bluuebunny/crossref_metadata_2025 huggingface dataset:
OUTCOME OF THE UNIDENTIFIED/UNACCOMPANIED PATIENT OF TRAUMATIC BRAIN INJURY IN TRAUMA UNIT OF GANDHI MEDICAL COLLEGE AND ASSOCIATED HAMIDIA HOSPITAL BHOPAL (INDIA)
Authors: Chaurasia Dr. I. D. , Shukla Dr. Shikha , Gupta Dr. Aryish , Maheshwari Dr. Rajat , Koshariya Dr. Mahim , Songara Dr. M.C.
Published: March 2020

All unidentified / unaccompanied & unknown TBI patients admitted in department of neurosurgery, Gandhi Medical College Bhopal from June 2016 to May 2019 were enrolled in this study. Management of unidentified and unaccompanied patients is difficult in any health care setup due to challenges in managing their day to day care. Traumatic brain injury is the most common cause of death in trauma patients.  We analyzed demography, mode of injury, clinical presentation & condition at admission, treatment given, hospital stay, outcome & factors affecting outcome of the patients. Very few studies in world literature are available on this subgroup of patients. We analyzed data pertaining to 100 consecutive patients at our hospital.

Aim and Objectives: The aim and objective of this study is to determine the outcome of traumatic Brain Injury in patients who were admitted in trauma unit/ Neurosurgery unit of Gandhi medical College Bhopal India from June 2016 to May 2019. As unaccompanied / unknown/ unidentified. In this study we collected the data of unknown/ unidentified patients of TBI to analyze the outcome.

Material and Methods: It was a prospective study of all unaccompanied/ unknown patients who were admitted in the trauma unit/ Neurosurgery unit of surgery department of Gandhi Medical College & Associated Hamidia Hospital Bhopal India from June 2016 to May 2019 a total number of 100 unidentified /unaccompanied patients were admitted whose data were collected and analyzed Departmental staff, social workers, police and media persons help were take in for relocation of unknown patients to their home or non government organization shelter homes .

Results: There were total 100 consecutive patient enrolment in this study, 87% of the patients were male. Most common age group was 40-59 years, 48% patients falls in this age group.

Most common cause of trauma was road traffic accident (48%), followed by Cause Unknown (36%). Overall mortality was 39%. Others clinical characteristic and type of lesion in traumatic brain injury of unidentified and unaccompanied patients is given in detail in.

Out of 100 patients, 43 (43%) patients were managed conservatively based on CT head findings and neurological status & 57 (57%) were operated. Decompressive Craniectomy was most common operative procedure depending on the clinical & neurological status. Overall complication rate during hospital stay was 26%.

Keywords: TBI, Unidentified Patient & Unaccompanied & Decompressive Craniectomy, Rehabilitation.
ASSESSMENT OF LIPID PROFILE AMONG PATIENTS OF NON-DIABETIC CHRONIC KIDNEY DISEASE AT TERTIARY CARE CENTRE
Authors: Gupta Dr Bakul
Published: March 2020

Background: Various studies have shown the association between dyslipidemia and cardio-vascular risk among patients of chronic renal disease but the association non-significant than patients with normal renal function. There was lack of evidence exists because patients with chronic renal disease were excluded from the major clinical studies where the association with that target dyslipidemia treatment was being evaluated

Material & Methods: The present prospective study was conducted among the patients of Chronic Kidney Disease above 18 years of age and diagnosed on the basis of history, detailed clinical examination, and biochemical and sonological examination based upon National Kidney Foundation (NKF) criteria were enrolled into the study. Clearance from hospital ethics committee was taken before start of study. Written informed consent was taken from each study participant.

Results:  In the present study out of total study participants of chronic kidney disease 46% were in the 3rd stage of CKD, 38% were in the 4th stage of CKD and 16% were in the 5th stage of CKD. Out of total study participants of chronic kidney disease, 82% were managed by conservative treatment and 18% were being managed by hemodialysis. Out of total study participants of chronic kidney disease, 38% had normal lipid profile while 62% patients had dyslipidemia. We found statistically significant (p value < 0.05) association between dyslipidemia and hemodialysis and association between dyslipidemia and stages of chronic kidney disease was statistically non- significant (p value > 0.05).

Conclusion:  We concluded from the present study that dyslipidemia is significantly associated as an additional risk factor in patients of Chronic Kidney Disease. We found significant association of hemodialysis with abnormal lipid profile.

Key words: Chronic kidney disease, dyslipidemia, hemodialysis.
DIARY BOOK MEDIA FOR MONITORING THE TEETH BRUSHING ACTION OF ELEMENTARY SCHOOL STUDENTS
Authors: Nugraheni Hermien , . Sadimin , Aryati Endah , Nurjati Raaufa I. , Rajiani Ismi
Published: March 2020

Background: Indonesian population who brushed their teeth correctly twice a day is only 2.8 %.This shows that education about brushing teeth must start early.  The purpose of this study was to determine whether there is an impact of education using diary book media on the correct action of brushing teeth on elementary school students.

