Asian Journal of Medical Research

Study on Identification of Rats and the Existence of Leptospira Bacteria. sp in the Flood Area of Puskesmas Tempe, Wajo District

Dr. Syamsuar — 2018-11-10

Background: Leptospirosis is one of the emerging infectious diseases caused by pathogenic bacteria called Leptospira and is transmitted from animals to humans (zoonosis). Mice as one of the reservoirs of leptospira bacteria found in urine and kidney. The aim of the study was to determining the presence of leptospira bacteria in rats in the flood prone area surrounding Community Health Center (Puskesmas) of Tempe, Wajo Regency. Subjects and Methods: The type of research used is descriptive research with observational approach. The samples in the study were rats caught with life trap in flood prone areas of Puskesmas Tempe area. Sampling is done by accidental sampling technique. Processing and data analysis is done by descriptive method and the kidney sample of the rattus was determined by PCR in the laboratory. Results: This study indicates that from the seven trapped rats, the types of rats in flood prone in Puskesmas Tempe area, Laelo and Salomenraleng villages, were Rattus tanezumi, Rattus norvegicus, Rattus Tiomanicus, which is none of them infected by Leptospira sp. Conclusion: In conclusion, the types of rats in flood-prone areas in the Tempe Community Health Center working area are Rattus tanezumi, Rattus norvegicus, Rattus Tiomanicus negatively contains leptopspira bacteria. Further research is needed with more samples, not only in the parameter areas but also in buffers with more sensitive methods.

Comparison of Esmolol and Dexamedetomidine Effects on Symphtomimmetic Response of Elective Surgical Patients After Laryngoscopy and Intubation.

Ankur Jain — 2018-10-10

Background: In anaesthetized patients laryngoscopy and tracheal intubation both are noxious stimuli’s causes hypertension and tachycardia that are marked sympathetic response which are unwanted, particularly in patients with cardiovascular or neurosurgical diseases undergoing anesthesia. Dexmedetomidine has unique pharmacokinetics making it difficult to compare with other routinely used drugs such as esmolol and lignocaine. Subjects and Methods: Study population (n=90) of the current study was randomly divided into three groups. Group I (control), group II (dexmedetomidine) and group III (esmolol) respectively received 20 ml 0.9% saline, 1 g/kg of dexmedetomidine and 1.5 g/kg of esmolol. Base line, 5 minutes after the study drug administration, induction baseline and 1, 3, 5, 7, and 10 minutes after orotracheal intubation heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product were recorded. Results: There was no significant difference in mean heart rate (p>0.05) at baseline between all three groups. A significant increase in mean heart rate of group I (4.72 %) whereas a significant decrease mean heart rate of group II (20.71%) and group III (4.32%) were recorded. It is evident from figure 1 that there was a significant decrease in SBP, DBP and MAP group II and group III compare to group I after the infusion and just before intubation. Mean SBP values increased in all the three groups at 1 min after intubation. The values of SBP in Group II were significantly lower than that of Group I and Group III (p < 0.01). Conclusion: Findings of the current study suggest that both dexmedetomidine and esmolol were found effective in improving symphtomimmetic response to laryngoscopy and inintubation in normotensive patients. However, dexmedetomidine showed better attenuation of haemodynamic response compare to esmolol.

To Study the Treatment Outcome of Various Management Strategies of Liver Abscess: A Prospective Study From A Tertiary Hospital Centre.

Mohammad Kashif — 2018-11-15

Background: Liver abscess was found more commonly in men between 18 and 60 years of age but can occur at any age. Approximately 80% were solitary and mainly located in right lobe of liver. The most common presenting clinical symptoms are upper abdominal pain, high-grade fever, nausea, and vomiting. The most common sign is right hypochondrial tenderness frequently with guarding and hepatomegaly. Some patients may present with jaundice and pleural effusion. Percutaneous catheter drainage was most widely used treatment method for liver abscess. Percutaneous needle aspiration also used for treatment of liver abscess, was a simpler, less costly and equally effective mode of treatment. In some patients of amoebic liver abscess associated with secondary bacterial infection and with ruptured liver abscess, surgical drainage had been the traditional mode of treatment. Subjects and Methods: Patients of unruptured liver abscess were randomly allocated into medical management, PCD and PNA groups for comparison. Results: Out of total 60 cases studied, Percutaneous catheter drainage (PCD) was most widely used treatment method in 27 (45%) cases of liver abscess. Percutaneous needle aspiration (PNA) also used for 21 (35%) cases, surgical treatment in 07 (11.67%) cases and only medical management was done in 05 (8.33%) cases of liver abscess. Conclusion: Percutaneous catheter drainage (PCD) was most widely used treatment method for liver abscess patients with 100% success rate and Percutaneous needle aspiration (PNA) was next to PCD with 81% success rate.

