesh, India. Genetic analysis was mainly performed by PCR and agarose gel electrophoresis.&nbsp; Genotype comparison was observed between control and ADPKD.<strong>Results: </strong>Dyspnea was the most common symptom at presentation, being present in 35 (100 %) of the patients. Cough with or without expectoration was All three genotypes of NOS3 were observed in both cases and controls of the present study. In both cases and controls wild type genotype is more followed by heterozygote and minor genotypes. Blood Urea Nitrogen and creatinine is more in the controls when compared to the ADPKD patients. The other core electrolytes are shown to be in the normal range in both case and controls of the present study. Glomerular filtration rate is also exhibited differences between cases and controls. None of the biochemical variable has shown significant differences among NOS3 genotypes. But the difference in glomerular filtration rate is significant among different genotypes.<strong>Conclusion: </strong>The present study confirms the significant association between the 27-bp VNTR and CKD advancement among the ADPKD patients in the rural population.</p> 2019-12-11T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1130 To Analyze the Modifier Effect of NOS3 Gene in Hypertensive Patients of ADPKD 2019-12-12T03:14:26+00:00 Shiva Nagendra Reddy Annapareddy aijournals@gmail.com Pratap Duggirala aijournals@gmail.com <p><strong>Background: </strong>Nitric oxide is important for the functional integrity of the vascular endothelium and is produced in endothelial cells by the enzyme endothelial nitric oxide synthase (eNOS). Hypertension has a strong genetic component, and the NOS3 gene, which encodes eNOS, represents an interesting candidate for contribution to the phenotype. The most clinically relevant polymorphisms in the NOS3 gene are a variable number tandem repeat (VNTR) in intron 4, and rs2070744 (T-786C) in the promoter region.<strong>Subjects and Methods: </strong>This study aims to investigate the association between these three polymorphisms in the NOS3 gene and modifier effect on age, progression of disease and hypertension in patients of ADPKD.<strong>Results: </strong>The present study carryout in the ADPKD patients admitted in NRI Medical College &amp; Hospital.Univariate and multivariate logistic regression analyses were performed to assess the effect of genotypes and hypertension on the progress of chronic kidney disease (CKD). A stratified analysis was also performed to assess the evidence of the modification of hypertension-CKD relationship among VNTR genotypes.<strong>Conclusion: </strong>The results of this study indicated that the polymorphism in NOS3 may be a genetic susceptibility factor for hypertension in the Indian population.</p> 2019-12-11T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1154 A Study of Clinical and Etiological Profile of Anaemia in Geriatric Patients in a Tertiary Care Hospital 2020-01-08T08:10:44+00:00 R P Buden aijournals@gmail.com <p><strong>Background: </strong>Geriatric anemia is a global health problem because of its high prevalence and associated significant morbidity and mortality.<strong>Aim: </strong>The objectives of this study were to estimate the pattern of anemia in the elderly patients and the underlying etiology of anemia. <strong>Subjects and Methods:</strong>This was a hospital-based prospective observational study, conducted in patients aged 60 years and above at SSIMS, T. Begur. Anemia is defined as hemoglobin level less than 13 g/dl in men and 12 g/dl in women.<strong>Results: </strong>Among the 100 older patients with anemia, the mean value of hemoglobin was 8.9 ± 2.3 g/dl. The etiological distribution of anemia was iron deficiency in 25 patients (25%), chronic disease in 22 patients (22%), hematological disorders in 20 (20%), chronic kidney disease in 12 (12%), multifactorial in 8 (8%), vitamin B12 deficiency in 3 (3%), folate deficiency in 1 (1%), and hypothyroidism in 1 patient (1%). No etiology could be found in 8 patients (8%). 57.6% of the iron-deficient patients had upper gastrointestinal lesions and 30.7% had a nutritional cause. Common chronic diseases causing anemia were malignancy (36.6%) and liver disease (29.1%). The myelodysplastic syndrome was the commonest hematological disorder. 53.35% of the patients had normocytic anemia, 40% had microcytic anemia, and 6.6% had macrocytic anemia.<strong>Conclusion: </strong>In most of the cases, anemia in the elderly had a treatable cause. Thus, a thorough investigation including gastrointestinal endoscopy is warranted. Unexplained progressive or unresponsive anemia requires bone marrow examination.