Asian Journal of Medical Research

Association of Diabetic Retinopathy and Lipid Profile in Diabetic Patients in Mathura District

Nitin Singh Salaria — 2019-02-13

Background: It is estimated that diabetes mellitus affects 4 percent of the world’s population, almost half of whom have some degree of diabetic retinopathy at any given time. Elevated serum lipid levels are associated with an increased risk of retinal hard exudate in persons with diabetic retinopathy. Therefore the current study was undertaken to determine the association of serum lipid profile with diabetic retinopathy and its severity. Subjects and Methods: One hundred fifty diabetic patients, out of these, 75 diabetic patients with retinopathy served as the study group I and 75 diabetic patients with no retinopathy formed group II (control group). Simultaneously, 75 age and sex matched healthy subjects were also studied as controls (group III). Serum total cholesterol, serum triglyceride, serum low density lipoprotein and serum high density lipoprotein were measured by using enzymatic method and autoanylyser. Fasting blood sugar and post prandial blood sugar were estimated by using GOD POD method. Results: Most of the patients in Group I had some degree of visual impairment. However there was no statistical significance with p >0.05. The mean value of total cholesterol was higher in both group I and group II with value being higher in group1 (229.09mg/dl) as compared to group II (215.32mg/dl). Triglyceride levels also followed the similar trend with group I having mean value of 238.95mg/dl and group II having 179.93 mg/dl. But only total cholesterol value had statistical significance p < 0.05. Conclusion: The present study demonstrated statistically significant correlation between diabetic retinopathy and hypercholesterolemia. Increased cholesterol level was significantly associated with the occurrence of all grades of retinopathy especially severe NPDR, very severe NPDR and PDR. No correlation was found between lipid profile and visual acuity. These data suggest that hyperlipidaemia should be promptly treated in diabetic patients.

Near Misses" Regarding Cataract Operation In Small Incision Cataract Surgery: How Do We Rectify Understanding And Documentation?

Pankaj Kumar Baranwal — 2019-02-13

Background: Aim: Near misses are widely reported to the precursors of adverse events that highlight vulnerabilities and potentially unsafe areas of practice .The aim of this study was to see if a descriptive method of recording near misses was an appropriate method for use in an ophthalmic operating theatre and to quantify how many untoward events were recorded using this system related to the cataract surgery. Subjects and Methods: The study was wholly conducted in a operation theatre in the HIMS, Varanasi. The operation theatre staff assigned to the patient in their journey through the operating theatre was asked to note any untoward events. As, at present, there is no consensus definition of near misses in ophthalmology the staff recorded, in free text, any events that they considered to be a deviation from the normal routine in that theatre. Results: 250 cataract cases were randomly enrolled, 48 "deviations from normal routine" were described in 46 patients - that is, 19% of cases. All forms distributed to the staff were returned (100% response rate). The commonest abnormal events were intraoperative (35), with a lesser number being recorded preoperatively (13). When these events were further classified, it was thought that 13 could be classified as near misses. Once true adverse event was recorded during the study. Conclusion: The result suggest that experienced staff in an ophthalmic theatre are a reliable source for collecting data regarding near misses. A consensus is now required to define near misses in ophthalmology and to devise a user friendly input system that can use these definitions to consistently record these potentially vital events.

Comparative Analysis of Surgical outcome and Complications of DCR and DCR with Tube Intubation in Young Patients with Chronic Dacryocystitis.

Dr Priyanka — 2019-03-04

Background: Purpose: To study surgical outcome and complications of DCR and DCR with tube intubation in young patient with chronic dacryocystitis. Subjects and Methods: A hospital based prospective randomized comparative clinical study conducted at Eye department Patna Medical College from 01.02.2018 to 30.01.2019 was done after taking approval of ethical committee of the institute. A total of 42 patients were recruited for the study and were randomly divided into two groups. Group A was DCR patients without intubation and group B was with intubation. The success rate, complications of each group was studied. Results: In group A, mean age of the patients was 26.6(+/- 4) with range of 21-34 years. In group B, mean age were 23.85 (+/-3.89) with range of 22-35 years. There were 9 males (21.40%) and 12 females (28.50%) in group A and 10 males (23.80%) and 11 females (26.10%) in Group B. Common intraoperative complications during surgery were bleeding from incision site due to angular vein injury, bleeding from nasal mucosa and nasal mucosal tearing. Success rate was 57.14% in non-intubated cases and 90.4% in intubated cases which was statistically significant. Fisher exact test statistics value (p= 0.0325)’. Conclusion: DCR with tube intubation may cause better success rate as compared to the DCR without tube intubation in young patients. However, larger population of this age group is needed to be studied for more longer period of time for a definitive conclusion.

Success Rate of Probing In Cases of Congenital Nasolacrimal Duct Obstruction at Various Age Group – A Hospital Based Study.

Dr Priyanka — 2019-03-04

Background: Purpose: To determine success rate of probing for congenital Nasolacrimal duct obstruction at various age group. Subjects and Methods: The study was a prospective non comparative study done in the Dept. of Ophthalmology, PMCH, Patna from Jan 2017 to Jan 2019. 36 children (72 eyes) aged 5 months to 48 months diagnosed with congenital NLD obstruction were included in the study These were divided into Group 1 – below 6 months , Group 2 – 7 months to 12 months , Group3 - 13 months to 24 months , Group4 - 25 months to 48 months . Probing was done under GA in all subjects. All patients were followed at 1 week, 1 month, 3 months and 6 months respectfully. The probing was considered successful when complete remission of symptoms occurred after two weeks following the procedure. Results: The success rate of probing was 100% (18 eyes) in group 1, 91% (22 eyes) in group 2, 81 % (13 eyes) in group 3, and 35.7% in group 4.The overall success rate was 76.9%. Conclusion: The success rate of probing decreased with increasing age and age over 24 months predicts poor outcome. Hence, one should proceed with early probing than to wait for spontaneous resolution.

Factors Associated with Under Corrected Refractive Errors in an Older Population

Madhavi Chevuturu — 2019-03-07

Background: Recent studies have shown severe impact of visual impairment in elderly population in the form of falls, fractures, poor mobility, general health, morbidity and mortality. Visual acuity can be improved by correcting the refractive errors. Therefore, the present study was designed to study the demographic and visual acuity related factors associated with undercorrected refractive error. Subjects and Methods: The present study included 1236 randomly selected subjects of 50 years and above age group. Among them 1000 subjects were included in the study. Logarithm of the minimum angle of resolution chart was used for measuring visual activity. The chart was read at 8 feet and retro illuminated with automatic calibration to 85 cd/m². Initially visual acuity was assessed with the subject’s current glasses, if worn .Then using a Humphrey 530 Automatic Refractor an objective refraction was performed on all participants. Results: Among all the study participants 230 patients showed visual acuity <45 letters (6/9 or worse) while there were 110 participants with under corrected refractive error (using the two line criterion). Hyperopia was very common among undercorrected refractive error subjects with p value <0.05. In contrast, no association was found between undercorrected refractive error and myopia (p>0.05). Time duration since last examination was directly relation between incidence of undercorrected refractive error in our study population with p value >0.05. Subjects who stated that they had worn distance glasses in the past were less likely to have undercorrected refractive error (OR 0.20; 95% CI 0.19 to 0.38; p>0.05). Conclusion: Findings of the present study demonstrated that prevalence of undercorrected refractive error is high in elderly population. Further, results of our study showed that aging, hyperopia, socioeconomic status and isolation were directly related to the undercorrected refractive error in elderly population. These undercorrected refractive errors can be corrected to some extent by using distance glasses in elderly population. These findings of our study might be helpful for the ophthalmologist recognising the risk factors and their consequences on visual acuity of elderly population.