Methods: The research design used was quasi-experimental with non- equivalent control group design. Interventions were given to elementary students in one school, and another school was used as a control group. Intervention activities carried out on the students are education using the correct diary or brushing diary. Analysis of the data used is a comparative test with a statistical t-test independent t-test, which aims to find out the average value difference between the group with the intervention and the group that did not get the intervention in the form of a diary media use or rubbing diary tooth

Result: The result is that there are differences in the actions of students who brush their teeth correctly in the group that gets the intervention and those who do not get the educational intervention using the media of the tooth brushing diary book. There is a difference in the correct action of brushing teeth between students before and after getting an educational intervention using a tooth brushing diary book.

Conclusion: School-age children are a time of imagination, creativity, and storytelling. So the diary or diary is very suitable as an educational medium in the effort to change behavior in introducing the way to maintain health of the teeth.

Keyword: Diary Book, Teeth Brushing Action, Students
CORRELATION OF BLOOD GROUP, CHEILOSCOPY, DACTYLOGRAPHIC PATTERN AMONG PHYSIOTHERAPY TRIBAL STUDENT IN CHHATTISGARH.
Authors: Thakur Rajni , Gautam Deepti
Published: March 2020

Aim: To establish between correlation of ABO blood group, cheiloscopy, dactylographic pattern.

Materials and Methods: This research was carried on 400 students 291 females and 109 males 17 to 27 years age groups in tribal belt Government Physiotherapy College in Chhattisgarh, India. In this research were Students selected those inbred were tribe belongs to Chhattisgarh state. Blood group, cheiloscopy, dactylographic pattern  analysed and correlated according to Landsteiner, Suzuki and Tsuchihashi, Michael and Kuchen classification.

Result: We obtained were 400 tribe students which included 109 male and 291 female students. highest frequency was 221 “O” blood group, least frequency obtained “AB’ 26 and total Rh positive 371 and Rh negative was 29, cleiloscopy pattern more frequency was observed in type II branched 209, dactylographic pattern, highest frequency in whorl 229, least common in 6 composite.

Conclusion: We knew that students framework cheiloscopy, dactylographic patterns and blood groups show paramount role in races, crime, forensic identification. Correlation of these three criterion, solely be worn in individual, races identification, but fairly, they can be worn to ratify facts in atrocity, misdeed where there are thoroughly trifling testimony.

Keywords: “O” positive, Worn, Tribes, Races, Agglutination, Chhattisgarh, Physiotherapy.
INJECTION PAIN OF PROPOFOL IN CHILDREN WITH MEDIUM PLUS LONG CHAIN TRIGLYCERIDES AND LONG CHAIN PROPOFOL MIXED WITH LIGNOCAINE
Authors: Mehta Jitendra Punamchand
Published: March 2020

Introduction: Propofol is widely accepted drug because of its rapid and smooth induction, short context-sensitive time, rapid terminal half-life time and low incidence of postoperative nausea and vomiting. It is used for sedation and anaesthesia for almost all types of surgeries. During a propofol injection, pain due to the long-chain triglyceride (LCT) emulsion is experienced by 70% of adults and up to 85% of children. Despite various strategies to reduce propofol injection pain, this still poses a clinical problem in adults and children, and the incidence reported to be 30–90%. A medium-chain triglyceride/long-chain triglyceride (MCT/LCT) emulsion has been advised to reduce injection pain as compared to propofol LCT in adults and teenagers

Material and Methods: 100 children aged 5–13 years, in American Society Anaesthesiologists (ASA) class I or II, undergoing elective general anaesthesia without any contraindication to propofol anaesthesia were included in the study. Injection pain following injection propofol was assessed in all patients, but the anaesthetist was blinded for which formula was being used.

Results: The demographic characteristics like age, sex, weight, amount of propofol given, ASA physical status and recovery period was calculated. No statistically significant difference was observed in both the groups. Incidence of pain and severe pain in LCT group was 24 (48%) and 7 (14%) respectively while incidence of pain and severe pain in MCT/LCT group was 15 (30%) and 1 (2%) respectively. Pain score was found less in group MCT / LCT.

Conclusion: Medium plus long chain triglycerides and long chain propofol along with lignocaine significantly reduces the incidence as well as the severity of injection pain in the paediatric age group and can be used in children for sedation or induction of anaesthesia.
BIOCHEMICAL AND CLINICAL EVALUATION OF CORRELATION OF PERIODONTITIS AND EARLY CAROTID ATHEROSCLEROSIS
Authors: Khatoon Shazia , Jain Samir
Published: March 2020

Periodontal disease is a disease characterized by inflammation of the periodontal tissues caused by microorganisms in the oral cavity and affects approximately 90% of the world population. Losses in the alveolar bone and connective tissue are observed due to periodontal diseases, which may lead to tooth loss. In addition, periodontal disease has been associated with many systemic diseases such as coronary artery diseases, stroke, head and neck cancer, pregnancy complications and diabetes. Periodontal disease is affected by risk factors such as smoking and diabetes, similar to vascular diseases. Hence based on above findings the present study was planned for Biochemical and Clinical Evaluation of Correlation of Periodontitis and Early Carotid Atherosclerosis.

The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. In the present study 20 cases of the Generalized chronic Periodontitis were enrolled in the Group A as study group patients. And 20 cases of Periodontally healthy individuals were enrolled in Group B as control group patients for comparative evaluation. Under aseptic measures, venous blood samples were drawn by venipuncture in antecubital fossa using 5ml syringe and collected in a plain vacuum tubes and transported to clinical laboratory for lipid profile analysis. Both the groups were subjected for ultrasonography for the assessment of Carotid Intima-Media Thickness (IMT) and Lipid Profile.