</p> 2019-12-17T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1156 The Role of C Reactive Protein in Fever without Focus among Children Aged Between 1 – 3 Years 2019-12-19T02:19:58+00:00 Dhipu Mathew aijournals@gmail.com Deepa Mathew aijournals@gmail.com <p><strong>Background: </strong>The incidence of invasive pneumococcal disease in children has come down because of polysaccharide vaccine. The increased incidence of bacteremia among young children may be due to part of maturational immune deficiency in the production of opsonic Ig Ganti bodies to the polysaccharide antigens present on en capsulated bacteria. Fever is a common present in gsymp to min paediatric out patient practice and in children less 3 years of age. Approximately 20%to30% of the children may have no identifiable cause off ever after history and physical examination. <strong>Subjects and Methods:</strong> Children in the age group of 1-3 years presenting to the outpatient department were screened for temperature &gt;39°C and who satisfied inclusion criteria were included in the study. Temperatures were recorded either in the axillary or rectal areas. Informed consent was obtained from parents or guardian &amp; clearance of Institutional Ethical Committee Review Board. Blood samples were taken for total WBC count, ANC, ESR and CRP and at the same time samples for blood culture. Blood cultured in various media incubated overnight and colony morphology was read. <strong>Results: </strong>CRP &gt;6mg/d1 was observed in 25 cases of children who had SBI giving rise to sensitivity of 75.8%, 46 children who did not have SBI have CRP &lt;6mg/d1 giving a specificity of 39.3%. Among 96 cases with CRP more than 6mg/d1 only 25 (26%) cases had SBI giving PPV of 26%. Among 54 cases of CRP &lt;6mg/d1 46(85%) cases did not have SBI giving a NPV of 85.2%. <strong>Conclusion: </strong>CRP determines more selective strategy for children with SBI for additional diagnostic studies and appropriate antibiotic therapy.</p> 2019-12-18T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1163 A Study on Megaloblastic Anaemia and Pancytopenia 2019-12-23T09:04:24+00:00 P. Sashikanth Reddy aijournals@gmail.com S. Srinivas aijournals@gmail.com <p><strong>Background: </strong>Megaloblastic Anaemia and pancytopenia are common medical problems,Vitamin B<sub>12</sub>and folic acid deficiencies are common causes for megaloblastic Anaemia. Pancytopenia is a condition where bone marrow becomes hypo plastic fails to produce mature blood cells, causes include myelodysplasia leukemia’s, drugs and ionizing radiation and always associated with decreased reticulocyte count. Megaloblastic Anaemia is commonly due to dietary deficiency and pregnancy. <strong>Aim: </strong>To study about megaloblastic Anaemia&amp; pancytopenia. <strong>Subjects and Methods: </strong>In our study we have examined 120 Anaemia patients for 1 year.out of these 120 patients most of than are having Iron deficiency Anaemia 32 patients are having megaloblastic Anaemia and 26 patients are having pancytopenia. after complete history taking and clinical exmination we have send the blood samples for investigations. <strong>Results: </strong>Total no. of megaloblastic Anaemia were 32 patients Males 18, Females 14 and the total no. of pancytopenia patients were 26 out of these 26, 15 were Males and 11 were Females common age group is 20 years and 40 years, The clinical features are fatigue, shortness of breath, parenthesis’s, Fever, Splenomegaly pallar are present in most of the cases. <strong>Conclusion: </strong>megaloblastic Anaemia and pancytopenia are common medical problems in India, especially rural areas, they should be suspected is pregnant woman with prolonged fever, Anaemia&amp; bleeding tendencies and lympledinopathy.</p> 2019-12-23T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1164 Assessment of the Prevalence, Severity, Risk Factors of Anemia Among 2-12 Years of Aged Children Attending a Hospital in Western Uttar Pradesh Region 2019-12-23T09:08:20+00:00 Sunjay Pathak aijournals@gmail.com Radesh Pathak aijournals@gmail.com <p><strong>Background: </strong>This study was done to create awareness among people about the problems of Anemia and health care providers in furthermanagement. The aim of this study was to assess the prevalence, severity, risk factors of anemia among 2-12 years of aged children attending a hospital.<strong>Subjects and Methods: </strong>Blood and stool samples were collected from the patient. Among those children with hemoglobin&lt;11 g/dl, were screened for iron deficiency anemia(serumferritinestimationisdone).Amongthese 500 children, 100 children with a hemoglobin level of 11gm/dl and serum ferritin &lt;12 μg/l were taken up for detailed study.<strong>Results: </strong>A total of 138 males 62.7% were having hemoglobin less than 11.4 gm. /dl indicating anemia. total 230 female children about 66.5% were detected with anemia, 73 (31.73%) children had Hemoglobin levels less than 8 gm. /dl indicating severe anemia and about 49 (21.30%) children had moderate anemia and 31 (13.47%) had mild anemia and only 77 (33.47%) were having their hemoglobin concentration of greater than 11.5 gm. /dl were classified asnon-anemic.<strong>Conclusion: </strong>Anemia was slightly more prevalent in girls of the same agegroup as compared to boys.</p> 2019-12-23T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1165 Study of Lipid Profile in Newly Detected Adult Hypertensive Patients 2019-12-23T09:11:43+00:00 Bindu C B aijournals@gmail.com Lokesh H C aijournals@gmail.com <p><strong>Background: </strong>Hypertension is a leading cause of mortality and morbidity worldwide which doubles the risk of cardiovascular diseases. Hypertension and dyslipidemia are major modifiable risk factors associated with an increasing risk of cardiovascular disease.