A Comparative Evaluation between Fixation Techniques Using Lag Screws and Mini Plates in the Treatment of Parasymphysis Fracture.

Harsh Kumar — 2019-02-13

Background: Aim: The objective of this study was to compare the results of lag screws and mini plates in treatment of parasymphysis fracture. Subjects and Methods: Forty patients of age group 20-45 yr old with clinical and radiological evidence of the traumatic injury to the parasymphysis were included in this study and were randomly divided in two groups. In group A––two 2.5 mm lag screws were placed in 20 patients and in group B––two 2.5 mm mini plates were placed in 20 patients. The statistical analysis was done by using SPSS 15. Results: The majority of patients in Group A, the time needed to complete the procedure ranges from 60 to 90 min (65%), while for the time range from 60 to 90 (55%) and 90 to 120 min (35%) in Group B. The difference in time required for completion of the procedures between the two groups was found to be statistically significant. In Group A, the duration of post-operative swelling varies as it is minimum for 5 days in 13 patients (65%) and maximum 15 days in 3 patients (15%). In Group B, swelling was present for minimum 5 days in 14 patients (70%) and maximum 15 days in 2 patients (10%) Conclusion: Although the sample size is less to reach to any conclusion, the results of our study suggest that the use of lag screws in the fixation of mandibular fractures can be a very demanding procedures as lag screw technique for Parasymphysis fracture provide several advantages over Mini plates.

Evaluation of Post Treatment Satisfaction in Orthodontic Patients

Sanket Platia — 2019-03-07

Background: The goal of orthodontic treatment is to produce a normal or ideal occlusion. However, there is a large variation in treatment outcome. There are a number of factors that may influence patient satisfaction; this includes physical comfort, emotional support, patient expectations and respect for their preference. The aim of the study was to assess the level of satisfaction of orthodontic patients after the treatment. Subjects and Methods: This study design involved a cross-sectional study of 170 orthodontic patients in the final stage of their orthodontic treatment. Results: Study show that a higher percentage of the participants reported that self-motivation was the main reason to go and see the orthodontist. A significantly high percentage of female patients reported that aesthetics was the main reason for seeking orthodontic treatment with more than half of the participants saying that they were very satisfied. Furthermore, 58% of the participants reported that orthodontic treatment improved their confidence and communication skills with no complications during the treatment. Conclusion: The overall response to the questionnaire revealed that, in general, patients who undergone orthodontic treatment remained satisfied with their facial aesthetics in a long-term period after the treatment was done.

Study on Single Dose Preoperative Antibiotic Prophylaxis versus Routine Long Term Postoperative Prophylaxis in Elective General Surgical Cases

Chandra Sekhar Chevuturu — 2019-02-13

Background: The preventive effect of the routine use of preoperative surgical antibiotic prophylaxis (SAP) on the occurrence of surgical site infections (SSI) prior to non-clean and implant surgery has long been recognized. Subjects and Methods: A total of 100 patients were included in the study and divided in to Group A and Group B. Group A contains patients with 1 g of cefotaxime sodium intravenously, that is, single dose was given 1 h before induction of anesthesia and Group B contains patients who were given first dose at 1 h before induction of anesthesia, and subsequent doses were given at an interval of 12 h after surgery for 5 days, that is, multiple dose. Results: This case comparative study were conducted in 100 cases, out of which 50 was included in Group A & 50 was included in Group B. In group A & B different surgical procedure have been done during the study period which is shown in table 1. In group A & B hernioplasty was done in 28% of total cases followed by other procedure. Conclusion: In can be concluded that single preoperative dose of cefotaxime sodium is cost-effective and is as effective as multiple-dose prophylaxis. In elective general surgical cases, it is a reliable method of prophylaxis.

Study on Clinical Profile and Surgical Management of Cases of Primary Vaginal Hydrocele

Prabhat Ranjan — 2019-02-13

Background: Hydrocele is one of the common surgical conditions seen in tropical countries. The present study was conducted to assess the clinical profile and outcomes of surgical management of primary vaginal hydrocele. Subjects and Methods: The present hospital based cross-sectional study was done on patients with scrotal swelling incorporating the testis and positive for transillumination. Detail history of the illness, clinical examination and laboratory investigations were recorded. Results: Most of the patients presented within one year. Right side was commonly involved. Post-operative pain and scrotal edema were the complications commonly seen. Conclusion: Post-operative pain was the most common complication followed by edema and hematoma.

Evaluation of Clinical Profile and Effect of Cervical Spinal Cord Injuries with or Without Bony Injuries

Sushil Acharya — 2019-02-13

Background: This study was design to study the clinical profile and outcome in patients of cervical spinal cord injury with or without bony injury. Subjects and Methods: All patients of cervical spinal cord injury with or without evidence of bony injury on X-ray were included in this study. In addition to X-ray finding, patient age, sex and MRI cervical spine were also recorded at the time of admission. Clinical profile and outcome was assessing with Benzel-Larson Grade included one to seven grades. Results: Total 87 patients of cervical spine injury were included in study, 25 patients were included in SCIWORA group while 62 patients were having associated with bony injuries. Both SCIWORA and SCI with bony injury ware more commonly due to fall from height and more common in males. Neurological recovery was more in SCIWORA than bony injury patients. Conclusion: Cervical spine cord injury is commonly seen in children, while associated bony injury is common in adult population. Early diagnosis and proper management for SCIWORA can improve neurological outcome in selected group of patients.

Assessment of Bacterial Profile of Pus Samples Obtained From Patients Undergoing Surgical Procedures: An Observational Study

Pushpendra Kumar — 2019-02-13

Background: Wound infection may initially be manifest as bacterial colonization, and it is only when colonization is combined with other factors, such as decreased vascular supply, intrinsic virulence of specific bacteria (eg, Staphylococcus aureus), and host immune factors, that true infection occurs. Hence; we planned the present study to assess bacterial profile of pus samples obtained from patients undergoing surgical procedures. Subjects and Methods: The present study included assessment of 30 pus samples sent from the surgery department, to the microbiology department. Collection of pus samples was done from the infected wounds. Detailed demographic data of all the patients was obtained. In the microbiology department, for studying the morphological profile of the clinical isolates, gram staining was done. Streaking of the pus samples was done on the blood agar, and MacConkey agar followed on incubation aerobically at 37 degree centigrade for 24 hour. Identification of microorganisms was done based on colonial morphology and pigment production. All the results were compiled and analysed by SPSS software. Results: Staphylococcus aureus was the most commonly isolated bacteria in the present study. Other bacteria’s obtained in the present study included Pseudomonas aeruginosa, Klebsiella species, Escherichia coli, Enterococci species and Enterobacter species. Conclusion: Most common organism isolated from pus discharge from infected wounds is S. aureus.