The data generated from the present study concluded that periodontal disease has association with early carotid atherosclerosis which is a risk factor for cardiovascular diseases .Thus oral health and systemic health are closely related and overall systemic health of an individual can be improved by maintaining a proper oral health regimen. It is important in terms of health policies that there is no need for an additional cost for this early diagnosis.

Keywords: Periodontitis, Early Carotid Atherosclerosis, Heart disease, etc.
PLASMA ATHEROGENIC INDEX IS AN INDEPENDENT INDICATOR AND PROGNOSTIC VALUE IN RAYNAUD’S PHENOMENON?
Authors: Kader Saadet , Comaklı Hakan
Published: March 2020

Objective: Raynaud’s phenomenon (RP)  is characterized by cold induced temporary ischaemia of the fingers or toes  and an inflammatory autoimmune disease of connective tissues.  Plasma atherogenic index (PAI) is a valuable marker for the cardiovascular disease and cardiac risk. The aim of this study was to evaluate the role and clinical use of PAI in RP patients.

Materials and Methods: In this retrospective-cohort study, we examined the clinical value count blood cells in 55 patients with RP and 14 clinical controls admitted Konya Training and Research Hospital Department of Cardiovascular Surgery between January 2016-March 2019 were investigated retrospectively screened.  PAI was measured as a logarithmic value of triglyceride to high-density cholesterol ratio. PAI levels <0.11 is accepted as low risk, 0,11-0,21 intermediate risk, and 0.21 >increased risk. PAI was measured as a logarithmic value of triglyceride to high-density cholesterol ratio. The lipid and other biochemical parameters of patient and control groups were examined and measured.

Results: The study consisted of 29 females (42.03%) and 40 males (57.97%). There was a significant difference between differences between PAI level groups. There was no significant difference in PAI results between genders (p>0.355).We also found disagreement in biochemical parameters and PAI between controls and patients.

Conclusion: When we evaluated PAI in the patients with RP and controls, it was determined that there was no significant difference in either parameter. However, PAI levels have showed that significant elevated between groups so It can be a simple, economic and non invasive marker to identify for future studies.

Keywords: Raynaud’s phenomenon, Plasma atherogenic index, Blood lipid components
COMPARISON OF ENDOSCOPIC ULTRASOUND AND COMPUTED TOMOGRAPHY FOR EVALUATION OF PANCREATIC MASS LESIONS ASSUMING HISTOPATHOLOGY AS GOLD STANDARD
Authors: Paliwal Anil Kumar , Mendiratta Kuldeep
Published: March 2020

Background-Diagnostic imaging is an important tool to evaluate pancreatic neoplasms. Accurate detection and staging are essential for ensuring appropriate selection of patients who will benefit from surgery and for preventing unnecessary surgeries in patients with unresectable disease. Ultrasound (US), multidetector computed tomography (MDCT) with multiplanar reconstruction and magnetic resonance imaging (MRI) can help to do a correct diagnosis.

Methods- Hospital based cross-sectional and quantitative study. Patients with suspected pancreatic mass lesions referred to Department of Radiodiagnosis and Modern Imaging and to Department of Gastroenterology for MDCT and EUS respectively.

Results- EUS sensitivity was 98.00%, specificity was 75.00% and by CT scan sensitivity was 93.00%, specificity was 88.00% for mass detection. EUS sensitivity was 88.00%, specificity was 72.00% and of CT scan sensitivity was 76.00%, specificity was 100.00% in detection of vascular involvement. EUS sensitivity was 86.00%, specificity was 74.00% and by CT scan sensitivity was 92.00%, specificity was 100.00% for detection of lymphadenopathy.

Conclusion- In conclusion, our results showed that CT with pancreas protocoland EUS correlate moderatelywell in terms of mass detection, masssize, vascular involvement and lymphadenopathy.

Keywords: CT, EUS, Pancreatic lesion.
A STUDY OF KNOWLEDGE, ATTITUDE, AND PRACTICES REGARDING BIOMEDICAL WASTE MANAGEMENT AMONG THE HEALTH CARE WORKERS AT A TERTIARY CARE TEACHING HOSPITAL OF WESTERN UTTAR PRADESH
Authors: Mehta Abhishek
Published: March 2020

Background: The hazardous impact of biomedical waste on the community and environment is enhanced manifold if it is not managed effectively. Appropriate knowledge and awareness amongst the health care workers about the biomedical waste management, will help in minimizing health care associated infections.

Purpose: There are no such studies in this part of the country to identify the gaps / lacunae in knowledge, attitude & practices amongst health care workers, so that timely corrective measures could be instituted in the form of educational interventions.

Material & Methods: This Questionnaire based descriptive study was undertaken at a tertiary care teaching hospital of western Uttar Pradesh in March 2018 after obtaining clearance from Institutional ethics committee. A total of 85 subjects (30 Doctors, 30 Nurses, 25 Laboratory technicians) were administered pre structured pre-validated anonymous questionnaire. Mean scores of the Knowledge, Attitudes and practices of the three groups were compared by Anova test and the comparison between any two study groups done using unpaired t test and the significance  level was set to 0.05.