Evaluation on Efficacy of Diagnostic Laparoscopy in the Diagnosis and Management of Chronic Abdominal Pain: A Teaching Hospital Based Study

Vishnu Kumar Sharma — 2018-11-15

Background: Chronic abdominal pain can be diagnostic challenge. These difficult patients are frequently seen by many different physicians and are subjected to myriad of tests without identifying the etiology of pain. Surgical consultation often occurs late after other modalities have failed to provide resolution of their symptoms. Subjects and Methods: This prospective study was conducted in the Department of Surgery, Varun Arjun Medical College & Rohilkhand Hospital, Banthra, Shahjahanpur, Uttar Pradesh, India. 45 Patients with chronic abdominal pain participate in this study. This study included patients presenting with history of nonspecific abdominal pain for 3 weeks or more who were admitted in surgical wards. Results: The most common site of pain was the periumbilical region (51.1%) followed by the right lower abdominal quadrant (23.3%). Twenty two patients were using either non-steroidal drugs or pain killers to relieve the pain, and five patients were using proton pump inhibitors. Fourteen patients (31.1%) had undergone at least one previous surgical abdominal procedure. All patient characteristics are summarised in table 3. The average length of the operative time was 54.09 minutes with the range from 32 to 116 minutes. There were no cases converted to open procedures. Out the 45 patients with chronic abdominal pain, a definitive diagnosis was established in 43 patients (95.5%), while no identifiable cause could be reached in two patients (4.4%). The most common laparoscopic findings were adhesions (77.8%). Other findings included appendiceal pathology (11.1%), hernia (2.2%), gall bladder pathology (2.2%), and mesenteric lymphadenopathy (2.2%). Table 2 summarises the laparoscopic diagnoses assigned to all patients. Laparoscopic management included adhesiolysis (35), appendectomy (5), hernia repair (1), cholecystectomy (1), and lymph node biopsy (1). Two patients had no interventions performed. Postoperative hospital stay ranged from two to twelve days with a mean of 3.8 days. Conclusion: In conclusion, Chronic abdominal pain of unknown origin represents a significant problem in surgical patients. Due to improvement in instrumentation and greater experience in the laparoscopy, the procedure no longer limited to visualization. This study showed that laparoscopy is an effective approach in the management of patients with chronic abdominal pain in whom conventional methods of investigations have failed to elicit a certain cause.

Correlation Between the Serum Sodium and Serum Magnesium Levels with Morbidity and Mortality in Case of Traumatic Brain Injuries

Rahul Mittal — 2018-11-15

Background: Traumatic brain injury (TBI) occurs when outside force traumatically injures the brain. Traumatic brain injury is a major cause of mortality and morbidity worldwide. The aim of present study is to establish the relationship between the serum levels of sodium & magnesium and prognosis of patients of head injury in terms of mortality and morbidity. Subjects and Methods: This study compromise of all those cases who were admitted as a case of head injury through Neurosurgery outpatient department or through causality department of S.V.B.P hospital attached to LLRM medical college, Meerut during one year. All the factors producing mortality were found. Patients were followed-up and asked to come periodically. Outcome was recorded. Results: Patients who are admitted with poor GCS & those having higher Serum Sodium levels (More than 160 meq/ L) in posttraumatic period have poor prognosis and longer hospital stay. Patients who are admitted with poor GCS & those having lower serum Magnesium levels (less than 1.3 meq/L) have poor prognosis and longer hospital stay. In patients who have GCS of 13-15 serum sodium level is not increased much and there prognosis is better than those patients with GCS of 3-8 or 9-12. In patients who have GCS of 13-15 serum Magnesium level is not decreased much and there prognosis is better than those patients with GCS of 3-8 or 9-12. Conclusion: Serum sodium and magnesium levels are good prognostic markers for morbidity and mortality in case of traumatic brain injuries.

Study on Laparoscopic versus Open Appendectomy: A Hospital Based Study

J Ahmed — 2018-11-15

Background: The putative advantages of the laparoscopic approach are quicker and less painful recovery, fewer postoperative complications and better cosmesis. It allows better assessment of other intra-abdominal pathologies. Subjects and Methods: A total of 56 patients were included in the study during this period, according to the inclusion and exclusion criteria. Out of this 56 patients, 28 underwent an open appendicectomy, 28 underwent a laparoscopic appendectomy. Results: Average age of patients undergoing LA was 24.3 years while it was 26.2 years for those undergoing OA. The operative duration was initially longer in the LA group as compared to that in the OA group but with the learning curve it decreased to less than that of OA; The use of analgesics, average hospital stay and return of bowel movements was better in case of LAas compared to OA. Conclusion: The Laparoscopic appendectomy is equally safe, and can provide less postoperative morbidity in experienced hands, as open appendectomy.