Study on Profile of Benign Breast Diseases at VIMS, Pawapuri

Bal Mukund Prasad — 2019-03-16

Background: Benign breast diseases are common cause of breast related illnesses. Proper assessment of cases is helpful in diagnosis and avoids unnecessary complications. Subjects and Methods: The present hospital based study was conducted upon 48 cases of benign breast illnesses to assess the clinico-aetiological profile. Background details of patients, detailed history and findings of clinical examination were recorded. Results: Most of the patients belonged to the age group of 21-30 years. Breast lump only was the most common presentation (62.5%), fibroadenoma was the most common cause (54.2%) and right side was most commonly involved (37.5%). Conclusion: Fibroadenoma is the most common cause of benign breast disease in this area.

An Epidemiological study and analysis of prognostic factors of testicular carcinoma

Manu Gupta — 2019-04-14

Background: Testicular carcinoma is an uncommon malignancy overall accounting for 1–2% of all tumours in men, testicular cancer is the most common malignancy in young men. The aim of the study was to analysis of prognostic factor of testicular carcinoma and determines their epidemiologic features, in order to provide a guideline for clinical treatment and follow ups. Subjects and Methods: Patient clinical data, including age, tumor position, pathological type, clinical stage, AFP, HCG and LDH levels, as well as postoperative treatment methods were identified and classified. Subsequently, the patients' conditions during the follow-up period following surgery were recorded. The survival rate was also calculated and prognosis was analyzed. Age upon operation, laterality of tumor, pathologic diagnosis, and preoperative serum AFP levels were reviewed. In GCT cases, preoperative serum AFP levels were analyzed to predict malignancy in different age groups. P<0.05 was considered to indicate a statistically significant difference. Results: A total of 195 cases with testicular carcinoma were enrolled in this study. In 62.6% cases tumors were located on the right side, and in (37.4%) tumors were located on the left side. The relation between the testicular seminoma and pathological Types shows that out of the 195 cases, 121(62.05%) cases were confirmed with typicaltesticular seminoma, 52(26.7%) cases with testicular seminoma combined with embryonal carcinoma and 22(11.3%) cases withtesticular seminoma combined with embryonal carcinoma and teratoma. Conclusion: We concluded that the pathological types should be confirmed to determine the postoperative adjunctive treatment method and improve the postoperative survival rate. Epidemiological features of TC show a persistent lack of the knowledge about the symptoms of TC in the general population, in spite of extended health education.

The Possibility of APE1/Ref-1 as a Biomarker in the Detection of Coronary Artery Disease

Vipul Bhasin — 2019-02-13

Background: Coronary Artery Disease, was the leading cause of mortality globally resulting in more than 7 million deaths annually. APE1/Ref-1 is a multifunctional protein that is found in the nucleus of eukaryotic cells. Objective: To investigate the possibility of APE1/Ref-1 as a biomarker in the detection of Coronary Artery Disease in Indian population. Subjects and Methods: 100 subjects were divided into two groups of cases and controls. The Case group had Fifty patients diagnosed of Coronary Artery Disease on the basis of Clinical findings with Electrocardiography, Biochemical Markers, Echocardiography and Angiogram(wherever possible) attending the OPD of Department of Internal Medicine of SGT Hospital. Fifty age and gender matched healthy individuals constituted the control group. The data was statistically analyzed by using Student’s t-test and P values < 0.05 were considered statistically significant. Results: The difference in the mean of case and control values of APE1/Ref-1 is statistically significant. Conclusion: Our findings suggest that APE1/Ref-1 has a positive shows positive correlation with in patients of CAD.

A Study on Renal Parameters among Patients with CKD

Swetha Sutrave — 2019-02-13

Background: Chronic renal failure usually occurs over many years as the internal structures of the kidney are slowly damaged. In the early stages, there may be no symptoms. Progression may be so gradual that symptoms do not occur until kidney function is less than one-tenth of the normal. Uremia also causes hypothermia, which is believed to be due, in part to inhibition of the Na+ pump by some retained toxins. Dialysis usually returns body temperature to normal. It is often accompanied by impairment of carbohydrates, fats and proteins and defective utilization of energy. Subjects and Methods: A group of 72 individuals with marginally raised serum creatinine irrespective of their gender between 20 to 65 yrs were included in the study. Renal dysfunction was suspected in all of them. It’s a prospective cross-sectional study conducted at the department of biochemistry. Results: Blood Urea levels were 12-102 mg/dl with mean 33.2+/- 18.12 SD. the Total Proteins among the subjects varied in range of 4.5- 8gm/dl levels with mean of 6.58+/- 0.69 SD. The Serum Albumin levels were 1.7 – 5gm/dl with mean of 3.70+/- 0.71 SD, the blood glucose levels range among the subjects were between 59 – 256 mg/dl where mean was about 108.59 +/- 33.5 SD. Conclusion: The various parametric distribution among the subject where the creatine levels ranged from 0.6-1.6 mg/dl with mean of 1.03+/- 0.23 SD. Blood Urea levels were 12-102 mg/dl with mean 33.2+/- 18.12 SD.

Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) as Predictor of Pre-diabetes in Non-Alcoholic Fatty Liver Disease (NAFLD)

Acharya Madhusmita — 2019-03-07

Background: India is the diabetes capital of the world with every fifth diabetic in the world is an Indian. Subjects and Methods: We studied Sixty non-alcoholic, non-diabetic, normotensive obese NAFLD subjects with WHR:>0.9 in males and >0.85 for females according to inclusion and exclusion criteria. Results: NAFLD, a chronic condition ranging from benign steatosis, (i.e., hepatic triglyceride accumulation >5.5% using magnetic resonance imaging or >5% corresponding to 50 mg/g by wet weight), to more significant liver injury, i.e.,non-alcoholic steato-hepatitis(NASH).Conclusion: Association of NAFLD with features of insulin resistance and was more prevalent among subjects with IGT. The increased risk for cardio-metabolic diseases in NAFLD might be due to hepatic overproduction of glucose, VLDL, inflammatory factors as a result of insulin resistance.