Results: While comparing Knowledge, attitude and practices between Doctors & Nurses, though doctors scored higher in all 3 sections but the difference was statistically significant only in the Knowledge and Practice levels. While comparing KAP scores between Nurses & Lab.technicians, though nurses scored higher but a statistically significant difference was seen in the attitude levels only.There was a statistically significant difference in the scores of Doctors, Nurses & Lab. Technicians in all the three sections

Conclusion: Such studies help in detecting the gaps & lacunae in knowledge, attitude & practices amongst different categories of health care providers which could be addressed through targeted educational interventions at regular intervals. This would help in reducing the incidence of health hazards due to improper BMW management.

Keywords: Knowledge, Attitude, Practices, Doctors, Nurses, Laboratory technicians, Questionnaire, Biomedical waste management.
ROLE OF TRANSVAGINAL SONOGRAPHY IN FIRST TRIMESTER VAGINAL BLEEDING
Authors: Dhawane Dr Sanjay Punjaji
Published: March 2020

Vaginal bleeding during the first trimester has been estimated to occur in 16% of all pregnant women, while the frequency of spontaneous abortion is estimated at around 10-20%. The clinical approach though helpful here is not of much value. Despite the latest technological developments and laboratory diagnosis the desired goal of early recognition is not achieved.

 This study was therefore planned with an objective to evaluate role of ultrasound in patients with first trimester vaginal bleeding. It was an Hospital based study where in a total 300 cases presented with complaint of bleeding per vaginum during first trimester, were enrolled for study. All patients underwent trans-abdominal and transvaginal sonography. About 60 % patients had normal viable pregnancy at time of initial sonography. Rest of the cases had a variety of abortions and other pregnancy related complications. Some of the conditions like molar pregnancy and ectopic pregnancy were life threatening and required immediate clinical intervention.

The Ultrasonographic examinations were done per abdominally by using ultrasound equipment. In the present study normal live embryo with subchorionic bleed was the most common cause of first trimester bleeding. Various types of abortions constituted the second commonest cause of first trimester bleeding. All cases were diagnosed correctly on ultrasonography with 100% sensitivity and accuracy and managed appropriately. Hence it can be suggested that ultrasound helped in establishing correct diagnosis timey and decides the line of management (1)

Keywords: Vaginal bleeding, first trimester, transvaginal sonography.
DYSLIPIDEMIA IN THYROID DISORDERS
Authors: Meena Daulat , Bairwa Ramavatar
Published: March 2020

Background: Thyroid hormones have profound metabolic effects, the most striking action being an increase in energy expenditure. Thyroid hormones play an important role in regulating lipid metabolism; and thyroid dysfunctions can result in lipid abnormalities which increase the risk of endothelial dysfunction, hypertension and cardiovascular disease.

Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group.

Results- The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group.

Conclusion: We conclude that, dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction.

Keywords: Total cholesterol, Triglycerides and LDL.
A STUDY ON COMBINED USE OF INTRAVENOUS AND TOPICAL TRANEXAMIC ACID FOLLOWING CEMENTLESS TOTAL HIP ARTHROPLASTY- A RANDOMISED CLINICAL TRIAL
Authors: Rathi Romil , Chandrakar Anurag
Published: March 2020

Purpose: This study was designed to compare the efficacy and safety of the combined use of tranexamic acid (TXA) with the intravenous (IV) or local use alone in total hip arthroplasty (THA).

Methods: 21 patients were randomised to a IV group, a local group or a combined group. Participants received 1.5 g IV-TXA in the IV group, 3 g local TXA in the local group, or 1 g IV-TXA combined with 2 g local TXA in the com- bined group. The primary outcomes were total blood loss (TBL), maximum haemoglobin drop, and the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE).

Results: TBL was (77.65 ± 18.95) ml in the combined group, which was significantly lower than in the IV group or the local group (p = 0.015, p = 0.001 respectively). Likewise, the mean values of maximum hemoglobin drop in the combined, IV, and local groups were 2.98 ± 0.78, 3.36 ± 0.78, and 3.89 ± 0.72 g/dL, respectively, with a significant intergroup difference (p<0.001 for all). Asymptomatic DVT was detected in 1 patient of the IV group, and 2 patients of the combined group with the use of ultrasound. There were no episodes of PE, and no significant differences were seen between groups in terms of complications.

Conclusions: Combined use of intravenous TXA and local TXA in primary unilateral THA can effectively decrease total blood loss and increase postoperative haemoglobin levels without influencing complication rates. It is sug- gested that this combined TXA regimen is more effective in decreasing blood loss in cementeless THA than intra- venous or local administration alone.

Keywords: Tranexamic acid, Total hip arthroplasty, Blood loss, Transfusion, Combined treatment
THE PROBLEM CALLED DEEP BITE AND ITS MANAGEMENT - A REVIEW.
Authors: Shukla Priti , Gupta Shraddha
Published: March 2020

Deep bite is one of the most common and most deleterious malocclusion seen in children as well as adults that can occur along with other associated malocclusions. An unfavorable sequelae of this malocclusion predisposes a patient to periodontal involvement. Abnormal function, improper mastication, excessive stresses, trauma, functional problems, bruxism, clenching and temporomandibular joint disturbance.
ESTIMATION OF STATURE FROM FOREARM & HAND LENGTH IN WEST BENGAL POPULATION
Authors: Koley Baishakhi , Bhanarkar Ujwala
Published: March 2020

