bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study of unusual burns at a tertiary burn unit: a prospective study
Authors: Durairaj Alagar Raja , Mahipathy Surya Rao Rao Venkata , Ramachandran Manimaran , Sundaramurthy Narayanamurthy 
Published: November 2017

Background: Unusual burns are not uncommon. They occur in the industrial as well as the domestic side. These are mainly burns due to chemicals, tar, fire walk and lightning burns. These burns occur as a result of improper handling of chemicals with poor safety measures or due to accidents. Here, we discuss about these burns, their epidemiology with treatment and preventive measures.Methods: The study was conducted at a tertiary care burn centre for a period of two years from Jan 2009 to Jan 2011. Forty-four patients with unusual burns were admitted and evaluated with a thorough history and clinical examination. Initial resuscitation was done followed by specific therapy in each of the cases.Results: The forty-four patients with unusual burns were categorized into chemical burns, lightning burns, tar burn, camphor burns, fire walk burns and miscellaneous types. These burns mostly involved adult males and were generally due to domestic reasons. 93% were due to accidents of which most of them were of the miscellaneous type (83%).Conclusions: Unusual burns are an important to know as these are occurring with regular frequency in the present days. These burns are usually accidental occurring in industries and in household setups. Proper education and safety measures could reduce the incidence of these unusual burns.
TSH receptor antibodies in breast cancer and benign breast disease: a hospital based study
Authors: Krishnaswamy Jawahar , Sattar Reshma 
Published: November 2017

Background: Associations between breast cancer, benign breast tumours and thyroid disorders are reported in numerous studies. Relationship between thyroperoxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), and breast cancer have been previously demonstrated. However, no analysis has been performed concerning an association between thyrotropin (TSH) receptor antibodies (TSHRAb) and breast cancer. The aim of the study was to evaluate the presence of TSH Receptor antibodies in women with breast cancer or benign breast tumours, and to analyze a possible relationship between TSH Receptor antibodies, and these two groups of breast diseases with emphasis to laboratory findings.Methods: Clinical and laboratory details of 87 women hospitalized were prospectively analyzed, using an Post hoc Tukey HSD for normally distributed continuous data, chi-square test for comparison.Results: TSH Receptor antibody levels in breast cancer was statistically significant. We observed TSHRAb more frequently in patients with breast cancer. We found that TSHRAb is the only variable possessing as a prognostic marker for breast cancer.Conclusions: The present study indicates that the serum levels of TSH Receptor Antibody are significant higher in patients with Breast cancer. These results have implications not only for the screening of patients but also for the development of new prognostic markers. Further high-quality prospective studies are needed to explore whether TSH Receptor Antibodies are potential prognostic markers for patients with Breast cancer.
Study of bacterial flora and their antibiotic sensitivity in peritonitis of various causes
Authors: Sahani Indra Singh , Dhupia Rakesh , Kothari Archana , Rajput Madhurendra , Gupta Ajay 
Published: November 2017

Background: Peritonitis is a common emergency encountered by surgeons the world over. Despite a better understanding of pathophysiology, advances in diagnosis, surgery, antimicrobial therapy and intensive care support, peritonitis remains a potentially fatal affliction. Intra-abdominal sepsis is important causes of mortality and morbidity. The treatment is based on rapid fluid resuscitation, initiation of antibiotic therapy and surgical intervention. The antibiotic chosen must cover the most frequently expected bacterial species depending upon the site of perforation. Objectives of the study was done to identify the type of organism present in bowel perforation and their sensitivity pattern to different antibiotics. A guideline will be framed for advising antibiotics to be used for different kinds of perforation.Methods: This was a prospective study of one year on 50 patients of secondary peritonitis due to bowel perforation, conducted in Amaltas institute of Medical Sciences, Dewas.Results: This study included 50 patients with an average age of 36 years (range: 3 days-75 years). There were 40 males and 10 females. The mean duration of hospitalization was 10.6 days (range: 3-25 days) with predominant site of perforation was ileum. E. coli emerged as main pathogenic microbe even in site specific culture, was closely followed by Klebsiella. A combination of third generation cephalosporins with sulbactam and metronidazole has been the most promising therapy to treat secondary bacterial peritonitis due to bowel perforation. It needs to be emphasized that although the sensitivity studies reveal an edge for meropenem over cefaperazone sulbactam, yet the preference of cephalosporin with sulbactam over meropenem is justified, considering the economic constraints and with a suitable foresight, to keep meropenem as a reserve drug because trends indicate that our microbes are fast becoming resistant to the promising combination of third generation cephalosporin with sulbactam and metronidazole.Conclusions: This study suggests that the current recommended empirical antibiotics need to be reassessed.
A study to test the validity of diabetic ulcer severity score (DUSS) at tertiary care hospital
Authors: Kumar V. Hari , Barazandeh Moghadam Abdul Ghader 
Published: November 2017