Evaluation of Blood Urea, Serum Creatinine and Cystatin C Levels in Type 2 Diabetic Patients: A Teaching Hospital Based Study

Debasis Debadatta Behera — 2019-03-07

Background: Type 2 diabetes mellitus is a common and an important cause of morbidity and mortality in both developing and developed countries. Subjects and Methods: 70 subjects were taken according to the exclusion & inclusion criteria, within the age group of 30-65 years and categorized into two groups (A & B). Results: The study group had fasting blood glucose of 139.3 ± 17.05 mg/dL and in the control group, the values were 84.16 ± 7.64 mg/dL respectively. The study group, the mean and standard deviation of blood cystatin C, Blood Urea and creatinine were 1.51 ± 0.32 mg/dL, 29.61 ± 7.54 mg/dL & 0.98 ± 0.23 mg/dL and in the control group; the values were 0.67 ± 0.1 9 mg/dL, 20.4 ± 4.21 mg/dL, 0.80 ± 0.11mg/dL respectively. These findings are similar to a study conducted by Borges et al. Table 1 shows the mean fasting blood sugar, serum cystatin c, blood urea and serum creatinine level was higher among cases when compared with controls and was statistically significant. Conclusion: Serum cystatin C is a significant predictor among patients with type 2 diabetic individuals and that the cystatin C test is more economical and more convenient than the standard method for GFR With the development of medical treatment level. Cystatin C in comparison with serum creatinine can be a useful maker in detecting renal impairment in type 2 diabetic individuals.

An Evaluation of Comparative Study of Serum Ferritin Levels in Myocardial Infraction Cases

Sadhana Verma — 2019-03-16

Background: MIs occur mostly due to coronary artery disease. The major risk factors of MIs are high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet and excessive alcohol intake. MI usually involves the complete blockage of a coronary artery. Subjects and Methods: This study conducted in the department of cardiology & biochemistry in LPS institute of cardiology, GSVM medical college ,Kanpur.. The population of this case – control study was 50 for each group. The duration of study was over a period of one year. Results: We were found that 42% patients were belongs to 41-50 age group in case group, whereas in control group 52% followed by other age group. In this study we showed association of acute myocardial infraction with high serum ferritin. Conclusion: To reduce cardiovascular morbidity and mortality it is essential to monitor serum ferritin levels regularly.

Study on Association between HbA1c and Lipid profile in Type 2 Diabetic Patients: A Teaching Hospital Based Study

Pallavi Anand — 2019-03-31

Background: Diabetes mellitus is characterized by chronic hyperglycaemia with disturbances in carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both. Subjects and Methods: type 2 diabetic patients (Age range of 25-70 years) with an age & sex matched along with 50 healthy controls were selected as per the inclusion and exclusion criteria. Results: The mean age (Mean ± SD) of cases and controls were 48.6±13.42 and 30.9±10.23 years and mean BMI 21.38±4.2 & 25.2±1.83 respectively [Table-1]. The Mean ± SD of cases and controls were FBS (134.62 ± 20.2), HbA1c (7.8 ± 2.42), TC (155.6±31.7), TG (152.3±26.04), HDL-C (43.4 ± 8.07) and LDL-C (81.78 ± 36.8) and FBS (104 ± 12.06), HbA1c (5.1 ± 1.4), TC (142.6±2.5), TG (112.5±20.3), HDL-C (49.6 ± 9.5) and LDL-C (104.06 ± 17.15) respectively[Table-1]. In this study, the level of FBS, HbA1c, TC, TG, LDL-c, were significantly increased (P<0.05) while HDL-c level was significantly decreased (P<0.05) as compare to controls. Conclusion: HbA1c showed positive correlation with TC, TG, & LDL-c and negative correlations were observed between HbA1C and HDL-c.

Study on Lipid Profile of Type 2 Diabetes Mellitus Patients Attending Medical College & Hospital

Mamta Singh — 2019-03-31

Background: Diabetes mellitus is major public health problem. It is associated with metabolic abnormalities and long term complications. Subjects and Methods: The present study included 150 cases of diabetes. Detailed history, clinical examination and assessment of glycemic control and serum lipid profile was done. Results: The mean total cholesterol level was 197.4 ±14.2 mg/dl, triglyceride level was 156.8 ± 21.7 mg/dl, HDL level was 42.3 ± 5.7 mg/dl, LDL level was 121.1 ± 9.3 mg/dl, VLDL level was 34.2 ± 6.5 mg/dl & LDL / HDL ratio was 2.81 ± 0.29. Conclusion: Serum lipid profile is deranged in diabetic patients.

Computed Tomographic Evaluation of Calvarial Thickness

Ankur Shah — 2019-02-13

Background: Majority of the cranial bones are characterized as flat bones and can be recognized because of their layered bony structure whereas the cancellous bone layer, is known as diploe, and it lies between two layers of dense cortex. The advent of Computed tomography has revolutionized the technology of imaging and diagnosis of the calvarium during the last few years. The present study was done to evaluate the calvarial thickness by CT. Subjects and Methods: This cross sectional observational study, was carried out on a total of 178 subjects undergoing CT Scan of Head in the department of Radiology. The frontal bone was divided into lower, middle and upper third. Similarly, the parietal and occipital bones were also divided into three parts namely anterior, middle and posterior third. All the data was arranged in a tabulated form and analyzed using SPSS software. Student t test was used for comparison. Probability value of less than 0.05 was considered as significant. Results: The mean age of the subjects was 38.98 years (Range 17 to 76 years). The posterior 3 rd parietal thickness amongst males was 4.60 +0.91 and females was 5.54 +1.63. Difference of calvarial thickness between male and female at this point was statistically significant. The anterior 3 rd parietal thickness on right side was 4.89 +0.79 and on left side was 4.45 +0.93. There was a significant difference between the two. Conclusion: The present study shows that the thickness of anterior third of the parietal bone on the right side was more than on the left side amongst both males and females. It also shows that the posterior 3rd parietal thickness among female was more than males.

Assessment of Presence of Cardiovascular Disease in Relation to Smoking

Rajiv Arora — 2019-02-13

Background: Smoking is a major risk factor for the development and progression of cardiovascular diseases. Thus, the present study investigates presence of cardiovascular disease in relation to smoking in people aged 45-50 years. Subjects and Methods: This cohort study was conducted among 40 people of age 45-50 years over the period of 6 months. All relevant clinical history was taken before the commencement of the study. Statistical analysis was done by using SPSS, version 15 (SPSS, Inc., Chicago, IL) and p<0.05 was considered statistically significant. Results: In our study total participants were 40 in which 27 were male and 13 were females. In our study 18 men were recent smoker and 9 were ex-smoker. In females 8 were recent smoker whereas 5 were ex-smoker. 13 recent and 5 ex-smoker men had cardiovascular disease whereas 7 recent and 5 ex-smoker women had cardiovascular disease. Conclusion: The results of this study reinforce that smoking is a significant factor in causation of cardiovascular disease. Thus, we have to make strategies for smoking cessation programs in the primary care setting.

Assessment of Efficacy of 2D Echo and Contrast Echo in Detection of Thrombus.