Background: In the present scenario of increasing crime rate the identification of an individual has become immensely important. Measurement of different body parts of human body to estimate stature plays a vital role for establishing individual identity, especially in those cases where mutilated body parts are found or mere body fragments discovered. Here comes the role of anthropometry, where length of hand, forearm, foot etc plays a vital role for estimation of stature of a human being. Objective: The objective of the present study is to find out the relation between length of forearm with hand and stature in west bengal population. Method:  For the purpose of study 300 young and healthy medical students both male and female, aged between 18 to 25 years, without any known disease or body deformity, were examined anthropometrically to measure their respective height with stadiometer and length of forearm with hand by vernier slide caliper. Result: The stature varied from 157.48 cm to 169.75 cm with mean value 167.0 cm and 159.0 in case of male and female subject respectively. On the other hand length of forearm with hand varied from 40.1 cm to 46.4 cm with mean value 46.2 and 43.2 respectively. Conclusion: Study results shows that length of forearm and hand poses significant correlation with stature.So, it may be desirable to apply this knowledge especially in cases of fragmented body parts or mutilated bodies.

Keywords: Length of hand, stature, anthropometrical measurement
INCIDENCE AND AETIOLOGY OF GASTROINTESTINAL PERFORATION: A HOSPITAL BASED PROSPECTIVE STUDY.
Authors: Pradhan Shwetabh , Bisht Abhinav , Acharya Abhijit
Published: March 2020

Objectives: This study was to evaluate the incidence and various aetilogical factors in patients of gastrointestinal perforation.

Methods: A detail history clinical examinations and relevant investigations were performed to all cases of gastrointestinal perforation. A total of 50 patients of gastrointestinal perforation with age group 0 to 80 years were enrolled. Patients were included on the presenting signs and symptoms like pain, vomiting, distension, alteration of bowel habits, fever, h/o loss of appetite and weight, dyspnoea and duration of illness. Clinical examination was followed by haematological, biochemical and radiological investigations were performed to all cases of gastrointestinal perforation.

Results: Data was analysed by using SPSS version 26 software. All data was tabulated and percentages were calculated. One sample t test was applied. Mean and standard deviation were observed. P value was taken less than or equal to 0.05 for significant differences.

Conclusions: Gastrointestinal perforation was commonly seen in younger age group. Ileum was the most common site for gastrointestinal perforation. Enteric fever and drugs were the most common aetiological factors of gastrointestinal perforation. Hence, awareness, early recognition of symptoms and referral of patients to hospital is very important for prevention and management of gastrointestinal perforation.

Key words: gastrointestinal perforation, aetiological factors, age, sex
TO STUDY EFFICACY OF AMISULPRIDE IN TREATMENT OF SCHIZOPHRENIA.
Authors: Raichandani Om Prakash , Kadam Abhijeet , Raichandani Sapna
Published: March 2020

The study was performed at the Department of Pharmacology in collaboration with Department of Psychiatry, NSCB Medical College, Jabalpur. The maximum numbers of patients in were in reproductive age group that is in between 20 to 49 years. The mean age in Amisulpride group was 33.26(±10.23) years while in Olanzapine group it was 31.25 (±12.22) years.

Schizophrenia was more common (80%) in younger (20-49years) age group. In our study the male /female ratio was 1.7. Our study supports the notion that Schizophrenia is more common in Married and Urban population. Only one patient from Olanzapine  Group suffered  Extrapyramidal  symptoms of  moderate severity requiring  withdrawal from study.2  patients  from Olanzapine group and 1 patient from Amisulpride group  had Tremors and Akathesia  of mild severity. There was no emergence of Extrapyramidal symptoms in rest of the patients (p>.05)

Keywords: Efficacy, Amisulpride, Olanzapine & Schizophrenia.
DIAGNOSTIC VALUUE OF FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) BIOPSY AND LYMPH NODES IN BREAST TUMOURS
Authors: Dhruv Surendra Kumar
Published: March 2020

INTRODUCTION:  Breast cancer is the most common solid cancer in women and one of the leading causes of cancer deaths in the western countries. In India it is a leading cause for mortality and morbidity. Prognosis of invasive ductal carcinoma (IDC) of breast is determined by anatomic extent of the disease and can be assessed by tumor size, lymph node status and metastasis, also biologic markers such as histological grade, hormone receptor expression, HER2 overexpression, and/or amplification and genomic panels can be used. The presence of metastatic in axillary lymph nodes confirms the capacity of a cancer to metastasize. It represents the single most prognostically potent element of clinical stage in potentially curable cases. Axillary lymph node dissection and histological evaluation has a continuing place in the staging and management of patients with breast cancer. It has been shown that cytological grade correlates well with the axillary lymph nodal metastasis and also prognosis. Axillary lymph node evaluation in breast cancer is usually performed preoperatively by clinical examination, sonography, lymph node resection and by ultrasound-guided fine-needle aspiration cytology.

MATERIAL AND METHODS: Patients with detected breast mass (palpable and non-palpable) and palpable axillary lymph node who were evaluated by FNAC. After sterile draping and sufficient disinfection, a 10-ml syringe was inserted into and withdrawn from the lymph node three times under aspiration while sonographically monitored. The procedure was performed by using 21-22 Gauge needle with 2–4 aspirations and it was repeated if the sample was inadequate. Ultrasound guided FNAC was performed for impalpable, and deeply located small lumps.