Background: For classification of ulcer of feet in diabetes, various systems of classification are in use. Notable among them are the University of Texas (UT) system and the Wagner system. One of the most recent such type of classification system is DUSS (Diabetic Ulcer Severity Score). Studies are required to validate the same. Objective was to test the validity of Diabetic Ulcer Severity Score (DUSS).Methods: Present follow up study was carried out among 50 known cases of diabetes having ulcer over foot. DUSS scoring was applied. Ulcer was graded into five grades. Patients were followed till the outcome was noted.Results: Most common ulcers were of DUSS score of 3. Major amputation was done in 15 (30%) patients and minor amputation in 12 (24%) patients. Toe amputation was done in total of 15 patients. None of the patients had forefoot amputation. Below knee amputation was done in total of 11 (22%) patients. Majority of the foot ulcers among study population with DUSS score 0, 1 and 2 healed by primary intension or skin grafting i.e., 1 (100%), 3 (75%) and 6 (46.15%) respectively. However, among those with score 3 and 4 majority required amputation i.e., 14 (70%) and 10 (83.33%) respectively. This difference in the DUSS score among the three groups was found to be statistically significant (P=0.004). The probability of healing with DUSS score 0 was 100%, 75% with DUSS score 1, 84.61% with DUSS score 2, 30% with DUSS score 3, 16.67% with DUSS score 4. The mean time for healing was 77 days. The mean time for amputation was 100 days.Conclusions: The proposed score classification system for the diabetic foot may enable better quality of life for diabetic patients and promote better low-cost care for millions of individuals worldwide.
Analysis of psychiatric problems in burn patients in a tertiary burn unit: a prospective study
Authors: Ramachandran Manimaran , Durairaj Alagar Raja , Rao Venkata Mahipathy Surya Rao , Sundaramurthy Narayanamurthy 
Published: November 2017

Background: Burn injuries in our part of the world generally occurs in the lower socio-economic groups. A large part of these patients suffers from underlying psychiatric disorders. This study is to see the prevalence rates and clinical diagnosis of psychiatric disorders and psychosocial problems as a predisposing factor to burns and squeal to burns in our population, hence necessitate the consultation with the psychiatric team management to improve the outcome from the time of critical phase recovery to the rehabilitation phase.Methods: 114 patients admitted with suicidal burns above the age of 15 years were included in the study at Dept. of Plastic, Reconstructive and Burn Surgery, Govt. Kilpauk Medical College and Hospital for a period of 2 years and evaluated.Results: The patients were mostly married females in the 2nd to 3rd decade of life. Most of them had some form of pre-morbid psychopathology. 60% of patients had >50% burns and only 17% were survivors. After 1 year of psychotherapy, most patients had returned to normalcy.Conclusions: In our study deformity related depression were more after recovery hence prevention of deformity with usage of appropriate splintage, wound management, early grafting and intense physiotherapy will produce a drastic change in their wellbeing and coping ability and help long term rehabilitation and return to normalcy.
Acute pancreatitis, its diagnosis with special reference to contrast enhanced CT scan (CECT) and serum enzyme studies: a comparative study in tertiary referral hospital of Odisha, India
Authors: Panda Srikanta , Tirkey Roshni , Swain Basanta Manjari , Jena Somanatha , Sarangi Ashok Kumar , Sarangi Anshuman 
Published: November 2017