<strong>Aims &amp; Objective</strong><strong>:</strong>To study the different components of lipid profile in&nbsp; newly detected adult hypertensive patients and&nbsp; to&nbsp; compare the lipid profile changes among newly detected adult&nbsp; hypertensive patients with normotensive patients&nbsp; in a tertiary care hospital.<strong>Subjects and Methods: </strong>The study was done in the department of General medicine in Hassan institute of medical sciences, Hassan, Karnataka a tertiary care hospital. Patients were selected randomly from outpatient and in patients departments after taking consent and fulfilling the inclusion and exclusion criteria. Two hundred and fifteen age and sex matched patients were enrolled for the study and they were divided into two groups based on blood pressure.&nbsp; Group A - study group (109)&nbsp;&nbsp; newly detected&nbsp;&nbsp; hypertension patients and Group B –control group (106) comprising normotensive patients. Both the groups fasting lipid profile was&nbsp;&nbsp; studied and compared.<strong>Results: </strong>Total 215 patients were&nbsp; included in the study, of which 109 patients were&nbsp; in&nbsp; group A (study group) comprising&nbsp; newly detected hypertension&nbsp; patients and 106 patients were in&nbsp; group B(control)&nbsp; comprising of normotensive&nbsp; patients<strong><u>.</u></strong> The mean SBP (systolic blood pressure) was 159.4 mm of Hg in Group A whereas it was 113.2 in Group B, the mean DBP (diastolic blood pressure) was 99.4mm of Hg in Hypertensive patients (Group A), and it was 73.1 in normotensive patients (Group B).Serum levels of cholesterol, triglyceride and LDL were 194.2, 152.2 and 122.2 mg/dl respectively in hypertensive patients, whereas in normotensive patients they were 146.4, 110.2 and 102.6 mg/dl respectively which were higher in hypertensive patients.Whereas serum HDL was almost the same in both the groups.<strong>Conclusion: </strong>Newly detected adult hypertensive patients are dyslipidemicas compared to normotensive&nbsp;&nbsp; patients, so proper blood pressure control and monitoring of lipid profile at regular intervals helps in preventing major complications such as cardiovascular diseases and cerebrovascular accidents.</p> 2019-12-23T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1166 Electro Cardiogram and Its Normal Variations in Healthy Adult 2019-12-30T06:16:15+00:00 Shahid Abdul Ansari aijournals@gmail.com Rakesh Dhir aijournals@gmail.com <p><strong>Background: </strong>Electro cardiogram is used to assess cardiac, rhythm and conduction and provides information about chamber size also. The Electrical activity is initiated in SA node and then to AV node and then to bundle of HIS and from that through the purkhjisystem spread to myocardium. Electrocardiogram is the best non-invasive investigation in diagnosing acute myocardial infarction and arrhythmias like atrial fibrillation and ventricular tachycardia. Electrolyte abnormalities like hypokalaemia and hyperkalaemia may also be detected with electrocardiogram.<strong>Aim:</strong>To study the normal variations QRS duration, ST, T changes and other rate and rhythm abnormalities, which can occur in healthy individuals.<strong>Subjects and Methods: </strong>We have examined 280 healthy adults ,among those 280 ,120 were females and 160 were males. The age group is between 20 and 60 years.ECG’S were taken after Careful history and clinical examination to rule out any heart diseases like coronary heart diseases, rheumatic heart diseases and hypertensive heart diseases. Drug history was also recorded especially regarding B blockers and Calcium channel Blockers.<strong>Results: </strong>Out of 280, females were 120 and males were 160 the age group is between 20 and 60 years. The heart rate is between 56 and 104. Normal sinus rhythm is observed in 146. The increased heart rate is seen in young adults ,T↓ are very common.<strong>Conclusion: </strong>Electro cardiogram is a best investigation in diagnosing acute myocardial infarction and certain arrhythmias. Even though normal variations are common it is very much useful in detecting certain conditions like silent Myocardial infarction which is very common in diabetic patients and old age Individuals.</p> 2019-12-23T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1176 Assessment of BMI and Risk of Diabetes Mellitus among Adults 2019-12-24T05:06:49+00:00 Arshied Hussain Bhat aijournals@gmail.com <p><strong>Background: </strong>Type 2 diabetes is the most common form and comprises of 90% of people with diabetes around the world. The present study was conducted to assess the effect of weight gain on risk of diabetes in adults. <strong>Subjects and Methods: </strong>The present study was conducted on 96 subjects of both genders. BMI was calculated as the body mass divided by the square of the body height, and is universally expressed in units of kg/m2, resulting from mass in kilograms and height in metres. In all subjects, fasting blood glucose level was estimated. <strong>Results: </strong>Out of 96 patients, males were 56 and females were 40. BMI was underweight in 5 males and 3 females, normal in 14 males and 10 females, overweight in 17 males and 14 females and obese in 20 males and 13 females. The difference was non- significant (P&gt;0.05). Out of 8 underweight, 1 had diabetes, out of 24 normal subjects, 5 had diabetes, out of 31 overweight, 22 had diabetes and out of 33 obese, 31 had diabetes. The difference was significant (P&lt; 0.05). <strong>Conclusion: </strong>Authors found that diabetes mellitus was significantly more frequent among obese patients thus obesity is considered as a risk factor of DM.