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Background: Excessive daytime sleepiness is a key symptom in patients with sleep- breathing disorders (SBD) and represents a new major public health issue due to its repercussions. The ESS is a simple and validated method, which measures the probability of falling asleep in a variety of situations. Aims and objectives is to study the accuracy of the Epworth Sleepiness Scale (ESS) questionnaire in the identification of Obstructive Sleep Apnoea (OSA) in patients with symptoms of sleep disordered breathing in a tertiary care centre.Methods: This present study was conducted in the Department of Respiratory medicine, New Medical College, Kota on 70 adult patients who presented with symptoms of Sleep Disordered Breathing and underwent Type 2 Polysomnography after answering Epworth sleepiness score in Hindi Language.Results: Epworth sleepiness scale has predicted excessive day time sleepiness in 60% of study subjects with ESS score more than 10 taken as cut off. Mean value for ESS in the study was 10.78. 35.71% of the patients had severe OSA diagnosed by polysomnography and 30% patients had moderate OSA. Mild OSA was detected in 7.14% patients. Sensitivity of the ESS score >10 in diagnosing OSA was found to be 72.5%. Specificity of the scale was 73.6%.There was significant correlation between ESS score and diagnosis of OSA (p value <0.001).Conclusions: The study concludes that ESS has got good relevance in predicting OSA in patients with sleep disordered breathing.
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Background: The treatment modality use in early pleural empyema mainly depends on the antimicrobial therapy along with thoracocentesis. In case of complicated empyema this modality does not work and lung not fully expand, until removal of adhesions. The main purpose of the current study is to analyze the experience of management of complicated parapneumonic effusion and empyema thoracic through rigid medical thoracoscopy under local anaesthesia. Aim and objective is to study the role of medical thoracoscopy in the management of empyema thoracic and parapneumonic effusion at tertiary health centre.Methods: This is a descriptive case series study in which 49 patients were recruited, who have clinically and radiologically show empyema thoracic, from department of Respiratory medicine, GMC, Kota, Rajasthan. All patients underwent medical thoracoscopy under local anesthesia. Written Informed consent was taken from the study participants. Ethical approval was obtained from Ethical Review Committee of the hospital. Patients who have HIV and Hbsag positive, those with multiple organ failure and bleeding disorders were excluded.Results: Total 49 patients, out of them 41(84%) were male and 8(16%) were female with mean age 45 years (range 18 to 70 years). Final evolution through chest x-ray revealed complete resolution or successful thoracoscopy done in 37 case of fibrinopurulent (92.50%) and 5 cases of organizing empyema (55.56%). overall success rate 85.71%. Total 7 cases (3 case of fibrinopurulent and 4 cases of organizing empyema) refer to higher center for decortications.Conclusions: Medical Thoracoscopy under local anaesthesia is a safe procedure, efficient and cost-effective intervention for early management of complicated empyema, particularly in early stage of empyema (fibro purulent).
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Background: Lung cancer is most common cause of cancer related death in men and women world wise responsible for over 1 million death annually. Lung cancer is leading cause of cancer death in united states and worldwide. Lung cancer is the most common neoplasm contributing more frequent among males causing cancer related mortality in both sexes. Objective of this study was to radiological presentation in bronchogenic carcinoma along with prevalence of pulmonary TB in a tertiary center.Methods: Total of 100 patients with histologically proven lung cancer, from July 2018 to June 2019 at a tertiary center Kota Rajasthan. Data of participants regarding demographics, history of smoking habit, clinical presentation, histopathological type, radiographic findings on chest radiograph, ultrasonography, computed tomography (CT) scan, Statistical analysis was performed using descriptive statistics of the collected data.Results: Most common age group of bronchogenic carcinomas was seen between 60-69 years of age (37%) with male predominance (82%). smoking history present in about (80%) patients. Most common radiological presentation was a mass lesion present in 91% patients (n=91) followed by unilateral hilar prominence present in 44% of patients (n=44). Other common finding includes mediastinal widening (38%), collapse (26%). pleural effusion (22%), metastasis (22%), cavitation (13%), consolidation (12%), bony erosion (11%), pneumothorax (5%), and pancost tumor (4%). prevalence of pulmonary TB in bronchogenic carcinoma is 9% and this is due to high burden of pulmonary TB in India.Conclusions: In this study adenocarcinoma was found to be most common type of lung cancer. Smoking is most common risk factor. Pulmonary TB coexistence with bronchogenic carcinoma was more common. The local immunity is deteriorated in cancer cases.