Background: Acute pancreatitis is sudden swelling and inflammation of the pancreas. It can be diagnosed on the basis of clinical and laboratory data. At times, it may be difficult to differentiate it from other acute abdominal conditions. In these patients, serum enzymes (amylase and lipase) study, imaging by ultrasonography (USG) and/or computed tomography (CT) is of immense value in arriving at a diagnosis. In this study, we have compared the role of serum enzymes (amylase and lipase) levels, with the imaging studies (US/CECT scan) in relation to early diagnosis of acute pancreatitis and to find out the most specific and sensitive diagnostic modality.Methods: 300 patients (220 males, 80 females) in age group of 21 to 62 years with a clinical diagnosis of acute pancreatitis, which were admitted to surgical ward of S.C.B. Medical College Hospital, Cuttack during a period from November 2013 to October 2015, were included in the study. All selected cases (clinically diagnosed as acute pancreatitis) were serially subjected to tests of serum amylase and lipase estimation, USG and CECT scan of abdomen.Results: In our study the most common cause found was gall stone disease followed by chronic alcoholism. Serum amylase test showed diagnostic accuracy of 46.66% whereas serum lipase it was 70 %. Further USG of abdomen diagnostic accuracy was 83.33%, finally CECT scan had a diagnostic accuracy of 93.33%.Conclusions: Comparing all the diagnostic modalities described above it was found that contrast enhanced CT scan has highest accuracy rate (i.e. about 93% in our study) in detecting acute pancreatitis. This study proved that CECT scan was very important in the following up of the patients in order to detecting regression of disease appearance and complication in relation to acute pancreatitis.
Role of modified Alvarado scoring system and USG abdomen in acute appendicitis: an overview
Authors: Singh Rajkishore , Singh Rajiv , Singh Kulwant 
Published: November 2017

Background: Acute appendicitis is the most common cause of an ‘acute abdomen’ in young adults and, as such, the associated symptoms and signs have become a paradigm for clinical teaching. Appendicitis is sufficiently common that appendicectomy (termed appendectomy in North America) is the most frequently performed urgent abdominal operation and is often the first major procedure performed by a surgeon in training. In this study we correlate the usefulness of Modified Alvarado scoring system(MASS) and ultrasonography(USG) in management of acute appendicitis.Methods: The study was done on 60 patients of symptomatic appendicitis, requiring management accordingly, attending surgical OPD of People’s College of Medical Sciences(PCMS) and Research Centre, Bhopal, India from 1st October 2011 to 30th August 2013. The study includes 60 patients between 5-60 yrs of age. They were prospectively evaluated on admission using the modified Alvarado Score to determine whether or not they had acute appendicitis, all equivocal cases were subjected to ultrasonography examination. The score and ultrasonography were correlated with the operative and histological findings.Results: All 60 patients underwent surgery. The sensitivity of the modified Alvarado score was 89.65% and sensitivity of USG was 91.37%, out of 60 cases of acute appendicitis male were 36 and remaining 24 cases were female. So, it showed sex ratio of 36:24, 3:2 which correlate with literature and other studies. With use of both MASS and USG as diagnostic tool, out of 60 cases 57 cases were positive and with the help of histopathology, it was confirmed in 58 cases.Conclusions: The modified Alvarado scoring system is a good diagnostic indicator for acute appendicitis. It helps in minimizing the rates of negative appendicectomy. It can be used as an adjunct to surgical decision-making along with ultrasonography in doubtful cases. When combined, modified Alvarado score and ultrasonography can work very effectively in diagnosing acute appendicitis(AA) correctly and in reducing the number of negative appendicectomy.
Comparison of acute inflammatory score and Alvarado score in diagnosis of acute appendicitis at a tertiary care hospital
Authors: Gopalam Padmaja Rani , Konidala M. V. Saila Suman 
Published: November 2017