Monica Razdan — 2019-03-20

Background: As echo is widely used to screen patients with coronary disease or heart failure at risk for LV thrombus, optimization of diagnostic strategies for thrombus detection is of substantial importance. Hence; we planned the present study to assess and compare the efficacy of 2D echo and contrast echo in detection of thrombus. Subjects and Methods: The present study included assessment and comparison of 2D echo and contrast echo in detection of thrombus. A total of 25 patients were included in the present study. Detailed demographic data and biochemical profile of all the patients was obtained. All the patients underwent both 2D echo and contrast echo. All the results were compiled in Microsoft excel sheet and were analysed by SPSS software. Results: 2D echo detected thrombus in 3 percent of the cases while the contrast echo detected thrombus in 12 percent of the cases. Significant results were obtained while comparing the prevalence of thrombus as detected by 2D echo and contrast echo. Conclusion: Efficacy of contrast echo s significantly higher than that of 2D echo in detecting LV thrombus.

Vitamin B12 Status in Type 2 Diabetes Mellitus Patients on Metformin therapy: A Teaching Hospital Based Study

Kamal Rajesh Jampana — 2019-03-31

Background: Diabetes is fast gaining the status of a potential epidemic in India, with more than 62 million diabetic individuals currently diagnosed with the disease. Subjects and Methods: 50, Type-2 diabetic patients on metformin therapy, with age ranging from 30 to 65 years and 50 healthy controls, were recruited from the General Medicine Department of Nimra Institute of Medical Sciences, according to inclusion and exclusion criteria. Results: In this study, the level of FBS, HbA1c, Fasting insulin, Homocysteine, C peptide, and Methyl Malonic acid were significantly increased (p <0.01), while Vitamin B12 levels were significantly decreased (p<0.01) in the study group, as compared to controls. It was observed that the mean level of vitamin B12 markers, homocysteine and methylmalonic acid were significantly higher and low level of vitamin B12 was found in patients who were on metformin therapy. Reports have shown that metformin use has a significant impact on the concentration of vitamin B12 in patients with T2DM.Conclusion: Metformin, which is the first line oral hypoglycemic agent as recommended by ADA, is significantly associated with decrease in vitamin B12 levels. There is moderate correlation between the markers of B12 status and levels of fasting blood sugar as well as HbA1C. There is a significant correlation between insulin and C-peptide with the markers of vitamin B12 status.

Microvascular complications and their association with duration of diabetes and glycemic indices in type 2 diabetes mellitus: An Hospital based study.

Vivek Bhardwaj — 2019-03-31

Background: The increased incidence of diabetes rapidly globally at an alarming rate. The presence of microvascular complications has been shown to have a negative impact on patient’s quality of life. There are few clinical studies in this direction but most of them lack sufficient power and are focused only towards one specific complication. Subjects and Methods: An observational single arm cross sectional study done in 100 cases of type 2 diabetes mellitus in department of medicine, Government Medical College Bharatpur, Rajasthan. Each subject underwent detailed history and complete clinical examination. Diabetes was diagnosed according to American Diabetes Association (ADA) revised criteria. Blood glucose level estimation was done by glucose oxidase method in venous blood. Glycosylated haemoglobin (HbA1C) was measured by ion-exchange chromatography method. Results: The overall male to female ratio was approx 1:1 in our study. Our study showed that the maximum patients were suffering from retinopathy 12 (66.66%) in more than 10 years duration of diabetes. Mostly patients suffering from diabetic neuropathy 28 (90.32%) were occurred in more than 10 years & 5-10 years of duration of diabetes. Maximum cases of nephropathy 21 (50%) were seen in 5-10 years of duration of diabetes. So proportion of neuropathy, retinopathy & nephropathy significantly increases, when duration of diabetes increased in our results. Conclusion: Duration of diabetes was found to be a main culprit of micro vascular complication. Screening with some simple test such as ECG, fundoscopy, biothesiometer and biochemical tests namely, lipid, protein and fat profile for all cases of diabetes is essential to identify the complications at an early age.

Evaluation of Outcome of Subjects with Shoulder Pain- A Retrospective Analysis

Raj Kishore Chaurasiya — 2019-02-13

Background: Shoulder pain is usually not related with favorable outcome in approximately 40-50% of all cases presenting to the primary health care hospital. Different prognostic factors have been regarded in few of the 16 studies like sex, type of injury, psychological factors, stresses, anatomical factors and impairment of strength. The aim of the present study was to evaluate the predictors of subject outcome with shoulder pain. Subjects and Methods: The present retrospective analysis was performed in the orthopedic department for a duration of 2 years. Anterior or posterior drawer tests were used to indicate the shoulder instability. Severe loss of motion was regarded when the patient had loss of more than 50% of the normal physiological motion range. Different treatment modalities were evaluated based on whether the patient needed that type of treatment or not. All the data thus obatined was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant. Results: The mean change in quickdash score after treatment was 16.76+/-9.21. The mean number of total visits was 12.43+/-5.28 and the mean visits per week was 2.25+/-0.62. There was a significant change in the quickdash score amongst the subjects. The number of visits to the doctor also showed significant effect. The presence of comorbidities also showed a significant difference amongst the subjects. Conclusion: The best predictors found in the study were the quickdash score and the incidence of visits to the health care services.

Assessment of Operative Management of Bimalleolar Fractures of Ankle Joint

Pravas Kumar — 2019-02-13

Background: Bimalleolar fractures have shown to have worse outcomes. The present study was conducted to assess operative management of bimalleolar fractures of ankle joint. Subjects and Methods: The present study was conducted on 60 cases of bimalleolar fractures of ankle joint. Patients with compound fractures, pilon fractures, syndesmotic injuries were excluded. In all patients, reason of fracture and operative outcome was recorded. Results: Functional outcome was excellent seen in 15, good in 30, fair in 12 and poor in 3. The difference was significant (P< 0.05). Post operative complications were superficial skin infection seen in 2 and restricted ankle movement in 1. Conclusion: Bimalleolar fractures of ankle joint are common amongst males. In maximum cases, good results were obtained.

Evaluation of Limb Length Discrepancy after Total Hip Replacement: A Teaching Hospital Based Study

Radha Krishna Choudhary — 2019-04-03

Background: Limb length discrepancy (LLD) or limb length inequality after Total hip arthroplasty (THA) is not an uncommon problem after THA and is associated with patient dissatisfaction, poorer outcome after THA and has been a common cause for litigation against orthopaedic surgeons. Subjects and Methods: Nineteen (19) Patients of age more than 25 yrs of either sex who have chronic symptoms of degenerative arthritis fitting inclusion criteria after excluding those who meet exclusion criteria are chosen among the outpatients at the Orthopaedic Department of WCMSRH, Jhajjar fulfilling the inclusion criteria. Results: In this study, postoperatively after THA, in 42.1% of cases, the limb to be operated were longer, in 10.5% of cases, the limb to be operated was shorter and in 47.4% postoperative limb length was equal as measured with absolute method and trochanteric method. Conclusion: All patients have good functional outcome after total hip replacement as functional score increases with time in subsequent follow up, irrespective of limb length discrepancy.