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Introduction: The association of type 2 diabetes mellitus and thyroid dysfunction is well known. Thyroid dysfunction especially subclinical hypothyroidism has been reported to be a risk factor for sight threateningdiabetic retinopathy. Therefore, it is of importance to investigate the determinants of clinical and subclinicalhypothyroidism in patients with diabetic retinopathy. This study was aimed to investigate the effect of hypothyroidism on diabetic retinopathy and the determinants of hypothyroidism.Aims: To study the association of hypothyroidism and diabetic retinopathy and its effect on severity of retinopathy in type 2 diabetes and investigate the determinants of hypothyroidism in patients with diabetic retinopathy.Subjects and methods: A cross sectional study conducted on one hundred patients of type 2 diabetes withdiabetic retinopathy. They were evaluated for status of diabetes control, thyroid function, lipid profile andretinopathy grade. Those found to have clinical and subclinical hypothyroidism were analyzed for variousclinical and biochemical parameters for possible determinants of thyroid dysfunction.Results: There were seventy-four euthyroid patients and eighteen with subclinical hypothyroidism and five withclinical hypothyroidism. Patients with subclinical hypothyroidism had severe form of retinopathy (61.11%versus 32.43%). The odds of having a subclinical hypothyroidism in patients with severe form of diabeticretinopathy was found to be significant (OR 3.23; p=.048 CI=1.10-9.88). High HBA1c was an independent determinant of abnormal thyroid function.Conclusions: About one fourth of type II diabetes patients with retinopathy have thyroid dysfunction. Thesepatients are also likely to have severe form of the retinopathy especially those having subclinical hypothyroidism. Thus, we recommend thyroid function test should be done in all patients with type II diabetes mellitus withretinopathy. Those identified as having subclinical hypothyroidism should be closely followed so as, to detectand prevent vision threatening complications
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Background: Diabetic nephropathy (DN) is one of the majormicrovascular complications of diabetes and it is defined as arise in the urinary albumin excretion rate and abnormal renalfunction. Some patient develop advanced renal impairmentwith normal urinary albumin level thus albuminuria is not theperfect marker for the early detection of Diabetic nephropathy.Cystatin C has been suggested one of such markers. The aimof this study was to examine the usefulness of cystatin C as anearly marker of diabetic nephropathy.Methods: It was a retrospective study to evaluate role ofCystatin C in Diabetic nephropathy. 52 patient’s report fromdepartment of medicine in Hindu Rao Hospital, were analysedand compared with age related controls.Results: Association was observed between increased levelsof blood urea, serum creatinine and cystatin C withalbuminuria. The association was statistically significant (pvalue < .05). The significant sensitivity and specificity range forcystatin C was better as compared to blood urea andcreatinine.Conclusion: Cystatin C appears to be a better marker fordetection of diabetic nephropathy in comparison to blood ureaand serum creatinine.
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Background: Defects in insulin action and hyperglycemiacould lead to changes in plasma lipoproteins in patients withdiabetes.These Patients with type 2 Diabetes often exhibit anatherogenic lipid profile, which greatly increases their risk ofcardiovascular deaths compared with people withoutdiabetes.This dyslipidemia may be a treatable risk factor forsubsequent cardiovascular disease.Methods: The study was done at Hindu Rao Hospital Delhi. Aretrospective analysis of 52 patients with Diabetes was done.Patients who were diagnosed as per WHO guidelines fordiabetes mellitus and on statin therapy for at least 3 monthswere chosen for analysis.Results: Results of this study show that the levels of LDL,HDL, TC and TG were significantly higher in type 2 diabetics.Conclusion: Good glycaemic control is required for preventingother associated co-morbid conditions. Therefore,early diagnosis of dyslipidemia can be used as a preventivemeasure for the development of cardiovascular disease (CVD)in type 2 diabetics.
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Statistics is the study of the collection, organization, analysis, interpretation and presentation of data. It deals with all aspects of data. It is usually noticed that some routine words are given technical meanings in statistical parlance (e.g. “mean,” “normal,” “significance,” “effect,” and “power”). It is essential to resist the temptation of conflating their technical meanings. A failure to do so may have a lot to do with the ready acceptance of the “effect size” and “power” arguments in recent years. As, statistics is used (i) to describe data in terms of the shape, central tendency, and dispersion of their simple frequency distribution, and (ii) to make decisions about the properties of the statistical populations on the basis of sample statistics. Statistical decisions are made with reference to a body of theoretical distributions: the distributions of various test statistics that are in turn derived from the appropriate sample statistics. In every case, the calculated test statistic is compared to the theoretical distribution, which is made up of an infinite number of tokens of the test statistic in question. Hence, the “in the long run” caution should be made explicit in every probabilistic statement based on inferential statistics (e.g. “the result is significant at the 0.05 level in the long run”).Despite the recent movement to discourage psychologists from conducting significance tests, significance tests can be defended by (i) clarifying some concepts, (ii) examining the role of statistics in empirical research, and (iii) showing that the sampling distribution of the test statistic is both the bridge between descriptive and inferential statistics and the probability foundation of significance tests. The present paper discusses the critical issues of statistics in psychological research.