Study on Desarda versus Lichtenstein Repair for Inguinal Hernia: A Teaching Hospital Based Study

Atul Tandon — 2018-11-15

Background: Hernia repair is one of the most commonly performed general surgical procedures worldwide. Subjects and Methods: A total of 46 Patients admitted to the surgical department with the diagnosis of primary inguinal hernia according to inclusion and exclusion criteria. Results: Mean operative time taken for total surgery in Desarda group was significantly shorter when compared to Lichtenstein group. No operative or post-operative mortality was detected in this study.Conclusion: Desserda repair had cost effective technique with significantly lower operative time, early return to basic and work activity, shorter hospital stays and less post-operative pain than Lichtenstein repair.

A Clinical Study on Dengue Fever

Srinivas. S — 2018-11-15

Background: Dengue fever is caused by Flavivirus and it is transmitted by Aedes aegyorti Mosquito each year 68 to 280 million cases of dengue fever areregistered. It is endemic in South east Asia, India, Srilanka, Africa and in Caribbian and America. It causes high morbidity and mortality. Subjects and Methods: We have conducted this study in Teleangana and Andhrapradesh in South India. Patients with dengue fever are included in this study. Total 450 patients were included in this study. Males and 275 and Female were 175. We have collected the blood and send for NS1 antigen and IgM antibody Elisa. Results: Dengue fever is positive in 85 Males(17% ) and 58 Females(13%) and the total dengue fever positive patients are 193 and out of these 193 positive 96 are IgM positive 47 are NS1 positive. Conclusion: Dengue fever is common in Indian subcontinent throughout the year particularly more common during in rainy season i.e June to September. So there is need to control mosquitoes by public health department and NGO’s and educate the people regarding protection from mosquitoes.

A Study on Sub Clinical Hypothyroidism in Pregnancy

Sree Gowri — 2018-11-15

Background: Subclinical hypothyroidism and hypothyroidism are common endocrinological disorder which affects mothers during pregnancy. It effects foetus also.Thyroid hormone screeching especially TSH (Thyroid stimulating hormone) and FT4 is important before pregnancy as thyroid hormone levels have important role for neurophysiological development of baby. Subjects and Methods: We have conducted this study on 435 antenatal women with 34-38 weeks of gestation. Detailed history was taken and clinical examination was done. Blood samples were send to serum TSH and FT4 measurement. Subclinical hypothyroidism was noted in 18 mother s and they were compared with 55 euthyroid pregnant women. Mothers were followed up till discharge from hospital new born weight, abgarscore and serum TSH after 48 hours of birth to 7 days was measured. Aim of the study: To study the prevalence and complications of subclinical hypothyroidism in pregnant women and new born. Results: In our study the prevalence of subclinical hypothyroidism was 4.15% complication of subclinical hypothyroidism were pre-eclampsia 13.25%, and abruption placenta 6.48%; foetus complications in subclinical hypothyroidism include low birth weights 28.12%; Intra uterine growth retardation 12.8%; still had born 12.6%; Jaundice 11.24% subclinical hypothyroidism in pregnancy is associated with neo natal complications and maternal complications. Conclusion: Subclinical hypothyroidism is associated with maternal and foetus complications. Screening for serum TSH and FT4 is essential to prevent the maternal and foetus complications.

Interrelationship between the Status of Vitamin- D and HbA1c in Type 2 Diabetes Mellitus in a Tertiary Care Center

Madhusmita Acharya — 2018-11-15

Background: The highest prevalence rates of T2DM are found in developing countries. Type 2 diabetes mellitus (T2DM) is a serious and growing global health problem. In 2013, there were 382 million people with diabetes; this number is estimated to grow to 592 million by 2035.Subjects and Methods: It’s a cross-sectional analytical study done in the Department of Biochemistry, VIMSAR, Burla. 100 known type-2 diabetic patients who gave consent to take part in the study were included as study subjects.Results:In our study the serum vitamin-D was correlated negatively with the HbA1C and the vitamin D deficiency was significantly associated with the glycemic control.Conclusion: The association of vitamin D deficiency with poor glycaemic control in patients with type-2 DM points towards the role vitamin supplementation could possibly play in regulation of glycaemia in these patients.