ABSTRACT
Background: Among 86 patients aged between 18 to 65 of both sexes having pleural effusion due to various clinical etiologies were studied.Methods: Chest x-ray PA. was studied, 20 ml of pleural fluid was aspirated to study bio-chemically, microbiologically and pathological. Echo-cardiography, USG abdomen and biopsy of pleura was also done in same patients in whom diagnosis or etiology was unclear.Results: Among 59(68.6%) had fever, 68(79%) had cough, 40(46.5%) had breathlessness, 20(23.2%) had pedal edema, 42(48.8%) had chest pain, 5(5.8%) had abdominal distention. 52(60.4%) had tubercular pleural effusion 34(39.5%) had non- tubercular pleural types of non-tubercular PE effusion (PE) included 8(23.5%) synpneumonic, 5(14.7%) had CCF, 11(32.3%) had malignancy, 2(5.88%) had RA, 2(5.88%) had dengue fever, 2(5.88%) had pancreatitis, 4(11.7%) had Hypoproteinaemia.Conclusions: This pragmatic approach to pleural effusion for patients with different clinical manifestations as pleural fluid analysis is gold standard method in evaluation pleural effusion of different etiology.Background: Among 86 patients aged between 18 to 65 of both sexes having pleural effusion due to various clinical etiologies were studied.Methods: Chest x-ray PA. was studied, 20 ml of pleural fluid was aspirated to study bio-chemically, microbiologically and pathological. Echo-cardiography, USG abdomen and biopsy of pleura was also done in same patients in whom diagnosis or etiology was unclear.Results: Among 59(68.6%) had fever, 68(79%) had cough, 40(46.5%) had breathlessness, 20(23.2%) had pedal edema, 42(48.8%) had chest pain, 5(5.8%) had abdominal distention. 52(60.4%) had tubercular pleural effusion 34(39.5%) had non- tubercular pleural types of non-tubercular PE effusion (PE) included 8(23.5%) synpneumonic, 5(14.7%) had CCF, 11(32.3%) had malignancy, 2(5.88%) had RA, 2(5.88%) had dengue fever, 2(5.88%) had pancreatitis, 4(11.7%) had Hypoproteinaemia.Conclusions: This pragmatic approach to pleural effusion for patients with different clinical manifestations as pleural fluid analysis is gold standard method in evaluation pleural effusion of different etiology.
ABSTRACT
Background: Among 83 patients of both sexes aged between 25 to 65 adults had NAFLD with metabolic syndrome were studied.Methods: U.S.G. biochemical study included total cholesterol, AST, ALP, S, Albumin total Bilirubin, FBS, HbA1c and blood pressure was recorded.Results: Among 16(19.2%) had grade-I (mild steatosis) 38(45.7%) had grade-II (Moderate steatosis), 29(34.9%) had grade-III (severe steatosis), The clinical manifestation were 49(59%) had BMI 22.8 to 23.2, 34(40.9%) had BMI 23.3 to 24.2. D.M status was 33(39.7%) were pre-diabetic, 50(60.2%) were diabetic mellitus. 19(22.8%) were norma- tensive, 64(77.1%) were hypertensive, 63(75.9%) were hyperlipidemic, 23(27.7%) had IHD. 4(4.81%) had MI. Mean value of total cholesterol was 223±9.2, Triglyceride 24.8±13.3, HDL 42.3±2.5, LDL 128±13.8, AST 52.8±3.6, ALT 67.2±6.8, ALP 107±11.8, S. Albumin 3.50±0.12, Total bilirubin 0.93±0.10, FBS 13.±12.2, HB A/c 9.10±402.Conclusions: The present study of NAFLD was performed by combination of radiological and laboratory techniques, greatly reducing the requirement for invasive biopsy and reduce the morbidity and mortality.
ABSTRACT
Background and Objectives: For many decades, attempts have been made to overcome the difficulties which surgeons encounter in the treatment of proximal femoral fractures. Extra medullary and intramedullary implants have improved in recent years, although consensus is lacking concerning the definition and classification of unstable intertrochanteric fractures, with uncertainties regarding treatment. In this era of technologically sound and tested fixation methods we shall compare functional outcomes and complications of various methods available for unstable it fracture fixation. The purpose of this study is to analyze the role of primary hemi arthroplasty in cases of unstable osteoporotic intertrochanteric femur fractures and compare the outcomes with conventional fixation techniques to find out a better management plan for the patient Materials and Methods: This is a prospective study of fifty cases of unstable intertrochanteric fractures, either treated with primary replacement (hemi or total) or fixation. Between january 2016 to january 2018, fifty patients with an unstable comminuted intertrochanteric femoral fracture (AO/OTA type 31A2.2, A2.3, A3.2, A3.3) were enrolled in the study, which was approved by our institutional review board. Inclusion Criteria: 1. More than 60 years of age. 2. All patients with unstable IT femur fracture type a. 31- A2.2 and 31- A2.3 (AO/OTA classification) b. Posteromedial fragmentation c. Basicervical d. Reverse oblique e. Displaced greater trochanter (lateral wall fractures) f. Patient must be ambulatory before sustaining injury Exclusion Criteria: a. Chronically debilitated and bed ridden patients. b. Compound fracture c. Medically compromised patients- ASA grade iv &v d. Local infection ¾ Stable fracture Results: Maximum patients (88%) belonged to 60-80 years of age. Since most of the patient belong to elderly age group, medical comorbidities are very common. Average requirement of blood transfusion needed was significantly higher in hemi replacement group than in fixation group. (Z= 3.56, p<0.05). This indicated the surgical complexity of hemi replacement There was significant shortening of limb in fixation group as compared to hemi replacement. (Z=6.98,p value <0.05) Thus hemi replacement provided faster rehabilitation to the patient. This implies that those patients who had hemi replacement had a significantly better activity of daily living. Harris hip scores were significantly better in hemi replacement group. (Z=4.31, p value<0.05) suggesting better functional outcomes. There was no significant difference between immediate postoperative complications though skin incision, operating time, and blood loss were significantly higher in hemi replacement group.(Z=0.7, p>0.05) but the rate of delayed complications and revision surgeries were significantly higher in fixation group. (p<0.05) There was no significant difference in mortality rates of both groups despite more blood loss and duration of surgeries in hemi replacement group. Interpretation and Conclusion: In conclusion we state that hemi replacement arthroplasty, is a valid treatment option for mobile and mentally healthy patients, as compared to fixation for faster rehabilitation and better activity of daily living. Aims & Objectives: To study the results of primary replacement (hemi or total) in unstable intertrochanteric fractures and compare it with conventional methods of fixation. To assess functional outcome in patients having unstable intertrochanteric fractures in both groups as per Harris hip score. To study the effect of pre-existing illness on final outcome of the patients in both groups. To study the stability of fixation in osteoporotic bones. To note any complication developed. To compare final outcome of this study with that of the other studies