ABSTRACT
Background: Gallstones, complex biomineralized deposits formed in the gallbladder, are still a major health problem all over the world. Cholelithiasis is common with the incidence ranging from 10% to 20% of the world population. Over the past two decades, a great deal has been learned about the epidemiology of and risk factors for gallstones. Ultrasonography has played a major role in this process, providing a rapid, risk-free method of screening large populations. Prior to the availability of ultrasound, most studies relied on highly selective autopsy data and limited oral cholecystography. Aim and objectives: To determine the Biochemical analysis of Gall stones and to study the clinical spectrum of acute cholecystitis. Materials and methods: About 50 consecutive cases were admitted, examined, investigated and diagnosed as calculus cholecystitis during the period of January 2016 to September 2016 are selected and detailed history of all the 50 cases were taken according to the proforma. Information regarding the age, nature of the symptoms, and duration of the symptoms, diet history, and history of OCP intake, Alcohol ingestion, and diabetes were obtained. All patients’ undergone detailed examination underwent investigations. Results: All cases fall between 22 and 75 years. There is an increased incidence in the 5th and 6th decade with the maximum incidence in the 5th decade. Pain abdomen was the most common Ganganesamy, S. Dharmarajan. Analysis of gallstones disease correlating with clinical symptoms in patients with calculous cholecystitis in emergency surgical unit at Kilpauk Medical College. IAIM, 2017; 4(8): 81-86. Page 82 presenting symptom in our study seen in 49 (98%) of the cases followed by fever in 17 (34%) cases. Dyspepsia was seen in 12 (24%) cases, 7 cases (14%) each presented with nausea/vomiting or jaundice. Among the ultrasonographic findings of cholelithiasis most common finding was thickened gall bladder wall seen in 40 cases (80%) Ultra sonogram revealed 76% (38 cases) had multiple stones and 24% (12) has solitary stone. Mass was seen in 5 cases (10%).Of the total 50 cases with cholelithiasis 38 patients (76%) had mixed stones, followed by pigment stones in 8 cases (16%) followed by cholesterol stones in remaining 4 cases (8%). Majority of the patients were in the age group 41-50 (32%) followed by the 51-60 age group (24%). Conclusion: Majority of patients underwent Laparoscopic cholecystectomy (86%) with reduced number of stay in the hospital, pain and disability as compared to open cholecystectomy. The commonest type of stone was mixed stone. Most of the gallstones were associated with grade 1 cholecystitis (78%), Grade 2 cholecystitis was seen in 20% of our study patients, Grade 3 was seen in 2% of our study patients.
ABSTRACT
BACKGROUND & OBJECTIVE: Since the first report of HIV-1 infection in Tamil Nadu, India, HIV-1 seroprevalence in India has increased steadily. Though interventions to prevent mother-to-child transmission (MTCT) are available, their implementation is a significant challenge. Therefore, among pregnant women in rural Tamil Nadu, the acceptance of education regarding HIV-1 infection and transmission and, among a systematic sample, knowledge, attitudes, and beliefs; the acceptance of HIV-1 voluntary counselling and testing (VCT); and the seroprevalence of HIV-1 infection as well as risk factors for seropositivity were assessed. METHODS: Pregnant women registered in the antenatal clinics at Namakkal District Hospital and Rasipuram Government Hospital, Tamil Nadu, India, were offered an educational session regarding HIV-1 infection and transmission. HIV-1 VCT, with informed consent, was offered. Positive results with HIV-1 rapid testing were confirmed with HIV-1 ELISA and Western blot assays. With informed consent, a systematic sample of the study population was asked to participate in pre- and posteducation assessments. Chi-square tests were used to evaluate HIV-1 risk factors. RESULTS: The educational session as well as VCT were well accepted by rural, pregnant, HIV-1- infected women. Of 3722 women registered for antenatal care at the two hospitals over a one year period, 3691 (99.2%) agreed to participate in the educational session and 3715 (99.8%) had VCT [74 had confirmed HIV-1 infection [seroprevalence: 2.0% (95% confidence interval (95%CI): 1.6%, 2.5%)]]. Of 759 eligible women, a systematic sample of 757 (99.7%) women participated in the pre- and post-education assessments. Although baseline knowledge regarding HIV-1 was limited, a highly significant improvement in such knowledge was observed (P<0.0001 for all comparisons of changes in knowledge, attitudes, and beliefs measured before and immediately after the educational session). The median per cent of correct responses increased from 26.4 per cent before the educational session to 93.8 per cent afterwards. Women whose husbands were long distance truck drivers were at increased risk of HIV-1 infection. Other factors associated with HIV-1 infection were clinical site (Namakkal District Hospital), a smaller number of persons in the household, being unmarried, and a history of previous surgeries. INTERPRETATION & CONCLUSION: The acceptability of education and of VCT among antenatal clinic attendees in this study was encouraging. However, the relatively high seroprevalence highlights the spread of HIV-1 from high risk groups to the general population and emphasizes the need for primary prevention of HIV-1 infection among adolescent girls and women of reproductive age in India.