RESULTS: A total of 156 patients were underwent for FNAC of the breast lump. Histological correlation of all the patients was done. The mean age of patients who underwent FNAC was 39.6 ± 9.42 years and all were female patients. The cytology reports were classified as benign, atypical, suspicious, malignancy, and unsatisfactory. In 59 (37.8%) cases benign lesions were observed of which the fibrocystic disease was the most common cytological diagnosis. 15 (9.6%) were atypical, 7(4.5%) were suspicious and in 72(46.2%) cases malignancy was diagnosed. In 3 (1.9%) cases sample was unsatisfactory. FNAC of the axillary lymph nodes was performed on 76 patients with palpable lymph nodes and histological correlation of axillary lymph node. In FNAC and histology correlation of axillary lymph node sensitivity was 81.94% (95% CI 71.11% to 90.02%) and specificity was 100% (95% CI39.76% to 100.00%) with positive predictive value of 100%.

CONCLUSION: FNAC is a rapid, cost effective and safe procedure for management of breast lumps.
A COMPARISON OF GLASGOW COMA SCORE WITH COMPUTED TOMOGRAPHIC FINDINGS IN CASES OF TRAUMATIC BRAIN INJURY AT TERIATRY CARE HOSPITAL BIKANER
Authors: Pareek Kapil , Sodhi Dinesh
Published: March 2020

Background: Our present study aimed at correlation of GCS score with computed tomographic findings in cases of head injury and to evaluate that GCS scoring can be used as an alternate tool in clinical management of head injuries in settings where CT scans are not available or contraindicated.

Methods: The present study was conducted in Department of Neurosurgery, Trauma center of S. P. Medical College and A.G. of Hospitals, Bikaner. The study group consisted of a total of 100 head injury patients presenting to the Trauma center and admitted in neurosurgery ward.

Results: Contusion was the most frequent finding in cases with positive CT scan findings. All (100%) subjects with severe head injury had positive CT scan findings.

Conclusions: Careful clinical selection based on GCS score before ordering CT scan can help reduce radiation exposure patients and pressure on limited resources. Studies with larger sample size would be warranted

Keywords: CT scan, head injury, Glasgow Coma Scale Score
TO COMPARE THE EFFICACY OF PGE2 GEL AND 25ΜG OF INTRAVAGINAL MISOPROSTOL FOR INDUCTION OF LABOR IN TERM PROM
Authors: Maheshwari Sunita , Jinger Shweta
Published: March 2020

Background: Induction of labour is one of the most common obstetric interventions worldwide. The study was conducted to compare the efficacy and safety of 25µg (low dose) vaginal Misoprostol with intracervical Dinoprostone for cervical ripening and induction of labour in term pregnancy.

Methods: For the purpose of this study, 100 term pregnancy patients (only primigravidae and second gravidae) were included who had spontaneous rupture of membrane before onset of labor. Data was collected from cases admitted in labor room at Pannadhay Mahila Chikitsalaya associated with RNT Medical College,Udaipur between July 2014 to July 2015.

Results: Requirement of Oxytocin for augmentation of labor between group A and group B. It is evident from the table that oxytocin was required in only 16% of patients in group A, while 46% in group B. This indicates that requirement of oxytocin was significantly less in misoprostol group (P<0.001).

Conclusion: This study was designed to assess efficacy of a 25 μg misoprostol vaginal tablet, Finding confirms that vaginal misoprostol tablet is as effective as dinoprostone in cervical ripening and labour induction with dinoprostone.

Keywords: Cervical ripening, Dinoprostone, Labour induction, Low- dose misoprostol.
SOCIO-CULTURAL FACTORS ASSOCIATED WITH NATURAL OPIOIDS USE IN NORTHWESTERN RAJASTHAN: A CROSS-SECTIONAL STUDY FROM TERTIARY CARE HOSPITAL.
Authors: Saini Vijay Kumar , Goya Dheeraj , Gehlawat Pratibha
Published: March 2020

Background: Opioid in natural form (afeem/amal and poppy husk) has been taken from ancient time in north India including Rajasthan. There are approximately 2.3 crore opioid users in India, according to National Survey. Various psychosocial and cultural factors are associated with its use. Socio-cultural factors for the use of natural opioids are inadequately studied. With this rationale, we planned a study to identify these socio-cultural factors.

Method and Material: This was a descriptive, cross-sectional study. 136 subjects were recruited. Along with socio-demographic profile, a semi-structured proforma of various socio-cultural factors was used.

Results: The majorities of subjects were male (97%), married (88.23%), farmer (62.50%), illiterate (44.11%) and hailed from rural areas (92.65). Most common factors associated with starting opioids were to increase work capacity in agricultural work (n= 46; 33.82%) followed by staying away from home for work (n= 36; 26.47%) and usage by another family members (n=34; 25%). Participants were continuously using natural opioids as it increases work capacity and concentration (n=61; 44.85%) and the reasons for quitting were unavailability and financial problems (n=60; 44.12%).

 Conclusion: Various socio-cultural factors play important role in initiation and maintenance of natural opioids use.