Background: Acute appendicitis remains as one of the most common surgical entity requiring early intervention. Hence there is always a need to develop a well-designed protocol for diagnosis and to reduce negative appendectomy. The most common and widely applied was Alvarado score and best performed in validating studies, but was observed with few drawbacks. A recently introduced appendicitis inflammatory response score (AIR) was designed to overcome the drawbacks associated with the implementation of Alvarado scoring system. The objective the present study was to evaluate the AIR score on cases of suspicious appendicitis and to compare it with Alvarado scorings system.Methods: A prospective study for a period of two years from March 2015 to February 2017 was conducted on consecutive patients who presented to emergency department and scoring was performed based on the necessary variables.Results: The present study was conducted on 300 cases suspicious of appendicitis. The results analysed showed the area under the ROC curve of the AIR score was 0.94 and better than the area under the curve of Alvarado score of 0.82. The AIR score also did well in difficult cases of women, children when compared to Alvarado score in diagnosis of appendicitis. In our study, in cases with >8 points, a lower sensitivity was observed in AIR scoring than Alvarado scoring (0.26 vs. 0.12), but was associated with higher specificity (1.00 vs. 0.95). In these cases, PPV turned out to be 1.00 for AIR scoring and 0.77 for Alvarado scoring.Conclusions: To conclude, AIR scoring performed well almost equally with Alvarado system with high specificity and high negative predictive value preventing unnecessary negative appendectomies. Follow up of these cases will help in deciding surgical intervention in unnecessary cases. This scoring system also prevents unnecessary and costly radiological investigations thereby reducing the financial burden to the patients.
Effect of adding various doses of clonidine as an adjunct in Transversus abdominis plane block in unilateral inguinal hernioplasty
Authors: Dhupia Rakesh , Jain Sunita , Sahani Inder Singh , Modi Vimal , Romday Rakesh , Kothari Archana 
Published: November 2017

Background: Transverses abdominis plane (TAP) block is a new regional anaesthetic technique for postoperative analgesia in abdominal surgeries, as a part of multimodal analgesia. We evaluated effect of two different doses of clonidine as an adjunct in TAP block in patients underwent unilateral inguinal hernioplasty.Methods: Sixty adult patients undergoing unilateral inguinal hernioplasty were randomized into two groups, Group A (n=30) received bilateral TAP block with bupivacaine 0.25% 38cc + clonidine (1cc) 150 microgram +1cc NS=40cc, Group B (n=30) received bupivacaine 0.25% 38cc+clonidine (2cc) 300 microgram=40cc, at the end of surgery. The postoperative pain was evaluated by visual analog score (VAS) for pain scoring at 2, 4, 6, 12 and at 24 hours. Subjective assessment of duration of analgesia was done.Results: The VAS score in patients who received clonidine 300 microgram Group B as an adjunct was significantly lower than who received 150 microgram Group A. Duration of analgesia was longer in Group B. 2 patients in Group B showed bradycardia treated with atropine. Sedation score was lesser in Group A.Conclusions: Clonidine showed dose dependant analgesia and adverse effect in TAP block for postoperative analgesia. Higher doses of clonidine may be used as an adjunct in TAP block.
A qualitative study on the perceptions of patients with urethral stricture
Authors: Pramanik Sandip , Pal Dilip Kumar , Bandyopadhyay Arup , Paul Uttam Kumar 
Published: November 2017

Background: Urethral stricture means narrowing of the urethra and is caused due to injury, instrumentation, infection etc. In as much as urethral stricture is a highly disabling condition and is common in our places, it definitely plays an important role in a sufferer daily life. In our project, we have ventured a qualitative study of perceptions and actual impositions on the life of patients suffering from chronic urethral stricture.Methods: The study was one of qualitative descriptive type involving in depth interviews (IDI) of 18 male patients of Urethral stricture who were diagnosed and treated at IPGMER.Results: The results showed that the IDIs could be divided into several categories each of which is further divided into several codes. The categories are given here with codes in parenthesis. Catheter related problems (leakage, block, physical problems, change, availability, health personnel, dress change, smell of urine, water drinking), disturbance of sleep (initiation, awakening, disturbance of bed partner, sleepless night), Role of family members (care giving, attitude, negligence), financial condition (jobless, help from friends, support, reversal of role, family crisis), social life (activity, enjoyment, getting hurt), mental health (loneliness, helplessness, sadness, getting hope) and sexual life (urge, erection, coital pain , discomfort).Conclusions: The major findings were that most of the patients had very good co-operation and care from the family; financial assistance was also obtained from family and friends. Majority of the patients were hopeful that they would be totally cured in near future.
Clinical relevance of MMP-9 in terms of neoplasm growth, invasion and metastasis in thyroid, breast and colorectal cancer
Authors: Kumar V. Hari , Hasan Omar Bin 
Published: November 2017