Assessment of Efficacy of Supraintercondylar and Supracondylar Femur Fractures Treated with Condylar Buttress Plates: A Comparative Study

Yusuf Ali Deoda — 2019-04-05

Background: Treatment of supraintercondylar and supracondylar femur fractures is generally challenging. This study was conducted to compare the efficacy of supraintercondylar and supracondylar femur fractures treated with condylar buttress plates. Subjects and Methods: The study was conducted in Department of Orthopaedics, Government S K Hospital, Sikar, Rajasthan, India. The sample size of 50 patients was selected for the study. Participants of age above 21 were included in the study. Among these in group I, there were 25 participants of supra intercondylar fractures whereas in group II , 25 participants of supra condylar fractures. Statistical analysis was done by using SPSS, version 22 (SPSS, Inc., Chicago, IL) and p<0.05 was considered statistically significant. Results: In our study, 32 were males whereas 18 were females. Supra intercondylar fractures were present in 17 males and 8 females whereas supra condylar fractures were present in 15 males and 10 females. Rate of union occur in 23 cases of Supra intercondylar fractures whereas in 24 cases supra condylar fractures. Complications such as stiffness, varus deformity occur more in supra intercondylar fractures. Time taken for union in both the cases are almost same. Conclusion: Our study concludes that clinical results of supracondylar fractures was better with condylar buttress plates as compared to supra intercondylar fractures.

Factors Affecting Immunization Status of Children Aged From 0-59 Months in Ethiopia

Gedif Mulat Alemayehu — 2019-03-07

Background: Immunization is the process of stimulating the body’s immunity against certain infectious diseases by administering vaccines. It is one of the main health interventions to prevent childhood morbidity and mortality. Objective: The objectives of the study were to determine the immunization coverage among children of aged 0-59 months old towards eight vaccine preventable diseases, to assess demographic and socio economic factors affecting immunization status among children aged 0-59 months and to assess the effect of media on immunization and vaccination status of children. Subjects and Methods: The data for this study were obtained from the Central Statistical Agency (CSA) on the 2011 Ethiopian Demographic and Health Survey (EDHS). The 2011 EDHS was the third national demographic and health survey conducted by CSA. The 2011 EDHS was conducted with the primary objective of generating health and demographic information on infant health and children vaccination, family planning, adult and maternal mortality, child and maternal nutrition, malaria, women’s empowerment, and knowledge of HIV/AIDS along with other household characteristics in the nine regions and two administrative regions both at rural and urban levels. The nationally representative EDHS 2011 data was collected under the guidance of the Central Statistical Agency of Ethiopia. Interviews were conducted with 16515 women, 14110 men and 11654 children (0-59 months). The data was analyzed using the statistical package for social science (SPSS) version 20 and Stata version 11. Results: The highest rate (75.5%) of children vaccinated was observed for mothers in the age group 45-49. On the other hand the lowest rate (59.8%) of vaccinated children was observed from mothers in the age group 15-19. The result of study reviled that mothers’ age in 5-year groups, place of residence, mothers’ education level, region, religion, frequency of listening to radio, wealth index and birth order are the most important factors of child vaccination status in Ethiopia. Conclusion: Mothers who had higher education, aged 40-44, live in urban, live in Tigray, and listen radio at least once a week are more likely to vaccinate their children. Being the first child for parents is more likely to be vaccinated than being fifth and above order. The health offices should work properly to raise the awareness of parents for vaccination by designing proper health education.

Statistical Analysis on Factors that Induces Females to Prostitution: The case of Gondar Town, Ethiopia.

Kasim Mohammed Yesuf — 2019-02-13

Background: Prostitution is the act of providing sexual services to another person in turn for payment. A considerable number of studies have been conducted on sex work in Ethiopia though they have given little insight and understanding on the life of sex workers outside their work environment particularly their role as mothers. The aim of the study was to identify factors that induce females to prostitution life. Subjects and Methods: To meet this requirement I have already collected the data by using self-administered questionnaire, which was distributed to the respondents. The data was gathered from Gondar town using purposive sampling from a total of 56 individuals. The study used chi- square test of association and binary logistic regression. Results: A according to the study, 35.7% of the respondents problem to engage in prostitution life was income, 28.6% of the respondents problem to engage in prostitution life was peer pressure, 21.4% of the respondents problem to engage in prostitution life was internal feeling, 7.1% of the respondent problem to engage in prostitution life was dismissed from university. Finally, the majority of the respondents involved in prostitution life around 57.1% were interested to live with their parents. Conclusion: The study concludes that prostitute’s origin they came from, their educational level, economic status, their family size, their father not alive before they engaged in prostitution life have great association with prostitution life.

Evaluation of Knowledge and Attitude Regarding HIV/AIDS among Adolescents of Varanasi

Narendra Kumar Sharma — 2019-03-31

Background: Acquired Immune Deficiency Syndrome (AIDS) is a well-known major health problem particularly in the developing countries.1 AIDS causes devastation to human life and destroys communities and takes away their hope.2The disease results in impairment of the human immune system and allows the emergence of many kinds of opportunistic infections. Subjects and Methods: A total of 150 adolescents (75-boys and 75-girls) of 13-20 years age group were randomly selected from a school in Varanasi. Simple Random sampling technique was adopted for selection of adolescents for achieving the desired sample size. Results: The study was conducted on 150 adolescents of which 75 were males and 75 females. Among these 133 study participants have knowledge about HIV/AIDS, 124 have knowledge regarding modes of transmission and 89 have knowledge regarding modes of prevention. Among the 133 adolescents, majority of adolescents 87.21% reported that the source of knowledge was electronic media. Conclusion: Burden of HIV/AIDS in the adolescent age group is high in most of the developing countries and in India as well. In the present study, though the study population is aware of the disease HIV/AIDS, but complete knowledge about the disease, its modes of spread and protective measures is not satisfactory. Several misconceptions about the disease do exist amongst the study population.

Postoperative Delirium in Older Inpatients: A survey of Nursing Staff Knowledge

Anant Kumar Verma — 2019-03-07

Background: Postoperative delirium is common in the elderly and is associated with poor outcome. However, its diagnosis is often missed or delayed. Nursing staff is at the frontline and plays a crucial role in the early detection and management of delirium. This study was designed to explore the knowledge and attitudes of nursing staff about delirium in the scope of an educational program implementation. Subjects and Methods: Qualitative and quantitative analyses conducted in four surgical wards and one intensive care unit in an Academic Hospital in India. A questionnaire was administered to 121 nurses and nursing assistants and semi structured interviews were conducted. Results: A total of 89 questionnaires were completed (response rate of 73.55%). Regarding symptoms, most of the nursing staff knew about disorientation and incoherent speech. However, few knew about acute onset and fluctuation, and the hypoactive form of delirium was virtually unknown. Regarding risk factors, while many knew about dehydration, drug use and the use of physical restraints, few knew about sensory impairment and infection. The staff globally knew about the main prevention measures, but knowledge on patient management was especially poor. Finally, no respondent knew about or used the Confusion Assessment Method. The qualitative analysis revealed a trivialization of delirium onset among older inpatients and the continuity of preconceived ideas on delirium, its diagnosis and its risk factors. Conclusion: This study provides a clearer understanding of staff learning needs and identifies potential issues to be addressed in order to increase future intervention efficacy.