 Key words:  Natural opioids, Opioid dependence, Socio-cultural factors, Northwestern Rajasthan, Agriculture work
CLINICAL PROFILE AND PSYCHIATRIC MORBIDITY IN PATIENTS WITH DELIBERATE SELF-HARM
Authors: Motwani Yogesh , Nair Shobha , Chaudhari Aditi , Mazumdar Kaustubh
Published: March 2020

Background: It requires detailed research to understand the psychopathology behind DSH attempts. Apart from social factors, psychiatric disorders and individual coping mechanisms can contribute to DSH. This study will be helpful in knowing the prevalence of psychiatric morbidity in these patients.

Aims and Objectives: To study the Psychiatric morbidity in patients with DSH.

Materials and Methods: This is a retrospective, descriptive study including 42 patients who had history of DSH and were referred to psychiatry department of BARC Hospital, Mumbai. Patients who were below 45 years of age at the time of DSH and above 18 years at the time of study were included. Their socio-demographic data were collected, psychiatric diagnosis were noted from the case files, personality disorders were evaluated using ICD-10 IPDE. Data were analysed using descriptive and analytic statistical methods.

Results: 42.86% of the population was diagnosed as having psychiatric disorder. Most common disorder was depression. 7.14% of the patients were diagnosed as having borderline personality disorder.

Conclusions: Depression was the most common psychiatric disorder found in our study.

Key words: Deliberate self-harm, psychiatric disorders, personality disorders.
ASSESSMENT OF THE QUALITY OF RECONSTRUCTION IN TOTAL HIP ARTHROPLASTY DONE IN PATIENTS AFTER ACETABULUM FRACTURE
Authors: Sharma Manish , Sen Ramesh Kumar , Aggarwal Sameer , Prakash Mahesh
Published: March 2020

Background: Acetabular fractures are complex orthopaedic injuries and require a fair amount of expertise for management. Although undisplaced acetabular fractures can be managed by nonoperative means, displaced acetabular fractures need operative intervention for reduction and stabilization.

Methods: The study was carried as a retrospective study, from February 2013 to July 2014. After getting the approval from the Ethics Committee of the Institute (Annexure I) and the consent from the patients the study was conducted on 49 patients who underwent Total Hip Arthroplasty after fracture acetabulum.

Results: On evaluation, patients at short term follow up had good clinical outcome on the basis of Harris hip score. The Harris hip scores improved progressively in the patients at 2-4 years follow up having mean HHS of 92 which further increased to 97 in patients who were followed up after 4 years. The patients at short term follow up of up to 2 years had comparatively lower quality of life scores when compared to the follow up at 2-4 years. The patients followed up after 4 years had the best quality of life.

Conclusion: We concluded that total hip arthroplasty after acetabulum fracture, as a result of good quality of reconstruction, a good functional outcome leads to improved quality of life in the patients.

Keywords: Hip, Arthroplasty, Reconstruction.
ANALYSIS OF THE RADIOLOGICAL ASSESSMENT OF RECONSTRUCTION IN TOTAL HIP ARTHROPLASTY
Authors: Sharma Manish , Sen Ramesh Kumar , Aggarwal Sameer , Prakash Mahesh
Published: March 2020

Background: Total hip Arthroplasty (THA) is one of the most common interventions in Orthopaedic surgery. Increase in incidence of THA appears likely with the growing elderly population. THA has revolutionised the management of the patients suffering from pathologies of the hip. The common indications for THA today are osteoarthritis hip, avascular necrosis hip, ankylosing spondylitis, rheumatoid arthritis and in posttraumatic hip.

Methods: The study was carried as a retrospective study, from February 2013 to July 2014. After getting the approval from the Ethics Committee of the Institute (Annexure I) and the consent from the patients the study was conducted on 49 patients who underwent Total Hip Arthroplasty after fracture acetabulum.

Results: Based on the treatment received for fracture acetabulum, the vertical offset measurement was done for 47 patients. The affected side was compared with the un-affected side in the patient and a restoration of vertical offset on the affected side within 20% of the unaffected side was taken as acceptable. In 31 patients acceptable vertical offset was restored.

Conclusion: Radiological assessment of the patients was done using 4 parameters. Measurement of Vertical offset, Horizontal offset, Body lever arm and Acetabular cup inclination was done. The affected side was compared with the un-affected side in the patient and a restoration of parameters on the affected side within 20% of the unaffected side was taken acceptable.

Keywords: Radiological, Arthroplasty, Reconstruction
TO ESTIMATE LIPID PROFILE IN PATIENTS WITH COPD
Authors: Jha Roshan Kumar , Ambad Ranjit S.
Published: March 2020

Background: Chronic Obstructive Pulmonary Disease (COPD) includes persistent bronchitis and emphysema, which is generally caused due to smoking of tobacco. (COPD) is an obstructive lung disorder characterized by airflow limitation that is progressive, associated with severe inflammatory response in the air passages and the lungs due to toxic particles. It interferes with normal breathing and is not fully reversible.

Objectives: 1. To estimate lipid profile (Total cholesterol (TCH), Triglycerides (TG), High density lipoprotein (HDL), Low density lipoprotein (LDL), Very low-density lipoprotein (VLDL)) in patients with Chronic Obstructive Pulmonary.

2. To find correlation of these parameters with severity of disease.

Material and Method: The study was conducted in Department of Biochemistry in collaboration with Department of Respiratory Medicine at Jawaharlal Nehru Medical College and AVBRH, Sawangi (Meghe) Wardha, India. Thirty-two patients diagnosed with COPD were selected from OPD and ward of Respiratory Medicine and thirty-two age and sex matched controls were taken.