</p> 2019-12-23T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1177 Thyroid Dysfunction in Patients with Liver Disease 2020-01-08T08:12:20+00:00 R P Buden aijournals@gmail.com <p><strong>Background: </strong>Liver disease related to alcohol (Ethanol, ethylalcohol) is very common global problem and is one ofthe major medical complications of alcohol abuse. Daily consumption is usual for causation of liver disease. <strong>Aim:</strong> To estimate the prevalence of thyroid dysfunction in patients with liver disease. <strong>Subjects and Methods: </strong>Early morning fasting serum thyroid stimulating hormone (TSH), serum total free thyroxine (FT4) and free triiodothyronine (FT3) was measured by radioimmunoassays in 100 index patients with liver cirrhosis who did not have history of thyroid diseases. <strong>Study Period:</strong> November 2018 to October 2019 The age of study population was in the range of 25-65 years. Out of 100 patients, 75 were males and 25 were females. <strong>Conclusion: </strong>Abnormalities in circulating thyroid hormone concentrations i.e hypothyroidism is noted especially in those with ethanol related liver cirrhosis and it is associated with more advanced liver disease.</p> 2019-12-23T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1233 A Clinical Study on Hyponatremia in Elderly, Hospitalized Patients 2019-12-31T01:51:31+00:00 P. Shashikath Reddy aijournals@gmail.com Harish Katragadda aijournals@gmail.com <p><strong>Background: </strong>Electrolytes abnormalities are very common abnormalities in elderly individuals, among these hyponatramia is very dangerous and with high mortality hyponatramia is labelled as when serum sodium is less than 135 m.eq/l. It is associated with profound disturbance of cerebral function. Clinical features of hyponatremia include confusion, lethargy, vomiting convulsions and coma.To most cases of hypomatremiareflects water imbalance and abnormal water handling not sodium. Rapid rate of development of electrolyte abnormality causes more severe cerebral symptoms than the levels of Na Aggressive treatment and inappropriate therapy is more harmful than hyponatremia. Common causes of hyponatremia are dehydration, chronic renal failure, AIDS, Hypothyroidism and infections.<strong>Aim: </strong>To study the pattern, clinical features and outcome of patients with hyponatremia.<strong>Subjects and Methods: </strong>This study in conducted for 1year in 2 rural medical colleges in Telangana and Andhra Pradesh we have conducted this study on 80 elderly patients.Hospitalized patients. The age group is between 6.5 and 80 years males were 54 and females were 36.<strong>Results: </strong>We have examined 80 patients, males were 54 and females were 36. The age group is between 65 and 80 years. Hyponatremia was observed in 28 patients out of these 28 patients males were 18 and females were 10. The common age group is between 70 and 75 years.<strong>Conclusion: </strong>Hyponatremia is very common in elderly patients. And it is mostly seen in ptswithCVA CAD, diabetes and sepsis. So when the elderly patients admitted with these coma bid conditions look for the early symptoms of hyponatremia and serum electrolyte should be tested. Early detection and early managements can prevent the mortality and morbidity is these patients.</p> 2019-12-30T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1234 Prevalence of Uremic Pruritus, Its Risk Factors and Impact on Health-Related Quality-Of-Life in Patients on Maintenance Hemodialysis 2019-12-31T01:59:31+00:00 Simran Kaur aijournals@gmail.com Deepak Sharma aijournals@gmail.com Suman Sethi aijournals@gmail.com Preet Mohinder Singh Sohal aijournals@gmail.com Harmandeep Singh Chahal aijournals@gmail.com Vikas Makkar aijournals@gmail.com <p><strong>Background: </strong>Renal pruritus is one of the most debilitating symptom of chronic kidney disease especially affecting patients on maintenance hemodialysis.<strong>Subjects and Methods: </strong>It was a cross-sectional questionnaire based study. Demographic, dialysis related and biochemical parameters of maintenance hemodialysis patients were recorded, and a pre-defined questionnaire was put to them. Severity was calculated with 12 point pruritus severity scale (PSS), health-related quality of life with SKINDEX-10, and sleep survey with&nbsp;ITCH-MOS.