Patient's Experience and Expectations of Breaking Bad News

Anant Kumar Verma — 2019-03-07

Background: To explore patient's perspectives and expectations from physicians with respect to breaking of bad news. Subjects and Methods: A cross-sectional survey was carried out in the outpatient department of a tertiary care teaching hospital Vardhman Institute of Medical Sciences, Pawapuri, Nalanda, India. All consenting individuals from 18 to 60 years of age were interviewed on the basis of a structured, pre-tested questionnaire. Results: The response rate for this study was 91.3%. A total of 400 respondents completed the full interview. About 60% patients had a fairly accurate idea about the implications of the phrase "bad news". A big proportion (44.1%) of people reported that bad news had been broken to them previously with incomplete details. From their personal experience, most respondents quoted "disease diagnosis" and "chances of survival" as most commonly encountered bad news. Diagnosis of cancer or its recurrence was stated as the most likely example of bad news (35.5%). A significant majority of respondents (40.5%) stated that it's the patient's absolute right to know bad news. A significant association for the relationship between both age as well as the gender of the respondents and type of emotional response expressed on hearing bad news (p=0.000) was observed. Conclusion: The response rate for this study was 91.3%. A total of 400 respondents completed the full interview. About 60% patients had a fairly accurate idea about the implications of the phrase "bad news". A big proportion (44.1%) of people reported that bad news had been broken to them previously with incomplete details. From their personal experience, most respondents quoted "disease diagnosis" and "chances of survival" as most commonly encountered bad news. Diagnosis of cancer or its recurrence was stated as the most likely example of bad news (35.5%). A significant majority of respondents (40.5%) stated that it's the patient's absolute right to know bad news. A significant association for the relationship between both age as well as the gender of the respondents and type of emotional response expressed on hearing bad news (p=0.000) was observed.

Reasons for Alcohol Dependence and Their Relationship with Addiction Beliefs, Attitude and Severity: A Cross-Sectional Study

Harini K. C — 2019-04-06

Background: Alcohol abuse is a complex problem because there are so many reasons why people fall into substance abuse in the first place. Unless all these reasons are considered, it will be difficult to effectively tackle the problem. The severity of dependence may be a direct consequence of the addiction beliefs and attitude of the person toward alcohol intake. Addiction beliefs and attitude about the substance can influence the reasons which are attributed for the substance dependence. This study has examined the various reasons for substance use and correlation of reasons for substance use with socio-demographic data, alcohol dependence severity, addiction beliefs in people with different attitudes. Subjects and Methods: It is a cross-sectional study done at A.J. Institute of Medical Sciences, Mangalore. After obtaining the ethical clearance the study was started. Simple random sampling technique (lottery method) was adopted to select the study participants. 90 study participants who met the inclusion criteria were enrolled in the study. The sample collection was done from December 2016 to November 2017. After obtaining a written informed consent, patients were screened for cognitive impairment with the help of Hindi mental status examination and then they were further evaluated using Socio demographic clinical proforma, Modified version of reasons for substance use scale (ReSUS), Addiction belief scale (ABS), Alcohol dependence scale, The scale for assessment of attitudes toward drinking and alcoholism, second version (SAADA II). Results: More the severity of dependence more are the reasons quoted. A significantly high number of people with attitude of rejection have quoted social enhancement as reasons for substance abuse. People with more severe dependence believe less in free –will model. People who believe in free-will model have more rejection kind of attitude. Conclusion: These findings have a direct implication on the prevention and treatment of alcohol dependence in the Indian context. Discussing the treatment options and providing proper psychological interventions would be more acceptable than emphasizing on pharmacological therapies alone. Primary prevention should be planned to fit the needs of the people.

Frequency of Thyroid Lesions on Fine Needle Aspiration Cytology in Different Age Groups: A Teaching Hospital-Based Study

Asma Kalim — 2019-03-07

Background: Thyroid Fine Needle Aspiration Cytology (FNAC) was introduced in Scandinavian countries in 1950s and became popular in the United States in 1970s and then worldwide in the 1980s. Subjects and Methods: A total of 129 patients with thyroid nodules were enrolled after fulfilling these inclusion & exclusion criteria and were sent for FNAC. Total of 129 patients presented with thyroid swelling were assessed clinically, along with laboratory investigations like thyroid function tests, ultrasonography and by FNAC study. Results: Nodular goiter was the commonest-34 (26.3%), colloid goiter- 13 (10.1%), nodular goiter with cystic change- 11(8.5%), thyroid cyst- 10(7.75%), nodular goitre with hyperplasia- 3 (2.3%). Hashimoto’s thyroiditis accounted for 45(34.9%), papillary carcinoma and papillary carcinoma with Hashimoto’s thyroiditis- 6(4.6%), diffuse hyperplasia- 2(1.55%), lymphocytic thyroiditis- 2(1.55%), follicular neoplasm- 1(0.77%). Conclusion: The wide range of lesions, both benign and malignant, can be diagnosed by FNAC thus restricting surgery to cases only requiring further histopathological evaluation. Nodular goiter (26.3%) is the foremost commonest cause of thyroid enlargement followed by Hashimoto’s thyroiditis.

Histopathological Study on Pattern of Prostatic Diseases in Patients Admitted at a Medical College.

Dhirendra Kumar — 2019-03-16

Background: Benign prostatic hyperplasia is common in elderly males, while accidental finding of prostatic carcinoma in TURP specimen is also not uncommon in this age group. Subjects and Methods: The present hospital based cross-sectional study was done to find the various histopathological patterns of the prostatic lesions seen in transurethral resection of prostate (TURP) specimens at a tertiary care center. Histopathological examination was done to observe the type and morphology of these lesions. Results: 90% of the patients suffered from benign prostatic hyperplasia while prevalence of carcinoma of prostate in TURP specimens was 5%. Conclusion: Routine histopathological examination of TURP specimen is helpful in diagnosing the undiagnosed cancer.

Clinico-Hematological Study of Pancytopenia in Adults at a Tertiary Care Center

Harshita Vaibhaw — 2019-03-17

Background: Pancytopenia is one of the important haematological derangements. Thorough investigation for ascertaining the cause is important. Subjects and Methods: The present cross-sectional study was conducted upon 112 patients of pancytopenia. Profile of the patients, clinical features and findings of haematological investigations and bone marrow aspiration were noted. Results: Mean age of the patients was 46.7 ± 9.3 years. Pallor was seen in all the patients. Megaloblastic anemia was present in 36.6%, acute leukemia in 11.6%, hypersplenism and lymphoprofilerative disorder each in 10.7%. Conclusion: Hematological investigations and bone marrow aspiration in patients suffering from pancytopenia is useful.