Result: The analysis of total cholesterol, triglycerides, HDL, LDL, VLDL in cases and controls. Result was statistically significant in between cases and controls of total cholesterol (p<0.001), HDL (p<0.001) and LDL (p<0.001), and statistically not significant in between cases and controls of triglycerides (p=0.6) and VLDL (p=0.98).

Conclusion: We conclude that smoking significantly affect lipid profile in COPD patients, as it increases LDL levels and decreases HDL levels. Hence all patients with COPD patients who are smoker’s needs to check their lipid profile. COPD is considered as systemic disease with various co morbidities, which may affect the lipid profile.

Keywords: Lipid profile, COPD, AAT, CVD, TNF-α, CRP and GOLD.
A RETROSPECTIVE STUDY TO COMPARE INFUSION OF PROPOFOL AND KETAMINE-PROPOFOL MIXTURE (KETOFOL) AS ANESTHETIC MAINTENANCE AGENTS IN PATIENTS UNDERGOING VARIOUS SURGICAL PROCEDURES IN TERTIARY CARE CENTRES
Authors: Goel Ravi Kumar , Agrawal Ghasiram
Published: March 2020

Introduction: The existing evidence suggests that the use of low doses and titers of ketamine can be effective in reducing the cardiovascular effects of propofol; nevertheless, this administration method can increase the chance of waking up during anesthesia. Some studies have reported the effect of anesthesia induction using a single propofol dose and low ketamine doses on the hemodynamic stability of patients in short-term outpatient operations in emergency departments. The aim of this study is to compare the effect of ketofol and propofol , to evaluate the intra and post-operative hemodynamic effects of ketofol infusion in comparison with propofol infusion.

Methods: This Retrospective study involved Prior Consent from the Hospital Authorities & was found to be within ethical standards. Data of 100 surgeries were selected which were managed with propofol ( 50 surgeries ) & ketofol ( 50 surgeries) separately   admitted to the local surgical units in last 5 years. The two groups were compared in terms of heart rate, systolic, diastolic and mean blood pressure, severity of pain and nausea, vomiting frequency and the doses of analgesics and antiemetic drugs used.

Results:  38 (76%)  out of 50 of the patients were male in the propofol group and 31 ( 62%)  out of 50 were male in the ketofol group and the difference was not Significant .The mean age of the patients was 39.68 ± 7.32 years in the ketofol and 34.14 ± 7.61 years in the propofol groups . There was no statistical difference between the two groups regarding age and sex distribution. There was no difference between the two groups regarding systolic, diastolic and mean arterial blood pressure before induction and after. The intensity of nausea was not significantly different between the two groups. Postoperative pain severity and drug dosage were not significantly different between the two study groups.

Conclusion: The infusion of a mixture of ketamine and propofol improves hemodynamic stability in addition to better analgesia compared to the infusion of propofol alone. But it led to heightened risk of nausea and vomiting. Future studies are recommended to address these issues. In addition, further studies are warranted to investigate the use of sub-hypnotic doses of ketamine + ketofol combination for infusion in surgical procedures. When these parameters are considered, ketofol might be used as an alternative to propofol.

Keyword: Ketofol, Propofol, Retrospective Study. Comparative study, Ketamine
TO STUDY CORRELATION OF CRITERIA LIKE OBESITY, DM, HYPERTENSION, DYSLIPIDEMIA IN RELATION WITH THYROID DISORDER
Authors: Ram Ravija Prasad , Sharma Shivam , Saraf Manish Kumar , Ahirwar Gyanendra
Published: March 2020

Background: In this study 100 cases of thyroid dysfunction were studied for the cardiovascular manifestations. Out of these, 60 cases were of hypothyroidism and 40 cases were of hyperthyroidism.

There was no age bar for inclusion in the study. All of these cases were selected from those attending the Endocrinology OPD in IMCHRC hospital, Indore.

Result: 78.3% cases of hypothyroidism in our study were suffering from obesity. Relationship between age group and obesity was not significant in these patients. In our study out of 40 patients suffering from hypothyroidism 10 (25%) patients have DM. In our study out of 60 patients suffering from hypothyroidism 28(46.7%) patients were have DM. In our study out of 40 patients of hyperthyroidism, 12 had dyslipidemia. In our study out of 60 patients of hypothyroidism, 41 had dyslipidemia.

Conclusion: In our study out of 60 patients suffering from hypothyroidism 28(46.7%) patients were found to have diabetes mellitus. All were females. Out of 60 patients of hypothyroidism, 33 had diastolic hypertension. Out of these 6.1% were male and 93.9% were female. Out of 60 patients of hypothyroidism, 41 had dyslipidemia, of these 97.6% were females only 2.4% were male.

Keywords: Cardiac, Manifestation, Thyroid, Hyperthyroidism & Hypothyroidism.
TREATMENT OF GRAVID PATIENT SUSTAINING FACIAL FRACTURE UNDER GENERAL ANESTHESIA
Authors: Kumar K.Santhosh , Giri, G.V.V. , Basu Raina , Pandyan Deepak A
Published: March 2020

Pregnancy is a physiologic condition where the maternal wellbeing imparts on the growth of the fetus. Hence it is important to know the effects of trauma and management of maxillofacial trauma in pregnancy. Hereby we describe a case of mandibular fracture in a pregnant patient who was treated under general anesthesia.