<strong>Results: </strong>The total of 164 patients (mean age 52 ± 17years, males-57.9%, females-42.1%) completing questionnaire and laboratory analysis were included in the study. Prevalence of pruritus was 53.7% (mild in 31.8%, moderate-45.5%, severe-22.7%). Prevalence was higher in diabetic CKD (p=0.0001), and irregularly dialyzed patients (p=0001). The severity of pruritus correlated with older age (p=0.004), shorter dialysis vintage (p=0.000), irregular dialysis (0.000), higher serum phosphorus (0.003), and parathyroid hormone level (0.000) and higher calcium-phosphorus product (0.001). SKINDEX-10 showed worsening symptoms, emotional and functional quality of life (p=0.000), and poorer sleep quality and quantity as per ITCH-MOS (0.000), with increasing severity of itching.<strong>Conclusion: </strong>Renal itch is highly prevalent in maintenance hemodialysis patients, most severely affecting diabetics, elderly, irregularly dialyzed patients, with poorly controlled mineral bone parameters. The severity correlates with worsening sleep and overall quality-of-life.</p> 2019-12-30T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1250 Prognostic Importance of Hyponatremia in Acute STEMI 2020-01-03T04:10:15+00:00 Hare Krishna Sharma aijournal@gmail.com Chinky Sharma aijournal@gmail.com Ajay Kumar aijournal@gmail.com <p><strong>Background: </strong>Hyponatremia develops in early phases of acute myocardial infarction, recently, several studies showing its importance as important early prognostic tool. Many studies shown that significant increase in plasma AVP level was in patients who had associated with complication as heart failureand fatal outcome after acute MI, and clinicalimprovement was noted following the rise in serum plasma level of sodium .hence Early developed hyponatremia is a unique&nbsp;&nbsp; indicator of neuro hormonal activity in the early phases of recent MI, so it can help predict the complication as long-term development of HF and death. OBJECTIVE: To observe the prognostic importance of hyponatremia in settings of acute STEMI event and helpfulness in prediction of short term and long term survival.<strong>Subjects and Methods:</strong>Randomized double blinded study, in 100 of patientswith acute S TEMI presented to outpatient department and indoor emergency patients.<strong>Results:</strong>Patients who developed hyponatremia at admission had higher mortality rate than the patients who developed hyponatremia at 72 hrs and normonatremic patients. Mortality in patients correlates with the severity of hyponatremia 5(100%) patient died with sodium levels &lt;130mmol/l whereas 5(16%) death occurred in the patient having sodium level between 131-134. (Odds ratio 6.0, pvalue 0.02).<strong>Conclusion: </strong>We concluded that hyponatremia developed in early as well as late phases of acute STEMI&nbsp; serve as&nbsp; is an ‘independent determinant of both short term (in hospital mortality, development of arrhythmias and heart failure) as well as long term survival (cardiac death, post discharge heart failure). Plasma sodium levels may help identify patient at risk.</p> 2019-12-30T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1251 A Comparative Study of Formative Assessment in Medicine Using Conventional Long Case Examination and Objective Structured Long Examination Record (OSLER) Among Final Year MBBS Students 2020-01-03T04:15:39+00:00 Suresh R M. aijournal@gmail.com Venugopal K aijournal@gmail.com Bindu C B aijournal@gmail.com Nachiketh N S aijournal@gmail.com <p><strong>Background: </strong>Most medical colleges in India traditionally use the Long Case Examination (LCE) in both formative and summative patterns of assessment in clinic. This age-old issue has been addressed over the years by the introduction of several modifications of the LCE such as OSCE and OSLER. OSCE, though attractive in its brevity and specificity of focus, falls short in terms of being comprehensive. This study was taken up to compare conventional LCE to OSCE and OSLER. <strong>Subjects and Methods:</strong>Final year MBBS students, posted to Department of General Medicine, HIMS, Hassan &nbsp;were studied for 5 months.Type of study: Prospective observational studyFour examiners were selected for the formative assessment: Examiners 1 and 2 were asked to assess the students assigned to Group 1; Examiners 3 and 4 were asked to assess Group 2. The OSLER method concentrates on the following ten items: (1) pace and clarity of presentation, (2)communication process, (3) systematic approach,&nbsp; (4) Establishment of case facts, (5) systematic examination, (6) Examination technique, (7) Establishment of correct physical findings.<strong>Results:</strong>The mean time taken for the assessment in Group 1 was 28.22 minutes and the SD was 7.588. The mean time taken for the assessment in Group 2 was 17.09 minutes and the SD was 4.546. <strong>Conclusion: </strong>In our study, the students seem to prefer the time-tested long case examination and did score better marks with the conventional method than with OSLER.</p> 2020-01-02T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1252 Etiology and Outcomes in Elderly Patients Admitted For Acute Infections 2020-01-03T04:19:30+00:00 Vinita Patil aijournal@gmail.com Elizabeth James aijournal@gmail.com Sangeeta Pednekar aijournal@gmail.com <p><strong>Background: </strong>Infectious diseases are a major cause of mortality in elderly. The present study aimed to assess various acute infections in elderly population admitting in our department and factors which are associated with their clinical outcomes.