Study on Histopathological Profile of Endometrial Biopsy in Patients of Abnormal Uterine Bleeding

Harshita Vaibhaw — 2019-03-17

Background: Abnormal uterine bleeding is one of the common gynaecological complain. Endometrial biopsy is essential tool for proper diagnosis. Subjects and Methods: The present observational study was conducted upon 207 specimens to assess the histopathological profile. Background details of patients, the presenting complain and histopathological findings were noted. Results: Most of the patients were above 45 years of age. Menorrhagia was the most common complain (53.1%) followed by metrorrhagia (29%) and polymenorrhagia (11.1%). Secretory pattern was seen in 36.2% and proliferative pattern in 31.9%. Chronic endometritis cases showed chronic nonspecific pattern in 5.8% and granulomatous changes in 1.9% cases. Conclusion: Endometrial biopsy is useful in diagnosis of etiology of these cases.

An Observational Study of the Clinical Profile of Congenital Hypothyroidism in Children.

Shiji Joseph — 2019-02-13

Background: Thyroid hormones are important for the general growth and development of the infant and the child, particularly in the differentiation and function of the nervous system. They are essential in the maturational events involved in the transition of the neonate to the adult. Subjects and Methods: The prospective, observational study was conducted in Department of Pediatrics, Institute of Maternal and Child Health, Calicut Medical College for a period of two years. After getting informed consent from the parents, history was taken followed by physical and systemic examination of the baby. Physical and systemic examination was done. Anthropometric measurements were taken and laboratory investigations were done. Results are expressed in terms of frequencies and means. Data is analyzed using SPSS. Results: Congenital hypothyroidism is often diagnosed very late. Mean age at diagnosis was 1.32 year in the present study. Birth weight may not be a clinically useful indicator of congenital hypothyroidism. Absence of classical clinical features in the new born period is the major reason for the delay in diagnosis. With delay in diagnosis of congenital hypothyroidism the predominant clinical features are those of prolonged hypothyroid state like microcephaly, short stature, macroglossia, dry skin and delayed bone age. Conclusion: Any child with facial puffiness, recent onset poor scholastic performance or excessive sleepiness with or without goiter should be suspected to have juvenile hypothyroidism and evaluated.

Assessments of Different Antibiotic Regime in Treatment of Diarrhoea of Paediatric Patients.

Sudhir Shantilal Mavadia — 2019-03-10

Background: One of the major health problem encountered worldwide among children is Diarrheal disorders. Fluid and electrolyte therapy is the mainstay of therapy. Hence; we planned the present study to assess the efficacy of different antibiotic regime in treatment of diarrhoea of paediatric patients. Subjects and Methods: A total of 40 paediatric patients with present of diarrhoea were included in the present study. All the patients were divided into two study groups with 20 patients in each group. Group 1 included subjects who were treated with ceftriaxone therapy while group2 included subjects who were treated with ciprofloxacin therapy. Microbial stool cultures were used as a standard for assessing the efficacy of both the antibiotic regimens. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software. Results: Mean age of the patients of group 1 and group 2 was 15.8 years and 14.9 years respectively. There were 12 males and 8 females in group 1 while there were 11 males and 9 females in group 2. Success rate among both the study groups was found to be 95 percent. Non- significant results were obtained while comparing the success rate of both the antibiotic treatment therapies. Conclusion: Both ceftriaxone and ciprofloxacin therapy are equally effective in treating diarrhoea in paediatric patients.

Outcome Analysis of Cisplatin-5 Flurouracil and Weekly 5-Flurouracil in Advanced Gastric Cancer.

G. Raja — 2019-03-17

Background: Advanced gastric cancer patients has poor survival rate of < 20% at 5 years. We intended to evaluate the outcomes of Cisplatin and 5-Flurouracil combination chemotherapy or 5 FU alone in this setting. Objectives: In this study we analyzed the outcomes such as response rate, progression free survival (PFS) at 6 months, and toxicity profiles of 3 weekly Cisplatin and 5-Flurouracil (PF) regimen and Weekly 5-Flurouracil (5-FU) therapy in advanced gastric cancer. Subjects and Methods: The outcomes of the chemotherapeutic regimens such as intravenous infusion of Cisplatin 75mg/m2 in divided doses and 5-Flurouracil 750mg/m2 for consecutive 3 days every 21 days (Group A) and intravenous infusion of 5-Flurouracil 500mg flat dose every week for 16 weeks (Group B) in stage III/IV gastric cancer were analyzed. Baseline parameters were obtained. Results: Twenty patients for both PF and weekly 5-FU regimens were recruited. The Overall response rate of Group A and B regimen was 40% and 20% respectively. PFS at the end 6 months was 60% and 35% respectively. Median time to progression was 5 months in group A and 3.6 months in group B. Hematological toxicity and Non hematological toxicity rates were in the acceptable range in Group A. Conclusion: Three weekly Cisplatin and 5-Flurouracil could be a good regimen when the performance status of the patient is good. Weekly 5-Flurouracil gives good quality of life and this regimen can be considered when the patient is not eligible for Cisplatin and 5-Flurouracil regimen in advanced gastric cancers.

The Prognostic Factors for Locally Advanced cervical Cancer Patients Treated by Cisplatin Based Concurrent Chemoradiotherpy- A Retrospective Study

S. Jeeva — 2019-03-17

Background: Aim: To identify the prognostic factors for the locally advanced cancer cervix patients treated with weekly cisplatin based concurrent chemoradiation. Subjects and Methods: We have analyzed 57 women with FIGO stage IB2-IIIB cervical cancer treated in the Oncology outpatient department of a tertiary care center between May 2014 to December 2016.Inclusion criteria includes patients treated with Radical Radiotherapy with cisplatin 30mg/m2.Median total dose to point A was 72Gy. Data regarding age, performance status, stage, histology, grade, tumour size, pretreatment haemoglobin level, radiological imaging details, pelvic nodal involvement, compliance to treatment, no. of chemotherapy cycles, total duration of radiotherapy and toxicity profiles are reviewed from medical records. Primary endpoints were to assess the prognostic factors that affects the tumor response and progression free survival and disease free survival. Survival analysis was estimated using the Kaplan-Meier method and multivariate Cox proportional hazard model, to estimate the hazard ratio and 95% confidence intervals using IBM SPSS statistical software. Results: The median follow-up time was 18 months. The 2 year overall survival was 31.6% and PFS is 29.8%. In univariate analysis presence of pelvic node, tumor size, radiotherapy treatment duration, no. of chemotherapy cycles were significantly associated with overall survival and progression free survival. In multivariate analysis, only tumour size and radiotherapy treatment duration significantly affected the overall survival and progression free survival. Conclusion: Bulky tumour and prolongation of treatment duration were poor prognostic factors for patients with locally advanced cervical cancer. Chemotherapy with a high cumulative dose of cisplatin tended to result in better survival.