Background: Cancer cells invade and metastasis commonly. This poses challenge in cancer management. MMP-9 can be clinically useful to predict the prognosis of the patients. Objective was to study clinical relevance of MMP-9 in terms of neoplasm growth, invasion and metastasis in Thyroid, Breast and Colorectal cancer.Methods: A hospital based cross sectional study was carried out in Department of General Surgery, Kamineni Institute of Medical Sciences, Narketpally for a period of two years. A total of 30 cases of carcinoma cases were studied. Out of these carcinoma cases, 10 were of gastrointestinal malignancy, 10 were of thyroid malignancy and 10 were of breast carcinoma.Results: For breast carcinoma, maximum cases were in the age group of 46-50 years (40%), for thyroid carcinoma, maximum cases were seen in the age group of more than 55 years (40%), for colo-rectal carcinoma, maximum cases were above the 50 years of age. For breast carcinoma, maximum cases were in stage III B (70%), for thyroid carcinoma, in III stage (60%) and for colo-rectal carcinoma, in Dukes C1 stage (60%). In breast cancer the positivity of MMP-9 was 66.7% in stage IIIA and it increased to 85.7% in stage IIIB. For thyroid cancer the positivity increased from 33.3% in stage III to 75% for stage IV A. In case of colo-rectal cancer, the positivity of MMP-9 expression increased from 66.7% for stage Dukes C 1 to 75% in stage Dukes C2 stage. Thus, for all types of carcinoma, the expression of MMP-9 increased with advancement of the stage.Conclusions: MMP-9 is a gelatinase which degrades extra cellular matrix and helps in tumor spread. It is expressed more in advanced stages of the malignant disease. It correlates with prognosis of the patient.
Comparison of bedside index of severity in acute pancreatitis (BISAP) and acute physiology and chronic health evaluation (APACHE II) score in assessing severity of acute pancreatitis
Authors: Pattanaik S. K. , Kumar V. Arvind , John Ajax 
Published: November 2017

Background: Acute Pancreatitis (AP) is one among the major diseases in the surgery wards with high rate of mortality. In spite of many scoring systems introduced to grade the severity of AP for optimal and timely management, mortality rate is still in a high pace. The aim of this study is to compare BISAP scoring system and APACHE II scoring system for accuracy and easiness in predicting the severity and mortality of AP and to deliver appropriate and timely intervention.Methods: The first 100 patients with AP in the year 2016 (January to August) were studied prospectively by calculating APACHE II score and BISAP score. According to Revised Atlanta classification severe AP was ascertained and the sensitivity and specificity of both scoring systems were assessed from chi square table. By using ROC curve accuracy and diagnostic value of two scoring systems were compared.Results: 100 patients with an age ranging from 20 to 80 years with a mean of 41.18 and male female ratio of 10.1:1 were studied. 95% of the patients presented with a symptom of abdominal pain and 49 out of 100 were having alcoholism as etiology. The average hospital stay of the patients was 12.03 days. Four patients died out of 11 severe AP and rest 89 were grouped into mild AP. BISAP score more than or equal to three have 64.2% chance of severe AP and was statistically significant in predicting the severity of AP. Areas under curve of the ROC curve after depicting the sensitivity and specificity of BISAP scores for severity and mortality were 0.90 and 0.96 respectively. APACHE II scores more than or equal to nine have 23.8% chance of severe AP and was statistically significant in predicting severity of AP. When sensitivity and specificity of APACHE II score were charted in ROC curve, areas under curve were 0.853 and 0.75 for severity and mortality in AP respectively.Conclusions: Compared to APACE II, BISAP is better scoring system in predicting both severity and mortality of AP on considering accuracy and easiness.