<strong>Subjects and Methods: </strong>Hundred patients, aged more than 65 years of age, having fever of less than 7 days duration or having symptoms of any of the major system admitted in our department were included. Detailed history, clinical and laboratory work-up was done to diagnose the cause of infection. Mortality of the patients during hospital stay was noted and factors associated with it were ascertained from statistical analysis.<strong>Results: </strong>Mean age of the patients was 75.84 years, two-thirds being males. Hypertension and diabetes mellitus were the most common co morbidities. Pulmonary infections accounted for majority of the infections (43%),urinary tract infections were the second most common causeof acute infection. Gastrointestinal infections (10%), central nervous system infections (6%), skin infections (4%) were other less common causes.During hospitalization, the most common complication was respiratory failure. Overall, 15 patients died during hospital stay. We found higher APACHE-II score and presence of pulmonary infections to be significantly associated with in-hospital mortality.<strong>Conclusion: </strong>A multi-disciplinary management of elderly patients with infections is required.</p> 2020-01-02T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1253 Study of Clinico Radiological Profile of Ischemic Cerebrovascular Stroke and Its Outcome at Tertiary Care Centre 2020-01-03T04:23:03+00:00 Vaishali Patel aijournal@gmail.com Asha Vagadiya aijournal@gmail.com <p><strong>Background: </strong>Ischemic CV stroke&nbsp; is disease of long term Disability and Death accounts for &gt;80% of total stroke events .The main objective of the study was to study clinical and radiological profile,&nbsp; risk factors&nbsp; and&nbsp; outcome of&nbsp; stroke.<strong>Subjects and Methods: </strong>An observational study of 46 patients of acute ischemic cerebrovascular stroke was conducted during January 2014 to November 2014. All patients were subjected to Sociodemographic,Clinical, family h/o risk factors, dietary,other lifestyle habits and examination with written consent. Apart from routine blood investigations , special investigations like Uric acid, urinary albumin creatinine ratio, ECG,2D Echo, Carotid Doppler , CT Scan/MRI brain were done within24 hours of onset. NIHSS and MRS scores were used for severity assessment.<strong>Results: </strong>Majority of patients were in 55-64 years (30.4%) age group with male predominance (52%) (mean age 55.52<u>+</u>12.61). Old aged patients are more likely to be selected for study. Microalbuminuria was found on 34 (73.9%) Patients&nbsp; with recent&nbsp; stroke. 52.1 % patients having serum uric acid &gt;8. 36.9 % patients. ECG suggested LVH and normal findings in 36.9% while 15.2% and 10.8% had stroke related changes and myocardial ischemia. Majority 30(65%) of patients showed concentric hypertrophy, followed by&nbsp; diastolic dysfunction 11(23%) on 2D Echo.Atherosclerotic changes seen in 60.8% on carotid Doppler study. majority 32.6 %&nbsp; patients were affected in MCA territory, followed by 23.9 % PCA territory followed by 19.5% infarct in thalamus. NIHSS and MRSmean score was&nbsp; 20.2<u>+</u> 12 and 3.9+1.8&nbsp; on admission and&nbsp;&nbsp; 15.7<u>+</u>13 and 3.23+ 1.91&nbsp; on&nbsp; discharge respectively.Hospital outcome was good. No mortality during entire study period.<strong>Conclusion: </strong>Stroke a high socioeconomic burden in community. Apart from Age and hypertension, microalbuminuria and uric acid may be considered as independent risk factors for ischemic stroke. Identification and&nbsp; treatment of risk factors can prevent stroke related morbidity and mortality.</p> 2020-01-02T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1254 Management and Outcome of AKI in Patients with Cirrhosis 2020-01-03T10:11:06+00:00 Gnanendra DM aijournal@gmail.com Kiran S aijournal@gmail.comi Parvesh Kumar Jain aijournal@gmail.com <p><strong>Background: </strong>The increased propensity for AKI in patients with cirrhosis stems from hemodynamic abnormalities typical of patients with cirrhosis and ascites15 which is due to development of portal hypertension and portosystemic collaterals with splanchnic and systemic vasodilatation , resulting in decrease in effective arterial blood volume with increase in renin angiotensin- aldosterone system (RAAS), sympathetic nervous system, and non osmotic release of antidiuretic hormone causing sodium retention, increased intravascular volume, and a hyperdynamic circulatory state16 complemented with increased production of nitric oxide which is considered the main cause of vasodilatation in cirrhosis. <strong>Subjects and Methods: </strong>All participating patients of either gender admitted in department of Gastroenterology at Tertiary care hospital with age &gt;18 years with either diagnosed or newly diagnosed case of cirrhosis of liver( including both compensated &amp; decompensated cases ) admitted with acute kidney injury diagnosed according to International Club of Ascites Classification&nbsp; were&nbsp; enrolled&nbsp; in&nbsp; this&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; study. <strong>Results: </strong>Among 26 patients requiring hemodialysis , 10 ( 38.5 %) of patients recovered from hemodialysis whereas 16 ( 61.5 %) of patients didn’t recovered from hemodialysis &amp; either died on hemodialysis or was discharged on hemodialysis which needs to be continued. <strong>Conclusion: </strong>Totally 25.5 % of patients expired during course of treatment in hospital whereas 74.5 % were survived the hospital stay.</p> 2020-01-02T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1322 A Study on Uric Acid Levels in Type 2 Diabetes Mellitus with Chronic Kidney Disease 2020-02-26T09:04:25+00:00 Vishwanath VN aijournal@gmail.com Vijaya Mohan aijournal@gmail.com <p><strong>Background: </strong>The classification of stages of CKD is based on the level of kidney function measured by GFR, stage 1 represents kidney damage with normal or elevated GFR and stage 5 represents a GFR of less than 15 ml/min or who require treatment with dialysis. In recent times a new equation the Chronic Kidney Disease-Epidemiological Collaboration (CKD-EPI) has been introduced. The CKD-EPI equation has lower bias, especially at an estimated GFR greater than 60 mL/min per 1.73 m2; however, precision remains limited. <strong>Subjects and Methods: </strong>The study was undertaken in the Department Of General Medicine,and a total 64 CKD patients are included in study who fulfilled the inclusion and exclusion criteria. These cases taken are not overlapped with other postgraduate students. The patients were randomly divided into two groups according group chosen by time of enrollment. <strong>Results: </strong>The Study reveals that, there was no statistical significant difference of mean serum uric acid among smokers and non-smokers in Type 2 diabetes mellitus with CKD(P&gt;0.05). <strong>Conclusion: </strong>Study reveals that, there was no statistical significant difference of mean serum uric acid among alcoholic and non-alcoholic cases in Type 2 diabetes mellitus with CKD(P&gt;0.05).</p> 2020-01-02T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1323 A Study on Uric Acid Levels in Non Diabetic Patients at a Tertiary Care Hospital 2020-02-26T09:06:56+00:00 Vishwanath VN aijournal@gmail.com Vijaya Mohan aijournal@gmail.com <p><strong>Background: </strong>The pathophysiology of diabetic nephropathy is complex and still not fully elucidated<em>.</em> Observational studies suggest a relationship of UA level with incident CKD, but studies evaluating the relationship with decline in kidney function in established CKD are conflictingSeveral prospective studies have suggested that hyperuricemia is associated with an increased risk of incident cardiovascular events and death in both nondiabetic and type 2 diabetic&nbsp; individuals Hyperuricemia&nbsp; also&nbsp; is&nbsp; largely&nbsp; prevalent&nbsp; in&nbsp; patients&nbsp; with&nbsp; chronic kidney disease(CKD). <strong>Subjects and Methods: </strong>The patients were randomly divided into two groups according group chosen by time of enrollment. By using simple random method, 64 study subjects will be taken, and the study subject is divided into 2 groups. A detailed history, anthropometry, vital signs, clinical examination and laboratory parameters were recorded for both the study group. <strong>Results: </strong>The Study reveals that, there was no statistical significant difference of mean serum uric acid among smokers and non-smokers in non-diabetes patients with CKD (P&gt;0.05).Study reveals that, there was no statistical significant difference of mean serum uric acid among alcoholic and non-alcoholic cases in non-diabetes patients with CKD (P&gt;0.05). <strong>Conclusion: </strong>non-diabetic patients with CKD cases (P&lt;0.05). There was an increasing trend in the mean serum creatinine concentration with a corresponding decreasing trend in eGFR across increasing UA categories There is significantly sloping down of GFR with increase of SUA level as model.</p> 2020-01-03T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1324 Clinical Profile of Patients with Chronic Kidney Disease 2020-02-26T09:37:04+00:00 Karan VN aijournal@gmail.com Vishwanath VN aijournal@gmail.com <p><strong>Background: </strong>DM is the leading cause of end-stage renal disease (ESRD), non-traumatic lower extremity amputations, and adult blindness. It also predisposes to cardiovascular diseases. With an increasing incidence worldwide, DM will be likely a leading cause of morbidity and mortality in the future<strong><sup>29</sup></strong>. Chronic kidney disease (CKD) encompasses a spectrum of different pathophysiologic processes associated with abnormal kidney function and a progressive decline in glomerular filtration rate. <strong>Subjects and Methods: </strong>A written informed consent was obtained from all patients. History regarding the duration of hypertension, the medications being taken, coexisting medical problems, and symptomatology suggestive of ischemic heart disease, transient ischemic attacks and that of renal involvement were documented. A detailed history, anthropometry, vital signs, clinical examination and laboratory parameters were recorded for both the study group. <strong>Results: </strong>The Study reveals that, there was statistically very highly significant difference of age among Type 2 diabetes mellitus with CKD and Non-diabetic patients with CKD (P&lt;0.001).Type 2 diabetes mellitus with CKD cases had significantly higher mean age as compare to Non-diabetic patients with CKD cases. <strong>Conclusion: </strong>There was statistical significant difference of mean serum uric acid among vegetarians and non-vegetarians with CKD patients (P&gt;0.05).It’s found that vegetarians have less SUA level when compare to mixed diet patients.</p> 2020-01-03T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1328 A Study on Correlation between Serum Cortisol and Stroke Severity with Serum Cortisol 2020-02-28T09:45:20+00:00 K.H Jnanendrappa aijournal@gmail.com <p><strong>Background: </strong>The stress response that occurs after the event of acute stroke causes the activation of the hypothalamo–pituitary–adrenal (HPA) axis. Certain studies have found that increased serum cortisol level in patients with acute stroke is related to larger infarct volume, greater stroke severity and poor outcome, including death. <strong>Subjects and Methods: </strong>About 50 new cases of acute ischemic stroke patients, within 72 hours of the acute neurological event , who were admitted in the Sridevi Medical College &amp; Hospital were included in the study. The study was conducted for a period of 6 months.(June 2018-December 2018). CT Brain was taken during admission to confirm acute ischemic stroke. NIHSS (National Institute of Health Stroke Scale)score for all the patients were assessed&nbsp; for severity at the time of admission. <strong>Results: </strong>Of the 50 cases, serum cortisol level of 23 cases were within&nbsp; normal limits(&lt;/=690nmol/L) of which 65.2% had NIHSS score of less than or equal to 6 and 34.8% of the cases had NIHSS score more than 6. <strong>Conclusion: </strong>Among the patients with acute ischemic stroke ,high serum cortisol levels at the time of admission correlates with,1. Clinical severity which is assessed by National Institute of Health Stroke Scale and&nbsp;2, Poor prognosis and functional outcome after 15 days which is assessed by Modified Rankin Scale.</p> 2020-01-03T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine http://aijournals.com/index.php/ajm/article/view/1341 Association of Birth-Weight, Obesity and Family History in the Development of Latent Autoimmune Diabetes in Adults (LADA) and Type 2 Diabetes Mellitus 2020-03-20T03:46:24+00:00 Shubhangi Verma aijournal@gmail.com Samarth Sharma aijournal@gmail.com Priyadershini Rangari aijournal@gmail.com <p><strong>Background: </strong>A proportion of subjects with adult-onset autoimmune diabetes does not require insulin-therapy at the time of diagnosis and are clinically similar to patients with type 2 Diabetes Mellitus (T2DM). <strong>Objectives:</strong> The present study was undertaken association of birth-weight, obesity and family history in the development of latent autoimmune diabetes in adults (LADA) and type 2 Diabetes Mellitus. <strong>Subjects and Methods: </strong>A total of 50 healthy controls, 50 type 2 diabetic and 50 patients with LADA were enrolled. Complete demographic details of all the patients were obtained. Clinical examination of all the patients was carried out and medical history of all the patients was obtained. Detailed medical history and family history of all the patients was recorded separately. A Performa was made and complete anthropometric parameters were recorded. Body mass index (BMI) was calculated. All the results were recorded in Microsoft excel sheet and was analysed by SPSS software. <strong>Results: </strong>While assessing association of birth-weight in the development of latent autoimmune diabetes in adults (LADA) and type 2 Diabetes Mellitus; it was observed that significantly higher proportion of patients of the diabetic group and the LADA group had low birth-weight in comparison to the patients of the control group. While assessing association of family history of diabetes in the development of latent autoimmune diabetes in adults (LADA) and type 2 Diabetes Mellitus; it was observed that significantly higher proportion of patients of the diabetic group and the LADA group had positive family history of diabetes in comparison to the patients of the control group. While assessing association of obesity in the development of latent autoimmune diabetes in adults (LADA) and type 2 Diabetes Mellitus; it was observed that mean BMI of the patients of the diabetic group and the LADA group was significantly higher in comparison to the patients of the control group. <strong>Conclusion: </strong>Low birth weight, obesity and positive family history of diabetes are important risk factors in the development of latent autoimmune diabetes in adults (LADA) and type II diabetes.</p> 2020-01-03T00:00:00+00:00 Copyright (c) 2019 Academia Journal of Medicine